Pandemic hits ‘critical point’ as Europe deaths top one million


Europe passed the grim milestone of one million coronavirus deaths on Monday, as the World Health Organization warned that infections are rising exponentially despite widespread efforts aimed at stopping them.

The death toll across Europe’s 52 countries, compiled by AFP from official sources, totalled at least 1,000,288 by 1830 GMT.

“We are in a critical point of the pandemic right now,” said Maria Van Kerkhove, the WHO’s technical lead on COVID-19.

“The trajectory of this pandemic is growing… exponentially.

“This is not the situation we want to be in 16 months into a pandemic, when we have proven control measures,” she told reporters.

The coronavirus has already killed more than 2.9 million people and infected nearly 136 million across the world.

But despite the sombre news in Europe—the world’s worst-hit region—Britain eased curbs for the first time in months on Monday, allowing Britons to enjoy a taste of freedom with a pint and a haircut.

The changes illustrate how fast-vaccinating countries are leaving other—mostly poorer—nations behind.

In South Africa, the president called for African-made vaccines as the continent lags behind, struggling with inadequate supplies as well as a lack of financing and logistical problems.

“Africa needs to harness its own continental capabilities and identify opportunities for collaboration,” Cyril Ramaphosa said.

Ramaphosa suggested India or Brazil could help after successfully developing their own generic pharmaceutical industries.

But both giants are battling severe COVID outbreaks, with India overtaking Brazil on Monday as the country with the second-highest number of infections after logging more than 168,000 new cases in a day.

Muslims prepare for second COVID Ramadan

Experts have warned that huge, mostly maskless crowds at political rallies and religious festivals have fuelled India’s caseload.

In the Himalayan city Haridwar, maskless Hindu pilgrims on Monday squeezed shoulder-to-shoulder on the banks of the Ganges River for a dip during the Kumbh Mela ritual.

Several Indian regions have tightened their coronavirus measures, with Maharashtra—India’s wealthiest state and current epicentre of its epidemic—imposing a weekend lockdown and night curfew.

Neighbouring Bangladesh has announced it will virtually seal itself off, shutting down both international and domestic transport starting Wednesday while shutting offices in an attempt to staunch its own spiralling outbreak.

Across the Muslim world, worshippers are gearing up for the start of their second Ramadan of the pandemic, with the holy fasting month due to kick off in many countries on Tuesday.

In Egypt, the Arab world’s most populous nation, the sanitary measures are less strict than a year ago when mosques were shut completely and a curfew was in force.

The mood in Cairo was relatively cheerful as the city prepared for special prayers on Monday night, with bright lights festooning the streets. Many of those rushing around the city shopping for last-minute supplies were maskless, however.

Saudi authorities have meanwhile said that only people immunised against COVID-19 will be allowed to perform the year-round umrah pilgrimage from the start of Ramadan.

Glimmers of hope

In Britain, despite one of the world’s highest COVID-19 death tolls, there were glimmers of hope Monday as pubs and restaurants were allowed to serve people outside—a move welcomed by the hard-hit hospitality sector, despite wintry temperatures.

“It’ll be great to see everybody again and see all the locals,” Louise Porter, landlady of The Crown Inn in Askrigg, northern England, told AFP.

“Our lives have just been turned upside down, just like everybody else’s,” she said, adding: “We’re still here to tell the tale.”

England’s hairdressers, indoor gyms and swimming pools also got the green light to reopen.

Once the worst-affected country in Europe, Britain launched a successful vaccination campaign coupled with lockdown measures that cut deaths by 95 percent and cases by 90 percent from January.

Italy has also been one of Europe’s hardest-hit countries, and on Monday, Rome saw the latest in a series of anti-lockdown demonstrations, with several hundred people turning out in protest against weeks of restaurant closures.

In France, now the European country with the most infections, an expansion of the vaccine rollout has buoyed optimism among lockdown-weary residents. Everyone aged over 55 years old is now eligible for a COVID vaccination.

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Vaccine rollout hits snag as health workers balk at shots

Vaccine rollout hits snag as health workers balk at shots

The desperately awaited vaccination drive against the coronavirus in the U.S. is running into resistance from an unlikely quarter: Surprising numbers of health care workers who have seen firsthand the death and misery inflicted by COVID-19 are refusing shots.

It is happening in nursing homes and, to a lesser degree, in hospitals, with employees expressing what experts say are unfounded fears of side effects from vaccines that were developed at record speed. More than three weeks into the campaign, some places are seeing as much as 80% of the staff holding back.

“I don’t think anyone wants to be a guinea pig,” said Dr. Stephen Noble, a 42-year-old cardiothoracic surgeon in Portland, Oregon, who is postponing getting vaccinated. “At the end of the day, as a man of science, I just want to see what the data show. And give me the full data.”

Alarmed by the phenomenon, some administrators have dangled everything from free breakfasts at Waffle House to a raffle for a car to get employees to roll up their sleeves. Some states have threatened to let other people cut ahead of health care workers in the line for shots.

“It’s far too low. It’s alarmingly low,” said Neil Pruitt, CEO of PruittHealth, which runs about 100 long-term care homes in the South, where fewer than 3 in 10 workers offered the vaccine so far have accepted it.

Many medical facilities from Florida to Washington state have boasted of near-universal acceptance of the shots, and workers have proudly plastered pictures of themselves on social media receiving the vaccine. Elsewhere, though, the drive has stumbled.

While the federal government has released no data on how many people offered the vaccines have taken them, glimpses of resistance have emerged around the country.

In Illinois, a big divide has opened at state-run veterans homes between residents and staff. The discrepancy was worst at the veterans home in Manteno, where 90% of residents were vaccinated but only 18% of the staff members.

In rural Ashland, Alabama, about 90 of some 200 workers at Clay County Hospital have yet to agree to get vaccinated, even with the place so overrun with COVID-19 patients that oxygen is running low and beds have been added to the intensive care unit, divided by plastic sheeting.

The pushback comes amid the most lethal phase in the outbreak yet, with the death toll at more than 350,000, and it could hinder the government’s effort to vaccinate somewhere between 70% and 85% of the U.S. population to achieve “herd immunity.”

Administrators and public health officials have expressed hope that more health workers will opt to be vaccinated as they see their colleagues take the shots without problems.

Oregon doctor Noble said he will wait until April or May to get the shots. He said it is vital for public health authorities not to overstate what they know about the vaccines. That is particularly important, he said, for Black people like him who are distrustful of government medical guidance because of past failures and abuses, such as the infamous Tuskegee experiment.

Medical journals have published extensive data on the vaccines, and the Food and Drug Administration has made its analysis public. But misinformation about the shots has spread wildly online, including falsehoods that they cause fertility problems.

Stormy Tatom, 30, a hospital ICU nurse in Beaumont, Texas, said she decided against getting vaccinated for now “because of the unknown long-term side effects.”

“I would say at least half of my coworkers feel the same way,” Tatom said.

There have been no signs of widespread severe side effects from the vaccines, and scientists say the drugs have been rigorously tested on tens of thousands and vetted by independent experts.

States have begun turning up the pressure. South Carolina’s governor gave health care workers until Jan. 15 to get a shot or “move to the back of the line.” Georgia’s top health official has allowed some vaccines to be diverted to other front-line workers, including firefighters and police, out of frustration with the slow uptake.

“There’s vaccine available but it’s literally sitting in freezers,” said Public Health Commissioner Dr. Kathleen Toomey. “That’s unacceptable. We have lives to save.”

Nursing homes were among the institutions given priority for the shots because the virus has cut a terrible swath through them. Long-term care residents and staff account for about 38% of the nation’s COVID-19 fatalities.

In West Virginia, only about 55% of nursing home workers agreed to the shots when they were first offered last month, according to Martin Wright, who leads the West Virginia Health Care Association.

“It’s a race against social media,” Wright said of battling falsehoods about the vaccines.

Ohio Gov. Mike DeWine said only 40% of the state’s nursing home workers have gotten shots. North Carolina’s top public health official estimated more than half were refusing the vaccine there.

SavaSeniorCare has offered cash to the 169 long-term care homes in its 20-state network to pay for gift cards, socially distanced parties or other incentives. But so far, data from about a third of its homes shows that 55% of workers have refused the vaccine.

CVS and Walgreens, which have been contracted by a majority of U.S. nursing homes to administer COVID-19 vaccinations, have not released specifics on the acceptance rate. CVS said that residents have agreed to be immunized at an “encouragingly high” rate but that “initial uptake among staff is low,” partly because of efforts to stagger when employees receive their shots.

Some facilities have vaccinated workers in stages so that the staff is not sidelined all at once if they suffer minor side effects, which can include fever and aches.

The hesitation isn’t surprising, given the mixed message from political leaders and misinformation online, said Dr. Wilbur Chen, a professor at the University of Maryland who specializes in the science of vaccines.

He noted that health care workers represent a broad range of jobs and backgrounds and said they are not necessarily more informed than the general public.

“They don’t know what to believe either,” Chen said. But he said he expects the hesitancy to subside as more people are vaccinated and public health officials get their message across.

Some places have already seen turnarounds, such as Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana.

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As virus hits Italy’s south, some flee troubled health care

Patients, some wrapped in blankets that look like they came from home, moan in their beds. What appears to be medical tubing and a wad of gauze or paper towels litter the floor of San Giuliano public hospital, which treats coronavirus patients in a bleak town in Italy’s Neapolitan hinterland.

In another surreptitiously filmed scene, 15 kilometers (9 miles) away in Naples, an elderly man suspected of having COVID-19 takes his last, labored breaths in a bathroom at the emergency room of Cardarelli Hospital, his undignified end memorialized on a phone camera by a fellow patient and posted online.

Meanwhile, outside the ER entrance for Cardarelli, the main health care facility for densely populated Naples, those desperate for oxygen for loved ones line up in their cars, waiting for nurses to bring tanks of the life-saving element to ailing passengers anxious to enter the crowded ER.

The pandemic, which has killed more than 46,000 people in Italy, has heightened the urgency of the plight of those seeking medical care in public hospitals in the country’s economically underdeveloped south. But these glimpsed moments of drama, while shocking, are nothing new to people here who depend on such care.

In late September, as coronavirus infections surged in Italy after a summer decline, prosecutors put 17 hospital managers and workers under investigation for an insect infestation at a Naples hospital. Cardarelli, meanwhile, was once accused by the consumer group Codacons of leaving patients crowded in corridors like they were “old boxes.”

Naples prosecutors are investigating the bathroom death at Cardarelli, and the hospital’s director has ordered an internal probe. At San Giuliano, hospital officials declined to speak to an AP reporter who visited Saturday, and there was no immediate answer at the hospital’s administrative office on Tuesday evening.

Many in the Naples area resign themselves to what the La Repubblica newspaper denounced as hellish, “Dantesque” waits to receive treatment for COVID-19. Others bundle up their loved ones and head north, where Italian health care enjoys a better reputation—but many hospitals there are also overwhelmed.

Lombardy in the north is again the epicenter of Italy’s latest coronavirus outbreak, as it was when the virus first hit Europe. In the regional capital of Milan, coronavirus infections rampaged through the city’s most prestigious home for the elderly early in the pandemic.

In the spring, a severe nationwide lockdown meant that while the north suffered the brunt, the south was largely spared. But now, the virus is hitting several regions hard at once—a phenomenon seen in other European countries.

With the Campania region that surrounds Naples now under strain, at least 116 patients sought treatment this month in neighboring Lazio, at Formia’s Dono Svizzero hospital. Some had tested positive for the virus, while others had other ailments and feared becoming infected with the virus in the area’s chaotic emergency rooms.

“If patients knock on the door, it’s open,” Paolo Nucero, head of the Formia hospital’s emergency room, told Italian state television. “At the moment, we’re holding up. But if we have a super flood, we will start suffering.”

Leaving one’s region to seek better medical treatment elsewhere in Italy is so prevalent that a foundation studying the quality of the nation’s health care publishes what it calls the “flight index.” The GIMBE Foundation found that nearly all those “fleeing” local health care went north.

In Italy’s health care system, each region manages its own spending. In a cruel illustration of the ”rich get richer while the poor get poorer” adage, footing the medical bills of Italians who travel outside their regions still falls to the region where they reside. That means a bonanza of funds for the northern regions providing the care but a drain on the coffers of poorer, southern parts.

Along the Naples waterfront, Luigi Orefice perched his 4-year-old son, Giovanni, on the thick wall lining the promenade. With fog ringing the Vesuvius volcano in the background, the postcard-like panorama would be familiar to tourists. But his job delivering beverages to hospitals lets Orefice see the ugly realities beyond the “O Sole Mio” image of the south.

His deliveries take him inside hospitals in the dead of night, when Orefice says he has witnessed lax protocols, like staff walking barefoot.

“We might have the best hospital department chief of staffs, but at the bottom, hospital workers are poorly managed,” he said.

Outside San Giuliano Hospital in Giugliano in Campania on a recent day, Feliciano Manna, a representative of the UIL labor syndicate for ambulance crews, noted that Campania lost about 15,000 health care workers in recent years to budget cuts. Italy’s Civil Protection force is currently recruiting 450 doctors to help the region care for COVID-19 patients.

Only weeks before the pandemic began did Campania’s public health care system emerge from years of central government control, part of efforts to cut waste and drive down costs.

The person behind the video inside San Giuliano Hospital “took advantage of a moment when he saw some wad of gauze of the floor,” said Manna. “The staff is doing super-human work,” he said. The video “doesn’t discredit that.”

In a parking lot behind the hospital, Giuseppe Sguiglia, 30, and his 26-year-old wife waited in their car, inching forward in a long line of people signed up for COVID-19 tests.

Last year, Sguiglia said, he had to use a local hospital. Judging from that experience, “we understood that Naples would be a disaster” if the pandemic spread south, he said.

Some cite the insidious influence of organized crime on some of Campania’s institutions.

In response to an AP query, the Interior Ministry said Monday that the minister will decide this month whether a sprawling Naples health care district should be put under temporary control of the ministry’s local prefect—depending on if it’s determined that the Camorra infiltrated its administration.

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