Tag: public health

Categories : COVIDTags :

Sceptical South Africans Want More Vaccine Info

On By ModernMedia

Professor Carin Runciman, Director of the Centre for Social Change at UJ, has said that most people who are sceptical about COVID vaccines simply want more information. 

An online survey of 10 000 South African adults conducted with the Human Sciences Research Council showed that 67% were likely to take the vaccine if it were offered to them. Runciman said that many of the participants had indicated that they wanted more information before they could decide to take it.

Government and scientists came for criticism recently for giving mixed messages about vaccines, which are a few days away from their first rollout in South Africa. With the first million doses arriving in SA from the end of January, an ambitious target of 31 000 vaccinations a day has been announced, though with few firm details. The majority (70%) of the vaccines are to be AstraZeneca, although given their delays in supplying the EU and the bloc’s subsequent restrictions on vaccine exports, that may impact on SA’s vaccination programme.

Opinions also differed according to age and race. In a very strange result, those with higher levels of education were less likely to want to take a vaccine than those with a lower level. Age and race also played a factor, although no explanation was offered for the discrepancy. “Black African adults were more likely to want to take the vaccine – 69% for black African adults, 55% for white adults – those who [are] older are more likely to want to take the vaccine compared to those that are younger. Those that have a less than matric education are much more likely to want to take the vaccine than those with a tertiary education.”

Source: Eyewitness News

Categories : COVIDTags :

EU to Restrict AstraZeneca Exports to Tackle Vaccine Shortage

On By ModernMedia

In response to AstraZeneca’s COVID vaccine production and delays, the European Union has warned that it will tighten exports of the company’s vaccine to countries outside its borders.

EU Health Commissioner Stella Kyriakides warned it would “take any action required to protect its citizens”, adding that she had requested detailed delivery schedules and a meeting next week with the company. She added that “in the future, all companies producing vaccines against Covid-19 in the EU will have to provide early notification whenever they want to export vaccines to third countries”.

The vaccine, developed by Oxford University and the British-Swedish company AstraZeneca, is still yet to be approved in the EU but should receive it by the end of January, with distribution set to start on the 15th of February. The EU has been suffering from a number of vaccination programme setbacks, including a previous announcement last week from Pfizer that its own deliveries were being delayed in order to upgrade manufacturing capabilities at a plant in Belgium, provoking ire amongst EU politicians. Italy’s PM has resigned over handling of the pandemic.

The EU had signed a deal in August to secure 300 million doses from AstraZeneca, with an option for another 100 million. Last week, AstraZeneca had announced a slowdown in delivery due to “reduced yields at a manufacturing site within our European supply chain”. The problem is thought to be from a manufacturing plant also in Belgium, which is run by an AstraZeneca partner firm. The exact size of the shortfall is not known but some believe it to be a drop of 31 million doses, or 60% of those meant to be delivered by the end of the quarter.

Where this leaves low and middle-income countries counting on the Oxford/AstraZeneca vaccines is unclear, but it certainly will add to mounting tension between countries seeking vaccines for their populations amidst the spread of more contagious COVID variants. President Cyril Ramaphosa warned in an address to the World Economic Forum that vaccine nationalism was a growing concern and threat to global recovery. The African Union’s vaccine task team has thus far managed to secure only 270 million doses.

Source: BBC News

Categories : COVIDTags :

Stellenbosch Doctors Urge Patience on Ivermectin

On By ModernMedia

The South African public should be patient and wait for data on Ivermectin’s effectiveness against COVID, according to Stellenbosch doctors, who urge patience. The doctors wrote an article published in the South African Medical Journal explaining that further studies need to be completed before ivermectin can be authorised for use.

A veterinarian parasiticide that may have relevant antiviral and anti-inflammatory properties, ivermectin has gathered considerable attention for possible use in COVID prophylaxis and treatment since a number of small trials appeared to show effectiveness. However, close examination shows that they are very weak. Doubts have been raised over whether the necessary concentrations used in vitro can be achieved in vivo.

In their article, the doctors noted that several large randomised controlled trials are underway, and the results of these will allow the possible effectiveness of ivermectin to be gauged. “Data for Ivermectin from larger RCTs are expected in early 2021,” the doctors wrote. “These data are very promising, showing large treatment effects and acceptable adverse effect profiles for ivermectin against Covid-19, especially when combined in meta-analyses.”

They pointed out that the hoped-for effectiveness of other medications had not been borne out. “As a recent example, the widely proclaimed benefits of hydroxychloroquine and chloroquine from observational studies proved to be unfounded in larger RCTs,” they wrote.

Ivermectin use has been banned by the government, to considerable resistance. A number of organisations have already demanded that ivermectin be administered as a COVID treatment, including Black First Land First, the New Economic Rights Alliance and AfriForum. Afriforum is contemplating legal action to have ivermectin authorised. These calls have come despite the South African Health Products Regulatory Authority (SAHPRA) repeatedly counselled against the use of ivermectin.

The doctors cautioned that although the data trends indicated a possible efficacy for ivermectin, the optimal dosage if effective still needed to be determined: “Higher than standard Ivermectin doses appear to be safe in humans, but at the time of writing there is still much uncertainty regarding the human dose required to achieve antiviral activity and a favourable benefit-to-risk balance.”

Source: IOL

Categories : COVIDTags :

Gauteng Doctors’ Struggle in COVID “Fever Tents”

On By ModernMedia

Angry doctors have opened up concerning recent images of severely ill patients at Steve Biko Academic Hospital (SBAH) being treated in tents amid pouring rain. These images came as David Makhura and MEC for Health Dr Nomathemba Mokgethi visited the hospital on Monday.

Speaking on condition of anonymity, two doctors at SBAH spoke to Daily Maverick about the reality of the situation. The doctors described a desperate situation of overwhelmed facilities, with patients possibly dying as much from the cold and rain as from untreated COVID – or indeed, a condition that presents similarly to COVID.

The image presented to the public by the government is “smoke and mirrors”, said Dr Felicia (not her real name). “This is a show. They [health officials] are lying to you people. They are lying. They are covering it up,” she said.”Fever tents” have been set up outside the Emergency Department, where patients remain while they are being screened for COVID. If they test negative, they are admitted to SBAH If they test positive, they are sent to Tshwane District Hospital.”

According to Dr Felicia, conditions in the tents are abysmal. “There is no nursing, there is no oxygen or beds in these tents. There is no oxygen in the tanks, we actually just do 10 minutes of CPR and many times we don’t have PPE to do it in.”

As infections continue to rise in South Africa, approaching 250 000 active cases, hospitals are buckling under the pressure, and doctors are expecting the worst to come.

Dr Monica (not her real name) spoke of her feelings of the situation. “I don’t feel like I am being protected by our hospital right now. I am running around like a chicken without a head. I feel very hopeless. I feel like I should not care anymore. Caring is actually just hurting me and the patients because instead of me doing what I said I was going to do when I left medicine, I am treating these people like numbers. Someone dies and you have to shrug your shoulders and move on to the next. There is not even a minute to mourn a person or to figure out what went wrong. I feel completely hopeless,” she said.

Dr Monica said people need to stop politicising the pandemic, and get the hospitals the resources they need. She also implored the reporters to convey their message. “Tell the people out there, this is serious. They must wear masks, they must social distance,” she said, breaking off and running to attend to a patient.

Source: Daily Maverick

Categories : COVIDTags :

US Health Workers’ Vaccine Hesitancy Is Cause for Concern

On By ModernMedia

Health care workers in various parts of the United States are showing extraordinarily high rates of COVID vaccine hesitancy: 20% to 40% of front line workers in Los Angeles, and 60% of nursing home workers said they would refuse to take the vaccine. This has generated great concern along with some instances of shaming, but failing to address these worries is potentially going to worsen the progression of the pandemic.

Fortunately, national surveys show that vaccine hesitancy is decreasing with some 60% of Americans now intending to receive a vaccine, but the high numbers among healthcare workers demands attention. Speaking to the Guardian, Dr Whitney Robinson, an epidemiologist at the University of North Carolina, said that if this is not addressed, “It could mean after all this work, after all this sacrifice, we could still be seeing outbreaks for years, not just 2021, maybe 2022, maybe 2023.”

In Atlanta, while hundreds of healthcare workers were on the list for vaccines, the doses were literally “sitting in the freezers” because no-one would take them.In one survey, up to 55% of New York firefighters said would not take the vaccines, so the Uniformed Firefighters Association president put together a 50 minute video with a virologist friend, addressing their concerns. Subsequent calls from firefighters showed the video had helped to change minds and increase vaccination numbers.

The concerns are varied. Some are concerned about possible side effects and long term consequences, or have read misinformation online. Others are worried about the effect it will have on pregnant and breastfeeding women. Still others believe that having the vaccine is unnecessary after having recovered it, as they have the antibodies in their system. A lot of the distrust may be from minority groups’ deep-rooted distrust of large-scale health programs such as vaccinations, according to Dr Nikhila Juvvadi, the chief clinical officer at Loretto hospital in Chicago. Many specifically mentioned the Tuskegee Study, where federal health officials studied African-American men with sexually transmitted diseases which were deliberately not treated.

“I’ve heard Tuskegee more times than I can count in the past month – and, you know, it’s a valid, valid concern,” said Juvvadi.
However, she said that individual conversations were effective in helping alleviate concerns about the vaccines.

Source: The Guardian

Categories : COVID Diseases, Syndromes and ConditionsTags :

A Four Century Old Manual for Social Distancing Rules

On By ModernMedia

A feature article from the BBC details how one doctor in the era of the Plague created an eerily familiar set of social distancing guidelines that matches a lot of our non-pharmaceutical COVID controls.

Staying at home and only sending out one person to do the shopping, keeping six feet apart and disinfecting goods – all of these feature in a manual created over four centuries ago to help protect Alghero, a small Italian town against the plague. The methods by a doctor named  Quinto Tiberio Angelerio, published in a 57-page booklet on his methods, titled Ectypa Pestilentis Status Algheriae Sardiniae.

Unlike most plague outbreaks, it failed to spread to neighbouring areas and died out within eight months – though not without claiming about 60% of the town’s initial population of 6000. Angelerio’s rules are thought to be at least partly responsible.

Ravaging Europe as well as Asia and North Africa, the plague left an unimaginable mark on Western society; tunnelling projects in London regularly run into mass graves of plague victims. Italian poet Francesco Petrarca wrote that future generations would likely not be able to grasp the scale of the calamity, and he is probably right in that regard. The plague continued to reappear, and devastated regions when it did – The Great Plague of London saw 24% of its populace dying over 1665 to 1666.

Although the germ theory of disease was then still centuries in the future, and bathing in urine was thought to be effective treatment, physicians in Europe believed in the contagion theory, thinking that diseases were spread through “miasmas” or “bad air”. This enabled them to come up with the idea of quarantines, from the Italian for “forty days” which was the standard isolation period.

Facing huge obstacles from a recalcitrant citizenry, Angelerio nevertheless persevered and soon a lockdown was enacted. This was not unique, as whole cities would be quarantined. Other rules that were enforced included a social distancing of six feet (as measured by a pole to be carried around by anyone outside), advising people to be careful shaking hands during mass, as well as railing preventing customers coming into contact with shopkeepers. He also used superstition to keep people in line, as European people of the time believed the plague to be divine punishment – although rule breakers were common, as they are now with COVID. He also advised cleaning and disinfecting houses, and household goods (or burning if replaceable), in addition to the contemporary practice of disinfecting newly arrived cargo. This was accomplished by fire or exposure to the wind, among others. However, the common practice of killing cats in response to plague was likely counterproductive, as rats hosted plague-carrying fleas.

Nevertheless, Angelero’s work was ahead of its time, and helped lay the foundations of modern disease control.

.Source: BBC Future

Categories : COVID UncategorizedTags :

Medical Aid Schemes to Share Cost of Nationwide Vaccination

On By ModernMedia

As arrangements are being made to pay for the COVID vaccination programme for South Africa, medical aid schemes are expected to contribute to the cost towards ensuring at least 67% of the population receives a vaccine, which is the minimum number to establish herd immunity.

Across South Africa, there are some 9 million medical aid beneficiaries, making up some 16% of the population and who collectively spent R186 billion last year on healthcare. The total cost of providing sufficient vaccines for the South African population is thought to range from R5 billion to R20 billion, depending on whether the vaccine is simply bought for the commercial price or whether the distribution and administration costs are factored in as well.

Discussions into paying for the mass vaccinations have suggested that mass-employers, such as mines, ought to contribute  This week, the Council for Medical Schemes (CMS) confirmed that vaccination would be a minimum prescribed benefit, so this will not be paid for out of medical savings.”The CMS acknowledges that there may be an additional cost burden to medical schemes for the provision of the vaccine, but this is not expected to be prohibitively high,” the body said. “In addition, industry associations have assured the CMS that vaccine costs can be absorbed by most medical schemes.”

South Africa’s vaccine source is not yet clear, although President Cyril Ramaphosa has hinted that Canada may share its excess vaccine stock. Canada currently has enough vaccine pre-purchase agreements to vaccinate its population five times over.

Source: Business Insider

Categories : COVIDTags :

New Study Shows Pollution May Accelerate COVID Spread

On By ModernMedia

A study from the McKelvey School of Engineering at Washington University shows that pollution may have contributed to the rapid spread of COVID through the United States.

The spread of COVID is directly associated with the long-term ambient level of PM2.5 (particles less 2.5 micrometres in diameter) and the reproduction number R0 for the coronavirus. PM2.5 are small enough to enter the lungs and cause damage. Matters are only worsened with secondary inorganic components in PM2.5.

Looking at 43 factors such as age, population density and time delays in lockdown orders, and comparing it to pollution statistics, they found a linear association with PM2.5 concentrations and inorganic components. Interestingly, this relationship only appeared above a certain level of air pollution.

“Annual mean PM2.5 national standards are set at or below 12 microgrammes per cubic metre, below that you are supposed to be safe,” said Rajan Chakrabarty, associate professor in the Department of Energy, Environmental & Chemical Engineering. “What we saw, the correlation we’re seeing is well below that standard.”

More detailed analysis showed that black carbon in the form of soot had a synergistic effect. “We found black carbon acts as a kind of catalyst. When there is soot present, PM2.5 has more of an acute effect on lung health, and therefore on R0.”

Source: Science Daily

Categories : COVIDTags :

No Lockdown May Worsen Economies

On By ModernMedia

In an article for The Conversation, Michael Smithson of the Australian National University argues that far from there being a toss-up between saving lives with a lockdown, and protecting the economy by keeping a country open, lockdown may in fact protect the economy.

Some arguments even leaned towards Indeed, US Treasury Secretary Steve Mnuchin said in June, “I think we’ve learned that if you shut down the economy, you’re going to create more damage.”

The choice of whether to implement lockdown has been a particularly difficult choice to make for South Africa, beset by deep inequality. Its lockdown caused its economy to shrink by 51% in the second quarter.

Economic and COVID data from 45 countries was sourced for analysis. The data has two outliers; namely China, which implemented a very effective early lockdown, and India, which implemented a strict lockdown that became very ineffective as time went by.

Consumer expenditure, an important indicator of economic activity, was negatively correlated with COVID cases, indicating that the economy fared better with attempts to suppress the virus (at least temporarily).

In European countries, GDP was positively correlated with COVID cases, indicating that economic activity itself drove up the rate of COVID cases. 

The article’s conclusions do have some limitations. The economic data were drawn from the second quarter, and COVID cases were taken as of June 30, but the pandemic hit different countries at different times. 

Categories : COVIDTags :

Effectiveness of COVID Government Interventions Compared

On By ModernMedia

Currently, the most widely used tool to deal with the spread of COVID are non-pharmaceutical interventions (NPIs), which involve measures such as social distancing. In the face of the sudden emergency of the COVID pandemic, governments around the world implemented a wide range of NPIs, some based on scientific advice and some not. The effectiveness of these government interventions is compared in a new study.

In order to evaluate the effectiveness of these responses, researchers studied government interventions across 79 countries and territories. Each item was ranked, making a comprehensive dataset of 6068 interventions and compared to the reproduction number, Rt. They were analysed with four computational methods, including machine learning.

The study found that the most effective interventions were those that restricted movement such as travel restrictions and lockdowns, as well as social distancing. Cancellations of gathering also seemed to be effective. The least effective were appeals for international aid, tracking and tracing, disinfecting surfaces had the least impact.

Interventions also had differing effectiveness depending on what stage of the pandemic they were implemented in.

The most consistently effective intervention across all locations was contact tracing and quarantine.

Source: News-Medical.Net