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Podcast and Video: TWiV Special: Presidential COVID-19 with Dr. Daniel Griffin | This Week in Virology.

[October 5, 2020]

Daniel Griffin discusses President Trump’s case of COVID-19, including the clinical course, the medications he received and why, and expectations for the next few weeks.

Host: Vincent Racaniello

Guest: Daniel Griffin

Watch on YouTube video [34:12]: https://youtu.be/ZFpp3pIRjGQ

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Intro music is by Ronald Jenkees

Send your virology questions and comments to twiv@microbe.tv


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A lot to lose… | News and Comment from Roy Lilley.

[6th October 2020] [UK] [England]


The fact that the Covid counting system, based on spreadsheets, has missed 16,000 people reminds us of the foolishness of cobbling together IT systems, instead of investing in end-2-end solutions.

PHE's, older, version of Excel has a 65,536 row limit, so in the data transfer from a big CSV file, rows were chopped off. The upgrade, to a later version of Excel, that copes with just over a million rows, costs about £100.

The budget for T&T is £12bn. An IT adudit might have been a good place to start?

PHE’s budgets were cut by 40%, no IT upgrades and so the gap in the data is easily dismissed by; ‘what do you expect’. 

However, in a long line of mistakes and mishandling, it contributes to a general sense that HMG is not really on top of things.

The national approach, based on BoJo’s strategic concept of ‘Whack-a-Mole’, is descending into cobble-together, bodge it and cobble-together.

If HMG’s approach is working, what would it be like if it wasn’t?

We seem to be missing a strategy. No18 says we have a plan; suppress the virus, keeping businesses going and pray for a vaccine.

The virus is not being suppressed, the numbers are on the way up, businesses are going broke and the people making the vaccines can’t tell us when we can expect to get a jab at the chemist’s.

Government is struggling under five pressures;

  • Pressure from political rivals, leading to an instinct to be less than frank when things go wrong… there’s a strong argument to be more inclusive in decision making.
  • Pressure from the media and pundits… daily press-briefing, a-la Scotland, would reduce a lot of speculation.
  • Pressure from lobby groups to open the economy. Regular explanations from scientific advisors would make it clear why, for instance, airport testing isn't worth doing and why 'Ten o'clock'? 
  • Pressure to lock-down resulting in confusing measures. Creating local and regional autonomy would make a lot of this go away.
  • Pressure to clarify a clear timescale for the future of vaccines. The present race is competitive, commercial and in confidence, developers having one eye on their share-price.

… all this creates internal pressures;

We have a plan but no strategy. Strategic-planning is an oxymoron. A strategy is a decision making framework. Plans are for carrying them out.

Neither is benchmarking against other countries and ‘world-class’ a strategy.

HMG don’t want a strategic plan but they do need a strategic position.

There are elementary mistakes that organisations make. Businesses use strategy in the concept of ‘what do we need to do to win in this market…’ 

Strategy is not about winning, it’s about success. You don’t have to ‘win’ in a market to be successful. 

Strategy should be about, who are our customers, what do they want and how can we get better at doing it.

HMG have made the same basic mistake. 

They’ve framed their Covid response in the context of, what do we need to do to ‘win’… in this case, ‘win the war against Covid’. 

Instead, they should be thinking; who do we need to protect, what do they want and how do we go about it.

There are two, competing priorities, protecting the wellness of the nation and the wealth of the nation. They are interrelated but separate, are irreconcilable.

Let’s ask the strategic question, framed differently; ‘what do the customers need…’ in this case, what does the public need?

They need to know how to make themselves safe and importantly, sustain their income.

A clear message about personal responsibility, for starters.

Taking a stab at HMG’s strategic position, using basic technique, I’ll go first. You can do yours later!

Five steps;

Our vision; whilst there is no vaccine publicly available, we will create a Covid-safe environment, where citizens can live lives as near normal as possible.

Values; openness, by publishing all data and inclusiveness by working with local professionals devolving to them as many decision-making powers and authorities as is possible and practicable.

Outcomes; to use all measures to maintain infection rates below R1 in all parts of the UK ensuring the safety of the public at work and day-to-day living.

Accountability; we are accountable to the public, for the performance of government departments, ministers and those holding devolved responsibilities, for their actions, through regular press briefings, Councils and Parliament.

Key performance indicators; we will be measured by public satisfaction with the management of the pandemic. Numbers of citizens, safely, returning to work, maintaining the R number below 1 in local, regional and national settings. Hospital-admissions within the capacity of the NHS. Care-home infections. The infection rates in places of education, prisons and hospitals. The percentage of covid-positive contacts who are tracked and traced.

... now you have a go!

Remember, strategically this is not about winning, there is nothing to win, but there is a huge amount to lose. 
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Timeliness of DTaP-IPV-Hib vaccination and development of atopic dermatitis between 4 months and 1 year of age – Register-based cohort study | The Journal of Allergy and Clinical Immunology: In Practice.

[Pay to View Full Text] [Received: December 18, 2019; Received in revised form: August 24, 2020; Accepted: September 14, 2020; Published: October 01, 2020] [In Press Journal Pre-Proof]

Highlights.

  • 1. What is already known about this topic?

    • Vaccines can trigger non-antigen specific immune responses. An Australian study of approximately 4000 children, found that delayed vaccination with the non-live DTaP vaccine was associated with reduced risk of atopic dermatitis
  • 2. What does this article add to our knowledge?

    • Delayed vaccination (at least 1 month) with the first dose of DTaP was associated with 6% lower risk of developing new cases of more severe atopic dermatitis between 4 months and 1 year of age in a cohort of nearly 900,000 Danish children.
  • 3. How does this study impact current management guidelines?

    • Many issues should be considered when designing vaccination programmes. Maternal pertussis vaccination accompanied with fewer and later doses of DTaP in children may reduce the occurrence of atopic dermatitis without compromising the protection against pertussis.

Abstract.

Background.

An Australian study including 4433 children found that delayed Diphtheria–Tetanus–acellular Pertussis containing vaccination was associated with reduced risk of developing atopic dermatitis (AD) before 1 year of age.

Objective.

We assessed if delayed vaccination against diphtheria, tetanus, acellular pertussis, polio, and Haemophilus Influenzae type b (DTaP) was associated with a reduced risk of new cases of AD before 1 year of age in Denmark.

Method.

s We used nationwide registers to follow 883,160 children born in Denmark from 1997 to 2012. Binary regression models adjusting for potential confounding factors were applied to estimate relative risks (aRR) of developing AD among children with delayed DTaP vaccination (defined as given 1 month or more after the recommended age) compared with timely vaccinated children.

Results.

Among 143,429 children with a delayed first dose of DTaP, 4847 (3.4%) developed AD between 4 months and 1 year of age, compared with 27,628 (3.7%) among 739,731 children not having delayed DTaP (aRR 0.94 (95% confidence interval (CI): 0.91-0.97)). The aRR was 0.94 (95% CI: 0.90-0.99) for children with a delayed second dose, and aRR=0.88 (95% CI: 0.2-0.93) comparing children with delayed first and second dose with all timely vaccinated children.

Conclusion.

The results support the hypothesis that delayed vaccination with DTaP is associated with reduced risk of developing new cases of AD after 4 months of age. The dose-dependent relationship strengthens the evidence of a causal relationship. Some countries are introducing maternal pertussis vaccination and delaying the first dose of DTaP, providing a possibility for further testing the hypothesis.

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UNICEF brings 10 million doses of polio vaccine to Sudan | ReliefWeb.

[News and Press Release] [Source: UNICEF] [Posted: 4 Oct 2020] [Originally Published: 1 Oct 2020] [Origin: View original]

KHARTOUM 01 October 2020 – Nearly 10 million doses of polio vaccine arrived today in Khartoum. These vaccines will be used during the National Polio Campaign planned for October to immunize 8.6 million of the country's children under the age of five.

On 8 August, vaccine-derived poliovirus type 2 (cVDPV2) was confirmed in Sudan. This strain of poliovirus is the result of low immunity and under-immunization of communities, rather than a problem with the vaccine.

The vaccination campaign, the first to be held nationwide in response to the virus detection, is being led by the Federal Ministry of Health, and supported by WHO and UNICEF. The aim is to boost immunity and protect vulnerable children against the virus. Both WHO and UNICEF are advising health workers and caregivers to observe strict health and safety measures against COVID-19 during the campaign.

“UNICEF with partners is supporting local authorities to control the spread of polio, as part of these efforts we have procured 10 million doses of polio vaccine to support vaccination campaign,” said Abdullah Fadil UNICEF Representative. “The campaign will be accompanied by a social mobilization campaign to encourage communities to get their children vaccinated.”

Last year, UNICEF provided Sudan with 7.1 million doses of oral polio vaccine for routine vaccination activities, and 13.5 million doses of oral polio vaccine for a campaign aiming to reach 7.6 million children through multiple vaccination activities. This year, thousands of children missed out on vaccinations due to the impact of the COVID-19 pandemic on health system and communities, worsening an existing immunity gap.

“We must protect children from the threat of polio, and the best way to do that is to increase the polio vaccination coverage and urge parents and communities to bring their children for vaccination to save them from the crippling disease”, said Abdullah Fadil. “A little effort now can give children the best health care service that they need in their first years of life,” he remarked.

“Vaccinating every child is the only way to stop this outbreak spreading further,” said Dr Ni’ma Saeed Abid, WHO Representative. “The pandemic has led to lower rates of routine immunization, placing children at even greater risk. We are committed to working with parents and caregivers to deliver vaccines, and urgently raise immunity levels.”

“This is a multi-country outbreak has been active in 4 out of 7 neighboring countries with Sudan. In addition to in-country efforts we started coordination with outbreak countries bordering Sudan to have holistic and comprehensive response,” said Dr.Ni’ma.

Link to the multimedia products here

Note to Editors:

There are multiple strains of polio, and there is a critical distinction between wild poliovirus, which is today only found in Afghanistan and Pakistan, and the strain detected in Sudan.

Outbreak response coordinated by the Federal Ministry of Health in collaboration with partners includes special campaigns launched on media in addition to community-based mobilization.

The polio campaign is supported by the Global Polio Eradication Initiative (GPEI), an organization dedicated to the eradication of polio. The GPEI is spearheaded by national governments, the World Health Organization (WHO), Rotary International, the US Centers for Disease Control and Prevention (CDC) and UNICEF, and supported by key partners including the Bill & Melinda Gates Foundation and GAVI, the Vaccine Alliance.

Media Contacts

Salma Ismail
Communications Officer
UNICEF Sudan
Tel: +249965101246
Email: saismail@unicef.org
Lina Mustapha
World Health Organization Tel: +249903079781


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Pakistan: Polio case reported in Quetta | DAWN.

[05 Oct 2020]

QUETTA: A polio case was reported from Balochistan’s capital on Sunday.

Health department officials confirmed that a nine-month-old child had tested positive for the poliovirus in Quetta.

They said the parents had refused to get administered polio drops to the child during the anti-polio campaign.

The number of polio cases has reached 21 during the current year in Balochistan.

Quetta, Pishin and Killa Abdullah districts have been declared sensitive regarding the poliovirus.


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Pakistan: Opinion: The second wave | The Express Tribune.

[October 05, 2020]

The writer is the former editor of The Express Tribune and tweets at @Tribunian
The writer is the former editor of The Express Tribune and tweets at @Tribunian

Kamal Siddiqi writes:

After managing the first wave of coronavirus infections, the government should now be preparing for the second. For its earlier work, the Imran Khan government earned praise in the manner the first wave was dealt with. World Health Organization chief Dr Tedros Adhanom praised the Pakistani government’s response against coronavirus and “recognised the positive trend of virus curtailment” in the country.

In an op-ed in a British online newspaper recently, Dr Tedros lauded Pakistan’s strategy saying that the country deployed the infrastructure built up over many years for polio to coronavirus. He also wrote that those community health workers who were trained to go door-to-door vaccinating children against polio have been redeployed and utilised for surveillance, contact tracing and care.

Earlier, Dr Tedros had listed Pakistan among six countries from which the international community should learn how to deal with the Covid-19 pandemic.

The challenge was to impose restrictions in such a way that the economy was not unduly impacted. More importantly, that the daily-wage earners would not suffer unduly. This is something that had been achieved to a large extent by the government.

But now with the re-opening of schools and educational institutions, we are seeing that numbers which had mercifully fallen have started to rise again. The government has decided to go for what it calls “small smart lockdowns”. This includes placing restrictions on buildings or houses instead of streets or mohallas.

We all know that the coronavirus is far from over. Some countries are still dealing with large epidemics like neighbouring India, but even those currently controlling the virus are waiting for the second wave. October started with the depressing news that the official death toll from Covid-19 surpassed one million worldwide as casualties continued to mount from a pandemic that has ravaged lives and countries.

The pandemic has brought great cities to a standstill, closed schools and factories, grounded air transport and unleashed the ongoing social and political uncertainty. It triggered restrictions on where people could go and when, while ushering in mandates to wear face coverings and discourage close contact with fellow humans. This seems to be the new world order — we call it the “new normal”.

Many victims perished alone, secluded in hospital wards and sealed-off rooms, their loved ones barred from their final moments. In Pakistan, there were several heart-wrenching stories as well. Namaz-e-Janaza for victims in Pakistan were held from a distance and people started questioning what the world held in store in coming times. We have come a long way since. Public confidence is being restored and activity is returning to pre-Covid times. This, of course, has meant that infections are also again on the rise.

According to some health sources, Pakistan is the 18th most-impacted country in the world, in terms of confirmed cases of the deadly virus. But given its population density as well as other factors, it has the potential of rising fast.

Dr Tedros recently said the pandemic could be over in under two years but warned that “no country can just pretend the pandemic is over”. This is a strong message for countries whose leadership is in danger of being complacent.

Pakistan is one such country. Here, due to some natural phenomenon and lack of extensive testing, the country till a month back was recording hundreds of Covid-19 cases daily, as compared to thousands in May and June. But, even with lesser cases, the facts on the ground remain unchanged.

The question now is how prepared we are for the second wave. Pakistan has a weak healthcare system and is unable to effectively provide proper medical care to its millions. We have not been able to eliminate infectious diseases like tuberculosis, hepatitis and most importantly, polio. We do not have the resources or the infrastructure in place. Experts now say that even if a vaccine for coronavirus is available quickly, there are few immediate benefits for less developed countries like Pakistan.

It is time perhaps for another round of measures. From public service messages to ensuring that people wear masks and follow SOPs in public spaces. For many it seems that the coronavirus has been eliminated in Pakistan. We have resumed public gatherings and it is clear people are not following SOPs. This could have far-reaching effects in days to come.


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Ethiopia to Vaccinate over 7 Mln Children against Polio | ReliefWeb.

[News and Press Release] [Source: Govt. Ethiopia] [Posted: 5 Oct 2020] [Originally Published: 2 Oct 2020] [Origin: View original]

Addis Ababa October 2/2020 (ENA) Ethiopia announced an immunization campaign to vaccinate more than 7 million Children against polio next week, according to Ethiopian Public Health Institution.

The four-day campaign will take place in Oromia, Somali, Southern Nations, Nationalities, and Peoples’ Region (SNNPR), Harari regional states as well as in Addis Ababa and Dire Dawa city administrations.

Ethiopian Public Health Institution (PHI) Deputy Director-General, Aschalew Abyneh told journalists today that the regions and city administrations are selected based on an assessment conducted throughout the country in December 2019 to see the prevalence of the disease.

The campaign is part of the on-going efforts to fight polio in the country, according to him.

About 7 million children aged between 5 and below the age of five years will be vaccinated in 44 zones and 334 districts of the stated regions and city administrations in the campaign beginning from October 7, 2020.

The Deputy Director-General said the institution has made the necessary preparations in terms of resource mobilization and assignment of health professionals to successfully carry out the door to door vaccination campaign.

Noting that signs of Polio have been currently observed in Kenya, Somalia, and Sudan, Ethiopian Public Health Institution is working with neighboring countries in order to control the disease throughout the horn of Africa, he added.


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