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Tag: Improve

  • Compendium of research projects at the interface of tuberculosis and COVID-19

    As the world comes together to tackle the COVID-19 pandemic, it is important to ensure that tuberculosis (TB) prevention and care approaches are adapting appropriately to ensure continuous and safe delivery of high-quality TB services. Considering the overlaps in TB and COVID-19 in disease presentation and transmission, the pandemic presents many questions for the TB field that may require learning through research and innovation. 

    To better understand challenges and opportunities in this space, the World Health Organization Global TB Programme is collating information on ongoing research at the interface of TB and COVID-19 (i.e. research which would improve TB prevention and care approaches in the context of the COVID-19 pandemic). We are developing a living compendium (listing), which will be updated periodically to make ongoing research projects and publications visible on its website. With your consent we would like to include any study you have in this compendium.

    To fulfill these objectives, we need the cooperation of organizations and individuals engaged in TB/COVID-19 research to complete this  one page template before 20 May 2020. We encourage you to please share this in your network, so we can reach all stakeholders widely.

    We thank you in advance for your cooperation, and please do not hesitate to contact us if you have any questions.

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    https://www.who.int/news-room/detail/04-05-2020-compendium-of-research-projects-at-the-interface-of-tuberculosis-and-covid-19

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  • WHO and European Investment Bank strengthen efforts to combat COVID-19 and build resilient health systems to face future pandemics

    • WHO and the European Investment Bank enhance cooperation to support countries in addressing the health impact of COVID-19
    • The first phase will address urgent needs and strengthen primary health care in ten African countries
    • Enhanced WHO-EIB partnership will scale up financing to assure the chain of essential supplies, including personal protective equipment, diagnostics and clinical management
    • New initiative will accelerate investment in health preparedness and primary health care with a focus on health work force, infrastructure, and water, sanitation and hygiene
    • The initiative involves measures to address the growing threat of antimicrobial resistance

    The World Health Organization and the European Investment Bank will boost cooperation to strengthen public health, supply of essential equipment, training and hygiene investment in countries most vulnerable to the COVID-19 pandemic.

    The new partnership between the United Nations health agency and the world’s largest international public bank, announced at WHO headquarters in Geneva earlier today, will help increase resilience to reduce the health and social impact of future health emergencies. 

    “Combining the public health experience of the World Health Organization and the financial expertise of the European Investment Bank will contribute to a more effective response to COVID-19 and other pressing health challenges,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. 

    “WHO looks forward to strengthening cooperation with the EIB to improve access to essential supplies including medical equipment and training, and deliver better water, sanitation and hygiene where most needed. New initiatives to improve primary health care in Africa and support the EU Malaria Fund hint at the potential impact of our new partnership,” Dr Tedros concluded.

    “The world is facing unprecedented health, social and economic shocks from COVID-19. The European Investment Bank is pleased to join forces with the World Health Organization as a key part of Team Europe’s efforts to address the global impact of the COVID-19 pandemic. The EU Bank’s new partnership with the WHO will help communities most at risk by scaling up local medical and public health efforts and better protect people around the world from future pandemics. This new cooperation will enable us to combat malaria, address anti-microbial resistance and enhance public health in Africa more effectively,” said Werner Hoyer, President of the European Investment Bank.

    Improving local public health efforts to tackle coronavirus

    The WHO and the EIB will increase cooperation to help governments in low- and middle-income countries to finance and secure access to essential medical supplies and protective equipment through central procurement.

    Building resilient health systems in vulnerable countries across Africa

    The WHO and the EIB will reinforce cooperation to support immediate COVID-19 needs and jointly develop targeted financing to enhance health investment and build resilient health systems and primary health care to address public health emergencies as well as accelerate progress towards Universal Health Coverage.

    The partnership will benefit from the EIB’s planned 1.4 billion EUR response to address the health, social and economic impact of COVID-19 in Africa.

    This will address immediate needs in the health sector and provide both technical assistance and support for medium-term investment in specialist health infrastructure.

    The collaboration envisages rapid identification and fast-track approval of financing for health care, medical equipment and supplies. 

    The first phase of the collaboration will see public health investment in ten African countries. 

    Long-term collaboration to overcome market failures in global health

    The agreement signed today establishes a close collaboration to overcome market failure and stimulate investments in global health, accelerating progress towards Universal Health Coverage. Increased cooperation between the WHO and the EIB will strengthen the resilience of national public health systems and enhance preparedness of vulnerable countries against future pandemics, thanks to investments in primary care infrastructure, health workers and improved water, sanitation and hygiene. 

    Future cooperation will strengthen the EIB’s 5.2 billion EUR global response to COVID-19 outside the European Union.

    Scaling up investment to tackle antimicrobial resistance

    The two organisations will also cooperate in an initiative to address investment barriers hindering development of new antimicrobial treatment and related diagnostics. Antimicrobial resistance is amongst the most significant global health threats.

    The WHO and the EIB are working on a new financing initiative to support development of novel antimicrobials and address the estimated 1 billion EUR needed to provide medium-term solutions to antimicrobial resistance. Other crucial partners have been invited to join this discussion. 

    Improving the effectiveness of malaria treatment

    Under the new agreement the EIB and WHO will support development of the EU Malaria Fund, a new 250 million EUR public-private initiative intended to address market failures holding back more effective malaria treatment. 

    Strengthening EIB support for healthcare, life science and COVID-19 investment

    In recent years the European Investment Bank has provided more than 2 billion EUR annually for health care and life science investment.

    In the context of the COVID-19 pandemic, the EIB is currently assessing over 20 projects in the field of vaccine development, diagnostic and treatment, leading to potential investments in the 700 million EUR range. The EIB will also take part in the EU’s rolling pledging effort for the coronavirus global response that is taking place on May 4th.

    Background information

    The European Investment Bank (EIB) is the long-term lending institution of the European Union owned by its Member States. It makes long-term finance available for sound investment in order to contribute towards EU policy goals.

    The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 150 offices, to promote health, keep the world safe and serve the vulnerable. Our goal for 2019-2023 is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and wellbeing. For updates on COVID-19 and public health advice to protect yourself from coronavirus, visit www.who.int and follow WHO on Twitter, Facebook, Instagram, LinkedIn, TikTok, Pinterest, Snapchat, YouTube

    WHO’s information site on the COVID-19 pandemic

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    https://www.who.int/news-room/detail/01-05-2020-who-and-european-investment-bank-strengthen-efforts-to-combat-covid-19-and-build-resilient-health-systems-to-face-future-pandemics

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  • Indonesia firmly committed to eliminating lymphatic filariasis as a public health problem

    Indonesia firmly committed to eliminating lymphatic filariasis as a public health problem

    Indonesia recently completed the last of its annual large-scale treatment for lymphatic filariasis (also known as elephantiasis or Penyakit Kaki Gajah) in Malaka District located in its southernmost province, East Nusa Tenggara. Unprecedented
    progress by the National Lymphatic Filariasis Elimination Programme has strongly placed the country on the path to achieving the elimination of lymphatic filariasis as a public health problem.

    “We reached an estimated number of 40.7 million people living in the 118 high-risk districts during this month-long treatment campaign in October 2019” said Dr Anung Sugihantono, who recently retired as Director General of Diseases
    Prevention and Control, Ministry of Health Indonesia. “    Single doses of diethylcarbamazine citrate and albendazole facilitated by WHO were delivered to all eligible populations.”

    In 2010, an estimated 125 million Indonesians were still at risk of the disease and required treatment.

    But things changed considerably in 2015 when Indonesia mounted an annual national campaign to resolutely address transmission of the disease and to tackle the morbidity and disability associated with it. The results were apparent as early as 2017, with
    remarkable progress.

    In Indonesia, LF is considered a significant public health concern. In 2009, risk mapping identified a population of 124.5 million people needing treatment for LF. The country initiated a national level LF elimination campaign in 2015, addressing both
    disease prevention and management. 

    “In 2017 and in just two years we managed to achieve 100% geographical coverage of all people requiring treatment” said Dr Sugihantono. “It meant achieving more than 78% epidemiological coverage – much higher than the generally recommended 65% to stop transmission.”

    Transmission of lymphatic filariasis can be stopped through large-scale treatment (or mass drug administration – MDA) of entire at- risk communities with recommended medicines once a year. These medicines kill the microfilariae in an infected patient’s
    blood preventing mosquitoes to transmit1 the disease to others. Through mass treatment, the aim is to reduce the reservoir of microfilariae in the blood to a level insufficient to maintain transmission by the mosquito vector.

    This strategy to interrupt transmission is the corner-stone of the World Health Organization’s (WHO) Global Program to Eliminate Lymphatic Filariasis (GPELF). Indonesia has been using the GPELF’s strategy since 2002 using a district or city
    as its implementation unit.

    In 2005, it listed the elimination of LF as a national priority for controlling infectious diseases and the medicines it has been using in large-scale treatment programmes are diethylcarbamazine citrate (DEC) and albendazole2 which are
    largely distributed by volunteer community health workers3.

    “Community health volunteers are themselves members of the community and know how to reach people effectively to improve compliance” said Dr. Stefanus Bria Seran, the Regent of Malaka District, one of LF endemic district in Indonesia. “Besides ensuring every single person ingests the medicine given to them, these community workers help in disseminating information well before a large-scale treatment campaign and also assist in reporting activities related to each treatment campaign”. 

    Indonesia’s efforts to eliminate lymphatic filariasis began in the 1970s but faced numerous challenges including programme coordination in the many inhabited islands, conducting information, education and awareness programmes, lack of capacity and
    insufficient medicines.

    Furthermore, the situation in Indonesia is unusual than in many other countries endemic for lymphatic filariasis as the country is endemic for all three species of thread-like filarial worms – Brugia malayi, Brugia timori, and Wuchereria bancrofti –
    that cause the disease. Most of the infections in Indonesia, however, are caused by B. malayi.

    In the past, some of the factors that prevented access to the medicines (DEC and albendazole) were social stigmatization linked to the disease, the vast geography of the territory and challenges in reaching remote populations.

    With an estimated population of 242 million, Indonesia is the world’s largest island nation and consists of approximately 17,000 islands, of which 5,000–6,000 are inhabited. It is the fourth most populated nation behind China, India, and the United
    States.

    Indonesia is endemic for many other neglected tropical diseases and an estimated 110 million Indonesians are believed to suffer from at least one neglected tropical disease (NTD), including lymphatic filariasis and soil-transmitted helminth infections.
    Leptospirosis (not classified as NTD) is also widespread.

    Indonesia is the only country of WHO’s South East Asia Region with endemic schistosomiasis. Like many other countries of the Region, it also faces recurrent threats of dengue outbreaks.

    Global progress

    The world has made significant progress towards the elimination of lymphatic filariasis as a public health problem.

    Sixteen countries4 and one territory are now acknowledged by WHO to have achieved elimination of lymphatic filariasis as a public health problem.  

    Seven additional countries have successfully implemented recommended strategies, stopped large-scale treatment and are under surveillance to demonstrate that elimination has been achieved.

    The disease

    Lymphatic filariasis is caused by infection with parasitic worms living in the lymphatic system. The larval stages of the parasite (microfilaria) circulate in the blood and are transmitted from person to person by mosquitoes.

    Infection involves asymptomatic, acute, and chronic conditions. Most infections are asymptomatic, showing no external signs while contributing to transmission of the parasite. Although asymptomatic, these infections still cause damage to the lymphatic
    system and the kidneys and alter the body’s immune system.

    When lymphatic filariasis develops into chronic conditions it leads to lymphoedema (tissue swelling) or elephantiasis (skin/tissue thickening) of limbs and hydrocele (scrotal swelling). Involvement of breasts and genital organs are common.

    Manifestation of the disease after infection takes time and can result in an altered lymphatic system, causing abnormal enlargement of body parts, and leading to severe disability and social stigmatization of those affected.

     

    1Lymphatic filariasis is transmitted by different types of mosquitoes – e.g the Culex mosquito which widespread across urban and semi-urban areas; Anopheles, mainly found in rural areas; and, Aedes, mainly
    in endemic islands in the Pacific.

    2In 2017, WHO recommended an alternative three drug treatment to accelerate the global elimination of lymphatic filariasis. The treatment, known as IDA, involves a combination of ivermectin, diethylcarbamazine citrate and albendazole.
    It is recommended annually in settings where its use is expected to have the greatest impact.

    3Community health workers, also called ‘cadres’, are volunteers who form part of the communities they serve and work with local
    communities to educate families. Their contribution in promoting health has been significant in the country.

    4Cambodia, The Cook Islands, Egypt, Kiribati, Maldives, Marshall Islands, Niue, Palau, Sri Lanka, Thailand, Togo, Tonga, Vanuatu, Viet Nam, Wallis and Futuna, and Yemen

    Indonesia firmly committed to eliminating lymphatic filariasis as a public health problem
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    https://www.who.int/news-room/detail/29-04-2020-indonesia-firmly-committed-to-eliminating-lymphatic-filariasis-as-a-public-health-problem

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  • New FAQs address healthcare workers questions on breastfeeding and COVID-19

    New FAQs address healthcare workers questions on breastfeeding and COVID-19

    Mothers and healthcare workers who support them have many questions and concerns about whether it is safe for mothers with confirmed or suspected COVID-19 to be close to and breastfeed their babies during the pandemic.

    To address their questions, WHO has released a list of Frequently asked questions: Breastfeeding and COVID-19. The FAQ complements the WHO interim guidance: Clinical management of severe acute respiratory infection when COVID-19 is suspected and draws upon other WHO recommendations on infant and young child feeding.

    The FAQs aim to provide information to healthcare workers supporting mothers and families in maternity services and community settings, and communicate how the interim guidance should be implemented. Additionally, the FAQs provide information about the protective effects of breastfeeding and skin-to-skin contact, and the harmful effects of inappropriate use of infant formula milk.

    Accompanying the FAQs is a decision tree which provides step-by-step guidance to health workers on how to support mothers with confirmed or suspected COVID-19 to breastfeed. It provides advice on what to do if mothers are not well enough to breastfeed, as well as appropriate hygiene measures for mothers, including wearing a medical mask if available, to reduce the possibility of the COVID-19 virus being spread to her infant.

    Benefits of breastfeeding outweigh potential risks

    The COVID-19 virus has not been detected in the breastmilk of any mother with confirmed and suspected COVID-19 and there is no evidence so far that the virus is transmitted through breastfeeding. Researchers continue to test breastmilk from mothers with the infection.

    WHO recommends that all mothers with confirmed or suspected COVID-19 continue to have skin-to-skin contact and to breastfeed. In all socio-economic settings, breastfeeding improves survival and provides lifelong health and development advantages to newborns and infants. Breastfeeding also reduces the risk of breast and ovarian cancer for the mother. Skin-to-skin contact, including kangaroo mother care, reduces neonatal mortality, especially for low birth weight newborns.

    While infants and children can contract COVID-19, they are at low risk of infection. The few confirmed cases of COVID-19 in young children to date have experienced only mild or asymptomatic illness.

    WHO’s recommendations on the care and feeding of infants whose mothers have confirmed or suspected COVID-19 aim to improve the immediate and lifelong survival, health and development of their newborns and infants. These recommendations consider the likelihood and potential risks of COVID-19 in infants and also the risks of serious illness and death when infants are not breastfed or when infant formula milk are used inappropriately.

    WHO’s Q&A on breastfeeding and COVID-19 also provides additional infection prevention advice to mothers with confirmed or suspected COVID-19.

    New FAQs address healthcare workers questions on breastfeeding and COVID-19
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    https://www.who.int/news-room/detail/28-04-2020-new-faqs-address-healthcare-workers-questions-on-breastfeeding-and-covid-19

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  • Maternal infections in health facilities

    Maternal infections in health facilities

    A clearer picture of the global impact 

    New research from the Global Maternal Sepsis Study (GLOSS), a major WHO/HRP initiative, shows that infection has a much larger impact on global maternal mortality and morbidity than previously thought.

    Logo of the Lancet Global HealthThe
    results from GLOSS, published in The Lancet Global Health, are the first to provide data on frequency of maternal infections and
    sepsis across the pregnancy and post-pregnancy period, in a large number of health facilities around the world. 

    Around 11 women per 1000 live births had an infection which resulted in or contributed to what is known as a severe maternal outcome – either they died or nearly died – during their hospitalization. 

    Urgent improvement is needed to manage this life-threatening risk faced by all pregnant and recently pregnant women, wherever they are in the world. 

    What is maternal sepsis and how does it lead to maternal death?

    Maternal sepsis is a life-threatening condition that arises when the body’s response to infection causes injury to its own tissues and organs during pregnancy, child-birth, post-abortion or the postpartum period.

    The latest global estimates place sepsis due to obstetric infections as the third most common cause of maternal mortality. However, this only includes infections as a direct result of pregnancy, such as endometritis or post-caesarean wound infections.

    Few
    previous studies include post-abortion infections. Neither do they address indirect infections such as respiratory and meningitis, which are aggravated by pregnancy but not directly caused by it.

    A better understanding of maternal infection

    GLOSS was a massive facility-based data collection effort led by WHO, accompanied by a ‘STOP SEPSIS!’ campaign to increase awareness among healthcare providers.

    The study gathered data on women who were admitted with suspected or confirmed infection during pregnancy or post-pregnancy over a one-week period in 2017. More than 2800 women participated in the study in 52 countries.

    GLOSS included healthcare facilities that care for women during pregnancy, childbirth or at the end of pregnancy, as well as facilities without maternity service but where women could be hospitalized during or after pregnancy, and data on infections
    which are not usually recorded as maternal sepsis, including post-abortion and indirect infections. 

    The result is a more complete understanding of the frequency and impact of maternal infections in health facilities. 

    GLOSS calls attention not only to the wider range of risks faced by pregnant women but also to the long period of time during which they are at risk. 

    Putting global numbers on maternal infection and sepsis

    Overall, around 70 pregnant or recently-pregnant women per 1000 live births were found to have a maternal infection needing hospital management. 

    Across the study, 11 women with either direct or indirect infection per 1000 live births developed a severe maternal outcome, but in low- and middle-income countries up to 15 women per 1000 births were affected.

    Infections were the underlying cause of most of the deaths recorded during the study, primarily post-abortion infection and indirect infections. Infections were also present in about a third of deaths attributed to other causes, such as postpartum
    haemorrhage.

    This suggests that the contribution of infection to global maternal mortality and morbidity may be larger than current reports of maternal sepsis mortality suggest.

    Preventing, identifying and treating maternal infection and sepsis

    Some of the most common maternal infections found in the study, such as urinary tract infections, post-caesarean and post-abortion infections, are largely preventable and treatable.

    GLOSS results suggest that current levels of monitoring and clinical care across health facilities are not enough to prevent, identify and treat levels of maternal infection effectively. 

    For instance, a complete set of vital signs was not reported for a third of the women in the study, on the day their infection was suspected or diagnosed. Delays in antimicrobial therapy were frequent.

    GLOSS also shows marked differences across countries, with the highest burden in low- and middle-income countries, compared with high-income countries.

    This may reflect the impact of broader health determinants in different country contexts. Challenges of overcrowding, limited access to water and sanitation and constraints to safe births by skilled birth attendants can reduce the ability of healthcare
    providers to manage the frequency and outcome of maternal infections.

    An opportunity to implement evidence-based practice

    GLOSS gives healthcare providers, policy-makers, and the public at large an opportunity: to mobilise around these data improve evidence-based practice, and save lives. 

    WHO has produced a number of resources which can support timely action to prevent, diagnose and treat maternal infection, as well as activities such as the upcoming SAVE LIVES: Clean Your Hands campaign
    on 5 May which celebrates the central role played by nurses and midwives in clean health care. 

    In addition, WHO will publish a global sepsis epidemiology report around the 73rd World Health Assembly (WHA) in May, as requested in the
    2017
    WHA Resolution on Improving the prevention, diagnosis and clinical managementof sepsis.

    Understanding why and how infection affects women is essential for equipping healthcare providers with life-saving knowledge and enabling health care systems to bring down global maternal mortality and morbidity.

    Related publications

    WHO recommendations for prevention and treatment of maternal peripartum infections

    WHO Clinical practice handbook for safe abortion

    Global guidelines on the prevention of surgical site infection

    WHO statement on maternal sepsis

    World Health Assembly resolution on Improving the prevention, diagnosis and clinical management of sepsis

    Health Topics

    Antimicrobial resistance

    Infection Prevention and Control

    Water Sanitation Hygiene

    Other links

    Global Maternal Sepsis Study

    SAVE LIVES: Clean Your Hands 5 May 2020

     

     

    Maternal infections in health facilities
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    https://www.who.int/news-room/detail/27-04-2020-maternal-infections-in-health-facilities

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  • What matters to women in the postnatal period?

    What matters to women in the postnatal period?

    The right to a positive maternity healthcare experience at every stage 

    Each pregnancy is unique and clinical needs can change across the pregnancy, childbirth and postnatal periods. One thing that never changes is the right to a positive experience at every stage. 

    Achieving the best possible physical, emotional, and psychological outcomes for every individual and newborn requires health systems to take a human rights-based approach: not only preventing maternal death and morbidity, but prioritising person-centred
    care and well-being.

    WHO is developing new guidelines for a positive experience of postnatal care, due to be published next year. To inform these guidelines and ensure that postnatal services can better meet the needs of women and their babies, WHO undertook a qualitative
    systematic review on what matters to women in the postnatal period.

    Joys and challenges in the postnatal period

    There is limited research about values and preferences in the postnatal period, defined by WHO as the first six weeks after childbirth. Studies have often focused on the results of specific postnatal interventions, rather than on the individuals who use
    them. 

    ‘What matters to women in the postnatal period: A meta-synthesis of qualitative studies,’ published in PLOS ONE, gives long-overdue respect to the authority of women’s own experiences. The authors review first-hand data from 15 countries
    and 36 studies published after the year 2000 relating to women’s beliefs, expectations and values at this significant time of life.  

    These studies affirm that a positive postnatal experience can result in joy, self-confidence and enhanced capacity to thrive as both a person and a parent.

    They are also vocal about the potential challenges of adjusting to a ‘new normal’ following childbirth, including changes in self-identity, relationships, and sexual behaviour.

    What is a positive postnatal experience? 

    A positive postnatal experience for a woman will be one that responds to her specific context and preferences. 

    It will provide the confidence, knowledge and skills women need in the weeks following childbirth, supporting them to adjust to any changes in their intimate relationships and build new family ones. Women will be better equipped to navigate physical and
    emotional challenges and to experience the dynamic achievement of personal growth. 

    This should be a shared responsibility, not a solitary one. Community has a critical role in enabling a positive postnatal experience, including partners, family and elders.

    It is crucial that healthcare providers meet each woman’s needs, as well as those of their babies. 

    Supporting choices and rights to improve postnatal health outcomes

    There are an estimated 303 000 maternal deaths annually, according to recent WHO figures. Most of these deaths occur postnatally. 

    The postnatal period is therefore a vital opportunity to improve both maternal and neonatal health and wellbeing: supporting healthy behaviors, providing life-skills education, facilitating breastfeeding, counselling women about family planning options,
    supporting good mental health, preventing and treating childbirth-related complications. 

    Health care systems that empower individuals by supporting their values, preferences and rights are fundamental to improving maternal and newborn health outcomes. 

    WHO’s guidance for positive maternity care

    WHO has recently released recommendations on antenatal care for a positive pregnancy experience, and on intrapartum care for a positive childbirth experience.

    These publications made important clinical updates, including an increase from four to eight recommended antenatal contacts, and a revision to the decision-making process for interventions to accelerate labour. 

    They also uphold every woman’s right to a positive maternity care experience: one where her pregnancy does not erase her competency, autonomy and right to participate in decision-making for her own care and the care of her newborn. 

    Women’s choices and rights to sexual and reproductive health care, including maternity care, should be respected at every stage of the continuum of maternal and newborn care. This is true across all income settings, as well as in humanitarian settings
    and during public health emergencies.

    When WHO’s postnatal guidelines are released next year, they will complete the maternity care series built around what matters to women.

    Rather than dividing care into three periods of antenatal, intrapartum and postnatal, these publications can be used to establish a model in which health systems support women, their baby and wider network physically, psychologically, socially and emotionally
    through this significant life event. 

    Other resources

     

    What matters to women in the postnatal period?
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    https://www.who.int/news-room/detail/22-04-2020-what-matters-to-women-in-the-postnatal-period

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  • Speed of Covid-19 deaths shock doctors and nurses

    Speed of Covid-19 deaths shock doctors and nurses

    Speed of Covid-19 deaths shock doctors and nurses 1

    NEW YORK: One medical worker called it “insane”, another said it induces paranoia – the speed with which patients are dying from the novel coronavirus is shocking even veteran doctors and nurses as they scramble to determine how to stop such sudden deterioration.

    Patients “look fine, feel fine, then you turn around and they’re unresponsive”, said Diana Torres, a nurse at Mount Sinai Hospital in New York, the epicentre of the pandemic in the US where the virus has infected nearly 430,000 people and caused more than 14,700 deaths.

    “I’m paranoid, scared to walk out of their rooms.”

    It isn’t just the elderly or patients with underlying health conditions, who can be fine one minute, and at death’s door the next.

    It can happen for the young and healthy, too, health professionals told Reuters.

    A young woman died unexpectedly while nurse Laurie Douglas was on duty at Our Lady of the Lake Hospital in Baton Rouge, Louisiana.

    After 34 years on the job, Douglas said she normally has “an intuition of who is going to fade and who may improve”.

    “But these people are throwing that out the window.

    “Last week, she was planning her wedding.

    “This week, her family is planning her funeral,“ she said, referring to the deceased patient.

    Patients might enter the hospital with strong oxygen levels and be engaged in happy conversation, said a resident emergency doctor at New York-Presbyterian Hospital, only to be “gasping for breath” and intubated a few hours later.

    “The scary thing is there are no rules to it,“ the resident said on condition of anonymity.

    These scenes are playing out everywhere as Covid-19 has infected more than 1.4 million worldwide and killed more than 85,000 as of Wednesday.

    The quick turns for the worse are likely products of an “overly exuberant” reaction by the immune system as it fights the virus, said Dr Otto Yang, an infectious disease specialist at the UCLA Medical Centre in Los Angeles.

    Called a cytokine storm, it occurs when the body overproduces immune cells and their activating compounds – cytokines – causing dangerously high blood pressure, lung damage and organ failure.

    Emily Muzyka, 25, a nurse in the New York suburbs, said she reached her breaking point last week, when a relatively healthy 44-year-old woman needed sudden intubation.

    “I had a meltdown that night,“ she said.

    “I cried to my boyfriend.”

    Intubation refers to inserting a tube into the mouth and through the airway of a Covid-19 patient struggling to breathe, so they can be hooked to a mechanical ventilator.

    Journalist Anick Jesdanun, who was in good health and had run 83 marathons, died last week from Covid-19, according to a post on Facebook by his cousin Prinda Mulpramook.

    Jesdanun, who was 51, at first didn’t need hospitalisation, according to the post.

    He had begun to recover and showed clear lungs and strong vital signs during a doctor’s visit in late March. But “a sudden setback” sent him to the emergency room on April 1, and “13 hours later we lost him”, Mulpramook wrote.

    A nurse at Mount Sinai’s intensive care unit recalled watching patients’ kidneys quickly shut down, adding that many require intravenous drips of the blood thinner Heparin.

    “It’s insane how sick they get, how quickly.

    “We’re really trying hard to figure out how to treat them.”

    Some of those hospitals are experimenting with unproven drugs in hopes of helping patients, including the anti-malaria medication hydroxychloroquine.

    “We’re essentially throwing the kitchen sink at these patients,“ a doctor said.

    Speed of Covid-19 deaths shock doctors and nurses
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    https://www.thesundaily.my/home/speed-of-covid-19-deaths-shock-doctors-and-nurses-AF2241516

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  • Urine test can predict how much a baby will grow in six months’ time

    Urine test can predict how much a baby will grow in six months’ time

    Metabolites from urine or blood samples can be used to predict how much a baby will grow six months ahead of time, which could improve interventions for chronic malnutrition
    Urine test can predict how much a baby will grow in six months’ time
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    https://www.newscientist.com/article/2240262-urine-test-can-predict-how-much-a-baby-will-grow-in-six-months-time/?utm_campaign=RSS%7CNSNS&utm_source=NSNS&utm_medium=RSS&utm_content=home

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  • We receive criticism daily, but it’s okay, we need it to improve: Annuar

    We receive criticism daily, but it’s okay, we need it to improve: Annuar

    We receive criticism daily, but it’s okay, we need it to improve: Annuar 2

    PETALING JAYA: Taking to Twitter with photographs of homeless people receiving shelter, Federal Territories Minister Tan Sri Annuar Musa said criticisms are needed for improvements.

    “We were criticised almost daily, but I think it’s ok. We need criticism in order to improve. Just be patient and remain steadfast in doing our level best during this difficult time,” Annuar tweeted.

    The minister has also posted other pictures showing homeless people receiving haircuts and places to sleep during the Movement Control Order (MCO).

    We receive criticism daily, but it’s okay, we need it to improve: Annuar
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    https://www.thesundaily.my/local/we-receive-criticism-daily-but-it-s-okay-we-need-it-to-improve-annuar-JE2237380

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  • #ThanksHealthHeros – World Health Day Message

    Today is World Health Day! This day is especially poignant as the focus is on nurses and health workers, who are on the frontline of the COVID-19 response across the world. They are the real heroes risking their lives to save the millions
    affected by COVID-19 as well as other deadly diseases like tuberculosis (TB).  They play a major role in providing high quality, respectful treatment and care, and leading community dialogue to address fears and questions. It is imperative that
    we come together to invest more, empower and protect the nursing and health workforce.

    Without nurses and health workers, we cannot achieve “Health for All” or end diseases like TB which claim millions of lives each year. The World Health Organization is calling for your support on World Health Day to ensure that the nursing
    and midwifery workforces are strong enough to ensure that everyone, everywhere gets the healthcare they need.

    Today, we would like to salute and thank nurses, midwives and other health workers around the world who are battling difficult situations to save lives and we pay tribute to those who lost their lives protecting others.

    Emily: A Day in the Life of a TB Nurse

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    Watch this story of Emily, a nurse managing the TB programme of the City Health Office in Tuguegarao City, Philippines. Her dream for Tuguegarao is to one day see zero TB cases and that no one dies from this infectious disease.

    Nurses and healthcare workers play a critical role in TB prevention and care. It’s time to invest in them to improve healthcare for all.

    We thank all the nurses and healthcare workers working to #EndTB!

    Read More
    https://www.who.int/news-room/detail/07-04-2020-thankshealthheros—world-health-day-message

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