How Biden plans to change the US pandemic response

‘President-elect Joe Biden and Vice President-elect Kamala Harris say they will move the US Covid-19 pandemic response in a dramatically different direction... Here are five ways Biden says the US coronavirus response will change when he's President. (1) Increased testing and contact tracing. (2) Additional investment in vaccines and treatments. (3) Mandatory masks and more PPE. (4) A push for 'clear, consistent, evidence-based guidance'. (5) Rejoining WHO and searching for future threats.

‘There were dauntingly high new case numbers last week, and by the time Biden takes office January 20, the influential University of Washington Institute of Health Metrics and Evaluation model projects there will be more than 372,000 Covid-19 deaths -- that's 135,000 more than the current total...’

Read here (CNN, Nov 9, 2020)

Health DG responds to open letter to PM from ‘MOH specialist’

Dr Noor Hisham Abdullah responds to the open letter of Dr Tachdjian to the prime minister "Covid-19: Wake up, enough talk, take action". ‘Even though it is not directed to me, but as the director-general of Health, I have to understand what this "Health Ministry (MOH) staffer" is trying to relay, regardless of the person's rank, grade, or profession. It occurred to me when it was said that the doctor was an "MOH specialist" it would surely attract everyone's attention to read it...’

Read here (Malaysiakini, Oct 12, 2020)

Wake up, enough talk, take action: An open letter to the PM from ‘MOH specialist’

‘Wake up dear Prime Minister Muhyiddin Yassin – you are a self-proclaimed “abah” (father) that wishes to “rotan” (cane) his rakyat for misbehaving and not following standard operating procedure (SOP). You fail to realise that the saddening facts of this Covid-19 wave listed down above are not due to Covid-19, but rather the failure of your administration to prioritise the health of the rakyat above all else...’

Read here (Malaysiakini, Oct 11, 2020) 

Health workers silenced, exposed and attacked

‘Governments must be held accountable for the deaths of health and essential workers who they have failed to protect from COVID-19, Amnesty International said today, as it released a new report documenting the experiences of health workers around the world.

‘The organization’s analysis of available data has revealed that more than 3000 health workers are known to have died from COVID-19 worldwide - a figure which is likely to be a significant underestimate.

‘Alarmingly, Amnesty International documented cases where health workers who raise safety concerns in the context of the COVID-19 response have faced retaliation, ranging from arrest and detention to threats and dismissal.’

Read here (Amnesty International, July 13, 2020)

‘You have to take action’: One hospital cleaner’s journey through the pandemic

‘Two years ago, Ernesta decided she wanted to improve things for the cleaners at Lewisham hospital. She believed they deserved better pay and better treatment. She joined the union, persuaded her colleagues to join, too, and they began to organise themselves. In a long campaign to improve their working lives – a campaign that has persevered through a pandemic – the cleaners have won various battles, but they still have more to fight. In the past three months, their vulnerability has also been made distressingly clear. Cleaners from all over the country have died from Covid-19 – two of those who died worked down the road from Lewisham at St George’s hospital in Tooting. The pandemic has revealed what was always obvious to Ernesta: a hospital can’t function without its cleaners. They are as vital to its purpose as any of the other frontline staff, and equally at risk.’

Read here (The Guardian, June 30, 2020)

Covid-19 has led to a pandemic of plastic pollution

‘Whether on the foreshore of the Thames or the deserted beaches of Soko, the planet is awash with pandemic plastic. Data are hard to come by but, for example, consumption of single-use plastic may have grown by 250-300% in America since the coronavirus took hold, says Antonis Mavropoulos of the International Solid Waste Association (ISWA), which represents recycling bodies in 102 countries. Much of that increase is down to demand for products designed to keep covid-19 at bay, including masks, visors and gloves. According to a forecast from Grand View Research, the global disposable-mask market will grow from an estimated $800m in 2019 to $166bn in 2020.’

Read here (The Economist, June 22, 2020)

US Department of Homeland Security develops DIY method to decontaminate masks with a multicooker

‘A household appliance, which may be sitting inside your kitchen cabinet, can now be used as a powerful tool in the fight to control COVID-19. Researchers with the Department of Homeland Security (DHS) Science and Technology Directorate (S&T) developed a do-it-yourself solution to decontaminate personal protective equipment (PPE) using a programmable multicooker...

‘Moist heat decontamination is achieved by treating masks with 149°F steam for 30 minutes. Key steps include placing the mask(s) in a paper bag, filling the multicooker with a half inch of water and setting the bag on a rack inside of it. S&T verified these conditions inactivate the virus below detectable limits in culture media and simulated saliva, while the masks still meet performance specifications after five treatments...

Read here (US DHS, June 19, 2020)

Full instructions, a video, fact sheet and FAQ about the process are available on the HHS S&T website. View video and download PDFs here

Death from Covid-19 of 23 health care workers in China

‘As of March 31, none of the 42,600 health care workers who went to Hubei Province to care for patients with Covid-19 were known to have been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).5 The 42,600 workers included one of us, an intensive care physician from Fujian Province who cared for patients with Covid-19 from January 29 to March 23, first in Wuhan Central Hospital, and then in Wuhan Jinyintan Hospital. These data suggest that sufficient precautions with rigorous enforcement can prevent health care workers from becoming infected with SARS-CoV-2 and the subsequent risk of death.’

Read here (New England Journal of Medicine, June 4, 2020)

Harnessing our humanity — How Washington’s health care workers have risen to the pandemic challenge

‘Given mounting PPE shortages and the rising death toll from Covid-19 among health care workers globally, such scenarios [of protocol modifications -- including the use of bandannas in place of face masks] induce terror and necessitate rethinking of routine standards of care. Should we run to codes of patients with known or suspected Covid-19? Should physicians refuse to intubate a patient unless they have adequate PPE? Should we offer bedside comfort to the elderly patient with possible Covid-19 who becomes increasingly delirious as unrecognizable health care workers speed in and out of the room while TV coverage of the pandemic drones on in the background? The clarion call of the profession — to put our patients’ needs above our own — is far less directive when meeting one patient’s needs may leave us too ill to care for the next.’

Read here (New England Journal of Medicine, May 28, 2020)

Call for clear face masks to be ‘the norm’

‘Standard face masks, which have become widespread as countries try to stop the spread of coronavirus, muffle words and obscure the mouth... Main dans la Main (Hand in Hand), an association which supports deaf and hearing impaired people in Chevrières, northern France, is among the organisations around the world that have created a mask with a transparent window... But one setting where homemade masks are not suitable - but where both PPE and communication are vital - is in hospitals. There is just one company in the US that has secured Food and Drug Administration (FDA) approval to make clear masks for clinical use.’

Read here (BBC, May 26, 2020)

The Guardian view on care work: A vocation that has been betrayed

‘The litany of government failures on social care during the Covid-19 emergency has become grimly familiar. But the mistakes bear repetition, as the latest figures record that close to 15,000 care home residents have died in England and Wales from the disease.

‘There is clear evidence that care homes were pressured into accommodating discharged hospital patients who had not been tested for coronavirus. Some turned out to be carrying it. Personal protective equipment was lethally slow to arrive. In some cases where homes did have functioning supply lines, these were commandeered to funnel PPE to hospitals. An absence of proper testing capacity meant care workers were operating in the dark as the virus spread. Access to hospital for residents was limited.’

Read here (The Guardian, May 19, 2020)

Coronavirus: Inside Wales’ largest hospital during pandemic

‘The constant low hum and whir of the ventilators keeping patients alive was punctuated by the urgent beep of monitors. Staff have to raise their voices to be heard here through the face masks and visors. They spend many long, hot hours in full PPE and leave with the marks of the shift on their faces.’

Read and view video here (BBC May 17, 2018)

‘The past six weeks have been unlike anything I’ve known’: A GP on how the pandemic has changed his work

‘It’s clear that though the lockdown has slashed transmission, it is provoking a silent epidemic of despair. Panic attacks, sleeplessness and plunging moods are all difficulties GPs are encountering daily – tough conversations to have at the best of times, but even tougher on the phone. Within our area of the city, we already know of suicides triggered by bankruptcies and business closures; and of marriages breaking down. Alcohol-induced injuries are up, as are injuries from assaults.’

Read here (The Guardian, May 12, 2020)

Access to lifesaving medical resources for African countries: COVID-19 testing and response, ethics, and politics

‘Having navigated Ebola, HIV, and tuberculosis epidemics, and a range of annual, sporadic, and concurrent outbreaks, several African countries have unparalleled disease response capacity. African governments are offering rare examples of effective international cooperation on COVID-19. The African Union started early to strengthen response with readiness assessments, an emergency ministerial meeting, and a continental strategy. However, with a highly transmissible and fast spreading virus these strengths can quickly be overwhelmed.’

Read here (The Lancet, May 7, 2020)

Major challenges remain in Covid-19 testing

‘The phrase “when we have adequate testing” has become the siren song within many conversations around return, namely in reopening the economy. Unfortunately, many of these conversations do not fully consider some critical issues around availability, test characteristics, and — importantly — test strategy. These issues suggest a need to rapidly consider other methods of protecting the population during reentry that can be implemented to complement testing. Such protective methods could include physical barriers, universal masking (while acknowledging supply-chain issues with personal protective equipment), and physical distancing in public spaces.’

Read here (Mckinsey & Co, May 2020)

FEMA prepares to send protective gear to nursing homes

‘The Federal Emergency Management Agency is preparing to send personal protective equipment to nursing homes, which have struggled to obtain gear weeks into the pandemic as the death toll climbs. A FEMA spokesperson told CNN the agency is preparing to coordinate shipments of PPE, like surgical masks, gowns and gloves, to nursing homes across the nation.

‘The move comes weeks into the coronavirus response and targets facilities hardest hit by the pandemic. Nursing homes have been particularly vulnerable to coronavirus in part because of the slice of the population they serve: elderly residents who, data suggests, may be at higher risk of the illness.’

Read here (CNN, April 29, 2020)

How the face mask became the world’s most coveted commodity

‘No object better symbolises the pandemic than the mask, and no object better explains the world into which the pandemic arrived. Social distancing, at first, felt like a strange notion: the inaction of it, the vagueness of it. But the mask sang out to our deepest consumeristic impulses. In the absence of a drug or a vaccine, the mask is the only material protection we can buy; it’s a product, and we’ve been trained like seals to respond to products. As a result, in every corner of every country, the humble face mask – this assembly of inexpensive plastic – has been elevated into a fetishised commodity. One mask broker described it as “a madhouse”, another as “the craziest market I’ve ever seen”...

‘Whatever the new normal is after this pandemic, everyone I spoke with agreed on one thing: there will be masks. Lots and lots of masks. They’ll be handed out on airlines and at hotels; they’ll be stacked next to the till at Boots; they’ll be stashed in sock drawers and linen closets in practically every home. Every country will produce and stockpile its own supply, unwilling to rely any more on the vagaries of the international market; Germany, forever ahead of the curve, has already begun.’

Read here (The Guardian, April 28, 2020)

Potential to develop a more effective cloth mask with finer weave, more layers and a better fit

This study, which compares the efficacy of cloth masks to medical masks in hospital healthcare workers (HCWs), says the following: ‘Cloth masks are used in resource-poor settings because of the reduced cost of a reusable option. Various types of cloth masks (made of cotton, gauze and other fibres) have been tested in vitro in the past and show lower filtration capacity compared with disposable masks.

‘The protection afforded by gauze masks increases with the fineness of the cloth and the number of layers, indicating potential to develop a more effective cloth mask, for example, with finer weave, more layers and a better fit.

‘Pandemics and emerging infections are more likely to arise in low-income or middle-income settings than in wealthy countries. In the interests of global public health, adequate attention should be paid to cloth mask use in such settings. The data from this study provide some reassurance about medical masks, and are the first data to show potential clinical efficacy of medical masks.’

Read here (NCBI, April 22, 2015)

US CDC, in the face of personal protection equipment (PPE) shortages, issues strategies to optimise the supply of PPEs

The strategies of the US Centers for Disease Control and Prevention (CDC) cover eye protection gear, isolation gowns, face masks, N95 respirators and reuse of filtering face respirators and ventilators.

‘CDC’s optimisation strategies for PPE offer options for use when PPE supplies are stressed, running low, or absent. Contingency strategies can help stretch PPE supplies when shortages are anticipated, for example if facilities have sufficient supplies now but are likely to run out soon. Crisis strategies can be considered during severe PPE shortages and should be used with the contingency options to help stretch available supplies for the most critical needs. As PPE availability returns to normal, healthcare facilities should promptly resume standard practices.’

Read here (CDC, April 22, 2020)

First UN solidarity flight departs Addis Ababa carrying vital COVID-19 medical supplies to all African nations

‘The first United Nations “Solidarity Flight” is scheduled to leave Addis Ababa, Ethiopia, today [April 14] - from there, the aircraft will transport the vital medical cargo to all countries in Africa, where supplies are desperately needed to contain the spread of COVID-19. WHO cargo is being  transported by the United Nations World Food Programme (WFP), and includes face shields, gloves, goggles, gowns, masks, medical aprons and thermometers, as well as ventilators.’

Read here (WHO, April 14, 2020)