Is Sweden's coronavirus strategy a cautionary tale or a success story?

‘Sweden was one of the few European countries not to impose a compulsory lockdown. Its unusual strategy for tackling the coronavirus outbreak has been both hailed as a success and condemned as a failure. So which is it? Those who regard the strategy as a success claim it reduced the economic impact, but it isn’t clear that it did. What is clear is that so far Sweden has had a more protracted outbreak with far more deaths per capita than its neighbours.

‘While it is sometimes implied that Sweden didn’t have a lockdown, it did. It was just largely voluntary, with only a few legal measures such as a ban on gatherings of more than 50 people. “Voluntary restrictions work as well as legal ones,” says the architect of Sweden’s strategy, chief epidemiologist Anders Tegnell.

Read here (New Scientist, August 13, 2020) 

Mandated Bacillus Calmette-Guérin (BCG) vaccination predicts flattened curves for the spread of COVID-19

‘Our analysis shows that mandatory BCG vaccination is associated with a flattening of the curve in the spread of COVID-19. The effect we demonstrate is quite substantial. For example, our model estimates that the total number of COVID-19–related deaths in the United States as of 29 March 2020 would have been 468—19% of the actual figure (2467)—if the United States had instituted the mandatory BCG vaccination several decades earlier.’

Read here (Advances Science, August 5, 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)

What the D614G mutation means for Covid-19 spread, fatality, treatment, and vaccine

‘We are facing the global shift of the SARS-CoV-2 variant — from D614 to G614. The G614 variant is more infectious in laboratory settings; whether it means increased viral spread in humans is unconfirmed. Current evidence says that the G614 variant is not any deadlier than D614. And so, treatment options should not be any more different. Both the D614 and G614 variants should react similarly to vaccines, studies suggest, as the mutation does not change the immunogenic part of the spike protein; that is, the receptor-binding domain (RBD).’

[This is a survey of literature by a young post-grad Malaysian. It gives a rounded picture of the D614G mutation without using too much jargon. Must counter check the accuracy of what's stated against the originals.] 

Read here (Medium, July 31, 2020)

Care homes and Covid-19 deaths: An opportunity to cut down mortality rates

‘The impact of COVID-19 on care home residents has been very different internationally, with some countries reporting no deaths (or infections) in care homes, such as Hong Kong, Jordan and Malta, and two countries reporting that over 80% of COVID-19 deaths were of care home residents. Without including the three countries with zero deaths, and with the caveat that the definitions used vary, on average the share of all COVID-19 deaths that were care home residents is 47% (based on 26 countries).’

Read here (International Long-term Care Policy Network, June 26, 2020)

What is the true death toll of the pandemic?

‘At least another 130,000 people worldwide have died during the coronavirus pandemic on top of 440,000 officially recorded deaths from the virus, according to BBC research. A review of preliminary mortality data from 27 countries shows that in many places the number of overall deaths during the pandemic has been higher than normal, even when accounting for the virus.’

Read here (BBC, June 19, 2020)

Dexamethasone proves to be life-saving drug

‘A cheap and widely available drug can help save the lives of patients seriously ill with coronavirus. The low-dose steroid treatment dexamethasone is a major breakthrough in the fight against the deadly virus, UK experts say...

‘It cut the risk of death by a third for patients on ventilators. For those on oxygen, it cut deaths by a fifth. Had the drug had been used to treat patients in the UK from the start of the pandemic, up to 5,000 lives could have been saved, researchers say. And it could be of huge benefit in poorer countries with high numbers of Covid-19 patients.’

Read here (BBC, June 16, 2020)

To understand who’s dying of Covid-19, look to social factors like race more than preexisting diseases

‘The Sutter and MIT studies cast doubt on whether individual risk factors are as important as social determinants of health in affecting someone’s chances of contracting severe and even fatal Covid-19. “It should cause us to ask a different set of questions about what puts you at risk of hospitalization or death,” Schwalbe said.

‘More and more evidence is pointing to social determinants of risk, which puts the role of underlying health conditions in a new light. “Comorbidities are still used to blame people for how hard they are hit by Covid-19,” said Philip Alberti, senior director for health equity research at the AAMC. To reduce the U.S. death toll now that many states are seeing a new surge in cases, he said, “our response to this disease” must look beyond the strictly medical.’

Read here (STAT News, June 15, 2020)

Pandemic exposes systemic staffing problems at US nursing homes - Special report by Reuters

‘In the United States, longstanding problems with staffing shortages and chronic turnover have left nursing homes especially exposed. An estimated 40% of the country’s more than 100,000 COVID-19 deaths are connected to long-term care facilities such as nursing homes or assisted-living centers, according to a Kaiser Family Foundation tally.

‘About a quarter of nursing homes responding to a recent federal survey reported shortages of direct-care staff during at least one of the last two weeks in May, according to a Reuters analysis of survey data from the Centers for Medicare and Medicaid Services.’

Read here (Reuters, June 10, 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)

Scientist defends Sweden’s hotly debated virus strategy

‘Sweden’s chief epidemiologist on Wednesday defended his country’s controversial coronavirus strategy, which avoided a lockdown but resulted in one of the highest per capita COVID-19 death rates in the world... “We still believe that our strategy is good, but there is always room for improvement. ... You can always get better at this job,” [Anders] Tegnell told a news conference in Stockholm.

‘According to the national health agency, Sweden, a nation of 10.2 million people, has seen 4,542 deaths linked to COVID-19, which is far more than its Nordic neighbors and one of the highest per capita death rates in the world. Denmark has had 580 coronavirus deaths, Finland has seen 320 and Norway has had 237, according to a tally by Johns Hopkins University.’

Read here (Associated Press, June 3, 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)

The coronavirus slayer! How Kerala's rock star health minister helped save it from Covid-19

‘On 20 January, KK Shailaja phoned one of her medically trained deputies. She had read online about a dangerous new virus spreading in China. “Will it come to us?” she asked. “Definitely, Madam,” he replied. And so the health minister of the Indian state of Kerala began her preparations.

‘Four months later, Kerala has reported only 524 cases of Covid-19, four deaths and – according to Shailaja – no community transmission. The state has a population of about 35 million and a GDP per capita of only £2,200. By contrast, the UK (double the population, GDP per capita of £33,100) has reported more than 40,000 deaths, while the US (10 times the population, GDP per capita of £51,000) has reported more than 82,000 deaths; both countries have rampant community transmission.’

Read here (The Guardian, May 14, 2020)

How to make sense of all the Covid-19 projections? A new model combines them

‘The [University of Massachusetts Amherst] team unveiled the first version four weeks ago and ever since has been adding in more forecasts and updating the projections weekly. The latest update — released Tuesday — incorporates eight models, including some oft-cited ones, such as those built by the Imperial College London, the University of Washington Institute for Health Metrics and Evaluation, Columbia University and Northeastern University. (The team also sends each week's release to the CDC, which publishes a version with a slight time lag.)

‘The projections vary substantially — with the most pessimistic forecasting a total death toll of 120,000 by June 6 and the most optimistic forecasting 103,000 deaths by that date. But the models have been inching closer to each other. Over the past several weeks, the distance between the highest and lowest estimates has halved from a gap of 36,000 deaths two weeks ago to a gap of 17,000 deaths in the most recent update released Tuesday.’

Read here (NPR or National Public Radio, US, May 13, 2020)

Study warns 1.1 million children, 56,000 mothers, could die as pandemic interrupts access to food & medical care

A new report finds 1.1 million children under 5 could die, and 56,700 maternal deaths occur, in the next six months from secondary impacts of the pandemic, like disruptions to health services and access to food... ‘Our most severe scenario (coverage reductions of 39·3–51·9% and wasting increase of 50%) over 6 months would result in 1,157,000 additional child deaths and 56,700 additional maternal deaths.’

Read here (The Lancet, May 12, 2020)

COVID-19 death rate sinking? Data reveals a complex reality

‘David Spiegelhalter, Professor of Public Understanding of Risk from the University of Cambridge, notes the differences in each country: "I would say the all-cause death number is the really unbiased measure of the impact of this epidemic. And it's the one I look up far more closely," he told DW. Data collected by DW both on all-cause deaths and COVID-19 deaths shows: Thousands more people are dying directly or indirectly due to COVID-19 than the official numbers suggest. DW's data analysis focused on Spain, England and Wales, but indicates a pattern present in other countries too.’

Read here (DW, May 7, 2020)

Shocking draft FEMA report sees 200,000 Covid-19 cases, 3,000 deaths daily by June 1

‘The shocking numbers come just as dozens of states begin to drop strict social distancing requirements and open businesses to workers and customers at President Donald Trump’s urging. A rate of 3,000 deaths a day would be about 90,000 deaths a month. That death toll rate would be a 70% increase from the current average of 1,750 a day. The number of current cases of COVID-19 in the nation is about 25,000 daily.’

Read here (Huffington Post, May 5, 2020). Download here

Covid-19 in rural America – Is there cause for concern?

‘Less densely populated rural areas initially saw slower spread of the new coronavirus, and both cases and deaths remain lower in non-metro areas than metro areas. However, there are troubling signs that the rates of growth in both cases and deaths are increasing more rapidly in rural areas, where the population tends to be older, younger people are more likely to have-risk health conditions, and hospitals have fewer ICU beds per capita.’

Read here (KFF, April 30, 2020)

Third of UK Covid-19 patients taken to hospital die, study finds. ‘On par with Ebola’

‘A third of patients admitted to hospital in the UK with Covid-19 are dying, according to a major study whose authors said the observed death rates put the illness on a par with Ebola. The study tracked the outcomes of nearly 17,000 patients – around one-third of all those admitted to hospital in the UK – and found that 33% had died, 49% were discharged and 17% were still receiving treatment after two weeks. The figures present a stark picture of outcomes for those whose illness escalates to the point of needing medical help.’

Read here (The Guardian, April 29, 2020)

US deaths soared in early weeks of pandemic, far exceeding number attributed to covid-19

‘In the early weeks of the coronavirus epidemic, the United States recorded an estimated 15,400 excess deaths, nearly two times as many as were publicly attributed to covid-19 at the time, according to an analysis of federal data conducted for The Washington Post by a research team led by the Yale School of Public Health.

‘The excess deaths are not necessarily attributable directly to covid-19, the disease caused by the coronavirus. They could include people who died because of the epidemic but not from the disease, such as those who were afraid to seek medical treatment for unrelated illnesses, as well as some number of deaths that are part of the ordinary variation in the death rate. The count is also affected by increases or decreases in other categories of deaths, such as suicides, homicides and motor vehicle accidents.’

Read here (Washington Post April 27, 2020)