ABUJA, Nigeria (AP) — Africa is seeing a increase in deliveries of vaccine doses to the continent, but only a single in four of its overall health personnel has been entirely vaccinated against COVID-19, the Planet Wellbeing Group regional business office mentioned on Thursday.
The most popular causes for the low vaccination charge amongst wellbeing employees on the continent of about 1.3 billion individuals involve vaccine hesitancy and the unavailability of vaccine companies, primarily in rural areas, Matshidiso Moeti, WHO’s Africa director, explained to an on the internet press briefing.
It truly is a hanging contrast to the more made international locations wherever additional than 80{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of wellness and care personnel in 22 mainly high-earnings nations have been thoroughly vaccinated, in accordance to a the latest WHO study.
The lower vaccination rate amongst well being workers in Africa “puts at threat not only their personal wellness and very well-staying but also that of the patients that they search following,” Moeti warned, contacting on African nations to “urgently speed up the rollout of vaccines to people on the frontlines.”
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Africa has an acute shortage of wellness staff, with only one particular state in the area acquiring the proposed amount of health workers to give necessary health companies.
“Any reduction of these important employees to COVID-19 owing to ailment or loss of life thus greatly impacts on support provision ability,” WHO’s Nigeria business office reported in a assertion.
Lots of of Africa’s health workers, including these operating in rural communities, however have “concerns around vaccine security and adverse facet outcomes,” the WHO regional director Moeti explained.
In Nigeria, Africa’s most populous region, only 300,000 — or 18{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} — of its 1.6 million health workers have been completely vaccinated.
A the latest review also observed that only 40{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of well being staff supposed to get the vaccine although significantly less than 50{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} hope to get their shot in Ethiopia, WHO said.
To boost the vaccination charge among well being personnel in Nigeria, nurses and midwives need to have to be more concerned in the vaccination method, in accordance to the president of the Countrywide Association of Nigeria Nurses and Midwives. With that and by means of health schooling, “many men and women will be convinced” to get the vaccine, Michael Nnachi claimed. “When the nurses are right concerned, we can achieve far more.”
Just about 7{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of Africa’s population has been entirely vaccinated, predominantly simply because of delays in vaccine supplies and vaccine hesitancy, Moeti explained. But right after difficult months in acquiring desired supplies, Africa is now looking at “an acceleration in the availability of vaccines.”
As more doses are arriving on the continent, more countries are introducing mandates — typically focusing on govt employees and public locations — to improve the vaccination fee.
“It will be superior to stability the ways of persuasion, information and facts sharing, growth of ability to deliver, intensification of the campaigns as well as using that supplemental tool of further more motivating people today to be vaccinated because they want to get companies that they have to have,” Moeti mentioned.
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The World Health Organization is monitoring a new variant with numerous mutations to the spike protein, scheduling a special meeting Friday to discuss what it may mean for vaccines and treatments, officials said Thursday.
The variant, called B.1.1.529, has been detected in South Africa in small numbers, according to the WHO.
“We don’t know very much about this yet. What we do know is that this variant has a large number of mutations. And the concern is that when you have so many mutations, it can have an impact on how the virus behaves,” Dr. Maria Van Kerkhove, WHO’s technical lead on Covid-19, said in a Q&A that was livestreamed on the organization’s social media channels.
The monitoring of the new variant comes as Covid cases surge around the world heading into the holiday season, with the WHO reporting hot spots in all regions and particularly in Europe.
The U.K. announced it would ban flights from six African countries, including South Africa, starting midday Friday.
The UK Health Security Agency “is investigating a new variant,” Health Secretary Sajid Javid said Thursday in a tweet announcing the travel restrictions. “More data is needed but we’re taking precautions now.”
South African scientists have detected more than 30 mutations to the spike protein, the part of the virus that binds to cells in the body, South African scientist Tulio de Oliveira said in a media briefing hosted by the South Africa Department of Health on Thursday.
The B.1.1.529 variant contains multiple mutations associated with increased antibody resistance, which may reduce the effectiveness of vaccines, along with mutations that generally make it more contagious, according to slides he presented at the briefing. Other mutations in the new variant haven’t been seen until now, so scientists don’t yet know whether they are significant or will change how the virus behaves, according to the presentation.
The variant has spread rapidly through the Gauteng province, which contains the country’s largest city of Johannesburg.
“Especially when the spike happens in Gauteng, everybody travels in and out of Gauteng from all corners of South Africa. So it’s a given that in the next few days, the beginning of rising positivity rate and numbers is going to be happening. It’s a matter of days and weeks before we see that,” South Africa Minister of Health Joe Phaahla said during the briefing.
The variant has also been detected in Botswana and Hong Kong, Phaahla said.
“Right now, researchers are getting together to understand where these mutations are in the spike protein and the furin cleavage site, and what that potentially may mean for our diagnostics or therapeutics and our vaccines,” Van Kerkhove said. She said there are fewer than 100 full genome sequences of the new mutation.
The virus evolution working group will decide if B.1.1.529 will become a variant of interest or a variant of concern, after which the WHO would assign the variant a Greek name, Van Kerkhove said.
“It’s really important that there are no knee-jerk responses here, especially with relation to South Africa,” Dr. Mike Ryan, executive director of the WHO’s emergencies program, said.
This year’s Thanksgiving holiday features one enormous difference from last year’s:
Vaccinations.
Fortunately, the Covid-19 vaccine became available earlier this year, and by now, about half of Georgians have received the shots.
Vaccinations have significantly lightened the mood around the country in regard to the virus, though Covid cases have begun to rise again.
Two-thirds of Americans plan to see family or friends from outside of their household for Thanksgiving, regardless of vaccination status, according to this week’s Axios-Ipsos Coronavirus Index.
Credit: Kaiser Health News
Less than a third (31{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) consider seeing friends or family for Thanksgiving as a large/moderate risk, compared to 64{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} this time last year, the poll found.
The nation’s top infectious disease expert has weighed in the new, less dangerous climate.
If you and your family members are fully vaccinated against Covid-19, it’s OK for you to ditch the masks this holiday season when you’re around each other, Dr. Anthony Fauci told CNN Sunday.
Fauci
But Fauci also said that if you are traveling or are unaware of the vaccination status of the people around you, then you should wear a mask in those situations.
Still, there are many families navigating tough personal decisions around the topic of vaccines.
A recent survey by the Harris Poll found that 42{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of vaccinated respondents had canceled at least one event or travel plan they had with people because they weren’t inoculated, the Los Angeles Times reported. The Times article also said that in a recent discussion on Twitter about banning unvaccinated relatives from holiday gatherings, several people declared themselves staunchly “no vax, no snax.”
For those planning a Thanksgiving gathering, experts advise that when it comes to people with young children not yet eligible for the vaccine, you can reduce the risk by making sure those around the kids are vaccinated.
Also, if you’ve in public indoor places and not vaccinated fully, wear a well-fitting mask over your nose and mouth, according to the CDC and the Georgia Department of Public Health. People who are fully vaccinated should wear a mask in public indoor settings in communities with substantial to high Covid transmission.
Other tips include:
** Wash your hands frequently with soap and warm water. Use hand sanitizer if soap and water aren’t available.
** If you are sick or have symptoms of Covid-19 or the flu, don’t host or attend a holiday gathering.
** Get tested if you have symptoms of Covid-19 or have had close contact with someone who has the virus.
** If you are not fully vaccinated for Covid and must travel, follow the CDC’s recommendations.
How about the bird?
For those of you, like me, who plan to fry a turkey for Thanksgiving, here are some safety tips from experts (I don’t count myself one, though it’s a family tradition).
On the safety checklist is setting up the fryer far enough away from the house. Another big safety reminder is making sure that the turkey isn’t frozen when it descends into bubbling peanut oil.
But there are plenty of other potential pitfalls. Thanksgiving is the peak day for home cooking fires, followed by Christmas Day and Christmas Eve.
The University of Georgia College of Agricultural and Environmental Sciences points out that some of the most serious injuries are caused by faulty or misused equipment, like unstable fryer stands, uninsulated pot handles and/or fry pots that have been overfilled with oil.
Filling the pot too full of oil can cause the oil to spill over when the turkey is placed in the pot. In addition to creating an oily mess, spillovers at cooking temperatures can cause severe burns.
Whole turkeys require about 3 minutes per pound to cook. To be sure your bird is safely cooked, the temperature must reach at least 165 degrees in the thickest part of the breast. Some cooks prefer the innermost part of the thigh to reach 180 degrees.
You may be nervous about lowering a 12-pound turkey into 8 gallons of bubbling oil in a pot suspended over an open propane flame. That’s understandable. Fortunately, there are now electric fryers available that take some of this guesswork out of the process.
Maddie Ellis was crying in her bedroom. Last fall, she was juggling her responsibilities as a fulltime UNC student and as the university editor for the Daily Tar Heel. It was too much.
“I just was really stressed all the time and super burnt out,” Ellis said. “I really struggled to find joy in each day. I was really just not doing well.”
Many days, she was terrified of the idea of making a mistake and she felt as if she were a failure. The stress was dragging down her personality and her health. She was finding it harder to control her negative emotions. She grew lethargic, which is not her style.
A friend Facetimed her when she was crying. At one point, the friend said, “I’ve never been more worried about someone than I am about you.”
Ellis’ mother said something similar, leading Ellis to seek professional help.
“Maybe if my mom is saying it, maybe it’s time,” she said.
Ellis raised the volume on the television and climbed into her empty bathtub, a place most isolated from her two roommates. She dialed the UNC-Chapel Hill’s Counseling and Psychological Services’ 24/7 hotline and made an appointment for a Zoom therapy session.
“I’m seeking professional help for something that I’ve always covered up and buried, and never really sought help for,” Ellis said.
Seeking help behind a screen
Since the start of the pandemic, more and more students have used virtual therapy as a way to seek mental health and wellness care.
The university’s CAPS program — a popular resource for UNC students — shifted to exclusively provide virtual counseling services after concerns of COVID-19 transmission last year.
Transitioning services from in-person to Zoom served as a way to continue offering services to UNC students at a time when many were exhausted and burned out from the stress of a remote semester. Around the same time, classes shifted to remote and most would stay like that for another year or so.
“Our number one priority at CAPS is the mental health and overall wellbeing of our students,” CAPS Associate and Clinical Director Avery Cook said. “We serve as a possible first step in helping students identify the level of care they need. We then guide them through the process of getting that care, whether it’s within CAPS or through an outside provider.”
The virtual services aren’t the same as in-person counseling. Ellis didn’t feel comfortable during her sessions of virtual therapy because the in-person human connection was missing.
“I feel like you miss some of the body language cues and you miss so much of that human interaction,” she said.
From the start of the pandemic up until early November, CAPS has served 6,571 students, and has provided more than 10,000 virtual appointments. The clinic also provided virtual group sessions and continued to refer students to local organizations if needed.
Those virtual services became more necessary during the pandemic.
Symptoms of moderate to severe depression among first-year students increased from 21.5 percent prior to COVID-19 to 31.7 percent four months into the pandemic, according to research from the Carolina Population Center and the UNC School of Medicine. Within the same time, the prevalence of moderate to severe anxiety went from 18.1{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} to 25.3{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} within the same timespan.
Black students, in addition to those from gender and sexual minorities, were hit hardest by the pandemic, the research showed.
Matthew Mills, a licensed clinical social worker and professor at UNC-Charlotte, isn’t a fan of virtual therapy services.
“If I had to choose between the two, I would definitely choose an in-person setting,” Mills said. “I think the vibe from most clinicians is trying to figure out how we do our work in a virtual setting effectively when some of us don’t operate in our best fields — how do we adapt.”
But he understands some of the benefits of virtual therapy, including being more accessible to those who can’t find transportation to see a counselor in-person or have a busy schedule. In addition, many of his colleagues are immuno-comproised, and so virtual therapy is the safest route to doing their jobs.
“It’s here to stay — I don’t see it going anywhere,” Mills said. “I think it definitely opens a new door.”
Nadia Charguia, medical director of UNC Psychiatry Outpatient Services, said the department is slowly transitioning to in-person services, but the vast majority of patients are being treated through tele-health services.
“It’s hard to take time off work, It’s hard to find time between classes,” she said. “We are definitely seeing a lot of folks gravitate towards virtual services because of how accessible they are.”
Talking behind a computer screen
Rachel Gora, currently a sophomore at UNC, has faced mental health struggles since the eighth grade.
By her senior year of high school in April 2020, she was increasingly depressed. Gore realized she wasn’t in touch with many of her friends and was missing out on a high school experience. She sought out virtual therapy, but there were constant technical issues during the appointments. Her counselor would often call her when Zoom wasn’t working at all or somebody’s WIFI was acting up as well. Sometimes, her audio would cut out at random moments.
That, coupled with her ADHD diagnoses, made it harder to consistently attend sessions. She often missed several sessions in a row, and she hasn’t been to a session in months. It was hard to repeatedly spend time on a task that didn’t seem as though it was worth her time.
“I think it was harder to connect online virtually rather than in-person because there’s just an aspect of connection that is missing,” Gore said. “It’s hard to put your finger down on why virtual is different but I definitely think it is.”
Taking steps to get help
Ellis’ struggles with mental health arose once she started at the DTH’s university desk. She immediately transitioned from a summer internship to the position.
Once the semester officially started, she spent most of her time at the DTH. It was rare to find a moment to herself. It also became harder to deal with her own emotions. At her first session with a CAPS specialist last November, Ellis found it difficult to put her thoughts into words, so she didn’t. She just sobbed.
Her therapist said she has a tendency to catastrophize and assume the worst will happen.
“These are some things that I did take away from it and like to think about in my life now,” Ellis said.
Between her second and third session, she did something that had rarely happened that semester – take a break. During Thanksgiving weekend, she visited the Outer Banks with friends for several days. She was finally able to read and hang out with friends.
When she returned to see her CAPS counselor for the third session, she had nothing but good things to tell her.
“It sounds like you don’t really need to talk today,” the therapist told her.
The answer immediately made her feel bad. Like her feelings weren’t valid. As though she was merely being dramatic about her issues over the course of the other two sessions.
So, she didn’t return.
Ellis emphasized the importance of being able to advocate for yourself during therapy. She accepted the therapist’s response without mentioning that she wanted to continue seeing a counselor to reflect on why the fall semester had been so tough.
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by Correspondent, North Carolina Health News November 24, 2021
Within a few weeks, perhaps before many Americans finish decorating for the holidays, the U.S. could have access to a new antiviral pill from Merck expected to alter the deadly trajectory of the covid-19 pandemic — with a second option from Pfizer to follow shortly after.
Now under federal review, both pills are being hailed by infectious-disease doctors not prone to superlatives.
“This is truly a game changer,” said Dr. Daniel Griffin, an expert on infectious diseases and immunology at Columbia University. “This is up there with vaccines. It’s not a substitute for vaccines; we still want to get people vaccinated. But, boy, this is just another great tool to have.”
The new regimens, which require 30 or 40 pills to be taken over five days, have been shown to dramatically reduce hospitalizations and prevent deaths in adults with mild to moderate covid who are at risk for severe disease because of age or underlying conditions. But experts say the success of the treatments would hinge on one uncertain factor: whether high-risk patients infected with covid will be able to get tested — and then treated — fast enough to make a difference.
“Early, accessible testing and access to the results in a time frame that allows us to make a decision is really going to be key to these medications,” said Dr. Erica Johnson, who chairs the Infectious Disease Board of the American Board of Internal Medicine. “It puts the onus on our public health strategy to make these available.”
In clinical trials, molnupiravir, the antiviral drug developed by Merck & Co. and Ridgeback Biotherapeutics, was given to non-hospitalized, unvaccinated, high-risk adult patients within five days of their first covid symptoms. Pfizer’s product, Paxlovid, was tested in similar patients as early as three days — just 72 hours — after symptoms emerged.
Results from the Merck trial, released last month, showed the drug reduced the risk of hospitalizations by about 50{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} and prevented deaths entirely. It will be considered by an advisory panel to the federal Food and Drug Administration on Nov. 30. Pfizer officials, who requested FDA emergency authorization for their drug on Nov. 16, said Paxlovid cut the risk of hospitalizations and deaths by 89{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}. Both drugs work by hampering the way the covid virus reproduces, though they do so at different points in the process.
But those promising results assume the drugs can be administered in the narrow window of time used in the trials, a proven challenge when getting antiviral treatments to actual patients. Similar drugs can prevent dire outcomes from influenza if given early, but research shows that only about 40{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of high-risk patients during five recent flu seasons sought medical care within three days of falling ill.
“That’s just not human nature,” said Kelly Wroblewski, director of infectious disease programs for the Association of Public Health Laboratories. “If you have a sniffle, you wait to see if it gets worse.”
Even when patients do seek early care, access to covid testing has been wildly variable since the start of the pandemic. U.S. testing capacity continues to be plagued by a host of problems, including supply-chain bottlenecks, staffing shortages, intermittent spikes in demand and results that can take hours — or far longer.
PCR, or polymerase chain reaction tests, the gold standard to detect SARS-CoV-2, can require scheduled appointments at medical offices or urgent care centers, and patients often wait days to learn the results. Rapid antigen tests are faster but less accurate, and some medical providers are hesitant to rely on them. Over-the-counter tests that can be used at home provide results quickly but are hard to find in stores and remain expensive. And it’s not yet clear how those results would be confirmed and whether they would be accepted as a reason for treatment.
“Get ready,” Griffin said. “You don’t want to call someone four days later to say, ‘Ooh, you’re now outside the window,’ and the efficacy of this oral medication has been lost because of problems on our end with getting those results.”
The situation is expected to improve after a Biden administration push to invest $3 billion in rapid testing, including $650 million to ramp up manufacturing capacity for rapid tests. But it could be months before the change is apparent.
“Supplies will be getting better, but it’s going to be slow,” said Mara Aspinall, co-founder of Arizona State University’s biomedical diagnostics program, who writes a weekly newsletter monitoring national testing capacity.
If getting tests will be tough, acquiring doses of the antiviral drugs is expected to be tougher, at least at first. The federal government has agreed to purchase about 3.1 million courses of molnupiravir for $2.2 billion, which works out to about $700 per course of treatment. The Biden administration is planning to announce a deal to pay $5 billion for 10 million courses of the Pfizer drug, paying about $500 per treatment course, according to The Washington Post.
Doses of the drugs distributed by the federal government would go to states and patients at no cost. But only a fraction of the planned inventory will be available to start, said Dr. Lisa Piercey, Tennessee’s health commissioner, who has been part of a small group of state health officials working on the distribution plans.
Under one scenario, in which 100,000 courses of the Merck drug are available as early as Dec. 6, Piercey said Tennessee would receive just 2,000 patient courses even as the state is reporting more than 1,200 new cases a week on average. Deciding which sick patients receive those scarce supplies will be “an educated stab in the dark,” Piercey said.
U.S. Department of Health and Human Services officials have said the antiviral treatments will be distributed through the same state-based system adopted for monoclonal antibody treatments. The lab-made molecules, delivered via IV infusion or injection, mimic human antibodies that fight the covid virus and reduce the risk of severe disease and death. Federal officials took over distribution in September, after a covid surge in Southern states with low vaccination rates led to a run on national supplies. They’re now allotted to states based on the number of recent covid cases and hospitalizations and past use.
The antivirals will be cheaper than the monoclonal antibody treatments, which cost the government about $1,250 per dose and can carry infusion fees that leave patients with hundreds of dollars in copays. The pills are much easier to use, and pharmacies likely will be allowed to order and dispense them for home use.
Still, the antiviral pills won’t replace the antibody treatments, said Dr. Brandon Webb, an infectious-disease specialist at Intermountain Healthcare in Salt Lake City.
Questions remain about the long-term safety of the drugs in some populations. Merck’s molnupiravir works by causing mutations that prevent the virus from reproducing. The Pfizer treatment, which includes Paxlovid and a low dose of ritonavir, an HIV antiretroviral, may cause interactions with other drugs or even over-the-counter supplements, Webb said.
Consequently, the antivirals likely won’t be used in children, people with kidney or liver disease, or pregnant people. They’ll need to be administered to patients capable of taking multiple pills at once, a couple of times a day, and those patients should be monitored to make sure they complete the therapy.
“We’ll be on an interesting tightrope in which we’ll be trying to identify eligible patients early on to treat them with antivirals,” Webb said. “We’re just going to need to be nimble and ready to pivot.”
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
Approximately seven billion euros has been planned for the development of proximity networks, facilities and telemedicine for territorial healthcare assistance, and €8.6 billion for innovation, research and digitalisation of the National Healthcare Service. In addition, who determines their level of technological advancement? Why is it that an international “certification” such as the EMRAM model (Electronic Medical Record Adoption Model), which could objectively evaluate this degree of maturity, is not widely taken up in Italy? This was discussed during the ‘Evidence-based investments in digital health. Instruments for measuring the maturity level for a strategic vision of evolution’, organised by the HIMSS Italian Community at the Catholic University of Rome earlier this month (12 November).
WHY IT MATTERS
Investments in digital healthcare are a central theme in the scenarios for developing the national healthcare systems in Europe after the impact of the pandemic. To guide and monitor these investments, it is essential to apply digital maturity assessment metrics in healthcare facilities and regional systems. To this end, HIMSS launched EMRAM in 2005. It is a path that offers guidance, assessment and benchmarking in the computerisation of clinical-care processes. Updated in 2018, the model is undergoing a further evolution of the standard which will be operational from January 2022. “In the new model, the focus shifts from the process to clinical outcomes, including patient involvement and the clinical use of EMR,” explained Ronan O’Connor, Vice President, Analytics – EMEA, HIMSS.
THE LARGER TREND
Nearly 65,000 health organisations have engaged in maturity model assessments in 50 countries around the world. Some 2,739 institutions have been validated at EMRAM Stage 6 or 7. These healthcare institutions have the potential to impact the care of over half a million people around the world. In Germany, for example, the government has invested €4.3 billion in the digitalisation of the health service and has started the evaluation of its more than 1,800 hospitals to understand the maturity level they are at. The funds of the national NRRP will arrive on the basis of a maturity path certified by a third party, namely HIMSS.
ON THE RECORD
“What fascinated me very much about this approach, which other countries such as France and Germany are also pursuing, and which we have begun to make a central issue in Italy both at the central and regional institutional level, is precisely this: a neutral model, an international benchmark used globally, and therefore an absolute standard that helps to measure the real maturity of information systems in our healthcare organisations”, said Elena Sini, of HIMSS Italian Community.
