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Discussion thread VII - COVID-19: Endemic Stage

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  • ScholerinED@med-mastodon.com
    @ScholerinED
    Top 3 things you can do to avoid Covid IMHO as an ER doc who has avoided it so far: 1. Masking 2. No indoor public dining/large gatherings 3. Gather in small groups only with other people who actually care and are also taking active measures not to get Covid. #CovidIsntOver
    6:14 PM · Nov 28, 2022
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    ScholerinED@med-mastodon.com
    @ScholerinED

    Dec 1
    Replying to
    @ScholerinED
    Thanks for the likes and comments. Stay safe out there. Here is a more comprehensive list with additional ways to help mitigate the spread of Covid and other respiratory illnesses...
    Quote Tweet

    ScholerinED@med-mastodon.com
    @ScholerinED
    ·
    Dec 1
    A list of all the things we can and should be doing as a community to decrease the spread of Covid from an ER doc who has remained Covid free so far , a Distancing
    Masking
    Filtration
    Isolation
    Testing
    Vaccination & Boosters
    Ventilation

    Show this thread
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    ScholerinED@med-mastodon.com
    @ScholerinED

    Dec 1
    Dammit, I should have said "Well that certainly went viral"
    8
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    ScholerinED@med-mastodon.com
    @ScholerinED
    Dec 5
    If you’ve already had Covid, taking precautions to not get it again are even more important.
    Quote Tweet

    ScholerinED@med-mastodon.com
    @ScholerinED

    Dec 5
    TLR; #CovidReinfection causes risk of;
    death (2x)
    hospitalization (3x)
    heart problems (3x)
    blood clots (3x) Also risk of problems with:
    Diabetes
    Fatigue
    Kidneys
    Mental health
    Musculoskeletal
    Neurologic
    Lung

    Stay safe & #WearAMask

    Comment


    • I wanted to make a comment about the flu, RSV, other various diseases, strep, etc. outbreaks that seem to be flourishing this fall and winter. This is an expected aftermath of a pandemic.

      Pandemic models show that after several waves of a pandemic illness the surviving population can be weakened. Other opportunistic illnesses can take hold. This is probably why the CDC is emphasizing hand washing now. Simply - after a pandemic circulates through the world, peoples' immune systems need some time to rebuild. During this time people can be more suspectible. With COVID-19 there is a debate of how much damage the virus does to the immune system. But nevertheless, any illness battle strains someone's immune system to some extent.

      So I am not surprised about the strep outbreak and the level of flu and RSV. We need to probably anticipate other bacteria and viruses to expose our collective vulnerabilities.

      It is up to you. Avoid COVID-19, or not. Vaccinate, mask, or not. Up your game on the hand washing and overall hygiene situation - or not.


      Please see:

      HSE confirms death of child (4) from strep A infection in east of Ireland

      UK: Alert issued to parents after Strep A kills six children in past month

      UK: Unseasonable & Robust Increase In Scarlet Fever/iGAS Cases

      Netherlands: 7 children die of strep A; strep and chickenpox cases higher than usual

      Discussion - Thoughts on a global outbreak of monkeypox

      CT: Yale Health sees “unprecedented” number of visits and calls this fall due to flu-like

      Belgium facing an "unprecedented" bronchiolitis epidemic

      CIDRAP- Flu activity climbs higher, more pediatric deaths reported

      CIDRAP- AAP issues guidance on alternatives to in-shortage amoxicillin

      US - Children’s hospitals call on Biden to declare emergency in response to ‘unprecedented’ RSV surge

      Comment


      • France -

        Translation Google

        “Wearing a compulsory mask, a bulwark against respiratory viruses”: the call from patient associations

        EXCLUSIVE. On the eve of the Christmas holidays, in a forum that we are revealing to you, twelve patient associations are asking the government to immediately restore the mask in places of great promiscuity.

        By Elsa Mari and
        Florence Mereo
        December 7 , 2022 at 7:11 p.m. , modified on December 8, 2022 at 6:27 a.m.

        Twelve patient associations urge the government to impose the mask in transport, pharmacies and crowded stores during these end-of-year celebrations. Here is their platform.

        France is facing an unprecedented situation. Three concomitant epidemics threaten it: a ninth wave of Covid , the early arrival of the flu , and the intense circulation of bronchiolitis . The risks are very clear: they concern not only the most fragile, but also our hospital system, which could find itself overwhelmed on the eve of the end of year celebrations.

        Limited means to fight against this “triple epidemic”

        Vaccination against influenza and Covid is a strategy of primary importance. But the shoe pinches since, by the admission of the Minister of Health, the levels of vaccination are very insufficient. The Covid and flu vaccination campaigns this fall have so far been a bitter failure .

        Whatever the reasons, and even if we manage to turn the tide, which we can only sincerely hope, it now seems too late for vaccination alone to be able to contain a situation that is deteriorating day by day. day.

        The therapeutic tools for protecting the most fragile have also been significantly reduced.

        The ineffectiveness of monoclonal antibodies against the BQ1.1 subvariant, now the majority in France, poses unprecedented risks to the 300,000 severely immunocompromised patients , who have already paid a very heavy price for Covid, now deprived of prophylactic treatments.

        The antivirals available today to prevent severe forms of Covid in frail people act as a cure, but have the major drawback of being contraindicated in the event of severe renal and hepatic insufficiency and of exposing patients to risks of drug interactions. They remain grossly under-prescribed to eligible individuals who, as a result, are at increased risk of hospitalization, resuscitation and death.

        A situation that makes people fear the worst for the fragile… But also for the hospital!

        This context poses an immense risk to the most fragile, infants, seniors, immunocompromised. But it also exposes our hospital, which is already in a highly critical situation, as well as all the patients who are or will be treated there, for whatever reason, to possible submersion in the next few weeks.

        Such a situation would be tragic and must absolutely be prevented. All the means that can contribute to this must be used simultaneously.

        Wearing a mask is one of them.

        For the moment, everyone decides whether or not to wear the mask, even if the Prime Minister has solemnly called for it to be worn “as soon as we are with fragile people or on public transport”.

        Interviewed on December 3 by Le Journal du Dimanche , Professor Brigitte Autran, President of the Committee for Monitoring and Anticipating Health Risks (COVARS), pleads for “strengthening the wearing of masks, as much as possible in closed places where there is significant promiscuity”, without however recommending making its wearing compulsory, considering that it is up to the government to decide.

        But these various calls have a very limited effectiveness: it is clear that wearing a mask remains a minority, in transport, in community pharmacies, or even in crowded stores in December, in generally ventilated conditions. insufficient.

        This situation is no longer tenable.

        Faced with its seriousness and its challenges, our associations are calling for the wearing of a mask to become compulsory again in areas of great promiscuity.

        The mask is sometimes painful to wear and certainly it makes the glasses fog up. But today, this tool, whose usefulness has been demonstrated, should help to reduce the pressure on health establishments and the professionals who work there. It must also contribute to the solidarity protection of the most vulnerable, by allowing them to escape the risks of contracting the virus, and sometimes of dying from it.

        Let's protect hospital. Let's protect the patients. Protect caregivers. Protect the most vulnerable among us. Let's protect each other.

        Signatories: ADMD, AFH, Help to Help, Heart Alliance, ANDAR, ELLyE, Cairo Federation, FFAAIR, Les Séropotes, Patients in the network, Renaloo, RoseUp.

        https://www.leparisien.fr/societe/sa...DLNOXACLO4.php
        "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
        -Nelson Mandela

        Comment


        • China risks between 1.3 and 2.1 million deaths if it ends its zero-COVID strategy

          Posted on Nov 27, 2022

          Analysis by Airfinity shows between 1.3 and 2.1 million lives could be at risk if China lifts its zero-COVID policy given low vaccination and booster rates as well as a lack of hybrid immunity.

          Airfinity’s risk analysis uses cumulative peak cases and deaths from Hong Kong's BA.1 wave as a proxy for mainland China.

          Hong Kong took a zero-COVID approach for the first two years of the pandemic. Therefore, when the more transmissible Omicron BA.1 sublineage hit back in February, population immunity from infection was low. This, combined with a low vaccine coverage, led to a huge wave of both infections and deaths, especially amongst the elderly.
          '
          Mainland China has very low levels of immunity across its population. Its citizens were vaccinated with domestically produced jabs Sinovac and Sinopharm which have been proven to have significantly lower efficacy and provide less protection against infection and death.

          This vaccine induced immunity has waned over time and with low booster uptake and no natural infections, the population is more susceptible to severe disease. China’s current booster uptake in over 80's is 40%, whilst Hong Kong’s primary series uptake was 34% back in February 2022 when it saw a large spike in cases due to the BA.1 omicron variant.

          ...
          https://www.airfinity.com/articles/c...its-zero-covid
          "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
          -Nelson Mandela

          Comment


          • Translation Google

            Covid-19: a disease that will probably never be eradicated and a taste of the future

            By SudOuest.fr with AFP
            Published on 12/12/2022 at 6:40 a.

            Experts anticipate a gradual transformation of the pandemic into an endemic virus, continuing to circulate and causing regular resurgences of the disease, such as measles or influenza

            Three years ago, the Covid-19 upset the planet. The pandemic is not over and researchers warn that we must expect other epidemics by learning the lessons of the crisis it has generated to better prepare for them.

            Is the Covid pandemic over soon?

            “We are not there yet,” warned the World Health Organization (WHO) in early December. While at least 90% of the world's population has some form of immunity, "gaps in surveillance, testing, sequencing, and vaccination continue to create the perfect conditions for the emergence of a concerning new variant that could cause significant mortality , ”warned its director general Tedros Adhanom Ghebreyesus.

            It is the WHO that declares the end of a pandemic. “It is always an extremely important moment, often subject to controversy”, notes Philippe Sansonetti, microbiologist at the Institut Pasteur , judging that the organization was probably not ready to “whistle the end” of the pandemic. Rather, what experts anticipate is a gradual transformation of the pandemic into an endemic virus, continuing to circulate and causing regular resurgences of the disease. This is the case today with measles or the seasonal flu.

            Can we eradicate this disease one day?

            It is very unlikely. The SARS epidemic (severe acute respiratory syndrome) which broke out worldwide in 2003 and caused almost 800 deaths, was able to be stemmed by isolation and quarantine measures. A virus, smallpox, was already declared "eradicated" in 1980 thanks to a WHO vaccination campaign.

            But this scenario remains extremely rare. “To eradicate a virus, it is necessary that the disease is clinically visible, that there is no animal reservoir, and to have a very effective vaccine, which protects for life. Covid-19 ticks all the wrong boxes,” emphasizes Philippe Sansonetti. Some of the carriers of Covid-19 are indeed asymptomatic, which affects isolation measures. And, unlike smallpox, the virus is transmitted to animals and could continue to circulate among them and reinfect humans. Finally, vaccines provide good protection against severe forms of the disease but little against reinfections, and booster doses are still necessary.
            ...
            What are the main risks ahead?

            For Étienne Simon-Lorière, Director of the Evolutionary Genomics Unit for RNA Viruses at the Institut Pasteur, "today we allow the virus to circulate far too much": each time it infects a person, mutations can appear. and are likely to cause it to evolve into more or less severe forms. “Even if it suits us all to believe that, we have no reason to think that it will become more sympathetic”.

            In addition, other respiratory viruses could emerge: since the appearance of Sars, Mers, and Sars-Cov2, “we have found a good dozen coronaviruses in bats which could potentially infect humans”, notes Arnaud Fontanet, specialist in emerging diseases at the Institut Pasteur.

            About 60%/70% of emerging diseases are of zoonotic origin, ie they are naturally transmitted from vertebrate animals to humans and vice versa. By occupying larger and larger areas of the globe, by travelling, by intensifying their interactions with animals, humans contribute to disrupting the ecosystem and favoring the transmission of viruses.

            How to prepare for it?

            For Arnaud Fontanet, “much can and must be done at the start of an epidemic”. Thus, in 2020, Denmark decided on confinement very early, which allowed it to get out of it more quickly. Another imperative: “to have the capacity to develop very early tests”, at the start of an epidemic, so as to isolate patients very quickly. “Unfortunately, today we are still in the reaction, not in the anticipation”, regrets the researcher.

            At the international level, the "one health" concept, which appeared in the early 2000s, which promotes a global approach to health issues with close links between human health, animal health and the environment, is new emphasis. A draft global agreement on the management of pandemics was also under discussion last week in Geneva, in the hope of avoiding the mistakes that marked the fight against Covid-19.

            https://www.sudouest.fr/sante/corona...r-13348275.php
            "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
            -Nelson Mandela

            Comment


            • Emily
              Emily commented
              Editing a comment
              WHO will not be able to turn the whole world into Denmark with reactive control measures. Denmark has a long history of overall good health and prosperity and a culture that reflects that.

              https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7217796
              The Covid-19 pandemic in Denmark: Big lessons from a small country

          • I moved the World Cup reporter deaths post to:

            https://flutrackers.com/forum/forum/...ously-in-qatar
            _____________________________________________

            Ask Congress to Investigate COVID Origins and Government Response to Pandemic H.R. 834

            i love myself. the quietest. simplest. most powerful. revolution ever. ---- nayyirah waheed
            Governments don't have or own souls.

            (My posts are not intended as advice or professional assessments of any kind.)
            Never forget Excalibur.

            Comment


            • WHO Director-General's opening remarks at the media briefing – 14 December 2022

              14 December 2022

              ...
              One year ago, Omicron had just been identified and was starting to take off.

              At that time, COVID-19 was killing 50,000 people each week. Last week, less than 10,000 people lost their lives.

              That’s still 10,000 too many – and there is still a lot that all countries can do to save lives – but we have come a long way.

              We’re hopeful that at some point next year, we will be able to say that COVID-19 is no longer a global health emergency.

              The criteria for declaring an end to the emergency will be among the topics of conversation when the Emergency Committee meets in January.

              Of course, this virus will not go away. It’s here to stay, and all countries will need to learn to manage it alongside other respiratory illnesses including influenza and RSV, both of which are now circulating intensely in many countries.

              However, we still face many uncertainties and challenges in 2023.

              Only one in five people in low-income countries has been vaccinated;

              Access to diagnostics and life-saving treatments for COVID-19 remains unacceptably unaffordable and unequal;

              The burden of post-COVID-19 condition is only likely to increase;

              And large gaps in surveillance remain, which is a weakness not only for detecting new variants of COVID-19, but also for monitoring the spread of other infections.

              As we look to end this emergency, we still need to understand how it began.

              We continue to call on China to share the data and conduct the studies that we have requested, to better understand the origins of this virus.

              As I have said many times, all hypotheses remain on the table.

              One of the most important lessons of the pandemic is that all countries need to strengthen their public health systems to prepare for, prevent, detect and respond rapidly to outbreaks, epidemics and pandemics.

              An advanced medical care system is not the same thing as a strong public health system.

              One of the other key lessons of the pandemic is the need for much stronger cooperation and collaboration, rather than the competition and confusion that marked the global response to COVID-19.

              So, I’m very pleased that last week, WHO’s Member States agreed to develop the first draft of a legally binding accord on pandemic prevention, preparedness and response, based on the principles of equity, solidarity and sovereignty.

              Member States will begin discussing this “zero draft” of the pandemic accord, in February.

              Even as the COVID-19 pandemic improved during the course of the year, we were confronted with many other emergencies.
              ...
              https://www.who.int/news-room/speech...-december-2022
              "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
              -Nelson Mandela

              Comment


              • COVID: what we know about new omicron variant BF.7


                Published: December 13, 2022 12.21pm EST

                Author

                Manal Mohammed
                Senior Lecturer, Medical Microbiology, University of Westminster

                ...
                Since the COVID variant omicron emerged in late 2021, it has rapidly evolved into multiple subvariants. One subvariant, BF.7, has recently been identified as the main variant spreading in Beijing, and is contributing to a wider surge of COVID infections in China.

                But what is this new variant, and should we be worried? Although reports from China about this variant’s characteristics are concerning, it doesn’t appear to be growing too much elsewhere in the world. Here’s what we know.

                BF.7, short for BA.5.2.1.7, is a sub-lineage of the omicron variant BA.5.

                Reports from China indicate BF.7 has the strongest infection ability out of the omicron subvariants in the country, being quicker to transmit than other variants, having a shorter incubation period, and with greater capacity to infect people who have had a previous COVID infection, or been vaccinated, or both.

                To put this into context, BF.7 is believed to have an R0, or basic reproduction number, of 10 to 18.6. This means an infected person will transmit the virus to an average of 10 to 18.6 other people. Research has shown omicron has an average R0 of 5.08.

                The high transmission rate of BF.7, taken with the risk of hidden spread due to the many asymptomatic carriers, is understood to be causing significant difficulty in controlling the epidemic in China.

                The symptoms of an infection with BF.7 are similar to those associated with other omicron subvariants, primarily upper respiratory symptoms. Patients may have a fever, cough, sore throat, runny nose and fatigue, among other symptoms. A minority of people can also experience gastrointestinal symptoms like vomiting and diarrhoea.

                BF.7 may well cause more serious illness in people with weaker immune systems.

                BF.7’s mutations

                As omicron has evolved, we’ve seen the emergence of new subvariants better able to escape immunity from vaccination or prior infection. BF.7 is no different.

                BF.7 carries a specific mutation, R346T, in the spike protein of SARS-CoV-2 (a protein on the surface of the virus that allows it to attach to and infect our cells). This mutation, which we also see in BF.7’s “parent” variant BA.5, has been linked with enhancing the capacity of the virus to escape neutralising antibodies generated by vaccines or previous infection.

                A recent study examined the neutralisation of BF.7 in sera (a component of blood that should contain antibodies) from triple-vaccinated healthcare workers, as well as patients infected during the omicron BA.1 and BA.5 waves of the pandemic. BF.7 was resistant to neutralisation, driven partly by the R346T mutation.

                BF.7 around the world

                BF.7 has been detected in several other countries around the world including India, the US, the UK and several European countries such as Belgium, Germany, France and Denmark.

                Despite BF.7’s immune-evasive characteristics, and worrying signs about its growth in China, the variant seems to be remaining fairly steady elsewhere. For example, in the US it was estimated to account for 5.7% of infections up to December 10, down from 6.6% the week prior.

                While the UK Health Security Agency identified BF.7 as one of the most concerning variants in terms of both growth and neutralisation data in a technical briefing published in October (it accounted for over 7% of cases at that time), the most recent briefing says BF.7 has been de-escalated due to reduced incidence and low growth rates in the UK.

                We don’t know exactly why the situation looks different in China. BF.7’s high R0 might be due in part to a low level of immunity in the Chinese population from previous infection, and possibly vaccination too. We should, of course, be cautious about the data from China as it’s based on reports, not peer-reviewed evidence yet.

                An evolving virus

                Since the emergence of SARS-CoV-2 three years ago, the virus has continued to evolve, acquiring genetic mutations more rapidly than expected.

                The emergence of BF.7 and other new variants is concerning. But vaccination is still the best weapon we have to fight COVID. And the recent approval by the UK drugs regulator of bivalent boosters, which target omicron alongside the original strain of SARS-CoV-2, is very promising.

                ...
                https://theconversation.com/covid-wh...nt-bf-7-196323
                "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                -Nelson Mandela

                Comment


                • Translation Google

                  Covid-19: No, the resurgence of the epidemic in China is not due to the lifting of restrictions

                  DISTURBING DYNAMICS “The increased intensity of transmissions occurred long before any change in the strategy” intended to limit contamination

                  20 Minutes with AFP
                  Published on 12/15/22 at 11:49

                  An explosive resurgence of the Covid-19 epidemic has been taking place in China for several weeks. However, on Wednesday, a World Health Organization (WHO) official explained that "China's explosion of cases began long before any easing of Beijing 's zero Covid policy " .

                  On Wednesday, China's health ministry also acknowledged that infections were "increasing rapidly" in the capital. Last week, the government suddenly abandoned its zero Covid strategy, decreeing in particular the end of the automatic placement in a quarantine center for people who tested positive and the cessation of massive screening campaigns.

                  The zero Covid strategy was “no longer the best option”

                  "The explosion of cases in China is not due to the lifting of anti- Covid restrictions," WHO's situation management officer Michael Ryan told reporters at WHO headquarters. health emergency.

                  This official estimated that the “disease has spread rapidly because … control measures in themselves do not stop it”. “The increased intensity of transmissions occurred long before any change in the strategy” intended to limit contamination, underlined the WHO official.

                  The zero Covid strategy was "no longer the best option", according to Michael Ryan. With the dominance of the highly contagious Omicron variant, extremely tough restrictions like those imposed in China do not serve the same purpose as in previous waves when vaccination coverage was low.

                  Accelerate vaccination campaigns

                  These types of measures were used to protect health systems while waiting for an improvement in vaccination coverage, but now their effectiveness is no longer the same, said this WHO official.

                  "Data from areas like Hong Kong show that Chinese inactivated vaccines, with a third dose, are working very well." But “you need this third dose” for the vaccination to be effective, he stressed. Currently, millions of elderly people are still not fully vaccinated and hospitals do not have the resources to handle a massive influx of sick people.

                  https://www.20minutes.fr/monde/40149...e-restrictions
                  "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                  -Nelson Mandela

                  Comment


                • bump this

                  Comment


                  • France -

                    ...
                    Again and again Covid patients, unvaccinated or vaccinated but very fragile, immunocompromised for example. Patients who stay longer than before in the hospital. "It is no longer the same profile as before, very acute, very severe Covid which passes in a few days or then worsens very quickly, explains Dr Peiffer-Smadja.There, these are people who will have a Covid and several complications such as cardiac decompensation . It's very rare that they stay less than a week."

                    Another problem is that the drugs used so far against Covid for these patients, monoclonal antibodies, are less effective. "With the current variants, these antibodies no longer work much, admits Dr. Nathan Peiffer-Smadja. We are really in difficulty therapeutically because there is not much."
                    ...

                    Post #3:
                    https://flutrackers.com/forum/forum/...-unprecedented
                    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                    -Nelson Mandela

                    Comment


                    • WHO Director-General's opening remarks at the media briefing – 21 December 2022

                      21 December 2022
                      ...

                      Certainly, we are in a much better place with the pandemic than we were a year ago, when we were in the early stages of the Omicron wave, with rapidly increasing cases and deaths.

                      But since the peak at the end of January, the number of weekly reported COVID-19 deaths has dropped almost 90%.

                      However, there are still too many uncertainties and gaps for us to say the pandemic is over:

                      Gaps in surveillance, testing and sequencing mean we do not understand well enough how the virus is changing;

                      Gaps in vaccination mean that millions of people – especially health workers and older people – remain at high-risk of severe disease and death;

                      Gaps in treatment mean people are dying needlessly;

                      Gaps in health systems leave them unable to cope with surges in patients with COVID-19, flu and other diseases;

                      Gaps in our understanding of post-COVID-19 condition mean we do not understand how best to treat people suffering with the long-term consequences of infection;

                      And gaps in our understanding of how this pandemic began compromise our ability to prevent future pandemics.

                      We continue to call on China to share the data and conduct the studies we have requested, and which we continue to request.

                      As I have said many times before, all hypotheses about the origins of this pandemic remain on the table.

                      At the same time, WHO is very concerned over the evolving situation in China, with increasing reports of severe disease.

                      In order to make a comprehensive risk assessment of the situation on the ground, WHO needs more detailed information on disease severity, hospital admissions and requirements for ICU support.


                      WHO is supporting China to focus its efforts on vaccinating people at the highest risk across the country, and we continue to offer our support for clinical care and protecting its health system.

                      ===

                      https://www.who.int/news-room/speech...-december-2022
                      "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                      -Nelson Mandela

                      Comment


                      • Originally posted by Pathfinder View Post
                        WHO Director-General's opening remarks at the media briefing – 21 December 2022

                        21 December 2022
                        ...

                        Certainly, we are in a much better place with the pandemic than we were a year ago, when we were in the early stages of the Omicron wave, with rapidly increasing cases and deaths.

                        But since the peak at the end of January, the number of weekly reported COVID-19 deaths has dropped almost 90%.

                        However, there are still too many uncertainties and gaps for us to say the pandemic is over:

                        Gaps in surveillance, testing and sequencing mean we do not understand well enough how the virus is changing;

                        Gaps in vaccination mean that millions of people – especially health workers and older people – remain at high-risk of severe disease and death;

                        Gaps in treatment mean people are dying needlessly;

                        Gaps in health systems leave them unable to cope with surges in patients with COVID-19, flu and other diseases;

                        Gaps in our understanding of post-COVID-19 condition mean we do not understand how best to treat people suffering with the long-term consequences of infection;

                        And gaps in our understanding of how this pandemic began compromise our ability to prevent future pandemics.

                        We continue to call on China to share the data and conduct the studies we have requested, and which we continue to request.

                        As I have said many times before, all hypotheses about the origins of this pandemic remain on the table.

                        At the same time, WHO is very concerned over the evolving situation in China, with increasing reports of severe disease.

                        In order to make a comprehensive risk assessment of the situation on the ground, WHO needs more detailed information on disease severity, hospital admissions and requirements for ICU support.


                        WHO is supporting China to focus its efforts on vaccinating people at the highest risk across the country, and we continue to offer our support for clinical care and protecting its health system.

                        ===

                        https://www.who.int/news-room/speech...-december-2022
                        hat tip Michael Coston for the tip on the death reduction number today.



                        I do not know what the WHO is talking about!?!?

                        China REDUCED their death count by one today. How can China possibly have severe COVID-19 disease if only 8 deaths have been announced since December 1 (in a country with over 1.4 billion people)? Obviously something is amiss.

                        Here is the government report. My bolding:




                        The latest situation of the novel coronavirus pneumonia as of 24:00 on December 20


                        Release time: 2022-12-21


                        From 00:00 to 24:00 on December 20, 31 provinces (autonomous regions, municipalities directly under the central government) and the Xinjiang Production and Construction Corps reported 3,101 new confirmed cases. Among them, 52 were imported cases (18 in Guangdong, 17 in Sichuan, 4 in Heilongjiang, 4 in Shanghai, 4 in Shandong, 3 in Liaoning, 1 in Chongqing, and 1 in Gansu); 3,049 local cases (1,171 in Guangdong, 1 in Beijing) 544 cases, 245 cases in Jiangxi, 204 cases in Chongqing, 184 cases in Fujian, 127 cases in Yunnan, 119 cases in Hunan, 108 cases in Shanghai, 86 cases in Sichuan, 59 cases in Tianjin, 37 cases in Zhejiang, 36 cases in Henan, 32 cases in Shanxi, and 22 cases in Shaanxi , 17 cases in Shandong, 16 cases in Guizhou, 15 cases in Hebei, 7 cases in Jiangsu, 6 cases in Heilongjiang, 5 cases in Qinghai, 4 cases in Guangxi, 3 cases in Inner Mongolia, and 2 cases in Hainan). There were no new deaths. There were 12 new suspected cases, all local cases (all in Shanghai).
                        There were 1,953 newly cured and discharged cases on that day , including 44 imported cases and 1,909 local cases (993 in Guangdong, 360 in Beijing, 127 in Yunnan, 76 in Chongqing, 75 in Fujian, 72 in Sichuan, 30 in Henan, and 30 in Guizhou. 30 cases, 21 cases in Hubei, 19 cases in Shaanxi, 15 cases in Liaoning, 13 cases in Hainan, 12 cases in Heilongjiang, 10 cases in Shanghai, 10 cases in Zhejiang, 9 cases in Shandong, 8 cases in Inner Mongolia, 7 cases in Jiangsu, 6 cases in Hebei, and 5 cases in Shanxi , 5 cases in Hunan, 3 cases in Tianjin, 1 case in Anhui, 1 case in Guangxi, and 1 case in Qinghai), 54,918 close contacts were released from medical observation, and the number of severe cases increased by 53 from the previous day.
                        There are 475 confirmed cases imported from abroad (no severe cases), and no existing suspected cases. A total of 28,760 confirmed cases, a total of 28,285 cured and discharged cases, and no deaths.
                        As of 24:00 on December 20, according to reports from 31 provinces (autonomous regions, municipalities directly under the Central Government) and the Xinjiang Production and Construction Corps, there were 37,111 confirmed cases (including 329 severe cases), a total of 343,855 cured and discharged cases, and a total of 5,241 deaths. * , a total of 386,276 confirmed cases have been reported , and there are 31 suspected cases. A total of 15,345,209 close contacts have been traced, and 252,610 close contacts are still under medical observation.
                        A total of 9,096,294 confirmed cases have been reported from Hong Kong, Macao and Taiwan . Among them, there were 489,096 cases in Hong Kong Special Administrative Region (106,785 cases were discharged, 11,243 deaths), 1,659 cases in Macau Special Administrative Region (1,270 cases were discharged, 16 deaths), and 8,605,539 cases in Taiwan (13,742 cases were discharged, 14,931 deaths).
                        Remarks: * Beijing reduced 1 case


                        http://www.nhc.gov.cn/xcs/yqtb/20221...e7c9758a.shtml

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                          China - Controversy about the counting of COVID-19 cases

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                          • Translation Google

                            Covid-19: “We are not at all on the end of the pandemic”

                            The Swiss epidemiologist and director of the Geneva Institute of Global Health, Antoine Flahault, analyzes for Capital the peak of the ninth wave of Covid-19, which France has just passed.

                            By Caroline Robin
                            Health journalist
                            Published on 21/12/2022 at 4:26 p.m. & Updated 22/12/2022 at 7:27 am

                            Can we really be happy to have reached the epidemic peak? Admittedly, the very first was life-saving and gave hope of emerging from particularly drastic confinement at the start of the Covid-19 pandemic. But things are different today. In particular because there are nine epidemic waves… including five, in 2022 alone . And that barrier gestures are no longer the norm within the population, despite the appeals to the French launched by the government in the midst of the triple epidemic of Covid, influenza and bronchiolitis. A report which, for the Swiss epidemiologist and director of the Geneva Institute of Global Health, Antoine Flahault, does not make it possible to predict the end of the Covid-19 pandemic. Maintenance.

                            Capital: That's it, France has crossed the peak of the ninth wave. But after so many epidemic waves, we know the song. Should we fear a rebound very quickly after Christmas?

                            Antoine Flahault : Indeed, we have seen an acceleration of the pandemic over the past year. In 2022, there were five waves in total, compared to only two in 2020 and 2021. Almost everyone was infected with Omicron. We are clearly not at all on the end of the pandemic, but rather on a very strong acceleration. We hardly see any respite, or even between two epidemic waves as in the summer of 2020. We no longer see mortality relapse. We are increasingly in a permanent high transmission plateau.

                            Capital: Is it the fault of a lesser application of barrier gestures? The government is content to recommend wearing a mask without making it compulsory...

                            Antoine Flahault : Yes, that completely explains the high level of contamination. We could live with it if the level of mortality was at the level of the flu . However, the mortality linked to Covid-19 is 4 to 5 times higher than for the flu. We are not taking all the measures that we could implement today to try to remedy this.

                            Capital: The Committee for monitoring and anticipating health risks (Covars) does not give a clear opinion on the wearing of a mask. Do you think it should be made compulsory?

                            Antoine Flahault: There are studies that show that in the United States, the obligation to wear a mask is much more effective than simply recommending it. In any case, in the West, the recommendation of the mask is not sufficient. Or, we could recommend the FFP2 mask to fragile people who are the only ones to wear the mask in transport and closed places. At least it would protect them better. It is a pity that the French health authorities are not very clear on this subject. As for the surgical mask, it is altruistic. He protects others above all else. So it is only effective if we all wear it. But to impose it, it would be necessary to define a numerical threshold, beyond which the mask is imposed in closed places.

                            Capital: From which indicator? The alert threshold for the incidence rate formerly set at 50 cases per 100,000 seems very far away...

                            Antoine Flahault: It's to be discussed with the scientists. We should perhaps not define the obligation to wear a mask on the basis of the level of contamination because this data depends on the number of tests carried out. We could possibly start from the level of hospitalizations or admissions to critical care. For example, from 1,500 people hospitalized for Covid, the mask is imposed.

                            In any case, a rule is missing which imposes the mask in an enclosed place where the CO2 sensor displays more than 600 ppm (part per million, editor's note) . If the rate is below 600 ppm indoors, the mask is less useful.

                            Capital: Precisely, what about air quality among health prevention measures? The pandemic has highlighted this problem, but we seem to be treading water.

                            Antoine Flahault:I like to take the example of water quality. Historically, the dangers of drinking water date back to the mid-19th century. John Snow discovered the reasons for the cholera epidemics in London, it was the fact of drinking the water of the Thames. The epidemic stopped after his demonstration. But it took 50 years for the public authorities to bring drinking water to homes. You don't realize it, but you flush toilets with water as pure as that of Evian. Thus, more risk of cholera. And I think we have the same problem with Covid-19. We breathe air polluted by viruses exhaled by others. And when we go to a closed place, we breathe an air whose quality we do not know. I think it will take some time between awareness and the moment when we proceed with the infrastructure works. Be that as it may, a more ambitious vision of buildings is needed.

                            https://www.capital.fr/economie-poli...ndemie-1455506
                            "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                            -Nelson Mandela

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