Category: Corona Virus Vaccine

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COVID-19 Vaccine Scheduling – UW Health

July 2, 2022

To schedule yourCOVID-19 vaccine appointment, please start by answering a few questions through the form below.

Please note: For infants and children through age 17 years, a parent or guardian must be present during the appointment or available by phone.

Online will be the fastest and most up-to-date way to schedule, but if you are having difficulties please call (608) 720-5055. We recommend accessing the online scheduling form from a computer instead of a mobile device in order to ensure the best usability experience.

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COVID-19 Vaccine Scheduling - UW Health

Covid-19 Tracker: Is ‘the worst’ on its way? – Mission Local

June 30, 2022

Good morning, Mission, and welcome to Virus Village, your (somewhat regular) Covid-19 data dump.

Hospitalizations, positivity rates, R Number models and wastewater monitoring are all up, while recorded infections remain flat.

Omicron sub-variants BA.4 and BA.5 are now taking over as the dominant strains in the world and will soon be dominant in the U.S. These variants are the most contagious yet. The virulence is open to question, but a rise in hospitalizations around the world, particularly in heavily vaxxed Portugal is not a good sign.

Here is a summary of the new variants.

What steps is San Franciscos Department of Public Health taking to mitigate transmission or warn of the dangers posed by the new variants?

Yesterday a subcommittee of the FDA recommended another booster for the fall which has been reconfigured to take into account omicron. But it was designed for omicron .1, not omicron .4 or .5. The data on the effectiveness of the vaccine is very limited, giving rise to a variety of interpretations.

Here are pros and cons for the new booster.

A universal corona virus vaccine is now being tested. This seems better than chasing after variants that keep changing.

High community spread undermines the effectiveness of individual responsibility and the use limited clinical tools. Understanding the infectivity of the airborne virus would seem logical, as would an emphasis on ventilation.

High community spread and re-infection increase the likelihood of long covid, says the World Health Organization. Heres an interview with UCSFs Dr. Lekshmi Santhosh on what we know and dont know about long covid.

What are the covid protocols in hospitals? Do they segregate covid patients from others? Do hospital workers wear N95s? Do they clean the air? How? And how often? Here is a summary on actions taken by academic hospitals around the country. There are no standards, and the diversity of practice is somewhat shocking. But not surprising.

Whats happening in San Francisco hospitals? Who knows? Our local celebrity experts prefer to discuss individual risk calculation rather than what their hospitals are doing to protect workers and patients.

Determined inaction by government officials at all levels has left us vulnerable to new variants and repeated surges. But why would anyone deliberately degrade community hubs, one of the most effective and hopeful programs developed in the City? As Ed Yong points out, community work has been foundational in fighting any pandemic.

Over 4 million (!!!) papers, studies and preprints have come out on covid, and we still know so little.

Scroll down for todays covid numbers.

Over the past week, hospitalizations jumped 33 percent (representing 27 more patients). On June 25, DPH reports there were 108 covid hospitalizations,or about12.4 covid hospitalizations per 100,000 residents (based on an 874,000 population). ICU patients had climbed to 22, but have fallen back to 15. The California Department of Public Health currently reports 115 covid patients in SF hospitals with 23 patients in ICU.

The latest report from the federal Department of Health and Human Services shows Zuckerberg San Francisco General Hospital with 12 covid patients and 8 ICU beds available, while across the Mission, CPMC had 8 covid patients and 4 ICU beds available. Of 106 reported covid patients in the City,52 were at either SFGH or UCSF, with at least 72 ICU beds available among reporting hospitals (which does not include the Veterans Administration or Laguna Honda). The California DPH currently reports 104 ICU beds available in San Francisco.

Between April 25 and June 24, DPH recorded 1,389 new infections among Mission residents (an increase of 5.8 percent from last week) or 250 new infections per 10,000 residents. During that period, Mission Bay continued with the highest rate at 432 new infections per 10,000 residents. Although Mission Bay was the only neighborhood with a rate above 400, 14 others had rates above 300 per 10,000 residents, with 9 in the east and southeast sectors of the City. In a surprise, Seacliff posted a rate of 327 per 100,000 residents (perhaps the City will pay more attention to transmission now).

DPH reports on June 21, the 7-day average of daily new infections recorded in the City rose to 422 or approximately 45.7 new infections per 100,000 residents (based on an 874,000 population), basically flat since last week. According to DPH, the 7-day average infection rate among vaccinated residents was 48.2 per 100,000 fully vaccinated residents and 94.8 per 100,000 unvaccinated residents. It is unclear whether fully vaccinated means 2, 3 or 4 doses. According to the New York Times, the 7-day average number on June 21 was 465. The latest report from the Times says the 7-day average on June 28 was 492, a 1 percent decrease over the past two weeks. As noted above, wastewater monitoring shows a substantial rise in the southeast sewers. This report comes from the Stanford model. The state is still reporting staffing problems.

So far in June, Asians recorded 3,279 new infections or 31.1 percent of the months cases; Whites 2,388 infections or 22.6 percent; Latinxs 1,333 infections or 12.6 percent; Blacks 484 infections or 4.6 percent; Multi-racials 72 infections or 0.7 percent; Pacific Islanders 54 infections or 0.5 percent; and Native Americans had 23 recorded infections in May or 0.2 percent of the June totals so far.

On June 21, the 7-day rolling Citywide average positivity rate rose 10.9 percent during the past week to 14.3 percent, while average daily testing dropped approximately 7.4 percent. Over the past two months, the Mission has had a positivity rate of 10.8 percent.

Vaccination rates in SF show virtually no change from last week.

For information on where to get vaccinated in and around the Mission, visit ourVaccination Page.

Nine new covid-related deaths, with 7 more in June, have been reported, bringing the total since the beginning of the year to 215. DPH wont say how many were vaccinated. Nor does it provide information on the race, ethnicity or socio-economic status of those who have recently died. According to DPH COVID-19 deaths are suspected to be associated with COVID-19. This means COVID-19 is listed as a cause of death or significant condition on the death certificate. Using a phrase like suspected to be associated with indicates the difficulty in determining a covid death. The fog gets denser as DPH reports, incredibly as it has for months, only 21 of the deaths are known to have had no underlying conditions, or comorbidities. DPH only supplies cumulative demographic numbers on deaths.

The lack of reliable infection number data makes R Number estimates very uncertain. Covid R Estimation on June 24 estimated the San Francisco R Number at 1.21 while its estimate for the California R Number on June 27 was 1.26. The ensemble, as of June 26, estimated the San Francisco R Number at .97 and its California R Number at .97. Note: All but one model in the ensemble show SF under 1.

So far in June, DPH reports 56 new infections and 0 new deaths in nursing homes (skilled nursing facilities), while in SROs (Single Room Occupancy hotels), DPH reports 40 new infections and 1 new death.

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Covid-19 Tracker: Is 'the worst' on its way? - Mission Local

‘Better vaccines’ needed to cover COVID variants, infectious disease experts say – KSTP

June 30, 2022

Dr. Gregory Poland, an infectious disease physician at Mayo Clinic in Rochester, told 5 EYEWITNESS NEWS the original vaccines against the COVID-19 virus did a terrific job keeping people out of the hospital and preventing death, but he said moving forward better vaccines need to be developed.

The current vaccines offer only mild benefit, in terms of infection, against those new variants, said Poland. So, the idea is, and both Moderna and Pfizer both plan no doing this, to devise vaccines that cover the Omicron variant.

Poland told 5 EYEWITNESS NEWS the goal is to possibly have an updated COVID vaccine by early fall by using part of the original vaccine and the vaccine that was used during the Omicron surge.

But, Poland said the ultimate goal is to develop a so-called Pan-Corona Vaccine which would offer better protection against all of the variants that have emerged with the virus.

The idea that we, and others are working on, is a Pan-Corona virus vaccine. Or, if you will, a universal Corona virus vaccine, said Poland. Thats still a ways off, but thats the goal.

Dr. Peter Bornstein, with St. Paul Infectious Disease Associates, told 5 EYEWITNESS NEWS he agrees with the push by the Food and Drug Administration to come up with a more effective vaccine.

We definitely need better vaccines. How much the virus itself will keep mutating, and have immunological escape from the vaccines, we just dont know yet, said Bornstein.

The FDA met Tuesday to discuss the future of new COVID vaccines, but did not yet offer any recommendations.

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'Better vaccines' needed to cover COVID variants, infectious disease experts say - KSTP

The fourth wave of the COVID-19 in Afghanistan | IDR – Dove Medical Press

June 28, 2022

Commentary

The first case of the Corona Virus Disease-2019 (COVID-19) in Afghanistan was detected on 22 February 2020 in a person who had returned from Qom city, Iran.1 As of 30 May 2022, a total of 180,176 confirmed cases, including 7701 deaths, were reported to the World Health Organization (WHO). The recovery rate is reported to be around 90% and Case Fatality Rate to be 4.29%.2 However, it is said that the actual figures of the infected cases might be much higher than the reported numbers.3

Meanwhile, a total of 6,118,557 doses of the COVID-19 vaccine have been administered to the residents in the country.2 Afghanistan is the lowest among many nations in terms of the COVID-19 vaccine coverage. As per the official reports, around 10% of the total population are vaccinated thus far, which is way behind the proposed target for 2022, ie 60%.

Since the beginning of the pandemic, the COVID-19 has spread throughout the country in four waves. The first wave was reported to span from the end of April to June 2020; the second wave began by October 2020 and lasted until the end of December 2020; the third wave reportedly began by April 2021 and lasted until mid-August 2021.2

An analysis of the recent data uploaded by the District Health Information Software-2 (DHIS2) reveals that the fourth wave of the COVID-19 passed in March 2022. As shown in Figure 1, the peak numbers were reported during the month of February 2022 with highest confirmed cases in the first and second weeks, ie 3850 and 3847 cases, respectively. By March 2022, the cases began to decline until the curve almost fattened in April 2022.

Figure 1 The trend of the COVID-19 confirmed cases during JanApr 2022 (fourth wave).

The COVID-19 pandemic hit Afghanistan at a time when the country was politically undergoing changes, with a fragile healthcare system which was unable to respond to the emergence of COVID-19 and to the needs of the most vulnerable people. The government lacked the means to communicate adequately with the citizens, trace contacts, collect and test samples. In the beginning of the fight against COVID-19, the government had only one dedicated hospital, the Afghan Japan Hospital, for the provision of COVID-19 related services, including sample collection. A few months later, Ali Jinnah Hospital was also designated to treat COVID-19 patients in Kabul. In both these hospitals, the outpatient and inpatient clients were very high, making it almost impossible to provide the needed health services and case detection.

Before August 15, 2021, overall, a total of 38 COVID-19 hospitals were operating throughout the country, all of them funded by international donors. Alongside these, Rapid Response Teams (RRTs) and District Centers (DCs) were also established as part of the Emergency Response to COVID-19 to conduct risk communication sessions, collect samples of suspected cases, trace contacts and advice on mild and moderate cases to be treated at home. These actions were vital in helping to reduce the burden of the COVID-19 designated hospitals, and thus enabled them to focus on the management of severe and critical cases. After the collapse of the previous government, all funding and supports to the COVID-19 emergency response were reduced and most of the hospitals were forced to stop their operations due to lack of funds, doctors, medicine, and even heating.4

The lack of healthcare personnel to collect the samples of suspected individuals and the shortage of kits for laboratory diagnostic tests are still the major challenges in most districts of Afghanistan. High levels of financial insecurity in several parts of the country have had a large and direct negative effect on the provision and coverage of healthcare services for the general public.5 Unfortunately, many people who have received their first shots of the COVID-19 vaccine have not received the next dose due to shortage or unavailability of vaccine.6

Although the fourth wave of the COVID-19 passed with no clear and accurate data of the mortality and morbidities, it is assumed that the next wave might not be too far. Challenges such as the lack of or insufficient donor funds, unstable political situation, inadequate healthcare services, insufficient healthcare workers and diagnostic capacity, illiteracy of people, poor economy and shortage of the COVID-19 vaccine are threatening to push the nation towards a devastating stage. The de facto authority also does not seem to have a clear plan to fight against the pandemic. Therefore, the international community, civil societies, healthcare workers and other stakeholders should pool their efforts immediately to improve and restore the health system.

Fortunately, many COVID-19 hospitals resumed their operations with the funds provided by international donors; however, for the long term, the COVID-19 services should be integrated in the countrys existing healthcare services framework, ie the Sehatmandi project. Moreover, awareness campaigns should be continued to keep the most vulnerable groups safe and protected. Vaccination services also need to be speeded up to have a significant portion of people immunized. Public willingness towards getting the vaccine should be increased through awareness campaigns mostly conducted by social media volunteers and healthcare workers.

The authors would like to sincerely thank Dr. Pakeer Oothuman, a former professor of parasitology at the University Kebangsaan Malaysia and International Islamic University Malaysia, for editing the manuscript.

The authors declare no conflicts of interest in relation to this work.

1. Mousavi SH, Shah J, Giang HTN, et al. The first COVID-19 case in Afghanistan acquired from Iran. Lancet Infect Dis. 2020;20(6):657658. doi:10.1016/S1473-3099(20)30231-0

2. World Health Organization. COVID-19 dashboards - Afghanistan situation. Available from: https://covid19.who.int/region/emro/country/af. Accessed May 31, 2022.

3. Nemat A, Asady A. The third wave of the COVID-19 in Afghanistan: an update on challenges and recommendations. J Multidiscip Healthc. 2021;14:20432045. doi:10.2147/JMDH.S325696

4. Al-Jazeera. COVID surge batters Afghanistans crumbling healthcare. Available from https://www.aljazeera.com/gallery/2022/2/10/photos-covid-surge-batters-afghanistans-crumbling-healthcare. Accessed February 11, 2022.

5. Shah J, Karimzadeh S, Al-Ahdal TMA, et al. COVID-19: the current situation in Afghanistan. Lancet Global Health. 2020;8(6):e771e772. doi:10.1016/S2214-109X(20)30124-8

6. World Health Organization (WHO) Regional Office for the Eastern Mediterranean. COVID-19 vaccines shipped by COVAX arrive in Afghanistan, Available from: http://www.emro.who.int/afg/afghanistan-news/covid-19-vaccines-shipped-by-covax-arrive-in-afghanistan.html.Accessed June 23, 2022.

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The fourth wave of the COVID-19 in Afghanistan | IDR - Dove Medical Press

Electroconvulsive Therapy in Japan During the COVID-19 | NDT – Dove Medical Press

June 28, 2022

Introduction

The coronavirus disease 2019 (COVID-19) pandemic has had a substantial impact on medical practice,1,2 and the use of electroconvulsive therapy (ECT) as a general anesthetic procedure has been no exception. From the outset of the global pandemic, concerns have arisen worldwide about the disadvantages for patients who needed but were not able to receive ECT. In several countries with severe outbreaks of COVID-19, the number of ECT cases declined in 2020, and some facilities stopped ECT completely.3,4 In April 2020, a group of psychiatrists in the United States appealed vigorously to the medical community to support that ECT is an essential treatment modality, even with limited medical resources, and that some patients can only be effectively treated by ECT.5 Specialists in ECT then developed recommendations for the criteria to guide ECT introduction and infection control measures during the COVID-19 pandemic.6,7

In Japan, the total number of COVID-19 deaths was lower than that in most other countries, and the government did not enforce strict lockdowns throughout the pandemic.8,9 However, large increases in the number of COVID-19 infections occurred in five waves until October 2021 (Figure 1), which challenged the countrys ability to maintain essential medical services, including ECT. As in other countries, the rapid spread of COVID-19 infection caused confusion in clinical practice. The Japanese Society of General Hospital Psychiatry made its own recommendations regarding ECT during the pandemic,10 referring to the criteria proposed by ECT specialists as previously noted, and each facility decided on its criteria for introducing ECT and infection protection measures based on these domestic and international recommendations. However, the number of ECT cases and the degree of infection control required varied based on differences in infection status in different regions throughout Japan and at different time points throughout the pandemic, resulting in a wide range of approaches to the issue.

Figure 1 Number of new positive coronavirus disease 2019 (COVID-19) cases for patients hospitalized in Japan (based on the website of the Ministry of Health, Labour and Welfare, outbreaks in Japan, etc. https://www.mhlw.go.jp/stf/covid-19/kokunainohasseijoukyou.html, accessed December 14, 2021). The first survey was conducted in August 2020 and the second survey in August 2021. The number of electroconvulsive therapy (ECT) cases from April to June 2020 was compared with that from April to June 2021, which approximately corresponds to the first and fourth waves, respectively, of the COVID-19 pandemic.

ECT is widely used in Japan as well as other countries, and the number of ECTs being administered is increasing, with about 96,000 ECTs (0.76 per 1000 population) performed in 2019.11 The estimated number of ETCs performed in Canada is approximately 67,000 (2.112.13 per 1000 population). To the best of our knowledge, to date no studies have investigated how ECT practice in Japan has changed in response to the COVID-19 pandemic, the degree to which the impact of COVID-19 on ECT practices varied by region, and how the infection control measures of each facility changed in response to shifts in infection during the pandemic. Our study describes how facilities offering ECT have struggled during the COVID-19 pandemic in Japan. We surveyed healthcare institutions, primarily university and general hospitals, regarding the changes in the numbers of ECT cases and in their decisions related to ECT in each facility throughout the pandemic, from the first wave in April 2020, through the fourth wave in AprilJune 2021, to the fifth wave in August 2021. Based on these survey results, we discuss the best way to deliver the necessary treatment to patients who require ECT with appropriate protective measures and with an awareness of a next wave of pandemic in the future.

Two surveys were administered for this study. In the first survey, in August 2020, we used a mainly selective and partly descriptive questionnaire using Google forms12,13 (see Supplemental Digital Content 1). The questions were related to: 1) ECT delivery before the spread of COVID-19 infection; 2) protection measures for COVID infection for low- and high-risk cases; and 3) ECT delivery during COVID-19 pandemic. In these questions, the criteria for determining whether each case was at high risk for infection were determined by each facility. In the second survey conducted in August 2021, new questions were added, focusing on the changes in the situation after the first survey. To understand the changes between the early and recent stages of the pandemic, the numbers of patients who underwent ECT from April 2020 to March 2021 (during the pandemic) and from April 2019 to March 2020 (before the pandemic) were compared. Similarly, the number of patients undergoing ECT from April to June 2020 was compared with the number from April to June 2021.

The participants were ECT training facilities accredited by the Japanese Society of General Hospital Psychiatry (JSGHP) and facilities belonging to the members of the JSGHP ECT Committee. In both the first and second surveys, university and general hospitals accounted for more than 90% of the respondents. Of the 60 facilities contacted for the first survey, responses were collected from 46 facilities, of which 28 were university hospitals, 15 were general hospitals with beds, 2 were psychiatric hospitals, and 1 was a general hospital without beds. Out of the 61 facilities contacted for the second survey, responses were collected from 32 facilities, of which 21 were university hospitals, 9 were general hospitals with beds, 1 was a psychiatric hospital, and 1 was a general hospital without beds. A total of 28 facilities, comprising 20 university hospitals, 7 general hospitals with beds, and 1 general hospital without beds, responded to both the first and second surveys.

In addition, we compared the ECT cases throughout the pandemic waves in urban areas, where the impact of the pandemic was significant, with other non-urban areas. Facilities in urban areas were those located in the eight prefectures (Tokyo, Osaka, Kanagawa, Saitama, Aichi, Chiba, Hyogo, and Fukuoka) with more than 70,000 infected people as of December 13, 2021.13

This study has been granted an exemption by the Ethics Committee of Kyoto University Graduate School and Faculty of Medicine, and was conducted in compliance with the ethical standards set forth in the 1964 Declaration of Helsinki and its subsequent revisions.

Changes in the number of patients undergoing ECT throughout the COVID-19 pandemic are shown in Figure 2. The number of patients undergoing ECT decreased in 34.4% of facilities from April 2020 to March 2021 compared with the number from April 2019 to March 2020, whereas the number of patients undergoing ECT increased in 37.5% facilities from April to June 2021 compared with the number from April to June 2020. Urban areas had more facilities with a decrease in the number of patients between 2019 and 2020 than non-urban areas, whereas non-urban areas had more facilities with an increase between 2020 and 2021 than urban areas.

Figure 2 Change in the number of electroconvulsive therapy (ECT) cases. The number of ECT cases was compared from April 2020 to March 2021 (during the pandemic) with that from April 2019 to March 2020 (before the pandemic). Similarly, the number of ECT cases from April to June 2020 (the early stage) was compared with that from April to June 2021 (the recent stage).

In terms of the types of hospital, of the 21 university hospitals, the number of patients undergoing ECT decreased in 10 facilities (47.6%) from April 2020 to March 2021 compared with those from April 2019 to March 2020, whereas the number of patients undergoing ECT decreased in 8 facilities (38.1%) from April to June 2021 compared with those from April to June 2020. Of the 10 general hospitals, the number of patients undergoing ECT decreased in 2 facilities (20.0%) from April 2020 to March 2021 compared with those from April 2019 to March 2020, whereas the number of patients undergoing ECT decreased in 2 facilities (20.0%) from April to June 2021 compared with the number from April to June 2020. Trends in psychiatric hospitals could not be ascertained because only 1 facility responded.

In terms of ECT restrictions, 20 facilities (62.5%) had never restricted ECT; 12 (37.5%) had temporary restrictions, and 3 (9.4%) had ongoing restrictions. Comparison between urban and non-urban areas showed that 9 (64.3%) in urban areas were temporarily restricted versus 3 (16.7%) in non-urban areas. As shown in Table 1, in August 2021 there were no longer any facilities that did not offer ECT to patients with a low risk of infection, and there was a slight increase in the number of facilities offering ECT to patients with a high risk of infection. Regarding the change in the decision to use ECT, in August 2020, 13 facilities (28.2%) used ECT only in severe patients requiring this treatment, whereas 4 (12.6%) did so in August 2021. Regarding the change in maintenance of patients undergoing ECT in the first wave of the pandemic in April 2020, the number of patients remained constant in 28 facilities (75.7%) and decreased in 7 (18.9%), whereas therapy was no longer offered in 2 facilities (5.4%). In the fourth wave in AprilJune 2021, the number of patients undergoing ECT remained constant in 23 facilities (82.1%) and decreased in 3 facilities (10.7%), whereas therapy was no longer offered in 2 facilities (7.1%).

Table 1 Administration of Electroconvulsive Therapy in Cases with Low or High Risk for Coronavirus Disease 2019 Infection

At the time of the second survey in August 2021, all facilities had established infection control standards, and 28 facilities (87.5%) had hospital-wide standards. To develop infection control standards, one facility referred to the Guide to the Treatment of New Coronavirus Infections, COVID-19 that was prepared by the Ministry of Health, Labor and Welfare and another referred to the Use of Modified Electroconvulsive Therapy During the COVID-19 Pandemic by the JSGHP ECT Committee.

Table 2 shows the infection control measures used by psychiatrists during administration of ECT in low-risk patients. An increased use of eye shields was noted in 2021 compared with 2020. The most common type of equipment used was a combination of surgical masks (non-N95 masks) and eye shields. The equipment used by anesthesiologists and other medical staff was similar to that of the psychiatrists (see Supplemental Digital Content 2). In addition, most respondents reported that their patients undergoing ECT wore a surgical mask to protect them from infection. Also mentioned were the infection control approaches of covering the upper part of the body with plastic and using a head chamber. As shown in Table 3, the other most common infection prevention measures were polymerase chain reaction (PCR) testing and limiting the number of medical staff during ECT administration.

Table 2 Infection Control Measures Used by Psychiatrists for Electroconvulsive Therapy Cases with Low Risk of Coronavirus Disease 2019 Infection

Table 3 Infection Control Measures Other Than PPE for ECT Patients

The COVID-19 tests performed on admission at the time of the second questionnaire are shown in Table 4. More than 50% of the facilities performed PCR tests in all cases. In contrast, only a limited number of the facilities performed antigen and antibody tests. Moreover, some facilities required pre-hospital self-isolation for patients, which means staying indoors and completely avoiding contact with other people before their admission for ECT to avoid infection. At the time of the second survey, 6 facilities (18.7%) had a pre-hospital self-isolation requirement period, of which 4 (12.5%) mandated a period of 14 days.

Table 4 Tests for COVID-19 Performed on Admission (August 2021)

The number of ECT procedures was less affected in Japan than that in several other countries.3,4,1416 According to a previous paper from Canada, between mid-March and mid-May 2020, the number of ECT procedures in that country decreased in 64% of facilities, with procedures completely stopped in 27% of facilities.3 In the United Kingdom and Ireland in April 2020, 88% of facilities reported a decrease in the number of ECT procedures and 24% had stopped completely, and in July 2020, 78% of facilities still reported a decrease in the number of procedures.4 The lower impact of the pandemic on ECT practices in Japan may be due to the relatively small number of infected people and few restrictions on movement in the society such as lockdowns. Each time that the COVID-19 infection spread, the Japanese government introduced a state of emergency, but the stay-at-home guidelines were voluntary. Non-essential businesses were asked to close, but rarely faced penalties for not complying.17

A comparison of urban and non-urban areas in Japan shows a marked decline in the number of patients undergoing ECT and enforcement restrictions in urban areas. The recovery in the number of patients undergoing ECT in urban areas during the fourth wave in AprilJune 2021 was slower than in the first wave in April 2020, suggesting that the impact of the pandemic may be prolonged in urban areas.

In August 2021, more than 80% of facilities were using maintenance ECT at the same rate as before, but some were still restricted in their use. There is an urgent need to resume maintenance ECT to reach pre-pandemic levels, with priority given to patients at high risk of relapse. In a follow-up study of 81 patients for whom maintenance ECT was abruptly discontinued because of the COVID-19 pandemic, 36 patients (44.44%) relapsed within a 6-month observation period.18 In another study, the relapse rate also increased when the treatment was continued with a decreased frequency.19 Patients at higher risk of relapse were those with diagnoses other than major depressive disorder (ie, bipolar disorder, schizophrenia, schizoaffective disorder) and those with shorter intervals between maintenance ECT treatments. These findings clearly indicate that maintenance ECT is an essential treatment for which the accessibility to and frequency of administration should be stable, even in the pandemic.

Most facilities considered PCR testing before ECT if a patient was suspected to be infected with COVID-19. This strategy is recommended by several past reports.6,10,20 Furthermore, many facilities required all staff to wear surgical masks and eye shields during ECT. Some studies recommend the use of gloves, gowns, or head covers, in addition to masks and eye shields,6,10,2026 so it may be necessary to consider their use in Japan for future responses to infection and pandemic.

Another less common, but potentially effective, strategy is to cover the upper bodies of patients or to use ECT head chambers for them. Some reports suggest that if bag-mask ventilation (BMV) is needed for a significant desaturation, it may be helpful to cover the patients head with a plastic sheet2224 and to place a breathing circuit filter between the mask and valve.24,25 Because BMV is a known aerosolizing procedure,26 routine BMV should not be provided prior to ECT.23 In one chart review study, when patients were pre-oxygenated with a non-rebreather mask for 35 minutes, more than 50% of them did not require BMV and electroencephalography seizure duration did not decrease significantly.27

Our study revealed an increase in the use of ECT in patients who were not at low risk of infection in 2021. This finding may be explained by widespread awareness of the safety of ECT using proper infection control. It is conceivable that urgent cases for ECT included these patients groups: those at high risk of suicide, those rapidly deteriorating physically due to psychiatric symptoms, older adults with co-morbidities, or those with respiratory disease who have severe psychiatric symptoms but for whom pharmacotherapy is difficult, and other patients who, without ECT, are at risk of serious harm to themselves or others, including COVID-19 infection.10,28,29 Successful cases of ECT for urgent patients not at low risk of infection and even for infected patients have been reported.3034 For example, ECT in symptomatic patients has been reported in the United Kingdom in a 67-year-old man diagnosed with a major depressive episode with catatonic features. The patient presented with fever and decreased oxygen saturation prior to ECT and was found to be COVID-19 positive. Treatment for pneumonia was initiated, and 4 later the patient underwent ECT twice weekly for a total of six sessions. Infection control measures for this case included all staff wearing N95 masks, caps, visors, gowns, plastic aprons, shoe covers, and three pairs of gloves, and equipment was thoroughly disinfected before the next procedure. Glycopyrronium was also administered prior to treatment to inhibit respiratory secretion. During the procedure, BMV was avoided, intubation was performed after the use of an oxygen mask, and the psychiatrist and psychiatric nurse left the room during intubation and extubation.32 The infection control procedures in this case were practiced as recommended in other papers.35,36 To our best knowledge, no cases of ECT have been reported for infected people in Japan as of December 2021. In situations for which ECT must be performed in infected patients, it is necessary to implement ECT while taking sufficient infection control measures, referring to prior approaches used for cases globally.

In the COVID-19 pandemic, some cases of unfortunate outcomes occurred due to the inability to perform ECT.37,38 Of note, there was one case in which ECT was effective for neuropsychiatric symptoms in COVID-19.39 All these reports reaffirm the importance of ECT. We must continue to provide ECT to as many eligible patients as possible with appropriate infection control measures. It is not possible to predict how the widespread use of vaccines,40,41 the development of oral drugs,42 and the emergence of mutant43,44 strains for COVID-19 will affect the pandemic in the future. Therefore, it may still take some time before we will be able to offer ECT in the same way we did pre-pandemic.

This report has certain noteworthy limitations. The survey results may have been biased because this questionnaire only covered JSGHP training facilities and ECT committee members facilities. These facilities were relatively experienced in ECT practice, and most of them were general hospitals, including university hospitals. In a nationwide survey of psychiatric institutions in 2010, ECT was performed in 356 facilities and 217 facilities were psychiatric hospitals.45 We have not fully assessed the status of ECT implementation in psychiatric hospitals. In addition, the criteria regarding whether each case was at high risk for infection were not uniform, as they were based on each facilitys standards throughout the survey. Moreover, the exact number of ECT cases could not be determined because the question regarding the number of cases offered answer options with a number range, such as 15 cases, for ease of answering the questionnaire. Furthermore, the second survey covered the beginning of the fifth wave of the COVID-19 pandemic, which had the largest number of infections. Therefore, it is not possible to make a simple comparison with the first questionnaire, which was conducted during the period of convergence of the COVID-19 infection. Finally, it was unclear whether there was a shortage of anesthesiologists in Japan during the study period. Other countries reported that several cases of ECT were stopped due to a shortage of anesthesiologists, especially in the early stages of infection,3,37 and a survey that includes the perspective of anesthesiologists is needed in the future.

To the best of our knowledge, this study is unique because it analyzes the course of more than 1 year during the COVID-19 pandemic from 2020 to 2021. This survey showed that ECT was heavily affected by the pandemic in 2020, but by the summer of 2021, the number of ECT cases and the decisions to use ECT were returning almost to previous levels, with infection control measures in place.

Dr Hirotsugu Kawashima reports I received lecture fees from Otsuka, Dainippon-Sumitomo, Eisai, Meiji-Seika Pharma. Dr Takashi Tsuboi reports personal fees from Dainippon Sumitomo, personal fees from Takeda Pharmaceutical, personal fees from Pfizer, personal fees from Yoshitomi Yakuhin, personal fees from Tsumura, personal fees from Otsuka Pharmaceutical, personal fees from Mochida Pharmaceutical, personal fees from Kyowa Pharmaceutical, personal fees from Meiji-Seika Pharma, personal fees from Eisai, personal fees from Mitsubishi Tanabe Pharma, personal fees from MSD, personal fees from Shionogi, outside the submitted work; The authors declare no other conflicts of interest in this work.

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Chatham County Public Health Department offering COVID-19 vaccines for children ages 6 months to 5 years – Chatham Journal Weekly

June 28, 2022

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If there was no corona vaccine, there would have been 42 lakh more deaths in India…, surprising disclosure in research – News Track English

June 24, 2022

New Delhi: The corona vaccine worked to prevent more than 42 lakh possible deaths in India in 2021. This has been claimed in a research published in The Lancet Infectious Disease Journal. This is based on estimates of the rate of deaths in India during the pandemic. The study found that the corona virus vaccine has reduced potential deaths by 20 million worldwide during the pandemic.

The researchers said that of a possible 31.4 million deaths in the first year of the vaccination program, 19.8 million were prevented worldwide. It has been estimated on the basis of deaths in 185 countries. It is also estimated that if 40 percent of the population in every country had been vaccinated by the end of 2021, 5,99,300 lives could have been saved.

This research has estimated the number of preventable deaths between December 8, 2020 and December 8, 2021. Which covers the first year during which the vaccine was introduced. Study lead author Oliver Watson said, 'For India, we estimate that 42,10,000 deaths due to vaccination were prevented in this period. This is our central estimate, with the uncertainty in the range of 36,65,000-43,70,000.

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If there was no corona vaccine, there would have been 42 lakh more deaths in India..., surprising disclosure in research - News Track English

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June 24, 2022

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Parents weigh COVID-19 vaccine for youngest kids | Local News | santafenewmexican.com – Santa Fe New Mexican

June 22, 2022

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Covid-19 cases have increased in France and the UK in the last 24 hours – The Catholic Transcript

June 20, 2022

Covit-19 infections have increased in European countries in the last 24 hours. In France, the number of positive cases rose to 50,000 in the last 24 hours from 18,000 daily at the end of May, according to the French health watchdog Santa Public France. An increase of approximately 743%.

In the UK, the ZOE Govt data, which coincides with the Platinum Jubilee celebrations of Queen Elizabeth II, rose from 164,030 on June 1 to 167,973 on June 14. Surprisingly, we are entering the third wave of 2022, said Steve Griffin, a virologist at the University of Leeds. A lot has been said about the decline in BA2 wave cases in recent weeks. However, this has not only been confirmed, but has started to rise again.

According to experts, the development of new infections is mainly due to the release of two new subtypes of omigran, BA.4 and BA.5, which are highly contagious in recent weeks between 10% and 15% more contagious, but reversing previous strains and default It is said that it does not cause more serious disease than lack of protective measures. However the impact on hospitals is yet to be calculated. However, French government spokeswoman Olivia Grgoire said they were vigilant and needed to announce measures such as the mandatory use of masks in health facilities and nursing homes. The states emergency is scheduled for July 31, and next Wednesday, July 22, during the Cabinet meeting.

Experts emphasize the importance of the vaccine, which reaches 79% of the population in France, with three doses. To combat Omigran and its subtypes, even the available vaccines have not yet been updated, which is still a very effective measure. New vaccines are being tested by Pfizer and Moderna, but it is not yet known when they will be available.

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