H5N1

Eluru on Wikipedia

Wikipedia now has an entry on the Eluru outbreak. It will doubtless be revised as we learn more, but this seems to be a good summary of the current situation. Excerpt:

Samples from patients and of the local water were collected the same day to determine the cause of the outbreak. Specialists from several worldwide and Indian scientific and medical institutions, such as the All India Institutes of Medical Sciences, the World Health Organization, the Indian Council of Medical Research, the National Institute of Nutrition, Centre for Cellular and Molecular Biology, and the Indian Institute of Chemical Technology had been sent to assess the situation and analyze the samples.  

However, the tests did not detect any water pollution or known virus infections (including COVID-19) upon analysis. Andhra Pradesh's Health Department reported that "initial blood test did not find any evidence of viral infection."  

Blood samples have also been tested for bacterial infections, such as meningitis, and antibodies. Viruses such as SARS-CoV-2, Japanese encephalitis, dengue, chikungunya, hepatitis and rabies have been ruled out as the cause, as have been water contamination, since "people not linked to the municipal water supply [have also] fallen ill", and air pollution. Blood tests and CT scans were not able to establish the cause or origin of the disease and cerebral spinal fluid tests "turned out to be normal."

As of 7 December 2020, the disease has been determined as non-contagious. 

During the COVID-19 pandemic, the state of Andhra Pradesh was one of the hardest hit areas in India, with over 800,000 cumulative cases by the time the disease initially appeared.  

Preliminary lab results suggested that organochlorine substances may be the cause. They are used as pesticides as well as in anti-mosquito fogging. On 7 December 2020, Indian health authorities unofficially declared "Mostly yes, but we are waiting for the laboratory report [for confirmation]" when asked about organochlorine being the disease-triggering agent.

Andhra Pradesh: Delhi AIIMS reveals reason behind Eluru mystery illness

Via ap7am.com, a report published at 7:31 a.m. December 8, local time: Andhra Pradesh: Delhi AIIMS reveals reason behind Eluru mystery illness.

NEW DELHI: All India Institute Of Medical Science (AIIMS) doctors revealed the reason behind the mysterious illness in Eluru, Andhra Pradesh. According to the reports, the AIIMS doctors found lead, nickel and heavy metals in the blood reports and said it is the reason behind the illness. 

They asked the Eluru officials to trace how the metals entered into the humans either water or milk.  

AIIMS doctors asked to send the samples of water and milk to them for tests. It is learnt that the people of Eluru and surrounding areas showing the same symptoms. As per reports, the Central team will visit the Eluru today to inquire about the situation.

AQI on Monday morning: Vancouver 228 (very unhealthy); Portland 468 (hazardous)

I just checked the AQI for Vancouver Second Narrows, which is not far from where I live, and it's the worst I've ever seen it:

Then I checked Portland Postal Bldg., Oregon, USA Air Pollution: Real-time Air Quality Index, and it's far worse than ours:

The public health consequences for the whole west coast, Canada and the US alike, are going to be serious.

 

Portland AQI: At 441, getting worse

A screenshot from the Portland, Oregon, USA Air Pollution: Real-time Air Quality Index:

By contrast, Vancouver Second Narrows is at 200 (very unhealthy), less than half Portland's. And our sky this evening has never looked worse in the 53 years I have lived here. The smoke is so thick the temperature has dropped sharply today.

I wonder what it's like in the ER's of West Coast hospitals tonight.

Smoke from wildfires can worsen COVID-19 risk, putting firefighters in even more danger

Via The Conversation: Smoke from wildfires can worsen COVID-19 risk, putting firefighters in even more danger. Excerpt:

Two forces of nature are colliding in the western United States, and wildland firefighters are caught in the middle.  

Emerging research suggests that the smoke firefighters breathe on the front lines of wildfires is putting them at greater risk from the new coronavirus, with potentially lethal effects. 

At the same time, firefighting conditions make precautions such as social distancing and hand-washing difficult, increasing the chance that, once the virus enters a fire camp, it could quickly spread.  

As an environmental toxicologist, I have spent the last decade expanding our understanding of how wood smoke exposure impacts human health. Much of my current research is focused on protecting the long-term health of wildland firefighters and the communities they serve. 

Air pollution and lingering COVID-19 damage 

People have long understood that the air they breathe can impact their health, dating back more than 2,000 years to Hippocrates in the treatise “On Airs, Waters, and Places.”  

Today, there is a growing consensus among researchers that air pollution, specifically the very fine particles called PM2.5, influences risk of respiratory illness. These particles are 50 times smaller than a grain of sand and can travel deep into the lungs. 

Italian scientists reported in 2014 that air pollutants can increase the viral load in the lungs and reduce the ability of specialized cells called macrophages to clear out viral invaders. Researchers in Montana later connected that effect to wood smoke. They found that animals exposed to wood smoke 24 hours before being exposed to a pathogen ended up with more pathogen in their lungs. The wood-smoke exposure decreased the macrophages’ ability to combat respiratory infection.  

Coronavirus research now suggests that long-term exposure to PM2.5 air pollution, produced by sources including wildfires, power plants and vehicles, may make the virus particularly deadly.

Russia closes border with China as 2019-nCoV coronavirus claims more lives

Via Pravda, a source I very rarely cite: Russia closes border with China as 2019-nCoV coronavirus claims more lives. Excerpt:

Russian Prime Minister Mikhail Mishustin ordered to temporarily close the border with China in the Far East of Russia as part of the fight against the spread of the new coronavirus.

"An order was signed today, it went into work. Today we will accordingly inform everyone about the measures to close the border in the Far Eastern region, as well as about other measures that the government has taken," Mishustin said at a government meeting. 

Not a single case of infection has been recorded on the territory of the Russian Federation so far, "but, of course, we must do everything to protect our people." Mishustin added that the government reports the situation to President Vladimir Putin on a daily basis. 

The Prime Minister also instructed Deputy Prime Minister Tatyana Golikova, who heads 24/7 operational headquarters for the prevention of the coronavirus infection, "to  regularly inform the general public about the current situation daily, about the measures that the government is taking so that people do not have a lack of information."

Bushfires: Being pregnant in a climate emergency was an existential challenge

Thanks to Dr. Alexandra Phelan to tweeting the link to this deeply disturbing report in The Guardian: Being pregnant in a climate emergency was an existential challenge. Miscarriage has brought a new grief. Excerpt:

On Boxing Day I had an article published about being pregnant in a climate emergency. It was about the conflicting and contradictory emotions many of us are forced to hold if we choose to take the leap of faith of bringing a child into the world in the midst of climate collapse.  

At the time I wrote that piece, the smoke came and went. Occasionally we caught snippets of blue sky.  

We could still hear birds then. See bees feeding on the summer flowers in our garden.  

Just six days later, the house surrounded by a dense glowing orange fog of smoke, my writing felt both prescient and dated. The birds were gone. Canberra, and the wildlife that lives in the national parks that encircle it, was suffocating. Climate collapse wasn’t a slow-moving force my child and I might gradually see impact our lives. It was here, now. Upon us and immediate.  

That was the day the smoke was the thickest. So thick it shut down the whole city, the airport closed, all roads in and out cut off with fire. It was the first day that felt like sunset from start to finish. A colour we’ve come to think of as “apocalypse orange”. 

When, even though no fire had crossed the borders of the Australian Capital Territory, Canberrans had their cars packed to evacuate. Where everyone clutched their iPhones flicking between the live fire reporting and the live air quality reporting. Back, and forth, back and forth … on and on, we livestreamed the end of the world.

That was also the day before I was due to have a pregnancy ultrasound. Sitting in my bedroom in the orange semi-light at midday I looked at the murky sight outside my window and wondered “What have I done?” At best, I was experiencing the type of prolonged and acute stress that means my baby was flooded with potentially life-altering cortisol hormones and had, despite my best efforts, no doubt been exposed to damaging levels of fine particulates. At the worst, had I created a person who would be born just to watch the world end?  

Perhaps, I thought, I have made a terrible mistake.  

Sitting 600km away in Melbourne as I write this, where the sky is blue and people come and go about their daily life, it’s hard to convey the intensity of living in the middle of a long-running disaster. The world narrows. Your ability to think critically evaporates.  

New daily rituals emerge – wake up, check the fire warnings, check the air quality reading. Get out of bed, check the air purifier. Next, wash brown smoky water out of clothing or animals that have left the sanctuary of the house for any period of time. 

Then go about your day, trapped inside, always with one eye on the live stream. Your social life reduces to rushing from your car inside a friend’s house where you look at the live stream together while externalising your shared internal monolog of “We are not OK. The world is not OK.”  

That next day, at the ultrasound, there was no heartbeat.

Bushfires: 'Air pollution in NSW is a public health emergency'

A statement from the Climate and Health Alliance, signed by 28 Australian health groups: Joint Statement: Air pollution in NSW is a public health emergency.

Smoke from bushfires has produced air pollution of up to 11 times the base ‘hazardous’ level in parts of Sydney and New South Wales. High levels of air pollution are expected to continue. 

There is no safe level of air pollution. The higher the level of pollution, the more hazardous the risks to health. Bushfire smoke is particularly hazardous because of the high levels of tiny particles (PM2.5). 

Babies, young children and those who are elderly or already experience chronic respiratory or cardiovascular disease are at higher risk, as are the socially and economically marginalised who may not have access to air conditioning or air purifiers.  

Air pollution is linked to diseases throughout life: including premature births, low birth weight babies, impaired lung development in children, asthma, heart disease, stroke, chronic obstructive pulmonary disease, and lung cancer. 

The levels of air pollution in NSW in recent weeks, and in the immediate future, remain hazardous to people’s health.  

This is a public health emergency  

Governments have a responsibility to protect the people they represent. 

Both the Federal and State Government of NSW must prioritise action to help reduce the risks to people’s health arising from hazardous air pollution from the bushfires that continue to burn relentlessly across the state.  

We call on Prime Minister Scott Morrison and NSW Premier Gladys Berejiklian to demonstrate the leadership this public health emergency demands, and to implement measures to help alleviate the health and climate crisis.  

Authorities are encouraging people in affected areas to avoid exercise and stay indoors with windows and doors closed and, if they have medication for respiratory conditions, to use their medications as directed.  

In accordance with advice from the NSW Department of Health, if you are particularly susceptible to bushfire smoke, consider staying with a friend or relative whose house has clean indoor air or leaving the area for a cleaner environment.  

Protecting health requires climate action  

Climate change is worsening many extreme weather events such as serious bushfire weather, which is having devastating impacts on human health. 

The air pollution events resulting from bushfires will become more and more frequent and are a result of climate change. Our governments must act quickly to rapidly and deeply reduce greenhouse gas emissions, which we know are driving climate change. 

This moment calls for political leadership  

All of our political leaders must acknowledge the health and environmental emergency of climate change, and step up and commit to urgent climate action by reducing greenhouse gas emissions in line with what the science demands.  

In addition to responding to this public health emergency, we call on Prime Minister Scott Morrison and Premier Gladys Berejiklian to lead action on climate change to protect our health. 

This must include a multi-portfolio response involving Federal and State governments and the development of a National Strategy on Climate, Health and Well-being. This will ensure a nationally coordinated approach to tackling the worsening health impacts of climate change, and that health service planning includes climate change preparedness to respond to the increasing demand for health services from extreme weather events, such as bushfires and heatwaves.

Australia: Governments must act on public health emergency from bushfire smoke, medical groups say

Via the Australia edition of The Guardian: Governments must act on public health emergency from bushfire smoke, medical groups say. Excerpt:

Some 22 groups representing health and medical professionals in Australia have issued a joint call to act on a “public health emergency” caused by smoke from the catastrophic bushfire season in New South Wales.  

In Sydney and others areas of NSW communities have been exposed to air pollution up to 11 times worse than “hazardous” levels. 

The group has produced a joint statement calling for political leadership while repeating a call for a national strategy to combat the health impacts of climate change.  

Dr Kate Charlesworth, a fellow of the Royal Australasian College of Physicians, which signed the statement, said: “Climate-related health effects are having the most impact on our most vulnerable: babies, children, the elderly and people with pre-existing disease. There is no safe level of air pollution.”

“To protect health, we need to shift rapidly away from fossil fuels and towards cleaner, healthier and safer forms of energy.” 

Among the 22 groups that signed the statement are the Australasian College of Emergency Medicine, Public Health Association of Australia, Australian College of Nursing, Australian Association of Social Workers and Lung Foundation Australia. 

The statement says the federal and NSW governments must “prioritise action to help reduce the risks to people’s health arising from hazardous air pollution”.  

Fiona Armstrong, executive of the Climate and Health Alliance, said: “This is a public health emergency.” She added: “Climate change is going to get much worse and we will see more and more of these events.”  

Dr Lai Heng Foong, of Doctors for the Environment Australia, which has also signed the statement, said: “Pollution from bushfire smoke remains hazardous to people, in the short term and also the long-term.”  

Many of the groups that have signed the statement are also pushing for Australia to respond to the health impacts of climate change. 

Mark Brooke, CEO of Lung Foundation Australia, said a national strategy was needed. 

“Climate change and air quality significantly contribute to poor lung health, increased health and economic burden, disability and death,” he said. 

“If we want to prevent the worst air pollution from bushfire smoke, one of the best things our governments can do, aside from fuel reduction burns, is to set stronger and better standards for everyday air quality.”

NSW bushfires: Doctors sound alarm over 'disastrous' impact of smoke on air pollution

Via The Guardian: NSW bushfires: doctors sound alarm over 'disastrous' impact of smoke on air pollution. Excerpt:

A Sydney GP working in the suburbs hardest hit by bushfire smoke plaguing New South Wales has said she is devastated for her patients, many of them unable to afford air filters, air conditioning or masks.  

Dr Kim Loo works in Riverstone, which along with Richmond and St Marys on Tuesday recorded some of the highest levels of ultra-fine PM2.5 particles, small enough to enter the lungs and bloodstream. On Tuesday afternoon, the 24-hour average index for Rouse Hill stood at 430, with anything above 200 rated “hazardous”. 

Levels ranged as high as 2,200 in some Sydney suburbs on Tuesday. Bathurst, Orange, Armidale and Goulburn also experienced hazardous air quality. 

“My poor patients, many live on the margins of poverty,” a tearful Loo told Guardian Australia. “They live in houses that aren’t sealed. I know there are guidelines telling people to stay inside if they have certain health conditions, but that’s no good if your house isn’t sealed and you can’t afford an air filter. 

“It is disastrous and it’s unprecedented. We have no experience dealing with this for such a long period. I have patients on oxygen for lung disease and they’re on it for 16 hours a day and they can’t go outside at all now. They’re isolated.” 

Loo is also angry. For several years she has been travelling to Canberra to talk to federal politicians, warning them of such a situation due to climate change. She has had meetings with state politicians as well.  

“And then I get really upset and it makes me so sad, because what climate change does is amplify social inequity,” Loo said as she drove to her clinic to face another day of treating smoke-affected patients. “People who can afford to filter their air and live in places where trees aren’t burning, or to fly somewhere else when the smoke gets bad, don’t feel the brunt of this. The people on the margins walk to my surgery, they don’t own a car. They can’t pay for food, let alone smoke masks.” 

In the week to 6 December, about 1,140 people presented to NSW emergency departments, 25% more than the usual weekly average. The largest increases have been in South Western Sydney Local Health District, which serves a region particularly affected by smoke. NSW Ambulance fielded about 2,330 calls in the same period, about 30% more than the average for a week. Hospitals are so far managing to cope with the demand.  

The vice-president of the Australian Medical Association, Dr Chris Zappala, is a respiratory physician and he said the weeks of relentless bushfire smoke were taking a toll on people’s sense of well-being. Many people were cutting back on normal activities such as exercise because of smoke inhalation and irritation to their eyes and respiratory system, he said.  

“There is no question that there is a quality of life and mental health cost from the confinement, and the worry that this prolonged period of smoke exposure causes,” Zappala said. “I had a mother of younger kids telling me her children were not allowed out to play at school, and the kids were experiencing boredom and agitation and other effects of prolonged confinement. People are appropriately not going out to exercise as much and it’s just a constraining, unhappy time.”