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) 

Singapore researchers develop ‘smart mask’ that can monitor signs associated with Covid-19

‘Local scientists have developed an integrated monitoring system that can be easily attached to any face mask in order to monitor the wearer for health indicators associated with Covid-19. Sensors pick up skin temperature, blood oxygen saturation, blood pressure and heart rate - all of which are parameters associated with coronaviruses. Professor Loh Xian Jun, who is one of the scientists behind the invention, told The Straits Times on Thursday (Sept 10) that the inspiration for the system came around the circuit breaker period.’

Read here (Straits Times, Sept 10, 2020)

How to decide who should get a Covid-19 vaccine first

‘If and when a safe and effective COVID-19 vaccine is available, what is the fairest way to distribute it? In a policy report published on Thursday in Science, 19 public health experts laid out an ethical framework called the Fair Priority Model. It is geared toward three principles: benefiting people and limiting harm, prioritizing countries already disadvantaged by poverty or low life expectancy, and avoiding discrimination.

‘The report is critical of previously suggested vaccine allocation plans, including two proposed by the World Health Organization: one of them would distribute vaccines to each country according to its population size, and the other would prioritize health care workers and adults who are above age 65 or have underlying health conditions.’

Read here (Scientific American, Sept 3, 2020)

WHO urges nations to join global shared vaccine bid

 ‘The WHO wrote to every country on Tuesday (Aug 18) urging them to quickly join its global shared vaccine programme - and spelled out who would get its eventual coronavirus jabs first. The World Health Organisation's director-general Tedros Adhanom Ghebreyesus said that without vaccinating the planet's highest-risk populations simultaneously, it would be impossible to rebuild the global economy.

‘And he said the most exposed 20 per cent of each country's population - including front-line health workers, adults over 65 and those with pre-existing conditions - would be targeted in the first wave of vaccinations, once the WHO-led COVAX shared facility can roll out a proven safe and effective vaccine.’

Read here (Straits Times, August 18, 2020)

Seroprevalence study estimates 6% of Britain's population infected, higher among ethnic minorities and healthcare workers

‘Researchers at Imperial College London reported findings from a large seroprevalence study involving more than 100,000 participants in the UK... It estimates the overall UK seroprevalence to be 6.0%, which translates to approximately 3.36 million adult infections through June 20. For comparison, the UK has reported 313,798 cumulative cases to date, which corresponds to approximately 0.6% of the total UK adult population.’ -- John Hopkins e-newsletter.

‘The pandemic of SARS-CoV-2 infection in England disproportionately affected ethnic minority groups and health and care home workers. The higher risk of infection in these groups may explain, at least in part, their increased risk of hospitalisation and mortality from COVID-19.’ Conclusion of the study.

Download here (Imperial College Institute of Global Health Innovation, August 2020)

India’s coronavirus fight and lessons from my family’s struggle with TB in the 1950s

‘During the current Covid-19 pandemic, I often imagine Biji [mother], with her gritty countenance, asking total strangers why they are not wearing a mask, or reprimanding a group of people for not maintaining a minimum social distance. I had already seen her tackling several difficult situations. But how did she get to a position where she could extract compliance and discipline from people around her?

‘The odds were heavily loaded against Biji for most of her wedded life. She lost four children to infant mortality. When Taaya [father, later inflicted with TB and died aged 43] lost his job, she struggled to run our home by stitching clothes or knitting cane chairs. One day in 1956, we had no vegetables, lentils, potatoes or cooking oil left at home. She gave me a one-anna coin to go and buy 200 grams of raw tomatoes, sprinkled salt on them, and we ate them with chapattis (Indian bread).

‘Alone, she braved deprivation but rarely succumbed to hopelessness. Each hardship only made her more determined to face life in a bold, liberated and result-oriented manner...’

J V Yakhmi is a former chairman of the Atomic Energy Education Society in Mumbai and a retired associate director of the physics group at the Bhabha Atomic Research Centre.

Read here (South China Morning Post, August 7, 2020)

Coronavirus: Just 0.3% of cases in Singapore admitted to ICU

‘While Covid-19 cases in Singapore have surged past 50,000, only a tiny fraction of those who fell ill - just 128, or 0.3 per cent - have been admitted to the intensive care unit (ICU) as of Monday. Experts said years of investment in healthcare, as well as a well thought out and executed strategy to keep infection numbers low, have helped to ensure the Republic has one of the world's lowest ICU admission - and fatality - rates from Covid-19.’

Read here (Straits Times, July 31, 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)

Once-model states suffer response fatigue as Covid-19 surges in India

‘The city of Bangalore... was a model for the response to Covid-19 in India just last week. But infections have doubled in the first six days of July, crossing 10,000. With about 1,000 new infections a day, the famed tech city is now gripped by confusion about bed availability, disappearing medical staff, and falling rates of testing...

‘The neighbouring state of Kerala, which received international praise for its early and rigorous response to the pandemic that began with its - and India's - first case on January 30, is also showing signs of response fatigue.’

Read here (Straits Times, July 7, 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)

India's female Corona-warriors: Underpaid and unappreciated

‘Asha workers connect their communities with the public health system. While technically volunteers, they perform crucial tasks, including recording data about births, deaths, marriages and child immunisations; providing information about nutrition, sanitation, maternal and child health; accompanying pregnant women and sick children to health care centres; and helping treat diarrhoea, fevers and tuberculosis.

‘The Covid-19 outbreak added to their duties. Ashas are now expected to educate people about precautions against infection, monitor quarantined households, trace contacts of infected people and help with testing. They have no holidays.’

Read here (Straits Times, June 27, 2020)

Fearing second Covid-19 wave, Europe aims to train ‘army’ of medics

‘Europeans are enjoying the gradual easing of coronavirus lockdown measures, but in hospitals, they are already preparing for the next wave of infections. Some intensive care specialists are trying to hire more permanent staff. Others want to create a reservist "army" of medical professionals ready to be deployed wherever needed to work in wards with seriously ill patients. European countries have been giving medics crash courses in how to deal with Covid-19 patients, and are now looking at ways to retrain staff to avoid shortages of key workers if there is a second wave of the novel coronavirus.’

Read here (Straits Times, June 22, 2020)

I'm an ICU doctor treating coronavirus patients. But somehow I'm not angry

‘Sometimes I wonder if my lack of anger means I don’t care enough; if I’ve been worn down by ventilators being turned off, patients dying, families asking for a final call. Perhaps emotions overwhelm and suffocate each other in such a situation, leaving no air for something as indulgent as anger. Perhaps my anger couldn’t compete with the humility of knowing that until early March, I and every doctor I knew had predicted that this virus posed little threat beyond a bad seasonal flu. Like my better judgment, perhaps my anger had lost.’

Read here (The Guardian, June 11, 2020)

Unsung heroines: Who cares for the carers?

Even before Covid-19, the world was facing a care crisis. The plight of often neglected, under-appreciated, under-protected and poorly equipped ‘frontline’ health personnel working to contain the pandemic has drawn attention to the tip of the care crisis iceberg. Oxfam’s annual early 2020 Davos report, Time to Care, estimates that 2.3 billion people will need care by 2030, 200 million more than in 2015, including 100 million more older people and an additional 100 million children aged 6 to 14 years.

Read here (IPS News, June 11, 2020)

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)

There are coronavirus solutions for resource-poor countries, too

‘No country, let alone poor countries, can afford to risk the health of, or indeed, drive away precious healthcare workers. Rather than put them at risk of infection, and in turn, risk infecting their patients, governments should consider alternatives. In this respect, Rwanda showed leadership. Their whole-of-government approach included: deterring people with suspected COVID-19 infections from coming to health facilities unless seriously unwell; minimising contact between health workers and infected patients; and focusing on prevention and care within communities.

‘The good news is that following decades of investments, many resource-poor countries have fleets of community-based health workers (CHWs). These workers deliver door-to-door services and know their communities well.’

Read here (Aljazeera, May 29, 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)

What Wuhan’s frontline medical workers can teach the world about the Covid-19 mental health battle

Key points: ‘The war against Covid-19 has left many Chinese health care workers suffering from depression, anxiety, insomnia and distress. Support from coworkers and the wider community provided a lifeline during the darkest of times.’

Read here (South China Morning Post, May 19, 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)

Guide for Covid-19 prevention in aged residential care facilities — Amar-Singh HSS, Vivienne Yong and Liew Tuan Hock

‘Older individuals in residential care need to be shielded from the risk of getting coronavirus infection. The key will be to try and create a bubble (a shield) in which the residents and staff live and operate, so as to minimise new individuals and infection entering the group. This guide and standard operating policy (SOP) aims to help offer ideas and initiatives that could be taken.

‘The guide covers the areas to consider with suggestions for improving Covid-19 prevention. It looks at policy, staff, residents, healthcare workers/therapists and visitors policies. The guide will be useful for nursing homes, old folks homes, retirement villages, palliative care facilities and also relevant to other residential care facilities for any age. It is relevant to non-governmental, private and governmental facilities.’

The full Aged Residential Care Facilities Guide is available for download and use from this link.

Read here (Malay Mail, May 18, 2020)