New COVID-19 infections fall globally for first time since September; WHO chief urges ‘extreme caution’
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UN/Canada: Last week saw the first global decline in newly reported cases of COVID-19 since September, the head of the UN World Health Organization (WHO) said on Monday, advising that the news, while welcome, must be interpreted with “extreme caution”.
An 11-year-old boy in India demonstrates the correct way to wear a mask.
Image cedit: UNICEF/Vinay Panjwani
Updating reporters during his regular briefing from Geneva, Director-General Tedros Adhanom Ghebreyesus described the global decline as fragile: brought on by falling cases in Europe, thanks to the difficult but necessary measures countries put in place in recent weeks.
“Gains can easily be lost,” the agency chief said, noting that COVID-19 is still on the rise in most other world regions, with an attendant increase in deaths.
Holidays – no time for complacency
He cautioned against complacency, especially with the holiday season approaching in many cultures and countries. Being with family and friends is not worth placing anyone at risk. “We all need to consider whose life we might be gambling with in the decisions we make.”
To be sure, the pandemic will change the way people celebrate, Tedros said. It will be important to follow local and national guidelines. For many, this is a season for staying home, avoiding crowded shopping centres, or ideally, making use of online shopping if possible. “Avoid gatherings with many different households and families coming together,” he said.
If travelling is essential, take precautions, he said: maintain distance from others and wear a mask in airports and train stations, as well as on planes, trains and buses. Cary hand sanitiser or wash hands frequently with soap and water. If feeling unwell, “don’t travel,” he insisted.
Disrupted services, increased risks for people living with HIV
For millions, COVID-19 is only one health they face, he said. People living with HIV also may have an increased risk of severe disease or death from COVID-19, he said.
A record 26 million people are on antiretroviral treatment – but the pace of increase has slowed, leaving 12 million people who are living with HIV without treatment. “12 million is big,” he assured.
A WHO survey of 127 countries earlier this year found that more than one quarter reported partial disruption to antiretroviral treatment.
However, with support from WHO, the number of countries reporting disruptions in HIV services has declined by almost 75 per cent since June. Only nine still report disruptions and only 12 report a critically low stock of antiretroviral medicines.
Such successes are mainly due to countries implementing WHO guidelines, he said, including providing longer antiretroviral prescriptions for 3 to 6 months, so patients can avoid health facilities. WHO also has worked closely with manufacturers and partners to ensure adequate supply of treatment.
Innovation, Innovation, Innovation
Moreover, he said countries also have introduced adaptations and innovations during COVID-19. In Africa, for example, many have built their testing system for COVID-19 on the existing lab infrastructure for HIV and tuberculosis. In Thailand, the Government has maintained pre-exposure prophylaxis services and tele-health counselling for men who have sex with men. And many countries have introduced more self-testing for HIV to support self-care.
WHO is urging all countries to maintain these innovations as part of the “new normal”, Tedros said, and to help expand testing and treatment.
With Worlds AIDS Day approaching on 1 December, he called for preserving the “incredible” gains made over the past 10 years: New HIV infections have declined by 23 percent since 2010, and AIDS-related deaths have fallen by 39 per cent.
Hope above all“If the pandemic has taught us anything, it is that in the face of an urgent health threat, the world can come together in new ways to defeat it,” he assured.
The world can defeat the pandemic using existing tools and the vaccines now in the pipeline. “The most important thing is, we need to have hope,” he said. And solidarity to work together.
WHO launches new roadmap on human resource strategies to ensure that all newborns survive and thrive
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WHO/Canadian-Media: Every year, an estimated 15 million babies are born preterm – before 37 weeks of pregnancy. That is more than 1 in 10 live births. Approximately 1 million children die each year worldwide due to complications from their early birth. Those that survive often face a lifetime of ill-health including disability, learning difficulties, and visual and hearing problems.
Image credit: Official Logo
Half of the babies born at or below 32 weeks (2 months early) die in low-income settings, due to a lack of feasible, cost-effective care, such as warmth, breastfeeding support, and basic care for infections and breathing difficulties. In high-income countries, almost all these babies survive.
On World Prematurity Day observed on Nov 17, WHO launched a new Roadmap on human resource strategies to improve newborn care in health facilities in low- and middle-income countries, aimed at improving quality of care for newborns, including small and sick babies, and supporting countries to achieve the SDG target to reduce neonatal mortality to less than 12 per 1000 live births by 2030.
As the COVID-19 pandemic overburdens already weak health systems in many countries, it is expected to increase the number of newborn deaths, particularly among babies born too soon. Disrupted essential health services, like family planning or antenatal check-ups, will leave women more at risk of preterm birth and vulnerable infants without the services they need.
“We have the power to prevent, diagnose and treat preterm birth, and save babies lives, if we invest in competent and specialized nurses and health workers to care for them,” Dr Anshu Banerjee, WHO Director for the Department of Maternal, Newborn, Child and Adolescent Health and Ageing. “As more pregnant women give birth in health facilities, we must also strengthen our health workforce to provide a positive pregnancy experience for each of them.”
Survival and health outcomes of preterm newborns can be enhanced by increasing access to interventions provided to the mother shortly before or during birth as well as interventions for the newborn baby. However, the highest burden of preterm birth, death and disability is concentrated in low- and middle-income countries, where competent and specialized health workers are in short supply.
Of the 30 million newborns who require inpatient care every year, approximately half do not have access to neonatal care services and those who have access often receive care of suboptimal quality. Skilled birth attendants, including medical doctors and midwives, are critical to the provision of high-quality newborn care and to improving newborn outcomes, not only at the time of birth and for routine postnatal care but also in health facilities to which mothers and newborns with complications are referred.
The new WHO roadmap consists of 10 strategies to guide countries in developing their policies to improve the number and competence of health workers to deliver high-quality essential care for all newborns and specialized care for small and sick newborns. It also aims to fill the gap in the numbers of health workers with specialized neonatal skills in low- and middle-income countries required to provide high-quality inpatient care for small and sick newborns.
Over the past three decades countries that have invested in their nursing and midwifery workforces have achieved sustained reductions in maternal and newborn mortality. With continued investments in universal access to high-quality newborn care an estimated 1.7 million newborns could be saved each year. Almost half of the effect would result from providing special and intensive hospital care for preterm, low-birth-weight or sick newborns.
Link to new roadmap
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Geneva/UN, Nov 19 (Canadian-Media): An advisory body of the UN health agency is not recommending the use of the high-profile antiviral drug Remdesivir for hospitalized COVID-19 patients, saying on Thursday there is insufficient evidence that it improves survival outcomes or cuts down on the need for patients to be put onto ventilators.
WHO found that Remdesivir has no meaningful effect on mortality of patients.
Image credit: © WHO/ NOOR/ Sebastian Liste
A World Health Organization (WHO) Guideline Development Group (GDG) panel of international experts made the recommendation in the BMJ – the weekly peer-reviewed medical journal, published by the British Medical Association – as part of so-called “living guidelines” to manage the coronavirus and help doctors make better decisions in consultation with patients.
“Living guidelines are useful in fast moving research areas like COVID-19 because they allow researchers to update previously vetted and peer reviewed evidence summaries as new information becomes available”, said WHO, in a press release on the findings.
Remdesivir has received global attention in treating severe coronavirus cases and is increasingly being used for hospitalized patients. But its role in clinical practice has remained uncertain.
WHO’s recommendation is based on new evidence comparing the effects of several drugs on treating the virus and includes data from four international randomized trials involving more than 7,000 COVID-19 inpatients.
After reviewing the evidence, the WHO GDG expert panel, which includes four patients who have had the coronavirus, concluded that the intravenously administered Remdesivir “has no meaningful effect on mortality or on other important outcomes for patients, such as the need for mechanical ventilation or time to clinical improvement”.
Arguing its use
The panel acknowledged that the certainty of the evidence is low and did not prove that Remdesivir has no benefit; but rather, “there is no evidence based on currently available data that it does improve important patient outcomes”, according to the WHO release.
However, the GDG supported the continued enrolment of patients into Remdesivir evaluation trials to determine whether more substantial evidence can be obtained, especially with regards to specific groups of patients.
The WHO press release also cites a feature article linked in the panel’s BMJ report, which says that the full story of Remdesivir will not be understood until its manufacturer, Gilead, releases full clinical study reports.
In the meantime, reports the journalist who wrote the feature, Jeremy Hsu, alternative treatments such as widely available corticosteroid, dexamethasone, that has been proved to reduce mortality among some severely-ill COVID-19 sufferers, are “now impacting discussions about Remdesivir’s cost-effectiveness”, in the words of the WHO press release.
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Washington, Nov 18 (Canadian-Media): Despite Canada's early successes in the pandemic, it still faces a worsening situation until a COVID-19 vaccine is rolled out widely, said Dr. Anthony Fauci, U.S. presidential adviser and the director of the U.S. National Institute for Allergy and Infectious Disease, media reports said.
Anthony Fauci. Image credit: Twitter handle
"Right now, the entire planet is in trouble. If you look at almost every country, there are very few exceptions," said Fauci and added that Public health measures need to be accelerated.
"The European Union, if you look at the number of new infections, it's out of sight. The United States is out of sight. Canada, which was supposedly doing so well, is also getting into trouble. There's a lot of community spread."
Fauci said the virus is primarily spreading at the household level among smaller groups of people who may not even know they're infected. People have to be vigilant about this with fast approaching holidays and colder months.
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United Nations, Nov 16 (Canadian-Media): As the number of people with diabetes surges, many are at “increased risk of severe disease and death from COVID-19”, the UN chief said in his message for World Diabetes Day, on Saturday.
Nearly one in five COVID-19 deaths in the African region is linked to diabetes, according to the World Health Organization. Image credit: WHO.
“Many efforts have been made to prevent and treat diabetes”, but the disease continues to rise rapidly in low and middle income countries, those “least well-equipped with the diagnostics, medicines, and knowledge to provide life-saving treatment”, said Secretary-General António Guterres.
Globally, some 422 million adults are living with diabetes (latest figures from 2014), according to the World Health Organization (WHO), compared to around 108 million in 1980 – rising from 4.7 to 8.5 per cent in the adult population.
This reflects an increase in associated risk factors, such as being overweight or obese.
Diabetes is a major cause of blindness, kidney failure, heart attack, stroke and lower limb amputation, and the COVID-19 pandemic has brought additional pain to those requiring regular care and treatment who struggle to access therapies for their condition.
A healthy diet, physical activity and not smoking can prevent or delay Type 2 diabetes, formerly called non-insulin-dependent or adult-onset diabetes, the UN said.
Moreover, the disease can be treated and its consequences avoided or delayed with medication, regular screening and treatment for complications.
Next year, WHO is launching the Global Diabetes Compact, “a new initiative that will bring structure and coherence to our complementary efforts to reduce the burden of diabetes”, informed Mr. Guterres.
“Let us work together to make sure that, through this ambitious and much-needed collaboration, we will soon be talking about the decline in diabetes as a public health problem”.
The theme for World Diabetes Day 2020 is “The Nurse and Diabetes", which aims to raise awareness around the crucial role of these health care professionals in supporting people living with diabetes.
Nurses, who currently account for over half of the global health workforce, also help people living with a wide range of health concerns.
People living with diabetes face a number of challenges, and education is vital to equip nurses with the skills to support them.
“As we strive to overcome the pandemic, let us do our utmost to ensure Universal Health Coverage, strengthen health systems and advance good health and resilience for all”, the UN chief said.