H5N1

China says spread of Covid ‘impossible’ to track as infections soar in Beijing

Via The Guardian: China says spread of Covid ‘impossible’ to track as infections soar in Beijing. Excerpt:

The spread of Covid-19 in China is now “impossible” to track, the country’s health authorities have said, announcing they have stopped recording asymptomatic cases in their daily tallies.  

The admission comes amid soaring presentations to hospitals and clinics as Covid-19 spreads rapidly through the population in the wake of the sudden removal of strict pandemic measures. Authorities have urged people not to seek emergency healthcare unless necessary, and announced the rollout of second boosters to elderly and vulnerable people.  

China’s government abruptly ended the long-running and strict zero-Covid policy last week, rolling back measures including travel restrictions and lockdowns. Health authorities also ended the mass testing drives and compulsory regular testing which were pillars of the policy. As a result, official daily reports have become an increasingly inaccurate measure of the outbreak.

On Tuesday the national health commission (NHC) announced it would no longer report asymptomatic cases, which for most of the pandemic have been reported as a separate – and usually much larger – cohort.  

“Many asymptomatic patients no longer participate in nucleic acid testing,” the NHC said. “It is impossible to accurately grasp the actual number of asymptomatic infections.”  

The commission officially reported just 2,291 symptomatic cases across China on Tuesday, at odds with reports from residents and health services of rampant infections – particularly in the capital Beijing.  

Vice-premier Sun Chunlan earlier said Beijing’s new infections were “rapidly growing”, according to state media.  

Official state media outlet China Daily reported Beijing had seen a more than six-fold increase in presentations to hospitals in the last week, and 16 times more to fever clinics.  

Li Ang, deputy director of Beijing Municipal Health Commission, told media that on 9 December there were 31,000 calls to emergency medical services, six times more than average.  

Anecdotally, residents are describing many friends, families, and co-workers falling ill with Covid, with one telling the Guardian it had “ripped through” the city. Employees at businesses, schools and embassies have described huge numbers of colleagues being home sick with the virus, or caring for family members. James Zimmerman, a Beijing-based lawyer, said on Twitter that 90% of people from his Beijing office had Covid.  

“Some obviously miserable. Many nursing kids/parents at home. Our ‘work at home’ policy is now ‘work at home if you’re well enough’. This thing came on like a runaway freight train,” he said.

China's COVID spike not due to lifting of restrictions - WHO director

Via Reuters: China's COVID spike not due to lifting of restrictions - WHO director. As shown above, the 7-day rolling average keeps falling, but that's because China has stopped counting asymptomatic cases.

GENEVA, Dec 14 (Reuters) - The recent explosion of COVID-19 infections in China is not due to the sudden easing by the government of its strict policy, a World Health Organization director said on Wednesday as he warned of low vaccination levels in the world's No. 2 economy.  

The WHO's emergencies director Mike Ryan said in a briefing with media that the virus was spreading "intensively" in the nation long before the lifting of restrictions.

He said "control measures" were not stopping the disease.  

The challenge for China in getting the virus under control is getting an adequate number of people vaccinated, he said.

Keeping the front door open: Ensuring access to primary care for all in Canada

Via CMAJ: Keeping the front door open: ensuring access to primary care for all in Canada. The key points:

• Primary care in Canada is in crisis; 4.6 million people did not have a regular family physician or primary care clinician before the COVID-19 pandemic and the situation is getting worse.  

• Emerging evidence suggests that if primary care delivery does not change, a larger family physician workforce would be needed to serve the current population, let alone a growing and aging one. 

• Interprofessional team-based care, coupled with payment reform, has the potential to improve primary care capacity, access and outcomes for patients, and provider well-being.  

• Bold reforms could include neighbourhood-based clinics that employ physicians and have accountability to the local population and regionally organized after-hours care that would obviate the need for walk-in clinics and allow for better use of resources.

China might be back to pre-Covid normal by mid-2023, health expert Zhong Nanshan forecasts

Credit: Xinhua

Via the South China Morning Post: China might be back to pre-Covid normal by mid-2023, health expert Zhong Nanshan forecasts. Zhong Nanshan is the patriarch of China's healthcare system, and he's been a major factor in the country's responses to infectious diseases since at least the early H5N1 cases. He seems surprisingly optimistic about the impending resurgence of COVID-19. Excerpt:

China should ramp up vaccination to avoid an epidemic of Covid-19 infections over the Lunar New Year, but could return to some normality by the middle of next year, according to a leading infectious disease expert.  

“It is highly unlikely that people will be restricted from travelling home for Lunar New Year celebrations in 2023, but it is still important to step up preparations,” state news agency Xinhua quoted Zhong Nanshan as saying in an interview in the southern city of Guangzhou on Friday.  

“I suggest that people who are ready to travel back home should get booster vaccinations so that they won’t develop serious symptoms even if they catch Covid.  

“A booster shot usually takes effect in two weeks. It will help to prevent mass transmission during the Lunar New Year migration when people gather in crowds.”  

Under the zero-Covid policy of the past three years, Chinese authorities have urged the public to stay put and avoid travel during holidays, including Lunar New Year, a time when people catch up with their family.  

But the policy dealt a heavy blow to the economy and authorities have been abandoning the toughest restrictions in the past few weeks.  

In the latest relaxation on Wednesday, authorities allowed home quarantine for people with mild and asymptomatic infections. Mass PCR testing was also dismantled and the country resumed its vaccination drive.  

Infections have surged in big cities like Beijing and Guangzhou as social and economic activity has picked up slowly. Analysts said the economic recovery would be bumpy as the mass infections would continue to disrupt the economy, with normal life only expected to return later next year.

The Lancet Series on racism, xenophobia, discrimination, and health

Via The Lancet: The Lancet Series on racism, xenophobia, discrimination, and health. The executive summary: 

Racism, xenophobia, and discrimination exist in every modern society causing avoidable disease and premature death among groups who are often already disadvantaged.

This Series examines how the historic systems and structures of power and oppression, and discriminatory ideologies have shaped policy and practice today, and are root causes of racial health inequities. 

Furthermore, by applying a global lens and intersectional framework, overlapping forms of oppression such as age, gender, and socioeconomic status and their impact on discrimination are analysed. Interventions to address the spectrum of drivers of adverse health outcomes with a focus on the structural, societal, legal, human right, institutional and system level are reviewed. 

Research recommendations and key approaches for moving forward are proposed.

BC wildlife rescue centres say they're overrun with calls for birds sick with suspected avian flu

Via CBC News: B.C. wildlife rescue centres say they're overrun with calls for birds sick with suspected avian flu. Excerpt:

The provincial and federal governments advise people not to handle sick birds, as wildlife rehabilitation centres say they are seeing increased calls from the public who want to try and help the animals suspected of having avian influenza.  

"It's been exceptional in my almost 37 years of doing this," said Elizabeth Melnick, who for decades has worked to rehabilitate injured or orphaned animals at her centre in Abbotsford.  

She said her centre, which runs on donations, is unable to keep up with calls, and even people bringing her sick birds such as wild geese and crows they've observed in distress, mostly in the Fraser Valley where avian flu has been detected.  

"It's really taken a toll," she said. "It's not a good situation at all."  

Seven commercial poultry farms have been quarantined with avian flu since Nov. 16 in Abbotsford and Chilliwack, the same area where 17 million birds were culled in 2004 to prevent the flu's spread. 

Officials in the industry say, so far, there has not been farm-to-farm transmission, but wild birds are spreading the disease as they can easily access poultry farms in the Fraser Valley, which are close together.  

The first poultry infection in B.C. this year was confirmed in mid-April. There have now been 57 confirmed cases, with the majority discovered this fall as wild birds migrate.

Iceland as stepping stone for spread of highly pathogenic avian influenza virus between Europe and North America

Via Emerging Infectious Diseases: Iceland as Stepping Stone for Spread of Highly Pathogenic Avian Influenza Virus between Europe and North America. The abstract:

Highly pathogenic avian influenza viruses (HPAIVs) of hemagglutinin type H5 and clade 2.3.4.4b have widely spread within the northern hemisphere since 2020 and threaten wild bird populations, as well as poultry production. 

We present phylogeographic evidence that Iceland has been used as a stepping stone for HPAIV translocation from northern Europe to North America by infected but mobile wild birds. At least 2 independent incursions of HPAIV H5N1 clade 2.3.4.4b assigned to 2 hemagglutinin clusters, B1 and B2, are documented for summer‒autumn 2021 and spring 2022. Spread of HPAIV H5N1 to and among colony-breeding pelagic avian species in Iceland is ongoing. 

Potentially devastating effects (i.e., local losses >25%) on these species caused by extended HPAIV circulation in space and time are being observed at several affected breeding sites throughout the North Atlantic.

Research: 1 in 8 adult Canadians experienced depression for first time during pandemic

Via the Helsinki Times: Research: 1 in 8 adult experienced depression for first time during pandemic. Excerpt:

One in eight older persons in Canada, according to recent large-scale research that included more than 20,000, experienced their first episode of depression during the epidemic.  

The statistics were significantly worse for people who had previously struggled with depression. Nearly half (45 per cent) of this population reported having depression by the fall of 2020.  

The analysis of responses from the Canadian Longitudinal Study on Aging, which gathered information from participants for an average of seven years, was published in the International Journal of Environmental Research and Public Health.  

"The high rate of first-onset depression in 2020 highlights the substantial mental health toll that the pandemic caused in a formerly mentally healthy group of older adults." says first author, Andie MacNeil, a recent Master of Social Work graduate from the Factor-Inwentash Faculty of Social Work (FIFSW) and the Institute for Life Course and Aging, University of Toronto.  

Although it is well known that depression among older adults increased during the pandemic, few studies have examined the proportion of people who developed the disorder for the first time or the proportion of people with a history of the condition who had a relapse.  

"The devastation of the pandemic which upended so many aspects of daily life hit those with a history of depression particularly hard," said co-author Sapriya Birk, a researcher formerly based in the Department of Neuroscience, Carleton University, Ottawa who is currently a medical student at McMaster University, Hamilton, Canada, adding, "Health professionals need to be vigilant in screening their patients who had mental health problems at an earlier time in their life."  

The researchers determined that a number of factors, such as low income and savings, loneliness, chronic pain, difficulty accessing healthcare, a history of traumatic childhood experiences, and family conflict, were linked to depression in older adults during the pandemic.

China ramps up livelihood, economic support amid COVID-19 control

Something is going on in China. The country seems fed up with lockdown measures, and the government is trying to calm things down. Via People's Daily, a Xinhua report: China ramps up livelihood, economic support amid COVID-19 control. Excerpt:

BEIJING, Nov. 26 (Xinhua) -- Local governments across China are rolling out policies to support businesses and residents amid the ongoing COVID-19 control, allowing virus-hit supermarkets to reopen sooner and reducing operating costs for struggling companies.  

The Chinese capital Beijing promised to expedite the reopening of shopping malls and supermarkets that sell livelihood-related products, as the latest effort to ensure the smooth operation of the city and the market while striving to corral the outbreak.  

Speaking at a media conference on Thursday, Beijing municipal government spokesperson Xu Hejian said that such business outlets, if affected by the COVID-19 cases, are allowed to reopen after one day of required closure and disinfection, and will not be closed for more than three days.  

Responding to public concerns, the Beijing government will rev up support for residents who have to leave their closed-off compounds to seek medical services, Xu said. Garbage from high-risk areas will be taken care of, the official added.  

Municipal officials also said they had directed major e-commerce companies to stock up with three to five times the usual level of supplies so as to stabilize prices.  

On Friday, Beijing reported 586 locally transmitted confirmed cases of COVID-19 and 2,009 locally transmitted asymptomatic cases. The latest outbreak has seen many restaurants and shops closed and residents advised to reduce unnecessary outings.  

In southwest China's Chongqing Municipality, which has registered more than 60,000 infections since Nov. 1, authorities organized retail companies to set up temporary stands outside the residential complexes that were under closed-off management.  

The government is also negotiating with e-commerce platforms to increase supplies while helping retailers resume business online after the closure of their physical shops, said Zhang Yongwu, head of the Chongqing municipal commission of commerce.  

The Ministry of Commerce has pledged greater efforts to ensure the supply of daily necessities, especially for residents in areas hit hard by the COVID-19 resurgence.

Progress toward regional measles elimination — worldwide, 2000–2021

Via MMWR: Progress Toward Regional Measles Elimination — Worldwide, 2000–2021. The summary:

What is already known about this topic?  

Progress toward measles elimination experienced setbacks in 2020 during the COVID-19 pandemic.  

What is added by this report?  

During 2000–2021, measles vaccination prevented an estimated 56 million deaths worldwide. In 2021, only 81% of children received their first dose of measles containing vaccine (MCV), the lowest coverage reported since 2008, leaving 25 million children vulnerable to measles. Measles surveillance continues to be suboptimal, and large and disruptive outbreaks were reported in 22 countries.  

What are the implications for public health practice?  

Reaching all children with 2 doses of MCV and strengthening measles surveillance is critical to close immunity gaps, prevent outbreaks, and recover progress lost during the pandemic.