The GeneXpert cartridge-based platform is used routinely at the CAPRISA clinic in Durban, South Africa, to rapidly test for tuberculosis and HIV viral load, but it is now also being used to test for COVID-19.
Shortly after instituting coronavirus disease 2019 (COVID-19) mitigation measures, such as banning air travel and closing schools, the South African government implemented a national lockdown on 27 March 2020 when there were 402 cases and the number of cases was doubling every 2 days (1). This drastic step, which set out to curb viral transmission by restricting the movement of people and their interactions, has had several unintended consequences for the provision of health care services for other prevalent conditions, in particular the prevention and treatment of tuberculosis (TB) and HIV. Key resources that had been extensively built up over decades for the control of HIV and TB are now being redirected to control COVID-19 in various countries in Africa, particularly South Africa. These include diagnostic platforms, community outreach programs, medical care access, and research infrastructure. However, the COVID-19 response also provides potential opportunities to enhance HIV and TB control.
In Africa, the COVID-19 epidemic is unfolding against a backdrop of the longstanding TB and HIV epidemics. South Africa ranks among the worst-affected countries in the world for both diseases. Despite having just 0.7% of the world's population, South Africa is home to 20% (7.7 to 7.9 million people) of the global burden of HIV infection (2) and ranks among the worst affected countries in the world for TB, with the fourth highest rate of HIV-TB co-infection (59%) (3). South Africa has made steady progress since 2010 in controlling both diseases. Increased access to antiretroviral drugs for treatment and for prevention of mother-to-child transmission of HIV has resulted in a 33% reduction in AIDS-related deaths between 2010 and 2018 (2). Similarly, the death rate among TB cases has declined from 224 per 100,000 population in 2010 to 110 per 100,000 population in 2018 (3). Have the strategies implemented for COVID-19 mitigation, particularly the lockdown, inadvertently threatened these gains in HIV and TB?
HIV and TB polymerase chain reaction (PCR) tests are key to treatment initiation and monitoring to achieve the United Nations goals for the control of HIV and TB. Disturbingly, these diagnostic tests declined during the lockdown. The 59% drop in the median number of daily GeneXpert TB testsa cartridge-based PCR test capable of diagnosing TB within 2 hours while simultaneously testing for drug resistancewas accompanied by a 33% reduction in new TB diagnoses (4). The restriction of people's movement and curtailment of public transport has led to substantial declines in patient attendance at health care facilities. A survey of 339 individuals in South Africa revealed that 57% were apprehensive about visiting a clinic or hospital during the lockdown, in part because of concerns that they may be exposed to infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from COVID-19 patients attending these facilities (5). Delayed HIV and TB testing impedes initiation of appropriate treatment, which increases the risk of new infections and drug resistance (6).
Both TB and HIV diagnostic platforms are important contributors to COVID-19 testing. The GeneXpert point-of-care testing platform, which is widely used in South Africa to diagnose TB, with more than 2 million individuals tested annually (7), is also being used to diagnose COVID-19. Until now, the limited availability of the GeneXpert COVID-19 cartridges has meant that spare capacity is mostly being used with little, if any, displacement of TB testing. Because there was also a decline in CD4+ assays (to test for immune status in HIV patients), it indicates decreased demand rather than displacement because this assay is not used for COVID-19. This may change as the demand for COVID-19 point-of-care testing rises and GeneXpert cartridges for COVID-19 become more readily available.
South African clinical laboratories have substantial capacity to perform high-throughput PCR assays for HIV viral load (more than 50,000 tests per day). However, the lack of COVID-19 test kits in South Africa, stemming from the global shortage, has meant that the available spare capacity on these platforms has sufficed for COVID-19 testing. The full potential of this PCR capacity is likely to be called upon when the country needs to expand COVID-19 PCR testing for the expected surge in cases, estimated to exceed 1 million at peak (8). Laboratory capacity for PCR testing developed for HIV and TB is now an essential resource for COVID-19 testing. The use of this capacity for COVID-19 needs to be monitored to identify and address any potential displacement of HIV and TB testing.
South Africa's experience in dealing with substantial HIV and TB epidemics has laid the foundations for the country's rapid, early community-based response. Both TB and COVID-19 are respiratory infections and can present with similar symptoms. They therefore present substantial infection control challenges, requiring timely and rapid diagnosis. Both diseases can spread more easily in conditions associated with poverty where social distancing is difficult to implement. Well-established community outreach capabilities for contact tracing, established for TB, were deployed to undertake contact tracing and quarantine monitoring for COVID-19.
With the highest HIV burden in the world, South Africa has a highly developed network of health care providers that includes tens of thousands of community health care workers who are trained to interact safely with infectious individuals and have experience in undertaking door-to-door visits in South Africa's most socially vulnerable communities. About 28,000 HIV community health care workers were deployed for COVID-19 symptom screening and testing referral (HIV outreach was put on hold) in 993 vulnerable, high-density communities, many lacking running water, to identify cases and thus reduce time to diagnosis and hence limit transmission. As clinical cases increased, there were insufficient tests for community-based screening, creating testing backlogs that delayed hospital patient results and led to curtailment of the community program with proposed adjustment to screening and quarantine without testing.
The established community engagement and outreach for HIV, TB, and noncommunicable diseases (such as hypertension and diabetes) provide an opportunity for integrating screening and testing in the long-term COVID-19 response. This approach will play an important role in reaching at-risk populations who do not readily make use of health services to establish a broader program of health promotion, prevention, and early detection. Such integration can be facilitated by the expansion of mobile onsite rapid testing approaches, using newly developed COVID-19 tests (9) and existing tests for HIV and other conditions on readily accessible samples such as saliva and blood from finger pricks. Combining health promotion programs for these diseases will reduce duplication and provide synergistic messaging because social distancing affects not only COVID-19 transmission but also that of TB and other respiratory infections. After the COVID-19 surge, integrated services could potentially provide an important approach to balancing ongoing vigilance for COVID-19 with early community-based detection of individuals with HIV and/or TB.
Access to medical care for nonCOVID-19 conditions was limited during the lockdown, with health facilities experiencing declines in the number of TB and HIV patients collecting their medication on schedule. The World Health Organization estimates that a 6-month disruption of antiretroviral therapy could lead to more than 500,000 additional deaths from AIDS-related illness in 2021 and a reversal of gains made in the prevention of mother-to-child transmission (10). In South Africa, 1090 TB patients and 10,950 HIV patients in one province have not collected their medications on schedule since the start of the national lockdown (11). A national survey of 19,330 individuals in South Africa found that 13.2% indicated that their medication for chronic disease was inaccessible during the lockdown (12). Furthermore, hospital admissions for HIV and TB declined as a result of hospitals reducing nonurgent admissions in preparation for a surge of COVID-19 cases and owing to closures to reduce exposure to COVID-19 patients. The potential negative impact on the continuity of care for HIV and TB patients could have substantial repercussions for both treatment and control, including development of drug resistance (6).
The biological and epidemiological interaction of COVID-19, HIV, and TB is not well understood. Patients immunocompromised by HIV or with TB lung disease could be more susceptible to severe COVID-19. However, preliminary results from a study of 12,987 COVID-19 patients in South Africa indicate that HIV and TB have a modest effect on COVID-19 mortality, with 12% and 2% of COVID-19 deaths attributable to HIV and TB, respectively, compared to 52% of COVID-19 deaths attributable to diabetes (13). The small contribution of HIV and TB to COVID-19 mortality is mainly due to these deaths occurring in older people, in whom HIV and active TB are not common. Integrated medical care for these three conditions is important as COVID-19 patients coinfected with HIV or TB start attending health care services in larger numbers.
South Africa's COVID-19 response, especially the lockdown, has led to substantial economic hardship, particularly among the poor and vulnerable. This has had a disproportionate impact on women, many of whom are self-employed or day laborers without a safety net (14). This may have a longer-term effect on increasing diseases associated with poverty (such as TB) and with gender, such as HIV, for which young women bear a disproportionate burden (15). The social determinants of HIV and TB will need to be carefully monitored to assess the impact of COVID-19. The effect of the lockdown on the economy, including declining taxes, is also likely to negatively affect funding for HIV and TB programs, among many others.
New and ongoing research on HIV and TB prevention and treatment have been severely affected by the COVID-19 epidemic. At the initiation of the lockdown in South Africa, the National Health Research Ethics Committee suspended all medical research, including clinical trials. Research progress on these two conditions has also slowed because several of the country's AIDS and TB researchers are redirecting their efforts to COVID-19. However, COVID-19 research efforts have increased collaboration and created new approaches to speed up therapeutic and vaccine development and testing, which will likely have long-term benefits for medical research beyond COVID-19. Several countries in Africa have well-developed HIV and TB clinical trial infrastructure that could contribute to COVID-19 vaccine trials. Past investments in infectious disease training and research have generated handsome returns to the COVID-19 response, highlighting the importance of maintaining these investments in the future.
Acknowledgments: We thank C. Baxter, W. Stevens, and A. Rademeyer for their assistance as well as the South African Department of Science and Innovation and Medical Research Council. Both authors are members of the South African Ministerial Advisory Committee for COVID-19.
"From day one, any discussion of herd immunity or survival of the fittest or, you know, 'Say farewell to the elderly,' are the things that just did not sound right for us," Jordan's Prime Minister Omar Razzaz tells NPR. "So we went for a very different model in Jordan, based on social solidarity." Jane Arraf/NPR hide caption
"From day one, any discussion of herd immunity or survival of the fittest or, you know, 'Say farewell to the elderly,' are the things that just did not sound right for us," Jordan's Prime Minister Omar Razzaz tells NPR. "So we went for a very different model in Jordan, based on social solidarity."
Jordanian Prime Minister Omar Razzaz sits in the front room of his family home in a middle-class Amman neighborhood of traditional white stone houses with small gardens and low walls. Unusually, in a region where senior officials typically live in gated compounds far from public view, the residential street has been kept open to traffic to minimize disruption to Razzaz's neighbors.
Razzaz, an MIT and Harvard-educated economist, was appointed by Jordan's King Abdullah II to head a new government two years ago, following anti-government protests that were sparked by IMF-mandated tax increases seen as bypassing the rich. Although he'd served previously as education minister, Razzaz was seen as a relative outsider.
The small, resource-poor kingdom is surrounded by dangers from neighboring countries: a war in Syria, conflict between the U.S. and Iran in Iraq, and Israeli plans to annex parts of the West Bank it occupies something Jordan says poses a danger to the entire region.
But those issues have taken a back seat to controlling the coronavirus a feat Jordan has accomplished with an early and severe lockdown. The country of roughly 10 million has registered 1,131 coronavirus cases, with 11 deaths.
Razzaz sees vulnerable groups in other countries paying a disproportionate price for policies that don't prioritize them, and says Jordan's approach from the start was to protect the most vulnerable.
"From day one, any discussion of herd immunity or survival of the fittest or, you know, 'Say farewell to the elderly,' are the things that just did not sound right for us," Razzaz tells NPR. "So we went for a very different model in Jordan, based on social solidarity, in fact, helping the weakest. We did everything we can to make sure our children, our elderly, our refugees you know, the haves and the have-nots are protected."
In mid-March, Jordan was one of the first countries in the region to shut its airports and borders for all but essential goods. Arriving passengers were sent into compulsory quarantine. All but emergency workers and security forces were confined to their homes, with even grocery stores shut and the army distributing bread to poor neighborhoods.
The government cut public sector salaries and allowed businesses to reduce workers' wages, but banned them from laying off employees.
Razzaz says in the last four months, almost half of Jordan's population received some form of government assistance.
This week, the country announced it would reopen its airport to flights from a dozen countries where coronavirus rates are also low. With no cases of local transmission on most days, Jordan has stopped enforcing mask wearing and reopened restaurants and shopping malls.
Razzaz says industry production is now back to pre-coronavirus standards, and Jordan is exporting pharmaceuticals and food to other countries.
Jordan took a chance with the lockdown, he says, but felt it had little choice, given the prospect of its health care system being overwhelmed with COVID-19 cases.
"When we took the steps that we took, we did that not because we were certain about the outcomes. So there's always hindsight ... But we're very, very glad we did what we did. And a lot of countries that waited longer, including the U.S., ... are having a harder time containing the coronavirus," he says.
Razzaz and health officials note Jordan remains on guard for a possible resurgence of the virus as its airport reopens.
The longer-term challenge is an already fragile economy in which unemployment is rising sharply. Tens of thousands of Jordanians have lost their jobs in the Arab Gulf states, as those economies decline due to the pandemic and a plunge in oil prices.
The official unemployment rate for the first quarter of the year had already topped 19%. Some economists expect the real rate could reach 30% by the end of the year, with many of the unemployed young people.
Razzaz says, though, he is not worried by the prospect of renewed demonstrations that could be sparked by the economic crisis.
"While some countries worry a lot about social unrest, we see it as people expressing views about that hardship," he says. "We're going to be proactive with employment and job creation. And if you get frustrated and want to shout, we have a constitution and set of laws and institutions that allow that to happen in democratic ways."
The other wild card facing the kingdom is Israel's annexation threat. Jordan, along with Egypt, is one of only two Arab countries in the region to have signed a peace treaty with Israel. Jordan's king says he might suspend the 26-year-old treaty if Israel takes unilateral steps to claim sovereignty over parts of the West Bank.
Israel cites Jewish ties and a strategic need for it, but most of the international community opposes such a move, which could doom Palestinian hopes for an independent state.
Jordan, where a majority of citizens are of Palestinian origin, would be the country most affected by Israel's move, and instability could ripple across the region.
Razzaz says Jordan has not changed its insistence on the need for an independent Palestinian state alongside Israel.
"If you don't provide a just solution for the Palestinian people and sovereignty, you are pushing them and the region towards despair and extremism. So will there be conflict under such conditions? Yes, there will be, definitely," he says. "I think what His Majesty and Jordan have been doing is sounding the alarm bells."
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Starting Friday at 8 a.m., new capacity restrictions will be imposed on Anchorage bars, restaurants, gyms and other establishments.
The new emergency order, Anchorage Mayor Ethan Berkowitzs 14th during the COVID-19 pandemic, was announced Wednesday afternoon.
The changes once again make for a more fettered city as residents wont be able to enjoy activities like dining out or gathering in large groups as freely as before. For many Anchorage businesses, the new order means fewer customers coming through the doors. It also means many businesses must now keep a log of customers who visit for longer periods, to aid with the citys strained capacity for contact tracing.
The restrictions come as cases in Anchorage and Alaska have surged, and follow capacity restrictions being imposed in several other U.S. cities and states.
Weve seen a rapid acceleration in the number of cases, Berkowitz said in a community briefing Wednesday. Berkowitz said the medical infrastructure is currently unable to keep pace with the rise in COVID-19 transmission.
We are experiencing exponential growth at this time, Anchorage Health Department Director Natasha Pineda said during the briefing.
Since Friday, there have been 260 more cases in Anchorage, Pineda said. The city is averaging 37.9 cases per day. Last week, the city reported 24.9 cases per day. State data updated Wednesday showed 1,068 total Municipality of Anchorage residents have tested positive for COVID-19, including 391 recovered cases, 668 active cases and nine deaths.
Anchorage Mayor Ethan Berkowitz announced new capacity restrictions for bar, restaurants, gyms and other gatherings beginning 8 a.m. on Friday. (Bill Roth / ADN)
On Sunday, the city saw a daily record with 65 new cases, Pineda said.
Currently, our reproduction rate is one of the highest in the country, for the state. I am sure that the Municipality of Anchorage is contributing to that increasing reproduction rate, she said. Which means our virus is growing fast.
Fifty-nine percent of the citys ICU beds are occupied. While those arent all COVID-19 patients, the city is starting to see a creep-up in need for beds for patients with the virus, Pineda said.
The cases are rising and the pressure on our system is imminent, she said.
Under the mayors new order, indoor gatherings will be limited to 25 people, and outdoor gatherings where people are consuming food or beverages will be limited to 50 people.
Bars will be limited to 25% of their maximum building capacity, including staff.
Restaurants and breweries can reach 50% of their maximum capacity indoors, including staff. Outdoor space will be limited to table service only, and tables must be spaced at least 10 feet apart.
When bars and restaurants were operating under limited capacity in May under the second phase of Berkowitzs reopening plan, several cited concerns about being able to turn a profit or break even with limited customers.
Under the new order, other indoor entertainment facilities, such as gyms, bingo halls and theaters, are limited to 50% of their building occupancy. General retail businesses and personal care businesses such as salons do not fall under the capacity restrictions.
The new regulations will not apply to farmers markets, outdoor food truck events or drive-in events where people are in their cars.
A notice requiring patrons to wear masks is posted at the entrance of Spenard Roadhouse on July 22, 2020. (Emily Mesner / ADN)
Also, all businesses that have sit-down service lasting at least 15 minutes must keep a log of all adult customers, recording their first and last names, phone numbers and email addresses to be used by contact tracers in the event of people being exposed to COVID-19 at their establishment. This record must be kept for 30 days.
Places like banks would also have to keep a log of visitors involved in extended, sit-down situations such as applying for a loan.
If a business does have COVID-19 exposure, employees as well as the state and local health departments must be notified. They also must assist public health authorities in alerting customers to the exposure.
Finally, hotels and other lodging are required to inform employees of any guests who are in quarantine or isolation due to travel or COVID-19 exposure. The hotels and lodges must also provide adequate personal protective equipment and cleaning supplies to employees.
Alaska has seen a significant and consistent increase in cases since reopening its economy, regularly hitting record single-day case counts. Recently, there have been several days with more than 100 cases.
Standing still in the face of adversity is not the kind of option that we have, Berkowitz said.
While hospitalizations and deaths are believed to be an especially lagging indicator of how present the virus is, all data is on somewhat of a delay. Pineda said daily case numbers are actually indicative of what was happening 10 to 14 days before.
That is why when we see this significant increase in numbers, were concerned, she said. That means the community spread has been happening over the past two weeks, and its still incubating and moving around our community.
On June 26, Berkowitz imposed a face covering mandate within the municipality to try to limit the spread of the virus when people are in public.
Anchorage Economic and Community Development Director Chris Schutte said there has been enforcement of the citys mask mandate. When someone files a complaint to the city about a business not complying, city workers will call the business and inform them of the mandate, Schutte said.
Schutte said there have been instances where businesses or employees were not complying.
Pineda said compliance is something the community is still working on, and said people should be wearing masks outside if they are coming within 6 feet of non-household members.
Berkowitz and Pineda said the decision to limit capacity is partially driven by the virus surging statewide, and in other parts of the country. Anchorage is the health care hub for Alaska, so outbreaks in other parts of the state can put a strain on the local health care infrastructure.
Part of Alaskas surge has involved the seafood industry.
When we are looking at hundreds of cases coming in from seafood workers, that will put a burden on our ability to provide capacity for people in Anchorage, Berkowitz said.
Clarification: An earlier version of this story cited Mayor Ethan Berkowitz saying general retail businesses would be limited to 50% capacity. The mayor misspoke when he announced that, his spokesperson later said. Those businesses will not be under a capacity restriction.
Also, an earlier version of this story cited Anchorage Health Department Director Natasha Pineda saying the city has had 430 new cases since Friday. The city later said that is incorrect; there were 260 new cases in that time.
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This month, Stephen Miller, the extremist anti-immigrant Trump adviser who has promoted white nationalist ideas, lost a relative to the coronavirus pandemic, and his uncle tellsMother Jones that the Trump administration is partly to blame for this death.
On July 4, David Glosser, the brother of Millers mother, posted a Facebook note announcing the death of his mother, Ruth Glosser, who was Millers maternal grandmother:
This morning my mother, Ruth Glosser, died of the late effects of COVID-19 like so many thousands of other people; both young and old. She survived the acute infection but was left with lung and neurological damage that destroyed her will to eat and her ability to breathe well enough to sustain arousal and consciousness. Over an 8-week period she gradually slipped away and died peacefully this morning.
David Glosser is a retired neuropsychologist and passionate Trump critic who has publicly decried Miller for his anti-immigrant policies, and he contends that Trumps initial lack of a response to the coronavirus crisis led to the deaths of tens of thousands of Americans who might have otherwise survived. In an interview, he says, With the death of my mother, Im angry and outraged at [Miller] directly and the administration he has devoted his energy to supporting.
In response to a request seeking comment from Miller, a White House spokesperson sent Mother Jones this statement:
This is categorically false, and a disgusting use of so-called journalism when the family deserves privacy to mourn the loss of a loved one. His grandmother did not pass away from COVID. She was diagnosed with COVID in March and passed away in July so that timeline does not add up at all. His grandmother died peacefully in her sleep from old age. I would hope that you would choose not to go down this road.
Glosser, a former health professional, posted his mothers death announcement on a public Facebook page. Responding to the White House statement, he writes in an email, Keeping the tragic facts about COVID deaths of our countrymen and women, young and old, from the American public serves no purpose other than to obscure the need for a coherent national, scientifically based, public health response to save others from this disease. My mother led a long, satisfying, productive life of family and community service. She had nothing to be ashamed of, and concealing her cause of death to offer privacy to me, our family, her hundreds of relatives and friends, does nothing to assuage our regret at her loss.
Moreover, Ruth Glossers death certificatewhich her son shared with Mother Joneslists her cause of death as respiratory arrest resulting from COVID-19.
Informed that Ruth Glossers death certificate cited COVID-19, the White House spokesperson replied, Again, this is categorically false. She had a mile [sic] case of COVID-19 in March. She was never hospitalized and made a full and quick recovery.
Miller has played a role in the Trump White Houses ineffectual response to the coronavirus crisis. He was credited with helping to write the Oval Office address Trump delivered on March 11 that was widely panned. In that speech, Trump branded the coronavirus as the foreign virus and downplayed the damage already caused by it. He hailed his administrations actions regarding the growing pandemic, ignoring his recent and repeated efforts to dismiss the threat posed by the virus. Trump announced in this speech that he would suspend all travel from Europe to the United Statesa statement that caused panic, as Americans overseas rushed back to the United States and ended up in crammed and unsafe conditions at US airports. (The ban only applied to foreign citizens.) In the months since, Miller has attempted to exploit the pandemic to implement anti-immigration measures.
On Facebook, Glosser described his 97-year-old mother as a scholar, a social worker, and the teacher of a generation of social work students in Western Pennsylvania who founded and administered a foster parents program for children with special needs in Johnstown. He added, Her passion was the careful documentation of the Glosser family and its flight from Czarist persecution in what is now Belarus to life and freedom in the USA. An ardent advocate of education, womens rights, and the struggle for civil rights in the USA. In an addendum to the post, he pointed out that she had depended on immigrants for her health care:
I neglected to mention that in moms declining years she was lovingly cared for by health aides nurses, and doctors from India, Philippines, Mexico, Nicaragua, Haiti, Korea, El Salvador, Uganda, and Nigeria. Immigrants all of them. I am indebted to them for helping us through some very difficult times. Without them there would be no one to take care of our elderly.
Glosser tells me that he tacked on this comment to register a political point: I wanted to make it clear the best I can that the message the Trump administration pumps outthat immigrants who come here spread death, destruction, disease, and murderis wrong. We were those people not too long ago. Thats the story of America.
Ruth Glosser was living in an assisted living facility in the Los Angeles area. According to her son, she contracted COVID-19 in early March, when the facility was low on tests and PPE. One or more of the staff, he says, were asymptomatic carriers of the virus, and the disease spread quickly through the facility. She had what might be regarded as a weak case, Glosser notes. She survived the immediate acute effects but lost 20 pounds within a few weeks and was very much weakened. His mother was hit hard by the neurological side effects and soon began a slow decline: She lost the will to eat because of enormous fatigue, enormous confusion, and the loss of her sense of smell and taste, and her lungs continued to deteriorate. Finally, she could not sustain a level of oxygen to remain conscious. In accordance with her living will, the oxygen was withdrawn. She basically fell asleep and died.
Like many other relatives of COVID-19 patients, Glosser found the hardest part of this loss was that he could not visit her because the facility had gone into lockdown: We did the best we could with phone calls and the occasional FaceTime. But as time went by, her ability to focus and to breath and talk diminished. I could get only a few words. I love you. But there was no chance to hold her hand and help her go out easy.
Glosser has long been a foe of the Trump administration and his nephew. Shortly before the 2016 election, in a letter to a Pennsylvanian newspaper, he criticized Miller for engineering Trumps assault on immigration. My nephew and I, he said, must both reflect long and hard on one awful truth. If in the early 20th century the USA had built a wall against poor desperate ignorant immigrants of a different religion, like the Glossers, all of us would have gone up the crematoria chimneys with the other six million kinsmen whom we can never know. He explains that this letter was written at the behest of several family members to disassociate the family from Miller.
In 2018, Glosser penned a piece forPolitico headlined Stephen Miller is an Immigration Hypocrite. I Know Because Im His Uncle. He wrote: I have watched with dismay and increasing horror as my nephew, an educated man who is well aware of his heritage, has become the architect of immigration policies that repudiate the very foundation of our familys life in this country. I shudder at the thought of what would have become of the Glossers had the same policies Stephen so coolly espousesthe travel ban, the radical decrease in refugees, the separation of children from their parents, and even talk of limiting citizenship for legal immigrantsbeen in effect when Wolf-Leib [Glosser] made his desperate bid for freedom and fled anti-Jewish pogroms for the United States.
In response to Miller and his now-wife setting up a wedding gift registry in February, Glosser sent a donation to a refugee relief organization and posted a not-too-subtle explanation on Facebook:
Ill be making a contribution to HIAS, a world wide agency that serves to protect refugees and helped to rescue my family from Czarist oppression in the Russian Empire in 1906. Had our refugee forebears not been helped to emigrate to the USA, they and their children would have been murdered by the racial madness of Nazism; as were the 74 of our relatives who were shut out of America by the race/religion based immigration exclusion act of 1925 enacted by the America First populists of the day. Protect the refugee and welcome the strangerthey built America.
Glosser notes that he has watched the Trump administrations managementor mismanagementof the pandemic with dismay, calling it chaotic, incompetent, uninformed, and entirely politically motivated. Trump, he asserts, is interested in only one thinghis political survival His initial response to the epidemic was denial, distraction, misinformation, propaganda and lies.
Glosser says that he cannot blame Trump for the fact that his mother was 97 years old and frail, but he insists Trump and his enablers bear tremendous responsibility for the failure to respond and their continued unwillingness to do what public health experts say must be done. An effective response, he notes, might have limited the number of deaths to 20,000: So Trump bears substantial responsibility for the deaths of over 100,000 Americans who didnt need to die, including my mother.
What is it like to have a family member in the middle of this failure? Glosser describes his nephew as an ambitious kid who for some reason decided to become infatuated with the idea of white supremacy and who has been obsessed with gaining power and influence. Miller, Glosser maintains, sees Trump as a useful idiot in his quest to advance his white power agendaHe has been able to use Trump to advance his political vendetta against the world. Glosser is not surprised that Miller has been part of the Trump administrations coronavirus failure: He has no ability to demonstrate empathy.
Ruth Glosser, according to David Glosser, was highly disturbed when Trump became president: She was terribly torn between the normal love for grandchildren and horror at the racist content of Trumps policies and Stephens role in it. He says he has not heard from Miller since his mother died. But that is no shocker. He has not spoken to Miller since the 2016 campaign.
Long-standing systemic health and social inequities have put members of racially and ethnically minoritized and marginalized communities at an increased risk for severe illness from COVID-19. With the disproportionate impact the pandemic has on Black, Latinx and other underserved communities, Kaiser PermanenteanAMA Health System Program Partnersends a clear message that the health program stands with those fighting for equity and justice.
We have a long-standing commitmentits in our DNAthat equity is important to us, said Edward M. Ellison, MD, a physician executive leading Permanente Medical Groups in Georgia and Southern California, and co-CEO of The Permanente Federation. It always has been equity, diversity and inclusion, and we recognize that there's more that we can do, and we want to do more.
In a recent call with Dr. Ellison, we discussed what Kaiser Permanente is doing to address inequities in health care. Here is what he had to say.
AMA: What inequities are driving the disproportionate impact of COVID-19 on Black and Latinx communities?
Dr. Ellison: Nationally it has been recognized that Black and Latinx communities have historically had increased challenges with access to health care in generalthe availability of proper nutrition, higher rates of preexisting conditions that we know predispose you to more significant outcomes with COVID-19, like heart disease, respiratory disease, diabetes, and there are other socioeconomic and environmental factors.
We also know the impact of ACEs [adverse childhood events] early in life and how that contributes to lifelong challenges with health, chronic stress, and what that can contribute to in terms of overall health.
In our country we've long had inequities in health care outcomes in Black, Latinx and underserved communities. COVID-19 has just exacerbated what we've observed in the past and highlighted the need to approach communities of color with targeted interventions to help us better serve and improve the outcomes, not just for COVID-19, but in all of the other areas.
Learn about five steps physicians can take to prioritize Black patients well-being.
AMA: What inspired Kaiser Permanentes 75-year commitment to equity and inclusion?
Dr. Ellison: I've been with the organization for 35 years and one of the things that drew meand kept me hereis I am inspired by the mission, vision and values of Kaiser Permanente. If you look at our mission, we are committed to providing high quality, affordable, accessible care for our members and the communities that we serve.
We have a history going back to the early days of Kaiser Permanente when Henry Kaiser declared that our hospitals would not be segregated. We want everyone to have equitable opportunities and recognized that with all thats going on in the country today, it was important to recommit. It was important to be public and make sure that all of our patients, our people, our communities knew where we stood. It was about how we've always had a long-standing commitment to closing gaps in health care inequities. We can always do better, but we've made a tremendous impact.
AMA: How do you help physicians and other health professionals maintain that commitment?
Dr. Ellison: One of the things that we have done is to embark on listening sessions. They have been powerful. I have appreciated the courage and the vulnerability of my Black colleagues and my Latinx colleagues who are sharing their experiences of discrimination and racism, and at times violence. There's so much for us to learn and so we want to use those learnings to help inform the actions that we take.
We participate in something called Hippocrates Circle, which includes our own physicians who have come from underserved populations and minority groups who found their own path through medicine to become physicians and overcame many obstacles. We affiliate with middle schools in underserved communities and students who self-identify as being interested in a career in medicine.
Kaiser Permanente sponsors fellowships for physicians to go into the community, identify need, and then help to address that need. There are many ways in which we try to help support our physicians and staff to stay connected to and understand how they can contribute and give back to the community.
We have something in Southern California called the Watts Counseling and Learning Center. It was founded in 1967, two years after the civil unrest in Watts and it started with just going out and meeting with mothers in the community.
We opened another facility, Baldwin Hills Crenshaw, in an underserved area in need of revitalization. We learned what they needed in the community and so when we built this facility, part of this almost nine-acre campus includes two and a half acres of green space and a two-mile walk.
They have this motto that health care is interwoven into people's daily lives, meeting people where they stand, and I think that's the philosophy that you take into making a difference in the communities. That particular facility was intentional40% of the contracts for building the building were to diverse businesses and companies owned by women, minorities, or veterans.
AMA: Are there different solutions for Latinx and Black communities, or does a broader solution work for all vulnerable communities?
Dr. Ellison: There are approaches that would be beneficial to all communities, including appropriate use of language, being culturally sensitive and responsive to different needs that different communities that we serve have, and understanding the impact of socioeconomic differences.
The cultural values for many Latinx patients and their families are gathering together, celebrating together, living in multi-generational households. But we know that is an added risk for COVID-19. We know that for the African American community, we have to work harder at building trust in the health care system because of past history.
We have to understand that there are actions we can take that are helpful, but it's not one size fits all. There are attributes beyond race that are impacted in terms of culture, socioeconomic conditions and educational background.
Learn about eight steps Kaiser Permanente is taking to suppress COVID-19.
AMA: During the COVID-19 pandemic with concerns about physical distancing, what ways have physicians continued to be involved in those communities?
Dr. Ellison: We've seen a tremendous acceleration of virtual care delivery of telemedicine both in terms of video and telephone, so understanding how you can meet the needs of the patient, even if it's virtually is really important. And those same cultural and language issues are just as important, if not more so.
Establishing a trusting relationship between the patient and the person providing care is really important and providing education to our physicians and other providers about how you can do that effectively, virtually. Then recognizing that not all of our members have access to virtual care.
Providing appropriate face-to-face care is still important but doing it in a safe way. Many of our patients want their care virtual right now for obvious reasons. And for those who need or desire face-to-face care, it's important that it's provided.
We worked hard to do outreach to our patients with communication about what's going on to reduce fear and uncertainty about the COVID virus, to get facts, to be as fact-based as possible, and to provide that in different languages so that we can make it easier for different communities to have the information that they need.
Learn more about helping patients put essential care ahead of COVID-19 fears.
AMA: Regarding staffing, how is Kaiser Permanente improving inclusiveness and diversity now and in the future?
Dr. Ellison: We're looking at how we recruit, how we develop individuals, how we provide opportunities for advancement. All of those are part of the work that we do, but I would say I'm very excited about the Kaiser Permanente School of Medicine.
In just a few weeks our first class of 50 students will be arriving. We took a very holistic approach in recruitment, so that we will be welcoming a class that does bring a diverse background and lived experiences.
We train a larger number of residents so after medical school, in a wide array of specialties, we have physicians being trained within our system and they're being exposed to the same vision, values and commitment in our organization.
It's also working with the communities and providing opportunities for minority-owned businesses to succeed. When we're contracting for services, were being intentional about providing opportunities from the communities that we serve.
AMA: Do you have any tips for other organizations that want to make a commitment to equity and inclusion?
Dr. Ellison: It starts with having a passionthat this is the right thing to do. I believe that it starts with the leadership of any organization. You have to create intentionality, be explicit in declaring what you value and why you value it. Create a safe space to execute on those values and create infrastructure that supports it and remove barriers to it.
The more of us that lean in together, the more successful that we'll be. But I do think it comes from also a place of humility knowing we don't have all the answers. It means listening to your peoplethey have the answers.
Whatever impact you can make, where you are with your opportunity, start there. Its about starting where you are and then reaching out and connecting. The more of us that do that, the more successful we'll be.
The AMA continues to compile criticalCOVID-19 health equity resourcesto shine a light on the structural issues that contribute to and could exacerbate already existing inequities. Physicians can also access the AMAsCOVID-19 FAQs about health equity in a pandemic.
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The city of Seward became the center of Alaskas two largest coronavirus outbreaks on Wednesday, with a factory trawler and a local seafood-processing plant where a combined 181 people had tested positive.
The American Seafoods ship carrying 85 infected crew members arrived in Seward from Unalaska on Wednesday afternoon.
After the 286-foot American Triumph moored at Sewards cruise ship dock, the crew disembarked and were ushered into the waiting buses by the drivers, who were wearing ventilated PPE suits. A handful of onlookers drove by as the crew disembarked, some with binoculars. They were taken to Anchorage.
Also on Wednesday, 96 seafood workers at the OBI Seafoods processing plant in Seward which employs 262 people tested positive for the novel coronavirus, causing the plant to temporarily shut down, city officials said.
An employee at the plant first tested positive for COVID-19 on Sunday, after seeking medical care for an unrelated health issue, the company said. The plant immediately closed so that the company could test all its employees and disinfect the campus.
The cases included 85 nonresident and 11 resident employees, according to a presentation from Alaskas state medical officer, Dr. Anne Zink, at a community briefing on Wednesday.
The OBI outbreak is the latest to hit the seafood industry in Alaska, occurring just days after the 85 crew members aboard the American Triumph tested positive for the virus, and more than 40 became infected at a plant operated by a Juneau fish processor.
Alaska is currently experiencing three large, separate outbreaks of COVID-19 in the seafood industry, said Dr. Joe McLaughlin, Alaskas State Epidemiologist, in a written statement Wednesday evening. These outbreaks are reminiscent of the meat packing plant outbreaks in the Lower 48 and stress the importance of vigilant symptom screening and prompt facility-wide testing in congregate work settings when index cases are identified.
Until now, the seafood industry has remained relatively unscathed despite concerns earlier in the year about the influx of out-of-state workers and potential for outbreaks in close quarters, on vessels and in processing plants that could overwhelm the states fragile health care system.
In response, 11 seafood companies released a letter addressed to communities to confirm our commitment that we are prioritizing health and safety of local residents in which they detailed their COVID-19 mitigation plans.
With the exception of some smaller outbreaks in Dillingham and Whittier, the companies safety plans appeared to have been mostly effective.
From Seward, infected crew from the ship and the plant were headed to Anchorage for isolation or quarantine, officials said. It isnt clear where the workers will be housed while in the city.
The sudden influx of infected people prompted municipal concerns about Anchorage hospital capacity. OBI Seafoods said in a statement that the vast majority of their employees who tested positive are not currently experiencing symptoms of the virus, and none have been hospitalized.
But the possibility that some could get sick enough to need medical care was a factor in Anchorage Mayor Ethan Berkowitzs decision to issue new restrictions on bars and restaurants Wednesday.
Berkowitz at a briefing said the new restrictions stemmed in part from Anchorages role providing medical care for most of the state including infected seafood workers, as well as residents of rural communities that rely on Anchorage hospitals.
When were looking at the hundreds of cases coming in from seafood workers, that will put a burden on our ability to provide capacity for people in Anchorage, he said. And so were watching the numbers not only inside Anchorage, were watching what is happening outside the community.
Crew disembark from the American Triumph and board busses in Seward on Wednesday, July 22, 2020. American Seafoods, which operates the factory trawler, reported over the weekend that 85 crew members tested positive for COVID-19. The crew disembarked in Seward and will be transported to Anchorage where they will be isolated for further care. (Loren Holmes / ADN)
Crew members from the American Triumph are transported by bus from Seward to Anchorage on Wednesday, July 22, 2020. American Seafoods, which operates the factory trawler, reported over the weekend that 85 crew members tested positive for COVID-19. The crew disembarked in Seward and will be transported to Anchorage where they will be isolated for further care. (Loren Holmes / ADN)
The American Triumph docks in Seward on Wednesday, July 22, 2020. American Seafoods, which operates the factory trawler, reported over the weekend that 85 crew members tested positive for COVID-19. The crew disembarked in Seward and will be transported by private bus to Anchorage where they will be isolated for further care. (Loren Holmes / ADN)
The OBI seafood processing plant in Seward, photographed on Wednesday, July 22, 2020. (Loren Holmes / ADN)
OBI Seafoods LLC was formed in June, the result of a merger between major processors Ocean Beauty Seafoods and Icicle Seafoods, and includes five shoreside locations in Alaska.
Earlier this summer, outbreaks were confirmed at two other OBI Seafoods plant locations in Dillingham, where 12 workers tested positive, and at the companys Excursion Inlet salmon processing plant in Southeast Alaska, where three employees also tested positive in late June.
The company has said it has extensive safety protocols in place to prevent an outbreak like this: All employees upon arrival in Alaska are required to quarantine for 14 days, and are then tested a second time, the company said in a statement. Every OBI employee also goes through a symptom and temperature check each day, according to the company.
But the close quarters and long working hours at fish processing plants can make social distancing difficult.
The American Triumph docks in Seward on Wednesday, July 22, 2020. American Seafoods, which operates the factory trawler, reported over the weekend that 85 crew members tested positive for COVID-19. The crew disembarked in Seward and will be transported by private bus to Anchorage where they will be isolated for further care. (Loren Holmes / ADN)
Crew disembark from the American Triumph and board busses in Seward on Wednesday, July 22, 2020. American Seafoods, which operates the factory trawler, reported over the weekend that 85 crew members tested positive for COVID-19. The crew disembarked in Seward and will be transported to Anchorage where they will be isolated for further care. (Loren Holmes / ADN)
Annie Berman reported from Anchorage and Loren Holmes from Seward.
The enormous number of Americans getting swabbed for the coronavirus has overwhelmed every step of the COVID-19 testing process, creating shortages of critical supplies in laboratories and inundating them with more specimens than they can process.
The testing spike, which experts say has been particularly dramatic over the past month as more coronavirus hot spots have popped up, has meant waits of up to two weeks or more for test results in some cases a far from ideal turnaround time.
Laboratories say they are working as fast as they can.
Full coverage of the coronavirus outbreak
"The challenges that labs are facing are complex," said Louise Serio, a spokesperson for the American Clinical Laboratory Association, a trade group that represents companies such as Quest Diagnostics and LabCorp. "There is a significant strain on the global supply chain."
Since the beginning of the pandemic, the American Clinical Laboratory Association's members have performed more than 23 million COVID-19 tests, Serio said. Testing capacity is increasing every week, she said, and employees are working round-the-clock to run as many tests as possible, but they are running out of necessary chemicals and other products faster than their manufacturers can replenish them.
"What we have consistently heard from members is that reagents, test kits, pipettes and platforms are all in great demand right now," she said.
The backlog could get worse if the outbreak continues on its current trajectory. On Thursday, the United States reached a somber milestone, surpassing 4 million confirmed coronavirus cases nationwide, according to data compiled by NBC News, just 15 days after hitting the 3 million mark.
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Dr. Scott Gottlieb, the former commissioner of the Food and Drug Administration, said on MSNBC's "Morning Joe" that access to testing and quick results is "likely to continue to be a challenging issue heading into the fall."
Testing lags will make it significantly harder to stop transmission of the virus, he said.
"After about 48 hours, the test really isn't that useful for the clinical management of the patient," Gottlieb said. "At that point, you're not going to be able to use the result to do effective contact tracing. Too much time has passed, and you're not giving information back to the provider and the patient that they could use."
His comments echoed those of Dr. Brett Giroir, the assistant secretary of health and human services for health, who is overseeing U.S. coronavirus testing and who has said three days is a "reasonable turnaround time" for results.
But given the surge in demand, that has been difficult to attain.
While some COVID-19 tests are done by a more rapid, cartridge-based method in hospitals for patients who are admitted, a much larger percentage in the U.S. are done by commercial labs.
Mike Geller, a spokesman for LabCorp, said LabCorp has so far performed 7.5 million molecular tests for COVID-19 and is processing 165,000 tests a day, with plans to increase capacity further. The average time to deliver results is three to five days from when a specimen was picked up; before the surge, the turnaround time was one to two days, he said.
Jim Davis, executive vice president of general diagnostics at Quest Diagnostics, said Quest has performed more than 8.5 million tests and is processing 130,000 tests a day. Quest anticipates that by the end of the month, it will have a daily capacity of 150,000 tests, which should help with the delays: Average turnaround time for test results right now is at least seven days, up from two to three days until several weeks ago, Davis said.
While Quest's test capacity has doubled over the last two months, demand has tripled, Davis said, with the last three to four weeks representing a steep increase. Labs are staffed 24/7, which they were not before the pandemic.
"We're asking everyone right now to work overtime," Davis said.
Federal funding and clearer guidance on testing from the federal government could help get turnaround times down. This week, the American Clinical Laboratory Association was among 50 health care organizations to call on Congress to dedicate more funding for testing.
"If the demand keeps increasing like it's been increasing over the last couple of weeks, the lab industry will never be able to keep up with it."
In the meantime, to best accommodate the backlogs, many testing sites are prioritizing certain patients.
At Northwell Health, New York's largest health care provider, screening tests for employment, travel or summer camp are considered lowest priority; those tests are typically sent out to the national commercial laboratories, while symptomatic patients awaiting clinical treatments are put at the top of the list, with their tests performed at Northwell's regional laboratories, said Dr. Dwayne Breining, executive director of Northwell Health Laboratories.
The turnaround time at the regional laboratories is one to two days, he said. (Northwell's hospitals, meanwhile, get results within thee hours using their cartridge tests.)
Breining said the U.S.'s maxed-out testing capacity reflects the country's struggle to contain the spread of the virus, and he urged Americans to take precautions.
"If the demand keeps increasing like it's been increasing over the last couple of weeks, the lab industry will never be able to keep up with it," he said. "I think the top priority is going to be mitigating the clinical spread of this virus by doing things we know work: things like social distancing, masking and monitoring.
"All those things make a huge difference," he added. "That would allow you to slow it down enough so that not only the lab testing industry, but the entire medical system, can catch up."
SAN DIEGO, July 24, 2020 (GLOBE NEWSWIRE) -- Bionano Genomics, Inc. (Nasdaq: BNGO) announced today that a recently formed international consortium of clinical and research sites is using its Saphyr genome imaging system to identify genomic variants that influence resistance or sensitivity to the SARS-CoV2 virus, or COVID-19 disease progression and drug response. The consortium is comparing the genome structures of those patients who show no or mild symptoms and those who show severe illness, while controlling for the known risk factors of age and chronic illness such as asthma, heart disease, diabetes, or other immune-compromising disease. The team plans to analyze at least 1,000 patient genomes with Saphyr.
The consortium was founded by Dr. Ravindra Kolhe, the Vice-Chair of Pathology and Section Chief of Molecular and Genetic Pathology at Augusta University and Dr. Alka Chaubey, Scientific Director for the Georgia Esoteric & Molecular Lab at Augusta University. Additionally, it consists of co-investigators from Baylor College of Medicine, Bostons Children's Hospital of Harvard University, Childrens National Medical Center, Columbia University, George Mason University, MD Anderson Cancer Center, the National Cancer Institute, Oregon Health and Science University, Rockefeller University, San Francisco State University, Sanford Burnham Prebys, UC San Diego, UC Santa Cruz, and Virginia Commonwealth University, with many more in the process of joining.
A number of companies have committed to supporting this effort as part of a global Tech Against Covid initiative. Rescale, the High-Performance Computing cloud platform fully integrated with Saphyr, and Amazon, a leading provider of on-demand cloud computing, are donating compute time for the Bionano data analysis. Genoox, the platform for annotation and classification of genomic variants, is donating its compute resources to analyze available sequencing data combined with Bionanos structural variation calls for an integrated analysis of small and large genomic variants.
Initial unpublished findings from the first 30 patients that have been analyzed show that Saphyr detects large amounts of structural variation in many putatively relevant genes, demonstrating that point mutations alone are unlikely to explain disease differences between patients. Bionanos Saphyr system is expected to provide the crucial structural variation data needed for a full understanding of genome structure in patients.
Dr. Ravindra Kolhe, founder of the consortium commented: We strongly believe that Bionanos Saphyr platform is uniquely capable of identifying variants that play an important role in regulating COVID-19 in patients, and may be able to explain some of the extreme variation in disease severity and progression that we see in patients. Other studies of the host genome are based on short-read sequencing or SNP-microarrays, and those technologies are unable to detect and account for the large amounts of structural variation thats present in clinically important regions of the genome. We are hopeful that our initial results will translate into discoveries that truly advance our understanding of this devastating disease, and will improve our ability to treat the sickest patients.
Erik Holmlin, PhD, CEO of Bionano Genomics commented: The COVID-19 Host Genome Structural Variation Consortium is an important expansion of Bionanos efforts to help the scientific and medical community in the development of novel, targeted, antiviral therapies or vaccines. We believe that Bionanos genome imaging technology is the only technology capable of detecting the structural variants that could protect against or predispose patients to the viral infection and influence the severity of the disease. We are thrilled that our technology is being used in a global effort to help bring this pandemic to a halt.
About Bionano GenomicsBionano is a genome analysis company providing tools and services based on its Saphyr system to scientists and clinicians conducting genetic research and patient testing. Bionanos Saphyr system is a platform for ultra-sensitive and ultra-specific structural variation detection that enables researchers and clinicians to accelerate the search for new diagnostics and therapeutic targets and to streamline the study of changes in chromosomes, which is known as cytogenetics. The Saphyr system is comprised of an instrument, chip consumables, reagents and a suite of data analysis tools, and genome analysis services to provide access to data generated by the Saphyr system for researchers who prefer not to adopt the Saphyr system in their labs. For more information, visitwww.bionanogenomics.com.
Forward-Looking StatementsThis press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Words such as may, will, expect, plan, anticipate, estimate, intend and similar expressions (as well as other words or expressions referencing future events, conditions or circumstances) convey uncertainty of future events or outcomes and are intended to identify these forward-looking statements. Forward-looking statements include statements regarding our intentions, beliefs, projections, outlook, analyses or current expectations concerning, among other things: planned scope of the consortiums research; preliminary findings regarding COVID-19 through the use of Saphyr; and Saphyrs ability to contribute to research and treatment of COVID-19, including discoveries that can advance an understanding of COVID-19 and improve the ability to treat patients. Each of these forward-looking statements involves risks and uncertainties. Actual results or developments may differ materially from those projected or implied in these forward-looking statements. Factors that may cause such a difference include the risks and uncertainties associated with: the impact of the COVID-19 pandemic on our business and the global economy; general market conditions; changes in the competitive landscape and the introduction of competitive products; changes in our strategic and commercial plans; our ability to obtain sufficient financing to fund our strategic plans and commercialization efforts; the loss of key members of management and our commercial team; and the risks and uncertainties associated withour business and financial condition in general, including the risks and uncertainties described in our filings with the Securities and Exchange Commission, including, without limitation, our Annual Report on Form 10-K for the year ended December 31, 2019 and in other filings subsequently made by us with the Securities and Exchange Commission. All forward-looking statements contained in this press release speak only as of the date on which they were made and are based on management's assumptions and estimates as of such date. We do not undertake any obligation to publicly update any forward-looking statements, whether as a result of the receipt of new information, the occurrence of future events or otherwise.
CONTACTSCompany Contact:Erik Holmlin, CEOBionano Genomics, Inc.+1 (858) 888-7610eholmlin@bionanogenomics.com
Investor Relations Contact:Ashley R. RobinsonLifeSci Advisors, LLC+1 (617) 430-7577arr@lifesciadvisors.com
Media Contact:Kirsten ThomasThe Ruth Group+1 (508) 280-6592kthomas@theruthgroup.com
Spanish health officials have warned the country could already be experiencing a second wave of coronavirus, as France, Germany and Belgium all reported steep rises in their number of cases.
Countries across Europe have reminded people of the need for vigilance amid rising cases as the summer holiday season continues.
On Friday, France said it was advising it citizens not to travel to the Spanish region of Catalonia in order to help contain the spread of the virus, while Norway said it was reimposing a 10-day quarantine requirement for people arriving from Spain measures that raised the spectre of renewed border restrictions across the continent.
Spains health ministry is tracking more than 280 active outbreaks across the country. On Friday, it logged 922 new Covid-19 cases slightly down from 971 over the previous 24 hours.
Mara Jos Sierra, the deputy head of Spains centre for health emergencies, said that while the curve had been flattened, community transmission was being seen in north-eastern areas.
It could already be a second wave, but thats not the most important thing, Sierra told reporters on Thursday. The most important thing is that we keep following whats going on, see what measures are necessary, and take them early.
She also said people needed to remember the incidence of the virus had tripled in just two weeks, from 8.76 cases per 100,000 people on 3 July to 27.39 per 100,000. Obviously, the curve is going up, but lets wait to see what kind of situation were in, she added.
Nearly 8,000 cases have been diagnosed in Catalonia over the past 14 days accounting for almost half of the 16,410 detected across Spain.
Catalonias public health secretary, Josep Maria Argimon, said the situation in and around Barcelona was at a critical moment and called on people to heed the regional governments request not to leave their homes unless strictly necessary.
There are growing fears the virus is being spread by people going to bars and nightclubs, and that restrictions may be needed to curb the rise in cases.
On Thursday, the government of the south-eastern region of Murcia ordered the 32,000 inhabitants of Totana back into the second phase of lockdown de-escalation after 55 cases were traced to a bar in the town.
Madrids regional government said on Friday it planned to rethink the guidelines on the number of people allowed to meet up at night.
Were going to introduce measures on nightlife, including limiting the number of people allowed on bar and restaurant terraces or other meeting places because the virus likes movement and large gatherings, said the regions deputy public health minister, Antonio Zapatero.
The regional government is also urging the central government to introduce more stringent controls at Madrids Barajas airport after it emerged that 77 people had arrived there with the virus since May.
Frances national health authority, Sant Publique, reported 1,062 new cases on Thursday and said that while there had been an increase among the over-75s and people in care homes, a rise had also been reported in cases among young adults.
The authority said there had been a slackening of the application of barrier gestures and reminded people that physical distancing needed to be maintained.
During the summer and holidays, it may seem artificial to greet each other at a distance, talk from a distance, wash hands regularly and wear masks in enclosed spaces, but this individual and collective effort is crucial to prevent the virus from encroaching on our freedom and the epidemic from rebounding, it said.
On Friday, the French president, Emmanuel Macron, held a meeting of the countrys defence council to discuss the increase in cases and consider fresh measures including whether to tighten controls on the borders with Belgium and Spain and possible quarantine measures for international passengers at airports.
Germanys Robert Koch Institute (RKI) reported 815 new cases on Friday, compared with 583 a week ago and 395 the week before.
Excluding recent outbreaks at meat processing plants, the rise was the biggest since mid-May. Figures tend to be higher on Fridays, due to reported cases stacking up during the week.
More than 40% of current cases are in the western state of North Rhine-Westphalia, but other states are also showing above-average rises.
Jonas Schmidt-Chanasit from the Bernhard-Nocht Institute for Tropical Medicine in Hamburg said the figures appeared to indicate an increase across the population rather than in specific locations such as around meat processing plants. If that was the case, it would make the virus more difficult to contain, he told Der Spiegel.
We need to see whether this is to do with large gatherings, that are now allowed, the reopening of kindergartens and schools, or is it to do with people returning from their holidays? he said.
People returning to Germany from the Balkans, Turkey and Mallorca have tested positive for the virus.
The RKI has put 100 countries on a list of risk areas, including the US, Israel and Luxembourg. The health ministry is widely expected to announce that tests for people returning from risk areas will soon be obligatory.
In Belgium, where the number of new weekly infections has risen by 89%, officials said a three-year-old girl had become the countrys youngest known victim.
The health spokesman Boudewijn Catry said three people were dying each day in Belgium from Covid-19, adding that recent deaths included those of the toddler and an 18-year-old.
Catry said the young girl had severe pre-existing conditions, but warned against complacency among the healthy, pointing out that 85% of new cases diagnosed last week were among people under 60.
Its true that its rare that a young person dies of Covid-19, but its clear that no one is immune, he said.
Agence France-Presse contributed to this report
