H5N1

‘It’s a little late’: US orders healthcare worker protections after thousands die

Via The Guardian: ‘It’s a little late’: US orders healthcare worker protections after thousands die. Excerpt:

US labor department officials on Thursday announced a temporary emergency standard to protect healthcare workers, saying they face “grave danger” in the workplace from the coronavirus pandemic. 

The new standard would require employers to remove workers who have Covid-19 from the workplace, notify workers of Covid exposure at work and strengthen requirements for employers to report worker deaths or hospitalizations to the Occupational Safety and Health Administration (Osha). 

“These are the workers who continue to go into work day in and day out to take care of us, to save our lives,” said Jim Frederick, acting assistant secretary of labor for occupational safety and health. “And we must make sure we do everything in our power to return the favor to protect them.” 

The new rules are set to take effect immediately after publication in the Federal Register and are expected to affect about 10.3 million healthcare workers nationwide. 

The government’s statement of reasons for the new rules cites the work of KHN and the Guardian in tallying more than 3,600 healthcare worker Covid deaths through 8 April. Journalists documented far more deaths than the limited count by the Centers for Disease Control and Prevention, which through May tallied 1,611 deaths on case-reporting forms that were often incomplete. 

The Lost on the Frontline project documented early calls for better respiratory protection for healthcare workers than loose-fitting face masks, noted serious complaints to Osha from hospital workers that went unaddressed and revealed repeated employer failures to report dozens of worker deaths. It also found that healthcare employers were often remiss in notifying workers about exposure to the coronavirus on the job. 

The new standard would address some of those problems.

50 doctors reported dead in 1 day from Covid-19 across India: Medical body

Via NDTV.com: 50 Doctors Reported Dead In 1 Day From Covid-19 Across India: Medical Body. And even that, as the end of the report suggests, is likely a severe undercount.

New Delhi: Anas Mujahid, 26, a junior Resident Doctor at Delhi's Guru Teg Bahadur Hospital  -- a dedicated Covid specialty -- died within hours of testing positive due to Covid. He is the youngest of 244 doctors who have lost their lives to Covid this year in India's second wave. Last year, 736 doctors had lost their lives during the first wave. A total of nearly 1,000 doctors across India have lost their lives due to Covid so far. 

Mujahid is survived by his parents and four siblings. 

A week has gone by, but his friend and colleague Dr Aamir Sohail is still struggling to come to terms with the loss. 

Mujahid had minor symptoms like sore throat and tested positive in an antigen test at the hospital. In a rare case of sudden progression, he collapsed soon after and died due to intracranial bleeding. He had not been vaccinated. 

"It was shocking. He had no comorbidity. His parents also told us that he has never faced any health issue. We just could not understand how it happened," Dr Aamir Sohail said. 

"He had not been vaccinated. Many colleagues here, including me, have not taken the jab. Our process of getting vaccinated while being on Covid duty, is long. We have to inform superiors and get their signature etc. He was planning to get the jab in the next few days." 

Dr Sohail added that he got infected last month and had moderate symptoms and is now doing fine. But he said it was hard to comprehend how his friend, who seemed perfectly fine hours ago, suddenly faced such severe issues and died. 

According to the Indian Medical Association, 244 doctors have lost their lives due to Covid in the second wave. Of them, 50 deaths were recorded yesterday. The highest number of fatalities have been reported from Bihar (69) followed by Uttar Pradesh (34) and Delhi (27). 

Only 3 per cent of these doctors were fully vaccinated. 

Five months into India's vaccination drive, only 66 per cent of India's healthcare workers have been fully vaccinated. The IMA said it is making all possible efforts to encourage doctors to take the jab. 

Dr Jayesh Lele, the General Secretary of IMA, told NDTV, "It is very unfortunate that we lost 50 doctors yesterday across India and 244 in the second wave since the first week of April". 

The IMA, he said, has found that many doctors have not taken the vaccine and the organisation will do everything it can to ensure that all doctors who are on the frontline take the jab. PromotedListen to the latest songs, only on JioSaavn.com 

"Secondly we want to highlight that doctors are understaffed and overworked. They sometimes work for 48 hours at a stretch without any rest. This adds to the viral load and they ultimately succumb to the infection. The government needs to take measures to boost the healthcare workforce," he added. 

While the IMA says that a thousand doctors have died due to Covid so far, the actual numbers may be far higher. The IMA only keeps a record of its nearly 3.5 lakh members. India, however, has more than 12 lakh doctors.

Outbreak Brief 4: Ebola virus disease (EVD) outbreak

Via Africa CDC and published on March 16: Outbreak Brief 4: Ebola virus disease (EVD) Outbreak.

Outbreak Update: Since the last brief (9 March 2021), one new probable case, two new deaths, and four new recoveries of Ebola virus disease (EVD) have been reported from the Democratic Republic of Congo (DR Congo) and Guinea. Cumulatively, 30 EVD cases, 15 deaths (CFR: 50%), and eight recoveries have been reported from DR Congo (12 cases; 6 deaths; 2 recoveries) and Guinea (18; 9; 6). Seven healthcare workers are amongst the confirmed cases: DR Congo (2) and Guinea (5). 

● DR Congo updates: Since the last brief, one new probable case, one new death, and no new recoveries from EVD have been reported. Cumulatively, 12 cases (11 confirmed and 1 probable) with six deaths (CFR: 50%), and two recoveries have been reported. See Table 1 for the breakdown by health zone. 

● Guinea updates: Since the last brief, no new confirmed cases or deaths have been reported. However, four new recoveries have been reported in Nzérékoré. Cumulatively, 18 cases (14 confirmed, 4 probable), nine deaths (CFR: 50%), and six recoveries have been reported. See Table 1 for the breakdown by region and sub-prefecture. 

● Cross-border updates: Between 15 February to 12 March 2021, 18 EVD-related alerts were reported in Sierra Leone. All alerts were investigated and tested negative for EVD by PCR. As of today no confirmed case has been reported from Sierra Leone.

COVID-19 in Moldova: 25 deaths and 1518 new cases confirmed

Via TRM.md: COVID-19 in Moldova: 25 deaths and 1518 new cases confirmed.

Another 1,518 new cases of COVID-19 infection were confirmed today in Moldova, and 25 people died as a result of complications caused by the new Coronavirus. 

Of the total number of cases, seven are imported. 

The total number of tests performed - 4,838, of which 4,503 primary and 305 repeated. 

The balance of COVID-19 cases in Moldova reached 184,856. 

Of the total number of cases, 69 are healthcare workers: 25 doctors, 34 nurses, 10 auxiliary staff. 

In all, 3,654 patients confirmed with COVID-19 infection are hospitalized in medical institutions, of which 317 are in an extremely serious health condition (57 patients are connected to assisted breathing). Another 601 people were healed. In all, 165,489 people were treated of COVID-19. 

9,381 people with mild and moderate forms of COVID-19 get treatment at home, and 17,273 are under home supervision. 

At the same time, the Ministry of Health, Labor and Social Protection announces about another 25 deaths caused by COVID-19, among those who died is an employee of the healthcare system. It is about the obstetrician-gynecologist from the Institute of Mother and Child, Anatolie Serbenco, aged 67. So far, 89 healthcare workers have died from COVID-19 infection. 

In all, 3.924 people in Moldova died from coronavirus in Moldova.  

WHO: Ebola virus disease – Guinea (17 February 2021)

Via ReliefWeb, WHO has published Disease outbreak news: Ebola virus disease – Guinea (17 February 2021). Excerpt:

On 14 February 2021, the Ministry of Health (MoH) of Guinea informed WHO of a cluster of Ebola Virus Disease (EVD) cases in the sub-prefecture of Gouécké, Nzérékoré Region, Guinea between 18 January and 13 February 2021. The cases showed symptoms of diarrhea, vomiting and bleeding after attending the burial of another relative (a 51 year-old nurse) on 1 February 2021. 

The index case of the cluster was a nurse who had originally presented at a health centre in Gouécké on 18 January 2021 with headache, physical weakness, nausea, vomiting, loss of appetite, abdominal pain, and fever. She was diagnosed with typhoid. She sought a second consultation at a health facility in Nzérékoré on 23 January 2021 for fever, vomiting, liquid stools, and physical weakness, and she was diagnosed with malaria. On 24 January she consulted a traditional practitioner in Nzérékoré, and she died on 28 January 2021. She was buried unsafely on 1 February in Gouécké. The other six cases are the five family members and the traditional practitioner she visited. 

Among the seven cases, five have died (4 probable and 1 confirmed). The other two confirmed cases are currently in isolation in dedicated health care facilities in Conakry and Gouécké, Nzérékoré region. 

The Ebolavirus species is not yet determined. Additional laboratory analyses are on-going to ascertain virus species. 

As of 15 February, one hundred and ninety-two (192) contacts have been identified, including 164 contacts in N’Zérékoré Health District and 28 in Ratoma Health District, Conakry. To date, no contacts have been reported to have travelled in neighboring countries. However, Nzérékoré is the second-largest city in Guinea and lies at the intersection of roads from Ganta (in Liberia), Danané (Côte d’Ivoire), and roads to other major hubs in Guinea like Kankan and Macenta in (Guinea). Therefore, there is concern about the exportation of EVD cases into the neighboring countries.

6 deaths from Ebola in Guinea: A serious mistake that costs money?

Via Guineematin.com: 6 deaths from Ebola in Guinea: a serious mistake that costs money? Now the question is: Where and how did the old woman, nurse Lucie Haba's stepmother, acquire Ebola? The Google translation:

A serious error by the agents of the Gouéké health center would have favored the spread of the Ebola virus, which reappeared recently in this sub-prefecture located more than 40 kilometers from the city of N'Zérékoré (in southern Guinea). The latter would have made a false diagnosis on a patient they received in December 2020 and who would be the first case of Ebola.

It was the health authorities of N'Zérékoré who announced the news on Wednesday, February 17, 2021, reports the correspondent of Guineematin.com on the spot. Contrary to what has been announced so far, the Ebola virus did not reappear at the end of January in Guinea, but long before. The nurse who died between January 27 and January 2021 is therefore not the first victim of this disease. 

Her stepmother, a 70-year-old who died in December 2020 at the Gouéké health center, is said to be patient zero (the first case). In any case, this is what the daily report of the Ebola hemorrhagic fever response teams published this Wednesday, February 17 in N'Zérékoré. 

According to this report, the old woman was hospitalized at the Gouéké health center after developing a vaginal hemorrhage. Health workers who diagnosed her concluded that she had "severe anemia". But, a few weeks after her death, the nurse who was caring for her and who happened to be her stepdaughter fell ill and also died. Several people who attended her funeral subsequently fell ill and three of them died. 

This is why, a few days after the tests which revealed the presence of the Ebola virus disease in Gouéké, the health authorities decided to count the old woman among the victims of Ebola. Which makes 6 deaths caused by the epidemic since its resurgence in Guinea. Deaths, most of which are believed to be due to the false diagnosis made by the health workers who received the first patient and which led to new contaminations. 

As for contacts, they went from 164 to 216 in N'Zérékoré, announce the health authorities.

More than 3 Ebola deaths in Guinea: here is the government's statement

Via Guineematin.com: More than 3 Ebola deaths in Guinea: here is the Government's statement. The Google translation:

In the afternoon of this Sunday, February 14, 2021, the Guinean Government declared "an epidemic of Ebola virus disease in the prefecture of N'Zérékoré, sub-prefecture of Gouecké", after examining the samples taken from sick people. According to the Guinean Ministry of Health, more than three people have already been killed by this disease which officially killed 2,536 people between the end of 2013 and the end of 2015. All the victims were said to have attended the funeral of a nurse at the center. of Goueké's health on February 01. 

Guineematin.com offers you, below, the Government's statement: 

Conakry, February 14, 2021.   

GOVERNMENT DECLARATION FOLLOWING THE DETECTION OF A CASE OF EBOLA FEVER IN THE GOUECKE SUB-PREFECTURE, N'ZEREKORE PREFECTURE 

The health authorities of the Ministry of Health were informed by the Prefectural Directorate of Health of N'Zérékoré of the detection of suspected cases of Ebola with symptoms of diarrhea, vomiting and bleeding in people who participated in the burial of 'a nurse from the Goueké health center. She died on January 28, 2021 and her burial took place on February 01 in Goueké. The first investigation carried out counted 7 cases, all over 25 years old (4 men and 3 women) including 3 cases of death (2 women and 1 man). All cases participated in the funeral of the nurse.   

The first three samples sent to the laboratories of Gueckedou and Conakry were POSITIVE for Ebola.   

Faced with this situation and in application of the international health regulations (IHR), the Guinean government declares an epidemic of Ebola virus disease in the prefecture of N'Zérékoré, sub-prefecture of Gouecké.   

A crisis meeting held on February 14, 2021 under the chairmanship of the Minister of Health, in the presence of technical and financial partners, international and national, at the ANSS recommended the following measures:   

• Isolation of all suspected cases at CTEPI N'Zérékoré and Conakry; 

• Case investigation to clarify data, identify other suspected cases and identify all contacts to be isolated;   

• Sending of an emergency investigation mission from the central level in support of the local teams in Gouecké;   

• Activation of the coordination and technical commissions of the response to Ebola;   

• Activation of intersectoral coordination through the One Health platform;   

• Supply of sensitization, prevention, diagnostic and care inputs;   

• Opening of a care center for cases detected in Gouecké;   

• Acceleration of procurement of Ebola vaccines from WHO;  

• Implementation of standard RSI procedures.   

The government thanks the technical and financial partners who quickly came forward to express their commitment to the response to this new outbreak of Ebola.   

The government reassures the population that all measures are being taken to stem this epidemic as quickly as possible. It invites the populations of the affected areas to respect hygiene and preventive measures and to report to the health authorities in the presence of suggestive signs (fever, diarrhea, vomiting and bleeding). 

Together we will win! 

The Minister of Health 

General practitioner Rémy LAMAH

North Kivu, DR Congo: A 4th case of Ebola notified in Butembo, it is a nurse

Via 7sur7.cd: North Kivu: A 4th case of Ebola notified in Butembo, it is a nurse. The Google translation:

A fourth case of the Ebola virus disease was notified in the Katwa health zone, in the town of Butembo, North Kivu province, it is in the east of the Democratic Republic of Congo this Sunday, February 14, 2021. 

This is a nurse, who has been in contact with one of the first three cases. She is 22 years old, living in the Musienene health zone, according to the provincial health minister who spoke to 7SUR7.CD. 

“Yes, we just registered a fourth case of Ebola. The patient is a nurse who showed symptoms a few days ago. She also has around 60 contacts who are already listed,” said Eugène Nzanzu Syalita. 

He announces the start of vaccination for this week which begins. More than 1,200 doses of vaccines are already on site in Butembo as well as teams from the World Health Organization (WHO) to try to cut the chain of contamination. 

The cumulative number of cases since the resurgence of the epidemic on February 7 in Biena (Lubero) is now 4 cases, including two deaths and two patients under treatment in the Katwa health zone in Butembo.

Suspected Ebola cases in Guinea rise to 8

Via GuineeNews.org: Suspected Ebola cases in Guinea: ANSS specifies! Every report I find seems to have a different number of cases; this one lists 8, all contracted at the February 1 funeral of an infected nurse. That would make 9, not counting whoever transmitted Ebola to her. The Google translation:

Information on suspected Ebola cases reported in N'Zérékoré prefecture. 

Following a burial, 8 cases of diarrhea, vomiting and bleeding were reported including 3 deaths in the sub-prefecture of Goueké, 45 km from N'Zérékoré. 

Samples were taken and sent to the Labs of Gueckedou and Conakry (haemorrhagic fever). 

4 patients have been isolated at the CTEPI in N'Zérékoré since February 11, and one in Conakry on February 12. 

The Gueckedou lab provided a first result revealing the presence of the EBOLA virus. A second confirmation is underway at the hemorrhagic fever laboratory in Conakry. 

Case history information: 

It was a nurse from the Goueké health center who fell ill, she was consulted by the head of the center and referred to N'Zérékoré center, she died between January 27 and 28, 2021. 

Her burial took place on February 01 in Goueké. 

It is among the people who took part in this funeral that these 08 cases were counted. 

Taken measures: 

Isolation of all suspected cases at CTEPI N'Zérékoré and Conakry. 

Case investigation to clarify data, identify other suspected cases, and identify and isolate all contacts. 

An investigative mission left for Goueke on February 13. 

Initiate steps to acquire vaccines against Ebola from WHO AND CDC with a view to possibly carrying out a belt vaccination in the affected areas. 

A declaration will be made upon re-confirmation. 

Next update Sunday February 14.

First deaths from Ebola in Guinea, a resurgence of the disease in West Africa

Thanks to Bojo Bodean for tweeting the link to the report in Le Monde: First deaths from Ebola in Guinea, a resurgence of the disease in West Africa. Excerpt from the Google translation:

Ebola hemorrhagic fever is back in Guinea, the first reported resurgence of the disease in West Africa, where the worst epidemic in the history of the virus started (2013-2016). 

"We are really concerned, there are already four deaths from Ebola hemorrhagic fever in the region of Nzérékoré [South-East] , including two in Nzérékoré itself and two in the sub-prefecture of Gouéké," in Forest Guinea, Guinean Minister of Health Rémy Lamah told Agence France-Presse (AFP) on Saturday (February 13). 

“There is a nurse from Gouéké who fell ill towards the end of January. She died between 27 and January 28 and was buried on 1st February in Gouéké,"  explained the head of the National Health Security Agency (ANSS), Dr. Sakoba Keïta, quoted by the GuineaMatin website. “Of those who attended the funeral, eight people showed signs: diarrhea, vomiting and bleeding. Three of them died and four others are hospitalized in Nzérékoré."

According to him, a patient had "escaped" but was found and was hospitalized in Conakry. Asked by AFP, Dr Keïta confirmed having made these comments. 

A crisis meeting on Sunday 

The boss of the ANSS and the Minister of Health have both indicated that the samples analyzed by a laboratory set up by the European Union in Guéckédou, in the region, had detected the presence of the Ebola virus. The results of additional analyzes were expected in the coming hours. 

"We have made all the arrangements, an alert team is on site to identify contact cases , " Minister Rémy Lamah told AFP. “I am worried as a human being, but I remain calm because we managed the first epidemic and vaccination is possible. There will be a crisis meeting tomorrow” Sunday. 

Causing a sudden fever, headaches, vomiting and diarrhea, the Ebola virus was first identified in 1976 in Zaire, now the Democratic Republic of Congo (DRC). Since then, this virus, for which there are two experimental vaccines but no cure, has spread terror in Africa several times.