Archive for January, 2020

Nurse battles Coronavirus on the Front Line

Monday, January 27th, 2020

Away from all the major updates and statistics, this personal account by Jiang Ting, a nurse with Guangdong Second Provincial General Hospital, reflects what it is like for perhaps hundreds of thousands of frontline medical staff battling this virus throughout China.

It’s 4 am on Monday when my colleague, Yi Bingkun, and I finished the night shift. It’s the 50th hour since we arrived in Wuhan to help fight against the novel coronavirus. The situation here is far more grievous than what we imagined, with more suspected cases and an acute shortage of medical staff. We are here to bring them hope, but it seems that we assume more responsibilities.

The ward was almost overloaded during our first night shift and we continued to receive more patients. My colleague and I plunged into work without delay after wearing protective suits.

However, an emergency occurred when a patient went into sudden cardiac arrest when we had just changed shifts. Kun (my colleague Yi Bingkun’s nickname) rushed to give chest compressions to the patient and I called a doctor for help.

The patient, unfortunately, died of severe illness after all rescue measures failed. The patient’s family, however, sent their gratitude to us. Their every single “Thank you” makes me feel warm and that the efforts we’ve made are worthwhile.

But Kun brought me more warmth because of his bravery and spirit.

I once asked him whether he felt afraid about the possibility of becoming infected when saving the patient. He told me that, “Yes, I was really scared at the time because I do have my family and my kid. But I was more afraid that the life might disappear in front of me.”

I’m really proud to have Kun as my team member.

Our night shift should have been finished at midnight, but it ended at 3 am that night. We found our clothes were drenched after we took off our protective suits. I remember that it was 5 am when we finished washing.

What is impressive is that my colleagues messaged us, worrying why Kun and I didn’t come back with the clock pointing to 1 am, 2 am or even 3 am. They urged us to let them know we were okay as soon as we came back. The tiredness soon lifted.

Kun and I were in a hurry to sum up our work last night at 8 am. Kun even drew a rough sketch of the ward to our colleagues, Xiong Minlong and Jiangjie, who cheered each other on at the time.

Wang Yan, associate chief physician of our hospital’s respiratory department, gave us lectures and advice during breakfast. Sun Liang and Zhong Lina also joined us for logistical management and preparation work.

The weather is really cold but we feel warm from the bottom of our hearts.

Come on, Wuhan! Come on, all my colleagues!

 

Coronavirus 2019-nCoV EDEC Risk Assessment 26th January

Monday, January 27th, 2020

RISK ASSESSMENT ISSUED BY THE EUROPEAN CENTRE FOR DISEASE PREVENTION AND CONTROL (EDEC) 26TH JANUARY

The following risk assessment has been issued by the EDEC cautioning that “there are considerable uncertainties in assessing the risk of this event, due to lack of detailed epidemiological analyses”.

On the basis of the information currently available, ECDC considers that:

  • “the potential impact of 2019-nCoV outbreaks is HIGH;
  • further global spread is LIKELY;
  • there is currently a MODERATE likelihood of infection for EU/EEA citizens residing in or visiting Wuhan, Hubei province, China;
  • there is a HIGH likelihood of further case importation into countries with the greatest volume of people who have travelled from Wuhan, Hubei Province (i.e. countries in Asia);
  • there is a MODERATE likelihood of further case importation into EU/EEA countries;
  • adherence to appropriate infection prevention and control practices, particularly in healthcare settings in EU/EEA countries with direct links to Hubei, means that the likelihood of a case detected in the EU resulting in secondary cases within the EU/EEA is LOW;
  • the impact of the late detection of an imported case in an EU/EEA country without the application of appropriate infection prevention and control measures would be HIGH, therefore in such a scenario the risk of secondary transmission in the community setting is estimated to be VERY HIGH”.

 

CORONAVIRUS Reducing exposure and reducing transmission of virus

Monday, January 27th, 2020

World Health Organisation standard recommendations for the general public to reduce exposure to and transmission of a range of illnesses are as follows, which include hand and respiratory hygiene, and safe food practices:

  • Frequently clean hands by using alcohol-based hand rub or soap and water;
  • When coughing and sneezing cover mouth and nose with flexed elbow or tissue – throw tissue away immediately and wash hands;
  • Avoid close contact with anyone who has fever and cough;
  • If you have fever, cough and difficulty breathing seek medical care early and share previous travel history with your health care provider;
  • When visiting live markets in areas currently experiencing cases of novel coronavirus, avoid direct unprotected contact with live animals and surfaces in contact with animals;
  • The consumption of raw or undercooked animal products should be avoided. Raw meat, milk or animal organs should be handled with care, to avoid cross-contamination with uncooked foods, as per good food safety practices.

CORONAVIRUS 2019-nCoV SITREP 27TH JANUARY.

Monday, January 27th, 2020

SITUATION OVERALL

Overall number reported around the world climbed to about 2,744.

There are 80 deaths, in China from 2019-nCoV an increase from 56 reported yesterday.

95% of deaths and more than 50% of infections are in Hubei province.

769 of those newly confirmed in the 24 hours through midnight Sunday.

WHO’s assessment of the risk of this event has not changed since the last risk assessment conducted on 22 January: very high in China, high at the regional level and high at the global level.

SITUATION IN WUHAN

5 million residents left Wuhan before lockdown, mayor reveals, as 1,000 new confirmed cases expected in city

There were about 9 million people remaining in the city after the lockdown, Zhou told a press conference.

Of the 2,700 people currently under observation in the city, about 1,000 were likely to be confirmed cases.

PORTUGAL

The Portuguese Ministry of Foreign Affairs advised against “non-essential trips” to China today, due to the new coronavirus, justifying the alert due to possible health risks and the current limitations on circulation within the country.

Ministry of Foreign Affairs (MNE), has  recommended “permanent attention to the constant evolution of the situation ”, as well as information published on the portals of the Directorate-General for Health, the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization.

CHINA

Health commission says battling the epidemic is becoming more complicated as the Chinese State Council extends the Lunar New Year holiday to February 2

It added that the virus had adapted to humans and appeared to have become more transmissible.

“There are signs showing the virus is becoming more transmissible. These walking ‘contagious agents’ [hidden carriers] make controlling the outbreak a lot more difficult.”

The authorities had also not ruled out the possibility of the virus mutating in the future, he said, which meant it could spread to different age groups.

To date, most of the people infected are in the 40-60 age range, health officials said earlier.

Speaking to the press on Sunday, Gao Fu, head of the Chinese Centre for Disease Control and Prevention, said the peak of the outbreak had yet to come.

ACTIONS BY OVERSEAS GOVERNMENTS

United States, France, Australia, Japan and Russia are all preparing to pull their citizens out of Wuhan, while others are ramping up measures to prevent people travelling from infected cities into their territories

The ABC reported that more than 100 Australian children were currently trapped in Wuhan.

The Foreign Office updated its guidance to “advise against all travel to Hubei province”.

560 Japanese citizens are confirmed in Hubei and chartered evacuation flights are being prepared to leave as soon as possible.

In the UK Both the home secretary, Priti Patel, and the foreign secretary, Dominic Raab have said ministers are considering an evacuation plan, but both stopped short of committing to one.

New Coronavirus – Situation  26th January 0800 hrs

Saturday, January 25th, 2020

Facts

Massive increas in last 24 hrs 2000 infected infected in China, 31 confirmed overseas. 10 countries affected

17 cities have suspended public transport affecting 56 million,

56 dead including a doctor in Wuhan none overseas.

China is suspending all tour groups and the sale of flight and hotel packages for its citizens headed overseas, starting on Monday.

The Portuguese authorities are cooperating with other European countries to reinforce support to national citizens who are in Wuhan, admitting the possibility of removing them.

The US is beginning an operation to evacuate its citizens and diplomats from Wuhan,

67 hospitals have opened special emergency rooms for patients with fevers.

The World Health Organization’s decided on Thursday not to classify the virus as an “international emergency”, partly because of the low number of overseas cases; this has surprised some experts.

UK, 2,000 travellers who have arrived recently from Wuhan are being sought. Fourteen people tested negative for the virus. 31 tested all negative.

WHAT IS IT?

It is a member of the coronavirus family that has never been encountered before. Like other coronaviruses, it has come from animals, or possibly seafood. No know vaccine. More details about the Virus from Public Health England here     

SYMPTOMS

The virus causes pneumonia. Coughs, fever and breathing difficulties. As this is viral pneumonia, antibiotics are of no use. Antiviral drugs only lessen the severity of symptoms. Spread through inhalation person to person.

Precautions on how to protect yourself from the virus while travelling:

  • Avoid contact with people who display symptoms similar to those of pneumonia or the common cold, like coughing or a runny nose.
  • Don’t touch your eyes, nose, or mouth with unwashed hands.
  • Wash your hands frequently with soap and water, and scrub for at least 20 seconds.
  • Use alcohol-based hand sanitizer when possible.
  • Avoid animals and animal markets.

PORTUGAL

Director Health Portugal said that “there are no suspicious cases in Portugal” of infections with the coronavirus, there is no alarm situation, but as a precaution she is “paying more attention” to cases exported outside China.

In Portugal, DGS activated protocols established for this type of situation reinforcing the National Health Service with the Health 24 line, through the number 800 242 424, and the medical support line, for screening..

“DGS, with their partners have contingency plans that are regularly tested, to detect, diagnose and treat

 

TRAVEL ADVICE

The Foreign and Commonwealth Office (FCO) advise against all travel to Hubei Province. If you are in this area and able to leave, you should do so.

 

COMPARISON WITH SARS

The first case is thought to have been reported on Nov. 16, 2002.

Health officials didn’t know what it was, and SARS was categorized by its symptoms, which were similar to pneumonia.

Took 4 months for it to be reported to the WHO on Feb. 14, 2003, when there were already more than 300 cases. Chinese officials were not sure what caused the illness. In 5 weeks there were cases in 13 countries and 10 deaths. Overall 8442 infected at 916 deaths mortality over 10%

Looking back at SARS, the fatality rate for SARS varied by age, “less than 1 % aged 24 years or younger, 6 % in persons aged 25 to 44 years, 15 % aged 45 to 64 years, and greater than 50 %s aged 65 years and older,”

So far, the deaths from 2019-nCoV have mostly been in older people many with existing health conditions

PORTUGAL WAS ONE OF the few countries in Europe with NO cases.

The healthcare system and hospitals are far better prepared today, with improved surveillance systems, medication and equipment [including masks] stockpiles, and a state-of-the-art 330-bed facility in the National Centre for Infectious Diseases that was built precisely to avoid a repeat of the SARS debacle,” he said.

In the past 100 years we have had four major flu virus mutations that have given rise to major pandemics. The first, the Spanish flu, during the Great War, was the deadliest in history: at least 50 million people died. It was extremely aggressive, unlike what happened 90 years later with H1N1, in 2009. We still don’t know the mortality rate of this new virus, but in SARS it was extremely high: 10%. The flu we have every year is around 1%. Last winter we will have had more than a million people with the flu and around 3,000 died.

Toll Reduction on A22 Planned

Saturday, January 25th, 2020

Toll reduction model will include interior and A22 and A28 motorways

The toll discount model, in addition to the interior territories, will be applied on the A22 motorways – Via do Infante, in the Algarve, and the A28, which connects Porto to Caminha, the minister of Territorial Cohesion announced yesterday.

“The idea is to work on a toll discount model for the interior and also for Via do Infante [A22] and A28”, said Ana Abrunhosa, in the final intervention of the parliamentary hearing on the State Budget proposal for 2020 (OE2020), which took place over five hours, in the Assembly of the Republic.

According to the person in charge of the Territorial Cohesion portfolio, the work for the implementation of discounts on motorway and expressway tolls “is advanced”, with the presentation of an ordinance “soon”.

“There is no question of abolishing tolls, it is a matter of reducing tolls”, reinforced the minister, explaining that the proposal to reduce tolls is under study, through a working group made up of members of the ministries of Territorial Cohesion, Infrastructure and Housing and Finance, which is working on “priorities” and “various scenarios for the gradual reduction of tolls”.

Recalling that this was a promise from the Government, Ana Abrunhosa assured that the working group responsible for the measure is giving “the highest priority to this matter” and working on a toll discount model “based on quantity discounts and discounts on rest days ”, correcting the initial information that it only covered weekends.

“We would very much like the discount to have some impact on rest days, which would benefit frequent users, as well as those who visit the territory,” said the minister, arguing that “the impacts of a small reduction are always significant”.

Thus, the Government intends to “give a political signal to these territories and make it feel in people’s pockets”.

“I cannot commit myself to dates, I cannot commit myself to percentages [of discount], because that will have to be announced jointly by the working group”, said the Minister of Territorial Cohesion.

RISK OF CONTAGION OF CORONVIRUS IN EUROPEAN UNION IS ALREADY MODERATE

Thursday, January 23rd, 2020

LATEST SITUATION IN CHINA

The European Centre for Disease Control has raised the risk of contagion in the European Union (EU) of the coronavirus to ‘moderate’, keeping an eye out for new developments, notably after the Chinese New Year celebrations.

“The ECDC is monitoring the situation and conducting rapid risk assessments, having verified in the most recent one, made on Wednesday, that there is a ‘moderate’ probability there are cases in the EU in the European Economic Area “, according to the Community executive in a written reply sent to the Lusa news agency.

This represents a “small increase” compared to the risk assessment made by ECDC last week and follows the “confirmation of human-to-human transmission”, said the community executive.

The virus has killed 18 people in China, with 633 affected with 95 in serious condition.

IN CHINA

Chinese authorities have imposed lockdown measures on five cities in an unprecedented effort to contain the outbreak during the busy lunar new year travel period.

Authorities banned transport links from Wuhan, the capital of Hubei province, on Thursday morning, suspending buses, subways, ferries and shutting the airport and train stations to outgoing passengers. Later in the day, the nearby central Chinese cities of Huanggang and Ezhou announced similar measures. Travel restrictions were also placed on the smaller cities of Chibi and Zhijiang.

Starting at midnight, long-distance buses, the rapid transit system, and train station in Huanggang would be shut, according to a notice from the local government. Cinemas, internet cafes, and other entertainment venues would all stop operating. Residents should not leave the city, except for “special reasons”.

 

The European Commission further states that, together with ECDC, it is making “efforts to support the carrying out of reports and rapid surveillance actions, should a case be detected in the EU”.

“As the situation evolves, the Commission and the Member States will continue to coordinate to ensure an optimal and aligned response across the EU,” says Brussels.

It is a new type of coronavirus, which is transmitted between animals and passed to humans, with records of transmission from person to person, but still in circumstances that are not fully substantiated.

The symptoms of these coronaviruses are more intense than the flu and include fever, pain, malaise and breathing difficulties, including shortness of breath.

Communique by Director General Health Coronavirus (2019-nCoV) 21st January 2020

Wednesday, January 22nd, 2020

Regarding the outbreak of pneumonia due to a new Coronavirus (2019-nCoV), taking place in China, the Directorate-General for Health informs:

According to information provided by the European Center for Disease Prevention and Control (ECDC), from January 21, 2020, since December 31, 2019, were 295 laboratory confirmed cases of infection with the new coronavirus (2019-nCoV)in China:

▪ 270 cases in Wuhan, including 4 deaths;

15 confirmed cases in Health professionals;

▪ 14 cases in Guangdong province; 5 cases in Beijing province; 2 cases in Shanghai  Thailand: 2 cases; Japan: 1 case; South Korea: 1 case.

  • The outbreak remains under investigation to better characterize the situation, with research active case management and contact surveillance to identify new cases. This fact reflected in the delay between the registration of locally reported cases and the notification international circuits, by the competent authorities.
  • All cases reported outside Wuhan refer to connection to this city.
  • Most cases are epidemiologically associated with a specific market for food and live animals (fish, seafood and poultry) in Wuhan (Wuhan’s Huanan Seafood Wholesale Market), which was cleared and closed to the public on January 1, 2020.
  • To date, there is no evidence of sustainable human-to-human transmission to date.
  • ECDC considers that there is a low probability of importing cases into Union countries

European / European Economic Area (EU / EEA).

  • The Directorate-General for Health (DGS), in continuity with the initiatives it has been developing since the identification of the new coronavirus, today it convened a committee of experts, composed by representatives of DGS, National Institute of Health Dr. Ricardo Jorge (INSA), Services Shared by the Ministry of Health, National Institute of Medical Emergency (INEM) and representatives of reference hospital units, among others.

The objective was to assess the evolution of the situation and to define, in a proactive and coordinated way, possible measures to be taken, according to the precautionary principle in the health response to the public.

The World Health Organization will meet tomorrow, 22 January 2020, the Health Committee Emergence of the International Health Regulations.

DGS continues to monitor the situation and reinforces the recommendations previously issued for travellers to Wuhan and Beijing, Guangdong and Shanghai, in China:

  • Avoid close contact with people who suffer from acute respiratory infections;
  • Wash your hands frequently, especially after direct contact with sick people;
  • Avoid contact with animals;
  • Adopt respiratory etiquette measures: cover your nose and mouth when sneezing or coughing (with tissue paper or with the arm, never with the hands; throw the tissue in the trash);
  • Wash your hands whenever you blow, sneeze or cough.
  • If travellers staying in Wuhan experience symptoms suggestive of illness during or after the trip, they should seek medical attention, informing you of your travel history.
  • You can also call 808 24 24 24 (SNS24) to clarify any points or ask questions

Communiqué 160_03_v1 of 1/21/2020 2/3

Alameda D. Afonso Henriques, 45 | 1049-005 Lisbon – Portugal | Tel: +351 21 843 05 00 | Fax: + 351 21 843 05 30 | E-mail: geral@dgs.min-saude.pt | www.dgs.pt

 

New Coronavirus in China – Number of Deaths Double

Wednesday, January 22nd, 2020

NEW CORONAVIRUS IN CHINA – NUMBER OF DEATHS DOUBLE

LATEST UPDATE 22ND JANUARY 1600 HRS

Mainland China has 444 confirmed cases and 17 fatalities as of 2000 hrs (China time) Wednesday 22nd January, according to state broadcaster CCTV. On Tuesday the figure was given as 9.

Most of the cases are in Hubei province where Wuhan is located, with smaller numbers in other provinces and municipalities, including Beijing, Shanghai and Guangdong. There had been 15 cases among medical professionals in Wuhan, with one in a critical condition.

Hong Kong reported two infections with positive results in initial tests, while Macau confirmed its first case on Wednesday. A five-year-old in the Philippine province of Cebu has been tested, while Australia has placed a man in isolation at his home in the city of Brisbane. Cases have been confirmed in USA, South Korea,

No deaths have been reported overseas.

The WHO is holding an emergency meeting today in Geneva to decide whether the outbreak should be declared an international public health emergency.

In Macau, the authorities announced that they will individually check passengers from Wuhan, “by air, sea or land”.

Chinese authorities have urged people to stop travelling in and out of Wuhan, the city at the centre of a new virus outbreak.

The virus, known also as 2019-nCoV, is understood to be a new strain of coronavirus that has not previously been identified in humans. The Sars virus that killed nearly 800 people globally in the early 2000s was also a coronavirus.

SYMPTOMS

The symptoms of these coronaviruses are more intense than the flu and include fever, pain, malaise and breathing difficulties. In the cases initially confirmed, 90% had fever, 80% dry cough, 20% shortness of breath and only about 15% had difficulty breathing.

What is the mortality rate of the new coronavirus?

According to currently available data, mortality from the new coronavirus stands at 1.5%, but health authorities warn that it is necessary to continue to monitor developments.

However, until now, 2019-nCoV is being considered less aggressive in its consequences, when compared to the atypical pneumonia of 2002/2003, which had a mortality rate around 10%.

The pulmonologist Filipe Froes recalls that all respiratory infections, including the flu, can cause death, especially in patients with other associated pathologies or more fragile and elderly people.

Outbreak or Respiratory Disease in Wuhan China

Wednesday, January 22nd, 2020

COMMUNICATION FROM THE DIRECTOR OF GENERAL HEALTH

OUTBREAK OF RESPIRATORY DISEASE IN WUHAN CHINA

PRECAUTIONARY MEASURES

Communiqué from the Director-General of Health

The Directorate-General for Health is monitoring the situation and recommends that travellers for that region of China take the following measures:

  • Avoid close contact with people who suffer from acute respiratory infections;
  • Wash your hands frequently, especially after direct contact with people sick;
  • Avoid contact with animals;
  • Adopt respiratory etiquette measures: cover your nose and mouth when sneezing or coughing (with a tissue or with your arm, never with your hands; throw the paper in the trash); wash your hands whenever you blow, sneeze or cough.

If travellers to that region of China show symptoms suggestive of illness during or after the trip, they should seek medical attention and inform the doctor about the history of the trip.

They can also call 808 24 24 24 (SNS24) to answer questions.

Communiqué 160_01_v2 of 1/14/2020 2/2

Alameda D. Afonso Henriques, 45 | 1049-005 Lisbon – Portugal | Tel: +351 21 843 05 00 | Fax: + 351 21 843 05 30 | E-mail: geral@dgs.min-saude.pt | www.dgs.pt

The Directorate-General for Health monitors the situation, in line with the organizations international organizations, in particular with WHO, and will disseminate new information whenever relevant.

World Health Organization information: