Connect with us

Health

The coronavirus is unstoppable.

Published

on

<!–

–>

Residents of Casalpusterlengo, an Italian town under lockdown, line up to enter a supermarket.

 

MIGUEL MEDINA/AFP via Getty Images

The global march of COVID-19 is beginning to look unstoppable. In just the past week, a countrywide outbreak surfaced in Iran, spawning additional cases in Iraq, Oman, and Bahrain. Italy put 10 towns in the north on lockdown after the virus rapidly spread there. An Italian physician carried the virus to the Spanish island of Tenerife, a popular holiday spot for northern Europeans, and Austria and Croatia reported their first cases. Meanwhile, South Korea’s outbreak kept growing explosively and Japan reported additional cases in the wake of the botched quarantine of a cruise ship.

The virus may be spreading stealthily in many more places. A modeling group at Imperial College London has estimated that about two-thirds of the cases exported from China have yet to be detected.

The World Health Organization (WHO) still avoided using the word “pandemic” to describe the burgeoning crisis today, instead talking about “epidemics in different parts of the world.” But many scientists say that regardless of what it’s called, the window for containment is now almost certainly shut. “It looks to me like this virus really has escaped from China and is being transmitted quite widely,” says Christopher Dye, an epidemiologist at the University of Oxford. “I’m now feeling much more pessimistic that it can be controlled.” In the United States, “disruption to everyday life might be severe,” Nancy Messonnier, who leads the coronavirus response for the U.S. Centers for Disease Control and Prevention, warned on 25 February. “We are asking the American public to work with us to prepare for the expectation that this is going to be bad.”

“Border measures will not be as effective or even feasible, and the focus will be on community mitigation measures until a vaccine becomes available in sufficient quantities,” says Luciana Borio, a former biodefense preparedness expert at the U.S. National Security Council who is now vice president at In-Q-Tel, a not-for-profit venture capital firm. “The fight now is to mitigate, keep the health care system working, and don’t panic,” adds Alessandro Vespignani, an infectious disease modeler at Northeastern University. “This has a range of outcomes from the equivalent of a very bad flu season to something that is perhaps a little bit worse than that.”Dye and others say it’s time to rethink the public health response. So far, efforts have focused on containment: slowing the spread of the virus within China, keeping it from being exported to other countries, and, when patients do cross borders, aggressively tracing anyone they were in contact with and quarantining those people for 2 weeks. But if the virus, named SARS-CoV-2, has gone global, travel restrictions may become less effective than measures to limit outbreaks and reduce their impact, wherever they are—for instance, by closing schools, preparing hospitals, or even imposing the kind of draconian quarantine imposed on huge cities in China.

Public health experts disagree, however, about how quickly the travel restrictions that have marked the first phase of the epidemic should be loosened. Early this week, the total number of cases stood at more than 80,000 with 2705 deaths—with 97% of the total still in China. Some countries have gone so far as to ban all flights to and from China; the United States quarantines anyone who has been in hard-hit Hubei province and refuses entry to foreign nationals if they have been anywhere in China during the past 2 weeks. Several countries have also added restrictions against South Korea and Iran.

The restrictions have worked to some degree, scientists say. “If we had not put a travel restriction on, we would have had many, many, many more travel-related cases than we have,” says Anthony Fauci, who heads the U.S. National Institute of Allergy and Infectious Diseases.

But many epidemiologists have claimed that travel bans buy little extra time, and WHO doesn’t endorse them. The received wisdom is that bans can backfire, for example, by hampering the flow of necessary medical supplies and eroding public trust. And as the list of affected countries grows, the bans will become harder to enforce and will make less sense: There is little point in spending huge amounts of resources to keep out the occasional infected person if you already have thousands in your own country. The restrictions also come at a steep price. China’s economy has already taken an enormous hit from COVID-19, as has the airline industry. China also exports many products, from pharmaceuticals to cellphones, and manufacturing disruptions are causing massive supply chain problems.

“It would be very hard politically and probably not even prudent to relax travel restrictions tomorrow,” says Harvard University epidemiologist Marc Lipsitch. “But in a week, if the news continues at the pace that it’s been the last few days, I think it will become clear that travel restrictions are not the major countermeasure anymore.”

Smaller scale containment efforts will remain helpful, says WHO’s Bruce Aylward, who led an international mission to China over the past 2 weeks. In a report from the mission that Aylward discussed but did not publicly release, the group concludes that the Chinese epidemic peaked between 23 January and 2 February and that the country’s aggressive containment efforts in Hubei, where at least 50 million people have been on lockdown, gave other provinces time to prepare for the virus and ultimately prevent “probably hundreds of thousands” of cases. “It’s important that other countries think about this and think about whether they apply something—not necessarily full lockdowns everywhere, but that same rigorous approach.”

Yet China’s domestic restrictions have come at a huge cost to individuals, says Lawrence Gostin, who specializes in global health policy at Georgetown University Law Center. He calls the policies “astounding, unprecedented, and medieval,” and says he is particularly concerned about the physical and mental well-being of people in Hubei who are housebound, under intensive surveillance, and facing shortages of health services. “This would be unthinkable in probably any country in the world but China,” he says. (Italy’s lockdowns are for relatively small towns, not major cities.)

China is slowly beginning to lift the restrictions in regions at lower risk, which could expose huge numbers of people to the infection, Dye says. “If normal life is restored in China, then we could expect another resurgence,” he adds.

Still, delaying illness can have a big payoff, Lipsitch says. It will mean a lower burden on hospitals and a chance to better train vulnerable health care workers on how to protect themselves, more time for citizens to prepare, and more time to test potentially life-saving drugs and, in the longer term, vaccines. “If I had a choice of getting [COVID-19] today or getting it 6 months from now, I would definitely prefer to get it 6 months from now,” Lipsitch says. Flattening the peak of an epidemic also means fewer people are infected overall, he says.

Other countries could adopt only certain elements from China’s strategy. An updated analysis co-authored by Dye and posted on the preprint server medRxiv concludes that suspending public transport, closing entertainment venues, and banning public gatherings were the most effective mitigation interventions in China. “We don’t have direct proof, of course, because we don’t have a properly controlled experiment,” Dye says. “But those measures were probably working to push down the number of cases.” One question is whether closing schools will help. “We just don’t know what role kids play” in the epidemic, Lipsitch says. “That’s something that anybody who has 100 or more cases could start to study.”

Some countries may decide it’s better not to impede the free flow of people too much, keep schools and businesses open, and forgo the quarantining of cities. “That’s quite a big decision to make with regards to public health,” Dye says, “because essentially, it’s saying, ‘We’re going to let this virus go.’”

To prepare for what’s coming, hospitals can stockpile respiratory equipment and add beds. More intensive use of the vaccines against influenza and pneumococcal infections could help reduce the burden of those respiratory diseases on the health care system and make it easier to identify COVID-19 cases, which produce similar symptoms. Governments can issue messages about the importance of handwashing and staying home if you’re ill.

Whatever the rest of the world does, it’s essential that it take action soon, Aylward says, and he hopes other countries will learn from China. “The single biggest lesson is: Speed is everything,” he says. “And you know what worries me most? Has the rest of the world learned the lesson of speed?”

Source link

Continue Reading

Health

COVID-19 cases jump by 40 in Manitoba – Brandon Sun

Published

on


Manitoba announced 40 new cases of COVID-19 in the province on Thursday, the largest single-day increase so far during the pandemic.

Thursday’s numbers bring the total number of cases up to 167, including 11 in the Prairie Mountain Health region, said the province’s chief public health officer, Dr. Brent Roussin. The total number of deaths remains at one, and five people are in intensive care.

The news follows the announcement on Wednesday that community transmission had started in the province. Roussin said there are five cases that Manitoba Health can’t trace back to travel or contact with another infected person. At this point, community transmission is only happening in Winnipeg, but he said everyone in the province should be taking the same social distancing measures.

“We want to ensure that people are aware that once we see this virus in the community at low levels, it’s possible to acquire that virus should you not practise social distancing,” he said.

“Stay home if you can, it limits your risk to acquiring this virus, it limits the risk to others of spreading this virus, so stay home as much as you can. That will be your biggest contribution to decreasing the spread of this virus.”

Now is not the time for any travel, even to cottages, Roussin said. While people may believe it allows them to more effectively isolate, it will put increased strain on rural health-care systems if they do get sick.

Several outbreaks of the virus have been identified in Manitoba health-care facilities, including at a personal care home in Gimli and the Health Sciences Centre in Winnipeg. Approximately 40 nurses at the Health Sciences Centre are self-isolating after possible exposure to the virus, while one worker at Betel Home in Gimli tested positive, he said.

In response, Lanette Siragusa, Shared Health’s chief nursing officer, announced health-care workers in hospitals, testing centres and other places will begin wearing surgical masks, gloves and gowns during all contact with patients. She said Manitoba Health has enough personal protective equipment to sustain the measure and more will be distributed according to need.

Shared Health is working on implementing the change at sites across the province and she said more information would be shared with people Thursday. 

“We have plans for this eventuality and the escalation of cases in recent days at health-care facilities means it is time for us to implement this change,” she said.

Hospital patients and personal care home residents who had close contact with people who tested positive for COVID-19 are also being tested, she said.

“These cases cause us all a great deal of concern, and we cannot emphasize enough the responsibility that all Manitobans have to do what we can to slow the spread of this virus,” she said.

In response to a question about opening hospitals dedicated to the virus, Siragusa said Manitoba Health is planning COVID-19 wards in hospitals across the province. It isn’t feasible to have all cases in one building, but hospitals — including the Brandon Regional Health Centre — could focus staff in one area to treat all patients with the virus.

“The concept is we can’t have it all in one site, but we can have them all united in one unit so the staff are concentrated there,” she said.

According to a spokesperson for Prairie Mountain Health, 342 people had been tested so far at the Brandon testing site as of the end of the day on April 1. At the Dauphin testing site, 23 people had been tested as of April 1.

Both testing sites are by referral only and are not walk-in clinics.

As of Thursday, the Cadham Provincial Laboratory had performed 11,327 tests in total.

» dmay@brandonsun.com

» Twitter: @DrewMay_

Let’s block ads! (Why?)



Source link

Continue Reading

Health

Ontario needs 900 new ICU beds to cope with coming surge in COVID-19 patients, models suggest – CBC.ca

Published

on


Ontario will have to add nearly 900 new intensive-care beds to its existing supply to be able to handle the surge in COVID-19 patients forecast under the best-case scenario in provincial models of the pandemic.

The province has an estimated 415 ICU beds available now, as the Ford government attempts to create the hundreds of new spaces experts expect they’ll need.

The additional beds would result in an approximate total of 1,300 dedicated ICU beds for COVID-19 patients.

The models released by the province on Friday suggest an increase in demand that could, in the best-case scenario, peak on April 18, but remain below Ontario’s total capacity if all 900 new beds are made available by then.

In the worst-case scenario, demand for ICU beds would rise sharply until at least the end of April, exceeding the province’s capacity as early as April 14, even with all 900 new spaces. 

However, that scenario will likely never come to pass, as signs indicate that the number of COVID-19 patients isn’t actually increasing as quickly as researchers thought it would. 

As seen in this graph released Friday as part of COVID-19 modelling projections, provincial health experts predict that there will be 80,000 cases by the end of April if the province sticks to its current intervention measures. (Ontario Ministry of Health and Long-Term Care)

Health officials say a continued commitment to physical distancing will help Ontario avoid the untenable strain on hospitals suggested by the worst-case numbers.

“If we can keep the prevalence of the disease to a lower level, the capacity that we have online, or that we could bring online, would indeed be sufficient,” said Matthew Anderson, president and CEO of Ontario Health.

The latest models also suggest that between 3,000 and 15,000 people will die of COVID-19 in Ontario during the pandemic. The model also forecasts 80,000 total cases by the end of April.

Few ICU beds remain at several GTA hospitals

Data obtained by CBC News shows a rapidly dwindling number of ICU beds in the Greater Toronto Area.

Just nine critical-care beds remain available among the 153 ICU beds in the hospitals of the Central Local Health Integration Network. Reports also show just 18 ICU beds available among the 130 critical care beds among the hospitals in the Mississauga Halton Local Health Integration Network

The Ontario government has given permission to all hospitals in the province to expand their capacity for COVID-19 patients, though it is not yet clear if they will have the staff necessary to accommodate that growth.

Health Minister Christine Elliott said the province is recruiting retired nurses, medical students and other volunteers to help staff overstretched hospital departments. 

Elliott said other hospitals may begin renting hotels, motels or retirement homes to increase capacity. Others, she said, are using field hospitals to prepare for the influx of patients. 

Christine Elliott says the province set up a website where people can volunteer to help staff overstretched hospital departments. 1:44

“That is something that is calibrated on an hour-by-hour basis, depending on where the outbreaks are happening,” Elliott said on Friday.

“We are ready to go, depending on where the hotspots are with COVID-19 and what each individual hospital needs, but they all have an individual plan in place right now to expand their capacity.”

There’s a ‘war being fought,’ emergency doctor warns

But some frontline workers say there’s not much more room to expand past their current capacity. 

Dr. Brett Belchetz, a Toronto emergency room physician, said although their hospital isn’t yet overrun, they’re not far from their limit. 

“If volumes are going to go up tremendously … we certainly will very quickly be in a situation where we will not have the equipment or the space or the supplies to care for those people,” Belchetz said in an interview with CBC Toronto.  

Although he said fewer COVID-19 patients are arriving at his emergency room, most of the people who are coming in are quite sick. 

Dr. Brett Belchetz says it’s been a ‘crazy few weeks’ in his hospital’s emergency room. (CBC)

And what people need to understand, Betchez said, is that “there is a war being fought out there.” 

If the province’s COVID-19 restrictions are unsuccessful, he said there won’t be enough ventilators to help all patients who are critically ill.

“The only way that we can stop that from happening is to prolong the outbreak to make sure we don’t have all those cases at the same time,” Beltchetz said.

“We cannot let our guard down.”

Let’s block ads! (Why?)



Source link

Continue Reading

Health

Google Mobility Reports a slippery slope: cyber security expert – Global News

Published

on


In an effort to assist governments with ensuring residents are remaining in their homes during the COVID-19 outbreak Google has provided Mobility Reports which depict growing and shrinking trends in a number of activities.

In both Nova Scotia and New Brunswick the sections outlining retail and recreation, grocery and pharmacy, transit use and attending the workplace all declined significantly.

READ MORE: Nova Scotia surpasses 200 COVID-19 cases

However, two other sections actually saw increases: residential, which refers to time spent at home, climbed by eight percent in New Brunswick and five in Nova Scotia. But the other – parks – rose dramatically by 101 per cent and 95, respectively.

For Nova Scotia Premier Stephen McNeil, the last section continues to be a source of frustration while a state of emergency continues in the province.

Story continues below advertisement

“At a glance, Nova Scotia is not doing well when it comes to staying away from our parks and beaches,” he said Friday before the conclusion of the day’s COVID-19 update with Dr. Robert Strang, the province’s chief medical officer of health.

“We don’t need online graphs to tell us what we need to do. We need to stay the blazes home.”

Tweet This

This type of data tracking isn’t new, nor is the idea of government’s using it to keep tabs on their citizens.






1:14
Coronavirus outbreak: ‘Critical time’ as Nova Scotia sees signs of community spread, officials say


Coronavirus outbreak: ‘Critical time’ as Nova Scotia sees signs of community spread, officials say

But it’s what’s done in the coming weeks and months surrounding the use of this technology that some cyber security experts say requires strong surveillance.

“History shows us governments, when they take on emergency powers during a crisis, don’t generally give those powers back,” explained David Shipley, CEO of Beauceron Security, a Fredericton firm that specializes in helping businesses become and remain secure online. “Any attempts to use this data has to have some careful consideration given to the sunset clauses.”

[ Sign up for our Health IQ newsletter for the latest coronavirus updates ]

“We need to know that after this emergency is over clearly they’re going to stop using that data and they’re going to delete the data they have gained,” he said.

Within the current climate, residents have been asked to remain at home as much as possible to curb the spread of the novel coronavirus.

Story continues below advertisement

Tracking devices during this state of emergency can certainly help give local governments and law enforcement a better idea of how well that is or isn’t being observed.

READ MORE: Surge in Canadian mobile and data use leads to complaints about service

But Shipley warns that the data gained from tracking mobile users isn’t foolproof and could lead to problems if used to target or surveil individuals, rather than amass information.

“The data can be flawed,” Shipley said.

Tweet This

“The data accuracy of location data depends on the quality of the measurement,” he explained. “If you’re a person living in an urban area in Atlantic Canada like Halifax and you’re close to your wifi and other data points, the more data points the more accurate it is.”

“But if you’re living in rural Atlantic Canada and you only have the cell phone signal for example, maybe not the GPS data, it can be as inaccurate as a couple of miles.”

The possibility of the data coming through inaccurately Shipley says should influence how it’s used, likening it to political polls rather than a scientific study.






1:24
Driver dies of COVID-19 weeks after complaining of passenger’s cough


Driver dies of COVID-19 weeks after complaining of passenger’s cough

He says while it can be used as a guide, citing how a mobility report uptick in trips to parks could then be followed up on, it’s critical that the way people’s personal data is monitored closely and their right to privacy isn’t taken away unknowingly.

Story continues below advertisement

“Using good data to make public policy decisions at an aggregate, anonymous level, again with respect to individual privacy and ultimately freedom, there’s potential,” he explained. “But tracking down individuals and treating us all like we’re under house arrest is a future I don’t think we signed up for.”

Although right now there’s no indication individual surveillance is being considered, it’s not that far-fetched according to Shipley who says it’s already ongoing elsewhere in the world.

“We actually saw examples in Asia, South Korea and Taiwan, where folks who took their devices off of them actually got visits from police because now they couldn’t be tracked,” Shipley explained. “If people start knocking on your doors to make sure you’re respecting quarantine because you haven’t had your device on you, well that’s effectively house arrest.”

Follow @Jeremy_Keefe

Questions about COVID-19? Here are some things you need to know:

Health officials caution against all international travel. Returning travellers are legally obligated to self-isolate for 14 days, beginning March 26, in case they develop symptoms and to prevent spreading the virus to others. Some provinces and territories have also implemented additional recommendations or enforcement measures to ensure those returning to the area self-isolate.

Symptoms can include fever, cough and difficulty breathing — very similar to a cold or flu. Some people can develop a more severe illness. People most at risk of this include older adults and people with severe chronic medical conditions like heart, lung or kidney disease. If you develop symptoms, contact public health authorities.

Story continues below advertisement

To prevent the virus from spreading, experts recommend frequent handwashing and coughing into your sleeve. They also recommend minimizing contact with others, staying home as much as possible and maintaining a distance of two metres from other people if you go out.

For full COVID-19 coverage from Global News, click here.”

© 2020 Global News, a division of Corus Entertainment Inc.

Let’s block ads! (Why?)



Source link

Continue Reading

Trending