Countries should meet these five criteria before easing lockdowns, study says. Many aren't even close

‘Countries should not ease coronavirus lockdown restrictions until they meet five criteria -- and many nations are not even close, according to a new analysis published in The Lancet medical journal. The research, published Thursday, said that the prerequisites for easing Covid-19 measures are: knowledge of infection status, community engagement, adequate public health capacity, adequate health system capacity and border controls.

‘The authors looked at nine high-income countries and territories that have started to relax restrictions -- Hong Kong, Japan, New Zealand, Singapore, South Korea, Germany, Norway, Spain and the UK. They found that many governments had failed to meet the criteria necessary to avoid new waves of infection, as seen in Spain, Germany and the UK.’

Read here (CNN, Sept 25, 2020)

The Covid silver linings playbook

• The first is that we are living through one of the most exciting and promising periods of medical invention and innovation in history. 
• Second, deeper cross-border private-sector collaboration, often outside the purview of governments, is fueling this process of scientific leapfrogging.
• Third, the economic disruptions resulting from the pandemic have fueled multiple private-sector efforts to collect and analyze a broader range of high-frequency data in domains extending far beyond medicine. 
• Fourth, the COVID-19 shock has raised our collective awareness and sensitivity to low-probability, high-impact “tail risks.”
• Fifth silver lining... The pandemic has led country after country to run a series of “natural experiments,” which have shed light on a host of issues that go well beyond health and economics.
• Finally, the crisis has required many companies to hold candid conversations about work-life balance, and to devise innovative solutions to accommodate employees’ needs.

Read here (Project Syndicate, Sept 15, 2020) 

What happens if China gets the Covid-19 vaccine first?

‘Fidler [David Fidler, an expert on global health and national security who has consulted for the WHO and the Centers for Disease Control and Prevention] thinks it’s too much to hope that geopolitics can stop interfering with public health. The current clash between the U.S. and China means the era of U.S.-led altruistic health initiatives done without the motivation of power over a rival, like President George W. Bush’s PEPFAR program to fight infectious diseases in Africa, is over. Today, great powers will try to press their advantage in whatever ways they can.

‘But China and the U.S. can try to keep the competition from spiraling out of control and destroying public health in its wake. In past eras of multipolar rivalry, antagonists have been able to set limits to that competition, singling out certain areas in which they can turn down the heat and cooperate a bit more. The U.S. and China could do that today, Fidler suggests, perhaps by agreeing to take their hands off the WHO.

‘That needs to happen soon. Because right now, nothing is off-limits—which means neither is the destruction of decades worth of public health norms. “If we don’t have some sort of global health détente between Beijing and Washington,” warns Fidler, “we’re in real trouble.”

Read here (Politico, August 31, 2020) 

Tech companies are transforming people’s bedrooms into ‘virtual hospitals.’ Will it last Post-Covid?

‘Telehealth advocates say now is the time to act. A range of virtual offerings could be revolutionary for patients who are seriously sick, need long-term care, or live in rural areas, where hospital closings have left millions of Americans without easy access to treatment. “The environment in a hospital, although it’s very conducive to high intensity care, is not that conducive to being able to engage in normal activities of daily living that might be actually important for recovery,” says Dr. Michael Apkon, president and CEO of Tufts Medical Center...

‘Telehealth can also play an important role in helping patients before they reach the point of needing hospital care. When non-urgent procedures were canceled during the early months of the pandemic, many Americans turned to virtual visits to keep up with routine treatment and ask for guidance from health care providers before venturing into offices.’

Read here (Time, August 10, 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)

How the pandemic defeated America

‘It is hard to stare directly at the biggest problems of our age. Pandemics, climate change, the sixth extinction of wildlife, food and water shortages—their scope is planetary, and their stakes are overwhelming. We have no choice, though, but to grapple with them. It is now abundantly clear what happens when global disasters collide with historical negligence.

‘COVID‑19 is an assault on America’s body, and a referendum on the ideas that animate its culture. Recovery is possible, but it demands radical introspection. America would be wise to help reverse the ruination of the natural world, a process that continues to shunt animal diseases into human bodies. It should strive to prevent sickness instead of profiting from it. It should build a health-care system that prizes resilience over brittle efficiency, and an information system that favors light over heat. It should rebuild its international alliances, its social safety net, and its trust in empiricism. It should address the health inequities that flow from its history. Not least, it should elect leaders with sound judgment, high character, and respect for science, logic, and reason.

‘The pandemic has been both tragedy and teacher. Its very etymology offers a clue about what is at stake in the greatest challenges of the future, and what is needed to address them. Pandemic. Pan and demos. All people.’

Read here (The Atlantic, August 4, 2020)

WHO warns of long road ahead, may never be a ‘silver bullet’

‘The World Health Organisation warned on Monday that there might never be a “silver bullet” for Covid-19 in the form of a perfect vaccine, and that the road to normality will be long, with some countries requiring a reset of strategy. WHO director general Tedros Adhanom Ghebreyesus and WHO emergencies head Mike Ryan exhorted nations to rigorously enforce health measures such as mask-wearing, social distancing, handwashing, contact tracing and testing. “For now, stopping outbreaks comes down to the basics of public health and disease control. The message to people and governments is clear: ‘Do it all’,” Tedros told a virtual news briefing from the UN body’s headquarters in Geneva.’

Read here (South China Morning Post, August 3, 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)

Inside the global quest to trace the origins of Covid-19 — and predict where it will go next

‘It has been 100 years since an infectious disease pushed the entire world’s population into hiding to the extent that COVID-19 has. And the primary approaches we take to combatting emerging microbes today are likewise centuries old: quarantine, hygiene and social distancing. We may never learn exactly where SARS-CoV-2 came from, and it’s clearly too late to prevent it from becoming a global tragedy. But extraordinary advances in scientific knowledge have given us new tools, like genetic sequencing, for a more comprehensive understanding of this virus than anyone could have imagined even a decade or two ago. These are already providing clues about how emerging viruses like SARS-CoV-2 operate and, most important, how they can be thwarted with more effective drugs and vaccines.’

Read here (Time Magazine, July 23, 2020)

Dr Anthony Fauci warns the coronavirus won’t ever be eradicated

‘White House coronavirus advisor Dr. Anthony Fauci said Wednesday it is unlikely the coronavirus will ever be eradicated. While the virus will not disappear, it’s possible world leaders and public health officials could work to bring the virus down to “low levels,” the director of the National Institute of Allergy and Infectious Diseases said during an interview with the TB Alliance.

“I think with a combination of good public health measures, a degree of global herd immunity and a good vaccine, which I do hope and feel cautiously optimistic that we will get, I think when we put all three of those together, we will get control of this, whether it’s this year or next year. I’m not certain,” he said.’

Read here (CNBC, July 22, 2020)

Will medical tourism survive Covid-19?

‘Treatment in Asia is up to 90% cheaper than private healthcare in the US. According to the MHTC [Malaysia Healthcare Travel Council], a coronary artery bypass graft that would cost $92 000 in the US, costs less than $10 000 in India, for example. Coupled with a steep reduction in the cost of long haul air travel, the region has successfully broadened the appeal of medical tourism beyond just the most affluent customers.

‘But all that was before the pandemic. The uncertainty of covid-19, lockdowns, border restrictions, and social distancing has stalled international travel. The UN World Tourism Organisation estimates that the travel industry could decline by 60% to 80% by the end of 2020, calling it the “worst crisis that international tourism has faced since records began.” It says Asia and the Pacific have been the regions hardest hit, with a loss of 33 million tourists.’

Read here (BMJ, July 10, 2020)

School openings across globe suggest ways to keep coronavirus at bay, despite outbreaks

“Outbreaks in schools are inevitable,” says Otto Helve, a pediatric infectious disease specialist at the Finnish Institute for Health and Welfare. “But there is good news.” So far, with some changes to schools’ daily routines, he says, the benefits of attending school seem to outweigh the risks—at least where community infection rates are low and officials are standing by to identify and isolate cases and close contacts.

This article discusses the following:

• How likely are children to catch and transmit the virus?
• Should children play together?
• Should kids wear masks?
• What should schools do when someone tests positive?
• Do schools spread the virus to the wider community?
• What lies ahead?

Read here (Science Magazine, July 7, 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)

‘Fighting Covid-19: China in action’

China's State Council Information Office published on June 7, 2020, a 65-page white paper to ‘keep a record of China’s efforts in its own fight against the virus, to share its experience with the rest of the world, and to clarify its ideas on the global battle.’

Read here (XinHua, June 7, 2020)

Covid-19 significantly impacts health services for noncommunicable diseases

“The results of this survey confirm what we have been hearing from countries for a number of weeks now,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “Many people who need treatment for diseases like cancer, cardiovascular disease and diabetes have not been receiving the health services and medicines they need since the COVID-19 pandemic began. It’s vital that countries find innovative ways to ensure that essential services for NCDs continue, even as they fight COVID-19.”

Read here (WHO, June 1, 2020)

Rapid assessment of service delivery for NCDs during the Covid-19 pandemic (PDF). Download here

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)

Why are Africa's coronavirus successes being overlooked?

‘Take the two African countries I have called home – Senegal and Ghana... Senegal is in a good position because its Covid-19 response planning began in earnest in January, as soon as the first international alert on the virus went out... As a result, this nation of 16 million people has had only 30 deaths... Ghana, with a population of 30 million, has a similar death toll to Senegal, partly because of an extensive system of contact tracing, utilising a large number of community health workers and volunteers, and other innovative techniques such as “pool testing”, in which multiple blood samples are tested and then followed up as individual tests only if a positive result is found. The advantages in this approach are now being studied by the World Health Organization.’

Read here (The Guardian, May 21, 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)

What does recovery from Covid-19 look like?

“Eighty to 85% of our patients who are infected do not need to be hospitalized, but they do require monitoring and medical care, most of which is now taking place with telehealth,” Dr. Ellman says. He says it’s typical for these patients to have a telehealth appointment, either on phone or video, at least every other day for 10 to 14 days from the onset of symptoms...

“Generally speaking, most patients can be managed outside of the hospital,” Dr. Sofair says. “But if you start to get sicker, early treatment can prevent complications. If you do need to be admitted to the hospital, that does not mean you will get really sick. Only a minority of patients end up in the ICU. We have had many good outcomes, and our doctors and nurses now have experience treating this.”

Read here (Yale Medicine, May 18, 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)