(MENAFN – Gulf Times) The World Health Organisation cautioned years ago that a mysterious ”disease X could spark an international contagion. The new coronavirus, with its ability to quickly morph from mild to deadly, is emerging as a contender. From recent reports about the stealthy ways the so-called Covid-19 virus spreads and maims, a picture is emerging of an enigmatic pathogen whose effects are mainly mild, but which occasionally and unpredictably turns deadly in the second week. In less than three months, it”s infected about 77,000 people, mostly in China, and killed more than 2,200. ”Whether it will be contained or not, this outbreak is rapidly becoming the first true pandemic challenge that fits the disease X category, Marion Koopmans, head of viroscience at Erasmus University Medical Center in Rotterdam, and a member of the WHO”s emergency committee, wrote on Wednesday in the journal Cell. The disease has now spread to more than two dozen countries and territories. Some of those infected caught the virus in their local community and have no known link to China, the US Centers for Disease Control and Prevention said. ”We are not seeing community spread here in the US yet, but it”s very possible – even likely – that it may eventually happen, Nancy Messonnier, director of the CDC”s National Center for Immunization and Respiratory Diseases, told reporters on Friday. Unlike Sars, its viral cousin, the COVID-19 virus replicates at high concentrations in the nose and throat akin to the common cold, and appears capable of spreading from those who show no, or mild, symptoms. That makes it impossible to control using the fever-checking measures that helped stop Sars 17 years ago.
Spreading surreptitiously A cluster of cases within a family living in the Chinese city of Anyang is presumed to have begun when a 20-year-old woman carried the virus from Wuhan, the outbreak”s epicentre, on January 10 and spread it while experiencing no illness, researchers said on Friday in the Journal of the American Medical Association. Five relatives subsequently developed fever and respiratory symptoms. Covid-19 is less deadly than Sars, which had a case fatality rate of 9.5%, but appears more contagious. Both viruses attack the respiratory and gastrointestinal tracts, via which they can potentially spread. While more than 80% of patients are reported to have a mild version of the disease and will recover, about one in seven develops pneumonia, difficulty breathing and other severe symptoms. About 5% of patients have critical illness, including respiratory failure, septic shock and multi-organ failure. ”Unlike Sars, COVID-19 infection has a broader spectrum of severity ranging from asymptomatic to mildly symptomatic to severe illness that requires mechanical ventilation, doctors in Singapore said in a paper in the same medical journal on Thursday. ”Clinical progression of the illness appears similar to Sars: patients developed pneumonia around the end of the first week to the beginning of the second week of illness.
Unpredictable illness Older adults, especially those with chronic conditions, such as hypertension and diabetes, have been found to have a higher risk of severe illness. Still, ”the experience to date in Singapore is that patients without significant co-morbid conditions can also develop severe illness, they said. Li Wenliang, the 34-year-old ophthalmologist who was one of the first to warn about the coronavirus in Wuhan, died earlier this month after receiving antibodies, antivirals, antibiotics, oxygen and having his blood pumped through an artificial lung. The doctor, who was in good health prior to his infection, appeared to have a relatively mild case until his lungs became inflamed, leading to the man”s death two days later, said Linfa Wang, who heads the emerging infectious disease programme at Duke-National University of Singapore Medical School. A similar pattern of inflammation noted among Covid-19 patients was observed in those who succumbed to the 1918 ”Spanish flu pandemic, said Gregory A Poland, the Mary Lowell Leary emeritus professor of medicine, infectious diseases, and molecular pharmacology and experimental therapeutics at the Mayo Clinic in Rochester, Minnesota. ”Whenever, you have an infection, you have a battle going on, Poland said in a phone interview on Thursday. ”And that battle is a battle between the damage that the virus is doing, and the damage the body can do when it tries to fight it off.
Mild symptoms Doctors studying a 50-year-old man who died in China last month found Covid-19 gave him mild chills and dry cough at the start, enabling him to continue working. But on his ninth day of illness, he was hospitalised with fatigue and shortness of breath, and treated with a barrage of germ-fighting and immune system-modulating treatments. He died five days later with lung damage reminiscent of SARS and MERS, another coronavirus-related outbreak, doctors at the Fifth Medical Center of PLA General Hospital in Beijing said in a February 16 study in the Lancet medical journal. Blood tests showed an over-activation of a type of infection-fighting cell that accounted for part of the ”severe immune injury he sustained, the authors said. Controversially, he had been given 80 milligrams twice daily of methylprednisolone, an immune-suppressing corticosteroid drug that”s in common use in China for severe cases, though has been linked to ”prolonged viral shedding in earlier studies of MERS, Sars and influenza, according to the WHO. The patient”s doctors recommended corticosteroids be considered alongside ventilator support for severely ill patients to prevent a deadly complication known as acute respiratory distress syndrome. He was given at least double what would typically be recommended for patients with the syndrome and other respiratory indications, said Reed Siemieniuk, a general internist and a health research methodologist at McMaster University in Hamilton, Ontario. Based on what was observed with Mers, the drug may delay viral clearance in Covid-19 patients, he said. ”Corticosteroids could cause more harm than good because of that risk, Siemieniuk said in an interview. ”I wouldn”t want to let a patient die without trying steroids, but I would wait until patients were extremely ill.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
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