Ukraine War discussion - Threat to Public Health

[Pathfinder]

China -

Foreign Ministry Spokesperson Wang Wenbin’s Regular Press Conference on September 21, 2022
...
Bloomberg: Earlier, President Vladimir Putin said in a televised address that he would use all available means in the fight over Ukraine. What’s the foreign ministry’s comment on Vladimir Putin’s latest words about the escalation of force on Ukraine?

Wang Wenbin: China’s position on the Ukraine crisis is consistent and clear. We call on the parties concerned to resolve the issue through dialogue and negotiation and find a solution that accommodates all parties’ legitimate security concerns. We also hope the international community will create conditions and space for that.
...
TASS: The People’s Republic of Donetsk and Luhansk, Kherson and Zaporizhzhia said that they will hold referendums on joining Russia from September 23 to 27. Do you have any comments on this?

Wang Wenbin: China’s position on the Ukraine issue is consistent and clear. We believe that all countries deserve respect for their sovereignty and territorial integrity, that the purposes and principles of the UN Charter should be observed, that the legitimate security concerns of any country should be taken seriously, and that support should be given to all efforts that are conducive to peacefully resolving the crisis. We call on the parties concerned to properly address differences through dialogue and consultation. China stands ready to work with members of the international community to continue to play a constructive part in deescalation efforts.
...
Reuters: Just to follow up on the questions about President Vladimir Putin’s televised address today, in these remarks, he also said that Russia would launch a partial military mobilization. This is Russia’s first mobilization since World War II. Is the foreign ministry concerned about how the situation is developing given that a military mobilization hasn’t been announced in such a long time?

Wang Wenbin: I already stated China’s position on the Ukraine crisis and I’m not going to go over it again.
...
https://www.fmprc.gov.cn/mfa_eng/xwf..._10769255.html

 

[Pathfinder]

max seddon

@maxseddon
Russia's defense ministry has confirmed it withdrew from Lyman, less than 24 hours after Putin claimed the area as part of Russia. This is a major setback. Clearly mobilization and rhetorical escalation aren't enough to turn the battlefield tide yet.

ft.com
Ukrainian forces encircle thousands of Russian troops in key eastern city
Kyiv edges towards full control of Lyman, a staging ground for Russian troops, in blow to Putin
8:23 AM · Oct 1, 2022·Twitter Web App

--------------------------------------

max seddon

@maxseddon
·
1h
Replying to
@maxseddon
Ramzan Kadyrov absolutely lays into Russia's general staff for losing Lyman – the starkest infighting we've seen among Russian forces so far. He calls on Putin to retaliate by declaring martial law on the border and using low-yield nuclear weapons.

t.me
Kadyrov_95
Я всегда говорил: нет ничего лучше озвученной правды, пусть горькой, обидной, но правды. Только так можно двигаться вперед. Поэтому я не могу молчать о том, что произошло в Красном Лимане. Обороной...

-------------------------------------
max seddon

@maxseddon
·
1h
Lots of Russian officials have bragged about Russia's nuclear capabilities in the last few months. But this is the first time any of them have called on Putin to actually use them. A lot of talk about this in elite circles in Moscow in recent weeks. This is a dangerous moment.

 

[Emily]

"But this desperation is very dangerous right now because they are losing again just south of Kharkov. And there are people in Washington talking about 'what else can we do?' There's actually talk about fighting and then winning a limited nuclear war, which, of course, is delusional. And we should have given up on that decades ago, but it's coming back in vogue."

Recorded September 9

 

[Emily]

https://www.sciencedirect.com/science/article/pii/S2589871X22000699
Sarah I. Ashbridge, Patrick S. Randolph-Quinney, Rob C. Janaway, Shari L. Forbes, Olga Ivshina,
Environmental conditions and bodily decomposition: Implications for long term management of war fatalities and the identification of the dead during the ongoing Ukrainian conflict,
Forensic Science International: Synergy,
Volume 5,
2022,
100284,
ISSN 2589-871X,
https://doi.org/10.1016/j.fsisyn.2022.100284.

1. Introduction

On 24 February 2022, Russia invaded Ukraine in what they referred to as a ‘special military operation’. Since then, both Russia and Ukraine have incurred heavy losses, though there remains great discrepancy between the deaths reported by both nations. In recent joint international interventions following mass casualty incidents, the majority of operations have been situated within countries in the global south; particularly within nations which do not have the appropriate medico-legal surviving infrastructures to provide the relief required in an emergency situation where high levels of deaths have been incurred. Two examples of this are the Asian Tsunami of 2004 and Haitian earthquake of 2010. The Asian Tsunami of 2004 had an epicentre 200 km west of Sumatra, with the resulting Tsunami impacting on coastal areas of Sri Lanka, Maldives, Indonesia, Malaysia, Thailand and India. It is estimated 227,000 deaths. The Haitian Earthquake 2010 of 7.0 magnitude resulted in death toll of 220,00, while the larger magnitude (7.2) earthquake of 2021 resulted in fewer fatalities of 2000. Both mass fatalities of 2004 and 2010 had considerable, multinational responses, which were challenged by scale, extent, and conditions, and resulted in operational protocols being reviewed [[1], [2], [3], [4], [5], [6]]. In Ukraine, there are robust forensic infrastructures at local and national levels, with well educated, trained and experienced staff. These infrastructures are connected to international structures such as the International Committee of the Red Cross (ICRC) and International Commission on Missing Persons (ICMP). Despite strong facilities and established procedures in Ukraine at the outset of the conflict, the intensity and nature of the fighting within densely populated areas has resulted in considerable civilian and military fatalities, inevitably this has led to temporary burials conducted during or during a lull in fighting. In areas retaken by Ukraine forces there has been considerable local effort to exhume bodies from temporary graves and to identify the remains using primarily DNA [7]. However, the scale of this activity is disproportionate to the scale of the casualties....

 

[Pathfinder]

Pope Francis
@Pontifex
·1 day ago

After seven months of hostilities in #Ukraine, let us use all diplomatic means, even those that have not been used so far, to bring an end to this terrible tragedy. War is an error and a horror! #Russia #Peace
...
I urge the protagonists of international life and the political leaders of nations to do everything possible to bring an end to the war, without being drawn into dangerous escalations, and to promote and support initiatives for dialogue. #Russia #Peace
...
Profoundly saddened by the immense suffering of the Ukrainian people as a result of the aggression they have suffered, I address an equally confident appeal to the President of #Ukraine to be open to serious proposals for peace.
@ZelenskyyUa
...
My appeal is addressed first and foremost to the President of the Russian Federation, imploring him to stop this spiral of violence and death, also for the sake of his own people. #Ukraine #Russia
@KremlinRussia_E
...
Let negotiations begin that will lead to solutions that are not imposed by force, but consensual, just and stable, based on respect for human life, as well as the sovereignty and territorial integrity of each country, and the rights of minorities. #Ukraine #Russia
...
I deeply deplore the grave situation that has arisen in recent days, with further actions contrary to the principles of international law. The risk of nuclear escalation thus increases giving rise to fears of uncontrollable and catastrophic consequences worldwide #Ukraine #Russia
...
The war in #Ukraine has become so serious, devastating and threatening as to cause great concern. In the name of God and of the sense of humanity that dwells in every heart, I renew my call for an immediate ceasefire. #Russia #Peace

 

[Emily]

https://www.sciencedirect.com/science/article/abs/pii/S0195670121001419
V. Kondratiuk, B.T. Jones, V. Kovalchuk, I. Kovalenko, V. Ganiuk, O. Kondratiuk, A. Frantsishko,
Phenotypic and genotypic characterization of antibiotic resistance in military hospital-associated bacteria from war injuries in the Eastern Ukraine conflict between 2014 and 2020,
Journal of Hospital Infection,
Volume 112,
2021,
Pages 69-76,
ISSN 0195-6701,
https://doi.org/10.1016/j.jhin.2021.03.020.
(https://www.sciencedirect.com/science/article/pii/S0195670121001419)
Abstract: Summary
Background
Infections from the recent conflict in Ukraine have been poorly investigated.
Aim
To describe the phenotypic and genotypic mechanisms of antibiotic resistance in pathogens associated with war injuries in the Ukraine conflict.
Methods
This report describes a retrospective multi-centre microbiological survey conducted in four Ukrainian military hospitals between 2014 and 2020. The phenotypes of 813 organisms obtained from 1061 tests of 162 patients were analysed. Fifty-two isolates underwent whole-genome sequencing.
Findings
Resistance was highest in Acinetobacter baumannii, with 92.5% ((48/52) 95% confidence interval (CI) 81.8–97.9) resistant to fluoroquinolones, 83.0% ((43/52) 95% CI 70.2–91.9) resistant to aminoglycosides, and 67.9% ((37/52) 95% CI 53.7–80.1) resistant to carbapenems. In contrast, resistance to carbapenems was 55.6% ((30/52) 95% CI 41.4–69.1) in Pseudomonas aeruginosa, 42.9% in Escherichia coli ((12/28) 95% CI 24.5–62.8), and 32.8% in Klebsiella pneumoniae ((20/34) 95% CI 21.3–46.0). Multi-drug-resistant strains harboured an abundance of antibiotic resistance genes. K. pneumoniae co-produced class A and D β-lactamases, in one case with blaNDM-1 and rmtC 16S rRNA methyltransferase. A. baumannii carried class A and D β-lactamases but not metallo-β-lactamases; in four isolates, carbapenemases were present with the RmtASE gene armA. P. aeruginosa harboured a wide range of class A and D β-lactamases along with metallo-β-lactamases, as well as the RmtB4 RmtASE gene. Gram-positive cocci were generally sensitive to the tested antibiotics.
Conclusion
The incidence of resistance among the studied pathogens was higher than that in Ukrainian civilian hospitals and European countries. The discovery of P. aeruginosa, A. baumannii, and K. pneumoniae co-producing carbapenemases and RmtASEs is of particular importance, and hospitals should be vigilant for their emergence.
Keywords: Military; Ukraine; Whole-genome sequencing; Phenotype; Bacterial multiple drug resistance

 

[Emily]

September 2022 paper - translated a bit. Sounds very bad.
ETA: Partial machine translation added.

https://edoc.rki.de/bitstream/handle...=1&isAllowed=y
Infektionsmedizinische und chirurgische Herausforderungen
durch Carbapenem-resistente bakterielle Erreger
bei der Versorgung Kriegsverletzter aus der Ukraine

Suggested citation
Dietze N, Trawinski H, Schönherr SG, Lippmann N,
Ranft D, Fichtner F, Laudi S, Notov D, Höch A,
Kleber C, Lübbert C: Infectious medicine and surgical
surgical challenges posed by carbapenem-
resistant bacterial pathogens during the care of
war casualties from Ukraine.
Epid Bull 2022;36:3-10 | DOI 10.25646/1044

Introduction
At Leipzig University Hospital (UKL), a risk-adapted screening for
risk-adapted screening for multiresistant pathogens (MRE) since 2012.
pathogens (MRE) since 2012.1 The introduction of comprehensive
introduction of comprehensive screening measures
was prompted by a prolonged outbreak in the years
years 2010 to 2013 caused by a KPC2forming
Klebsiella pneumoniae strain (sequence type ST258),
which was transmitted by transfer/repatriation of a ventilator
patient requiring ventilation from Rhodes, Greece.
Greece.2,3 The inclusion criteria of the risk-adjusted
criteria for risk-adapted screening at the UKL include the
at the UKL include transfer from another medical
from another medical care facility or
or origin/return from a country with a high risk for
at high risk for the spread of MRE.4
Civilian victims of the armed conflicts in
of the war in Ukraine are increasingly having to
of the local health care system, civilian victims of the
be treated in other countries due to the overload of the local
and are transported to Germany via the "cloverleaf concept "5 as part of the
European aid to Germany, among other things.
Germany as part of European aid. The surgical challenges posed
The surgical challenges of taking on war casualties are
by the high risk of serious wound infections
infections caused by MREs and extensive bone
defects. The risk for
infections is increased when patients are taken over from
patients from Ukrainian military hospitals is described as high.6
hospitals is described as high.6 In addition to hygiene deficits, this
This is due not only to hygiene deficits, but also to a very
antibiotics are used in a very broad, calculated manner with simultaneous
treatment of open wounds at the same time. This results in a high
high selection pressure on bacterial pathogens with secondary
secondary, multiresistant deep infections

The goal of this report is to bring attention to the
the complexity of care for war-wounded and other
and other patients from Ukraine and the associated
and the associated infection and re-infection risks....

Methods
Microbiological and clinical data of selected
data of selected adult female patients from
Ukraine, who have been admitted to the UKL for medical
UKL since April 2022. In the
retrospective data analysis included all microbiological
results with evidence of multidrug-resistant
multidrug-resistant isolates were included in the retrospective data analysis.
The microbiological screening criteria established at the UKL in 2012
established at the UKL since 2012 applied to all patients
from the Ukraine were applied to all patients
patients. Based on the experience of 2010, the
the transfer of these persons was planned to take place outside
outside of our emergency structures in single rooms on our
to our ward for septic surgery. The
screening included nasal/pharyngeal swabs for the detection of
detection of methicillin-resistant Staphylococcus
aureus strains (MRSA) and rectal swabs to detect multidrug-resistant
for the detection of multidrug-resistant Gram-negative
bacteria (MRGN). For the detection of pathogens
cultural methods using chromogenic media (CHROMagar
media (CHROMagar MRSA, CHROMAgar ESBL and
ESBL and CHROMAgar mSuperCARBA) as well as specific molecular
specific molecular biological methods (MRSAPCR and
methods (MRSAPCR and multiplex carbapenemase
PCR). This allows the detection of mecA (MRSA) and blaVIM
as well as genes of the types blaVIM, blaNDM1, blaKPC,
blaOXA48, blaGES, and blaIMP (gram-negative erga
species) can be detected. The species identi
identification was performed by MALDITOF mass spectrometry.
trometry. For antimicrobial resistance testing, the microbouillon
the microbouillon dilution method according to ISO
ISO 207761 was used for antimicrobial resistance testing.
The subsequent evaluation of the results followed the current...

Translated with www.DeepL.com/Translator (free version)

 

[Pathfinder]

Translation Google


Putin promises 'severe' responses in case of Ukrainian attacks on Russia

France Media Agency| Published on October 10, 2022 at 06:25
AFP

Russian President Vladimir Putin on Monday promised "severe" responses in the event of new Ukrainian attacks against Russia, two days after the partial destruction of the Crimean bridge, strategic infrastructure and symbol of the annexation of the eponymous Ukrainian peninsula.

"If attempts at terrorist attacks on our territory continue, Russia's responses will be severe and their magnitude will correspond to the level of the threats posed," Putin said at the start of a televised meeting of the Russian Security Council.


“No one should have any doubts,” he warned.

https://www.tvanouvelles.ca/2022/10...n-cas-dattaques-urkainiennes-contre-la-russie

 

[sharon sanders]

snip

The leaders of the Group of Seven of the world’s most developed economies will hold an emergency meeting Tuesday to discuss Russia’s war in Ukraine, following coordinated Russian missile strikes on civilian targets in cities across the country. Zelenskyy is also expected to speak at the meeting via videolink.

Top officials in the United States, European Union and at the United Nations expressed shock and horror Monday over the strikes. U.N. Secretary-General Antonio Guterres was “shocked” by the attacks, saying through a spokesperson that they represented an escalation of the war.

The strikes have damaged significant parts of Ukraine’s energy grid, prompting the nation’s energy ministry to announce it would halt exports of electricity to the EU starting Tuesday.

more....

https://www.cnbc.com/2022/10/11/russia-ukraine-live-updates.html

 

[Pathfinder]

...
Oct 11, 10:49 AM EDT

Russia open to Biden-Putin meeting at upcoming G-20 summit

Ahead of the Group of 20 summit in Bali, Indonesia, next month, Russia indicated it may be open to a meeting between President Joe Biden and President Vladimir Putin, Russian Foreign Minister Sergey Lavrov said in an interview with news agency Interfax.

"We have repeatedly said that we never refuse meetings," Lavrov said, according to Interfax. "If a proposal is made, it will be considered by us."

The White House National Security Council pointed to a comment made by Biden on Thursday outside the White House.

When asked by a reporter if he would meet with Putin, Biden responded, "That remains to be seen."

-ABC News' Anastasia Bagaeva and Ben Gittleson

...
https://abcnews.go.com/International/live-updates/russia-ukraine/?id=88905005

 

[Emily]

My bolding. Author is a veteran of the CIA and the State Department’s Office of Counter Terrorism.

https://sonar21.com/there-is-no-single-war-in-ukraine-and-nato-is-in-trouble/
There is No Single War In Ukraine and NATO Is In Trouble

11 October 2022 by Larry Johnson
....
Tank battles on rolling plains is great grist for a Hollywood blockbuster, but the real peril for Ukraine has been on display over the last two days–Russia’s hypersonic missiles, cruise missiles and air launched rockets mangling power nodes and military headquarters throughout Ukraine. The Russian strikes in the last two days significantly degraded Ukraine’s ability to supply electricity and critical heat to its major cities. The attacks also are disrupting Ukraine’s cell phone network and its ability to move troops and equipment from the west to the frontlines in the east.

Ukraine does not have a comparable capability to counter the Russian attacks. Moreover, the Russian missile barrage has highlighter the weakness, if not absence, of Ukraine’s anti-missile defense system. It is neither a mistake nor a coincidence that Russia’s strikes in major Ukrainian cities–more than 100 missiles– caused very few human casualties, especially on the civilian side of the ledger. Despite Ukrainian claims that Russia’s strikes killed civilians, the evidence suggests otherwise–Ukraine’s own anti-missile system failed to intercept the Russian targets and then fell to earth and hit apartments and schools...

 

[Pathfinder]

Putin describes India and China as 'close allies and partners; says they always talked about resolving Ukraine conflict peacefully

PTIASTANAOCTOBER 15, 2022 01:58 IST
UPDATED: OCTOBER 15, 2022 11:53 IST

Russian President Vladimir Putin on Friday described India and China as "close allies and partners" and said that the two Asian giants always talked about the need to initiate a dialogue and resolve the Ukraine conflict peacefully, nearly a month after Prime Minister Narendra Modi told him during a summit that today's era is not of war.
...
"We know their position. These are our close allies and partners and we respect their position,” Putin stressed.

India has not yet condemned the Russian invasion of Ukraine and it has been maintaining that the crisis must be resolved through diplomacy and dialogue.

In a bilateral meeting with President Putin on the sidelines of the annual summit of the Shanghai Cooperation Organisation (SCO) in Samarkand last month, Prime Minister Modi underlined the importance of "democracy, dialogue and diplomacy" while calling for an early cessation of hostilities in Ukraine.

"I know today's era is not of war. We discussed this issue with you on phone several times, that democracy, diplomacy and dialogue touch the entire world. We will have the opportunity to talk today about how we can move forward on the road of peace in the coming days," Modi said in his first in-person meeting with Putin since the Ukraine conflict began in February.

On the sidelines of the SCO Summit, Putin also met Chinese President Xi Jinping, who raised "questions and concerns" over the Ukraine conflict.

This was perhaps for the first time in over six months of Russia's Ukraine war, China, which remained a steadfast ally of Moscow and declined to condemn the invasion, aired its concerns over Putin’s move.

"We highly value the balanced position of our Chinese friends when it comes to the Ukraine crisis. We understand your questions and concerns about this,” Putin was quoted as saying by the Hong Kong based South China Morning Post.
...
https://www.thehindu.com/news/inter...raine-conflict-peacefully/article66012153.ece

 

[Emily]

https://sonar21.com/what-is-russia-planning-to-do-next/
What Is Russia Planning To Do Next In Ukraine?

16 October 2022 by Larry Johnson

In the face of Western reports that Russia is on its heels and retreating, the facts on the ground tell a different story. For starters, Russian allies with embassies still operating in Kiev are shutting down and ordering their personnel to leave Ukraine. This includes China, Tajikistan, Krygyzstan, Uzbekistan, Turkenistan,Serbia, Belarus, India and Egypt. Note that these embassies have remained open during the last seven months of the war with Russia. The decisions to cutback or cease operations is one indicator that these countries expect a major escalation in the war on the part of Russia in the near future.

Another piece of evidence that implies Russia is beefing up for a new offensive comes via Belarus. Russia is moving a large number of trucks, armored personnel carriers and tanks to Belarus. Take a look at these two videos...

 

[Emily]

Russia has been evacuating Kherson. Now that Ukraine has destroyed bridges and the ferry, those remaining will be trapped in the floods, no matter who destroys the dam.

https://www.wsj.com/articles/ukraine...ee-11666351776

Ukraine Strikes Occupied Kherson as More Civilians Flee
Russian forces target Zaporizhzhia and Kharkiv with strikes, causing several injuries

By Yaroslav Trofimov
Updated Oct. 21, 2022 2:51 pm ET
Ukrainian artillery struck the ferry crossing in the southern city of Kherson, the only regional capital captured by Moscow since the February invasion, as Russian forces pounded the cities of Zaporizhzhia and Kharkiv with renewed strikes.

The Russian military had set up ferry crossings after repeated Ukrainian strikes on the Antonivsky bridge, a crucial link with other occupied areas that Russia used to resupply forces in Kherson, made it unusable. The only alternative bridge, over...

https://www.msn.com/en-us/news/world...on/ar-AA13e78r

UPI
Zelensky: Russia to target dam in southern Ukraine to flood Kherson
Clyde Hughes - Yesterday 9:16 AM

Oct. 21 (UPI) -- Ukrainian President Volodymyr Zelensky warned on Thursday that Russia was plotting to blow up a large hydroelectric dam in southern Ukraine, which would cause devastating flooding to Kherson along with 80 other towns and villages.
...

A week ago, Moscow-installed officials in Kherson, which Russia has occupied since early in the war, called for the evacuation of civilians in the area. Russian President Vladimir Putin signed a decree claiming his country has annexed Kherson and three other Ukrainian regions.

Russian Gen. Sergei Surovikin, Moscow's new military commander in Ukraine, said it is Kyiv that is actually planning "banned methods of warfare" in Kherson city and the hydroelectric dam. He said the rumor justified the "evacuation" of the civilian population...

 

[Pathfinder]

Why Now Is the Time for Russia and Ukraine to Talk | Opinion

MICHAEL GFOELLER AND DAVID H. RUNDELL
ON 11/3/22 AT 6:38 AM EDT
...
Ukraine has had historically flexible borders. Until 1918 the city of Lviv, (then Limburg) was Austrian. Between the two world wars, western Ukraine was Polish. Crimea was transferred from the Russian Soviet Socialist Republic to the Ukrainian one only in 1954 primarily to increase the number of Russian speakers in Ukraine. Not counting Crimea, post-Soviet Ukraine has now lost nearly 20 percent of its prewar territory and become almost entirely dependent on foreign arms and financial assistance, three quarters of which is American. Millions have been made homeless or fled the country. As manpower reserves and the tax base collapse, inflation has soared, and infrastructure been systemically destroyed. Despite recent gains, it is not at all clear that Ukraine is winning the war. Yet Ukraine remains a difficult country to help. Its post-Soviet governments have been profoundly corrupt, and one cannot give money endlessly to a man with a hole in his pocket.

Russia on the other hand is largely self-sufficient in food, energy, and armaments. The ruble is stronger today than it was a year ago. Western sanctions have caused more economic havoc in Europe than Russia. It is perhaps worth remembering that Putin's parents lived through the Siege of Leningrad where 600,000 Russians chose to starve to death rather than surrender. It seems unlikely that he will now capitulate because he can no longer buy a Big Mac.

We do, in fact, live in a rules-based world order, and one of the cardinal rules of international relations is that large powers expect to control a sphere of influence that they will fight to defend, as we are prepared to do in Taiwan. One of the principal functions of diplomacy is avoiding or ending the carnage of military conflicts. Most often, that involves talking to people with opposing views whom you neither like nor trust.

What would a negotiated solution look like? It should begin with an honest appreciation of what the local populations want. Support for self-determination has been a central plank of American foreign policy since President Woodrow Wilson went to Versailles. We remain confident that the consent of the governed is the most fundamental form of legitimacy. The Czechs and Slovaks peacefully went their separate ways. Citizens of Quebec were allowed to vote on remaining Canadian. The people of Scotland were given a chance to leave the United Kingdom. The British even got to vote on staying in the European Union. Don't the people of Crimea and the Donbas deserve as much? If we trusted the U.N. to monitor Iran's nuclear activities, surely it can also be trusted to organize and monitor a fair election.

The First Crimean War (1853-1856) ended in a negotiated compromise. In all probability, the Second Crimean War will end the same way. In 1962, when faced with the possibly of nuclear Armageddon during the Cuban Missile Crisis, President Kennedy did his utmost to defuse the situation through independent thinking, negotiations, and compromise. Today, we face a similar situation. There are numerous issues to negotiate, but a ceasefire and plebiscite would be a good place to start. This would be complicated, controversial, and expensive to administer, but so is continuing to support and fund a war. The suffering of the Ukrainian population is getting worse by the day and winter is coming. It is time for creative thinking and effective diplomacy to end this war before it spins further out of control.
...
https://www.newsweek.com/why-now-time-russia-ukraine-talk-opinion-1756438

 

[Emily]

They have taken away access to antibiotics from people just when they need them the most. Now they will die before bringing resistant bacteria to bother the rest of the world.

https://www.bmj.com/content/379/bmj.o2731.full

Melwani M. How war is spreading drug resistant superbugs across Ukraine and beyond BMJ 2022; 379 2731 doi:10.1136/bmj.o2731

The rush to transport patients to specialist aid is driving antimicrobial resistance in Ukraine—and beyond. Mihir Melwani reports

Fifteen year old Ana lost her family to a Russian rocket strike. She survived the attack, but ultimately lost her life to an invisible enemy: drug resistant bacteria.

When rockets fell from the sky on her home in eastern Ukraine—not far from the frontline—Ana was critically wounded and taken to a local hospital. Samples from her wounds were sent to the laboratory for culturing and an infection of a multidrug resistant strain of Klebsiella pneumoniae bacteria was found.

Ana, whose name has been changed for privacy, was suffering from severe bleeding and shrapnel injuries—penetrating pelvic injuries and extreme soft tissue damage to the right thigh. “You can’t imagine the trauma. It was like half of her thigh was just broken,” Denis Surkov, one of the doctors who treated her, describes. The infection spread and sepsis set in. Soon, Ana would experience multiple organ failure, and spend six weeks in an intensive care unit (ICU).

After finally stabilising, she was transferred across the country to Surkov’s western Ukraine paediatric hospital, but the infection was uncontrollable. Septic shock set in again, and four days later Ana became another statistic of the war.

“We collect the most severe paediatric patients from eastern hospitals,” says Surkov, who is deputy medical director for anaesthesiology and intensive care at St Nicholas Children’s Hospital in Lviv. “At least two thirds of patients already have hospital acquired, multidrug resistant strains of bacteria. It’s a huge problem because of high mortality.”

The infection that killed Ana was resistant to all the antibiotics that the hospital had on hand, including imiprenum and menoprenum, often seen as a last resort for the most resistant bacteria.

Hotbed for antimicrobial resistance

Antimicrobial resistance is not a new problem, says Ostap Zubach, an orthopaedic and trauma surgeon at Lviv’s Medical Union Hospital. “People have been fighting it for a while. But in the case of war, it becomes more dramatic.”
Chaotic scenes are now the norm in Ukraine, and proper hygiene has become a victim of the rush to transport the wounded away from battlefields and to specialist help.
Since the war began, Zubach’s patients have been facing major blast wounds—including soft tissue damage, compound fractures, and third degree burns. “Like many Ukrainian doctors, I dream about clear surgery. But war breeds special wounds. Contamination is a big problem,” he says.
Blast injuries from artillery shells and mines mean all sorts of dirt, dust, and metal shrapnel—known as explosive metabolites—are contaminating these wounds, causing infections that aren’t responding to first line antibiotics.
On top of this contamination, the migration of civilians and patients from Ukraine’s east to west has resulted in the spread of bacterial flora from one region to another, increasing the potential for the spread of drug resistant bacteria between patients in hospitals.
Military casualties go through a messy evacuation and hospital admission process, being passed from one ambulance to the next and stabilised by their comrades along the way. Once out of the red zone, they’re brought either to a field hospital or to a nearby regional hospital.
Life comes first on the frontline, and hygiene is not a priority when vehicles are often outrunning targeted Russian shelling and gunfire. A combat medic source reports sanitising his ambulance with a chlorhexidine detergent solution “according to the schedule, not specifically after each casualty.”
Those who require more complex procedures and care are often transported to central or western Ukraine—many to Zubach’s ward—but passing a patient between hospitals has consequences. Zubach receives many patients on medical evacuation trains coming from Ukraine’s east—and the sheer volume of patients carrying the bacterial flora of the emergency departments they’ve been admitted to is causing surges of drug resistant infections. “It’s a wartime traumatic epidemic,” he says.


Too easy to access

Historically, Ukraine has been relaxed in its control of antibiotics. Any patient could go to a pharmacy and buy them without a prescription.
As broad spectrum antibiotics are used for simple infections, sensitive microbes are killed, leaving behind bacteria that are resistant to the given drug.
In August 2022, the Ukrainian ministry of health implemented a new process where all patients are required to obtain a prescription from their doctor before buying antibiotics. This move was introduced to reduce abuse of antibiotics by patients, and is the first step to controlling the outbreak of drug resistant infections...

 

[Emily]

https://www.reuters.com/world/europe...ar-2022-12-08/
'Burn everything': Poland chokes on the smog of war

By Marek Strzelecki and Kuba Stezycki

OLPINY, Poland, Dec 8 (Reuters) - The Tkaczuk family moved from the Polish city of Krakow to the village of Olpiny in the Carpathian foothills in 2018 in search of cleaner country air.
Four years on, as the fallout from the Ukraine war halted Russian gas supplies to Poland, the local authorities postponed a ban on the dirtiest stoves for heating, and air pollution in Olpiny exceeded the norms by four-fold last month.
"I feel completely helpless and abandoned by the state," said Julia Tkaczuk, 38, whose five-year-old son has asthma. "Every sneeze is a warning sign for me."
It's even worse in Krakow, Poland's second-biggest city.
On the night of Nov. 20, as temperatures slipped below zero for the first time this year, the only city in the world with a higher concentration of fine particulate matter (PM 2.5) in the air was New Delhi, according to Airly, an organisation based in California that monitors pollution.
While a number of European countries besides Poland, such as Germany and Hungary, are burning more polluting brown coal, or lignite, to keep the lights on, experts say it's the use of the fuel at home that will have the biggest impact on health.

In the municipality where the Tkaczuk's live, coal is the main heating source and 40% of households use outdated furnaces known as "smokers" because of the poisonous fumes they emit.
Piotr Kleczkowski, a professor at Krakow's AGH University specialising in environmental protection, estimates that the suspension of the ban in the Tkaczuk's province will result in up to 1,500 premature deaths this winter.
Lignite contains several times more sulphur and ash, and five times more mercury, than black coal, and provides three times less energy. Burning it at home spews out a deadly combination of sulphur and mercury, raising the risk of asthma, lung cancer, cardiac arrest and strokes.
"It gets worse: with more sulphur in the air, mercury finds it easier to get into our lungs," said Kleczkowski, referring to the way the two elements combine in polluted air...

 

[Mary Wilson]

VIDEO: https://twitter.com/maria_avdv/statu...79892229398528


Maria Avdeeva@maria_avdv
Kharkiv received body armor for children. I wish this news never existed.

7:22 AM · Dec 15, 2022


Maria Avdeeva@maria_avdv· 15h

Volunteers will use this body armor during the evacuation of children from the areas under Russian shelling.

 

[sharon sanders]

bump this

 

[Emily]

Full text at link.

https://www.sciencedirect.com/science/article/pii/S1878875022011834
Justin K. Zhang, Kathleen S. Botterbush, Kazimir Bagdady, Chi Hou Lei, Philippe Mercier, Tobias A. Mattei,
Blast-Related Traumatic Brain Injuries Secondary to Thermobaric Explosives: Implications for the War in Ukraine,
World Neurosurgery,
Volume 167, 2022, Pages 176-183.e4,
ISSN 1878-8750,
https://doi.org/10.1016/j.wneu.2022.08.073.
(https://www.sciencedirect.com/science/article/pii/S1878875022011834)

Abstract: Blast-related traumatic brain injury (bTBI) is a significant cause of wartime morbidity and mortality. In recent decades, thermobaric explosives have emerged as particularly devastating weapons associated with bTBI. With recent documentation of the use of these weapons in the war in Ukraine, clinicians and laypersons alike could benefit from an improved understanding behind the dynamic interplay between explosive weaponry, its potential for bTBI, and the subsequent long-term consequences of these injuries. Therefore, we provide a general overview of the history and mechanism of action of thermobaric weapons and their potential to cause bTBI. In addition, we highlight the long-term cognitive and neuropsychiatric sequelae following bTBI and discuss diagnostic, therapeutic, and rehabilitation strategies, with the aim of helping to guide mitigation strategies and humanitarian relief in Ukraine. Thermobaric weapons produce a powerful blast wave capable of causing bTBIs, which can be further classified from primary to quaternary injuries. When modeling the hypothetical use of thermobaric weapons in Odessa, Ukraine, we estimate that the detonation of a salvo of thermobaric rockets has the potential to affect approximately 272 persons with bTBIs. In addition to the short-term damage, patients with bTBIs can present with long-term symptoms (e.g., post-traumatic stress disorder), which incur substantial financial costs and social consequences. Although these results are jarring, history has seen radical advancements in the understanding, diagnosis, and management of bTBI. Moving forward, a better understanding of the mechanism and long-term sequelae of bTBIs could help guide humanitarian relief to those affected by the war in Ukraine.

Keywords: Blast-related traumatic brain injury; Post-traumatic stress disorder; Thermobaric weapons; Traumatic brain injury; Ukraine

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