Tag: covid

Categories : COVIDTags :

COVID in Zambia More Widespread Than Believed

On By ModernMedia

A new study from Zambia has found almost a fifth of recently-deceased people in mid-2020 tested positive for COVID. 

The study, from the Boston University School of Public Health (BUSPH) study in Zambia, upends the notion that Africa somehow ‘dodged’ the worst of the COVID pandemic. Rather, the low reported rates are merely reflective of a lack of testing ability.

“Our findings cast doubt on the assumption that COVID-19 somehow skipped Africa or has not impacted the continent as heavily,” said study co-author Dr Lawrence Mwananyanda, a BUSPH adjunct research assistant professor of global health based in Lusaka. “This study shows that with proper diagnostics and testing, we can begin to identify the scale of COVID-19 in African countries such as Zambia. I hope this study will encourage African governments to look closer at the rollout of COVID-19 testing, as well as empower Africans to take proactive steps–such as wearing masks, physically distancing, and skipping handshakes–to protect themselves from COVID-19.”

The findings have important implications for global policy makers, who will need to ensure access to vaccines worldwide, along with monitoring.

The University Teaching Hospital morgue sees roughly 80% of people who die in Lusaka pass through it. From June to September, polymerase chain reaction tests detected COVID in 70 out of 364 recently-deceased people. A peak of 31% positive results was observed in July. Unlike the typical pattern of COVID deaths elsewhere, most of the deceased people who tested positive in this study were under 60 years old, including seven children. Given how rare paediatric COVID deaths are elsewhere, this is surprising, the researchers noted.

The researchers sought information about the symptoms of the 70 who tested positive. “In nearly all cases where we had those data, we found typical symptoms for COVID-19, yet only 6 had been tested before death,” Gill said. Of 75% of deaths outside hospital, none had been tested.

Monitoring COVID is not a simple task, especially in a country with limited resources. Zambia’s Ministry of Health has been very proactive and supportive of this and other COVID studies, the researchers said.

“They’re really grateful that we can provide them this data, and they can make informed decisions moving forward with this epidemic,” said Dr Mwananyanda.

The researchers were well-positioned to track COVID in Zambia, having conducted the ongoing Zambia Pertussis/RSV Infant Mortality Estimation Study (ZPRIME) at the morgue.

“Building studies such as this from scratch can take time and resources that can be difficult in the time needed to tackle the COVID-19 pandemic. We invested a lot of time and money and human resources to building infrastructure that allowed for that extensive surveillance,” said co-author Rachel Pieciak, a research fellow at BUSPH. “So, what we’ve done was repurpose ZPRIME study capacity to focus on enrolling all deaths across all ages and testing for COVID-19.”

The researchers expressed hope that similar studies could be repurposed for the COVID fight.

Source: News-Medical.Net

Journal information: Mwananyanda, L., et al. (2021) Covid-19 deaths in Africa: prospective systematic postmortem surveillance study. BMJ. doi.org/10.1136/bmj.n334.

Categories : COVIDTags :

Volunteers to Take Part in COVID Human Challenge Trial

On By ModernMedia

The first trial of its kind is set to start in the UK, with healthy volunteers being sought to be deliberately infected with COVID in a human challenge test.

The study will seek 90 healthy volunteers aged 18-30 to be infected with COVID in a safe, controlled environment. Among the study’s objectives is a desire to find out exactly how much of a viral load is needed to infect someone with COVID.

The window of opportunity in the UK for a large-scale study of this type is gradually closing because eventually it will no longer be possible to find people have not been vaccinated. However, a significant amount of information can be gleaned from even small-scale studies. This includes how second-generation vaccines compare to how well vaccines protect against new variants.

Human challenge tests have been an important part of developing understanding of and treatments for a number of diseases. The first human challenge trials for dengue fever took place in the 1900s. Although abandoned in favour of animal testing, animals were not sufficiently close to humans to advance research. Recent human challenge trials helped to develop an effective vaccine for the disease.

Clive Dix, interim chair of the Vaccines Taskforce, explained: “We have secured a number of safe and effective vaccines for the UK, but it is essential that we continue to develop new vaccines and treatments for Covid-19.

“We expect these studies to offer unique insights into how the virus works and help us understand which promising vaccines offer the best chance of preventing the infection.”

Applicants will be screened, including determining if they had COVID before, and then be intranasally infected with the virus. Volunteers will receive compensation of £4500 (about R90 000) over the course of a year, which will include follow-up tests.

Source: BBC News

Categories : Diet and Nutrition General InterestTags :

Health Experts Call for a Sugar Tax Increase to 20%

On By ModernMedia

In advance of Finance Minister Tito Mboweni’s annual budget presentation on 24 February, health specialists have been calling for an increase in the health promotion levy from 11% to 20%. 

The health promotion levy (or ‘sugar tax’) was put into effect in April 2018, and imposes an 11% tax on sugar sweetened beverages. Specialists called for an increase in this tax on Tuesday at a webinar rub by the Healthy Living Alliance (Heala), saying that this was a prudent time to do it because the health sector is currently battling the COVID pandemic.

Most people hospitalised with COVID in SA have comorbidities such as diabetes and hypertension, said Karen Hofman, director of the Wits Centre for Health Economics and Decision Science (Priceless SA). Sugar, especially in liquid form, is a risk factor for obesity, diabetes, hypertension, cardiovascular disease, a number of common cancers and dental decay. She added that had those comorbidities had been prevented, the country could have been in a much better position.

Hofman said that people think they have “control over what [they] are eating and drinking”, but in fact don’t, having been heavily influenced by their environment from an early age. For the tax to have any effect, it should be increased to 20%, based on the World Health Organization and other health experts’ recommendations.

Heala head, Lawrence Mbalati, said the sugar tax had created R5.4-billion for the government within its first two years. This would have been enough to finance South Africa’s downpayment for COVID vaccines from the Covax facility almost 20 times over, in spite of its minimal contribution to the overall budget. 

A doubling of the sugar tax would net an additional R2 billion to help fight COVID, Mbalati said.

“This is a watershed moment for the country,” Mbalati continued. “Government revenues are under immense pressure and funding the fight against Covid-19, including vaccines, remains critical.”

Hofman said that research in other countries with a sugar tax had shown a fall in volume of taxable beverages by 51%, and a 29% reduction in sugar intake.

“SA must address commercially driven epidemics with taxes, mandatory food labelling and mandatory comprehensive marketing bans,” Hofman said.

Source: Mail & Guardian

Categories : COVID Medical IndustryTags :

Over Half of SA Has Had COVID, Says Discovery CEO

On By ModernMedia

From the number of excess deaths in South Africa, it appears that over half of South Africa has been infected with COVID at least once.

The CEO and founder of the Discovery Group, Adrian Gore, has said in an interview on 702’s The Money Show that he believes over half of the South African population has had COVID. He believes that there is “absolutely no ambiguity” that the “sky high” excess death rates recorded in SA are attributable to COVID. He said that the excess deaths point to over 50% of the SA population having been infected with COVID so far.

The latest data released by the South African Medical Research Council (SAMRC) puts the number of excess deaths in SA over the course of the pandemic at 137 731 – nearly triple the official death toll from COVID. Nearly 5000 Discovery members and 12 staff members have died. 
Last week, SA National Blood Service released a study showing that 32% of people in the Northern Cape up to 63% of people in the Eastern Cape had contracted COVID. Gore said that this high infection rate would hopefully reduce the impact of the third wave predicted to arrive in the colder winter months.

“We are hoping that a third wave may take longer and might be less because we think the infection rate has been high.” He said, adding that if the first and second phases of vaccination targetting healthcare workers and vulnerable individuals was completed by mid-year, a third wave might be completely avoided.

He said that young, healthy people who can afford a vaccine should not be able to get one before those who were older and more vulnerable. “Not following this process would mean low-risk people get vaccinated before the clinically vulnerable, resulting in unnecessary illness and death. This cannot and should not happen,” he said in a Linkedin post.

He also refuted the rumour that Discovery was not paying contributions towards non-members’ vaccinations. In fact, he said on The Money Show, that medical aid schemes have extra cash to pay for this since members had been going for fewer treatments during the pandemic. This amounts to some R24 billion in surplus, as revealed by regulatory filings, which would be right in the middle of cost estimates for SA’s entire vaccination programme as opposed to the 30% amount that medical aid companies were being expected to contribute.

Source: Business Insider

Categories : COVID General InterestTags :

The Second Vaccine Dose Can Hit Hard

On By ModernMedia

The scuttlebut among healthcare workers is that the second dose of a COVID vaccine hits much harder than the first – unless you’ve had COVID, in which case the first is equally as bad.

TJ Maltese, DO, a neurologist in private practice on Long Island in New York state, was fine with the first dose of the Moderna vaccine but was flattened by the second one.

Dr Maltese got his second jab on a Friday at 4:30 pm. Within two hours his arm was sore. Overnight, he developed flu-like symptoms, and on Saturday experienced chills and body aches, with a lingering fever. He could have pushed through if he’d had to work, he said, but he rode out his symptoms on his couch with the help of the occasional painkiller.

By 9 pm on Saturday evening, Dr Maltese started to feel better, getting a good night’s sleep and on Sunday was fine again.

“I know plenty of people with minimal symptoms after the second dose, so it’s not definite you’ll feel side effects,” he wrote in a Facebook post. “But be prepared for the possibility.”

Immunology and the phase III clinical trial data from the vaccine backs up the view that the second dose is worse, and some hospitals have even altered their scheduling to allow time for recuperation after the second dose. Adverse reactions to the BCG vaccine in Brazilian school children, for example, have been reported to be common with the second dose, though still rare.  

Immunologists and infectious disease experts interviewed by MedPage Today and who shared their second-dose experiences said it’s not unexpected that second-dose reactions are more intense than the first. Typical reactions to the COVID vaccines include fever, headache and fatigue as the immune system responds to a vaccine’s antigens.

“The first time the immune system comes into contact with something, it’s getting primed,” said Purvi Parikh, MD, an immunologist at NYU Langone Health in New York City. “That goes for everything, from vaccines to allergies. It’s rare on the first time to have a strong reaction. After that, the immune system recognizes it, so you have a much stronger reaction.”

“We saw it in the trials, so it’s really not surprising,” Parikh added. “Now we’re seeing it in real time as the vaccines are being rolled out.”

More adverse effects were reported after the second dose in both Pfizer’s and Moderna’s phase III trial data. For Moderna, the rates were 54.9% versus 42.2% for placebo after the first dose and 79.4% versus 36.5% for placebo after the second dose.

Stanley Weiss, MD, an infectious disease specialist and epidemiologist at Rutgers New Jersey Medical School, told MedPage Today that because his institution served as a Moderna trial site, the primary investigator was able to give an early update on what to expect following vaccination.

“They said there was a very high rate of fatigue after the second dose, so we encouraged administrators … to figure that many healthcare workers getting the vaccine might not be well enough to work the day after the second dose,” Dr Weiss said.

Drs Weiss and Parikh both experienced a stronger response to the second COVID dose. 

Zubin Damania, MD, aka ZDoggMD, said he was knocked out by the second dose of Moderna vaccine, joking on his show that, “I couldn’t sleep, I had a fever, rigors, body aches, a headache — full-on man-flu.”

Paul Offit, MD, said that he also experienced fever and fatigue after taking the second dose of the Pfizer vaccine.

“That reaction is less common in people over 65, and I’m over 65, so I’m thinking I’m not going to suffer that, but I did,” Dr Offit said.

Older people are not expected to have as intense a reaction due to their weaker immune systems. According to Dr Parikh, “The idea is that their immune system is not as robust as a young person’s.”
The same immunological underpinnings of why reactions to the second dose are worse also apply to those who’ve had COVID.
Victoria Arthur, MD, of Lexington Pediatrics in Massachusetts, had suspected she had contracted COVID in March 2020 but could not prove it. When she received the Moderna vaccine, she felt much worse than her colleagues.

“How I felt was how everyone else was describing their second vaccine,” Dr Arthur told MedPage Today. Within three hours of her jab, she was suffering from a headache, neck pain, and cognitive fog. She awoke at 3am with nausea and stomach cramps, and spent the whole of the next day in bed. 

“I’m always grateful when I have a reaction, that means the body is doing its thing,” she said. “I’m very fortunate to have been given the vaccine, so any side effect is worth it.”

In spite of the side effects, these health care professionals all expressed gratitude at having been vaccinated.

Dr Weiss said that people shouldn’t be discouraged by the side effects from the second dose and not get vaccinated: “The benefits greatly overwhelm the risk of side effects. It’s not a reason to delay.”

Source: MedPage Today

Categories : COVID General InterestTags :

WHO Team in China Denied Key COVID Information

On By ModernMedia

The World Health Organization team sent to China to investigate the origins of the COVID virus have been frustrated in their efforts to secure key data.

Team member Dominic Dwyer, infectious disease expert, said that they had only been given a summary instead of the raw patient data that they had requested.

Raw, anonymised patient data is part of standard outbreak investigation, Dwyer said, and this was particularly important because half of the initial 174 patients had no contact with the wet market.

“That’s why we’ve persisted to ask for that,” said Dwyer. “Why that doesn’t happen, I couldn’t comment. Whether it’s political or time or it’s difficult.”

Although Wuhan is the site of the initial outbreak, China has sought to cast doubt on its origin there, pointing to a source outside the country that may have come in with frozen food.

US national security adviser Jake Sullivan said that he had “deep concerns” over the initial findings of the investigation, saying that “It is imperative that this report be independent, with expert findings free from intervention or alteration by the Chinese government.”

Peter Ben Embarek, the WHO delegation leader, said that the virus likely had an animal origin and may have taken a “very long and convoluted path involving also movements across borders”. The possibility that it may have travelled in frozen food is worth investigating, he added.

After their two week quarantine, the WHO team members were only allowed to go on visits organised by their Chinese hosts. Thea Kolsen Fischer, an immunologist and another WHO team member, said to the New York Times that she saw the investigation as “highly geopolitical”.

“Everybody knows how much pressure there is on China to be open to an investigation and also how much blame there might be associated with this,” she said.

Team member Peter Daszak, and president of the EcoHealth Alliance, said that it “was not my experience”.

“As lead of animal/environment working group I found trust and openness with my China counterparts. We did get access to critical new data throughout,” he tweeted.

“New data included environmental and animal carcass testing, names of suppliers to Huanan market, analyses of excess mortality in Hubei, range of Covid-like symptoms for months prior, sequence data linked to early cases and site visits with unvetted live question and answer.”

Source: The Guardian

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 :

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.