As Britain is hit by a second wave of coronavirus infections and deaths, the country’s doctors and nurses are bracing for what is expected to be a deluge of new patients over the next six months. But this time, they say, the wave is coming without the same sense of caution among a coronavirus-weary public, nor with a clear government strategy to contain the virus and address rapidly filling intensive care units.
Politicians across the political spectrum in Britain largely accepted the need for the country’s first lockdown in the spring, and doctors limped through the crisis, fueled by adrenaline and the hope that the government could keep an eventual resurgence of cases from inundating the health service again.
That hope has not been realized. With 367 deaths and 22,885 confirmed cases on Tuesday alone, Britain has a second wave of infections that could test its overextended health service even more severely than the first did.
A decision by England’s health service to restore normal services has meant that there are fewer unoccupied hospital beds now than there were in the spring, and fewer doctors available to redeploy to coronavirus wards.
Making matters worse, hospitals are already receiving the usual wintertime stream of patients with influenza and other illnesses that can fill them above 95 percent of capacity even in a normal year.
“The first time around, it’s almost like a once-in-a-lifetime kind of medical challenge,” said Paul Whitaker, a respiratory doctor in Bradford, in northern England, where the number of coronavirus patients has returned to its early May peak.
“At the time, it felt like the thing to do, because it was unavoidable and we had to do our bit,” said Tom Lawton, an intensive care doctor in Bradford. “It was that kind of Blitz spirit. Whereas this time, it feels like this could have been avoided, and clearly it has been avoided in a number of countries.”
In other developments around the world:
President Cyril Ramaphosa of South Africa has gone into quarantine after a guest at a charity dinner he attended last weekend tested positive for the coronavirus. Mr. Ramaphosa was not showing any symptoms, his office said Wednesday. Before receiving the results of the test on Tuesday, Mr. Ramaphosa attended several public events in Johannesburg, although he and most of the attendees wore masks. With at least 717,000 total cases and 19,000 deaths, South Africa has been the hardest-hit country in Africa during the pandemic.
Hawaii will allow travelers from Japan to skip a mandatory 14-day quarantine beginning Nov. 6 if they present proof of a negative Covid-19 test, Gov. David Ige announced Tuesday. “Many of Hawaii’s residents trace their ancestry back to Japan, and welcoming our Japanese guests back to Hawaii is an important step in maintaining the close relationship between our two regions,” Mr. Ige said. To bypass quarantine, visitors from Japan must show a negative coronavirus result on a test taken no more than 72 hours before their departure.
Archana Ghugare’s ringtone, a Hindu devotional song, has been the background score of her life since March. By 7 a.m. on a mid-October day, the 41-year-old has already received two calls about suspected COVID-19 cases in Pavnar, her village in the Indian state of Maharashtra. As she gets ready and rushes out the door an hour later, she receives at least four more.
“My family jokes that not even Prime Minister Modi gets as many calls as I do,” she says.
Ghugare, and nearly a million other Accredited Social Health Activists (ASHAs) assigned to rural villages and small towns across India, are on the front lines of the country’s fight against the coronavirus. Every day, Ghugare goes door to door in search of potential COVID-19 cases, working to get patients tested or to help them find treatment.
With 8 million confirmed COVID-19 cases, India has the second-highest tally in the world after the United States and its health infrastructure struggled to cope with the surge in COVID-19 patients this summer. India spends only 1.3% of its GDP on public health care, among the lowest in the world. The situation is stark in rural areas where 66% of India’s 1.3 billion people live and where health facilities are scant and medical professionals can be hard to find.
India’s ASHA program is likely the world’s largest army of all-female community health workers. They are the foot soldiers of the country’s health system. Established in 2005, a key focus of the program was reducing maternal and infant deaths, so all recruits are women. They have also played an essential role in India’s efforts to eradicate polio and increase immunization, according to numerous studies.
Read More: How the Pandemic Is Reshaping India
But even as health authorities have leaned on ASHAs to quell the spread of COVID-19 in rural areas, where a substantial number of new cases have been reported, many of these health care workers say the government is failing them. Pay was meager to begin with, but some workers have reported not being paid for months. Their hours have increased dramatically, but pay rises, when they have come, have not reflected the increased demands. Many ASHAs have also complained about not being provided adequate protective equipment for their high-risk work.
“They are the unsung heroes who are fighting to contain the unfettered spread of the virus in rural areas,” says Dr. Smisha Agarwal, Research Director at the John Hopkins Global Health Initiative. She argues it is vital to improve pay to boost morale and sustain this frontline workforce.
Ghugare was chosen from her village of 7,000 people in 2011. Since then, she has overseen countless births, meticulously monitored the health of thousands of newborn babies and strictly ensured immunization through door-to-door awareness campaigns. The personal relationships she built over the years have helped in the fight against COVID-19, giving her a good grasp of the medical histories of most of the 1,500 people assigned to her. “It’s all in
People have also begun complaining about long wait times.
“There is some disbelief that you’ve had six months to prepare for this and why haven’t you been training more nurses,” said Dr. Tamás Szakmany, an intensive care doctor in Newport, Wales. But, he said, “it’s not just like you’ve got a car factory and you suddenly need more transmissions, so you train the factory workers to build more transmissions. It’s just not that simple.”
Among doctors and nurses, a sense of battle fatigue has set in. Extra weekend shifts that were intended to be temporary have lasted through the summer, especially in northern cities where coronavirus wards remained busy even as a national lockdown was lifted in the summer. Health workers are calling in sick, many of them with anxiety and depression.
Rapid testing remains scarce for doctors and nurses. And health workers on coronavirus wards are supplied only with basic surgical masks, not the heavier-duty N-95 masks reserved for intensive care units.
“The first time around, it’s almost like a once-in-a-lifetime kind of medical challenge,” said Paul Whitaker, a respiratory doctor in Bradford, in northern England, where the number of coronavirus patients has returned to its early May peak.
“The hospital provided packed lunches for us all,” Dr. Whitaker added. “People were sending good luck messages. But the prospect of going into another six months, which is almost certainly what it’s going to be, is relatively frightening. How are you going to maintain the morale, the focus and the energy of all these people?”
In the ex-mining and manufacturing towns in England’s north that have been hit hardest by the latest surge of infections, doctors are especially harried. Nearly 40 percent of critically ill patients are now classified as the country’s most deprived, compared to a quarter of such patients in the spring and early summer.
Health workers in some hospitals in Liege, Belgium’s third largest city and a coronavirus hotspot, have been asked to continue working even if they test positive for Covid-19 — as long as they are not showing any symptoms of the disease.
Top health official have warned that Belgium could run out of intensive care beds in as little as two weeks and some hospitals are facing staff shortages. The country of 11.5 million people has reported on average more than 13,000 cases a day in the past week, according to the national public health institute Sciensano. The Covid-19 outbreak in Belgium is the second worst in Europe in terms of new cases per capita, after only the Czech Republic.
Yves Van Laethem, Belgium’s spokesperson for the fight against the coronavirus, warned that unless Belgians change their behavior, intensive care units will reach their capacity of 2,000 patients in 15 days.
Liege, the largest city in the French-speaking Wallonia region, has the highest incidence rate in Belgium. Tje communications director of Liege University Hospital, Louis Maraite, told CNN on Tuesday that because of staff shortages, the hospital had “no choice” but to make doctors and nurses who tested positive but have no symptoms come to work.
“This is not a problem as they are working in coronavirus units with patients who also tested positive,” he added. Maraite said that health workers with Covid-19 accounted for 5% to 10% of the total hospital workforce.
Health workers who show symptoms, such as fever, have been asked not to come to work, and Maraite said the hospital could not force asymptomatic health workers to show up.
Another Liège hospital, CHC MontLégia, also confirmed to CNN that positive asymptomatic health workers have been asked to continue working on a voluntary basis and in the “strict observance of sanitary measures” that include limiting contact with their colleagues.
Video: ‘Great Influenza’ author outlines what herd immunity supporters won’t say (CNN)
The spokesperson for the private hospital’s communication department told CNN that positive asymptomatic staff are working mainly in Covid-19 units but can work across all units including those with non-covid patients, except the geriatric, neonatology and oncology departments, where patients are “particularly vulnerable”.
A spokeswoman for the Belgian Health Ministry told CNN allowing asymptomatic health workers to continue working is allowed in “very strict conditions” because there are not enough health care workers. “We try to ensure the security of all patients,” she added.
At a news conference Monday, Van Laethem said that 1,000 of the country’s intensive beds are already being used, with total of 1,250 set to be occupied by the end of the week. Both hospital and intensive care admissions are doubling every eight days, he added.
In an interview with state broadcaster RTBF on Monday,
Workers at 11 Tenet Healthcare Hospitals Across California Overwhelmingly Vote to Strike, Calling for Contract to Address Pandemic Safety
LOS ANGELES, Oct. 27, 2020
Employees Want to Work with Tenet on a Contract that Ensures PPE, Staffing, and Clear Safety Protocols
LOS ANGELES, Oct. 27, 2020 /PRNewswire/ — Workers at 11 Tenet Healthcare hospitals in California have voted overwhelmingly to go on strike to demand that the giant hospital chain bargain in good faith with employees over health, safety, and other working conditions in their facilities, as caregivers continue to risk their lives caring for patients with COVID-19.
The strike vote covers 4,300 workers at the 11 facilities who are members of SEIU-United Healthcare Workers West. The vote margin was 96 percent in favor of the strike.
Tenet has rejected most of the workers’ proposals on pandemic safety. Workers are asking Tenet to go beyond the minimal federal guidelines to make sure the most comprehensive protections are in place.
“We are scared to come to work knowing we are at great risk of exposure to COVID-19,” said Gisella Thomas, a respiratory therapist at Desert Regional Medical Center in Palm Springs. “We want to work with management at our hospitals to increase protections for our health, our patients’ health, our families’ health, and the health of our communities. We have put forth a pandemic safety proposal that addresses issues workers are concerned about, like staffing, PPE, and increased COVID-19 testing for employees.”
Tenet has made more than $1 billion in profits in the first three quarters of 2020 and received more than $250 million in taxpayer bailout money in California alone. Tenet’s Chief Executive Officer Ron Rittenmeyer was paid more than $24 million in 2019, and the chain’s president and chief operating officer Saum Sutaria was paid nearly $14 million.
“We are calling on Tenet to increase its investment in worker safety and staffing in the middle of the worst pandemic in over a century – to ensure the safety of healthcare workers, our patients, and our entire communities.”
The strike will occur at the following Tenet hospitals in California:
INDIO: John F. Kennedy Memorial Hospital
JOSHUA TREE: High Desert Medical Center
LAKEWOOD: Lakewood Regional Medical Center
LOS ALAMITOS: Los Alamitos Medical Center
MANTECA: Doctors Hospital of Manteca
MODESTO: Doctors Medical Center
PALM SPRINGS: Desert Regional Medical Center
SAN LUIS OBISPO: Sierra Vista Regional Medical Center
SAN RAMON: San Ramon Regional Medical Center
TEMPLETON: Twin Cities Community Hospital
TURLOCK: Emanuel Medical Center
SEIU-United Healthcare Workers West (SEIU-UHW) is one of the largest unions of hospital workers in the United States, with 97,000 members. Learn more at www.seiu-uhw.org.
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SOURCE SEIU-United Healthcare Workers West
Nurses comprised the highest percentage of coronavirus hospitalizations over other types of health care personnel, says a new report from the Centers for Disease Control and Prevention (CDC).
The agency assessed data from the COVID-19–Associated Hospitalization Surveillance Network (COVID-NET). Of over 6,000 adults who were hospitalized with coronavirus between March to late May, 5.9% were health care workers.
MOTHER AND DAUGHTER WORKING TOGETHER AS NURSES TO TREAT CORONAVIRUS PATIENTS: ‘WE’RE JUST CALLED TO STEP UP’
Almost one-third of the hospitalized health care workers were nurses. In total, over 36% of health care personnel worked in nursing-related jobs, including certified nursing assistants.
“Nurses are frontline workers and might be at particular risk for exposure because of their frequent and close patient contact, leading to extended cumulative exposure time,” according to the CDC report.
Of all the health care personnel, nearly 90% had at least one underlying condition, and obesity was the most common at 73%. Nearly one-third of the workers required intensive care, and 4% died.
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Nurses make up a significant proportion of health care workers in the U.S. The CDC noted that, in 2019, registered nurses comprised about one-third of health care practitioners.
Serious cases of COVID-19 among health care workers at risk of transmission “could decrease the workforce capacity of the health care system,” the CDC wrote.
The agency stressed the importance of face masks while inside health care facilities to lower the risk of virus transmission. Eye protection was advised during patient contact in areas with elevated community virus spread.
The data had limitations, including how it was unknown whether workers were infected in the workplace or out in the community.
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The global hunt for a COVID-19 vaccine for kids is only just beginning, a lagging start that has some U.S. pediatricians worried they may not know if any shots work for young children in time for the next school year. (Oct. 21)
The governor also urged tourists to ‘follow our rules’
Gov. Steve Sisolak says frontline health care workers can expect to receive the first doses of a long-awaited coronavirus vaccine as soon as it arrives.
Sisolak unveiled the state’s plan to roll out the vaccine at a Monday press conference in Carson City, telling reporters the state will rely on its existing vaccine inventory system to get the doses out.
“I want to be very clear, there are still many unknowns before a vaccine is ready for distribution,” the first-term Democrat said from a conference room at the state Legislature. “But I want you to know we will be prepared when the time comes.
“There is no approved vaccine at this time,” Sisolak added. “There’s a lot of speculation, but no definitive timeline for when one may be approved. … We’re fortunate to have an existing framework managed by a team of experts who work on this on a day-to-day basis.”
More on this: A look at Sisolak’s coronavirus vaccine priority plan
Nevada Governor Steve Sisolak speaks during a press conference in the Nevada State Legislature Building in Carson City on June 24, 2020. (Photo: JASON BEAN/RGJ)
Officials said the so-called “Nevada Playbook” should be considered a “living document” that will be added to and adjusted in response to the vaccine’s availability.
A copy of the plan released shortly after Monday’s press conference shows the vaccine rollout will be quarterbacked by the Nevada Division of Public and Behavioral Health, which plans to coordinate with many of the same doctors, pharmacies and other immunization providers the agency has worked with during past pandemics.
Officials expect to direct the state’s initially limited supply of injections toward “critical populations” of health care workers and other virus-vulnerable populations, including those with underlying medical conditions and people over the age of 65.
They soon hope to recruit and enroll enough providers to offer the vaccine at hospitals, pharmacies, nursing homes, mobile health clinics and a whole host of other locations outlined in the 102-page plan.
Sisolak on rising COVID-19 cases
Governor Sisolak speaks during a press conference in the Nevada State Capital Building in Carson City with regards to the COVID-19 crisis on April 21, 2020. (Photo: JASON BEAN/RGJ)
Sisolak last week urged Nevadans to push past “COVID fatigue,” and to keep wearing their masks, in order to keep the state’s economy running.
Earlier this month, he loosened a statewide cap on large gatherings, but warned the state could pull back in the face of an “alarming trend” of new cases and hospitalizations that could put hospitals under strain during flu season.
Sisolak returned to that
Most of the health care workers hospitalized with the coronavirus are nurses, according to a new Centers for Disease Control and Prevention report.
The report found that nearly 6% of all patients hospitalized with COVID-19 were health care workers, with 36.3% of those patients being nurses. More than two-thirds, 67.4%, had direct patient contact and more than 4% of the health care workers who were hospitalized died.
Photos: Daily Life, Disrupted
The CDC’s report included medical records from nearly 7,000 coronavirus patients who were in the hospital between March 1 and May 31.
Nearly 90% of health care workers who were hospitalized with the virus had at least one underlying medical condition, with the most common, 73%, being obesity.
According to the report, the median age of the hospitalized health care worker was 49, compared to 62 among the general population. Most health care workers in the hospital with COVID-19 were women, with a large proportion being Black.
Additionally, the report found that the median length of hospitalization among the providers with COVID-19 was four days and 27.5% of providers were admitted to the intensive care unit for a median of six days.
The CDC said the findings were comparable to those reported among health care providers with COVID-19 in China.
In the U.S., nursing-related occupations account for a large proportion of the health care workplace, and in 2019 registered nurses represented approximately one-third of health care providers.
TOPEKA, Kan. (AP) — Health care workers and long-term care residents will be among those who will get the coronavirus vaccine first in Kansas, a draft plan shows.
Kansas’ 45-page plan was filed in the past week with the Centers for Disease Control and Prevention, The Kansas City Star reported. Other groups that will be prioritized for the initial rounds of vaccinations include people with underlying medical conditions, people 65 and older and essential workers.
Phil Griffin, the Kansas Department of Health and Environment bureau director for disease control and prevention, said the agency will use advisory committees to help determine who should receive the vaccine next. The plan indicates KDHE is taking input from groups representing individuals with disabilities, people of color, children and other demographics.
Griffin said there have been questions about whether states will receive vaccines based on the severity of the virus in their area, but no definitive answers. Kansas is being hard hit at the moment, though conditions could be significantly different months from now. Reported new cases and deaths are currently trending upward.
The state health department reported Monday that Kansas had 2,113 new confirmed and probable coronavirus cases since Friday, an increase of 3% that brought the total number of infections reported in the state to 72,968. The department also reported 13 additional COVID-19-related deaths, bringing the Kansas death toll to 872.
On Monday, the health department in Norton County reported a coronavirus outbreak killed 10 residents in a nursing home in northwestern Kansas. It said all 62 residents and an unspecified number of employees at the Andbe Home in Norton had tested positive for the virus.
Some vaccines in development require a second dose, likely taken three weeks to a month after the first. Kansas plans to give every vaccine recipient a card with instructions when they receive their initial dose, its plan says.
The vaccine is free, but recipients or their insurance may be asked to pay a small administrative fee, likely less than $20. No one, however, will be denied a vaccine based on the ability to pay.
The logistics of storing and distributing the vaccine could prove challenging, especially if the vaccine requires ultracold storage. Griffin said a survey of about 100 Kansas hospitals showed that just 10% currently have the capacity for ultracold storage.
But Griffin said the Centers for Disease Control and Prevention and HHS have advised Kansas “to not be focused on purchasing or expanding” ultracold storage capacity. He said vaccines requiring those conditions would be shipped directly from manufacturers in special units that can hold up to 5,000 doses.
The boxes can maintain the required temperature for up to 10 days if strict guidelines about how often they’re opened are followed, Griffin said.
“It is going to be a big lift,” Griffin said of the vaccination effort. “There’s no hesitation in saying that.”
Copyright 2020 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
More Hispanic workers impacted by Covid-19 in food processing and agriculture workplaces, CDC study finds
More Hispanic workers were impacted by the coronavirus pandemic in food processing plants, manufacturing plants and agriculture workplaces in the US last spring than workers of other races or ethnicities, a team led by the US Centers for Disease Control and Prevention reported Monday.
The study found that nearly 73% of workers at meat and poultry plants and similar settings across the country who were diagnosed with the virus were Hispanic or Latino, despite accounting for only 37% of the work force in these work places.
“Our study supports findings from prior reports that part of the disproportionate burden of COVID-19 among some racial and ethnic minority groups is likely related to occupational risk,” the team wrote.
Officials across the country have been reporting for months that the pandemic was disproportionately impacting communities of color due to a variety of reasons, including working and living conditions as well as equitable access to healthcare.
The CDC examined information collected from state health departments about workers with confirmed Covid-19 in food processing and manufacturing plants and agricultural settings between March 1 and May 31.
Nearly 73% of people diagnosed with coronavirus were Hispanic or Latino, 6.3% were Black and 4.1% were Asian or Pacific Islander, the survey found. This suggests “Hispanic or Latino, non-Hispanic Black, and non-Hispanic Asian/Pacific Islander workers in these workplaces might be disproportionately affected by COVID-19,” the researchers wrote in the CDC journal Emerging Infectious Diseases.
The researchers found reports on mass testing in US meat and poultry plants revealed widespread coronavirus outbreaks and found high numbers of asymptomatic or presymptomatic infections.
High-density workplaces can cause a higher risk for transmission of Covid-19, the researchers reported.
“These findings support the need for comprehensive testing strategies, coupled with contact tracing and symptom screening, for high-density critical infrastructure workplaces to aid in identifying infections and reducing transmission within the workplace,” the study concluded.
Only 36 states reported data, and testing strategies varied by workplace so that influenced the number of cases detected, the CDC said. Plus workers hesitant to report illness could have led to an underestimation of cases among workers.