Category: Covid-19

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Nightmares and tears: Covid-19 takes a heavy toll on health care workers in Colorado – CNN

December 2, 2020

"I guess with all of the death happening, the fact that I'm so exhausted, it's like, I don't even have time to process it," Tapia said. "But then, when I sit down with someone and they ask me questions, I just break down, because it's the first time I've had to think about it, and it's hard."

So many of her patients in long-term care facilities have died from the disease, "I got to a point where I stopped counting," Tapia said.

Gov. Jared Polis, who recently tested positive for the coronavirus, said last week that more Coloradans are now infected with the virus than at any time since the start of the pandemic, with about 1 in 41 residents in the state testing positive.

"The rates in our long-term care facilities all over have skyrocketed, the deaths have skyrocketed. It's a different volume now and sadly much, much worse," than earlier in the pandemic, Tapia said.

Before the pandemic, Allison Boerner, a charge nurse in a hospital emergency room in Parker, in the Denver metro area, said her work had never caused her to lose sleep. Now she regularly has nightmares or flashbacks, she said.

"When I close my eyes at night, I see my patients either dying or the family members that I've had to tell, be involved in telling, that their loved one is no longer here," Boerner said. "That's what I see the most."

"I don't have any explanation other than it's like living a nightmare," she said of having to tell relatives that their loved ones had died, and she cannot physically comfort them.

Boerner said she also hadn't cried a lot on the job -- before the pandemic.

"You hold that back in. You want to stay tough for the family, and stoic," Boerner said. "And there's been a lot of tears shed in ER rooms during Covid."

"Because we are treating that person dying like our loved one dying, because they don't have anyone else, and they need that grace, and they need that human touch, and they need someone to be there when they're taking their last breath," she said.

The experiences will always be with her, Boerner said.

"Death is something that no one wants to have to deal with, but we all have to deal with it. It's something that's inevitable. And to not let family be with a loved one that's dying is something that you will never forget," she said.

At the beginning of the pandemic, people were afraid to come to the emergency room because of the virus. Now, the number of patients her ER is seeing is "overwhelming," Boerner said, and nurses are working overtime.

"Now the fear is gone, and everyone has Covid, and everyone's coming to the emergency room on top of all the other patients we're seeing, and it's inundating the system," she said.

A doctor who treats the elderly and works as a hospice physician, Tapia said death isn't new to her, and she sees her job as ensuring "people have the best quality of life, consistent with their values and goals, that they can have towards that end transition."

But Covid-19 has made that almost impossible, because what's most important, at the end of life, is to be with loved ones, she said.

"Their families can't visit, or they can do it through a screen, or they might get one compassionate visit covered in PP," or personal protection equipment, Tapia said. "It's just devastating, the loneliness."

And that's after patients had endured long stretches of not seeing family and friends because of limited visitation.

"We had to shut down and make it so people couldn't visit to protect them, but I don't know if it protected them, because of the loneliness and the isolation that it caused," she said.

"And then because of mismanagement of this entire pandemic, they're still getting it, you know? So, it's like, all right, so you're still dying of Covid, and you haven't been able to see your loved ones. What was the point to any of that?"

It's clear that the crisis is taking a heavy toll on both health care workers and their coworkers.

Boerner tears up when talking about the toll the pandemic is taking on the people she works with.

"You know, we lean on each other," Boerner said. "The holidays have been rough for a lot of us. We're not seeing our families; we're doing everything we can to keep the public safe. And so, it was extremely frustrating for us when people are not doing that."

Tapia said she absolutely sees depression on the rise among her colleagues.

"Depression, anxiety, you know, hopelessness, fatigue, burnout," she said.

Tapia said she is coping by having more therapy sessions, which have gone up "astronomically because of Covid," medication and a new puppy.

"Covid is very much why I am on antidepressants, and they have really, really helped," she said.

A number of frontline workers have quit, according to Tapia.

"The emotional toll is huge for all of the frontline workers," she said.

"So, I think we're going to hit a point where especially nurses, this country's not going to have them, you know, staffing the care we need is going to be a huge problem."

For those who stay, the problems won't be over when the crisis ends, she said.

"I think a lot are really just trying to take one step after the other, do the next right thing," she said. "And I think there's going to be a huge reckoning when things calm down and people get to really process what's happened to them."

Anna-Maja Rappard and Jon Passantino contributed to this report.

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Nightmares and tears: Covid-19 takes a heavy toll on health care workers in Colorado - CNN

Myanmars response to the COVID-19 pandemic – Brookings Institution

December 2, 2020

During the first wave of the coronavirus pandemic, from late March to early August, Myanmar recorded just 360 cases and 6 deaths. Early in the crisis, the government rapidly implemented measures to contain the virus. Just as it started easing them though, the country was hit by a major second wave in mid-August. Daily cases increased from less than 10 per day in early August to over 1,000 per day in mid-October. This wave has overwhelmed Myanmars inadequate and understaffed health infrastructure. By November 20, there were 76,414 confirmed cases and 1,695 deaths (Figure 1).

Source: Ministry of Health and Sports, Myanmar.Note: Data as of November 20, 2020.

In the November 2020 national elections, Myanmar civilian leader Aung San Suu Kyis party won comfortably to stay in power. The government now faces the task of stemming the rapid increase in cases. What can the country do to quickly contain COVID-19? Duke Universitys Center for Policy Impact in Global Health and Community Partners International in Yangon analyzed Myanmars pandemic preparedness and its policy response to provide an answer to this question. Besides summarizing the current situation of the COVID-19 pandemic, our recent policy report identifies policy gaps that the new government has to plug.

A day after the World Health Organization notified governments about the unexplained pneumonia cases in Wuhan in January, Myanmar set up surveillance at points of entry to the country. Since March, it has implemented domestic and international travel restrictions while issuing guidance on personal hygiene, COVID-19 symptoms, and social restrictions in public spaces (Figure 2).

Key: blue indicates public health policies; green indicates social and economic measures; orange indicates health system response

Inadequate testing capacity. Since the start of the pandemic, the government took steps to expand its testing capacity. In early October, it could conduct over 10,000 tests daily, a substantial rise from the 380 tests per day in March. But this is not enough to keep pace with the soaring second wave. Since mid-October, the rate of positive tests has been about 10 percentimplying that the confirmed cases represent only a small fraction of infected people. As of November 22, Myanmar had conducted 1,998.7 tests per 100,000 people. Limited availability of detection systems, dependence on other countries for testing kits, and shortages of human resources such as trained laboratory technicians and logistics and data managers are some of the main factors compromising laboratory testing.

Unprepared health system. According to the 2019 Global Health Security Index, Myanmar was least prepared in terms of the availability of health systems to treat the sick and protect health care workers. Myanmar had just 6.7 physicians per 10,000 people in 2018, significantly lower than the global average of 15.6 physicians per 10,000 people in 2017. Besides, it only had 10.4 hospital beds per 10,000 people. In March 2020, Myanmar reported just 0.71 intensive care unit beds and 0.46 ventilators per 100,000 population, which were insufficient to deal with even a moderate outbreak. The government has increased surge capacity by constructing makeshift hospitals, quarantine centers, and clinics; and procuring ventilators and securing funding for ICU units. But these efforts are compromised by the scarcity of medical staff. The government has called upon volunteers to work at state quarantine centers, but mandatory 14-day quarantine and increasing caseloads have stressed volunteers. In addition, some of the quarantine centers are reportedly poorly managed, increasing the transmission risk in centers; 10 percent of the total confirmed cases in the second wave are among health care workers.

Income and food shortages. Myanmars economy has been hurt badly by the pandemic, giving rise to income and food insecurity. The sharp decline in remittances due to the pandemic is likely to reduce household income. Eighty percent of Myanmars workforce is informal. Scores of day laborers have lost their jobs. Women constitutea majority of the hospitality and garment sectors, so they have been disproportionately affected by factory closures. About 4 out of 5 households reported skipping meals, and others have incurred debt to buy food. The government implemented several measures under the COVID-19 Economic Relief Plan (CERP) such as unemployment benefits to registered workers, targeted cash assistance, and a one-time food distribution to households without a regular income. It established a fund of 400 billion kyat (around $309 million) to support garment, tourism, and small and medium enterprises (SMEs) via soft loans. Soft loans were also extended to farmers, roadside vendors, and the microfinance sector. But the current cash transfer of MMK40,000 per household translates to a daily income equivalent that is below the poverty line. Besides, the CERP lacks policies that target women who have lost their livelihoods due to the pandemic.

Domestic unrest. Conflict between the government and the Ethnic Armed Organizations (EAOs) makes it hard to organize an effective pandemic response. The conflict has led to the displacement of the population as well as the disruption of transport routes and supply chains. In May, the committee that coordinates and collaborates with EAOs to control and treat COVID-19 announced a unilateral ceasefire with EAOs, but the strife between the military and the Arakan Army continues in Rakhine and Chin. As of November 20, Rakhine had the fourth-highest confirmed cases in the country, and they continue to grow. The government has supplied personal protective equipment at campsites for internally displaced persons (IDPs), but congestion and poor living conditions in IDP camps heighten transmission risk.

Myanmar is yet to reach the peak of the COVID-19 outbreak, so the full scale of responses to tackle the pandemic is still not clear. But the current state of the pandemic, the governments responses, and lessons from other countries point to three areas that need attention.

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Myanmars response to the COVID-19 pandemic - Brookings Institution

Maine COVID-19 wave continues, with 232 new cases and four more deaths – Press Herald

December 2, 2020

Maine reported 232 new cases of COVID-19 on Wednesday, and four additional deaths.

The seven-day daily average of new cases now stands at 169.4, compared to 217 a week ago, and 78.7 a month ago.

Since the pandemic began, Maine has logged 12,208 cases of COCID-19, and 218 have died. Dr. Nirav Shah, Maine Center for Disease Control and Prevention director, will address the media at 2 p.m. today.

Meanwhile, Gov. Janet Mills is quarantining after an exposure to COVID-19.

I am feeling fine and not experiencing any symptoms whatsoever; but as we have said all along, no one is immune from exposure to this virus, Mills said in a statement released Tuesday evening by her office.

Mills said a member of her Maine State Police security detail, known as the Executive Protection Unit, is presumed to be positive for the virus by the Maine CDC. The officer developed symptoms Monday and is awaiting the result of a test.

The 232 new cases continues a trend of high daily case counts and comes a day after Maine reported 20 new deaths.

Dr. David Seder, who treats some of Maine most critically ill COVID-19 patients at Maine Medical Center in Portland, said in an interview Tuesday to expect a tough winter. Even though treatments have improved, and patients are more likely to survive the disease when compared to the spring, COVID-19 is still a dangerous and deadly disease.

Hospitalizations have risen sharply in the wake of rising case numbers, with 138 COVID-19 patients in Maine hospitals Tuesday, including 46 in critical care and 19 on a ventilator. The CDC is expected to update hospitalization data later today.

This story will be updated.

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Maine COVID-19 wave continues, with 232 new cases and four more deaths - Press Herald

Apple expands partnership with RED to combat HIV/AIDS and COVID-19 – Apple Newsroom

December 2, 2020

As the COVID-19 pandemic continues, Apple is offering more ways than ever for customers to support (RED)s fight against HIV/AIDS in Africa while simultaneously protecting those communities from COVID-19.

In 2006, Apple joined (RED)s mission to end the HIV/AIDS epidemic in sub-Saharan Africa. Over the last 14 years, Apples partnership with (RED) has led to almost $250 million in donations for the Global Funds HIV/AIDS programs that offer prevention, testing, and counseling services. Since 2006, Apple-supported grants have provided over 10.8 million people with care and support services, helped with distribution of more than 167 million HIV tests, and provided 13.8 million people with ongoing access to life-saving antiretroviral (ARV) treatment.

This year, communities around the world are grappling with HIV/AIDS as they also work to respond and protect against COVID-19, particularly for vulnerable populations. COVID-19 has created challenges in accessing care, diagnostics, and supplies, often disrupting crucial HIV/AIDS programs. To alleviate these challenges and ensure continuity in life-saving HIV/AIDS services, Apples contributions were redirected to the Global Funds COVID-19 Response at the onset of the pandemic earlier this year. Thanks in part to support from Apple and Apple customers, the Global Funds COVID-19 Response has been able to alleviate the impact of COVID-19 on the communities most affected by HIV/AIDS and provide critical support in health systems threatened by the COVID-19 outbreak.

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Apple expands partnership with RED to combat HIV/AIDS and COVID-19 - Apple Newsroom

One-Year-Old Maryland Boy Dies From COVID-19; Youngest Victim In State, Gov. Hogan Says – CBS Baltimore

December 2, 2020

ANNAPOLIS, Md. (WJZ) A one-year-old boy from Maryland has died from COVID-19, Gov. Larry Hogan said Tuesday afternoon. Hes the youngest victim of the pandemic in the state.

Hogan got choked up while making the announcement during a news conference Tuesday afternoon. Further details about the one-year-olds death were not immediately available.

CORONAVIRUS RESOURCES:

On Monday, the state reported its first death of a child younger than 10. The infant died on Sunday, but his death was reported on Monday.

Data from the states health department Tuesday morning showed one death of a person between the ages of 0 and 9 and three deaths of those between 10 and 19. That includes 15-year-oldDaryana Dysonfrom Baltimore County back in May.

MORE HOGAN NEWS CONFERENCE COVERAGE:

Hogan spoke on the same day the state surpassed a total of 200,000 COVID-19 cases since the pandemic began. On Tuesday, the state reported its third-highest daily case increase with 2,765 new cases reported, bringing the states total to 201,135.

Watch Gov. Hogans full Tuesday afternoon news conference below:

For the latest information on coronavirus go to the Maryland Health Departments website or call 211. You can find all of WJZs coverage on coronavirus in Maryland here.

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One-Year-Old Maryland Boy Dies From COVID-19; Youngest Victim In State, Gov. Hogan Says - CBS Baltimore

Apple PPE donation helps Zambia in the fight against COVID-19 and HIV – Apple Newsroom

December 2, 2020

Zambia has seen significant progress in the fight against HIV/AIDS over the last two decades. In 2003, 61,000 Zambians were dying from AIDS-related illnesses every year. Because of the work of the Global Fund, in partnership with the government of Zambia and healthcare providers, AIDS-related deaths have declined by over 70 percent and new infections have been cut in half since their peak. The Global Fund also supports a larger goal thats spearheaded by the United Nations: End the AIDS epidemic by 2030.

In 10 years, I have no doubt that AIDS will become an issue in the history books, as long as we keep the lid on issues of misinformation, says Siame of CHAZ. With disrupters like COVID-19, we know that we will still have to do a lot of work to ensure that we get to that point. But I think COVID-19 has been proof of the [Global Funds] capacity to adapt to changing circumstances.

Tembo of Cardinal Adam Memorial Hospital is hopeful that the additional measures coordinated by the Global Fund, including the shipments of Apple PPE, will help his patients feel secure enough to return for their regular treatments.

Our patients will benefit because when they come to the facility, they know that they are protected as well,he says.

Kalunga, Tembos patient, agrees, and has words of advice to other members of the community who may be nervous to come in for treatment.

I go to the clinic; I havent gotten COVID-19. So, let them also follow my suit.

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Apple PPE donation helps Zambia in the fight against COVID-19 and HIV - Apple Newsroom

COVID-19: What you need to know about the coronavirus pandemic on 2 December – World Economic Forum

December 2, 2020

1. How COVID-19 is affecting the globe

Confirmed cases of COVID-19 have now passed 63.8 million globally, according to the Johns Hopkins Coronavirus Resource Center. The number of confirmed deaths stands at more than 1.48 million.

Poland is set to surpass one million COVID-19 cases today, according to Health Minister Adam Niedzielski.

India's daily COVID-19 cases have stayed below 50,000 for the 25th straight day, with 36,604 new infections reported according to health ministry data.

The OECD's latest Economic Outlook highlights an improvement in the global economy, which is set to grow 4.2% next year and ease to 3.7% in 2022, after shrinking 4.2% this year.

The Netherlands has made masks mandatory in hopes of slowing the spread of coronavirus. With the country in a partial lockdown since 13 October, health authorities said new cases had fallen to 33,949 in the week ended 1 December, down slightly from 36,931 cases in the week ended 24 November.

Major energy companies have slashed the value of their oil and gas assets by around $80 billion, after revising the long-term outlook for fuel prices in the wake of the coronavirus epidemic and the energy transition.

Energy companies have written off $80 billion in value in recent quarters.

Image: Reuters

Authorities in South Korea have almost doubled the number of test venues for this year's nationwide university entrance exam for high school students, to allow more social distancing. The eight-hour test will take place at 31,291 venues on Thursday, after a delay of two weeks.

The United Nations has urged all countries to designate seafarers and other marine personnel as key workers as COVID-19 travel restrictions have left hundreds of thousands stranded at sea for months.

2. Britain and United States prepare to deploy vaccine

Britain's health minister, Matt Hancock, announced that Britain will begin vaccinating people with the Pfizer vaccine next week, after the country's regulator approved the jab.

From early next week we will start a programme of vaccinating people against COVID-19 here in this country, he told Sky News.

Meanwhile, top US health officials announced plans to begin vaccinating Americans against the coronavirus as early as mid-December, as nationwide deaths hit the highest number for a single day in six months.

2,597 new deaths were reported in the United States on the 1st of December, 2020.

Image: Our World in Data

20 million people could be inoculated against COVID-19 by the end of 2020 and most Americans will have access to highly effective vaccines by mid-2021, the chief adviser of President Donald Trumps Operation Warp Speed programme said.

3. What makes a super spreader?

A new study from the University of Florida has identified two key features that could make it more likely for you to become a so-called 'super spreader'.

Teeth create a narrowing effect in the jet that makes it stronger and more turbulent, said Michael Kinzel, study co-author and an assistant professor with UCFs Department of Mechanical Engineering. "They actually appear to drive transmission. So, if you see someone without teeth, you can actually expect a weaker jet from the sneeze from them.

A visual representation of how germs can spread from different individuals.

Image: Fontes et al., Physics of Fluids 32, 111904 (2020)

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COVID-19: What you need to know about the coronavirus pandemic on 2 December - World Economic Forum

Hospitals mixed on imposing staff COVID-19 vaccination mandates – Modern Healthcare

December 2, 2020

An advisory panel of experts for the Centers for Disease Control and Prevention on Tuesday recommended that healthcare workers should be first-in-line to receive a coronavirus vaccine.

In a 13-1 vote, the Advisory Committee on Immunization Practices said vaccine allocation should prioritize the country's 21 million frontline healthcare workers and 3 million residents in long-term care facilities, it is unclear whether hospitals will require their workers to inoculate once it becomes available.

Rush University Medical Center in Chicago has no plans to make a coronavirus vaccine mandatory for staff in the next year, according to Dr. John Segreti, a hospital epidemiologist and medical director of infection control and prevention at Rush. He said the provider's decision stems from supply and delivery uncertainties, as well as questions about potential adverse reactions from the vaccines.

"I think the healthcare industry will strongly encourage their (healthcare personnel) to get vaccinated I doubt many will mandate it this year," he said.

Like other employers, hospitals have the right to mandate vaccinations as a condition of employment. Employees can opt to exempt themselves from such requirements for medical reasons or religious beliefs, which would then require employers to provide them with "reasonable", alternative work accommodations.

The number of providers who have flu vaccination requirements has steadily increased in recent years in an effort to reduce rates of infections and illnesses acquired within healthcare settings. A 2018 JAMA Network Open study that surveyed more than 500 hospitals on their policies regarding mandatory influenza vaccination requirements found that the share of providers who require staff to get a flu shot had increased from 44% in 2013 to nearly 70% in 2017.

Experts say mandatory vaccination policies have been a major factor in driving up flu vaccination coverage among healthcare staff. Flu vaccination coverage among healthcare personnel was more than 80% during the 2019-2020 flu season, according to the CDC, compared to 64% during the 2010-2011 season. Personnel who were required to get a flu shot had a rate of 94%, while employees who were not required to a get a shot had a coverage rate of 70%.

Segreti said Rush requires its employees, volunteers and students to receive the flu vaccine each year. But he said say they are taking a wait-and-see approach with coronavirus vaccines.

"If the vaccine proves safe and effective, we may mandate it in the future," Segreti said.

UNC Health in Chapel Hill, North Carolina is taking a similar approach to Rush,saying it plans to recommend all its employees get vaccinated if the remaining trials are positive. But the health system doesn't plan to make vaccinations mandatory.

"While we do not yet have answers to many key questions surrounding a potential vaccine and its rollout plan or timeline, we are grateful to have a team of regional and national experts to review vaccine data and to guide our decisions and planning efforts," according to UNC Health's statement. "Our goal is to then provide as much data and information as possible to both our co-workers, patients and the community related to the vaccine."

But Dr. Steven Corwin, CEO of New York-Presbyterian Hospital, said in a recent interview with Modern Healthcare that the organization was inclined to mandate staff get vaccinated but stressed the decision would come down to how much supply is available versus the demand to get vaccinated.

"I would be inclined to mandate it because we don't want our healthcare workers to get sick, and we don't want our healthcare workers to infect each other, which can happen, or infect patients, which can happen," Corwin said. "I think that's critically important to do."

Federal officials have estimated the most promising coronavirus vaccine candidates one from Pfizer and BioNTech and another developed by Moderna could gain emergency use authorization by the U.S. Food and Drug Administration and start to be distributed in a few weeks.

Yet the speed at which the vaccines were developed is playing a part in the public's mixed view over its safety and efficacy.

A recent Gallup Panel survey conducted between Oct. 19 and Nov. 1 found 58% of Americans reported they were willing to get vaccinated against the coronavirus, an increase from 50% who said they were willing back in September. Among those who said they would not get vaccinated, 37% reported the development timeline of the vaccine was their top reason for concern, while 26% said they wanted to wait to confirm the vaccine was safe.

Corwin acknowledged there remained concerns over the safety of a new coronavirus vaccine in certain populations, such as among pregnant women. He said any vaccination mandate the health system instituted would exclude those individuals, along with others with qualified exemptions.

"But short of that, I think it would be unfair to the public to (not have the workforce get vaccinated) to be honest with you," Corwin said.

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Hospitals mixed on imposing staff COVID-19 vaccination mandates - Modern Healthcare

State reports COVID-19 outbreaks at three local schools – The Times Herald

December 2, 2020

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A COVID-19 nasal swab test kit sits on a table Thursday, Aug. 13, 2020, during a clinic held by the St. Clair County Health Department at Yale High School.(Photo: Brian Wells/Times Herald)

The state of Michigan reported this week three schools in St. Clair County were experiencing COVID-19 outbreaks. Local health officials said the outbreaks happened before the closure of school buildings in recent weeks, and their reporting on the state's website was delayed.

"These cases should not be taken out of context," St. Clair County Health Department Public Health Officer Dr. Annette Mercatante said in a written statement."The trends of the school outbreak postings is that outbreaks are slowing down with switching to all virtual, which is what we would expect. Outbreaks in other congregate settings that continue to be in person continue to increase. It can be safely assumed that if you are still going out to work, play or socialize you will have exposure to COVID-19 and eventually will get infected. This is resulting in greater hospitalizations and other stressors on our healthcare systems and will result in further deaths."

This content is being provided for free as a public service to our readers during the coronavirus outbreak. Please support local journalism by subscribing to the Times Herald atthetimesherald.com/subscribe.

Port Huron High School and Capac Elementary School were reported to have outbreaks only among staff, with Landmark Academy having an outbreak among both staff and students. Port Huron High School had two cases reported in the outbreak, Capac Elementary School had three cases and Landmark Academy had four cases.

An outbreak is defined as an educational institution having two or more COVID-19 cases who could have shred exposure on school grounds and are from different households. Students and staff believed to have been exposed to COVID-19 outside of school grounds and are not believed to have spread the virus in the school are not included in the state's outbreak reporting.

Information is reported by local health departments to the state, Michigan Department of Health and Human Services spokeswoman Lyn Sutfin said. Schools only report cases for individuals who were at school during their infections period.

Capac Community Schools returned to in-person classes for pre-kindergarten through sixth grade students, according to a post on the district's Facebook page.

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Contact Jeremy Ervinat (810) 989-6273 or jervin@gannett.com.Follow him on Twitter@ErvinJeremy.

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State reports COVID-19 outbreaks at three local schools - The Times Herald

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