Why the US is experiencing a coronavirus plateau

News Network
June 9, 2020

Washington, Jun 9: When epidemiologists talked about "flattening the curve," they probably didn't mean it this way: the US hit its peak coronavirus caseload in April, but since that time the graph has been on a seemingly unending plateau.

That's unlike several other hard-hit countries which have successfully pushed down their numbers of new cases, including Spain and Italy, which now have bell-shaped curves.

Experts say the prolonged nature of the US epidemic is the result of the cumulative impact of regional outbreaks, as the virus that started out primarily on the coasts and in major cities moves inward.

Layered on top of that are the effects of lifting lockdowns in parts of the country that are experiencing rising cases, as well as a lapse in compliance with social distancing guidelines because of economic hardship, and in some cases a belief that the threat is overstated.

"The US is a large country both in geography and population, and the virus is at very different stages in different parts of the country," Tom Frieden, a former director of the Centers for Disease Control and Prevention told AFP.

The US saw more than 35,000 new cases for several days in April. While that figure has declined, it has still been exceeding 20,000 regularly in recent days.

By contrast, Italy was regularly hitting more than 5,000 cases per day in March but is currently experiencing figures in the low hundreds.

"We did not act quickly and robustly enough to stop the virus spreading initially, and data indicate that it travelled from initial hotspots along major transport routes into other urban and rural areas," added Frieden, now CEO of the non-profit Resolve to Save Lives.

To wit: the East Coast states of New York, New Jersey and Massachusetts accounted for about 50 percent of all cases until about a month or so ago -- but now the geographic footprint of the US epidemic has shifted to the Midwest and southeast, including Florida.

Another key problem, said Jennifer Nuzzo, an epidemiologist at Johns Hopkins, is that the United States is still not doing enough testing, contact tracing and isolation.

After coming late to the testing party -- for reasons ranging from technical issues to regulatory hurdles -- the US has now conducted more COVID-19 tests than any other country.

It even has one of the highest per capita rates per country of 62 per 1,000 people, according to the website ourworldindata.org -- better than Germany (52 per 1,000) and South Korea (20 per 1,000).

But according to Nuzzo, these numbers are misleading, because "the amount of testing that a country should do should be scaled to the size of its epidemic.

"The United States has the largest epidemic in the world so obviously we need to do a lot more testing than any other country."

For Johns Hopkins, the more important metric is the positivity rate -- that is, out of all tests conducted, how many came back positive for COVID-19.

As of June 7, the United States had an average daily positivity rate of 14 percent, well above the World Health Organization guideline of 5 percent over two weeks before social distancing guidelines should be relaxed.

By contrast, Germany, which has tested far fewer people in relation to its population, has a positivity rate of 5 percent.

Even if testing were scaled up, carrying out tests in of itself does very little good without the next steps -- finding out who was exposed and then asking them to isolate.

Here also, too many US states are lagging woefully behind.

Texas, which is experiencing a surge in cases after relaxing its lockdown, is a case in point. The state targeted hiring a modest 4,000 tracers by June, but according to local reports is still more than a thousand shy of even that goal.

Opt-in app based efforts have also been slow to get off the ground.

Then there is the fact that some people are growing tired of lockdowns, while others don't have the economic luxury of being able to stay home for prolonged periods.

The government sent some 160 million Americans a single stimulus check of up to $1,200 back in April but it's not clear whether more will be forthcoming.

Still others, particularly in so-called red states under Republican leadership, have chafed under restrictions and mask-wearing guidelines that they see as an affront to their personal freedom.

"The US is kind of on the extreme of the individual liberty side," Sten Vermund, dean of the Yale School of Public Health, told AFP.

Part of this has to do with mixed messaging from Republican leaders, including President Donald Trump, said Nuzzo.

"We have had at the highest political level an assertion that this is a situation that's been overblown, and that maybe certain protective behaviors are not necessary," she said.

More recently, tens of thousands of people across the country have taken to the streets to protest the killing on an unarmed black man by police, risking coronavirus infection to demonstrate against the public health threat of racialized state violence.

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News Network
May 14,2020

May 14: The UN’s children agency has warned that an additional 6,000 children could die daily from preventable causes over the next six months as the COVID-19 pandemic weakens the health systems and disrupts routine services, the first time that the number of children dying before their fifth birthday could increase worldwide in decades.

As the coronavirus outbreak enters its fifth month, the UN Children’s Fund (UNICEF) requested USD 1.6 billion to support its humanitarian response for children impacted by the pandemic.

The health crisis is “quickly becoming a child rights crisis. And without urgent action, a further 6,000 under-fives could die each day,” it said.

With a dramatic increase in the costs of supplies, shipment and care, the agency appeal is up from a USD 651.6 million request made in late March – reflecting the devastating socioeconomic consequences of the disease and families’ rising needs.

"Schools are closed, parents are out of work and families are under strain," UNICEF Executive Director Henrietta Fore said on Tuesday.

 “As we reimagine what a post-COVID world would look like, these funds will help us respond to the crisis, recover from its aftermath, and protect children from its knock-on effects.”

The estimate of the 6,000 additional deaths from preventable causes over the next six months is based on an analysis by researchers from the Johns Hopkins Bloomberg School of Public Health, published on Wednesday in the Lancet Global Health Journal.

UNICEF said it was based on the worst of three scenarios analysing 118 low and middle-income countries, estimating that an additional 1.2 million deaths could occur in just the next six months, due to reductions in routine health coverage, and an increase in so-called child wasting.

Around 56,700 more maternal deaths could also occur in just six months, in addition to the 144,000 likely deaths across the same group of countries. The worst case scenario, of children dying before their fifth birthdays, would represent an increase "for the first time in decades,” Fore said.

"We must not let mothers and children become collateral damage in the fight against the virus. And we must not let decades of progress on reducing preventable child and maternal deaths, be lost,” she said.

Access to essential services, like routine immunisation, has already been compromised for hundreds of millions of children and threatens a significant increase in child mortality.

According to a UNICEF analysis, some 77 per cent of children under the age of 18 worldwide are living in one of 132 countries with COVID-19 movement restrictions.

The UN agency also spotlighted that the mental health and psychosocial impact of restricted movement, school closures and subsequent isolation are likely to intensify already high levels of stress, especially for vulnerable youth.

At the same time, they maintained that children living under restricted movement and socio-economic decline are in greater jeopardy of violence and neglect. Girls and women are at increased risk of sexual and gender-based violence.

The UNICEF pointed out that in many cases, refugee, migrant and internally displaced children are experiencing reduced access to protection and services while being increasingly exposed to xenophobia and discrimination.

“We have seen what the pandemic is doing to countries with developed health systems and we are concerned about what it would do to countries with weaker systems and fewer available resources,” Fore said.

In countries suffering from humanitarian crises, UNICEF is working to prevent transmission and mitigate the collateral impacts on children, women and vulnerable populations – with a special focus on access to health, nutrition, water and sanitation, education and protection.

To date, the UN agency said it has received USD 215 million to support its pandemic response, and additional funding will help build upon already-achieved results.

Within its response, UNICEF has reached more than 1.67 billion people with COVID-19 prevention messaging around hand washing and cough and sneeze hygiene; over 12 million with critical water, sanitation and hygiene supplies; and nearly 80 million children with distance or home-based learning.

The UN agency has also shipped to 52 countries, more than 6.6 million gloves, 1.3 million surgical masks, 428,000 N95 respirators and 34,500 COVID-19 diagnostic tests, among other items.

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Agencies
May 30,2020

Washington, May 30: US President Donald Trump on Friday said that America is terminating its relationship with the World Health Organization as he blamed it and China for the deaths and destruction caused by the COVID-19 pandemic across the globe.

Stating that the funding of the WHO would now be diverted to other global public health organisations, Trump announced a series of decisions against China including issuing proclamation to deny entry to certain Chinese nationals and tightening of regulations against Chinese investments in America.

"Because they (WHO) have failed to make the requested and greatly needed reforms, we will be today terminating our relationship with the World Health Organization and redirecting those funds to other worldwide and deserving urgent global public health needs, Trump said.

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News Network
April 10,2020

Melbourne, Apr 10: Scientists have identified six drug candidates from more than 10,000 compounds that may help treat COVID-19.

The research, published in the journal Nature, tested the efficacy of approved drugs, drug candidates in clinical trials and other compounds.

"Currently there are no targeted therapeutics or effective treatment options for COVID-19," said Professor Luke Guddat from the University of Queensland in Australia.

"In order to rapidly discover lead compounds for clinical use, we initiated a programme of high-throughput drug screening, both in laboratories and also using the latest computer software to predict how different drugs bind to the virus," Guddat said.

The project targeted the main COVID-19 virus enzyme, known as the main protease or Mpro, which plays a pivotal role in mediating viral replication, the researchers said.

This makes it an attractive drug target for this virus, and as people don't naturally have this enzyme, compounds that target it are likely to have low toxicity, they said.

"We add the drugs directly to the enzyme or to cell cultures growing the virus and assess how much of each compound is required to stop the enzyme from working or to kill the virus. If the amount is small, then we have a promising compound for further studies," said Guddat.

After assaying thousands of drugs, researchers found of the six that appear to be effective in inhibiting the enzyme, one is of particular interest.

"We're particularly looking at several leads that have been subjected to clinical trials including for the prevention and treatment of various disorders such as cardiovascular diseases, arthritis, stroke, atherosclerosis and cancer," Guddat said.

Researchers said compounds that are already along the pipeline to drug discovery are preferred, as they can be further tested as antivirals at an accelerated rate compared to new drug leads that would have to go through this process from scratch.

"With continued and up-scaled efforts we are optimistic that new candidates can enter the COVID-19 drug discovery pipeline in the near future," Guddat said.

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