Friday, 24 July 2020

COVID-19 Coronavirus UK and World News update 24th July 2020.

COVID-19 Coronavirus UK and World News update 24th July 2020.

The UK added 770 cases today and now has reported a total of 297,914 positive cases of COVID-19. We completed 152,533 tests yesterday. 1,634 people were in hospital on Wednesday 22nd, with 111 using a ventilator yesterday. 

In the 24 hours up until 5pm yesterday, we lost another 123 people who have tested positive to COVID-19. We now very sadly have a total of 45,677 officially reported losses of life in all settings.

England 256,428 / 41,082
Northern Ireland 5,891 / 556
Scotland 18,520 / 2,491
Wales 17,075 / 1,548

Rep. Of Ireland 25,845 (+19) cases and 1,763 losses of life. 

There have now been a total of 15,795,688 reported cases worldwide. The number of people who have lost their lives worldwide to COVID-19 is 639,159. Already 9,627,155 people have recovered.

New normal closed places close spaces

"Almost 10 million COVID19 cases, or two-thirds of all cases globally, are from 10 countries, and almost half of all cases reported so far are from just three countries. 
As we have said previously, political leadership and community engagement are the two vital pillars of the COVID19 response. 
One of the tools governments can use is the law – not to coerce, but to protect health while protecting human rights."
Dr Tedros, Head of WHO, at the launch of COVID-19 Law Lab, a platform that shares legal documents from over 190 countries.

If you are obese, your risk of serious illness from COVID is bigger, and that risk increases along with your increasing weight. It is anticipated that the English Government will be encouraging those of us carrying some extra pounds to lighten up a bit. It's for your own good - don't say I didn't tell you. 

I did tell you a little while ago that the English Government are very scared of a second wave over Winter at the same time as flu, and were planning the biggest ever vaccination programme. They've announced they'll have over 30 million vaccinations available:
"Expanded flu vaccination programme to protect vulnerable people and support the NHS."
- all school year groups up to year 7
- people aged over 65, pregnant women, those with pre-existing conditions including at-risk under 2s
- Free vaccine to be made available for people aged 50 to 64 later in the year.
- Households of those on the shielded patient list eligible for free flu vaccination and school programme expanded to the first year of secondary schools for the first time.

from today face coverings are mandatiory in UK shops and many enclosed spaces.

The disaster in the USA is beginning to reach the nightmare levels that we all hope to avoid. Yesterday officials in Starr County, South Texas, met to decide which patients receive priority for a hospital bed, and who will have to be sent home. 
This tiny (and poor) county, was previously held up as an example of 'how to do it', but was over-ridden by Texas Gov. Greg Abbott, who issued orders for the reopening of the whole state. Per 100,000 people, they have reported around 92 cases a day for the past week.

I promised I'd look into miscarriage and stillbirth, because there are word-of-mouth reports that there is an increase. Because this is a trigger for a lot of people, I have put what I found at the very bottom of this post.

face coverings uk gov public spaces

Over 150 US professionals have already added their name to a letter asking for the country to be shut down again. It's lengthy and stark, here's a snippet: 
"In March, people went home and stayed there for weeks, to keep themselves and their neighbors safe. You didn’t use the time to set us up to defeat the virus. And then you started to reopen anyway, and too quickly. 
Right now we are on a path to lose more than 200,000 American lives by November 1st. Yet, in many states people can drink in bars, get a haircut, eat inside a restaurant, get a tattoo, get a massage, and do myriad other normal, pleasant, but non-essential activities. 
Get our priorities straight." 

On Wednesday 22nd July alone, 280,355 new official cases of COVID were reported worldwide. The highest daily figure yet. 

I've mentioned before that medical staff are at a higher risk of becoming seriously ill, because of the amount of COVID they are exposed to initially. If you've never been exposed before, and you inhale a few droplets in a shop is very different to getting a lung full from a patient with an horrific cough or who you are trying to treat. I saw the most clear and concise comment about why this matters on Quora from 'Just Lorien': 
"If you get a small load, before the virus replicates enough to be a threat, your body will already be triggered to defend against the virus and have much less to destroy.
If you get a large load then by the time your body is aware of the virus, the virus has infected a large amount of cells causing serious harm. It will take more time to eradicate the attack while your body plays catch up."
It's all about that exponential growth.... (1 infects 2, each infect 2, each of them infect 2 etc). It explains why your family don't as a rule become suddenly and dangerously ill if you get COVID - you've probably all been more gently exposed already. 

A new US CDC report shows clearly that young, previously healthy adults can take a long time to recover from even mild COVID19. The study found that "nearly 1 in 5 adults ages 18-34 who had milder outpatient COVID-19 had not returned to their usual health after 14-21 days". 

Long term health US CDC

China and the US have been shaking their fists at each other again. The US demanded the Chinese embassy in Houston close, after accusing them of trying to steal America's medical and other secrets. China denied it and have now ordered the US to close its consulate in Chengdu. There are still 6 other US embassies and consulates in mainland China, so this could go on for a while. 

The Wall Street Journal is reporting that Chilean and other Southern Hemisphere doctors, treating huge numbers of COVID patients, really panicked about the prospect of the seasonal flu cases on top as they went into their Winter. So far, it hasn't happened. In fact, the numbers of people catching seasonal flu are so low, it offers hope to panicked hospitals, authorities and medics worldwide.
"In Chile, for instance, there've been only 1,134 seasonal respiratory infections, compared with 20,949 during the same period last year."
Flu isn't as easy to catch as COVID, and the social distancing, mask-wearing and other measures are working just as effectively to suppress flu and respiratory illnesses as they are COVID. Fingers crossed that translates worldwide. 

Thorax (respiratory medicine journal) yesterday published results of some research into face coverings.  They have video and high speed photos which are really impressive and a bit eeeuw. They found 1 layer of t-shirt material was much better than nothing when breathing or coughing, but barely did anything when the person sneezed. 2 layers of (175gsm) cotton fabric was significantly better, and it takes 12 layers to be as effective as a mask a surgeon would wear. They recommend 3 layers if possible, but it's good to know that in an emergency, the no-sew t-shirt mask isn't at all useless. 

Using Face ID and it not working is no excuse not to wear a mask. Android and IOS have an 'alternate appearance' option - and it'll save time in the long run. You're welcome. 

From August 1st in every single American McDonald's restaurant you will have to wear a face covering. (Remember you also have to now in England.)
Journalists were classed as essential workers by the UK government, which made a lot of people laugh, but Reuters Institute and Oxford Uni have surveyed them, and found that covering COVID has affected their mental health. Around the world many have seen or read things which they can't forget, they've put themselves in danger,  caught COVID, lost colleagues, had to abide by their government's official line even when they could see it was wrong, and worked incredibly long hours. They've also had to learn science and medicine at super fast speed. (I'm actually hoping someone launches a degree because I'm pretty sure I could pass it!). 

And with that,  Saturday is my real day off. Back Sunday - stay well, control the sneeze, save the NHS.... 

Some people. All of them with medics and nurses they'd want to thank:

Countries / Cases / Losses of life (some states /provinces yet to report):

USA 4,203,872 (+33,554) 147,836 (+487)
Brazil 2,303,661 (+13,710) 84,440 (+233) 
India 1,335,471 (+47,341) 31,398 (+753) 
Russia 800,849 (+5,811) 13,046 (+154) 
South Africa 408,052 not yet reported today 6,093
Peru 371,096 not yet reported today 17,654
Mexico 370,712 (+8,438) 41,908 (+718) 
Chile 338,759 not yet reported today 8,838
Spain 319,501 (+2,255) 28,432 (+3) 
UK 297,914 (+770) 45,677 (+123) 
Iran 286,523 (+2,489) 15,289 (+215)
Pakistan 270,400 (+1,209) 5,763 (+54)
Saudi Arabia 262,772 (+2,378) 2,672 (+37) 
Italy 245,590 (+252) 35,097 (+5)
Colombia 226,373 not yet reported today 7,688
Canada 112,867 (+195) 8,877 (+3)
Qatar 108,638 (+394) 164
Iraq 104,711 (+2,485) 4,212 (+90) 
Indonesia 95,418 (+1,761) 4,665 (+89) 
Ukraine 62,823 (+972) 1,571 (+20) 
Kuwait 62,625 (+753) 425 (+4) 
Israel 59,475 (+1,493) 448 (+6) 
Dominican Republic 59,077 (+1,462) 1,036 (+30) 
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Trigger warnings for the below: 
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I have searched and I cannot find any figures or studies suggesting an increase in miscarriage or SIDS, absolutely nothing. If it's out there, it's not mentioned in any official government or public health advice either. I can't promise you that COVID, lockdown and everything that goes with it hasn't had an effect, but if it has, it must be small because it hasn't become news anywhere.
There was a study released last week which suggests that stillbirths (after 24 weeks) and caesarians have increased. Incredibly importantly, the numbers are very, very tiny, so the authors start by saying:
"High rates of preterm birth and cesarean delivery have been reported in women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, studies have inadequate power to assess uncommon outcomes like stillbirth."
They compared data from October 1st 2019 - January 31st 2020 with data from February 1st - June 14th:
'The incidence of stillbirth was significantly higher during the pandemic period (16: 9.31 per 1000 births) than during the prepandemic period (4: 2.38 per 1000 births).' 
Tiny figures like this can be heavily affected by random fluctuations, but a difference of 12 children shouldn't be ignored. Research is ongoing to try to see if this is representative, and why? None of the infants died due to known effects of COVID, but it could be responsible in other ways : 
"Alternatively, the increase in stillbirths may have resulted from indirect effects such as reluctance to attend hospital when needed (e.g. with reduced fetal movements), fear of contracting infection, or not wanting to add to the National Health Service burden."
The Royal College of Midwives/ Imperial College / Cardiff Clinical Trials Unit have set up PAN-COVID dot ORG, and they have already registered over 1,400 professionals from 150 sites, who will share their data on pregnancy and neonatal experience, to inform each other. They have not yet published any results, but one to look out for. 



Sources

https://coronavirus-staging.data.gov.uk/

https://twitter.com/DHSCgovuk/status/1286586975491956741?s=19 - Image 
https://www.wsj.com/articles/covid-19-measures-have-all-but-wiped-out-the-flu-in-the-southern-hemisphere-11595440682
https://www.quora.com/Viral-load-is-apparently-a-big-factor-with-COVID-19-how-much-initial-exposure-you-have-influences-how-bad-youll-have-it-Why-Wouldnt-the-virus-duplicate-in-your-cells-constantly-growing-anyway-Why-does-the-initial/answer/John-Forrester-32
https://www.bbc.co.uk/news/health-53515078
https://www.gov.uk/government/news/most-comprehensive-flu-programme-in-uk-history-will-be-rolled-out-this-winter
https://eu.usatoday.com/story/money/food/2020/07/24/mask-mandates-mcdonalds-requiring-face-masks-nationwide-coronavirus/5502037002/
https://www.cdc.gov/mmwr/volumes/69/wr/mm6930e1.htm?s_cid=mm6930e1_w
Face covering effectiveness:
https://thorax.bmj.com/content/early/2020/07/24/thoraxjnl-2020-215748

Pregnancy
https://pan-covid.org/
https://www.nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk/pregnancy-and-coronavirus/
https://www.npeu.ox.ac.uk/ukoss
https://www.medscape.com/viewarticle/934231

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