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As World Blood Donor Day Approaches, COVID-19 Strains Supply

Even before the emergence of the new coronavirus, Africa’s blood supply fell short of demand. The pandemic has increased the deficit, raising risks to people needing treatment for ailments and medical emergencies, health officials say.

“The problem that we are seeing is that we have a reduction [in] the number of blood donors during this outbreak because people are afraid to go to blood services,” said Dr. Andre Loua, the World Health Organization’s Africa region technical officer for blood safety.

Along with fears of infection, countries’ restrictions on mobility and trade affect the availability of blood and of reagents, bags and other products needed to draw, test and store it, added Jean-Baptiste Nikiema, the WHO regional adviser for essential medicine, who joined Loua in a Skype interview with VOA last month. “So this is taking us to high risk of shortages of products to test the blood and also to collect the blood. And in the coming months, if the situation is not better, we can get in trouble.”

The WHO hopes to raise awareness of the need for blood and to spur donations globally through Sunday’s commemoration of World Blood Donor Day, an annual event since 2005.

 

Donation rates generally correspond with national incomes, the WHO says. The median rate is 31.5 per thousand people in high-income countries and 5.0 in low-income countries.

Most sub-Saharan African countries have made progress in ensuring blood safety and availability since 2013, said Loua and Nikiema, speaking from Brazzaville, Democratic Republic of the Congo, where the WHO has a regional office.

Nonetheless, “patients requiring transfusion do not have timely access to safe blood and blood components in the region,” they wrote in a 2019 article co-authored with two other experts.

Transfusions most often are needed by women after childbirth; children who are malnourished, anemic or infected with malaria; victims of trauma or accidents; and patients with sickle cell anemia. More than 1 in 5 people in the region are anemic; the rate climbs to 3 in 5 among children age 5 or younger.

If blood is not replaced, a patient can bleed to death.

In Kenya, the pandemic has almost halved blood donations and created a “challenging” situation, its Health Ministry said in announcing a nationwide blood drive Friday.

Before the onset of COVID-19, the Kenya National Blood Transfusion Service used to collect at least 450 pints of blood every day, according to Dr. Rashid Aman, the chief administrative secretary. Donations have fallen to roughly 250 pints, “which has caused a major strain on our blood bank.”

In neighboring Ethiopia, home to 108 million people, authorities at the National Blood Bank Service were alarmed by a precipitous drop in donations – from roughly 300 donations a day in the capital, Addis Ababa, to just under 30 after COVID-19’s emergence.

“This left us in great danger,” Yaregal Benti, the bank service’s director, told VOA’s Horn of Africa service. So the blood service recruited Prime Minister Abiy Ahmed and other government officials to extend their arms and set an example. That was on April 22.

Two weeks later, donors had significantly increased the nation’s blood reserves, Yaregal said, praising their generosity. “Where there is a shortage of face masks or mechanical ventilators, you can ask or force factories to produce them. But there is no such production for blood.”

 

Unpaid donors contribute most of the available blood supply in 79 countries, the WHO says, but in 56 countries, patients’ relatives or friends or paid donors contribute the most.

The International Federation of Red Cross and Red Crescent Societies promotes unpaid donation, Dr. Adeiza Ben Adinoyi, an Africa regional officer, said in an interview. Blood is perishable, with a maximum 32-day shelf life even when refrigerated, so “you need a system of ensuring that the blood supply chain is adequate at every given point in time.”

Many African countries have weak health systems that have been further compromised by COVID-19. Loua called for more aid not only from donors but also from “developed countries, because we don’t have sufficient resources.”

Loua also noted challenges involving convalescent plasma, drawn from recovered COVID-19 patients and used as an experimental therapy to treat new cases. In sub-Saharan Africa, he said, most countries’ national blood services have “insufficient capability … to collect, process and store convalescent plasma in a quality manner.”

Since 2004, the United States has supported blood supply safety programming in more than a dozen sub-Saharan African countries as part of the President’s Emergency Plan for AIDS Relief. It has allocated $6.9 billion for the current fiscal year alone, though the White House has proposed reducing that to $4.4 billion in 2021.

In October, the program cut off funds for Kenya’s National Blood Transfusion Service as part of its effort to have countries assume more fiscal responsibility, according to Devex, a global development media site. It reported that it had unsuccessfully sought an extension – and that Ethiopia, Tanzania and Swaziland had shifted to covering all blood collection and testing costs as of 2016.

 

 

Source: Voice Of America

 

India Reports 2nd Record-Breaking Day of New Coronavirus Cases

India reported its largest surge in new COVID-19 cases in a 24-hour period Saturday.  The 11,458 new infections surpassed the previous record of 10,956 cases reported Friday.

The surge comes as India has reopened stores, shopping malls, manufacturing plants and places of worship. The country’s two-month lockdown that began in March has been eased, with restrictions remaining largely intact in high-risk areas.

India’s record surge of new cases propels the massive South Asian nation to fourth place worldwide, surpassed only by the U.S., Brazil and Russia.

China’s National Health Commission reported 11 new cases Saturday. The agency said five of the new infections were detected in people who had traveled overseas, while the remaining six were locally transmitted in Beijing. The coronavirus emerged in China late last year.

U.S. President Donald Trump is delivering the commencement address at the West Point Military Academy Saturday. The graduation ceremonies will be held on the academy’s parade grounds instead of the football stadium so the cadets can be seated 2 meters apart, in the school’s efforts to prevent the spread of the coronavirus.  Family and friends will not be allowed to attend.

The cadets can remove their masks, if they want, once they are seated. The president does not like to wear a mask.

Norway said Friday it would maintain travel restrictions for visitors from Sweden. Unlike other European countries, Sweden did not impose lockdown measures, opting only to advise social distancing and banning gatherings of more than 50 people.

 

While new infections are slowing in most of Europe, the European Union’s health commissioner, Stella Kyriakides, said Friday that countries should be prepared to reimpose restrictions if they see a rise in infections.

A major study forecasts millions sinking into extreme poverty because of the coronavirus pandemic.

A report by the United Nations University says the economic fallout could plunge 395 million people into conditions in which they are forced to live on $1.90 a day or less – the definition of extreme poverty.

A separate World Bank report this week put that number between 70 million and 100 million people.

“The outlook for the world’s poorest looks grim unless governments do more and do it quickly and make up the daily loss of income the poor face,” one of the U.N. report’s authors, Andy Sumner, said. “The result is progress on poverty reduction could be set back 20-30 years and making the UN goal of ending poverty look like a pipe dream.”

The U.N. report says South Asia – India in particular – will see the largest number of people sinking into extreme poverty, followed by sub-Saharan Africa.

Experts are appealing to economically powerful nations, such as the United States, to forgive the debts of developing countries that would take a strong hit from the pandemic.

 

 

 

Source: Voice Of America

Six Things to Know About the COVID-19 Pandemic Now

WASHINGTON – Every day for the past two weeks, roughly 900 people have died of COVID-19 in the United States. The case count has been stuck at about 20,000 per day.

That’s down from the peak in mid-April, when more than 2,000 were dying and more than 30,000 were testing positive every day.

But progress on controlling the epidemic has stalled.

Stay-at-home orders; closing restaurants, bars and theaters; and canceling large gatherings succeeded in slowing the spread of the coronavirus that causes COVID-19.

In epidemiological terms, the curve flattened. But as the country comes out of lockdown, the curve is staying flat, at a time when health officials say it needs to be curving downward.

Summer headwinds

Weather is working against the virus for now. Summer’s warmth and humidity seem to tamp down, but not eliminate, the risk of infection.

The trend will reverse beginning in late August and September. Climate conditions will begin to tilt in favor of the virus, and the expected second wave will begin.

“It’s very important during the summer season, when the seasonality is going to our advantage, to make sure we do it right,” said health metrics sciences professor Ali Mokdad at the University of Washington Institute for Health Metrics and Evaluation.

That means “that we keep our guard (up) and we reduce the circulation of the virus to as low as possible,” he said in an interview.

Much of the United States is lowering its guard, however.

 

Reopening and resurgence

All 50 states have begun relaxing restrictions and reopening businesses.

At the same time, several states have seen increases in the number of new cases.

But not every state that has reopened has seen an uptick. Experts don’t know why cases in Arizona have spiked while cases in Georgia have plateaued, for example.

“Somehow, states that have reopened and have not seen a resurgence are doing something right,” University of Arizona associate professor of public health policy management Joe Gerald said in an interview.

“If we just knew what that was, then we could replicate it in other states and maybe get on with our lives and do as little economic damage to our economy as possible,” he added. “I just don’t think we have it yet.”

Wear a mask

Masks could be one factor.

Evidence keeps piling up that they can make a significant dent in transmission rates.

Wearing a mask is the “simplest, most effective option” for keeping infection numbers down, Harvard University epidemiology professor Michael Mina said in a briefing for reporters. “There’s no doubt about that.”

But masks – even masks – have become a political issue.

One poll found Democrats are nearly twice as likely as Republicans to wear one every time they leave the house.

Testing and tracing

To control the disease, public health officials must know who has it. After a botched start, testing for coronavirus infection has ramped up over the past few months.

But capacity is patchy across the country. Experts suggest that states are doing enough testing when 5 percent come back positive, but nearly half of states have not reached that threshold.

When patients test positive, health officials then need to find out who else they may have infected and get those people tested and isolated, too. Public health officials called for an army of more than 100,000 contact tracers to do the job.

Despite a wave of hiring in the past month, “we’re nowhere near the levels” needed, said government affairs chief Adriane Casalotti at the National Association of County and City Health Officials.

Vaccines

Ultimately, a vaccine will be needed to bring the pandemic to an end. Scientists are racing to produce a safe and effective vaccine by early next year, an unprecedented pace.

The World Health Organization tallies 10 candidates currently in human testing and 126 in preclinical studies. One vaccine, from the University of Oxford, is beginning late-stage testing. Biotech company Moderna says it will start its final stage of testing next month.

To make a vaccine available as soon as possible, several companies, with backing from various governments and public-private partnerships, are scaling up manufacturing before they know if any of them work.

 

Treatments

Only one drug so far has worked against COVID-19, and its benefits are limited. Remdesivir, from pharmaceutical company Gilead, shortened hospital stays for COVID-19 patients in one study. It did not have a significant impact on saving lives, however.

The anti-malaria drug hydroxychloroquine gained attention early in the pandemic, but it has not yet proved its usefulness.

Small, preliminary studies of patients in France and China showed some promise. With nothing else available to treat COVID-19, doctors around the world have given thousands of patients the drug without knowing if it works.

Though experts cautioned that the research was far from conclusive, U.S. President Donald Trump and some of his conservative allies said hydroxychloroquine could be a “game changer” based on the early research. Trump said he took it to prevent infection.

But a study found it did no better than a placebo at preventing health care workers and others at high risk of infection from developing COVID-19.

Whether it helps to treat the disease remains an open question. One recent study suggested it does not, but it was retracted after the data came under question. Other research is under way in the United States and internationally.

Several other treatments are under study, including anti-HIV drug combination lopinavir–ritonavir, and antibodies from COVID-19 patients who have recovered.

 

Source: Voice Of America