Monday, November 01, 2021

Benighted Vaccine Ignorance : Thinning of the Eastern European Population


"It's not a tall tale. I see that this disease kills, and strong immunity wouldn't be enough -- only a vaccine can offer protection."
"I'm really scared and I'm pleading with doctors to help me correct my mistake [buying a fake vaccination certificate for his travel documents hauling cargo to European points]."
"You can't heat this illness. You can buy a counterfeit certificate, but you can't buy antibodies."
"Ukrainians are slowly starting to realize there is no alternative to vaccination."
Andriy Melnik, truck driver, Kyiv, Ukraine

"We're seeing low vaccine uptake in a whole swath of countries across that part of the region [Eastern Europe]."
"Historical issues around vaccines come to play. In some countries, the whole vaccine issue is politicized."
Catherine Smallwood, Europe COVID-19 incident manager, World Health Organization

"We are on the verge of catastrophe, pushed by aggressive opponents of vaccination and the lack of funds."
"Regrettably, five workers in my ward have quit over the past week."
Dr.Serhiy Shvets, head, surgical ward, Biliaivka Hospital, Ukraine
"I'm weeping in despair when I see that 99 percent of patients in serious condition with COVID-19 are unvaccinated, and those people could have protected themselves."
"We are left struggling to save them without sufficient drugs and resources."
"Fake stories have spread widely, making people believe in microchips and genetic mutations."
:Some Orthodox priests have openly and aggressively urged people not to get vaccinated, and social networks have been filled with the most absurd rumours."
"Ukrainians have learned to distrust any authorities' initiatives, and vaccination isn't an exclusion."
Dr.Olha Kobevko infectious disease specialist, Chernivtsi Hospital, Ukraine 
A medic tends to coronavirus disease (COVID-19) patients at the intensive care unit (ICU) of Pirogov hospital in Sofia, Bulgaria, October 15, 2021. Picture taken October 15, 2021. REUTERS/Stoyan Nenov
A medic tends to coronavirus disease (COVID-19) patients at the intensive care unit (ICU) of Pirogov hospital in Sofia, Bulgaria, October 15, 2021. Photo: October 15, 2021. REUTERS/Stoyan Nenov
 
On the African continent, populations vulnerable to the SARS-CoV-2 virus causing COVID in every country have little option over whether or not to be inoculated against the novel coronavirus. They haven't the opportunity, since vaccines of any type and origin are scarce, and where vaccines are available they're short-dated and there is a serious lack of syringes. The WHO  calls this lack of equity. It is the wealthy countries of the world that are swimming in vaccines.

And there anti-vaxxers and vaccine-hesitant people in significant numbers represent the only deterrence to having the majority of any population inoculated against COVID. The promises made by advanced countries in the West with ample access to medical equipment and vaccine doses to provide the WHO vaccine-sharing program Covax with doses for the less advanced countries of the world are not meeting their obligations. In Europe there is no shortage of vaccines. The EU is acknowledged as having a high rate of vaccine coverage altogether.

And then, there is Eastern Europe, a dismal failure in vaccine uptake by its populations. Unsurprisingly, as a result of resistance to vaccines, the countries of Eastern Europe are facing a catastrophic rise of     COVID cases, hospitalizations and deaths. Exceptions to the widespread trend of vaccine rejection are the Baltic nations, Poland, the Czech Republic, Slovenia and Hungary. Public distrust is driving a low uptake of vaccines in other Eastern European countries, however.
 
Medical workers carry a patient suspected of having coronavirus on a stretcher at a hospital in Kommunarka, outside Moscow, Russia, Monday, Oct. 11, 2021.
Medical workers carry a patient suspected of having coronavirus on a stretcher at a hospital in Kommunarka, outside Moscow, Russia, Monday, Oct. 11, 2021    AP Photo/Alexander Zemlianichenko
 
There were 1,159 recorded COVID-related deaths in Russia in 24 hours, last week, the largest daily death count since the beginning of the pandemic. Roughly a third of the country's 146 million population has been fully vaccinated. In response, the Kremlin ordered a nonworking period to last to November 7. In Hungary private companies can require their employees to be vaccinated if they want to retain their employment, and government employees are required to be be vaccinated. 

Poland reported its highest number of daily infections at over 8,000 last Thursday. A mere 15 percent of the adult population in Ukraine is fully vaccinated, representing the second-lowest rate in Europe, following Armenia's 7 percent. Teachers, government employees and other workers are required to be fully vaccinated by November 8 in Ukraine to avoid suspension in pay. People may not board planes, trains or long-distance buses without proof of vaccination or a negative test.

A black market in counterfeit documents has emerged with fake vaccination certificates selling for $100 to $300. Police have opened 800 criminal cases into workers at 15 hospitals in Ukraine being involved in counterfeit certificates, with 100 mobile units deployed to track down users, according to the Interior Minister. Last week, a former lawmaker was among those arrested. In the western city of Chernivtsi, ten to 23 patients die daily of COVID, with those aged in their 30s and 40s impacted.

Believing the rumours that Western vaccines contain microchips to control people, Lidia Buiko, 72, chose the Chinese Sinovac vaccine: "Priests have urged us to think twice about getting immunized -- it would be impossible to get rid of the chip", she explained, waiting for her injection in a Kyiv clinic. It is estimated that roughly half of Ukrainian medical workers express vaccine reluctance. "The risks of misinformation to vaccination have never been  higher; nor have the stakes", commented     UNICEF representative in Ukraine Murat Sahin.

About 35 percent of vaccine-eligible adults in Romania are fully immunized where tighter restrictions are in effect requiring vaccination certificates for attending a gym, the movies or shopping malls. With a 10 p.m. curfew, shops close at 9 p.m., bars and nightclubs shuttered for 30 days, and masks are mandatory in public. 
 
Bulgaria has a quarter of its adult population fully vaccinated and reports record numbers of infections and deaths. Official data identify Bulgaria with the highest COVID-19 mortality rate in the 27-nation European Union, with 94 percent of deaths representing the unvaccinated.Authorities in Georgia launched a lottery of cash prizes to entice the population to be vaccinated, where 33 percent of the population has been fully vaccinated.
"[So many are] afraid of the vaccines because of the immense [amount of] fake information that has flooded social media and TV."
"Every day we see people arriving with shortness of breath and most of them are feeling sorry for not being vaccinated."
Dr.Dragos Zaharia, Marius Nasta Institute of Pneumology, Bucharest

"[The government's information campaign] was not designed according to the peculiarities of our country."
"The emphasis should have been done, for instance, on the Georgian Orthodox church, because we have many instances when priests are saying that vaccination is a sin."
Dr.Bidzina Kulumbegov, Georgia
A healthcare worker is waiting for patients at a Covid-19 vaccination centre at The Military Medical Academy in Sofia.
A healthcare worker is waiting for patients at a Covid-19 vaccination centre at The Military Medical Academy in Sofia.

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Sunday, November 01, 2020

Surrendering Hostilities to Mutual Disaster Response

"We have never experienced anything like it."
"People are panicking."
George Dionysion, vice-mayor, Greek island of Samos
 
"Everybody says it was 15 seconds but it was like 15 hours for us."
"Everything inside our house dropped to the floor. The building next to ours was completely destroyed and ours has cracks in the walls. We are obviously happy to get out alive."
"Some of our neighbours, unfortunately, did not make it."
Resident, Izmir, Turkey
 
"I am very used to earthquakes ... so I didn't take it very seriously at first but this time it was really scary."
Ilke Cide, doctoral student, Guzelbahce, Izmir
Turkey
Rescue workers and local people carry a wounded person found in the debris of a collapsed building, in Izmir, Turkey, on Friday. (Ismail Gokmen/AP)
 
Turkey is one of the most earthquake-prone countries in the world. It sits atop major fault lines that criss-cross under the Aegean Sea, close to Turkey's coastline. It has a recent history of truly deadly catastrophic earthquakes. In August of 1999 a 7.6 magnitude quake struck Izmit, a city located southeast of Istanbul, when 17,000 people were killed. Another quake in 2011 that took place in the eastern city of Van killed over 500 people.

This most recent earthquake that struck the Aegean Sea on Friday was rated at 7.0 by the U.S. Geological survey, felt along Turkey's Aegean coast and the north-western Marmara region. It also struck the coast of Greece, affecting the Greek island of Samos, where the destructive force of the tremor was far less pronounced. In Izmir, 20 buildings collapsed entirely, leaving 30 people dead, but the death toll is certain to rise as five thousand emergency rescue personnel desperately dig through the ruins in hopes of rescuing people.
 
Rescue teams on Saturday plowed through concrete blocs and debris of eight collapsed buildings in Izmir, Turkey's third-largest city, in search of survivors of a powerful earthquake. (Darko Bandic/The Associated Press)
 
To the present, there have been one hundred people rescued from the collapsed buildings in the tragedy that left 885 residents injured. Frightened people ran from their homes onto streets in a general state of panic in Izmir. Soon afterward the tsunami struck, leaving neighbourhoods deluged with surging sea water sweeping debris inland, and fish stranded once it began to recede. The country's Disaster and Emergency Management Presidency began compiling casualty figures which swiftly began to increase from the initial counts.

Social media footage shows debris including refrigerators, chairs and tables floating through the streets carried by the deluge. Cars in Izmir's Seferihisar district were dragged by the seawater to eventually be piled atop each other, a mountain of vehicles sloshed together in a heap by the tsunami. Fish were found 50 metres inland from the shore. The 45,000 residents of the Greek island of Samos were urged to remain far from coastal areas.
 
"It was a very big earthquake. It's difficult to have a bigger one", said Eftyhmios Lekkas, head of Greece's organization for anti-seismic planning.

The presidents of both Greek and Turkey set aside their longstanding differences most recently exacerbated by rival oceanic natural resource claims, to offer condolences and assistance to one another.


 

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Tuesday, September 15, 2020

New York City Post-Pandemic Lockdown

"Everything that made New York so distinctively New York has gone; its shopping, its Broadway theatres, its all-night cafes and late-night bars."
Fashion buyer, Manhattanite Natasha Field
 
"[The location is no longer workable as a luxury destination [Fifth Avenue] and the situation is unlikely to change] even in a post-pandemic New York City, should such a day arrive."
"In the current social and economic climate, filled with COVID-19 related restrictions, social distancing measures, a lack of consumer confidence and a prevailing fear of patronizing in-person 'non-essential' luxury boutiques [Valentino's future has become untenable]."
Valentino representatives, lease-releasing lawsuit
Fifth Avenue is empty of traffic as people remain at home to stop the spread of the Coronavirus pandemic on March 31, 2020 in New York City.
Fifth Avenue is empty of traffic as people remain at home to stop the spread of the Coronavirus pandemic in New York City. Noam Galai | Getty Images

"There's no reason to do business in New York. I can do the same volume in Florida in the same square feet as I would have in New York, with my expenses being much less."
Michael Weinstein, chief executive, Ark Restaurants
 
"We tried for a while at the beginning, unable to bring ourselves to leave the place we had dreamed of living [in] for so long."
"But when was the last time I went to a club, concert, great restaurant? I asked myself. What is New York without any of those things? Not much, quite frankly."
"I think the virus has just reframed people's relationship with the city. Maybe it will never be repaired, and that's not necessarily a bad thing."
Tom Harper, 32 former New Yorker, Vermont 

Broadway theaters will remain closed until January 2021, if not longer, because of the coronavirus pandemic.  Getty Images

Fifth Avenue will never be the same again, and nor will Manhattan following one of the world's most disastrous global pandemic hits. The attraction of Millionaire's Row, symbolic of New York City's prosperity and global cachet has been eclipsed. Vacated elite brand names have left great yawning gaps in the sparkling presentation of shops like Victoria's Secret and Kate Spade, boarded up now alongside high-end Italian handbag maker Valentino and Barney's.

Businesses deemed to be non-essential were ordered closed in the March lockdown hoping to contain the spread of the novel coronavirus and now that life has re-surfaced in the Big Apple many of those shuttered stores may never re-open, their intention to weather the storm defeated after five months, as a new, barren and unattractive landscape has taken the place of the former glittering, excitement-inducing one that may never return.

Tourists? Where are they? Wealthy residents to patronize the high-end stores? They appear to have vanished in a great rush to leave the city hosting a deadly virus for greener shores elsewhere. The city that played reluctant host to one of the nation's longest, strictest shutdowns no longer shines as a place to do business. Foot traffic at the famed stores in Manhattan has been reduced by 85 percent from a year earlier, and no one foresees appealing future prospects.

Vincent Tullo The New York Times
Close to three thousand established businesses shuttered for good in the past four months and the century-old New York Daily News tabloid was forced to close its newsroom at Penn Plaza, the company saying the paper would continue publishing while evaluating "real estate needs". Indoor dining is not yet considered a wise choice in a city which has recorded over 32,000 deaths, impelling scores of restaurants to close and move out to Long Island shores in lock-step with former Manhattanites.

As for the office towers, they have seen fewer than 15 percent of white-collar workers returning to their offices and surveys suggest many will continue with the new protocol of working from home through to 2021. The Upper East Side has become a ghost town, many of its residents in financial distress no longer able to support steep costs associated with rentals and taxes. United Van Lines chief executive claims to have helped relocate hundreds out of the city to the Hamptons, Hudson Valley, Connecticut and Vermont in recent months.

The combined wealth in the city fell by $336 billion in the twelve months ending June 30, according to a report from New World Wealth and Webster Pacific. While revenues generated in other areas of the state recovered, tax collections in NYC dropped 46 percent in June leading municipal politicians to propose a wealth tax targeting the city's 100 billionaires, to help restore an enormous revenue shortfall.

Last month, Governor Andrew Cuomo who rejected imposing greater taxes on the ultra-wealthy for fear they would leave for good, issued a plea for them to return. "They are in their Hamptons homes, or Hudson Valley or Connecticut. I talk to them literally every day. I say 'when are you coming back? I'll buy you a drink. I'll cook'," he said.

The Wall St. Bull is seen standing on a nearly empty Broadway in the financial district, as the coronavirus disease (COVID-19) outbreak continues, in New York City, New York, U.S., March 23, 2020.
The Wall St. Bull is seen standing on a nearly empty Broadway in the financial district, as the coronavirus disease (COVID-19) outbreak continues, in New York City, New York, U.S
Mike Segar | Reuters

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Tuesday, June 30, 2020

A Tale of Global Disaster

"This means we have already tested all the people that need to be tested. We are also rolling out large scale screening to key regions and key populations [of the city] and improving our capability of testing."
Zhang Qiang, Beijing municipal committee official

"[The virus continues to have the] upper hand ]even while Americans were tired of restrictions imposed to contain its spread]."
"We are moving too fast."
"It's like leaning into a left hook. You are going to get hit hard. And that's what is happening."
Tom Frieden, director, U.S.Centers for Disease Control and Prevention (2009-2017)
florida
A man rides a bicycle as people walk on Ocean Drive in Miami Beach, Florida on June 26, 2020. (Chandan Khanna/AFP/Getty Images/CNN)

On Sunday the U.S.Centers for Disease Control and Prevention reported 2,504,175 novel coronavirus cases representing an increase of 44,703 cases from the previous count. The number of deaths in the United States had risen to 125,484, with an additional 508 that day. A staggering number, given that the worldwide case totals now sit at ten million, with deaths creeping up to the half-million mark. The U.S. figures indicate that it alone is responsible for a huge number of cases out of the worldwide total. Some 'left hook' that has turned out to be.

In both its case total and COVID-linked fatalities the United States has attained the world's highest numbers. The most technologically advanced nation on Earth, the wealthiest of advanced economies has demonstrated an inability to control the virus spread. And that situation will ensure that other countries, emerging from their own dread exposure to the vicissitudes of the SARS-CoV-2 virus preying on the human respiratory system, will take steps to ban American citizens from entry to their borders.

Canada, sitting north of its neighbour on the North American continent as of late Sunday had 103,250 confirmed cases, with 8,522 deaths, an increase from 102,959 and 8,516 deaths of the day before, with a population about one-tenth that of the United States.

Beijing had collected 8.29 million patient samples for testing, completing 7.69 million tests. Its first case from the outbreak representing a second wave was reported on June 11 where 311 people have tested positive for the virus since then, in the city of over 20 million people. China, where the original outbreak first emerged, has successfully controlled its outbreaks using all the means available to a dictatorship.
Brazil
The intensive care unit treating COVID-19 patients at the Gilberto Novaes Hospital in the Manaus, in Brazil's Amazon region, has been operating close to capacity.

If the Chinese population feels put-upon and strained over severe lock-down procedures, it is not too likely there will be mass protests erupting over forced self-isolation in a population long accustomed to following orders, and avoiding government punishment. In the final analysis the entire population stands to benefit from strict isolation resulting in infection control. In stark contrast, Americans have protested, loudly and vociferously.

And they have taken to disowning the need to self-isolate, sick of lockdown, assembling in numbers to protest, with young Americans descending on beaches on hot sunny summer days, recapturing what has been lost to the necessity to avoid infection. And so, infections have risen substantially because the young feel invulnerable, and they know that their youth will protect them from severe health repercussions, and the entire population is once again plunged into viral infection territory.

The seven months it has taken for a half-million people globally to die of this mysterious new zoonotic has marked a grim milestone in global pandemics. One long anticipated by health experts, but ignored by governments. The repercussions to ordinary life that has been occasioned by the presence of this virus will likely never be fully reversed. The uncertainty surrounding the ability of the virus to change its characteristics, to resurge and rampage anew will ensure that a measure of social distancing will reflect a new normal.
A woman stands behind a fence as she waits for the delivery of goods she ordered online in a residential area under lockdown near the closed Xinfadi market in Beijing.
A woman stands behind a fence as she waits for the delivery of goods she ordered online in a residential area under lockdown near the closed Xinfadi market in Beijing.

Working, schooling, shopping, eating out, holidaying, travelling, all human activities integral to normal life and needs will be irretrievably altered for the foreseeable future, successful vaccine or not since, as most virologists now claim, there will be many more such zoonotics to emerge over time, and preparedness must, as a result, also become a new way of survival.

India and Brazil are now hard put in their efforts to control their own outbreaks, registering over 10,000 cases daily and accounting for over a third of all new cases in the past week. Out of Brazil a record 54,700 new cases were reported on June 19. The death toll in Latin America, according to some researchers could rise to over 350,000 by October, from its current total of 100,000.

China, New Zealand and Australia, all believing they had successfully 'flattened the curve' and were emerging out from under their epidemics, have seen resurgences as new outbreaks have destroyed the elation of a few weeks earlier when authorities in all those countries were jubilant over having fended off the virus. It is not yet ready to exit the scene, and it is not known when it will be, with or without a vaccine emerging within the next year, year-and-a-half.
A fresh cluster of novel coronavirus cases have emerged from a wholesale food market in Beijing, after the city reported no new local infections for nearly two months.
A fresh cluster of novel coronavirus cases have emerged from a wholesale food market in Beijing, after the city reported no new local infections for nearly two months.

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Saturday, June 06, 2020

Sweden's Mea Culpa

"What every country is trying to do is to keep people apart, using the measures we have and the traditions we have to implement those measures."
"The citizen has the responsibility not to spread a disease."
“If we were to encounter the same illness with the same knowledge that we have today, I think our response would land somewhere in between what Sweden did and what the rest of the world has done."
Swedish public health agency's chief epidemiologist, Anders Tegnell

"[Tegnell] still can’t give an exact answer on what other measures should have been taken. That question remains, I think."
"For months, critics have been consistently dismissed. Sweden has done everything right, the rest of the world has done it wrong. And now, suddenly, this."
Sweden’s minister of health and social affairs, Lena Hallengren
sweden coronavirus at the bar
People had lunch at a restaurant in Stockholm on April 21, 2020, during the COVID-19 pandemic.
Jonathan Nackstrand/AFP via Getty Images
The "this" that Sweden's Minister of Health refers to is a staggering death toll. It is a gamble that failed. Sweden is no further ahead economically, it failed in its goal to establish a country-wide 'herd immunity' effect that would in theory have seen the SARS-CoV-2 virus extinguish itself in exasperation at being unable to infect people because too many were immune to its lethal blandishments. The Swedes, goes the theory, are so logical in their thinking and so capable of independence of thought they would self-protect naturally.

No need for government to get in the way, to autocratically impose limits on people's freedom of movement. Common sense would prevail. Except, somehow, it failed to. Yes, there were some restrictions imposed; no large gatherings permitted and some schools were closed, while those who were able to work from home were encouraged to do just that. Otherwise, life in Sweden went on undisturbed, nothing out of the ordinary, no routines upended by inconvenient lockdowns.

Restaurants and bars remained open, schools for children under age 16 operated as per usual, in a decidedly calculated move to do things differently, logically, under the guidance of Anders Tegnell, the country's authoritative epidemiologist whose judgement everyone appeared to trust and to revel in. Who just happens to be the very same man who now regrets the immense loss of life in his country; win some, lose some.

He did enjoy the support of those who would have nothing to do with lockdown. And Swedes themselves in general appeared copacetic, confirmed in their belief in themselves and their government. And life went on. Though it stopped for many. Sweden has a death rate that considerably exceeds its neighbours' who did go into lockdown, and this was not the way things were supposed to turn out.

Sweden realized 450- deaths-per-million (for a total of 4,500 deaths), while comparable deaths-per-million for neighbours like Denmark (100), Finland (58), Norway (44) appear almost palatable by comparison, if any deaths at all can be felt to be acceptable under any conditions.That deaths-per-million for Sweden represents one of the worst the world has seen, even in hard-hit Europe. So much for death avoidance; that just didn't pan out.

And then there is the economy. While not the worst that Europe has seen, the country's economy is in fairly dire straits, a reflection of what has occurred around the world. Sweden has a drop in GDP of seven percent projected, commensurate with the same conditions and results seen elsewhere; in other words, nothing whatever gained. For one thing, it is hugely dependent on trade with neighbouring countries and they have been in no position to trade. A forgotten calculus.

Anders Tegnell
Anders Tegnell Photographer: Pontus Lundahl/AFP via Getty Images
Herd immunity? The general consensus is that at least 60 percent of the population would have to be considered immune to have the entire population protectively impacted.Yet by April's end no more than 7.3 percent of the population were seen to have acquired a degree of immunity. Stockholm's eventual figure, according to Mr. Tegnell might reach just over 20 percent, and that most certainly does not equate with effective herd immunity. Another calculus gone kaput.

 

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Sunday, May 03, 2020


World Health Organization Unresponsive to Queries on COVID Recommendations and Timelines

"We haven't any alternative pitched to us [from the World Health Organization] at all. There could be perhaps an alternative pitch, which we would consider."
We asked for him [Canadian Dr.Bruce Aylward, WHO senior advisor] just to show up for an hour knowing that his time is valuable, but just one hour knowing that we would work around his time zone."
Canadian Member of Parliament Matt Jeneroux

"WHO has stated its strong commitment to a timely review of the global response in a transparent, independent and comprehensive manner."
"We are in the initial phase of the most complex and time-sensitive public health response in the history of the organization and our single-minded focus is thus on working with countries in the fight against the [global SARS-CoV-2] pandemic."
Canadian House of Commons Committee letter to WHO 

"To me this is not about politics. I am not there [on the committee] to delve into the politics of the WHO. I am purely interested in their information and the way they responded to the COVID-19 crisis."
"I don't understand the difference. If he is prepared to come forward and on the record answer questions, why wouldn't he want to do that with our committee."
Member of Parliament Don Davies
Bruce Aylward of the World Health Organisation (WHO) attends a news conference of the WHO-China Joint Mission about its investigation of the coronavirus outbreak in Beijing, China, Feb. 24, 2020. Thomas Peter/Reuters

The World Health Organization has been criticized for giving the impression by its actions and statements clearly in favour of the Chinese response to the novel coronavirus, that its behaviour toward the Chinese Communist Party leadership is simply too deferential when its mandate is meant to be strictly objectively scientific in orientation, ensuring its guidance and advice to the world's nations is without bias, based strictly on medical science and factual evidence.

Not only has its chief, Tedros Adhanom Ghebreyesus, come under suspicion for the perceived unctuousness he displays toward China's Xi Jinping but that suspicion has now extended toward the former assistant director general of the World Health Organization who led an expert group examining the coronavirus' emergence in China. Dr.Aylward, in an interview with a television station out of Hong Kong where the issue of Taiwan was raised, terminated the interview rather than respond.

And because the WHO through Dr.Tedros initially praised the Chinese response and parroted its findings on human-to-human transmission, and played down the impending seriousness of the growing infection and death rate just as China did, leading to the international community being lulled into a state of complacency when a state of immediate alert should have been mandated, many countries' authorities have questions they would like answers to from the WHO.

COVID-19
Resident doctor Kelvin Lou puts a CVC line into a patient in a COVID suspect room in the COVID-19 intensive care unit at St. Paul's hospital in downtown Vancouver, Tuesday, April 21, 2020. (THE CANADIAN PRESS / Jonathan Hayward)

To that end, the Canadian House of Commons committee looking into the issue had twice invited Dr. Aylward to come before them to respond to a number of queries relating to the novel coronavirus. To each of those invitations, Dr.Aylward responded in the negative. Had he recommended the presence of a senor aid to represent him, who would answer those questions, the committee would have accepted that as a reasonable alternative, but no such offer was forthcoming.

The UN agency's legal counsel responded to the committee by letter following the first invitation when counsel Derek Walton advised the agency is prepared for its decisions to undergo a full review, but not at the present. To which the head of the parliamentary committee, MP Jeneroux pointed out that Dr.Aylward has given time for media interviews, and as such it appears reasonable for him to spare time for an appearance before the committee representing his own government as a citizen of Canada.

That, since the Canadian response to the crisis of this global pandemic that has impacted so heavily around the world as an infectious disease afflicting over a million people worldwide with steadily growing numbers, while 244,000 people have died so far from its complications, the issues are of monumental importance. All the more so that the crisis and its response, driven by recommendations from the WHO, makes it incumbent on that body to be responsible for itself to the very audience so dependent on its guidance.

Dr. Theresa Tam, Canada’s chief public health officer,  Blair Gable / Reuters


The World Health Organization had been unequivocal, recommending against travel restrictions and border closings initially, with a side note that it would be 'racist' to close borders to China. They also advised against the use of protective masks by the public. Recommendations which Canada's chief public health officer, Dr.Theresa Tam, was guided by as she agreed with the WHO's recommendations before eventually changing her opinion over those issues.

PHAC Coronavirus Map of Canada
Provided by: Public Health Agency of Canada



COVID World Cases

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Wednesday, April 29, 2020

Brazil "Much Ado About Nothing" COVID-19

"Undercounting empowers populists to say, 'See, things are not that bad."
"There is a huge effort by the federal government [of Brazil] to deny the gravity of the pandemic."
Pedro Doria, former executive editor, O Globo

"The big conclusion is that we don't know what the real scenario is."
"It gives the sensation that it is more controlled, when the reality is very different."
Leonardo Costa Ribeiro, economist, Federal University of Minas Gerais

"As a researcher, I look at the data and make analyses for the government."
"But as a citizen, I'm frustrated. The government is trying to control the epidemic without the elements of how to control it, because they don't know how serious it is."
"It will get much worse. There will be lines at the hospitals. There will be lines at the cemeteries."
"The next few weeks will be very dark."
Domingos Alves, data scientist, University of Sao Paulo

"Brazil could be thought of as a barometer of what could be expected in other countries."
"Information is paramount. The more we have, the more we can make the population aware of what it is exactly that we are facing."
Marcelo Gomes, researcher, Oswaldo Cruz Foundation
Brazilian President Jair Bolsonaro speaks to his supporters during a protest Sunday.
Brazilian President Jair Bolsonaro speaks to his supporters during a protest Sunday.

In Brazil the problem of inadequate testing numbers in the battle against the global pandemic that the novel coronavirus out of China represents within the global community is almost totally absent. Not even the bare minimum is being done in Latin America's largest country, with a population of almost 210 million people, which has tested up to 40,000 cases, 12 times fewer than is being done in Iran, with its population of 82 million. Both countries have been hit hard by the SARS-CoV-2 virus causing COVID-19. Both deny the extent that the virus has penetrated their populations.

Patients that are hospitalized are not tested, and nor are some medical professions even while people are dying in their homes without having been tested. Brazil's President Jair Bolsonaro speaks of the pandemic as a 'fantasy' behind a 'a little flu'. The numbers, he declared earlier in the month "looked like the virus is starting to leave". Demonstrating in point of fact, that his is the 'fantasy' of the state of the epidemic in his country.

Brazil's health minister, Luis Henrique Mandetta, repeatedly, publicly contradicting the president on the crisis' severity, has been fired for his monumental audacity in undercutting the casual messaging of the president. And even as his supporters gather in city streets, repeating their president's calls for the economy to be reopened, data scientists warn the Brazilian epidemic of COVID is dramatically, dangerously more severe than they realize.

According to researchers at the Federal University of Minas Gerais, the country suffers eight times more cases of the coronavirus than official numbers admit to. A University of Sao Paulo research team is convinced the real number is 15 times greater than the official one, in other words up to 711,000 cases. Close to 37,300 people have been hospitalized this year if government statistics are to be believed, with respiratory ailments.


Half of that number of hospitalized patients have test results, while in Sao Paulo close to 1,300 people have died of unidentified respiratory problems in comparison to last year's 50 people. In Amazonas state's capital city so many people are being buried, representing three times the average rate, trenches are being dug for mass graves. At least it has that in common with Iran.

"We are not talking about testing the entire country. We are going to use the tests so that people tested will reflect the Brazilian population", said the new health minister, Nelson Teich who has declared increased testing the new pillar of the nation's pandemic response. To that purpose, the government has plans to buy 45 million tests, sufficient for a fifth of the population, though when the tests arrive or when they're intended for use remains a mystery. One can only hope they aren't arriving from China.

Brazil's laboratories, according to analysts, have been overwhelmed by a backlog of testing, they are not equipped to process tests at scale. And when it comes to competing on the international scrum for badly needed medical supplies and testing equipment, wealthier nations are winning that battle, able to pay out more or leverage advantageous ties with China. The country that gave the world COVID-19 now basks in popularity as a source for (faulty) medical supplies and equipment.

Police officers wearing protective masks patrol the Rocinha slum in Rio de Janeiro. Photograph: Ricardo Moraes/Reute


"Sometimes they don't even wait for me to say my mother's name before hanging up."
"Nobody tells me what really happened to her. It was all very fast, and we just wanted an answer."
"It's inhumane."
Bruna Marques, 24, Sao Paulo state, grieving her mother's death

"One day, I saw on the news that in all of Sao Paulo there had been 20 burials of coronavirus victims."
"But I knew at my cemetery alone, there had been 27."
Manoel Norberto Pereira, gravedigger, Sao Paulo

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Monday, April 27, 2020

Social Distancing in Closed Environments

"Very early on, we wrote two letters that we posted on social media that got tonnes of attention."
"Our method of protecting ourselves and the public from being infected is social distancing. And if  you can't social distance ... you're just inviting disaster to strike."
"If you've got two people who are in a stadium and you tell them, close your eyes and just start walking around, the odds that they're going to walk into each other are pretty small. But if you have those same two people doing that in a room that's six-by-six metres, there's a pretty good chance that they're going to knock into each other. It's a simple function of the ability or the inability to distance." 
"One of the advantages we have with long-term care facilities is at least we've been able to understand some degree of the problem. Someone's peeled back the scab, so to speak, to look under the bandage and we can see how absolutely horrific what was going on has been."
"The residents in these populations, we're just going to lose them. And that's a scar upon us if we can't protect our vulnerable."
"These are not closed systems. There are people who go and work there. And if we can't protect the healthcare workers, then almost certainly we're not protecting the health-care workers' families and therefore we're not protecting the public that is in contact with the health-care worker and their families and therefore we're not going to be able to get a hold of this whole problem."
Dr.Andrew Morris, professor of medicine, University of Toronto

"I think we're starting to see very quickly that hospitals are not really the front line of this pandemic in Canada."
"I think now people are almost playing a game of catch-up when you start looking at these settings [care homes for the elderly or disabled]."
Dr.Samir Sinha, director of geriatrics, Mount Sinai Hospital, Toronto
Flowers are see outside Résidence Herron, a long-term-care home in the Montreal suburb of Dorval, Sunday, April 12, 2020.
The Quebec coronor's office has launched an investigation into a long-term care home in a suburb of Montreal where 31 people have died in a conditions the premier has called "deplorable"

It has now been six weeks and ongoing, where Canadians across the country have been counselled that it is up to everyone to 'flatten the curve'. To remain sequestered in their homes, to go out only on rare occasions when it's absolutely necessary, to remain distant physically from others. Schools closed, non-essential businesses shuttered, public spaces and events off limits, borders closed, travel plans nixed. All well and good, but none of this affected long-term care homes, yet fully 78 percent of all COVID-linked deaths have occurred in long-term care homes.

All of these measures to try to control a hugely infectious and sometimes morbidly-threatening new cornavirus were predicted before the virus entered North America. Dr. Morris, for one, was alert early on that COVID-19 would present an enormous problem to Canada when it arrived, as it surely would. But even he and colleagues of his whose thoughts took a similar track, were unable to visualize just how dramatically the Canadian reality of life-normalcy would ultimately be affected.

The Eatonville Care Centre, where multiple deaths from COVID-19 have occurred, is shown in Toronto on Tuesday, April 14, 2020. THE CANADIAN PRESS/Nathan Denette
He and his colleagues got together to draft several letters outlining the situation that would unfold and their recommendations for an early response to the situation before it became a reality. At the time it seemed so difficult to believe that the country would swiftly be engulfed in a seemingly unstoppable epidemic they scarcely thought their communications would be given the serious consideration it required. Later, it would occur to them that though that attention was forthcoming, they had themselves failed to communicate the extent of the dire conditions that would ensue.

Now that Canadians have embarked on a voyage of countradicting the basic human impulse of sociability in an effort to halt the spread of the virus causing COVID-19, the very enormity of the threat takes on new proportions to our understanding of just how vulnerable we are as a population. But it is a readily identifiable demographic of the population that has borne the brunt of the infections.

Precautions were taken to close schools and daycares to shield children from the SARS-CoV-2 virus, the most readily identifiable group within any population that is given first thought. Fears of overwhelmed hospital emergencies failed to materialize, with hospital admissions and ICU capacity at not only manageable levels, but anxiously awaiting the arrivals of other emergency situations more commonly making use of those facilities that have suddenly disappeared.

People are withholding their presence at Hospital Emergencies, hoping that their worrying symptoms of heart problems, stroke, appendicitis, accidental injuries will somehow abate, rather than subject themselves to the possibility of appearing at a hospital teeming with infectious agents and find themselves infected with the dread virus. And then there is another casualty that few had given prior thought to, but several of Dr. Morris's colleagues had.

The virus that thrives in the company of groups of people in close communion, and sees its opportunities dwindling when people exercise caution to keep physical distances, found its metier when it entered the confines of closed gatherings, where people are placed in situations with tight physical spaces and an abundance of potential targets. Places like nursing homes and long-term care homes, prisons and shelters for the homeless. "Congregate settings", perfect for a virus to thrive.
If more isn’t done to protect shelters, prisons and in other so-called “congregate settings,” advocates warn more mass outbreaks are inevitable. Francis Georgian/Postmedia/File

And in long-term and nursing homes the virus has done precisely that. Shelters and prisons next on the list. "I think we're going to see numbers jump dramatically", Cathy Crowe, a nurse with decades of working with the homeless in Toronto, stated. While many shelters are attempting to implement some elements of social distancing, in their limited spaces it is beyond difficult to adequately achieve.

"It's pretty much impossible to maintain social distancing in pretty much every congregate setting of a shelter or a drop-in, to be perfectly honest", Diana McNally, with her years working in Toronto shelters, offered. "The diagnostic differentiation of COVID among people experiencing homelessness is very challenging", Dr. Naheed Dossani, palliative care physician who often works with the homeless, pointed out.

In prisons and jails outbreaks are beginning to occur. "I'm speaking to senior citizens who are serving prison sentences and telling me, I didn't know this was going to be a death sentence", Paul Champ, a lawyer in Ottawa stated. As for long-term care homes where well over fifty percent of the COVID deaths not only in Canada but globally, have been taking place, the sheer vulnerability of the aged, infirm and health-compromised has shocked the world.

Homeless people make shelters on the sidewalk
As the coronavirus outbreak continues, Los Angeles has been providing unhoused people with motorhomes and RVs, which allow them to maintain social distance.  Photograph: APU GOMES/Getty Images

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Monday, April 20, 2020

Coping Desperately With an Insatiable Novel Coronavirus

"To protect and build towards our shared prosperity at least $100 billion is needed to immediately resource a health and social safety net response."
"In a best-case scenario -- $44 billion would be required for testing, personal protection equipment, and to treat all those requiring hospitalization."
"We estimate that between five million and 29 million people will be pushed below the extreme poverty line of $1.90 per day owing to the impact of COVID-19."
UN Economic Commission for Africa (UNECA)


Nigeria, the most populous and oil-wealthiest country on the African continent is set to lose between $14 billion and $19.2 billion in revenues from oil exports this extraordinary year of 2020. But then, the pricing war between Russia and Saudi Arabia not only beggared their own oil exports, but impacted deleteriously on oil revenues of first-world advanced countries like Canada. So Nigeria has not been alone in experiencing a drop of revenues from oil.

Family in Nigeria
87 million people live in extreme poverty, in Nigeeia. Photograph: Sombo Sombo/Alamy

Yet even when Nigeria was receiving full value on the market from its oil exports, as one of two African wealthiest countries, it has never managed its economy to benefit its huge population of close to 200 million people, close to half of whom live in dire poverty, outstripping even India's indigent numbers with its far more numerous total population.

The African continent sees so many of its 54 countries in turmoil, beset with poverty and backwardness, conflict, ethnic and religious confrontations, tribal divisions of competitive advantage and never-ending territorial ambitions. All that, and endemic corruption, and national leaders wedded to self-aggrandizement siphoning off their nations' wealth to make themselves wealthy, withholding services other than to those who support their tyranny all make for a formula for failure.

So fa there have been fewer than 20,00 confirmed cases of the novel coronavirus throughout the total of Africa's 54 countries while over two million have been reported globally. But the UNECA now warns that the pandemic is likely to kill at the very least 300,000 Africans, while placing 29 million in extreme poverty unless $100 billion is released as a continental safety net. This, at a time when the world's economy is fast sinking.

While EU countries Italy and Spain have been brought low by the virus, flooded with cases of COVID-19, with an incredible death rate resulting, they have appealed for help in securing personal protection equipment for their medical personnel who are also dying of the virus, and critical medication, seeing none of their neighbours in the European Union responding to their pleas. All countries of the world are facing dangerous shortages of drugs and protective equipment for health workers. Where will such short-supply equipment be sourced for Africa?
A private security guard stands with a semi-automatic rifle loaded with rubber bullets in Hillbrow, Johannesburg, on April 17, 2020
A private security guard stands with a semi-automatic rifle loaded with rubber bullets in Hillbrow, Johannesburg, on April 17, 2020
Moreover, African finance ministers have now as well collectively called for an additional $100 billion in stimulus; effectively placing a stop to all external debt service. This, at a time when countries in Europe, North America and South Asia are struggling to support their economies, borrowing heavily in a desperate attempt to shore up local business enterprise and mass unemployment to avoid total economic collapse. Focusing on stimulus for their own badly faltering financial status where is the stimulus for Africa to come from?

The UN agency created a four-scenario model based on preventive measures introduced by governments in Africa so that in the total absence of interventions a calculated 1.2 billion Africans would be infected, with 3.3 million dying this year. In other words, in a continent of 1.3 billion people in total, the forecast is for virtually all to contract the novel coronavirus. A winnowing out of the weakest and most vulnerable. Nature at its survival-harshest.
Municipal workers dressed in protective gear rest while on duty disinfecting a street during the COVID-19 coronavirus pandemic in the Bab el-Oued district of Algeria's capital Algiers on April 9
Municipal workers dressed in protective gear rest while on duty disinfecting a street during the COVID-19 coronavirus pandemic in the Bab el-Oued district of Algeria's capital Algiers on April 9

However, since most of Africa has mandated social distancing ranging from curfews and travel guidelines in some countries to full lockdowns in others, with best-case scenarios reflecting intense social distancing, Africa would see 122.8 million infections, 2.3 million hospitalizations and 300,000 deaths, once a threshold of 0.2 deaths per 100,000 people weekly has been reached.

Then there is the dire reality of 36 percent of Africans living without access to household basic hygienic facilities, and adding to that the continent has 1.8 hospital beds per 1,000 people where advanced, developed countries average 5.98 beds per 1,000 people, and again a formula for disaster. Balancing that is the youth demographic of 60 percent below the age of 25, an age far less dramatically health-compromised by the infectious coronavirus.

Yet, Africa being Africa, 56 percent of the urban population live in overcrowded slums with a greater, vulnerable population resulting from HIV/AIDS, tuberculosis and malnutrition. According to the UNECA report, 94 percent of Africa's pharmaceuticals are imported, hard up against 70 countries globally responding to their own flood of COVID cases banning or limiting exports of supplies essential to fighting the virus. A situation again, universally shared.
A man carries a box of protective masks to emergency workers Thursday in Dakar, the capital of Senegal. The West African country has seen relatively few confirmed cases of the coronavirus to this point — but global health officials fear that won't always be the case.  John Wessels/AFP via Getty Images

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Friday, September 06, 2019

Coping With Explosive Drug Dependencies in Scotland

"We're seeing diseases that  you would associate with old age in a lot of these middle-aged men with a long history of drug use."
"What your body tolerates at 18 it doesn't tolerate at 38 or 48."
Dr. Carole Hunter, lead pharmacist, Glasgow Addiction Services

"The jigsaw is complex."
"It's our history, it's the way we consume drugs, it's the chronic underfunding and underperforming treatment services we have."
"Underline that with austerity and welfare cuts in recent years, and you've got the perfect storm for this to happen."
"We've managed to keep a lot of the aging cohort alive through our current drug treatment services, but they get to a certain point where that blanket is not enough. They need respiratory care, they need mental health care, they need help with housing, employment, welfare and a whole host of other things."
Amdrew McAuley, senior research fellow on substance use, Glasgow Caledonian University

"I know the instinct from the U.K government is that they don't want to be seen in any way to be condoning illegal drug use."
"But people are dying. We need to do things that at first feel difficult."
Scotland Public Health Minister Joe FitzPatrick
heroin

"Street Valium", or etizolam has flooded into Glasgow. "People are dying with one bad pill", said Halth Minister Joe FitzPatrick. The drug Etizolam has been discovered in close to half of all drug deaths that occurred last year in Scotland. Unlike the scourge of overdose deaths where fentanyl and carfentanil, two hugely powerful opioids -- one more deadly than the other -- have entered Canada and the United States -- mostly from China -- Scotland has not yet seen their presence.

But even without those two deadly scourges, Scotland struggles with drug dependency and its inevitable death toll. The situation has become so dire in that country it is now being referred to as the "drug-death capital of the world", a distinguishing prize the nation could well do without. There were 1,187 drug-related deaths last year, a record for Scotland, representing an increase of 27 percent from the previous year.

And what distinguishes these deaths is that it is older, long-term opioid users who are now accounting for the greater proportion of the deaths.

Over twenty years ago Edinburgh's addiction rate was infamous. The known 60,000 drug users in Scotland, routinely involved in a prolonged history of opioids or benzodiazepines keep the crisis in drug-related deaths at a high level of dramatic life expiration for no good reason. Those who fail to die of drug overdoses are experiencing disturbing health deterioration with the onset of medical conditions familiarly seen in much older people.

Drug users suffer from both physical and mental health issues. As an example, one patient who has been using drugs since age 19 and who has overdosed no fewer than four times in the past year. "I've nearly died four times", the now-43-year-old says. "It's getting harder for me to recover as I get older". He is being treated for deep-vein thrombosis, hepatitis C and skin abscesses, and lately has been urinating blood.


Life expectancy until 1950 was on a par with most of Western Europe, even better. Following the Second World War, Scotland's progress was slower than that of any other Western European country and the varied reasons behind Scotland's drug crisis can be attributed to economic policies that left regions in a deeply impoverished state where treatment services were neglected and drugs became deadlier. Needle exchanges introduced in the 1980s along with naloxone to reverse overdoses have been in widespread use since 2011.

Methadone as an opioid substitute therapy is free, available at most pharmacies. Efforts by the Edinburgh Access Practice treatment center to boost more people into treatment faster and to begin to address issues behind their drug use are positive factors in response to the epidemic of drug use, but there are few such facilities. Controlled substances like heroin fall under the British government's jurisdiction and there is resistance from conservative lawmakers to move to more progressive drug policies.


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