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What we can do to flatten the coronavirus curve – Times of India

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The number of coronavirus cases has spiked in recent weeks, overburdening healthcare resources and infrastructure. According to the US Centers for Disease Control and Prevention (CDC), managing the outbreak will require considerable reduction in the number of new cases cropping up. Health experts have frequently referred to the need for ‘flattening the curve’, which is essentially a strategy to prevent a huge spike in cases. TOI takes a look at how epidemics are managed and why ‘flattening the coronavirus curve’ is critical.

WHAT IS FLATTENING THE CURVE?


The course of an epidemic is determined by a variable called the virus reproductive rate, which is the number of further cases each new case will give rise to. If this rate is high, the number of cases will sharply rise before starting to decline (for want of new people to infect). This happens when measures to slow down the spread of the virus are not sufficient, there is then likely to be a large jump in infections in a short period of time. But with adequate intervention, both at the government and personal level, the reproductive rate can be kept low, hence the curve is more gentle.
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The steps we take now, individually and as a community, will determine the trajectory of the #COVID19 epidemic. This in turn will determine how many lives are lost. It is not just a matter of protecting yourself; it is a matter of protecting the most vulnerable among us

Carl Bergstrom, Biologist /Co-creater of ‘ flattening’ the curve graph

FLATTENING OUTBREAK CURVE CRITICAL FOR DISEASE MANAGEMENT

Flattening the curve is essential — it would mean slower growth in cases, or spreading out the number of cases over a longer period of time, by enforcing prevention methods so that the steep mountain of cases is ‘flattened’ into a more gentle hillock. Although Covid-19 appears to be more infectious than the common flu and has a higher mortality rate, appropriate intervention can make a significant difference, as evident by the difference in pattern of the virus’s spread in various countries.

It’s only a matter of time before Covid-19 reaches countries with much weaker health systems than China, South Korea, the US or Europe. When it does, the fatality rate may increase due to lack of access to critical care facilities for the most severe cases

Global Preparedness Monitoring Squad

In the absence of adequate intervention, however, the outbreak will peak very quickly, infecting more people than the healthcare system is capable of treating simultaneously, which means severe cases will not get the treatment they need and more deaths.

The objective is to ‘flatten’ the curve or delay the outbreak from reaching its peak so that healthcare systems are not overburdened. To do this, governments should limit travel, domestic and international, and restrict mass gatherings to more effectively isolate infected people. But individuals too can help by washing their hands frequently, coughing or sneezing into their elbows, and avoiding crowds. If you feel sick, even with minor symptoms, stay away from others as much as possible and get in contact with a doctor or hospital. For people over 60 and those with chronic medical ailments — the two groups considered most vulnerable to severe pneumonia from Covid-19 — CDC has posted new guidance to “avoid crowds as much as possible.”

Also, the disease gets harder to manage when health professionals themselves get sick as they attempt to handle the spike in cases; their well-being is, therefore, essential.

Personal, rather than government action, in western democracies might be the most important issue. Self-isolation, seeking medical advice remotely unless symptoms are severe, and social distancing are key

Lancet

THE THREE PHASES OF AN EPIDEMIC

PHASE I

In Phase I, the first cases are reported. Several nations are still in this phase. Phase I is when the disease is easiest to contain. Identifying infected people and isolating them while tracking down those they have come in contact with is critical. Staying in Phase I long enough for a vaccine to emerge is ideal but almost impossible without extreme measures like blanket international travel bans.

PHASE II

In Phase II, early containment efforts have failed to keep up with the rapid spread of the disease. Many infected people have spread the disease by travelling or going to work. In countries like Italy and Iran, there has been a spike in new cases, which has placed immense pressure on their limited health resources.

The objective in Phase II is to stop all human-to-human transmission of the disease before it spreads to everyone. Italy and South Korea have now deployed all social distancing measures to slow down the rate at which people get infected in an attempt to flatten the curve.

Mitigation strategies can delay the peak of this coming wave of cases so volume of cases can decline further while we plan to create capacity but there’s no time to waste. The role of politicians now is to support experts

Dr Howard Ovens, Sinai Health Systems

PHASE III


In Phase III, either everyone is infected or the outbreak is brought under control with a vaccination. But the world is still at least a full year away from a vaccine.

China, however, has managed to return from Phase III to Phase I with dramatic disease management measures.

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Source: CDC, The Spinoff, media reports

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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.

The Canadian Press. All rights reserved.

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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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