Category: COVID

Categories : COVID General InterestTags :

Chinatowns around the World Battle COVID and Xenophobia

On By ModernMedia

The BBC explores how the various Chinatowns around the world have been battling loss of business caused by COVID lockdowns, along with fear and xenophobia.

Sam Wo’s, a restaurant in San Francisco’s Chinatown, had been hit hard by COVID just like other businesses there.

The lockdowns had not yet happened but anti-Asian sentiment kept customers away. “All the Italian restaurants in North Beach were still busy and packed and then you went through the tunnel to Union Square and those guys had lines waiting to get in. And then you drive around Chinatown and it’s completely empty,”  Sam Wo’s co-owner Steven Lee told the BBC.

“So we know that xenophobia was affecting small businesses. Why would other districts be busy and we’re not?”

In the 12 months since, it has been forced to cut its staff numbers from 23 to three due to a lack of customers.

“People wouldn’t show up, they were just scared,” Mr Lee tells the BBC. “We had to rally and tell people to fight the virus, not the people and all this kind of stuff – but it didn’t help much.”

In the Japanese city of Yokohama, this went beyond mere avoidance; anti-Chinese notes were left on the doors of restaurants in March. Sales had plummeted to 10% of what they were the year before. The mayor of Yokohama railed against these notes, and locals voiced their support for their Chinatown, telling businesses to “hang in there” and promising to visit again.

In many Chinatowns, the lockdowns then worsened an already dire situation. 

“I know many businesses in Chinatown have closed. It’s terrifying,” Ying Hou, who runs Shandong MaMa in the Australian city of Melbourne, told the BBC. “There are gift houses where tourists come to buy souvenirs – most of them didn’t make it and have closed down.”

Ms Ying says her business is down 50%, but fortunately the shop is the only one in Chinatown to sell fish dumplings. Melbourne gave rent relief to many businesses, but this is now coming to an end. And now Melbourne is about to be plunged into a new five day lockdown surrounding the Australian Open. 

However, many are finding new answers to the problems posed by COVID. In New York, after Chinatown turned into a “ghost town” with the lockdowns closing down even essential businesses by May, Karho Leung took a page out of Hong Kong barber shops’ reactions to COVID and installed dividers and other measures. He advertised these safety enhancements, which went viral and resulted in a surge of business from pent-up demand.

Mr Leung added to his business and others that were struggling by embracing social media and online delivery companies such as Uber Eats. 
Organisations made up of ordinary citizens are also helping to keep their cities’ Chinatowns afloat as well. Send Chinatown Love is helping Chinatown businesses there with their online and social media presence to help generate business, creating “food crawls” to drum up foot traffic.

“Everything started happening around January, February of last year, which is the most lucrative and joyous and festive times for Chinatown. They took a hit with that business and lost most of it,” said Louise Palmer, who is a representative for the group. “So they ended up going into lockdown in March at a deficit, which kind of set a really terrible precedent for what the rest of the year would look like.”

Meanwhile, in San Francisco, in a hopeful development, business is picking up again since outdoor dining became allowed. Mr Lee said that Chinatown is booming again, and is planning to open a nightclub.

“We’re the oldest Chinatown in the country. We’re the tourist attraction that everybody comes to when they come to San Francisco. So we have to preserve it,” Mr Lee said.

Source: BBC News

Categories : Addiction COVIDTags :

Opioid Overdoses in US Increasing due to COVID

On By ModernMedia

The COVID pandemic has not seen a drop in the United States’ opioid crisis, rather there has been an exacerbation of the problem.

A study published in JAMA Psychiatry examined the impact that the COVID pandemic had on the US opioid crisis. 

Opioid misuse and addiction is an ongoing and increasing problem in the US, making up two thirds of overdoses. Some three million Americans have suffered opioid use disorder at some point. With approximately 100 million Americans living with chronic or acute pain, the situation is seemingly intractable. In 2019, there were 70 000 deaths from opioid overdoses, making it a top priority in public health, academic, and political debates. When the COVID pandemic hit, it did not displace the opioid crisis through distraction or somehow preventing access to opioids, it fanned the flames of it. 

Researchers analysed 190 million ED visits, and over March to October 2020. they observed an increase of  up to 45% in weekly opioid overdose admissions over the same period in 2019. Overall, ED visits for opioid overdoses had increased 28.8% compared to the previous year.

In September, the CDC warned that deaths from opioid overdoses were up by 38.4% in the first half of the year. The many stresses of the pandemic, such as its associated lockdowns and job losses and losing loved ones, has fuelled the opioid abuse. The same study also found that visits to the ED for mental health conditions, domestic violence, and child abuse and neglect increased over the same period of time, along with suicide attempts. 

Source: ABC News

Journal information: Holland KM, Jones C, Vivolo-Kantor AM, et al. Trends in US Emergency Department Visits for Mental Health, Overdose, and Violence Outcomes Before and During the COVID-19 Pandemic. JAMA Psychiatry. Published online February 03, 2021. doi:10.1001/jamapsychiatry.2020.4402

Categories : Ageing COVID General InterestTags :

Europe’s Oldest Living Person, 116, Survives COVID

On By ModernMedia

A 116 year old French nun who is Europe’s oldest living person has survived COVID after testing positive.

French nun Sister Andrée had tested positive for COVID in her retirement home in Toulon, but had remained symptom-free. Most of the 88 residents at the home contracted the virus, 10 of whom died. 

Sister Andrée, who is blind and in a wheelchair, said that her main complaint was the solitude necessitated by being confined to her room.
“I didn’t even realise I had it,” she told Var-Matin newspaper:

David Tavella, a spokesperson for the nursing home, told the newspaper that she had no fear of the virus.

“She didn’t ask me about her health but about her routine. She wanted to know for example if the meal and bed times were going to change. She showed no fear of the illness, in fact she was more worried about the other residents,” Mr Tavella said.

When asked by France’s BFM Television if she had been scared of having COVID, she responded: “No, I wasn’t scared because I wasn’t scared to die … I’m happy to be with you, but I would wish to be somewhere else – join my big brother and my grandfather and my grandmother.”

In addition to being Europest oldest living person, she is also the world’s second oldest living person. The oldest living person in the world is Kane Tanaka in Japan, who turned 118 on January 2. Having lived through the First World War as a child, Sister Andrée will turn 117 on Thursday.

Source: The Guardian

Categories : COVIDTags :

Wrong Syringes in Japan Will Waste Millions of Vaccine Doses

On By ModernMedia

When it begins inoculations, Japan will lose millions of vaccine doses because of a lack of the ‘low dead space’ syringes needed to extract the maximum number doses from each vial.

Japan had ordered 144 million doses of the Pfizer vaccine on the assumption that each vial equated to six doses. Low dead space syringes leave less vaccine in the syringe after injection, especially around the base of the needle, and result in minimal wastage. However, since low dead space syringes are in short supply in that country, regular syringes will have to be used which can only withdraw enough vaccine for five doses. This will result in the wastage of up to 24 million doses of vaccine.

“The syringes used in Japan can only draw five doses,” health minister Norihisa Tamura said, quoted by the Kyodo news agency. “We will use all the syringes we have that can draw six doses, but it will, of course, not be enough as more shots are administered.”

In large-scale vaccination programmes, the wasted vaccine in each vial becomes an issue. Skill is a factor in preserving the vaccine, but the amount of dead space in a syringe and the achievable accuracy also has a significant effect. One study showed that the amount that can be withdrawn from each vial can vary by as much 42% depending on the type of syringe used.
The US and EU have also reported shortages of low dead space syringes, and this may result in competition and supply shortages.

Japan is set to begin the first round of inoculations with 10 000 to 20 000 healthcare workers, and from there giving priority to other healthcare workers and vulnerable individuals. Inoculations for those aged 16 to 59 are not expected to begin until July.

Source: The Guardian

Categories : COVIDTags :

SARS-CoV-2 Mutation Evolved in Immunocompromised Patient

On By ModernMedia

The discovery of SARS-CoV-2 mutations evolving in an immunocompromised patient treated with convalescent plasma has been revealed by Ravindra Gupta, MD, PhD, of University of Cambridge in England, and team.

“We have documented a repeated evolutionary response by SARS-CoV-2 in the presence of antibody therapy during the course of a persistent infection in an immunocompromised host,” the authors wrote.

Previous research has shown that immunosuppressed patients could serve as reservoirs for norovirus variants.

Although they did not claim the UK variant was created by that particular case, Gupta’s group speculated that the plasma therapy could have unleashed the resistant variants, and could do so in other immunosuppressed patients too.

They wrote that, in such patients, “the antibodies administered [in plasma] have little support from cytotoxic T cells, thereby reducing chances of clearance and theoretically raising the potential for escape mutations.” 

They cautioned that convalescent plasma use should be limited, and only with appropriate infection control in monitoring in immunosuppressed patients.

A man in his 70s, who had received immunotoxic chemotherapy to treat lymphoma eight years previously, was initially hospitalised in May with neutropenic sepsis, and, about a week later, tested positive for SARS-CoV-2. He was discharged later in May, but in late June was readmitted with cough and breathlessness.

His condition worsened and he received dexamethasone and two 10-day courses of remdesivir 5 days apart. On two days around July 20, convalescent plasma was administered; more remdesivir and convalescent plasma was administered about 4 weeks later. He died shortly afterward.

Gupta and team took viral samples from this patient on 23 occasions, and over the first 57 days, they observed little change in viral population upon treatment with remdesivir, but after the July round of convalescent plasma, a shift in viral genotype occurred.

Initially the patient’s viral serotype showed a mutation first reported in China. However, in late July, a variant was observed with two alterations in the spike protein, including the deletion seen in the B.1.1.7 variant. Testing showed a twofold reduced susceptibility to the antibodies in the convalescent plasma.

The team wrote that this sort of evolution is unlikely to emerge in immunocompetent patients. They cautioned against using convalescent plasma in severe COVID patients, and especially those who were immunosuppressed.

The study’s limitations included being only a single case, and samples were taken from the upper respiratory tract and not the lower respiratory tract. 
Given South Africa’s large HIV positive population, if viral evolution is driven by convalescent plasma in immunosuppressed patients, this raises questions for the country’s COVID strategy.

Source: MedPage Today

Journal information: Kemp SA, et al “SARS-CoV-2 evolution during treatment of chronic infection” Nature 2021; DOI: 10.1038/s41586-021-03291-y.

Categories : COVIDTags :

As COVID Variants Dominate, Better Mask Use is Needed

On By ModernMedia

Evidence is accumulating that COVID is commonly transmitted through small aerosolised droplets emitted during regular speaking and breathing—a problem compounded by the enhanced contagiousness of variants such as 501Y.V2, the strain which dominates in South Africa.

Masks have become ubiquitous in the pandemic-struck world, and even fashionable, with many different types available. However, their effectiveness varies considerably from top-of-the-range N95 masks to a pulled-up shirt which offers very little protection.
“How well a mask works depends on two things: filtration and fit,” said Professor Linsey Marr, who studies airborne disease transmission at Virginia Tech .

“Good filtration removes as many particles as possible, and a good fit means that there are no leaks around the sides of your mask, where air—and viruses—can leak through,” she said, noting that even a small gap could result in a 50% reduction in effectiveness.

We do not recommend wearing more than two masks. Adding more layers proves diminishing returns and can compromise breathability. It must remain easy to breathe through the layers; otherwise, air is more likely to leak in around the sides of the mask.

Wearing a cloth mask over a surgical mask, or ‘double masking’ does improve effectiveness as it serves to tighten the surgical mask’s fit. Air escapes around the corners and edges of the mask, as anyone who has worn glasses and had them fog up in the cold can attest to.

While N95 masks are the best available, there are also equivalents such as KN95 or FFP2.

“They all provide a similar level of filtration, meaning protection of particles going in and out,” said Ranu Dhillon, a global health physician at Brigham and Women’s Hospital and Harvard Medical School. Dhillon is frustrated at the lack of transparency and education for the public about masks.

Health care workers, for example, get their masks tested for fit, something which could be also done by members of the public.

Donald Milton, a professor of environmental health at the University of Maryland, said that the key to understanding the COVID airborne transmission threat is to treat it like cigarette smoke. Ventilation helps, but if you have someone between you and an exhaust vent, then masks will definitely help.

Before the pandemic, Milton and Dhillon courted controversy by demonstrating that most viral transmission was in the form of small droplets emitted when speaking or breathing, and the contribution to transmission by coughing and sneezing was smaller than previously thought. The two researchers are hopeful that their findings will find their way into official COVID policy, and future research may even see masks becoming a common sight during peak flu seasons.

Source: Japan Times

Categories : COVIDTags :

Reckless to Discard AstraZeneca Vaccines, Says Prof Madhi

On By ModernMedia

Professor Shabir Madhi of Wits University says that it would be reckless to simply abandon South Africa’s stock of AstraZeneca vaccine doses, even after a small trial showed it to have minimal effect against the local variant.

One million doses of AstraZeneca vaccine had been scheduled for rollout, but that plan has been put on hold after preliminary results showed that it conferred minimal effectiveness against mild-to-moderate infections by the dominant 501Y.V2 strain in South Africa. 

Madhi said that scientists needed more time to go through the data, said Madhi.

“I think it would be highly reckless for us to discard the vaccine. We paid a high price for it and so the vaccines do have a role in protecting from severe disease. I think an important feature in all the vaccines is that generally, vaccines work much better in preventing severe disease.”

There is already a closing window of opportunity, since it was recently discovered that the first batch of one million doses received from the Serum Institute of India would be expiring in April.

Madhi said that there were other options to put the vaccine to good use.
“If we’re strategic in terms of the rollout, we might still be able to get the vaccine used, not two doses per individual but at least a single dose and we could possibly follow it up then with another vaccine and a few vaccines that might come online in the next two or three months.”

In an interview with the BBC, he said that the disappointing results of the trial had not been able to show the effectiveness against severe COVID, as the sample size was too small and too young, with an average age of 31, but that it might still have a protective effect in different age groups. “There’s still some hope that the AstraZeneca vaccine might well perform as well as the Johnson & Johnson vaccine in a different age group demographic that I address of severe disease,” he said.

Source: Eyewitness News

Categories : COVID General InterestTags :

Drone Company to Start New Rural Vaccine Delivery Service

On By ModernMedia

Zipline, a company that has made its name using drones to deliver medicines to remote locations in countries like Rwanda, has announced that it is to expand its capability to include all COVID vaccines.

In a press release, Zipline said that it is partnering with a COVID vaccine manufacturer, the identity of which was not disclosed, to add on the ability to deliver vaccines that require ultra cold temperatures in specialised refrigerated containers.

For remote rural locations, the Pfizer/BioNTech vaccine is not an option because of  its stringent temperature storage requirements of minus 70 degrees celsius. In such situations, the choice of COVID vaccines is limited to the more expensive Moderna vaccine, which still requires freezing temperatures, or vaccines like those from Johnsons & Johnson or AstraZeneca, which don’t have as high effectiveness but are able to be stored at normal refrigerator temperature ranges.

Zipline is planning to add these ultracold storage refrigerators at all of its drone bases. A clinic in its network would be able to request a few dozen doses of vaccine, and the company’s drones would be able to deliver it in a special refrigerated container.

Zipline operates fixed-wing, battery-powered drones that can make a round trip of up to 80 kilometres. Each base that the drones operate from can service an area of over 22 500 square kilometres, completely ignoring difficult terrain and lack of road access which may endanger drivers. A trip which could take hours in a 4 by 4 can be done in under an hour.
The drones can deliver a 1.75kg payload by parachute at a designated location, and return to base. Since the drone navigates by GPS, it can do so in a range of weather conditions, and by day or night.

Zipline CEO Keller Rinaudo said that his company wants to help rural areas that have been hard hit by COVID. “Where you live shouldn’t determine whether or not you get a COVID-19 vaccine,” he said in the release. “We can help health systems bypass infrastructure and supply chain challenges through instant delivery.”

Source: Bloomberg

Categories : COVIDTags :

UK to Look at Mixing of Different Vaccines

On By ModernMedia

The UK is launching a trial to explore the mixing of vaccines can be combined. Some, like Russia’s Sputnik vaccine, already combine two different types of vaccines, but these were specifically designed and tested to work together. 

Current guidance in the UK says that anyone who receives a Pfizer-BioNTech or Oxford-AstraZeneca vaccine dose should get the second dose of that same vaccine. Only in exceptional circumstances such as not knowing what vaccine was given will a different vaccine be administered.

The main aim was to enhance logistical flexibility. The Oxford/AstraZeneca, Johnson & Johnson and Novavax vaccines can all be stored at normal refrigerator temperatures, while the Moderna vaccine must be stored at -20C, within normal freezer range, and Pfizer/BioNTech’s vaccine needs an ultra-cold -70C. Not requiring a second dose of the same vaccine could ease up storage requirements. 

However, with previous vaccines, mixing different vaccine types worked and even strengthened their overall effectiveness. Some Ebola immunisation programmes, for example, combine two different vaccines to achieve greater protection.

The trial will comprise some 800 participants aged 50 or older, receiving a combination of Oxford/AstraZeneca and Pfizer/BioNTech in either order.

Some vaccines that work by using a virus to deliver the antigens, and there is some evidence to suggest that the immune system starts to focus on the viral delivery system instead of the antigen. Thus, combining vaccines will keep the immune system’s attention on the antigens.

Chief investigator, Prof Matthew Snape from the University of Oxford, said the “tremendously exciting study” would provide critical information for vaccine rollouts.

Animal studies have shown “a better antibody response with a mixed schedule rather than the straight schedule” of vaccine doses, he said.

“It will be really interesting to see if the different delivery methods actually could lead to an enhanced immune response [in humans],” he said, “or at least a response that’s as good as giving the straight schedule of the same doses”.

Source: BBC News

Categories : COVIDTags :

Viral Load Drives the Transmission of COVID

On By ModernMedia

Knowing what factors drive the transmission of COVID is crucial to informing schemes to contain and adapt to its spread.

There is abundant data on location and duration of exposure to COVID, but there is precious little on any other factors, the researchers noted.

The SARS-CoV-2 virus is detectable in respiratory tract samples 1-2 days before symptom onset, and can continue for several weeks afterward. But the detection of viral RNA is not necessarily related to infectiousness, and no studies had established the connection between viral load and COVID transmission, although viral load had been linked to COVID mortality.

The researchers used linked index cases of COVID to determine that viral load was the principle factor behind COVID transmission, and is the largest such study to date. This emphasises the need for initiating proper contact tracing.

The researchers conducted a post-hoc analysis of 314 cases during the initial COVID wave in Spain, of whom 90% (282) had at least one close contact, resulting in a total of 753 contacts. Viral load was the key indicator of COVID transmission.

The overall secondary attack rate (proportion of COVID-positive contacts) during the study period was 17%. However, this rate varied from 12% when the viral load of the index case was lower than 1×10⁶ copies per mL, to 24% when it was 1×10¹⁰ copies per mL or higher.

Running multivariate analyses, the researchers found no association between sex, age, diabetes, cardiovascular disease, or respiratory disease and the risk of or time to developing symptomatic COVID. There was a significant association of incubation time with initial viral load, increasing from five days among patients with a high viral load to seven days among participants with a low viral load.

The researchers wrote: “Taken together, our results indicate that the viral load, rather than symptoms, might be the predominant driver of transmission.”

They conclude that all cases should be considered potential transmitters of the virus. They also suggest viral load assessment in patients with large numbers of contacts, and risk stratification by time to symptom appearance based on viral load. 

Source: News-Medical.Net

Journal information: Marks M, et al. Transmission of COVID-19 in 282 clusters in Catalonia, Spain: a cohort study. The Lancet Infectious Disease, 2021. DOI: https://doi.org/10.1016/S1473-3099(20)30985-3, https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30985-3/fulltext