“My mother told me to be a lady. And for her, that meant be your own person, be independent”.

“Fight for the things that you care about, but do it in a way that will lead others to join you”

“We are at last beginning to relegate to the history books the idea of the token woman”

“When I’m sometimes asked, ‘When will there be enough (women on the Supreme Court)?’ and my answer is: ‘When there are nine”. People are shocked. But there’d been nine men, and nobody’s ever raised a question about that.”

“Women will only have true equality when men share with them the responsibility of bringing up the next generation”.

Ruth Bader Ginsburg

Justice

I put this collection together in memory of Ruth Bader Ginsburg, the US Supreme Court Judge who died four days ago. With all the ugly and divisive political posturing we see as a result of her death, we can easily forget what a remarkable strong woman she was. She was a champion of gender equity, inequality and injustice and will be dearly missed, especially at this time of political, economic and social upheaval.
She has been described as a “the demure firebrand who in her 80s became a legal, cultural and feminist icon.
Chief Justice John Roberts said of her “Our nation has lost a justice of historic stature, we at the Supreme Court have lost a cherished colleague. Today we mourn but with confidence that future generations will remember Ruth Bader Ginsburg as we knew her, a tireless and resolute champion of justice.”
She was the architect of the legal fight for women’s rights in the 1970s and served for 27 years on America’s highest court, becoming its most prominent member.
I fear that it will not only be Americans who mourn her passing but the ramifications of her loss will be felt around the world.
I have put together a collection of poems around the theme of justice and human rights with poems from France, Jamaica, USA, India, Zimbabwe and Canada

Remembering Ruth Bader Ginsburg

Jean De La Fontaine (1621-1695)
Jean de La Fontaine was a French fabulist and one of the most widely read French poets of the 17th century. He is known above all for his Fables, which provided a model for subsequent fabulists across Europe and numerous alternative versions in France, as well as in French regional languages.
After a long period of royal suspicion, he was admitted to the French Academy and his reputation in France has never faded since. Evidence of this is found in the many pictures and statues of the writer, later depictions on medals, coins and postage stamps.

The Country Justice

TWO lawyers to their cause so well adhered,
A country justice quite confused appeared,
By them the facts were rendered so obscure
With which the truth remained he was not sure.
At length, completely tired, two straws he sought
Of diff’rent lengths, and to the parties brought.
These in his hand he held:–the plaintiff drew
(So fate decreed) the shortest of the two.
On this the other homeward took his way,
To boast how nicely he had gained the day.

THE bench complained: the magistrate replied
Don’t blame I pray–’tis nothing new I’ve tried;
Courts often judge at hazard in the law,
Without deciding by the longest straw.

Claude McKay (1889-1948)
Claude McKay was born in Jamaica in 1889. He was educated by his older brother, who possessed a library of English novels, poetry, and scientific texts.
In 1912, McKay published a book of verse called Songs of Jamaica recording his impressions of black life in Jamaica in dialect. That same year, he travelled to the United States to attend Tuskegee Institute in Alabama. He remained there only a few months, leaving to study agriculture at Kansas State University.
In 1917, he published two sonnets, “The Harlem Dancer” and “Invocation,” and later used the form in writing about social and political concerns from his perspective as a black man in the United States. McKay also wrote on a variety of subjects, from his Jamaican homeland to romantic love, with a use of passionate language.
During the twenties, McKay developed an interest in Communism and travelled to Russia and then to France. In 1934, McKay moved back to the United States and lived in Harlem, New York. Losing faith in Communism, he turned his attention to the teachings of various spiritual and political leaders in Harlem, eventually converting to Catholicism.
McKay’s viewpoints and poetic achievements in the earlier part of the twentieth century set the tone for the Harlem Renaissance and gained the deep respect of younger black poets of the time, including Langston Hughes.

America

Although she feeds me bread of bitterness,
And sinks into my throat her tiger’s tooth,
Stealing my breath of life, I will confess
I love this cultured hell that tests my youth!
Her vigor flows like tides into my blood,
Giving me strength erect against her hate.
Her bigness sweeps my being like a flood.
Yet as a rebel fronts a king in state,
I stand within her walls with not a shred
Of terror, malice, not a word of jeer.
Darkly I gaze into the days ahead,
And see her might and granite wonders there,
Beneath the touch of Time’s unerring hand,
Like priceless treasures sinking in the sand.

America – Claude McKay

James Mercer Langston Hughes (1902 –1967)
James Mercer Langston Hughes was an American poet, social activist, novelist, playwright, and columnist from Joplin, Missouri. He was one of the earliest innovators of the then-new literary art form called jazz poetry. Hughes is best known as a leader of the Harlem Renaissance.
He was born in 1902 in Joplin Missouri. He was the great-great-grandson of Charles Henry Langston, whose brother John Mercer Langston was the first Black American to be elected to public office.
In the frequent absence of his mother, who was constantly moving around looking for work, he was raised by his grandmother until he was thirteen, when he moved to Lincoln, Illinois, to live with his mother and her new husband. It was in Lincoln that he started to write poetry. After graduation from Cleveland’s Central High School, he spent a year in Mexico with his father and a year at Columbia University. After a while he dropped out of the degree course but continued to write poetry.

Justice

That Justice is a blind goddess
Is a thing to which we black are wise:
Her bandage hides two festering sores
That once perhaps were eyes.

Justice by Langston Hughes – Poetry Reading

I, too

I, too, sing America.
I am the darker brother.
They send me to eat in the kitchen
When company comes,
But I laugh,
And eat well,
And grow strong.
Tomorrow,
I’ll be at the table
When company comes.
Nobody’ll dare
Say to me,
“Eat in the kitchen,”
Then.
Besides,
They’ll see how beautiful I am
And be ashamed—
I, too, am America.

Langston Hughes – I, Too

Maya Angelou (1928-2014)
Maya Angelou was born Marguerite Johnson in St. Louis, Missouri, on April 4, 1928. She grew up in St. Louis and Stamps, Arkansas. She was an author, poet, historian, songwriter, playwright, dancer, stage and screen producer, director, performer, singer, and civil rights activist. She was best known for her seven autobiographical books

Still I Rise

You may write me down in history
With your bitter, twisted lies,
You may trod me in the very dirt
But still, like dust, I’ll rise.

Does my sassiness upset you?
Why are you beset with gloom?
’Cause I walk like I’ve got oil wells
Pumping in my living room.
Just like moons and like suns,
With the certainty of tides,
Just like hopes springing high,
Still I’ll rise.

Did you want to see me broken?
Bowed head and lowered eyes?
Shoulders falling down like teardrops,
Weakened by my soulful cries?

Does my haughtiness offend you?
Don’t you take it awful hard
’Cause I laugh like I’ve got gold mines
Diggin’ in my own backyard.

You may shoot me with your words,
You may cut me with your eyes,
You may kill me with your hatefulness,
But still, like air, I’ll rise.

Does my sexiness upset you?
Does it come as a surprise
That I dance like I’ve got diamonds
At the meeting of my thighs?

Out of the huts of history’s shame
I rise
Up from a past that’s rooted in pain
I rise
I’m a black ocean, leaping and wide,
Welling and swelling I bear in the tide.

Leaving behind nights of terror and fear
I rise
Into a daybreak that’s wondrously clear
I rise
Bringing the gifts that my ancestors gave,
I am the dream and the hope of the slave.
I rise
I rise
I rise.
Maya Angelou reads “And Still I Rise”

Alberto Ríos (1952)
Born in 1952, Alberto Ríos is the inaugural state poet laureate of Arizona and the author of many poetry collections. In 1981, he received the Walt Whitman Award for his collection Whispering to Fool the Wind (Sheep Meadow Press, 1982).
Since 1994 he has been Regents Professor of English at Arizona State University in Tempe, where he has taught since 1982. In 2013, Ríos was named the inaugural state poet laureate of Arizona. He served as Chancellor of the Academy of American Poets from 2014 to 2020. In 2017, he was appointed as the new director of the Virginia G. Piper Center for Creative Writing at Arizona State University.

The Border: A Double Sonnet

The border is a line that birds cannot see.
The border is a beautiful piece of paper folded carelessly in half.
The border is where flint first met steel, starting a century of fires.
The border is a belt that is too tight, holding things up but making it hard to breathe.
The border is a rusted hinge that does not bend.
The border is the blood clot in the river’s vein.
The border says stop to the wind, but the wind speaks another language, and keeps going.
The border is a brand, the “Double-X” of barbed wire scarred into the skin of so many.
The border has always been a welcome stopping place but is now a stop sign, always red.
The border is a jump rope still there even after the game is finished.
The border is a real crack in an imaginary dam.
The border used to be an actual place, but now, it is the act of a thousand imaginations.
The border, the word border, sounds like order, but in this place they do not rhyme.
The border is a handshake that becomes a squeezing contest.
The border smells like cars at noon and wood smoke in the evening.
The border is the place between the two pages in a book where the spine is bent too far.
The border is two men in love with the same woman.
The border is an equation in search of an equals sign.
The border is the location of the factory where lightning and thunder are made.
The border is “NoNo” The Clown, who can’t make anyone laugh.
The border is a locked door that has been promoted.
The border is a moat but without a castle on either side.
The border has become Checkpoint Chale.
The border is a place of plans constantly broken and repaired and broken.
The border is mighty, but even the parting of the seas created a path, not a barrier.
The border is a big, neat, clean, clear black line on a map that does not exist.
The border is the line in new bifocals: below, small things get bigger; above, nothing changes.
The border is a skunk with a white line down its back.
The Border: A Double Sonnet

Praveen Kumar (1949)
Praveen Kumar is an Indian bilingual poet who was born in Mangaluru. He has worked in government service as a senior police officer for over 30 years. He has been writing poetry for twenty-four years and has published many poetry collections.
In his student days he was a prize-winning orator and writer. He is a familiar face in national seminars and TV networks in India as a Poet and thinker and some of his poems have figured in school textbooks.

Justice

Justice begotten in exchange is no justice,
For, exchange is trade,
A distressing gain through loss;
Justice is inherent right,
Though wrapped in black packs
In dark hall of race for survival
Like gold strains bound in mud
Till exploited;
She is cool like ice
And still like rock;
No easy road to charm her soul
While hardship makes her no more justice.

She, in inaccessible moon,
She, in inaccessible moon,
She, in inaccessible moon,
A charming dream of undying hopes.

She appears by disappearance
And cracks confidence;
You feel her flight outward
While strange shadows dull your Self;
You cannot catch her back,
You cannot catch her back,
For, in outward flight, she sinks to darkness
Where eyes blind
And distance rises;
Your hands, raised for justice,
Grope in hopeless void till strain
And give up unending fight forever
As dreams never win realities of deceits;

You see her in shades
In gloom’s dark sea;
She surfaces from night’s unending darkness
Like hopeless inaccessible mirage
In your eyes
While the world sees there plain darkness;
She is unseen to all
She is unseen to all, but,
You, who lost her out;
Men seek justice
In passion’s thousand hues,
As she is invisible otherwise;
Aye, justice hides from justice
And breeds injustice.

Why justice is shackled to greed and bribe?
Why justice is fished out from popular mood?
Lost in thick jungle of lightless night,
Like rat, caught in the sack of death,
Like deer, caught in lion’s lair,
She never reaches Self by herself.

Justice is the just haunt of nature’s all games
What man for his crave molests and tames.

Justice must be just for all to see
In glow of crystal brightness
And impose herself in natural ease
Like flood seizes low-lying lands
And fill all pits of man’s callousness;
It is justice of course,
It is justice in natural haunt,
That none gain by trade
Nor lose ever.

For, justice that limps in darkness is justice dead,
A corps you can never infuse life with.

Alas, justice lives feeble life
And yields to injustice in comfort;
It haunts as ghost after death
As if seeking rebirth
To live again weightless life
With no passion for just path,
Nor for anything just and fair.

Justice with no heart for truth,
Justice with no dash for right cause
Is justice dead indeed.

Tinashe Severa
Tinashe Severa is a young up and coming Zimbabwean short story writer, novelist and poet. His writing is sometimes comical but he is a also a strong social commentator. Currently he is an accounting student at Africa university, in Mutare. His works include “The pulpit speaks” (poetry collection 2005), Poems of Tinashe Severa (E book 2006) and The hut.(short story collection 2006)

Justice stands still

When justice stands still
only the fool hearted,
will contemplate pursuing even the most just of causes,
when justice stands still,
the brave only will seek retribution
for sins committed against them and their kinsman,
can any gleamse of sovereignty exist
where justice takes a tea break,
and when justice decides to stand still
will any sanity prevail,
where justice once stood still,
can any unity ever be restored

once upon a time the jews were slandered and abused
but they had the courage to stand up and refuse,
when justice stands still,
the supposed saviours become the enslavers,
who then will stand up to refuse for the people
when just the law makers become peace detractors,
creating laws meant not to ensure harmony,
but to bring woo to the masses,
when justice stands still,
they will seek to devour,
those they once vowed to protect,
justice stands still,
the eleventh plague,
not just a biblical fantasy,
but a present reality

Rupi Kaur (1992)
Rupi Kaur is an Indian-born Canadian feminist, poet, illustrator, and author. Kaur rose to fame on Instagram and Tumblr through sharing her short visual poetry. As a 21-year-old university student, Rupi wrote, illustrated, and self-published her first collection, milk and honey.
Rupi’s collections of poetry, “milk and honey” and “the sun and her flowers”, have sold millions of copies and been translated in over 42 languages. Her work touches on love, loss, trauma, healing, feminism, and migration.

You are more than beautiful

i want to apologise to all the women
i have called pretty.
before i’ve called them intelligent or brave.
i’m sorry i made it sound as though
something as simple as what you’re born with
is the most you have to be proud of
when your spirit has crushed mountains
from now on i will say things like, you are resilient
or, you are extraordinary.
not because i don’t think you’re pretty.
but because you are so much more than that

Freedom of speech

you tell me to quiet down cause
my opinions make me less beautiful
but i was not made with fire in my belly
so i could put it out
i was not made with lightness in my tongue
so i could be easy to swallow
i was made heavy
half blade and half silk
difficult to forget but
not easy for the mind to follow

Being strong

the kindest words my father said to me
women like you drown oceans

Fathers and daughters

every time you
tell your daughter
you yell at her
out of love
you teach her to confuse
anger with kindness
which seems like a good idea
till she grows up
to trust men who hurt her
cause they look so much
like you

Rupi Kaur reads poetry from her collection ‘Milk and Honey’

Today’s Posts

New articles published in Rural and Remote Health:
6404 – Asia – Mental health care in rural and remote areas necessitate greater attention during the COVID-19 pandemic
Pre-COVID-19, rural communities already experienced limited access to mental health care. Lockdown during the COVID-19 pandemic has resulted in social isolation, financial insecurity and weakening of social support systems, resulting in a deterioration in adult mental health. Many ideas and improvements are filling the gaps in mental health care during this difficult time, but, as this Letter to the editor highlights, more emphasis is needed on rural and remote communities.
6379 – Asia – COVID-19 leads to physically severe experiences for the rural elderly in Japan, during Obon
The COVID-19 pandemic has not only been affecting people’s health, but has also had negative impacts on social interaction. This Letter to the editor reports on the experiences of elderly rural people in Japan preparing for the celebration of Obon (a traditional Japanese holiday week in August) during the pandemic.
5754 – North America – Patient and provider perspectives on eHealth interventions in Canada and Australia: a scoping review
This scoping review provides a synthesis of the literature on patient and provider perspectives of eHealth initiatives in rural Australian and Canadian communities. The focus on first person perspectives draws attention to the importance of centering patient voices in the evaluation of healthcare interventions such as eHealth.
1. Nature: Who gets a COVID vaccine first? Access plans are taking shape
Advisory groups around the world release guidance to prioritize health-care workers and those in front-line jobs.
Whether it takes weeks, as US President Donald Trump has hinted, or months, as most health-care experts expect, an approved vaccine against the coronavirus is coming, and it’s hotly anticipated. Still, it will initially be in short supply while manufacturers scale up production. As the pandemic continues to put millions at risk daily, including health-care workers, older people and those with pre-existing diseases, who should get vaccinated first?
This week, a strategic advisory group at the World Health Organization (WHO) weighed in with preliminary guidance for global vaccine allocation, identifying groups that should be prioritized. These recommendations join a draft plan from a panel assembled by the US National Academies of Sciences, Engineering, and Medicine (NASEM), released earlier this month.
https://www.nature.com/articles/d41586-020-02684-9?utm_source=Nature+Briefing&utm_campaign=01ae4fb885-briefing-dy-20200918&utm_medium=email&utm_term=0_c9dfd39373-01ae4fb885-45238390
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2. Europe: Wonca Europe: Respect and Gratitude to Health Workers on “World Patient Safety Day 2020”
I am Prof Mehmet Ungan, president of the World Organization of Family Doctors in Europe and I am inviting our Member Organizations to light up their websites or any iconic item in orange as a signature of the WHO Campaign for patient Safety Day 2020. The World Health Organization (WHO) suggested “orange” color. I invite you to use the “orange” colour on 17th September.
ORANGE illumination will be a gesture of respect and gratitude to all health workers risking their own lives and, moreover, while struggling to save people’s lives many die.
May I draw your attention to WHO call urging all stakeholders to “Speak up for health worker safety!”
Family Doctors from 48 countries of the WONCA Europe MOs and PHC Professionals share the WHO’s position that countries should mention “Recognition of health workers’ dedication and hard work”, particularly amid the current fight against COVID-19. This year it is a priority in the WHO World Patient Safety Day 2020!
We are strongly emphasizing that the delivery of primary health care services should focus the available resources on “patient”, “community needs” but also on the needs of Health Workers to have a sustainable health workforce.
https://www.woncaeurope.org/news/view/respect-and-gratitude-to-health-workers-on-world-patient-safety-day-2020?fbclid=IwAR3hOfFrEZ2jxKH6SZKc6_EpFsKSzvnnDBPdZDG2H0G1ZR7UdWgTXzzj8iw
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3. Philippines: The Manila Times: Pandemic vs. pandemic: Covid-19 hampers fight against HIV
As coronavirus disease 2019 (Covid-19) swept through the South, Mel Prince watched with alarm as some of the human immunodeficiency virus (HIV) positive patients she helps in the rural Black Belt stopped showing up for lab tests and doctor’s visits.
Some fell back into drug and alcohol abuse. Others feared the acquired immunodeficiency syndrome (AIDS) virus made them more vulnerable to the coronavirus and refused to leave their homes.
Around the same time, Prince’s HIV organization in Selma, Alabama, stopped sending staff to health fairs and other sites to test people for HIV.
https://www.manilatimes.net/2020/09/15/news/latest-stories/pandemic-vs-pandemic-covid-19-hampers-fight-against-hiv/768231/?utm_term=Autofeed&utm_medium=Social&utm_source=Twitter#Echobox=1600125276
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4. International: BBC: Covid-19: New fear grips Europe as cases top 30m worldwide
The number of confirmed coronavirus cases across the globe has surpassed 30 million, according to figures by America’s Johns Hopkins University.
More than 940,000 have died with Covid-19 since the outbreak began in China late last year.
The US, India and Brazil have the most confirmed cases, but there is a renewed spike in infections across Europe.
Many northern hemisphere countries are now bracing for a second wave of the pandemic as winter approaches.
https://www.bbc.co.uk/news/world-54199825
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5. Myanmar: Bloomberg: Myanmar Locks Down Biggest City as Cases Soar Ahead of Elections
Myanmar locked down most of Yangon province, home to its largest city, for two weeks to contain a record surge in coronavirus infections ahead of the general elections scheduled for November.
The strict stay-at-home order from Monday bars more than one member of a family venturing out for shopping and curbs travel from Yangon township to other cities except for essential work, according to guidelines issued Sunday by the nation’s Central Committee on Covid-19 Control. Essential services such as banking, healthcare, fuel stations and food outlets will be allowed to operate as usual, it said.
https://www.bloomberg.com/news/articles/2020-09-21/myanmar-locks-down-biggest-city-as-cases-soar-ahead-of-elections
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6. Sweden: The Guardian: Sweden spared European surge as coronavirus infections stay low
Chief epidemiologist puts low number of cases down to light-touch ‘sustainable’ approach
While many European countries are seeing new cases surge to levels not seen since the peak of the Covid-19 pandemic, Sweden – whose light-touch approach has made it an international outlier – has one of the continent’s lowest infection rates.
According to the European Centre for Disease Prevention and Control (ECDC), the Scandinavian country’s 14-day cumulative total of new caseswas 22.2 per 100,000 inhabitants on Tuesday, against 279 in Spain, 158.5 in France, 118 in the Czech Republic, 77 in Belgium and 59 in the UK, all of which imposed lockdowns this spring. Twenty-two of the 31 European countries surveyed by the ECDC had higher infection rates. New cases, now reported in Sweden only from Tuesday to Friday, are running at roughly the rate seen in late-March, while data from the national health agency showed only 1.2% of its 120,000 tests last week came back positive.
https://www.theguardian.com/world/2020/sep/15/sweden-records-its-fewest-daily-covid-19-cases-since-march
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7. UK: The Guardian: Engagement with anti-vaccine Facebook posts trebles in one month
Exclusive: Guardian analysis prompts calls for new drive to combat conspiracy theories
Engagement with anti-vaccine posts on a sample of UK Facebook pages trebled between July and August, analysis by the Guardian has found, triggering calls for a major new push to tackle conspiracy theories.
Interactions on posts expressing scepticism or hostility towards vaccines on six UK Facebook pages increased from 12,000 in July to 42,000 in August, according to the analysis, conducted using the social media analytics tool CrowdTangle.
The pages were selected by running keyword searches on terms associated with the anti-vaccine movement, creating a list of pages that frequently shared disinformation and conspiracy theories.
A Facebook page for an alternative medicine business that has 1.9m likes shared about 50 posts expressing scepticism about vaccines during the last three months. These included posts containing conspiracy theories about Bill Gates and false claims that vaccines are a form of population control.
According to polling published this summer, 53% of the UK population said they were “certain or very likely” to take a potential Covid-19 vaccine, and a further 20% were “fairly likely to”.
Another of the pages analysed has more than 500,000 likes and posted several times linking to a feature-length followup to the Plandemicconspiracy theory video that went viral in May. One post promoting the film, hosted on a separate site, received 118,000 views. The film blames the outbreak on big pharma, Gates and the World Health Organization, and warns that wearing masks is dangerous because it “literally activates your own virus”.
https://www.theguardian.com/media/2020/sep/19/engagement-anti-vaccine-facebook-posts-trebles-one-month-coronavirus
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8. Nature: Comparative Analysis of Eleven Healthcare-Associated Outbreaks of Middle East Respiratory Syndrome Coronavirus (Mers-Cov) from 2015 to 2017
Since its emergence in 2012, 2,260 cases and 803 deaths due to Middle East respiratory syndrome coronavirus (MERS-CoV) have been reported to the World Health Organization. Most cases were due to transmission in healthcare settings, sometimes causing large outbreaks. We analyzed epidemiologic and clinical data of laboratory-confirmed MERS-CoV cases from eleven healthcare-associated outbreaks in the Kingdom of Saudi Arabia and the Republic of Korea between 2015–2017. We quantified key epidemiological differences between outbreaks. Twenty-five percent (n = 105/422) of MERS cases who acquired infection in a hospital setting were healthcare personnel. In multivariate analyses, age ≥65 (OR 4.8, 95%CI: 2.6–8.7) and the presence of underlying comorbidities (OR: 2.7, 95% CI: 1.3–5.7) were associated with increased mortality whereas working as healthcare personnel was protective (OR 0.07, 95% CI: 0.01–0.34). At the start of these outbreaks, the reproduction number ranged from 1.0 to 5.7; it dropped below 1 within 2 to 6 weeks. This study provides a comprehensive characterization of MERS HCA-outbreaks. Our results highlight heterogeneities in the epidemiological profile of healthcare-associated outbreaks. The limitations of our study stress the urgent need for standardized data collection for high-threat respiratory pathogens, such as MERS-CoV.
https://www.nature.com/articles/s41598-019-43586-9
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9. India: The Telegraph on Line: Stillbirths jump during Covid-19 pandemic
The Union health ministry did not respond to repeated requests for comment and provide nationwide data
Mantasha Bano was 28-weeks pregnant when her cries of sudden, unbearable pain prompted neighbours to call an ambulance in Uttar Pradesh. It never came, and Bano’s baby was stillborn. Medical workers in the northern state have reported a marked increase in stillbirths as the coronavirus pandemic strains hard-pressed rural health services, including maternity care, in one of the countries worst-hit by Covid-19. Bano, 22, said she believed her baby could have survived if the ambulance had arrived quickly.Coronavirus infections are rising faster in India than anywhere else in the world as the country repeatedly reports the highest global daily caseloads, including a record jump in new cases on Friday.
The World Health Organisation fears the situation could get worse as the virus spreads into the vast countryside, where 60 per cent of India’s 1.35 billion people live.
As the virus stretches manpower and equipment to the limit, state-run health facilities are reserving beds, tests such as ultrasound scans and treatment for critical cases involving Covid-19 or serious accidents, local health workers said.
Workers from the government’s Accredited Social Health Activists (Asha) — usually the first point of contact in rural India — have also been deployed to fight the pandemic.
https://www.telegraphindia.com/india/stillbirths-jump-in-coronavirus-pandemic/cid/1791992?utm_source=twitter&utm_medium=social&utm_campaign=tt_daily_twit
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10. Singapore: BBC: Video: Singapore rolls out Covid tracing tokens
Singapore is distributing tens of thousands of devices that can track where a person has been and who they have interacted with.
The small bluetooth device is meant for those who do not own smartphones and cannot use a contact tracing app that was previously rolled out by the Singapore government.
While there are some concerns over about data protection, authorities say the token helps vulnerable groups to feel safer when out and about.
For instance, the token helps elderly people keep a a precise record of their whereabouts.
https://www.bbc.co.uk/news/av/world-asia-54206824
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11. Philippines: The Inquirer: Coron’s rural health unit hit by COVID-19 infections
The operation of the rural health unit (RHU) in the town of Coron in Palawan province was suspended until Monday next week after four of its staff contracted the coronavirus disease (COVID-19).
Dr. Alan Guintapan, municipal health officer, said a teleconsultation system, where a resident could just place a call for a consultation, was set in place, while the Coron RHU would stay close for decontamination and swab testing of its personnel.
Guintapan said they would try to continue to serve the residents of the town via the phone consultation scheme and would send the medicine to the patients’ location instead.
Coron, one of the municipalities on the Calamian Islands Group (the other towns are Busuanga, Culion, and Linapacan), is one of the country’s most popular tourist destinations. It shut its doors to tourists after the coronavirus pandemic struck the country in mid-March.
Coron has, however, experienced a surge in COVID-19 cases since mid-August when it reopened its door to returning residents. The town currently has 35 active cases.
The four health care personnel from RHU were also listed as among the local transmission cases reported this week.
https://newsinfo.inquirer.net/1336578/corons-rural-health-unit-hit-by-covid-19-infections?utm_medium=Social&utm_source=Twitter#Echobox=1600321541
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12. USA: Washington Post: Trump contradicts health advisers on coronavirus vaccine timetable as death toll mounts
President Trump’s public rebuke of a top federal health official who did not parrot White House talking points about a fast-track coronavirus vaccine is the latest example of the president’s effort to enforce an upbeat narrative about the pandemic, even if that does not square with the facts.
Robert Redfield, director of the Centers for Disease Control and Prevention, is the most recent government physician or scientist to run afoul of Trump’s coronavirus message machine. He did so in congressional testimony Wednesday, saying a vaccine greenlighted later this year would probably not be available to most Americans until sometime in 2021 because those most in need would get the first doses. Redfield also rankled Trump by saying face masks are “more guaranteed to protect me against covid than when I take a covid vaccine.”
Trump said Redfield “made a mistake” on both counts, although the CDC director’s projection about the timetable for vaccine approval and distribution mirrored those of other top officials, including Operation Warp Speed chief scientist Moncef Slaoui and Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases.
https://www.washingtonpost.com/politics/trump-redfield-vaccine-timetable/2020/09/17/155ce8ce-f90f-11ea-a275-1a2c2d36e1f1_story.html?utm_campaign=wp_to_your_health&utm_medium=email&utm_source=newsletter&wpisrc=nl_tyh&wpmk=1&pwapi_token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJjb29raWVuYW1lIjoid3BfY3J0aWQiLCJpc3MiOiJDYXJ0YSIsImNvb2tpZXZhbHVlIjoiNWU4YWMxZTY5YmJjMGYwYTJlNzk3ODE3IiwidGFnIjoiNWY2NTEzOTU5ZDJmZGEyYzM2OTk2ODEzIiwidXJsIjoiaHR0cHM6Ly93d3cud2FzaGluZ3RvbnBvc3QuY29tL3BvbGl0aWNzL3RydW1wLXJlZGZpZWxkLXZhY2NpbmUtdGltZXRhYmxlLzIwMjAvMDkvMTcvMTU1Y2U4Y2UtZjkwZi0xMWVhLWEyNzUtMWEyYzJkMzZlMWYxX3N0b3J5Lmh0bWw_dXRtX2NhbXBhaWduPXdwX3RvX3lvdXJfaGVhbHRoJnV0bV9tZWRpdW09ZW1haWwmdXRtX3NvdXJjZT1uZXdzbGV0dGVyJndwaXNyYz1ubF90eWgmd3Btaz0xIn0.Zt2da2niw84wUH8H4QVC1Q1U3wHCDtnoeJRFCKUgGtk
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13. USA: Daily Kos: Video: COVID Spread in Rural Areas – We really do have a problem!
When you read the news or listen to commentary on TV, it’s easy to presume that most of the COVID-19 cases are in big cities. In terms of absolute numbers, that’s true. However, if you scale the case count for local population size, a different picture emerges.
This movie shows how confirmed cases of COVID have developed across the country. In this context, it’s important to remember that new confirmed case volumes are driven by two factors:
The local rate of infection
The aggressiveness of local testing
There are anecdotal accounts that various jurisdictions are/were more or less agressive in their testing. Early on, that was dictated by the availability of testing. As tests become more readily available, it depends more on the testing protocol and policy. If a city offers free, drive-up testing to the public (no prescription required), it will likely report more confirmed cases than a locale that uses a more conservative approach.
Nonetheless, the video shows patterns of new cases that are so widespread that I can’t believe the story is simply about testing protocol. IMO, this video shows the broad brush pattern by which COVID-19 spread across America.
https://m.dailykos.com/stories/2020/5/4/1942482/-COVID-Spread-in-Rural-Areas-We-really-do-have-a-problem?detail=emaildkre
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14. CDC: Long-Term Effects of COVID-19
CDC is actively working to learn more about the whole range of short- and long-term health effects associated with COVID-19. As the pandemic unfolds, we are learning that many organs besides the lungs are affected by COVID-19 and there are many ways the infection can affect someone’s health.
One of the health effects that CDC is closely watching and working to understand relates to COVID-19 and the heart. Heart conditions associated with COVID-19 include inflammation and damage to the heart muscle itself, known as myocarditis, or inflammation of the covering of the heart, known as pericarditis. These conditions can occur by themselves or in combination. Heart damage may be an important part of severe disease and death from COVID-19, especially in older people with underlying illness. Heart damage like this might also explain some frequently reported long-term symptoms like shortness of breath, chest pain, and heart palpitations.
The risk of heart damage may not be limited to older and middle-aged adults. For example, young adults with COVID-19, including athletes, can also suffer from myocarditis. Severe heart damage has occurred in young, healthy people, but is rare. There may be more cases of mild effects of COVID-19 on the heart that can be diagnosed with special imaging tests, including in younger people with mild or minimal symptoms; however, the long-term significance of these mild effects on the heart are unknown. CDC will continue to assess and provide updates as new data emerge.
The best strategies for preventing COVID-19 infection in youth and adults are to wear a mask in public places, stay at least 6 feet away from other people, frequently wash your hands, and avoid crowds and confined or poorly ventilated spaces.
https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html
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15. International: Healio: Infectious Disease News: Efforts to prevent COVID-19 led to global decline in flu
Interventions to prevent SARS-CoV-2 transmission have led to a global decline in influenza during the COVID-19 pandemic, researchers reported in MMWR.
In addition to causing a significant drop in the percentage of respiratory specimens that tested positive for influenza in the early days of the pandemic in the United States, measures such as mask wearing, social distancing, school closures and telework have kept positive tests at “historically low interseasonal levels,” the researchers said. The Southern Hemisphere has experienced a similar effect.
If the measures continue through the fall, the influenza season in the U.S. “might be blunted or delayed,” according to the report.
https://www.healio.com/news/infectious-disease/20200917/efforts-to-prevent-covid19-led-to-global-decline-in-flu
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16. Taiwan: CNBC: How Taiwan beat the coronavirus
Taiwan has been praised for its highly effective Covid-19 response.
Taiwan, which has nearly 24 million citizens, has had only 451 cases and seven deaths.
Taiwan had a plan in place for years, which involved quarantines, contact tracing and wide availability of masks, among other things.
CNBC is looking at how places around the world have tackled Covid-19. By talking to a wide range of experts, as well as everyday citizens, we’re taking stock of what’s gone well — and what hasn’t.
Taiwan, the third subject of our series, has confirmed 451 Covid-19 cases and seven deaths in a population of 23.7 million. Everything is mostly reopened, and the only signs of Covid-19 are the frequent temperature checks and the expectation to wear masks on the subway. People are traveling internally for vacations, including visiting restaurants, bars and beaches, and most are back to the office.
By way of comparison, the U.S., with about 330 million people, has seen more than 3.4 million cases and more than 136,000 deaths.
https://www.cnbc.com/2020/07/15/how-taiwan-beat-the-coronavirus.html
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USA: Washington Post: An Idaho ‘no-masker’ pastor prayed against a mask mandate. He’s now in intensive care for covid-19.
When coronavirus cases began increasing in Coeur d’Alene, Idaho, in late July, Pastor Paul Van Noy prayed with his congregation that the city council would not pass a mask mandate.
“I don’t want to be told I have to wear a mask,” he said at the lectern. “We’re adults and we don’t need the government to tell us what to do.”
A little over a month later, he and his wife contracted the virus and he has landed in the hospital’s intensive care unit struggling to breathe, he said in a statement this week.
“I haven’t taken this Covid seriously enough,” his wife, Brenda, said on Facebook Sept. 4, shortly after her husband was admitted to the ICU.
A self-proclaimed “no-masker,” Van Noy told the worshipers gathered at Candlelight Christian Fellowship on July 22 that his first inclination was to resist complying with a local mask ordinance. After some consideration, he said the congregation was bound by the Bible to follow any ordinance requiring masks passed by their local leaders — but he prayed it would not come to that.
https://www.washingtonpost.com/nation/2020/09/18/coronavirus-idaho-pastor-icu/?utm_campaign=wp_to_your_health&utm_medium=email&utm_source=newsletter&wpisrc=nl_tyh&wpmk=1&pwapi_token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJjb29raWVuYW1lIjoid3BfY3J0aWQiLCJpc3MiOiJDYXJ0YSIsImNvb2tpZXZhbHVlIjoiNWU4YWMxZTY5YmJjMGYwYTJlNzk3ODE3IiwidGFnIjoiNWY2NTEzOTU5ZDJmZGEyYzM2OTk2ODEzIiwidXJsIjoiaHR0cHM6Ly93d3cud2FzaGluZ3RvbnBvc3QuY29tL25hdGlvbi8yMDIwLzA5LzE4L2Nvcm9uYXZpcnVzLWlkYWhvLXBhc3Rvci1pY3UvP3V0bV9jYW1wYWlnbj13cF90b195b3VyX2hlYWx0aCZ1dG1fbWVkaXVtPWVtYWlsJnV0bV9zb3VyY2U9bmV3c2xldHRlciZ3cGlzcmM9bmxfdHloJndwbWs9MSJ9.b0TCGf-ioJiiEWs4WTivPca-CX7yhxQD_QYY1aXy9Io
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17. International: Thermofischer: Understanding Zoonotic Transmission of SARS-CoV-2 Using RNA Sequencing
The COVID-19 pandemic has now reached every corner of the world and is due to the zoonotic transmission of the SARS-CoV-2 virus from wild animals to humans. As human population increases, greater contact with wildlife may occur and result in the increasing probability of novel diseases introduced to humans that our immune system cannot defend against. Identifying possible zoonotic source of the disease is important to understand how to fight current outbreaks such as COVID-19, and prevent future outbreaks.
While bats are thought to be the source for the SARS-CoV-2 virus, the actual transmission is unknown and there may even be an intermediate species that was part of the transfer. In a recent study, researchers performed RNA sequencing using the Ion Torrent S5 sequencer to help them identify SARS-CoV-2 related coronaviruses in Malayan pangolins, which are the most illegally trafficked mammal in China. With the streamlined workflow of the Ion Torrent Total RNA-Seq Kit, RNA reads can be quickly aligned to known viral sequences to identify known pathogens or characterize ones not yet discovered. In this case, two sub-lineages were discovered, including one that exhibits strong similarity to the SARS-CoV-2 receptor binding domain, critical for viral infection.
https://www.thermofisher.com/blog/behindthebench/understanding-zoonotic-transmission-of-sars-cov-2-using-rna-sequencing/
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18. USA: The Hill: Gates: US needs ‘to own up to the fact that we didn’t do a good job’ on COVID-19 response
Bill Gates said Sunday that the U.S. needs “to own up to the fact that we didn’t do a good job” in its response to the coronavirus pandemic.
The co-founder of Microsoft and philanthropist told “Fox News Sunday” that the U.S. “did a very poor job” in managing the COVID-19 pandemic, compared to other countries.
“I do think we need to own up to the fact that we didn’t do a good job,” he said. “Part of the reluctance, I think, to fix the testing system now is nobody wants to admit that it’s still outrageous” that the wealthier get more access and the delays in receiving results in 24 hours.
“That should not be the case,” Gates added. “The U.S. has more of these machines, more of this capacity than other countries by a huge amount.”
Gates also specifically cited the implementation of the U.S.’s restrictions on travellers coming from China and Europe, saying they caused a “rush” that the country was not prepared to handle. President Trump instituted restrictions on those coming from China in February and from Europe in March and has touted both moves for saving lives during the pandemic.
Gates said his “main focus now” is to “get the tools right” and “get the testing right.”
“We will have time to look at those mistakes which in February and March were super unfortunate,” he said. “But we can’t pretend like we get a good grade even today.”
Gates’s comments come as more than 6.7 million COVID-19 cases have been confirmed in the U.S., leading to almost 200,000 deaths, according to data from Johns Hopkins University.
https://thehill.com/homenews/sunday-talk-shows/517287-gates-us-needs-to-own-up-to-the-fact-that-we-didnt-do-a-good-job
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19. CDC: Coronavirus Self-Checker
The Coronavirus Self-Checker is an interactive clinical assessment tool that will assist individuals ages 13 and older, and parents and caregivers of children ages 2 to 12 on deciding when to seek testing or medical care if they suspect they or someone they know has contracted COVID-19 or has come into close contact with someone who has COVID-19.
The online, mobile-friendly tool asks a series of questions, and based on the user’s responses, provides recommended actions and resources
https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/coronavirus-self-checker.html
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20. Europe: The Conversation: Apple News: How worried should we be about the coronavirus resurgence in Europe? Three experts weigh in
Coronavirus is back in large numbers across Europe. Since governments began to lift lockdowns at the start of the European summer, positive cases of COVID-19 have been steadily increasing in countries that previously had the spread of the disease under control, including Spain, France, Italy and Germany.
In recent days, France has recorded its highest daily tally of the new cases since the height of the pandemic in April, while Spain faces the continent’s most significant resurgence in infections.
In the UK, certain areas have been placed into local lockdowns to stem the spread of the virus, as schools begin to reopen across its four countries, though the government says rates remain flat outside the locked down hotspots.
https://apple.news/AzB8B6zAEQZSUditmg7gvDA
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21. Spain: Catalonia: Journal of Medical Internet Research: Teleconsultation Between Patients and Health Care Professionals in the Catalan Primary Care Service: Message Annotation Analysis in a Retrospective Cross-Sectional Study
Over the last decade, telemedicine services have been introduced in the public health care systems of several industrialized countries. In Catalonia, the use of eConsulta, an asynchronous teleconsultation service between primary care professionals and citizens in the public health care system, has already reached 1 million cases. Before the COVID-19 pandemic, the use of eConsulta was growing at a monthly rate of 7%, and the growth has been exponential from March 15, 2020 to the present day. Despite its widespread usage, there is little qualitative evidence describing how this tool is used.
This study shows the ability of eConsulta to reduce the number of face-to-face visits for 55% (79% × 65%) to 79% of cases. In comparison to previous research, these results are slightly more pessimistic, although the rates are still high and in line with administrative data proxies, showing that 84% of patients using teleconsultations do not make an in-person appointment in the following 3 months. With respect to the type of consultation performed, our results are similar to the existing literature, thus providing robust support for eConsulta’s usage. The mixed degree of consensus among professionals implies that results derived from artificial intelligence tools such as message classification algorithms should be interpreted in light of these shortcomings.
https://www.jmir.org/2020/9/e19149/
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22. UK: Journal of Medical Internet Research: The use of patient-facing teleconsultations in the National Health Service: A Scoping review
The NHS’s Long Term Plan has set out a vision of enabling patients to access digital interactions with healthcare professionals within five years, including by video link.
Technological improvements mean that teleconsultations are now more accessible than ever. Teleconsultations appear to be safe and effective in the right clinical situations. Where offered, it is likely that patients will be supportive of such measures though they should only be offered as an option to support traditional care models rather than replace them outright. Well resourced, goal directed implementation of teleconsultations can be cost effective for healthcare providers.
https://jmir.org/preprint/15380?utm_source=TrendMD&utm_medium=cpc&utm_campaign=JMIR_TrendMD_0
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23. Sweden: Financial Times: Anders Tegnell and the Swedish Covid experiment
The controversial epidemiologist believes lockdown is ‘using a hammer to kill a fly’. Could he be proved right?
At the start of this year, Anders Tegnell was just a low-profile bureaucrat in a country of 10m people, heading a department that collects and analyses data on public health. Today, he has become one of the best known — and most controversial — figures of the global coronavirus crisis. The 64-year-old Swedish doctor was meant to spend 2020 helping Somalia set up a public health agency as well as sending questionnaires out to Swedes to gauge different aspects of their wellbeing. Instead, his approach to Covid-19 — to keep schools, restaurants, fitness centres and borders open while refusing to follow China in imposing a formal lockdown — has seen him become an unlikely polarising figure for a polarised age. For many Swedes, their state epidemiologist has embodied a rational approach as other countries have appeared to sacrifice science to emotion. “I wish I were coming with you to see him,” one of Sweden’s leading chief executives confided to me just before I went to see Tegnell. “The way he has stood for what he believes in while the rest of the world does something else is admirable.”
Public support for Tegnell has remained high over a period in which life, while very different to before, has been more normal than in many other countries. Such is his stock in Sweden that there are stories of people having his bespectacled face tattooed on their bodies, while some on the American and British right have seized on Tegnell as a champion of freedoms they feel they have lost during lockdown.
https://www.ft.com/content/5cc92d45-fbdb-43b7-9c66-26501693a371?utm_source=Nature+Briefing&utm_campaign=4d087a87b0-briefing-dy-20200916&utm_medium=email&utm_term=0_c9dfd39373-4d087a87b0-45238390
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24. World Food Programme: Video: WFP in Zimbabwe
What comes to mind when you think about Zimbabwe watch the video to check your knowledge and find out more about our fight against hunger.
https://www.facebook.com/watch/?extid=9wDoC60SGGVASMv9&v=809114346514754
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25. USA: CNBC: Coronavirus recession ends for the rich but is far from over for lower-income communities
The recession caused by the coronavirus pandemic is largely over for some groups, like rich, White and college-educated Americans.
They were less likely to become unemployed and their jobs rebounded quickly. They were more likely to save stimulus money. Financial assets like stocks and real estate have boomed.
Some economists have called this a “K-shaped” recovery as other groups have a much different experience.
The economic crisis unleashed by the coronavirus pandemic may be over for some groups of Americans — primarily the wealthy and White — even as it lingers in other corners of the country.
No group was spared from the recession’s initial shock, which pushed unemployment to heights unseen since the Great Depression.
But the wealthy, White and higher-educated were the least likely to lose their jobs. And those among them who did have largely recovered.
https://www.cnbc.com/2020/09/20/coronavirus-recession-ends-for-rich-crisis-persists-for-others.html
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26. Sudan: Care: Torrential Rainfall and Floods in Sudan Leave 650,000 People in Despair
People displaced by the heaviest flooding in over a century are now at greater risk of contracting COVID-19
Water. Muddy, mosquito-infested water, as far as the eye can see. A few chairs, some bags, a makeshift shelter of a few sticks and palm leaves. This is the living situation for countless families in the East African nation of Sudan. A disaster that doesn’t make headlines in a busy global news cycle.
The past weeks have seen unusually heavy rain fall and flooding in large parts of the country. The rainy season in the East African country usually starts in June and lasts until October. But this year, a record rainfall has been noted since mid-July and water levels of the Blue Nile are still expected to rise in the coming days. As of mid-September, over 111,000 houses have been severely damaged or destroyed, 17 out of 18 states are affected.
“People are literally left with nothing,” reports Tesfaye Hussein, CARE’s Coordinator for Public Health, Water and Sanitation. “They camp out in the open. We’re very concerned for women and young girls in these areas, there simply isn’t enough protection for them. They tend to bear the brunt of such disasters, fetching water from far away places, leaving out meals to feed their children or younger siblings.”
https://www.care.org/news-and-stories/news/torrential-rainfall-and-floods-in-sudan-leave-650000-people-in-despair/
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27. Europe: EURACTIV: Europe’s health after COVID-19
Many EU countries are now experiencing the second wave of the COVID-10 pandemic and it seems that the lack of Europe-wide coordination that marked the first wave is still there.
Different COVID-10 tests and the re-introduction of travel restrictions are among the main problems EU citizens have to face in their daily lives.
For many stakeholders, this public health crisis has helped Europe learn some lessons and the challenge now is to decide what is next, how EU health policies can be better managed and coordinated.
The EU pharma industry has recently said that once Europe emerges from this crisis, we should not only rebuild our economies and get our societies back on their feet but also “take the opportunity to implement an ambitious reform agenda for European health systems”.
Funding healthcare, saving costs, digitising the sector and putting patients at the centre of the discussion will be among the main priorities EU policymakers will have to push forward in the years to come.
https://www.euractiv.com/section/coronavirus/special_report/europes-health-after-covid-19/
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28. Africa: WHO: Noncommunicable diseases increase risk of dying from COVID-19 in Africa
There is increasing evidence that Africans living with noncommunicable diseases (NCDs) such as hypertension and diabetes are more likely to suffer severe cases of COVID-19 and die.In South Africa, which accounts for nearly half of all cases and deaths on the continent, 61% of the COVID-19 patients in hospitals had hypertension and 52% had diabetes. And 45% of people aged 60–69 who died from COVID-19 also had hypertension. In Kenya, around half of COVID-19 deaths occurred in people with NCDs, while in the Democratic Republic of the Congo, such patients accounted for 85% of all COVID-19 deaths.
According to a World Health Organization (WHO) preliminary analysis of 14 countries in the African region, hypertension, diabetes, cardiovascular disease and asthma are the co-morbidities most associated with COVID-19 patients. These chronic conditions require continuous treatment, but as governments address the ongoing pandemic, health services for NCDs have been severely disrupted.
“Millions of Africans living with noncommunicable diseases are at greater risk of complications or dying from COVID-19,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “So it is very concerning to find that just when people with hypertension and other chronic conditions most need support, many are being left out in the cold.”
http://whotogo-whoafroccmaster.newsweaver.com/JournalEnglishNewsletter/1a79qewbt6e
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29. International: Think Global Health: Health-Systems Strengthening in the Age of COVID-19
As the pandemic stresses many health-systems to their breaking point, it’s more important than ever to bolster them now The COVID-19 pandemic has forced focus on health-systems and their capacity to handle strain. News headlines have been dominated by shortages of personal protective equipment, inadequate testing supplies, municipal hospital beds reaching capacity, and emergency construction of makeshift structures to contain patient overflow. The capacity and robustness of health-systems around the world have been laid bare during this global pandemic—just when they have never been more critical.
Over time only a smaller share of development assistance for health has gone towards health-systems strengthening activities. These contributions have gone to support activities such as health worker training and updating cold chain equipment systems, which are essential inputs for health-systems to run smoothly. Funding for health-systems strengthening has also been aimed at instituting policies that streamline or enhance the process of procuring medicine and medical supplies. According to the Institute for Health Metrics and Evaluation (IHME) latest financing global health report, Tracking Health Spending in a Time of Crisis,which two of us co-authored, even though total funding for health-systems strengthening has increased over time, it has shrunk as a percentage of total development assistance for health, down from 21 percent ($1.6 billion) in 1990 to 14 percent ($5.6 billion) in 2019.
https://www.thinkglobalhealth.org/article/health-systems-strengthening-age-covid-19
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30. USA: CNN: Adults with Covid-19 about ‘twice as likely’ to say they have dined at a restaurant, CDC study suggests
Adults who tested positive for Covid-19 were approximately twice as likely to have reported dining at a restaurant in the 14 days before becoming ill than those who tested negative, according to a new study from the US Centers for Disease Control and Prevention.
“In addition to dining at a restaurant, case-patients were more likely to report going to a bar/coffee shop, but only when the analysis was restricted to participants without close contact with persons with known COVID-19 before illness onset,” the researchers wrote.
The study, published on Thursday, included data on 314 adults who were tested for Covid-19 in July because they were experiencing symptoms; 154 tested positive and 160 tested negative. The tests were administered at 11 different health care facilities across 10 US states: California, Colorado, Maryland, Massachusetts, Minnesota, North Carolina, Ohio, Tennessee, Utah and Washington.
https://edition.cnn.com/2020/09/10/health/restaurant-dining-covid-19-cdc-study-wellness/index.html

31. Nature: The lasting misery of coronavirus long-haulers
Months after infection with SARS-CoV-2, some people are still battling crushing fatigue, lung damage and other symptoms of ‘long COVID’.
The lung scans were the first sign of trouble. In the early weeks of the coronavirus pandemic, clinical radiologist Ali Gholamrezanezhad began to notice that some people who had cleared their COVID-19 infection still had distinct signs of damage. “Unfortunately, sometimes the scar never goes away,” he says.
Gholamrezanezhad, at the University of Southern California in Los Angeles, and his team started tracking patients in January using computed tomography (CT) scanning to study their lungs. They followed up on 33 of them more than a month later, and their as-yet-unpublished data suggest that more than one-third had tissue death that has led to visible scars. The team plans to follow the group for several years.
These patients are likely to represent the worst-case scenario. Because most infected people do not end up in hospital, Gholamrezanezhad says the overall rate of such intermediate-term lung damage is likely to be much lower — his best guess is that it is less than 10%. Nevertheless, given that 28.2 million people are known to have been infected so far, and that the lungs are just one of the places that clinicians have detected damage, even that low percentage implies that hundreds of thousands of people are experiencing lasting health consequences.
https://www.nature.com/articles/d41586-020-02598-6?utm_source=Nature+Briefing&utm_campaign=5c5685b5a3-briefing-dy-20200911_COPY_01&utm_medium=email&utm_term=0_c9dfd39373-5c5685b5a3-45358758&fbclid=IwAR0FI26Gb5SyZubO4WZl7eRm1cdEaK6L0CjV7TiINRfYBIE9njgRN-KSU8Q
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32. China: Science Daily: Study reveals COVID-19 transmission rate on trains
A study by scientists from the University of Southampton has examined the chances of catching COVID-19 in a train carriage carrying an infectious person.
Based on high-speed routes in China, researchers from WorldPop found that for train passengers sitting within three rows (widthwise) and five columns (lengthwise) of an infected person (index patient) between zero and ten percent (10.3) caught the disease. The average rate of transmission for these ‘close contact’ travellers was 0.32 percent.
The study, in collaboration with the Chinese Academy of Sciences, China Academy of Electronics and Information Technology, and Chinese Centre for Disease Control and Prevention, also showed that passengers travelling in seats directly adjacent to an index patient suffered the highest level of transmission, with an average of 3.5 percent contracting the disease. For those sitting on the same row, the figure was 1.5 percent.
The ‘attack rate’ for each seat — the number of passengers in a given seat diagnosed with COVID-19, divided by the total number of passengers travelling in the same seat — increased by 0.15 percent for every hour that a person travelled with an index patient. For those in adjacent seats, this rate of increase was higher at 1.3 percent per hour.
Interestingly, the researchers found that only 0.075 percent of people who used a seat previously occupied by an index patient went on to contract the disease.
https://www.sciencedaily.com/releases/2020/07/200731102634.htm
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33. USA: CDC: SARS-CoV-2–Associated Deaths Among Persons Aged <21 Years — United States, February 12–July 31, 2020 What is already known about this topic? Symptoms associated with SARS-CoV-2 infection are milder in children compared with adults. What is added by this report? Among 121 SARS-CoV-2–associated deaths among persons aged <21 years reported to CDC by July 31, 2020, 12 (10%) were infants and 85 (70%) were aged 10–20 years. Hispanic, non-Hispanic Black and non-Hispanic American Indian/Alaskan Native persons accounted for 94 (78%) of these deaths; 33% of deaths occurred outside of a hospital. What are the implications for public health practice? Persons aged <21 years exposed to SARS-CoV-2 should be monitored for complications. Ongoing surveillance for SARS-CoV-2–associated infection, hospitalization, and death among persons aged <21 years should be continued as schools reopen in the United States. https://www.cdc.gov/mmwr/volumes/69/wr/mm6937e4.htm S P 34. USA: CNN: CDC: Updated CDC guidance acknowledges coronavirus can spread through the air The US Centers for Disease Control and Prevention updated guidance on its website to say coronavirus can commonly spread "through respiratory droplets or small particles, such as those in aerosols," which are produced even when a person breathes. "Airborne viruses, including COVID-19, are among the most contagious and easily spread," the site now says. Previously, the CDC page said that Covid-19 was thought to spread mainly between people in close contact -- about 6 feet -- and "through respiratory droplets produced when an infected person coughs, sneezes or talks." The page, updated Friday, still says Covid-19 most commonly spreads between people who are in close contact with one another, and now says the virus is known to spread "through respiratory droplets or small particles, such as those in aerosols, produced when an infected person coughs, sneezes, sings, talks or breathes." https://edition.cnn.com/2020/09/20/health/cdc-coronavirus-airborne-transmission/index.html S ED 35. USA: AAAS: Why pregnant women face special risks from COVID-19 Yalda Afshar hears the worries every day from her patients: Will COVID-19 hit me harder because I’m pregnant? If I’m infected, will the virus damage my baby? Afshar, a high-risk obstetrician at Ronald Reagan University of California (UC), Los Angeles, Medical Center, understands the women’s concerns better than most: Her first child is due in October. Data on pregnancy and COVID-19 are woefully incomplete. But they offer some reassurance: Fetal infections later in pregnancy appear to be rare, and experts are cautiously optimistic that the coronavirus won’t warp early fetal development. But emerging data suggest some substance to the other worry of Afshar’s patients: Pregnancy does appear to make women’s bodies more vulnerable to severe COVID-19, the disease caused by SARS-CoV-2. That’s partly because of pregnant women’s uniquely adjusted immune systems, and partly because the coronavirus’ points of attack—the lungs and the cardiovascular system—are already stressed in pregnancy. The prescription for caregivers is simple, says David Baud, an expert on emerging infectious diseases and pregnancy at Lausanne University Hospital: “Protect your pregnant patients. The first ones who need the masks are pregnant women. The first to avoid social contact should be pregnant women.” https://www.sciencemag.org/news/2020/08/why-pregnant-women-face-special-risks-covid-19?utm_source=Nature+Briefing&utm_campaign=0c2a3fff6f-briefing-dy-20200807&utm_medium=email&utm_term=0_c9dfd39373-0c2a3fff6f-45238390 S ED 36. USA: Elemental: Why More Covid-19 Patients Are Surviving the ICU Intensive care has risen to the challenge of 2020. Here’s what has changed. This story is part of “Six Months In,” a special weeklong Elemental series reflecting on where we’ve been, what we’ve learned, and what the future holds for the Covid-19 pandemic. Matt Morgan, MD, an intensive care doctor at the University Hospital of Wales, in the United Kingdom, vividly remembers his first Covid-19 patient. It was a busy day at his hospital, and the patient was so ill upon arrival at the intensive care unit (ICU) that they needed life support almost immediately. Back then, in late March, Morgan knew that Covid-19 had already caused havoc in Italy and begun spreading in the U.K. Morgan, who is also Wales’ lead for critical care research, had expected the disease would reach his hospital, but it was only when he and his team began treating patients infected with SARS-CoV-2 that they realized how serious Covid-19 can be. “It’s fair to say in those early days we thought Covid was a lung disease,” he says. The virus is now known to cause problems in other organs, including the heart, kidneys, and brain. In some cases, patients who survive are left with long-lasting symptoms. https://elemental.medium.com/amp/p/34e05fe9eba7?utm_source=Nature+Briefing&utm_campaign=38a29cc4a2-briefing-dy-20200917&utm_medium=email&utm_term=0_c9dfd39373-38a29cc4a2-45238390 S ED 37. USA: Buisness Insider: Forget vitamins: Fauci says the 3 best things 'to keep your immune system working optimally' cost nothing Dr. Anthony Fauci supplements his diet with two vitamins: C and D. For the general public, he recommends getting enough sleep, maintaining a healthy diet, and avoiding or alleviating stress as the three most potent ways to keep your immune system strong. "That is much more healthy living than giving yourself supplements of anything," he said. https://www.businessinsider.com/fauci-3-tips-keep-your-immune-system-strong-vitamins-sleep-2020-9?r=US&IR=T S ED 38. Nature: COVID-19 must catalyse changes to clinical development The response to the COVID-19 pandemic has shown that exceptional efforts can dramatically accelerate the clinical development of vaccines. We propose that it is time to also take immediate actions to improve clinical trials in other areas to better serve all patients. In the few months since the emergence of COVID-19, multiple organizations have engaged with the urgent challenge to rapidly develop a safe and effective vaccine. As one of those organizations, working with our partner BioNTech, we are doing things very differently. And if we succeed, we will develop a COVID-19 vaccine in less than a year, compared with the typical timeframe of 10 or more years for vaccine development1. So what, one might say. Extraordinary times deserve extraordinary actions. But how can we take such exceptional action for COVID-19, but not cancer, life-limiting autoimmune conditions or a myriad of other major medical needs? Are these patients somehow less deserving? Of course not. So what will it take to emerge from the COVID-19 pandemic with a clinical trials ecosystem that better serves patients? Here, we propose actions in two crucial areas: equity in access to clinical trials and awareness of the options available for patients; and speed, efficiency and innovation in clinical development. https://www.nature.com/articles/d41573-020-00149-2?utm_source=Nature+Briefing&utm_campaign=247a1596f8-briefing-dy-20200911_COPY_01&utm_medium=email&utm_term=0_c9dfd39373-247a1596f8-45238390 S ED 39. USA: Washington Post: It’s time to focus on potential long-term organ damage from covid-19 New cases of covid-19 are declining across the country, so it's tempting to wonder whether the worst of the pandemic is behind us. Not by a long shot. Even as cases decline, it is possible we could soon be grappling with the burden of prolonged or permanent organ damage among the millions of people who have survived covid-19. There’s still a lot we don’t know about the long-term effects of this disease, but they could cripple not just these “survivors" but also our health-care system and our economy, too. The latest research suggests that this novel coronavirus does widespread damage to blood vessels far beyond the lungs and is thus far more dangerous than previously thought. One of us, William Li, recently co-authored a study in the New England Journal of Medicine comparing the lungs of covid-19 patients to those of patients killed by influenza, and to healthy lungs. The coronavirus was found to infect and inflict serious damage to the vascular endothelium the single layer of cells that line the blood vessels of organs such as our brain, kidneys, heart and lungs. Coronavirus patients also have a much higher likelihood of experiencing clots in these blood vessels. https://www.washingtonpost.com/opinions/2020/09/14/its-time-focus-potential-long-term-organ-damage-covid-19/?utm_campaign=wp_to_your_health&utm_medium=email&utm_source=newsletter&wpisrc=nl_tyh&wpmk=1&pwapi_token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJjb29raWVuYW1lIjoid3BfY3J0aWQiLCJpc3MiOiJDYXJ0YSIsImNvb2tpZXZhbHVlIjoiNWU4YWMxZTY5YmJjMGYwYTJlNzk3ODE3IiwidGFnIjoiNWY1ZmQ4YzY5ZDJmZGEyYzM2OTU0ZDhlIiwidXJsIjoiaHR0cHM6Ly93d3cud2FzaGluZ3RvbnBvc3QuY29tL29waW5pb25zLzIwMjAvMDkvMTQvaXRzLXRpbWUtZm9jdXMtcG90ZW50aWFsLWxvbmctdGVybS1vcmdhbi1kYW1hZ2UtY292aWQtMTkvP3V0bV9jYW1wYWlnbj13cF90b195b3VyX2hlYWx0aCZ1dG1fbWVkaXVtPWVtYWlsJnV0bV9zb3VyY2U9bmV3c2xldHRlciZ3cGlzcmM9bmxfdHloJndwbWs9MSJ9.6HlueIdL-RTFtNjn2PIkFBvVrpq9-eaUQdHvfmw_3Bs S ED 40. Japan: The Washington Post: In Japan, coronavirus discrimination proves almost as hard to eradicate as the disease When a cluster of coronavirus infections broke out in Kyoto's Horikawa Hospital, medical staffers were not only battling a potentially deadly disease at work. They came home to fight an even more unsettling disease — fear and discrimination. Their children were turned away from nursery schools and after-school clubs, their spouses were told not to come to work, three were fired from their second jobs and one was told point-blank to stay away from a favorite diner. “Our staff were really shocked, severely shocked,” said Masaaki Yamada, the hospital’s administration chief, explaining that the affected workers had not necessarily been in close contact with infected patients. “Some even said they were afraid to go home, and afraid of being seen by their neighbors,” he said. “They got family members to put the garbage out for them. Some said they would go to work when it was dark and come home when it was dark again.” https://www.washingtonpost.com/world/asia_pacific/japan-coronavirus-discrimination/2020/09/13/e82e5aa4-eea0-11ea-bd08-1b10132b458f_story.html?utm_campaign=wp_to_your_health&utm_medium=email&utm_source=newsletter&wpisrc=nl_tyh&wpmk=1&pwapi_token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJjb29raWVuYW1lIjoid3BfY3J0aWQiLCJpc3MiOiJDYXJ0YSIsImNvb2tpZXZhbHVlIjoiNWU4YWMxZTY5YmJjMGYwYTJlNzk3ODE3IiwidGFnIjoiNWY1ZmQ4YzY5ZDJmZGEyYzM2OTU0ZDhlIiwidXJsIjoiaHR0cHM6Ly93d3cud2FzaGluZ3RvbnBvc3QuY29tL3dvcmxkL2FzaWFfcGFjaWZpYy9qYXBhbi1jb3JvbmF2aXJ1cy1kaXNjcmltaW5hdGlvbi8yMDIwLzA5LzEzL2U4MmU1YWE0LWVlYTAtMTFlYS1iZDA4LTFiMTAxMzJiNDU4Zl9zdG9yeS5odG1sP3V0bV9jYW1wYWlnbj13cF90b195b3VyX2hlYWx0aCZ1dG1fbWVkaXVtPWVtYWlsJnV0bV9zb3VyY2U9bmV3c2xldHRlciZ3cGlzcmM9bmxfdHloJndwbWs9MSJ9.e66gaOS7sR7CyCGmd1J9wILZcW2Ciss3Y9FaoZuxHgs N Best wishes to you all Stay Safe John Wynn-Jones

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