Category: COVID

Categories : COVID PaediatricsTags :

Infant with COVID Airlifted Out as Texas Hospitals Fill Up

On By ModernMedia
Photo by Fas Khan on Unsplash
Photo by Fas Khan on Unsplash

An 11-month-old girl in Houston, Texas, had to be airlifted to a hospital in a different city because no paediatric hospitals in Houston would accept her as a transfer patient.

“She needed to be intubated immediately because she was having seizures,” said Patricia Darnauer, the administrator for LBJ Hospital. “We looked at all five major paediatric hospital groups and none [had beds] available.”

The little girl will be receiving treatment at Baylor Scott & White McLane Children’s Medical Center some 220 kilometres away.

The situation is sad but not surprising for Dr Christina Propst, who is one of the most outspoken pediatricians in Houston. Ever since the pandemic began in the US, Dr Propst has encouraged masking, social distancing, and being cautious to anyone who would listen.

“The emergency rooms at the major children’s hospitals here in Houston, the largest medical center in the world, are extremely crowded,” said Dr Propst. “They are filling, if not full, as are the hospitals and intensive care units.”

Delta variant infecting more children
Dr Propst and other clinicians ascribed the scarcity of paediatric beds, to the delta variant of COVID noticeably affecting more children, as well as being more transmissible. Texas Children’s Hospital has 30 children and adolescents hospitalised with COVID, compared to their January peak of 40.

However, the problem is worsened by widespread cases of Respiratory Syncytial Virus (RSV) in children. This is all taking place during the summer break for US schools, where doctors are used to injuries from playing outdoors.

Darnauer spoke of high numbers of patients at her hospital. “We are back beyond our pre-pandemic volumes at LBJ.”

Dr Propst advises mask wearing for those children not old enough for the vaccine, and she would also like to see Texas once again allow public schools to mandate masks. Unlike many other countries, COVID health regulations are largely up to individual states.

“If children are not masking in schools, it will be a major problem,” said Dr Propst.

She added that, even in normal times, the start of the school year generally causes a lot of germs to spread.

“It is typical that two weeks after school we see a great surge of strep and other sources of infection. We are bracing ourselves, not a question of when, it will be bad,” she said.

Source: ABC13

Categories : COVIDTags :

Western Cape Third Wave Peak Expected Anytime Now

On By ModernMedia
Image by Quicknews

Western Cape premier Alan Winde said that the province is at the peak of its third wave of COVID infections.

“We are beginning to see the flattening of the curve at our peak as new case infections start to plateau again,” he said in a briefing on Thursday. “This happened after an initial plateau two weeks ago, and then a subsequent increase the week thereafter.

“This is largely explained by a disruption in testing caused by the taxi violence in the Cape Metro during that time.”

Winde supplied the following information:

The ‘R’ number is currently 1.1 and the test positivity rate is 41.5%. New hospital admissions are at 339 per day, with a slight downturn. Deaths have increased, with about 108 deaths per day and will be the last indicator to fall.

Winde said that provincial authorities are simultaneously monitoring the number of trauma admissions to hospitals to ensure that there is sufficient capacity in the province’s hospitals and that it can proactively identify any risks so that they can be addressed.
Senior CSIR researcher Ridhwaan Suliman, PhD, who was been analysing COVID data tweeted an update on Friday night, indicating that there was still no sign of the peak passing just yet:

https://twitter.com/rid1tweets/status/1423718531208785921

Source: BusinessTech

Categories : COVIDTags :

High-dose Heparin Reduces Worsening in Moderate COVID

On By ModernMedia
Source: Fusion Medical Animation on Unsplash

Giving moderately ill hospitalised COVID patients a full-dose of heparin reduced the risk for organ support, and shortened hospital stays, a large clinical trial has found.

However, the use of this treatment strategy for critically ill COVID patients did not result in the same outcomes. 

“These results make for a compelling example of how important it is to stratify patients with different disease severity in clinical trials. What might help one subgroup of patients might be of no benefit, or even harmful, in another,” said NHLBI Director Gary H. Gibbons, M.D.

Researchers have observed that in some people who died from COVID, blood clots had formed throughout their bodies, even in their smallest blood vessels. Antithrombotics, which include blood thinners or anticoagulants, help prevent clot formation in certain diseases. It was not known which antithrombotic drug, what dose, and at what point during the course of COVID, antithrombotics might be effective. To answer these urgent questions, three international partners came together and harmonised their trial protocols to study the effects of using a full, or therapeutic dose, of heparin versus a low, or prophylactic dose, of heparin in moderately and critically ill patients hospitalised with COVID.

Moderately ill patients were defined as being hospitalised for COVID without needing organ support, and critically ill patients as hospitalised for COVID and needing intensive care level of support, including respiratory and/or cardiovascular organ support.

In April 2020, hospitalised COVID patients received either a low or full dose of heparin for up to 14 days after enrollment. By December 2020, interim results suggested that in critically ill patients, full-dose anticoagulation did not reduce the need for organ support and may even be harmful. However, one month later, results suggested full heparin doses likely benefited moderately ill patients.
“The formal conclusions from these studies suggest that initiating therapeutic anticoagulation is beneficial for moderately ill patients and once patients develop severe COVID-19, it may be too late for anticoagulation with heparin to alter the consequences of this disease,” said Judith Hochman, M.D., senior associate dean for Clinical Sciences at New York University, a corresponding author. “The medication evaluated in these trials is familiar to doctors around the world and is widely accessible, making the findings highly applicable to moderately ill COVID-19 patients.”

Fnal trial data analysis included 1098 critically ill and 2219 moderately ill patients. Among moderately ill patients, researchers found that the likelihood of full-dose heparin to reduce the need for organ support compared to those who received low-dose heparin was 99%. Major bleeding was rare. For critically ill patients, full-dose heparin also decreased the number of major thrombotic events, but it did not reduce the need for organ support or shorten hospital stay.

“More work needs to be done to continue to improve outcomes in patients with COVID-19,” said Matthew D. Neal, M.D., the Roberta G. Simmons Associate Professor of Surgery at the University of Pittsburgh, co-senior author. “Given what we know about the type of blood clots in patients with COVID-19, testing anti-platelet agents is a particularly exciting approach.”

Source: NIH

Categories : COVIDTags :

WHO Calls for COVID Booster Pause to Let World Vaccinate

On By ModernMedia

The head  of the World Health Organization (WHO) on Wednesday called for a moratorium on COVID vaccine boosters until “at least the end of September” to enable the world’s most vulnerable people to be inoculated.

“I understand the concern of all Governments to protect their people from the Delta variant, but we cannot accept countries that have already used most of the global supply of vaccines using even more of it, while the world’s most vulnerable people remain unprotected”, said Tedros Adhanom Gebreyesus, WHO head.

Speaking during his weekly press conference, Tedros recalled that in May he had asked for international support to promote global vaccinations with the goal of enabling a minimum of 10 percent of each country’s population to be vaccinated by the end of September.  

With the time already half gone, he lamented the lack of progress towards that goal, and even less towards the target of 30 percent vaccinated by year end.

Widening inequality
So far, more than four billion COVID vaccine doses had been administered around the globe, 80 percent of them in high- and middle-income countries – even though less than half of the world’s population live there, the WHO chief said.

As of May, high-income countries had administered about 50 doses for every 100 people, a figure that has since almost doubled, while supply shortages in low-income countries meant only 1.5 doses for every 100.

“Still, some rich countries are considering booster doses even though there are hundreds of millions of people waiting to have access to a first dose”, stressed Tedros, urging that most of those vaccines instead go to low-income countries.

The WHO has insisted global vaccination requires cooperation by all, “especially the handful of countries and companies that control the global supply of vaccines”.

Tedros said that the G20 nations have a vital role to play as its members are the largest producers, consumers, and donors of COVID vaccines.

“It’s no understatement to say that the course of the pandemic depends on the leadership of the G20 countries”, he said, adding, that one month from now, the G20 health ministers will meet, ahead of the October summit and calling on them to “make concrete commitments to support WHO’s global vaccination targets. We call on vaccine producers to prioritise COVAX“.

Tedros also called on leaders and influential personalities, as well as every individual and community to support the moratorium on booster doses.

Booster’s immune benefit questionable
Meanwhile, Dr Jarbas Barbosa, deputy director of the Pan American Health Organization (PAHO) emphasized that so far there is no evidence that a booster dose adds immune benefits to people who already have the full vaccination course.

Source: UN News

Categories : COVID Obstetrics & GynaecologyTags :

No COVID Impact on Increased Preterm Births or Stillbirths

On By ModernMedia
Source: Anna Hecker on Unsplash

A study found no increases in preterm births or stillbirths during the first year of the COVID pandemic, which will help alleviate concerns around pregnancy and COVID. The large study of more than 2.4 million births in Ontario is published in CMAJ (Canadian Medical Association Journal).

Infection, inflammation, stress, medical or pregnancy-induced disorders, genetic predisposition, and environmental factors are risk factors for stillbirth and preterm birth, although in many instances the exact mechanism is not yet known.

During the COVID pandemic, reports emerged of declining rates of preterm births in countries such as the Netherlands, Ireland and the United States, while the United Kingdom, Italy, India while others reported increases in stillbirths and some variability in preterm birth rates. However, most studies were limited by their small size.

To identify a possible shift, the study researchers analysed Ontario births over an 18-year period and compared these trends in the prepandemic period (2002–2019) with the pandemic period (January to December 2020).

“We found no unusual changes in rates of preterm birth or stillbirth during the pandemic, which is reassuring,” said Dr Prakesh Shah, a paediatrician-in-chief at Sinai Health and professor at University of Toronto, Toronto, Ontario.

It is possible that measures related to the pandemic and compliance with them could affect preterm birth rates in different settings. Thus, the researchers examined birth outcomes in the public health units with higher SARS-CoV-2 positivity rates (Toronto, Peel Region, York Region and Ottawa), and also compared urban and rural births and those in neighbourhoods with different average income levels.

“In some areas and in certain people, the restrictions could be beneficial, and in other settings or individuals, restrictions could have the opposite effect,” said Dr Shah.  

International studies are now underway to help understand the impact of COVID on pregnancy and childbirth around the globe.

Source: EurekAlert!

Categories : COVID General InterestTags :

Japan Tries to Curb COVID with Public Shaming

On By ModernMedia
A train station in Japan. Photo by Zhipeng Ya on Unsplash

The Japanese government, struggling to control its latest and largest COVID outbreak while maintaining the Olympic bubble, is turning to a new tactic — public shaming.

On Monday, Japan’s health ministry released the names of three people who broke COVID rules after returning from overseas. An official statement said that the three people, two returning from South Korea and one from Hawaii, had clearly acted to avoid contact with the authorities.

All three had negative virus tests on arrival at the airport but thereafter neglected to report their health condition and did not respond to location-monitoring apps or video calls from the health authorities.

In May, the Japanese government had said that about 100 people a day were flouting the border control rules, and warned that it would disclose the names of violators soon.

Japanese authorities are struggling to adapt their COVID response as caseloads surge to their highest levels of the pandemic and vaccinations continue to lag behind other wealthy nations. Public fatigue seems to be setting in from the on-and-off emergency measures the government has imposed in various cities.

And in the face of rising cases, the Japanese government failed to speed up its vaccination campaign. It has maintained that hosting the Olympics inside a tightly controlled bubble, with spectators and athletes isolated from the public, did risk exacerbating the outbreak.

While comparatively few infections have occurred inside the Games, totalling about 300 so far, some Japanese people say that seeing the Olympics held in Tokyo has encouraged them to relax against the virus. The first cases were reported on July 17, with two members of the South Africa soccer team testing positive despite having tested negative on their departure.

Yet the outbreak has continued to worsen. On Tuesday, officials said they had recorded more than 8300 daily cases across Japan, slightly down from the weekend’s record high of more than 10 000. A total of 3709 cases were reported in Tokyo, also slightly lower than previous days.

On Monday the government said that it would hospitalise only those with severe cases of COVID, to avoid increasing the strain on hospitals, suggesting that they are already starting to struggle with the influx of cases.

Source: New York Times

Categories : COVIDTags :

Human Rights Commission Inundated with Complaints of Pressure to Vaccinate

On By ModernMedia
Photo by Bill Oxford on Unsplash

The South African Human Rights Commission (SAHRC) said that it had been inundated with complaints from people who claimed they had been pressured to get a COVID vaccination. These included tenants being threatened with eviction if they did not vaccinate.

Employees and tenants were not the only ones coming forward; companies had also approached the commission for guidance and clarification. The situation is something of a grey area for employers, according to the Department of Labour’s director-general Thobile Lamati.

“Can the employer then force the employees to take the vaccine? This is a very difficult question because we have different work places and different situations,” he said, adding that a worker could not be compelled to take a vaccine without the risks being explained to them.

On Friday morning, acting Health Minister Mmamaloko Kubayi-Ngubane reiterated that vaccination was purely voluntary and confirmed that employers were not allowed to force workers to get the jab.

Nevertheless, the government is encouraging all eligible South Africans to achieve herd immunity, and exit the cycle of waves and economically crippling lockdowns. However, inoculation has not been mandatory, with a target of around two-thirds of the population vaccinated. In a statement, President Cyril Ramaphosa said that only one in ten South Africans now believed that COVID vaccines were not safe.

The commission’s Buang Jones said they would also be examining the reasons given by some people refusing to receive vaccines.

“The reasons may range from medical, religious or other constitutional accounts. But complainants will be requested to take us through their reasoning and the team will be offering advice to those who have complained to the commission.”

Jones said that companies also voiced concerns about the negative impact that COVID had had on their finances.

“That they would like staff to be at work and ensure that the company functions optimally. Their concern is there will be increases in sick leave taken and it will affect production. They are also concerned about the rights of other employees to have chosen to take the vaccine.”

Source: Eyewitness News

Categories : COVIDTags :

Breakthrough Infections Among Vaccinated Alarmed CDC

On By ModernMedia
Image source: CDC/Unsplash

Three-quarters of COVID cases were among the vaccinated in an outbreak during large public gatherings at Cape Cod island in Massachusetts, USA, with the Delta variant predominating, researchers found. This helped reverse the official US recommendations on mask-wearing when fully vaccinated.

Of 469 cases linked to numerous summer events and large summer gatherings in a small town, 346 (74%) happened in fully vaccinated people, and almost 80% of those cases were symptomatic, reported Catherine Brown, DVM, of the Massachusetts Department of Public Health, and colleagues.

There were five hospitalisations, four among fully vaccinated people, and no deaths. Of 133 cases with sequence information available, 89% were from the Delta variant, the authors wrote in the Morbidity and Mortality Weekly Report.

Moreover, vaccination coverage in Massachusetts was reported to be 69% as of July 3, they noted.

The data on this outbreak, along with the Delta variant, reportedly motivated the Centers for Disease Contol’s change in indoor masking guidance earlier last week. 

CDC Director Rochelle Walensky, MD, noted that “rapid receipt and review of unpublished data” contributed to the guideline change.

The authors found that RT-PCR cycle threshold (Ct) values in vaccinated and unvaccinated people were comparable. Pointing to these high viral loads among the vaccinated in this case, Dr Walensky said it suggested that vaccinated individuals infected with Delta could still transmit the virus.

“This finding is concerning and was a pivotal discovery leading to CDC’s updated mask recommendation,” she said, saying it was “updated to ensure the vaccinated public would not unknowingly transmit virus to others, including their unvaccinated or immunocompromised loved ones.”

The authors detailed increased reports of COVID cases in Barnstable County, beginning on July 10, including those who were fully vaccinated. Many COVID patients reported attending large indoor and outdoor gatherings.

They identified a cluster of cases, 346 of them fully vaccinated, in Massachusetts residents, who tested COVID positive 14 days or sooner after travel to or staying in Barnstable County.

Cases were also reported from residents of other states who traveled to this town during the period, and reports of secondary transmission.

The authors urged stricter prevention measures at such events, given, “the potential risk of infection during attendance at large public gatherings that include travelers from many areas with differing levels of transmission.”

Source: MedPage Today

Journal information: Brown CM, et al “Outbreak of SARS-CoV-2 Infections, Including COVID-19 Vaccine Breakthrough Infections, Associated with Large Public Gatherings – Barnstable County, Massachusetts, July 2021” MMWR 2021; Published July 30, 2021.

Categories : COVIDTags :

Intranasal Administration of AstraZeneca Vaccine Reduces Viral Shedding

On By ModernMedia

A multi-institutional team of researchers has found that administering the AstraZeneca COVID vaccine intranasally to infected hamsters and monkeys reduced viral loads in nasal swabs, suggesting reduced shedding.

The group describes the testing they conducted with COVID-infected animals and the possible implications of their work, in their paper published in the journal Science Translational Medicine.

Another COVID surge is occurring in a number of countries where vaccinations are readily available, likely due to the arrival of new variants and wide resistance to the vaccinations. Breakthrough infections have been reported in vaccinated individuals. These has resulted in renewed calls for mask-wearing, even in vaccinated individuals. This is because it is not yet clear if vaccinated people can infect other people, even if they have no symptoms. In this new effort, the researchers suggest that adding intranasal inoculation to vaccination efforts might help.

Currently, the vast majority of vaccines developed and in use are intramuscular, given via shots in the arm. Recently, a team at the University of Alabama noted that an intranasal administration of COVID vaccines would seem to make more sense, since COVID is a disease of the nose, throat and lungs. In this new study, the researchers have given an already existing COVID vaccine intranasally to test animals with COVID to see what would happen.

They found that intranasal administration of the AstraZeneca vaccine to infected hamsters and monkeys led to lowered viral loads on nasal swabs, indicating that intranasal administration reduces viral shedding and thereby transmissibility of the virus.

Unfortunately, prior research has also shown that vaccines given intranasally confer immunity for a shorter period of time than intramuscular vaccination. Thus, as the team in Alabama noted, the best approach might turn out to be a combination of a shot in the arm along with a puff of mist up the nose to confer both short-term and long-term protection.

Source: MedicalXpress

Journal information: Neeltje van Doremalen et al, Intranasal ChAdOx1 nCoV-19/AZD1222 vaccination reduces viral shedding after SARS-CoV-2 D614G challenge in preclinical models, Science Translational Medicine (2021). DOI: 10.1126/scitranslmed.abh0755