H5N1

As COVID-19 slams Houston hospitals, it’s like New York ‘All over again’

Via The New York Times: As Coronavirus Slams Houston Hospitals, It’s Like New York ‘All Over Again’. Excerpt:

HOUSTON — Over the past week, Dr. Aric Bakshy, an emergency physician at Houston Methodist, had to decide which coronavirus patients he should admit to the increasingly busy hospital and which he could safely send home.  

To discuss questions like these, he has turned to doctors at hospitals where he trained in New York City that were overwhelmed by the coronavirus this spring. Now their situations are reversed.  

Thumbing through a dog-eared notebook during a recent shift, Dr. Bakshy counted about a dozen people he had treated for coronavirus symptoms. His colleagues in Houston had attended to many more. Meanwhile, friends at Elmhurst Hospital in Queens told him that their emergency department was seeing only one or two virus patients a day.  

“The surge is here,” Dr. Bakshy said.  

As Houston’s hospitals face the worst outbreak of the virus in Texas, now one of the nation’s hot zones, Dr. Bakshy and others are experiencing some of the same challenges that their New York counterparts did just a few months ago and are trying to adapt some lessons from that crisis.

Like New York City in March, the Houston hospitals are experiencing a steep rise in caseloads that is filling their beds, stretching their staffing, creating a backlog in testing and limiting the availability of other medical services. Attempts to buy more supplies — including certain protective gear, vital-sign monitors and testing components — are frustrated by weeks of delays, according to hospital leaders. 

Methodist is swiftly expanding capacity and hiring more staff, including local nurses who had left their jobs to work in New York when the city’s hospitals were pummeled. “A bed’s a bed until you have a staff,” said Avery Taylor, the nurse manager of a coronavirus unit created just outside Houston in March. 

But with the virus raging across the region, medical workers are falling ill. Dr. Bakshy was one of the first at Methodist to have Covid-19, getting it in early March. As of this past week, the number of nurses being hired to help open new units would only replace those out sick. 

Methodist, a top-ranked system of eight hospitals, had nearly 400 coronavirus inpatients last Sunday. Nearly a week later — even as physicians tried to be conservative in admitting patients and discharged others as soon as they safely could — the figure was 575. 

The flagship hospital added 130 inpatient beds in recent days and rapidly filled them. Now, administrators estimate that the number of Covid-19 patients across the system could reach 800 or 900 in coming weeks, and are planning to accommodate up to 1,000.

COVID-19 in Canada: Care aides at Lynn Valley Care Centre join Hospital Employees' Union

Via email, a news release from the HEU:

Care aides at the Lynn Valley Care Centre in North Vancouver have voted to join the Hospital Employees’ Union in a mail-in ballot overseen by B.C.’s Employment Standards Branch, and counted today.

Lynn Valley Care Centre was the site of Canada’s first COVID-related death, and the outbreak claimed 20 lives before it was declared over in early May. More than 50 residents and two dozen staff were infected with COVID-19.

The care aides voted 97 per cent in favour of joining HEU.

“This group of care aides were the first to face the risks and uncertainty of working in a long-term care home in the midst of a COVID-19 outbreak,” says HEU secretary-business manager Jennifer Whiteside.

“They showed a lot of courage and compassion during this crisis to ensure good care for their residents. By joining the union, they’ve united their voices for better and safer working and caring conditions – and fair treatment from their employer.

“We are really pleased to welcome this group of workers back into HEU.”

The care aides at the Lynn Valley Care Centre are employed by Pro Vita Care Management – a subcontracting company established after the previous B.C. Liberal government opened up long-term care homes to contracting out in 2002.

HEU represented care aides at the site before their work was contracted out about 15 years ago under legislation brought in by the BC Liberals, and then again with the subsequent subcontractor. But care aides have been without union representation at the site since the care home operator changed subcontractors in 2012.

The union represents Pro Vita staff at nine other seniors’ care sites.

HEU represents more than 50,000 health care workers in British Columbia, including more than 15,000 care aides.

WHO AFRO: COVID-19 Sitrep 18 (1 July 2020)

WHO AFRO has published Situation Report - COVID-19 - Sitrep 18 (2020).

The coronavirus disease 2019 (COVID-19) outbreak continues to grow in the WHO African Region since it was first detected in Algeria on 25 February 2020. Since our last External Situation Report 17 issued on 24 June 2020 (from 24 to 30 June 2020), a total of 67 077 new confirmed COVID-19 cases (a 28% increase) was reported from 45 countries. 

Of the 67 077 reported new cases in the region, 43% (45 101) were recorded in South Africa. South Africa remains the epicentre of the COVID-19 outbreak in the region, consistently registering the highest daily case incidence, now standing at more than 6 000 cases daily in the past week. On 27 June 2020, the WHO African Region and South Africa recorded their highest daily case count of 10 421 and 7 210, respectively. The WHO African region also recorded the highest daily death toll of 172 on 30 June 2020. 

During this period, six countries in the region observed the highest percentage increase in incidence cases: Seychelles 636% (from 11 to 81 cases), Zambia 213% (from 509 to 1 594 cases), Namibia 182% (from 72 to 203 cases), Botswana 155% (from 89 to 227 cases), Malawi 58% (from 803 to 1 265 cases) and Angola 50% (from 189 to 284 cases). Seychelles reported new confirmed COVID-19 cases after 78 consecutive days of zero reporting. The confirmed case-patients were part of 207 sea crew arriving on two Air Seychelles chartered flights. Eleven crewmen turned positive on antibody test, of which three tested positive by polymerase chain reaction (PCR) on 24 June 2020. This event occurred just as the Government was considering opening up commercial flights and tourism from 1 July 2020. 

Only Equatorial Guinea and United Republic of Tanzania did not officially submit reports indicating any confirmed cases in the past week. 

A total of 26 new health worker infections were recorded from three countries: Malawi (18), Sierra Leone (5) and South Sudan (3). 

From 24 to 30 June 2020, an additional 898 COVID-19 related deaths (17% increase) were reported from 31 countries, with 62% (555) of the deaths recorded in South Africa. This was followed by Nigeria, which registered the second highest number of deaths, at 57, followed by Algeria with 51 deaths. The other countries that reported new deaths include; Democratic Republic of the Congo (35), Ethiopia (28), Senegal (23), Kenya (20), Ghana (17), Mauritania (16), Central African Republic (10), Benin (8), Côte d'Ivoire (8), Cabo Verde (7), Zambia (6), Cameroon (5), Madagascar (5), Mali (5), Malawi (5), Sierra Leone (5), Guinea-Bissau (5), Congo (4), Eswatini (4), Guinea (4), Angola (3), Gabon (3), South Sudan (3), Liberia (2), Mozambique (1), Sao Tome and Principe (1) and Zimbabwe (2). 

During the reporting period (24 to 30 June 2020), the cumulative number of COVID-19 cases in the region exceeded 300 000, and is now at 303 986 cases, including 303 665 confirmed and 321 probable cases, reported across the 47 Member States. The probable cases have been reported from Sao Tome and Principe (320) and Democratic Republic of the Congo (1). A total of 6 155 deaths have been reported in 42 countries, giving an overall case fatality ratio (CFR) of 2.0%. 

Five countries (Eritrea, Seychelles, Lesotho, Namibia and Uganda) have not registered any COVID-19 related deaths since the beginning of the pandemic.

Canada: 69 new COVID-19 cases in Alberta Saturday; numbers up at Calgary condo and Edmonton hospital outbreaks

Via Globalnews.ca: 69 new COVID-19 cases in Alberta Saturday; numbers up at Calgary condo and Edmonton hospital outbreaks. Excerpt:

Alberta saw 69 new cases of COVID-19 confirmed on Saturday, bringing active numbers to 520 provincially.  

The Edmonton and Calgary zones are now close in case numbers: Edmonton zone still has the highest rate, with 228 active cases. Calgary zone currently sits at 221 cases.  

In the rest of the province, there are 36 cases in the North zone, 31 in the South zone and two in the Central zone. Two other cases are in an unknown zone.  

In Alberta, there are currently 42 people in hospital, eight of whom are in intensive care.  

In total, 154 people have died from COVID-19 in the province, although there have been no new deaths reported since Thursday.   

A condominium outbreak in Calgary’s East Village neighbourhood saw an increase of six cases Saturday, bringing the total number of confirmed cases at the building to 40.  

Of those, there have been nine recoveries, meaning that there are currently 31 active cases at Verve Condominiums.  

The high-rise 25-storey condo has a total of 228 units, and on Thursday, Alberta’s chief medical officer of health said officials are working with building management to contain the spread.  

“They’re making sure that there is enhanced cleaning,” Dr. Deena Hinshaw said. “They’ve offered testing to everyone in that building whether or not they have symptoms. 

“This particular outbreak, at the moment, it does seem that possibly high-touch surfaces are a mechanism. That’s still being explored.”

Edmonton’s Misericordia Hospital outbreak 

The outbreak at the Misericordia Community Hospital in Edmonton saw an increase of two cases — one patient and one staff member — Saturday, according to Alberta Health.  

The total number of patients who have tested positive as of Saturday is at 10. One patient died on Thursday, according to Alberta Health. 

An employee at the hospital also received a positive test Saturday, bringing the total number of staff members who tested positive for the virus to nine.

Italy sees COVID-19 'warning signs' after Rome outbreaks

Via France24, an AFP report: Italy sees Covid-19 'warning signs' after Rome outbreaks.

Italy's top health agency on Friday urged caution after last week seeing "warning signs" of new coronavirus transmission, especially over outbreaks of cases in Rome.  

In its weekly report, the Higher Institute of Health (ISS) said the situation was generally positive but that there was still "a significant circulation of the virus".  

"In some regions, a high number of new cases of COVID-19 infection continues to be reported," the agency said in the report for the week June 8-14. 

Lazio, the region including the capital Rome, topped the number of cases, exceeding Lombardy, the original epicentre of the epidemic in the country.  

Two outbreaks were identified in recent days in Rome, where health officials say the situation is "under control". One was an illegally occupied building in a working-class neighbourhood and the other in a hospital.  

"This should encourage caution because it indicates that in certain parts of the country, the circulation of the virus is still significant," the report said. 

The epidemic has killed more than 34,500 people in Italy, since the first case was recorded in Codogno in Lombardy, the first infection identified outside China where the disease appeared in December 2019. 

The disease now appears to be under control in Italy, with an average of a few dozen deaths per day and a reduced number of infections.

Could MMR vaccine protect against COVID-19 sequelae?

Via mBio: Could an Unrelated Live Attenuated Vaccine Serve as a Preventive Measure To Dampen Septic Inflammation Associated with COVID-19 Infection? The abstract:

We propose the concept that administration of an unrelated live attenuated vaccine, such as MMR (measles, mumps, rubella), could serve as a preventive measure against the worst sequelae of coronavirus disease 2019 (COVID-19). 

There is mounting evidence that live attenuated vaccines provide nonspecific protection against lethal infections unrelated to the target pathogen of the vaccine by inducing “trained” nonspecific innate immune cells for improved host responses against subsequent infections. Mortality in COVID-19 cases is strongly associated with progressive lung inflammation and eventual sepsis. Vaccination with MMR in immunocompetent individuals has no contraindications and may be especially effective for health care workers who can easily be exposed to COVID-19. 

Following the lead of other countries conducting clinical trials with the live attenuated Mycobacterium bovis BCG (BCG) vaccine under a similar concept, a clinical trial with MMR in high-risk populations may provide a “low-risk–high-reward” preventive measure in saving lives during this unprecedented COVID-19 pandemic.

WHO AFRO Situation report - COVID-19 - Sitrep 16

WHO AFRO has published Situation Report - COVID-19 - Sitrep 16 (2020). Excerpt:

Since the coronavirus disease 2019 (COVID-19) outbreak was first detected in the WHO African Region in Algeria on 25 February 2020, the outbreak continues to progress with rising incidence cases and associated deaths. Since our last situation report on 10 June 2020 (External Situation Report 15), an additional 42 173 new confirmed COVID-19 cases (a 30% increase) were reported from 42 countries. Of the 42 173 reported new cases in the region, South Africa contributed more than half, 55% (23 343), of the cases. During this period, five countries in the region observed the highest percentage increase in cases: Eritrea 195% (from 41 to 121 cases), Mauritania 62% (from 1 162 to 1 887 cases), Benin 57% (from 339 to 532 cases), Ethiopia 55% (from 2 336 to 3 630 cases) and Angola 50% (from 96 to 142 cases). 

Seychelles, Equatorial Guinea, Lesotho and Mauritius have reported zero new confirmed COVID-19 cases in the past 70, 26, 15 and 12 days, respectively and therefore did not record any new cases this reporting period. Eritrea reported 24 new confirmed cases after eight days of zero reporting. These were among returnees who had completed their quarantine period at Adibara quarantine entre. Seventy-three new health worker infections were recorded from six countries, including Cameroon (32), Sierra Leone (22), Malawi (8), South Sudan (4), Uganda (4) and Senegal (3). The region has registered 14 424 new recoveries in this reporting period.  

From 10 to 16 June 2020, an additional 854 deaths (25% increase) were reported from 31 countries: South Africa reported the highest number of 463 new deaths in this reporting period. The other countries that reported new deaths include; Algeria (64), Cameroon (61), Nigeria (59), Mauritania (30), Ethiopia (29), Democratic Republic of the Congo (21), Senegal (18), Kenya (17), Mali (12), Ghana (10), South Sudan (10), Central African Republic (9), Côte d'Ivoire (8), Gabon (8), Benin (5), Congo (3), Madagascar (3), Guinea (3), Guinea-Bissau (3), Chad (3), Angola (2), Mozambique (2), Cabo Verde (2), Liberia (2), Malawi (2), Eswatini (2), Comoros (1), Sierra Leone (1), Zambia (3) and Niger (1).  

As of 16 June 2020, the cumulative total of 185 070 COVID-19 cases, including 184 796 confirmed and 274 probable cases, were reported across the 47 countries in the region. The probable cases have been reported from Sao Tome and Principe (273) and Democratic Republic of the Congo (1). A total of 4 316 deaths have been reported in 42 countries, giving an overall case fatality ratio (CFR) of 2.3%. Five countries have not registered any COVID-19 related deaths since the beginning of the pandemic in the region: Eritrea, Seychelles, Lesotho, Namibia and Uganda.

Burundi: COVID-19 scare in Rumonge

The recently deceased president of Burundi was a COVID-19 denialist, but with his departure the country may be facing reality. Via Burundi Eco: Rumonge: confinement of nursing staff. The Google translation:

The staff members of the Rumonge hospital placed in confinement work in the internal medicine service of this hospital and have contacted a patient who was hospitalized in this hospital and who was later transferred to one of the hospitals in Bujumbura after that he tested positive for Covid 19, sources close to the hospital said. 

These two doctors and six nurses are confined to their homes and are waiting to be tested with Covid-19 after coming into contact with a patient who tested positive for Covid-19 when he was hospitalized in the internal medicine service of this hospital. 

The nursing staff and the sick and sick guards try to multiply the prevention measures by respecting the distance of at least one and a half meters between a patient and the doctor or the attending nurse. 

The activities continue normally in this hospital but the nursing staff and the sick and sick guards try to multiply the preventive measures by respecting the distance of at least one and a half meters between a patient and the attending doctor or nurse. 

Relaxation of preventive measures 

Prevention measures are no longer scrupulously observed, especially in rural areas, buckets of water are no longer visible where many people end up. Some people have resumed the practice of waving hands or kissing as if nothing had happened.  

The wearing of the mask is no longer observed except in hospitals. Many people indicate that they do not know the mode of contamination of the Coronavirus and even less the symptoms of this pandemic.  

There is a lack of communication and awareness about this pandemic, regrets a manager of an organization that works in the health promotion sector. They call on the health and administrative authorities to raise awareness on the measures to prevent this pandemic.  

The porosity of the borders between Burundi and the DRC on the one hand   and between Burundi and Tanzania on the other hand is of great concern, because people can enter or leave without passing through the official border posts and the risk of contamination is real. 

The fishermen who make back and forth movements between Burundi and the Democratic Republic of Congo worry people who say that this constitutes a risk of contamination par excellence. 

Health and administrative authorities and religious denominations should regularly communicate on this pandemic and increase awareness-raising sessions for the population, say the heads of human rights organizations. 

Some people, especially in rural areas, have little information about this pandemic, especially on the means of prevention and the symptoms of this disease, report the same sources.  

Many people questioned asked the Ministry of Public Health to set up a Covid-19 screening center at one of the hospitals in the South region to better combat this pandemic.  

Sources close to the office of the governor of the province of Rumonge indicate that instructions have been given to the administrative authorities to make the population aware of the danger of this pandemic by insisting on the prevention measures and the denunciation of any person who would smuggle in from neighboring countries to be quarantined.  

Let us recall that the cholera epidemic first appeared in Burundi in the Rumonge province in 1978.

WHO AFRO - Situation Report - COVID-19 - Sitrep 15 (2020)

WHO AFRO has published Situation Report - COVID-19 - Sitrep 15 (2020). Notably, this report makes no mention of Burundi, whose president's sudden death, reported as a heart attack, may have been due to COVID-19. Excerpt:

The coronavirus disease 2019 (COVID-19) outbreak continues in the WHO African Region (with Algeria confirming the first case on 25 February 2020), with rising incidence cases and associated deaths. 

Since our last situation report on 3 June 2020 (External Situation Report 14), an additional 33 555 new confirmed COVID-19 cases (a 31% increase) were reported from 44 countries. During this period, six countries in the WHO African region observed the highest percentage increase in cases: Mauritania 98% (from 588 to 1 162 cases), Ethiopia 74% (from 1 344 to 2 336 cases), Central African Republic 73% (from 1 069 to 1 850 cases), South Sudan 62% (from 994 to 1 606 cases) and Zimbabwe 52% (from 206 to 314 cases). 

In the same reporting week, Malawi and Namibia reported clusters of cases that were identified in quarantine areas as nationals continue to return from neighbouring affected countries. Three new countries, Cabo Verde, Ethiopia and Uganda, joined the list of countries reporting health worker infections. The region has registered 18 643 new recoveries in this reporting period compared to 15 015 in our previous report.  

Seychelles and Equatorial Guinea have reported zero new confirmed COVID-19 cases in the past 63 and 19 days, respectively. Although United Republic of Tanzania has no new confirmed cases in our database in the last 24 hours, there are no official reports indicating zero confirmed cases. Furthermore, Eritrea reported two new confirmed COVID-19 cases after 44 consecutive days of zero reporting. This was a couple who had their blood sample taken during the random community testing. 

From 3 to 9 June 2020, an additional 698 new deaths (25% increase) were reported from 23 countries: South Africa (407), Algeria (57), Nigeria (51), Mauritania (35), Democratic Republic of the Congo (19), Ethiopia (18), Kenya (17), Mali (16), Cameroon (15), Ghana (10), South Sudan (10), Senegal (9), Chad (5), Côte d'Ivoire (5), Congo (4), Guinea-Bissau (4), Sierra Leone (4), Liberia (3), Madagascar (3), Zambia (3), Central African Republic (1), Benin (1) and Gabon (1). 

As of 9 June 2020, the cumulative total of COVID-19 cases is 142 897, including 142 633 confirmed and 264 probable cases, reported across the 47 countries in the region. The probable cases have been reported from Sao Tome and Principe (219), Comoros (44) and Democratic Republic of the Congo (1). A total of 3 462 deaths have been reported in 42 countries, giving an overall case fatality ratio (CFR) of 2.4%. Five countries have not registered any COVID-19 related deaths since the beginning of the pandemic in the region: Eritrea, Seychelles, Lesotho, Namibia and Uganda.

COVID-19 in the DRC: Dr Muyembe fears large-scale contamination of healthcare workers

Via Actualite.cd: Covid-19: Dr Muyembe fears large-scale contamination of healthcare workers. The Google translation:

The coordinator of the Covid-19 response team in the DRC, Professor Doctor Jean-Jacques Muyembe Tamfum, this Monday, June 8, has raised concerns about the massive transmission of the disease in hospitals, especially among staff caregiver.  

His fear is based on the weakness of preventive measures in sanitary facilities.  

"I think that there is a great weakness, it is in the prevention and the reduction of the risks of transmission of the epidemic in healthcare. This is a weak point to be reinforced not only for Ebola but also for the COVID-19 I am afraid that the infection could reach a large number of nursing staff and create panic in the healthcare setting and therefore demoralize the nursing staff. in hospitals," said Dr. Muyembe when meeting with the European Union delegation. 

Janez Lenarčič, European Commissioner for Crisis Management, Philippe Goffin, Belgian Minister for Foreign Affairs and Defense and Jean-Yves le Drian, French Minister for Europe and Foreign Affairs, have been staying in Kinshasa since Monday June 8. This visit is part of a "humanitarian airlift" initiated by the European Union to support the fight against Covid-19.  

Upon arrival, they spoke with Doctor Jean-Jacques Muyembe at the National Institute for Biomedical Research (INRB). They will be received this same Monday by the President of the Republic Félix-Antoine Tshisekedi Tshilombo.  

The delegation led a shipment of three flights from the EU humanitarian airlift to the DRC which includes water purifiers, nutritional support and general medical supplies. Also laboratory equipment, masks, gloves and personal protective equipment.