“The earth laughs in flowers.”
Ralph Waldo Emerson

“I must have flowers, always, and always.”
Claude Monet

“I know a bank where the wild thyme blows,
Where oxlips and the nodding violet grows,
Quite over-canopied with luscious woodbine,
With sweet musk-roses and with eglantine.”
William Shakespeare (A Midsummer Night’s Dream)

“A flower blossoms for its own joy.”
Oscar Wilde

“Who wants flowers when you’re dead? Nobody.”
J.D. Salinger (The Catcher in the Rye)

Flowers

Today’s Poems are based on the theme of flowers. Flowers feature in all aspects of our lives. They are used as tokens of love, faithfulness, friendship and grief. Their blossoms are transient, and poets often conjure images of flowers to remind us of our mortality and our frailty. We labour to grow flowers in and around our houses and gardens because they make us feel comfortable, peaceful and happy. Whatever the signify, they are items of great beauty and they are to be celebrated and adored.

We have 8 poems from around the world starting in the 8th Century and finishing in the 21st Century
Please enjoy!

Bai Juyi (772-846)
Bai Juyi was a renowned Chinese poet and Tang dynasty government official. Many of his poems concern his career or observations made about everyday life, including as governor of three different provinces. Bai was also influential in the historical development of Japanese literature

Regret for Red Peonies

A melancholy walk among red peonies;
When evening comes, only two flowers remain.
They will not survive the morning wind;
I regret their passing by the campfire’s light.

Translated by Baudelaire Jones

William Wordsworth (1770-1850)
William Wordsworth was an English Romantic poet who, with Samuel Taylor Coleridge, helped to launch the Romantic Age in English literature with their joint publication Lyrical Ballads.
Some of you will remember that I have already included this poem before but it is impossible to put together a collection of poems on flowers without including this wonderful joyous poem form such a great romantic poet.
The poem records a moment when Wordsworth was walking with his siter Dorothy when they came across an expanse of wild daffodils. She recorded the event in her diary; “I never saw daffodils so beautiful they grew among the mossy stones about & about them, some rested their heads upon these stones as on a pillow for weariness & the rest tossed and reeled and danced & seemed as if they verily laughed with the wind that blew upon them over the Lake, they looked so gay ever dancing ever changing.”

I wandered lonely as a Cloud

I wandered lonely as a Cloud
That floats on high o’er Vales and Hills,
When all at once I saw a crowd,
A host of golden Daffodils;
Beside the Lake, beneath the trees,
Fluttering and dancing in the breeze.

Continuous as the stars that shine
And twinkle on the Milky Way,
They stretched in never-ending line
Along the margin of a bay:
Ten thousand saw I at a glance,
Tossing their heads in sprightly dance.

The waves beside them danced, but they
Out-did the sparkling waves in glee:—
A Poet could not but be gay
In such a jocund company:
I gazed—and gazed—but little thought
What wealth the shew to me had brought:

For oft when on my couch I lie
In vacant or in pensive mood,
They flash upon that inward eye
Which is the bliss of solitude,
And then my heart with pleasure fills,
And dances with the Daffodils.

Listen to the poem recited by Victor Vertunni

William Blake (1775-1827)
William Blake was an English poet, painter, and printmaker. Largely unrecognised during his lifetime, Blake is now considered a inspirational figure in the history of the poetry and visual arts of the Romantic Age.
The sunflower acts as an allegory for a human being: in particular, a traveller. They are tired of life and wish for something more. This takes the form of an afterlife that may also be associated with a world of imagination where people can visualise their highest aspirations. Blake presents this (afterlife/imagination) as an end-goal that everyone should attempt to reach, as he believes that it will enable them to escape from the brutal realities of human existence.

Ah! Sunflower

Ah Sunflower, weary of time,
Who countest the steps of the sun;
Seeking after that sweet golden clime
Where the traveller’s journey is done;

Where the Youth pined away with desire,
And the pale virgin shrouded in snow,
Arise from their graves, and aspire
Where my Sunflower wishes to go!

Ah Sunflower, William Blake, read by Allen Ginsberg

Percy Shelley (1792-1822)
Percy Bysshe Shelley was one of the major English Romantic poets, widely regarded as one of the greatest lyric and philosophical poets in the English language.
The Flower That Smiles Today is a poem about the brevity of all things – all hopes, desires, and delights the world has to offer are short-lived and doomed to die. Everything is fleeting and transitory.

The flower that smiles to-day

The flower that smiles to-day
To-morrow dies;
All that we wish to stay
Tempts and then flies.
What is this world’s delight?
Lightning that mocks the night,
Brief even as bright.

Virtue, how frail it is!
Friendship how rare!
Love, how it sells poor bliss
For proud despair!
But we, though soon they fall,
Survive their joy, and all
Which ours we call.

Whilst skies are blue and bright,
Whilst flowers are gay,
Whilst eyes that change ere night
Make glad the day;
Whilst yet the calm hours creep,
Dream thou—and from thy sleep
Then wake to weep.

A. E. Housman (1859-1936)
Alfred Edward Housman, usually known as A. E. Housman, was an English classical scholar and poet. He is best known for his cycle of poems A Shropshire Lad which evoke the dooms and disappointments of youth in the English countryside.
This poem is not so well known. The Lent Lily’ is, the daffodil. Daffodils don’t last long, and we have a narrow window every spring to enjoy their beauty in all its bright and yellowness. Like Wordswoths poem above it is celebration of their joyous quality, is as much a reminder that part of the joy of daffodils lies in their being recollected long after they have been seen and admired.

The Lent Lily

’Tis spring; come out to ramble
The hilly brakes around,
For under thorn and bramble
About the hollow ground
The primroses are found.

And there’s the windflower chilly
With all the winds at play,
And there’s the Lenten lily
That has not long to stay
And dies on Easter day.

And since till girls go maying
You find the primrose still,
And find the windflower playing
With every wind at will,
But not the daffodil,

Bring baskets now, and sally
Upon the spring’s array,
And bear from hill and valley
The daffodil away
That dies on Easter day.

A E Houseman – The Lent Lilly

Rabindranath Tagore (1861-1941)
Rabindranath Tagore was a Bengali poet, writer, music composer, and painter from the Indian subcontinent whose poetry we have already met a week ago. The poem talks once again about the short-lived life of the flower and the transience of our lives. We all have something to offer however insignificant we might appear. We can offer ourselves up to something greater.

Flower

Pluck this little flower and take it, delay not! I fear lest it
droop and drop into the dust.

I may not find a place in thy garland, but honour it with a touch of
pain from thy hand and pluck it. I fear lest the day end before I am
aware, and the time of offering go by.

Though its colour be not deep and its smell be faint, use this flower
in thy service and pluck it while there is time.

Listen to the poem

Peter Seeger (1919-2014)
Peter Seeger was an American folk singer and social activist. He had a string of hit records during the early 1950s as a member of the Weavers.
Where Have All the Flowers Gone?” is a modern protest folk song written by Pete Seeger. In fact he wrote the melody and the first 3 verses. Additional verses were added in May 1960 by Joe Hickerson . The New Statesman listed it as one of the “Top 20 Political Songs”.
It has been recorded many times but probably the most well known is by Peter, Paul and Mary in 1962

Where have all the flowers gone

Where have all the flowers gone, long time passing?
Where have all the flowers gone, long time ago?
Where have all the flowers gone?
Young girls have picked them everyone.
Oh, when will they ever learn?
Oh, when will they ever learn?

Where have all the young girls gone, long time passing?
Where have all the young girls gone, long time ago?
Where have all the young girls gone?
Gone for husbands everyone.
Oh, when will they ever learn?
Oh, when will they ever learn?

Where have all the husbands gone, long time passing?
Where have all the husbands gone, long time ago?
Where have all the husbands gone?
Gone for soldiers everyone
Oh, when will they ever learn?
Oh, when will they ever learn?

Where have all the soldiers gone, long time passing?
Where have all the soldiers gone, long time ago?
Where have all the soldiers gone?
Gone to graveyards, everyone.
Oh, when will they ever learn?
Oh, when will they ever learn?

Where have all the graveyards gone, long time passing?
Where have all the graveyards gone, long time ago?
Where have all the graveyards gone?
Gone to flowers, everyone.
Oh, when will they ever learn?
Oh, when will they ever learn?

Where have all the flowers gone, long time passing?
Where have all the flowers gone, long time ago?
Where have all the flowers gone?
Young girls have picked them everyone.
Oh, when will they ever learn?
Oh, when will they ever learn?

Listen to Peter Paul and Mary

Ishan Malik
I must apologise but I can find very little about Ishan Malik on the internet. I believe he is young and writes in Urdu. Please let me know, if you can find more about him.
I loved this poem which was written in 2006. Simple but also profound. Please enjoy

Rose in Full Bloom

Rambling down a cobbled pathway,
I stumbled upon a wild rose,
Deep garnet red,
Velveteen petals each curled to perfection,
Luminescent and innocently pretty,
A coy damsel oblivious of her beauty,
Fading away unadored and unsung,
Looking at me, she blushed
I stood love stung, adoring her,
Borrowed a steam bearing a bud
Planted her proudly in my garden,
Ever day, day after day,
I watched my rose break out of its chrysalis,
Groomed it with devout care,
Nurturing it with fertilizer,
Admiring it with every moment,
Watching it grown and come into full bloom,
Tall and elegant till it grew
And looked down on me!

Please look at the Wonca Featured Doctor this month. Dr Ferdinando Petrazzuoli
Is an Italian Rural Family Doctor from Campania region, Italy. He is heavily involved in the Europe Wonca Rural Network, EURIPA as the chair of its Scientific Board. Congratulations to Ferdinando. Let’s have more rural doctors as featured doctors

https://www.globalfamilydoctor.com/member/WoncaPeople/PETRAZZUOLIDrFerdinando.aspx

Today’s post:

New articles published in Rural and Remote Health:
5615 – Australasia – Can neonatal pneumothorax be successfully managed in regional Australia?
There is little available data about neonatal pneumothorax outside of neonatal intensive care units, especially amongst regional health services with paediatric facilities. This study reviews the role of Australian regional health services in managing this condition.

1. Africa: AAAS: The pandemic appears to have spared Africa so far. Scientists are struggling to explain why
Although Africa reported its millionth official COVID-19 case last week, it seems to have weathered the pandemic relatively well so far, with fewer than one confirmed case for every thousand people and just 23,000 deaths so far. Yet several antibody surveys suggest far more Africans have been infected with the coronavirus—a discrepancy that is puzzling scientists around the continent. “We do not have an answer,” says immunologist Sophie Uyoga at the Kenya Medical Research Institute–Wellcome Trust Research Programme.
After testing more than 3000 blood donors, Uyoga and colleagues estimated in a preprint last month that one in 20 Kenyans aged 15 to 64—or 1.6 million people—has antibodies to SARS-CoV-2, an indication of past infection. That would put Kenya on a par with Spain in mid-May when that country was descending from its coronavirus peak and had 27,000 official COVID-19 deaths. Kenya’s official toll stood at 100 when the study ended. And Kenya’s hospitals are not reporting huge numbers of people with COVID-19 symptoms.
Other antibody studies in Africa have yielded similarly surprising findings. From a survey of 500 asymptomatic health care workers in Blantyre, Malawi, immunologist Kondwani Jambo of the Malawi–Liverpool Wellcome Trust Clinical Research Programme and colleagues concluded that up to 12.3% of them had been exposed to the coronavirus. Based on those findings and mortality ratios for COVID-19 elsewhere, they estimated that the reported number of deaths in Blantyre at the time, 17, was eight times lower than expected.
https://www.sciencemag.org/news/2020/08/pandemic-appears-have-spared-africa-so-far-scientists-are-struggling-explain-why

2. Africa: Medical Brief: Africa: Benefits of childhood vaccination programmes far outweigh risks of COVID-19 transmission
during the COVID-19 pandemic far outweigh the risk of SARS-CoV-2 transmission that might be associated with clinic visits, according to a modelling study.
For every additional COVID-19 death that might be associated with additional exposure to the virus during routine clinic visits, the model predicts that 84 deaths in children before five years of age could be prevented by continuing with routine vaccinations. The additional risk of COVID-19 transmission associated with clinic visits is predicted to primarily affect older adults living in the same household as the vaccinated children. The findings suggest that continuing with usual vaccination schedules could prevent 702,000 child deaths from the point of immunisation until they reach five years of age.
The study looked at all 54 countries of Africa and found that in all countries, the number of child deaths averted through vaccination far exceeded the number of excess COVID-19 deaths that might be associated with clinic visits.
https://www.medicalbrief.co.za/archives/africa-benefits-of-childhood-vaccination-programmes-far-outweigh-risks-of-covid-19-transmission/
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3. South Africa: COVID-19 has changed the way South Africa’s only toll-free mental health helpline works. Here’s why it matters
When COVID-19 hit, South African Depression and Anxiety Group (Sadag) helplines were flooded with calls. But the outbreak changed more than call volumes, it changed the way Sadag worked. Could the lessons it learned shape the future of mental healthcare in South Africa?
Kaelo Mahao, not their real name, lives with anxiety and bipolar disorder, a mental health condition that causes extreme mood changes. Mahao also uses the pronoun “they”. Some people with Mahao’s condition experience prolonged sadness and feel hopeless or fatigued at times. At other moments, people with bipolar may have loads of energy — so much so that they struggle to sleep. Psychiatric medication can help them to stabilise these changes in mood.
But when South Africa instituted its national coronavirus lockdown in late March, Mahao was faced with a life-threatening dilemma: to leave home to collect their medication and risk their fear of contracting the new coronavirus triggering their crippling anxiety, or to go without their pills and put themselves in danger of a possible depressive episode. To get by, Mahao decided to split their tablets in half to stretch their remaining stock.
https://bhekisisa.org/article/2020-08-11-covid19-mental-health-south-africa-telemedicine-depression-anxiety-group/
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4. Russia: Nature: Russia’s fast-track coronavirus vaccine draws outrage over safety
The immunization is the first approved for widespread use but could be dangerous because it hasn’t been tested in large trials, say researchers.
Russia’s president Vladimir Putin announced on 11 August that the country’s health regulator had become the world’s first to approve a coronavirus vaccine for widespread use — but scientists worldwide have condemned the decision as dangerously rushed. Russia hasn’t completed large trials to test its safety and efficacy, and rolling out an inadequately vetted vaccine could put at risk people who receive it, researchers say. It could also impede global efforts to develop quality COVID-19 immunizations, they suggest.
“That the Russians may be skipping such measures and steps is what worries our community of vaccine scientists. If they get it wrong it could undermine the entire global enterprise,” says Peter Hotez, a vaccine scientist at Baylor College of Medicine in Houston, Texas.
https://www.nature.com/articles/d41586-020-02386-2?utm_source=Nature+Briefing&utm_campaign=400aa96402-briefing-dy-20200811&utm_medium=email&utm_term=0_c9dfd39373-400aa96402-45238390
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5. UK: The Independent: Coronavirus: Cover-up fears as reviews of Covid-19 deaths among NHS staff to be kept secret
Exclusive: Findings from more than 620 reviews of health and care staff deaths to remain hidden
Ministers have been accused of trying to cover up the findings from investigations into hundreds of health and social care worker deaths linked to coronavirus after it emerged the results will not be made public.
The Independent revealed on Tuesday that medical examiners across England and Wales have been asked by ministers to investigate more than 620 deaths of frontline staff that occurred during the pandemic.
The senior doctors will review the circumstances and medical cause of death in each case and attempt to determine whether the worker may have caught the virus during the course of their duties.
https://www.independent.co.uk/news/health/coronavirus-nhs-staff-deaths-secret-cover-up-ministers-a9667156.html
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6. South Africa: Wits Journal of Clinical Medicine: Coronavirus Disease 2019 (COVID-19) and Psychiatric Sequelae in South Africa: Anxiety and Beyond
Abstract:The 2019 coronavirus (COVID-19) pandemic has brought unprecedented challenges to the health sector nationwide and internationally. Across all disciplines, unique and novel modes of presentation with substantial morbidity and mortality are being encountered, and growing evidence suggests that psychiatric comorbidity is likely among COVID-19 patients.
Objective: This article aims to broaden the current discussion on the psychiatric sequalae of COVID-19, which has largely focused on anxiety, and examine the recently documented psychiatric sequelae of COVID-19 infection, the secondary effects of the pandemic on public mental health, and future psychiatric conditions that may arise due to COVID-19.
Methods: We conducted an in-depth review of the current global psychiatric literature and describe the wide range of psychopathological presentations reported among past COVID-19 patients worldwide and those that are expected to emerge.
Results: Current discussions in the psychiatric literature on COVID-19 report anxiety and anxiety disorders as a predominant set of clinical presentations during the pandemic. The impacts of direct COVID-19 infection, associated psychopathological sequelae, and drastic lifestyle changes due to the COVID-19 pandemic in South Africa, are associated with a broad range of psychopathologies and other neuropsychiatric presentations. Pre-existing societal conditions and burdens on the health system in South Africa prompt healthcare providers and public health planners to accordingly prepare for the expected rise in new psychiatric presentations.
Conclusion: Greater awareness of the various psychiatric conditions attributed to COVID-19 infection may allow for earlier screening, more effective treatment, and greater positive health outcomes and better prepare health systems to address the growing pandemic in South Africa.
https://journals.co.za/docserver/fulltext/wjcm_v2_n2_a3.pdf?expires=1595495465&id=id&accname=guest&checksum=D5FD10CFA883822A7A46F4ED1308116F
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7. Spain: La Razon: Madrid registra 720 positivos por Covid-19 en 24 horas, 66 más que ayer, y los fallecidos se mantienen en 4
Madrid registers 720 positives for Covid-19 in 24 hours, 66 more than yesterday, and the deceased remain at 4
La Comunidad de Madrid notifica que los casos positivos por covid-19 siguen creciendo aunque a un ritmo menor con respecto a ayer, con 720, con 66 más y los fallecidos vuelven a sumar cuatro
The Community of Madrid notifies that the positive cases for covid-19 continue to grow although at a slower rate compared to yesterday, with 720, with 66 more and the deceased again add four
El informe diario de situación de la pandemia en la Comunidad de Madrid que publica la Dirección General de Salud Pública, Servicio Madrileño de Salud y hospitales privados, vuelve a registrar un aumento en el número de casos positivos detectados por pruebas PCR, con 720 contagios en las úlltimas 24 horas, lo que supone 66 casos más que los indicados ayer, que fueron 654, cifra esta última que supuso un incremento del doble de casos que el día anterior. Sin embargo, el informe de hoy refleja un considerable descenso en el ritmo de aumento de contagios con respecto a ayer. Además, notifica 1671 casos nuevos incorporados, entre los que ya se han contabilizado los 720 de hoy. Con las cifras de hoy, ya son 90.587 los positivos detectados por pruebas PCR desde el inicio de la pandemia en la región.
https://www.larazon.es/madrid/20200813/v6jdenafljda3nydz63gho26nq.html
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8. Ireland: RTE: 200 more cases of Covid-19 ‘deeply concerning’, says Glynn
The Department of Health has been notified of 200 additional cases of Covid-19 today. This is the largest number of cases in a single day since the beginning of May.
It brings the total number of cases in the country to date to 27,191.
There has been no further deaths today meaning the number of coronavirus-related deaths remains at 1,774.
Of the cases notified today 103 are men and 96 are women. 68% are under 45 years of age.
Of the cases, 68 are associated with outbreaks or are close contacts of a confirmed case and 25 cases have been identified as community transmission.
https://www.rte.ie/news/coronavirus/2020/0815/1159333-coronavirus-ireland/
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9. South Africa: Daily Maverick: Ramaphosa takes South Africa out of hard lockdown, lifts cigarette and alcohol ban
You can gym, go on holiday, buy alcohol and smokes too. But there are still thousands of infections happening every day.
Covid-19 is likely peaking in South Africa, President Cyril Ramaphosa announced late on Saturday night as he lifted two of the most unpopular lockdown measures – the bans on alcohol and cigarettes.
From midnight on Monday, South Africa will move to Level 2 lockdown. In addition, by next week you can go to the gym again and travel across your provincial borders on holiday. You can’t travel abroad yet, though, as international travel other than for essential needs is still ruled out.
https://www.dailymaverick.co.za/article/2020-08-15-ramaphosa-takes-south-africa-out-of-hard-lockdown-lifts-cigarette-and-alcohol-ban/
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10. Somalia: Care: Stigma Harming Somalia’s Efforts to Stop COVID-19
Stigma around COVID-19 is stopping Somalis from seeking medical treatment and thwarting efforts in Somalia and Somaliland to stop the spread of the virus, including track and trace.
In CARE-supported health centres in Somalia/Somaliland, the number of people seeking consultations for communicable diseases has fallen by more than a quarter [26 percent] since the first case of COVID-19 was recorded, with fear of stigma for having the virus being a major factor.
“Our teams are seeing people who have tested positive running away from their homes out of fear of being stigmatized by the community,” said Abdinur Elmi, CARE Somalia/Somaliland’s Emergency Director.
https://care.org/news-and-stories/press-releases/stigma-harming-somalias-efforts-to-stop-covid-19/
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11. USA: The Hill: CDC director warns of ‘worst fall’ in history if people don’t follow COVID-19 guidelines
If Americans don’t follow coronavirus prevention measures such as wearing masks and social distancing, the country could be in for its “worst fall” in history, the head of the Centers for Disease Control and Prevention (CDC) warned Thursday.
During an interview with WebMD, CDC Director Robert Redfield said a virus surge, along with the upcoming flu season, could create the “worst fall” that “we’ve ever had.” Colder weather in the fall will likely drive more people indoors, where health experts say COVID-19 spreads more easily.
Coinciding flu and COVID-19 outbreaks could overwhelm hospitals and drain resources, threatening lives and the response to the pandemic.
Redfield said the CDC is urging people to get a flu shot, and the agency has purchased an extra 10 million doses of the vaccine — compared with the typical 500,000 — to make sure states have enough to cover uninsured adults.
https://thehill.com/policy/healthcare/511841-cdc-director-warns-of-worst-fall-in-history-if-people-dont-follow-covid
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12. South Africa: Medical Brief: SA’s nurses: Poorly trained, in poor health, and living in fear
Most of South Africa‘s nurses lack confidence in their training, more than 40% have poor health, and a quarter are experiencing severe psychological distress, reports a health care workers study led by the Human Sciences Research Council.
City Press reports that the country’s health care workers, particularly nurses, are also living in fear of contracting a deadly virus and then passing it on to their families.
The survey, says City Press, shows that nurses, often described as the backbone of the healthcare system, appear to be the Cinderellas of the health sector – lagging behind in critical training regarding COVID-19 treatment guidelines. And they have little confidence in their own knowledge about the many moving parts of the virus and its progression.
The study was led by the Human Sciences Research Council in collaboration with theUniversity of KwaZulu-Natal’s College of Health Sciences and the Edendale Hospital in Pietermaritzburg, KwaZulu-Natal. It surveyed 7 808 healthcare professionals – 36.7% of whom were nurses. Nurses make up 65% of the country’s healthcare workforce, and the majority of them are women.
The report says the survey was conducted as the pandemic started gaining ground locally – between 11 April and 7 May. At the time, there were only 2,003 confirmed cases in the country. “The survey has given us confirmation of what we knew and what we’ve been raising (as concerns) as far back as April. We asked for training (on COVID-19) in April, as it was our foresight from complaints from our members (that it would be a problem),” said Simon Hlungwani, president of the Democratic Nursing Organisation of SA (Denosa).
https://www.medicalbrief.co.za/archives/sas-nurses-poorly-trained-in-poor-health-and-living-in-fear/
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13. Kenya: KENYA MEDICAL ASSOCIATION: Video: Covid-19 Management and webinar videos
https://www.youtube.com/channel/UCic-Qz-KPei5QodC9iF2cQQ?app=desktop
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14. Australia: Tasmanian Government: Covid-safe Behaviours: COVID-safe behaviour keeps the community safe
We all have the opportunity and a responsibility to protect lives and livelihoods by maintaining ‘COVID-safe behaviours’ – it’s that simple and yet, incredibly effective.
As a community, we are all learning how to live with COVID-19 for the foreseeable future. The threat from this virus will remain until a vaccine becomes available. This means that whilst we have been able to return to doing some things as normal there are a few restrictions and behaviours that we will have to keep up over the long term. Each and every Tasmanian has an important role to play. Our actions will determine Tasmania’s future, the protection of vulnerable people and the response to potential cases and outbreaks.
There are 5 key behaviours that we must all be aware of and follow, every day. These behaviours will ensure that we lower the risks and continue to save lives during the pandemic. Remember them, remind your family and friends about them and keep them up.
https://www.coronavirus.tas.gov.au/keeping-yourself-safe/covid-safe-behaviours
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15. China: CBS News: Chicken wings imported to China from Brazil test positive for COVID-19, Chinese officials say
While the CDC says there is no evidence to suggest that consuming or handling food is associated with COVID-19, China has been increasing screenings amid concerns over food imports.
Coronaviruses are thought to spread mostly person-to-person through respiratory droplets, the CDC says. However, “it is possible that a person can get COVID-19 by touching a surface or object, including food or food packaging, that has the virus on it and then touching their own mouth, nose, or possibly their eyes,” the CDC says.
This is not thought to be the main way the virus spreads, and the risk of getting COVID-19 from food is thought to be very low, the CDC says. “The virus that causes COVID-19 cannot grow on food. Although bacteria can grow on food, a virus requires a living host like a person or an animal to multiply,” the CDC says.
https://www.cbsnews.com/news/china-covid-19-chicken-wings-brazil/
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16. South Africa: Psychologial Society of South Africa: Suggested Guidelines on Telepsychology in South Africa
• HPCSA Booklet 10 – Guidelines for Good Practice in Telemedicine
• Evans, D. (2018). Some guidelines for telepsychology in South
https://www.psyssa.com/wp-content/uploads/2020/03/Some-guidelines-for-telepsychology-in-South-Africa.pdf
• Online therapy consent form template
https://www.psyssa.com/suggested-guidelines-on-telepsychology-in-south-africa/
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17. WHO: COVID-19 Emergency Committee highlights need for response efforts over long term
The Emergency Committee on COVID-19, convened by the WHO Director-General under the International Health Regulations (2005) (IHR), held its fourth meeting on 31 July. In its statement following the meeting, published today, it expressed “appreciation for WHO and partners’ COVID-19 pandemic response efforts, and highlighted the anticipated lengthy duration of this COVID-19 pandemic, noting the importance of sustained community, national, regional, and global response efforts.”
After a full discussion and review of the evidence, the Committee unanimously agreed that the outbreak still constitutes a public health emergency of international concern (PHEIC) and offered this advice to Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
Dr Tedros accepted the advice of the Committee and confirmed that the outbreak of COVID-19 continues to constitute a PHEIC. The Director-General declared a PHEIC—WHO’s highest level of alarm under IHR—on 30 January at a time when there were fewer than 100 cases and no deaths outside China. He issued the Committee’s advice to States Parties as Temporary Recommendations under the IHR.
https://www.who.int/news-room/detail/01-08-2020-covid-19-emergency-committee-highlights-need-for-response-efforts-over-long-term
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18. Spain: El Mundo: Encuentran coronavirus “viable” en el aire a casi 5 metros de un paciente: Las muestras se recogieron en una habitación de hospital, a una distancia que va más allá de las recomendaciones de distanciamiento
“Viable” coronavirus found in the air almost 5 meters from a patient: The samples were collected in a hospital room, at a distance that goes beyond the distance recommendations
Puede que los famosos dos metros de distanciamiento social no sirvan absolutamente de nada cuando se esté en un espacio cerrado, sea éste un restaurante al que vamos a cenar, una escuela que separe un poco los pupitres de sus alumnos o una oficina que haya distanciado el ordenador de sus trabajadores. Aunque sigue existiendo cierta controversia sobre el papel de los aerosoles o micropartículas en suspensión a la hora de transmitir la Covid (la OMS sigue defendiendo que se produce a través de las gotículas que se expulsan al toser o estornudar y que son de mayor tamaño), un nuevo estudio indica que ha hallado virus “viable” y, por tanto, infeccioso en el aire de una habitación a cinco metros de un paciente.
https://www.elmundo.es/ciencia-y-salud/salud/2020/08/13/5f354913fdddff54b68b45a9.html
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19. USA : Yale News: Quick and affordable saliva-based COVID-19 test developed by Yale scientists receives FDA Emergency Use Authorization
A saliva-based laboratory diagnostic test developed by researchers at the Yale School of Public Health to determine whether someone is infected with the novel coronavirus has been granted an emergency use authorization by the U.S. Food and Drug Administration (FDA).
The method, called SalivaDirect, is being further validated as a test for asymptomatic individuals through a program that tests players and staff from the National Basketball Association (NBA). SalivaDirect is simpler, less expensive, and less invasive than the traditional method for such testing, known as nasopharyngeal (NP) swabbing. Results so far have found that SalivaDirect is highly sensitive and yields similar outcomes as NP swabbing.
With the FDA’s emergency use authorization, the testing method is immediately available to other diagnostic laboratories that want to start using the new test, which can be scaled up quickly for use across the nation — and, perhaps, beyond — in the coming weeks, the researchers said. A key component of SalivaDirect, they note, is that the method has been validated with reagents and instruments from multiple vendors. This flexibility enables continued testing if some vendors encounter supply chain issues, as experienced early in the pandemic.
https://news.yale.edu/2020/08/15/yales-rapid-covid-19-saliva-test-receives-fda-emergency-use-authorization
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20. USA: STAT: Winter is coming: Why America’s window of opportunity to beat back Covid-19 is closing
The good news: The United States has a window of opportunity to beat back Covid-19 before things get much, much worse.
The bad news: That window is rapidly closing. And the country seems unwilling or unable to seize the moment.
Winter is coming. Winter means cold and flu season, which is all but sure to complicate the task of figuring out who is sick with Covid-19 and who is suffering from a less threatening respiratory tract infection. It also means that cherished outdoor freedoms that link us to pre-Covid life — pop-up restaurant patios, picnics in parks, trips to the beach — will soon be out of reach, at least in northern parts of the country.
Unless Americans use the dwindling weeks between now and the onset of “indoor weather” to tamp down transmission in the country, this winter could be Dickensianly bleak, public health experts warn.
https://www.statnews.com/2020/08/10/winter-is-coming-as-flu-season-nears-americas-window-of-opportunity-to-beat-back-covid-19-is-narrowing/?utm_source=Nature+Briefing&utm_campaign=400aa96402-briefing-dy-20200811&utm_medium=email&utm_term=0_c9dfd39373-400aa96402-45238390
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21. Nature Editorial: How to stop COVID-19 fuelling a resurgence of AIDS, malaria and tuberculosis
A focus on the coronavirus has disrupted detection and treatment of other infectious diseases. Governments and funders can do four things to avert a catastrophe.
AIDS, malaria and tuberculosis (TB), three of the deadliest infectious diseases, together kill 2.4 million people every year, with TB alone responsible for 1.5 million deaths. And deaths from these diseases could almost double over the next year, according to the Global Fund to Fight AIDS, Tuberculosis and Malaria, a consortium of donors that funds treatments. The reason: coronavirus. It’s a horrifying prospect, and calls for an urgent action plan.
More than three months of lockdowns have prevented many people from accessing treatments for non-COVID infectious diseases; at the same time, new cases of these illnesses will have gone undetected. Although lockdowns are easing, it will take some time for health care to get back to normal, as authorities continue to prioritize COVID-19. Taken together, this is resulting in a surge of cases.
https://www.nature.com/articles/d41586-020-02334-0?utm_source=Nature+Briefing&utm_campaign=b6db6ce366-briefing-dy-20200813&utm_medium=email&utm_term=0_c9dfd39373-b6db6ce366-45238390
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22. New Zealand: Reuters: Explainer: What we know about possible COVID-19 transmission from freight and packages
China reported several cases of frozen food packaging contaminated with the novel coronavirus this week, while New Zealand said it is investigating the possibility that its latest COVID-19 cases could be traced to imported freight. New Zealand reported its first COVID-19 cases in more than three months on Wednesday, prompting a swift reimposition of movement restrictions. Health officials raised the possibility that the virus had arrived in New Zealand via freight, given one of the infected people works at a cool store that takes imported frozen goods from overseas. China said on Thursday a sample of frozen chicken wings imported into Shenzhen from Brazil had tested positive for the virus. The discovery by local disease control centres was part of routine screenings of meat and seafood imports that have been carried out since June, when a new outbreak in Beijing was linked to the city’s Xinfadi wholesale food centre. Earlier this week, traces of the virus were found in China on the packaging of frozen shrimp from Ecuador and on the outer packaging of imported frozen seafood that arrived at Yantai port from Dalian in northeast China.
https://www.reuters.com/article/us-health-coronavirus-packages-explainer-idUSKCN25918W
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23. USA: Nature: ‘We’re in one of the cataclysmic times of change’: first female NSF director on discrimination and COVID-19
One-time head of the US National Science Foundation Rita Colwell speaks out on sexism — and how her experiences as a leader in science can inform pandemic response. Rita Colwell is the former director of the US National Science Foundation (NSF) — the first woman to hold that post — and a leader in cholera research. In her new book, A Lab of One’s Own: One Woman’s Personal Journey Through Sexism in Science (written with Sharon Bertsch McGrayne), she opens up on one topic she hasn’t said much about publicly: her battle to improve the situation for women in science. “I reached an age and stage in my career where I can be as candid as I wish,” says Colwell, a microbiologist at the University of Maryland College Park. She spoke to Nature about discrimination, and how her experiences as a researcher and agency leader during the 2001 anthrax bioterror attacks can inform the response to the coronavirus pandemic. You’ve been a scientist since the 1950s. What’s changed, and what hasn’t, regarding sexism in science? When I was an undergraduate, I went to the department chairman to ask for a fellowship to allow me to do a master’s. I was told, quite bluntly, that they didn’t waste fellowships on women. I don’t think any chair, dean or faculty member would say that today. It would probably be nuanced, to the effect of, “we don’t have any available”. That makes it less obvious, and I’m not so sure less hurtful — because it still deflects the career path.
https://www.nature.com/articles/d41586-020-02314-4?utm_source=Nature+Briefing&utm_campaign=400aa96402-briefing-dy-20200811&utm_medium=email&utm_term=0_c9dfd39373-400aa96402-45238390
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24. WHO: Community-based health care, including outreach and campaigns, in the context of the COVID-19 pandemic
Community-based health care is an essential part of primary care at all times; in the context of the COVID-19 pandemic, the distinct capacity of trusted community members for social engagement and delivering care where it is needed is ever more critical. This joint WHO, UNICEF and IFRC guidance addresses the role of community-based health care in the pandemic context. It includes practical recommendations for decision makers to help keep communities and health workers safe, to sustain essential services at the community level, and to ensure an effective response to COVID-19. Using this comprehensive and coordinated approach will help countries strengthen the resilience of community-based health services throughout the pandemic, into early recovery and beyond.
https://www.who.int/publications/i/item/WHO-2019-nCoV-Comm_health_care-2020.1
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25. Japan: MedRXiv: Closed environments facilitate secondary transmission of coronavirus disease 2019 (COVID-19)
Objective: To identify common features of cases with novel coronavirus disease (COVID-19) so as to better understand what factors promote secondary transmission including superspreading events. Methods: A total of 110 cases were examined among eleven clusters and sporadic cases, and investigated who acquired infection from whom. The clusters included four in Tokyo and one each in Aichi, Fukuoka, Hokkaido, Ishikawa, Kanagawa and Wakayama prefectures. The number of secondary cases generated by each primary case was calculated using contact tracing data. Results: Of the 110 cases examined, 27 (24.6%) were primary cases who generated secondary cases. The odds that a primary case transmitted COVID-19 in a closed environment was 18.7 times greater compared to an open-air environment (95% confidence interval [CI]: 6.0, 57.9). Conclusions: It is plausible that closed environments contribute to secondary transmission of COVID-19 and promote superspreading events. Our findings are also consistent with the declining incidence of COVID-19 cases in China, as gathering in closed environments was prohibited in the wake of the rapid spread of the disease.
https://www.medrxiv.org/content/10.1101/2020.02.28.20029272v2?utm_campaign=wp_to_your_health&utm_medium=email&utm_source=newsletter&wpisrc=nl_tyh&wpmk=1&pwapi_token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJjb29raWVuYW1lIjoid3BfY3J0aWQiLCJpc3MiOiJDYXJ0YSIsImNvb2tpZXZhbHVlIjoiNWU4YWMxZTY5YmJjMGYwYTJlNzk3ODE3IiwidGFnIjoiNWYzMzA0NWNmZTFmZjY1ZTExN2M4YjE5IiwidXJsIjoiaHR0cHM6Ly93d3cubWVkcnhpdi5vcmcvY29udGVudC8xMC4xMTAxLzIwMjAuMDIuMjguMjAwMjkyNzJ2Mj91dG1fY2FtcGFpZ249d3BfdG9feW91cl9oZWFsdGgmdXRtX21lZGl1bT1lbWFpbCZ1dG1fc291cmNlPW5ld3NsZXR0ZXImd3Bpc3JjPW5sX3R5aCZ3cG1rPTEifQ.bEBDUo7A0uCqNzreeYcfrRcRNRGdDj6L7UxFhrnob2Q
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26. India: Spice Route India Newsletter: Happy Hypoxia in COVID-19
The coronavirus disease is no longer just a pandemic. It is a mystery that has baffled doctors and collapsed the most robust health infrastructures in the world. The novel virus is regularly presenting with an array of peculiarities, but one of them appears to be flouting at one of the most basic and established scientific principles. Happy hypoxia or silent hypoxia is the condition when COVID-19 patients present with oxygen saturation, which is significantly low and life-endangering (as little as 50%), but without any difficulty in breathing or dyspnea.
http://bulletin.spicerouteindia.in/happy_hypoxia.html
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27. USA: John Hopkins: Factors Associated with Disease Severity and Mortality among Patients with Coronavirus Disease 2019: A Systematic Review and Meta-Analysis
Background: Understanding the factors associated with disease severity and mortality in Coronavirus disease (COVID19) is imperative to effectively triage patients. We performed a systematic review to determine the demographic, clinical, laboratory and radiological factors associated with severity and mortality in COVID-19. Methods: We searched PubMed, Embase and WHO database for English language articles from inception until May 8, 2020. We included Observational studies with direct comparison of clinical characteristics between a) patients who died and those who survived or b) patients with severe disease and those without severe disease. Data extraction and quality assessment were performed by two authors independently. Results: Among 15680 articles from the literature search, 109 articles were included in the analysis. The risk of mortality was higher in patients with increasing age, male gender (RR 1.45; 95%CI 1.23,1.71), dyspnea (RR 2.55; 95%CI 1.88,2.46), diabetes (RR 1.59; 95%CI 1.41,1.78), hypertension (RR 1.90; 95%CI 1.69,2.15). Congestive heart failure (OR 4.76; 95%CI 1.34,16.97), hilar lymphadenopathy (OR 8.34; 95%CI 2.57,27.08), bilateral lung involvement (OR 4.86; 95%CI 3.19,7.39) and reticular pattern (OR 5.54; 95%CI 1.24,24.67) were associated with severe disease. Clinically relevant cut-offs for leukocytosis(>10.0 x109/L), lymphopenia(< 1.1 x109/L), elevated C-reactive protein(>100mg/L), LDH(>250U/L) and D-dimer(>1mg/L) had higher odds of severe disease and greater risk of mortality. Conclusion: Knowledge of the factors associated of disease severity and mortality identified in our study may assist in clinical decision-making and critical-care resource allocation for patients with COVID-19.
https://www.medrxiv.org/content/10.1101/2020.08.07.20166868v1
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28. Nature: A negative COVID-19 test does not mean recovery
Pandemic policy must include defining and measuring what we mean by mild infection.
Eight months into the global pandemic, we’re still measuring its effects only in deaths. Non-hospitalized cases are loosely termed ‘mild’ and are not followed up. Recovery is implied by discharge from hospital or testing negative for the virus. Ill health in those classed as ‘recovered’ is going largely unmeasured. And, worldwide, millions of those still alive who got ill without being tested or hospitalized are simply not being counted.
Previously healthy people with persistent symptoms such as chest heaviness, breathlessness, muscle pains, palpitations and fatigue, which prevent them from resuming work or physical or caring activities, are still classed under the umbrella of ‘mild COVID’. Data from a UK smartphone app for tracking symptoms suggests that at least one in ten of those reporting are ill for more than three weeks. Symptoms lasting several weeks and impairing a person’s usual function should not be called mild.
https://www.nature.com/articles/d41586-020-02335-z
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29. Korea: JAMA: Clinical Course and Molecular Viral Shedding Among Asymptomatic and Symptomatic Patients With SARS-CoV-2 Infection in a Community Treatment Center in the Republic of Korea
Are there viral load differences between asymptomatic and symptomatic patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection?
In this cohort study that included 303 patients with SARS-CoV-2 infection isolated in a community treatment center in the Republic of Korea, 110 (36.3%) were asymptomatic at the time of isolation and 21 of these (19.1%) developed symptoms during isolation. The cycle threshold values of reverse transcription–polymerase chain reaction for SARS-CoV-2 in asymptomatic patients were similar to those in symptomatic patients.
Many individuals with SARS-CoV-2 infection remained asymptomatic for a prolonged period, and viral load was similar to that in symptomatic patients; therefore, isolation of infected persons should be performed regardless of symptoms.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2769235
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30. International: International Journal for Equity in Health: Health equity and COVID-19: global perspectives
The COVID-19 is disproportionally affecting the poor, minorities and a broad range of vulnerable populations, due to its inequitable spread in areas of dense population and limited mitigation capacity due to high prevalence of chronic conditions or poor access to high quality public health and medical care. Moreover, the collateral effects of the pandemic due to the global economic downturn, and social isolation and movement restriction measures, are unequally affecting those in the lowest power strata of societies. To address the challenges to health equity and describe some of the approaches taken by governments and local organizations, we have compiled 13 country case studies from various regions around the world: China, Brazil, Thailand, Sub Saharan Africa, Nicaragua, Armenia, India, Guatemala, United States of America (USA), Israel, Australia, Colombia, and Belgium. This compilation is by no-means representative or all inclusive, and we encourage researchers to continue advancing global knowledge on COVID-19 health equity related issues, through rigorous research and generation of a strong evidence base of new empirical studies in this field.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316580/
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31. UK: Anaesthesia: A cross‐sectional study of immune seroconversion to SARS‐CoV‐2 in frontline maternity health professionals
COVID‐19, the respiratory disease caused by SARS‐CoV‐2, is thought to cause a milder illness in pregnancy with a greater proportion of asymptomatic carriers. This has important implications for the risk of patient‐to‐staff, staff‐to‐staff and staff‐to‐patient transmission among health professionals in maternity units. The aim of this study was to investigate the prevalence of previously undiagnosed SARS‐CoV‐2 infection in health professionals from two tertiary‐level maternity units in London, UK, and to determine associations between healthcare workers’ characteristics, reported symptoms and serological evidence of prior SARS‐CoV‐2 infection. In total, 200 anaesthetists, midwives and obstetricians, with no previously confirmed diagnosis of COVID‐19, were tested for immune seroconversion using laboratory IgG assays. Comprehensive symptom and medical histories were also collected. Five out of 40 (12.5%; 95%CI 4.2–26.8%) anaesthetists, 7/52 (13.5%; 95%CI 5.6–25.8%) obstetricians and 17/108 (15.7%; 95%CI 9.5–24.0%) midwives were seropositive, with an overall total of 29/200 (14.5%; 95%CI 9.9–20.1%) of maternity healthcare workers testing positive for IgG antibodies against SARS‐CoV‐2. Of those who had seroconverted, 10/29 (35.5%) were completely asymptomatic. Fever or cough were only present in 6/29 (21%) and 10/29 (35%) respectively. Anosmia was the most common symptom occurring in 15/29 (52%) seropositive participants and was the only symptom that was predictive of positive seroconversion (OR 18; 95%CI 6–55). Of those who were seropositive, 59% had not self‐isolated at any point and continued to provide patient care in the hospital setting. This is the largest study of baseline immune seroconversion in maternity healthcare workers conducted to date and reveals that one out of six were seropositive, of whom one out of three were asymptomatic. This has significant implications for the risk of occupational transmission of SARS‐CoV‐2 for both staff and patients in maternity units. Regular testing of staff, including asymptomatic staff should be considered to reduce transmission risk.
https://onlinelibrary.wiley.com/doi/full/10.1111/anae.15229
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32. USA: PLOS ONE: Development and validation of a model for individualized prediction of hospitalization risk in 4,536 patients with COVID-19
Coronavirus Disease 2019 is a pandemic that is straining healthcare resources, mainly hospital beds. Multiple risk factors of disease progression requiring hospitalization have been identified, but medical decision-making remains complex.
To characterize a large cohort of patients hospitalized with COVID-19, their outcomes, develop and validate a statistical model that allows individualized prediction of future hospitalization risk for a patient newly diagnosed with COVID-19.
4,536 patients tested positive for SARS-CoV-2 during the study period. Of those, 958 (21.1%) required hospitalization. By day 3 of hospitalization, 24% of patients were transferred to the intensive care unit, and around half of the remaining patients were discharged home. Ten patients died. Hospitalization risk was increased with older age, black race, male sex, former smoking history, diabetes, hypertension, chronic lung disease, poor socioeconomic status, shortness of breath, diarrhea, and certain medications (NSAIDs, immunosuppressive treatment). Hospitalization risk was reduced with prior flu vaccination. Model discrimination was excellent with an area under the curve of 0.900 (95% confidence interval of 0.886–0.914) in the development cohort, and 0.813 (0.786, 0.839) in the validation cohort. The scaled Brier score was 42.6% (95% CI 37.8%, 47.4%) in the development cohort and 25.6% (19.9%, 31.3%) in the validation cohort. Calibration was very good
Our study crystallizes published risk factors of COVID-19 progression, but also provides new data on the role of social influencers of health, race, and influenza vaccination. In a context of a pandemic and limited healthcare resources, individualized outcome prediction through this nomogram or online risk calculator can facilitate complex medical decision-making.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0237419
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33. Philippines: Phillstar Global: ‘Stop use of thermal scanners, mists at checkpoints’
Medical experts are urging the police in Metro Manila to discontinue some measures being implemented at quarantine checkpoints to avoid further spreading the coronavirus disease 2019 in communities.
According to the National Capital Region Police Office (NCRPO), medical professionals suggested during a meeting last Friday to stop the use of thermal scanners and misting tents at the quarantine control points.
The experts – composed of doctors from San Lazaro Hospital, Sta. Ana Hospital, Chinese General Hospital and the health offices of Quezon City and Muntinlupa City – also recommended a stop to the use of the disinfection tent as “studies show it is no longer effective in the elimination of the (coronavirus).”
In June, doctor and police Capt. Casey Gutierrez died after inhaling disinfectant. He attended to a patient undergoing quarantine at the PhilSports Arena and got sanitized at the misting tent.
After the incident, the Department of the Interior and Local Government (DILG) ordered a ban on using disinfection tents by uniformed personnel, as its ability to help kill the coronavirus has not yet been proven.
https://www.philstar.com/headlines/2020/08/10/2034129/stop-use-thermal-scanners-mists-checkpoints
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34. South Africa: Medical Brief: Nervous COVID-19 patients want home care rather than hospital admission
Nervousness over overcrowded hospitals has led to a demand for private doctors to create COVID-19 “wards” in patient’s homes, reports The Times.
Many patients refuse to go to hospital for fear of not seeing their families again. Others have been turned away because of hospitals’ lack of capacity.
Durban doctor Naseeba Kathrada started a COVID home-management team to alleviate stress on hospitals and on infected patients. “We provide support to doctors to better manage their patients at home by assisting with the oxygen concentrators, thermometers, machines to monitor blood sugar and blood pressure levels, the supply of supplements, a laboratory to conduct tests, psychologists, physiotherapists and a chiropractor,” she said. Doctors direct physiotherapists to do mainly virtual home care by helping with breathing techniques. In severe cases, patients are referred to hospital.
https://www.medicalbrief.co.za/archives/nervous-covid-19-patients-want-home-care-rather-than-hospital-admission/
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35. USA: Washington Post: Wearing a neck gaiter may be worse than no mask at all, researchers find
Duke study finds some cotton cloth masks are about as effective as surgical masks, while thin polyester spandex gaiters may be worse than going maskless.
As the number of novel coronavirus cases continues to rise nationwide, the recurring message from many public health experts and doctors has been simple: Wearing masks saves lives.
“We are not defenseless against covid-19,” Robert R. Redfield, director of the Centers for Disease Control and Prevention, said in July. “Cloth face coverings are one of the most powerful weapons we have to slow and stop the spread of the virus – particularly when used universally within a community setting.”
But as face coverings have become increasingly commonplace in American life, so have questions about efficacy — and now a group of researchers from Duke University are aiming to provide some answers.
In a recently published study, the researchers unveiled a simple method to evaluate the effectiveness of various types of masks, analyzing more than a dozen different facial coverings ranging from hospital-grade N95 respirators to bandanas. Of the 14 masks and other coverings tested, the study found that some easily accessible cotton cloth masks are about as effective as standard surgical masks, while popular alternatives such as neck gaiters made of thin, stretchy material may be worse than not wearing a mask at all.
https://www.washingtonpost.com/lifestyle/wellness/mask-test-duke-covid/2020/08/10/4f2bb888-db18-11ea-b205-ff838e15a9a6_story.html?utm_campaign=wp_to_your_health&utm_medium=email&utm_source=newsletter&wpisrc=nl_tyh&wpmk=1&pwapi_token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJjb29raWVuYW1lIjoid3BfY3J0aWQiLCJpc3MiOiJDYXJ0YSIsImNvb2tpZXZhbHVlIjoiNWU4YWMxZTY5YmJjMGYwYTJlNzk3ODE3IiwidGFnIjoiNWYzMzA0NWNmZTFmZjY1ZTExN2M4YjE5IiwidXJsIjoiaHR0cHM6Ly93d3cud2FzaGluZ3RvbnBvc3QuY29tL2xpZmVzdHlsZS93ZWxsbmVzcy9tYXNrLXRlc3QtZHVrZS1jb3ZpZC8yMDIwLzA4LzEwLzRmMmJiODg4LWRiMTgtMTFlYS1iMjA1LWZmODM4ZTE1YTlhNl9zdG9yeS5odG1sP3V0bV9jYW1wYWlnbj13cF90b195b3VyX2hlYWx0aCZ1dG1fbWVkaXVtPWVtYWlsJnV0bV9zb3VyY2U9bmV3c2xldHRlciZ3cGlzcmM9bmxfdHloJndwbWs9MSJ9.jkrogfRH7-5Ze3u-NE8BCYIjX_0sIlHm2UrfZxSDMiE
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36. International: Centre for Global Development: Protecting Community Health Workers: PPE Needs and Recommendations for Policy Action
Community health workers (CHWs) are often the first point of care for vulnerable and underserved populations in low- and middle-income countries.
Personal protective equipment (PPE) is required for CHWs to safely support COVID-19 response efforts and maintain essential services. Unfortunately, the COVID-19 outbreak has caused a surge in demand for—and corresponding global shortage of—PPE. While this deficit affects all health workers, recent evidence suggests CHWs in low- and middle-income countries have been disproportionally affected due, in large part, to their incomplete integration within national health systems (Ballard & Westgate, 2020).
CHWs played a vital role in the 2014-2016 Ebola response and are already doing the same during COVID-19: in many low and middle income countries, CHWs are at the frontlines preventing, detecting, and responding to the outbreak (Wiah et al., 2020). CHWs are a significant pillar of basic public health interventions as they conduct contract tracing and support isolation; robust networks of CHWs may be one of the many reasons why some countries (e.g., Ghana, South Africa) have been successfully mitigating spread (Moore, 2020). CHWs are also critical to ensuring that the coverage of essential services does not decline—a common occurrence during crises which can ultimately kill more people than the epidemic itself. Without PPE, however, community health workers can neither stop COVID-19 nor provide health services. (See Box 1 for a discussion of the critical role of CHWs where other health services are scarce.)
https://www.cgdev.org/publication/protecting-community-health-workers-ppe-needs-and-recommendations-policy-action
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37. USA: Washington Post: Who should get a coronavirus vaccine first?
Experts weigh priority for health-care and essential workers and people of color
With some coronavirus vaccine trials in their much-anticipated final stage, U.S. officials and experts are wrestling with one of the most difficult issues facing the country: Who should be first to get limited doses of a vaccine during one of the worst public health crises in a century?
Discussions have begun to identify priority groups for initial vaccination against covid-19, the disease caused by the virus. Those discussions, involving federal health officials and outside experts, are based on planning developed during the 2009 H1N1 influenza pandemic. The highest priority would go to health-care and essential workers and high-risk populations. This proposed group would also include older adults, residents of long-term-care facilities and people with underlying medical conditions.
A federal advisory panel that provides vaccine recommendations to the Centers for Disease Control and Prevention presented an overview of the priority groups last month and met again Wednesday to discuss the issue.
https://www.washingtonpost.com/health/2020/07/29/covid-vaccine-essential-workers-high-risk-populations/?utm_campaign=wp_to_your_health&utm_medium=email&utm_source=newsletter&wpisrc=nl_tyh&wpmk=1&pwapi_token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJjb29raWVuYW1lIjoid3BfY3J0aWQiLCJpc3MiOiJDYXJ0YSIsImNvb2tpZXZhbHVlIjoiNWU4YWMxZTY5YmJjMGYwYTJlNzk3ODE3IiwidGFnIjoiNWYyMWUyZDRmZTFmZjY1ZTExNzAyZGI2IiwidXJsIjoiaHR0cHM6Ly93d3cud2FzaGluZ3RvbnBvc3QuY29tL2hlYWx0aC8yMDIwLzA3LzI5L2NvdmlkLXZhY2NpbmUtZXNzZW50aWFsLXdvcmtlcnMtaGlnaC1yaXNrLXBvcHVsYXRpb25zLz91dG1fY2FtcGFpZ249d3BfdG9feW91cl9oZWFsdGgmdXRtX21lZGl1bT1lbWFpbCZ1dG1fc291cmNlPW5ld3NsZXR0ZXImd3Bpc3JjPW5sX3R5aCZ3cG1rPTEifQ.LL3TX5UxqIc61m9Ohx6MAkZVkj1M2BMPG0xltmWgl-8
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38. South Africa: Daily Maverick: How Covid-19 emergency procurement turned into a cadres’ feast
With billions allocated to fight the biggest public health emergency of our times, and with eased regulations on procurement, bent civil servants and connected companies have taken the gap. How did an emergency health procurement budget of about R50-billion become a cadres’ feast? Here’s one story that illustrates the trend. Harvey Sicelo Buthelezi is the perfect example of a connected cadre. His CV is dotted with jobs in government and executive jobs outside of government, but which need political connectivity.
https://www.dailymaverick.co.za/article/2020-07-29-how-covid-19-emergency-procurement-turned-into-a-cadres-feast/?utm_medium=email&utm_campaign=First%20Thing%20Wednesday%2029%20July%20Hydro%20SAICA&utm_content=First%20Thing%20Wednesday%2029%20July%20Hydro%20SAICA+CID_13029ce53105a6a740ee167209627e5e&utm_source=TouchBasePro&utm_term=How%20Covid-19%20emergency%20procurement%20turned%20into%20a%20cadres%20feast#gsc.tab=0
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39. International: Community Health Impact Coalition: Community Health Workers are poised to play a pivotal role in fighting COVID-19, especially in countries with vulnerable health systems.
Here’s how you can act:
• Get the evidence
• Trade notes
• Make concrete plans
• Share resource is
• Strengthen systems
• Advocate
https://chwimpact.org/covid19
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40. UK: General Medical Council: Europe Economics: Regulatory approaches to telemedicine
Europe Economics has been commissioned by the General Medical Council to review regulatory approaches to telemedicine around the world. The aim of this work is to understand how various regulators define telemedicine, what kind of requirements they impose on doctors, and how they deal with the possibility of doctors from another jurisdiction providing remote medical services to patients.
We adopted a multi-strand approach to the research including desk research, an online survey, and telephone interviews. Our desk research and interviews focused on a selection of countries where telemedicine regulation is more developed, i.e. the United States of America, Canada, France, Denmark, Portugal, Australia, New Zealand, and Singapore. The survey prompted responses from a wider set of regulators and organisations.
See Attached

41. Argentina: Pagina12: Coronavirus en Argentina: se registraron 7482 nuevos contagios
Hubo, además, 160 muertos en las últimas 24 horas Según el último parte del Ministerio de Salud, el AMBA sigue siendo la región del país más comprometida, ya que la provincia de Buenos Aires registró un record de 5200 casos, y la Ciudad 1237 contagios en una sola jornada.
Coronavirus in Argentina: 7482 new infections were registered
There were also 160 deaths in the last 24 hours
According to the last part of the Ministry of Health, the AMBA continues to be the most compromised region of the country, since the province of Buenos Aires registered a record of 5200 cases, and the City 1237 infections in a single day.
https://www.pagina12.com.ar/283709-coronavirus-en-argentina-se-registraron-7482-nuevos-contagio
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42. South Africa: Daily Maverick: Gauteng doctors make urgent public appeal for lifesaving oxygen concentrators
Doctors have made an urgent appeal for people to lend them their oxygen concentrators or to donate to an account for the rental of these machines as they try to address the oxygen needs of Covid-19 patients at the Nasrec Field Hospital while the facility is being expanded.
Gauteng is currently the epicentre of the Covid-19 pandemic with around 5,000 new cases a day. The province is experiencing a public hospital crisis as all state hospitals have reached capacity and there is an urgent need to assist patients with oxygen.
A collective of healthcare professionals who are volunteering at the Nasrec Field Hospital has sent out an urgent call to members of the public to lend them their oxygen concentrators or assist with financial support to enable them to rent these machines so they can also help patients who are more seriously ill.
Lynne Wilkinson, who is part of the collective, said they have not been able to find any oxygen concentrators at any suppliers in the province.
https://www.dailymaverick.co.za/article/2020-07-10-gauteng-doctors-make-urgent-public-appeal-for-lifesaving-oxygen-concentrators/#gsc.tab=0
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43. USA: The Strategist: How to Travel and Commute Amid the Coronavirus Outbreak, According to Experts
With lockdown orders relaxing and expiring across the country, more and more people are beginning to travel — both for work and leisure. As of July 24, face masks are now mandatory in a number of public spaces, including shops and supermarkets, post offices, and indoor shopping centers (they have been mandatory on public transport and taxis since June).
To find out the safest way to commute during the pandemic, we checked in with a handful of experts — including Dr. Waleed Javaid, the director of infection prevention and control at Mount Sinai Downtown; Dr. David Hirschwerk, an infectious-disease specialist at North Shore University Hospital; Dr. Aaron Glatt, the chair of medicine at Mount Sinai South Nassau and a spokesman for the Infectious Diseases Society of America; and Dr. Syra Madad, an American pathogen preparedness expert and epidemiologist — many of whom we also spoke to in early March, around the time the coronavirus epidemic became a global pandemic.
https://www.thestrategist.co.uk/article/coronavirus-travel-advice.html
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44. USA: Washington Post: Forty percent of people with coronavirus infections have no symptoms. Might they be the key to ending the pandemic?
New research suggests that some of us may be partially protected due to past encounters with common cold coronaviruses
When researcher Monica Gandhi began digging deeper into outbreaks of the novel coronavirus, she was struck by the extraordinarily high number of infected people who had no symptoms.
A Boston homeless shelter had 147 infected residents, but 88 percent had no symptoms even though they shared their living space. A Tyson Foods poultry plant in Springdale, Ark., had 481 infections, and 95 percent were asymptomatic. Prisons in Arkansas, North Carolina, Ohio and Virginia counted 3,277 infected people, but 96 percent were asymptomatic.
During its seven-month global rampage, the coronavirus has claimed more than 700,000 lives. But Gandhi began to think the bigger mystery might be why it has left so many more practically unscathed.
What was it about these asymptomatic people, who lived or worked so closely to others who fell severely ill, she wondered, that protected them? Did the “dose” of their viral exposure make a difference? Was it genetics? Or might some people already have partial resistance to the virus, contrary to our initial understanding?
https://www.washingtonpost.com/health/2020/08/08/asymptomatic-coronavirus-covid/?hpid=hp_hp-banner-main_virus-asymptomatic-130pm%3Ahomepage%2Fstory-ans&utm_campaign=wp_to_your_health&utm_medium=email&utm_source=newsletter&wpisrc=nl_tyh&wpmk=1&pwapi_token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJjb29raWVuYW1lIjoid3BfY3J0aWQiLCJpc3MiOiJDYXJ0YSIsImNvb2tpZXZhbHVlIjoiNWU4YWMxZTY5YmJjMGYwYTJlNzk3ODE3IiwidGFnIjoid3BfdG9feW91cl9oZWFsdGgiLCJ1cmwiOiJodHRwczovL3d3dy53YXNoaW5ndG9ucG9zdC5jb20vaGVhbHRoLzIwMjAvMDgvMDgvYXN5bXB0b21hdGljLWNvcm9uYXZpcnVzLWNvdmlkLz9ocGlkPWhwX2hwLWJhbm5lci1tYWluX3ZpcnVzLWFzeW1wdG9tYXRpYy0xMzBwbSUzQWhvbWVwYWdlJTJGc3RvcnktYW5zJnV0bV9jYW1wYWlnbj13cF90b195b3VyX2hlYWx0aCZ1dG1fbWVkaXVtPWVtYWlsJnV0bV9zb3VyY2U9bmV3c2xldHRlciZ3cGlzcmM9bmxfdHloJndwbWs9MSJ9.nLUY5yDFSo6zzLgHHY9rnS2KEab_JPDKedJ2zWbIrQc
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Malawi: AfroPHC: University of Malawi: Video + Family Medicine Newsletter
Video link to a Wonca Africa webinar on Covid-19 response in Malawi that took place on 24th July 2020. Our registrars Dr. Patrick Chisepo, Dr. Modai Mnenula and Faculty member Dr. Bente van der Meijden gave their presentations during the webinar, and it was hosted by Prof Moosa of University of Witwatersrand.
Also attached is the Newsletter

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45. Nature: The trials of global research under the coronavirus
Researchers share how they have adapted fieldwork and collaborations in the face of travel bans and closed borders.
International collaborations account for almost one-quarter of all publications and produce notable citations and influence. But the coronavirus pandemic is likely to choke off much of this momentum: researchers can’t meet face-to-face when would-be travellers are cautioned against flying or are banned from certain destinations. The impact of COVID-19 threatens to derail decades of shared scientific progress across many parts of the world, particularly in the United States and western Europe, where international partnerships had been growing swiftly.
Since 1991, science has benefited from increased funding and ease of communications, along with dismantled geopolitical barriers. Wealthier nations such as the United Kingdom, United States, France and Germany have seen a 10-fold increase in internationally co-authored papers, and Brazil, Russia, India and China have had a 20-fold increase. The United States and China are the leading research collaborators globally, and partner more with each other than with any other country.
https://www.nature.com/articles/d41586-020-02326-0?utm_source=Nature+Briefing&utm_campaign=86b34a9516-briefing-dy-20200810&utm_medium=email&utm_term=0_c9dfd39373-86b34a9516-45238390
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Best wishes to you all.
Next post will be next Monday
John Wynn-Jones

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