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Obesity, diabetes raise Covid-19 death risk – Hindustan Times

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Young adults with the coronavirus disease (Covid-19) usually get mild symptoms, but risks of complications and death rise significantly for people under 35 with obesity, hypertension and diabetes, according to a new research.

An analysis of clinical profiles of 3,222 young adults (aged 18-34 years; mean age of 28.3 years) hospitalised for Covid-19 between April 1 and June 30 in 419 hospitals in the US revealed that 21% of them needed intensive care, 10% required mechanical ventilation, and 2.7% died.

Morbid obesity, diabetes and hypertension were the most common risk factors in young adults, with those having more than one of these conditions facing risks comparable to older adults having no pre-existing illnesses, reported a study published in JAMA Internal Medicine, which is the journal of the American Medical Association.

The study found that 36.8% of hospitalised young adults were obese, 24.5% were morbidly obese, 18.2% had diabetes, and 16.1% had hypertension (morbid obesity, hypertension and being male are associated with greater risk of mechanical ventilation and death).

In India too, men with Covid-19 are twice more likely to die than women, with men accounting for 69% of all deaths, reveals health ministry data. People under 40 with Covid-19 account for fewer than 10% of total Covid-19 deaths in India, with deaths being the highest in the 61-70 years age group in both genders.

“People under 40 usually have mild disease and most cases can be managed at home or in Covid Care Homes. Those who are hospitalised almost always have co-morbidities like obesity, diabetes and hypertension, and less than 5% need ICU admission. But if they do and are put on ventilator, their vascular risk increases and their chances of getting a heart attack or stroke becomes the same as older adults,” said Dr Yatin Mehta, chairman Institute of Critical Care and Anaesthesiology, Medanta The Medicity, Gurugram.

Covid-19 has also been called a vascular disease as it leads to the formation of blood clots in arteries and veins, which can block blood supply to the heart, brain and lungs and lead to stroke, heart attack and respiratory failure.

“If you are obese, you are likely to be diabetic or have hypertension, and vice versa, so the risk is compounded,” said Dr Mehta.

The progression of Covid-19-induced thrombosis is very rapid in young adults, with deaths often occurring within 24 hours of hospitalisation. “Older adults die of pneumonia and other Covid-19-related complications, but sudden, unexpected death is more common in young adults in their 20s and 30s, whose condition dips very rapidly. In such cases, the cause of death is usually cardiovascular, with abnormal clotting in brain, lungs and heart leading to cardiac arrest,” said Dr Shiv K Sarin, director, Institute of Liver and Biliary Sciences, New Delhi.

At Max SuperSpecialty in New Delhi’s Saket, people under 40 account for less than 4.5% deaths, with 29% deaths occurring in those between 40 and 59 years old, and 47% deaths in the 60-74 age group.

Those over 75 years account for 18% deaths at the hospital. “Young people have mild disease and rarely need hospitalsiation, but they need to be isolated to break the chain of infection, which makes testing, tracking and treating important, as does social distancing and wearing masks,” said Dr Sandeep Budhiraja, clinical director, Max Healthcare.

“We should not look at the absolute number of cases and deaths; those will always be high, given India’s large population. What we must look at is deaths per million, and India has 56 deaths per million compared to 596 for the US and 61 for Brazil, which remain far lower than other countries even if you factor in some amount of under-reporting…,” said Dr Budhiraja.

Four young adults, the takeaway is that those with obesity, diabetes, and hypertension share the same risks as older adults. So they must seek Covid-19 treatment under supervision from the moment they get their test results.

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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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.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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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.

The Canadian Press. All rights reserved.

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