Bushfires and COVID take their toll on new moms and babies

Almost seven in 10 pregnant women and new mothers (65%) in the ACT and southeast New South Wales say they were severely exposed to bushfire smoke in our recent summer.

Almost nine in 10 (85%) said they isolated themselves and their family at some point this year due to the COVID-19 pandemic.

These are early results of the Mother and Child 2020 (MC2020) survey being conducted by researchers from The Australian National University (ANU), University of Canberra and University of Wollongong, in partnership with Canberra Health Services and NSW Health.

The MC2020 study is examining the effects of this year’s bushfires and COVID-19 on the health and wellbeing of pregnant women and their babies. Mid-way through the survey, 750 women have participated.

The researchers are urging more women to enroll to increase the strength of the study findings. They are encouraging mothers from Aboriginal, Torres Strait Islander and multicultural communities to share their experiences.

The survey highlights the challenges women and their babies faced throughout the bushfires and pandemic as well as their adaptability and resilience in both the short and longer term.

Lead ANU researcher Professor Christopher Nolan said the results will be used to form a series of recommendations on how to improve our health system and emergency responses during major crises. “We need to listen to the experiences of these mothers and look at the challenges they faced during the bushfires and pandemic. Understanding these challenges is the only way we can look to improve these systems in the future,” Professor Nolan said. “We are very grateful for the women who have already joined the study.”

Ms Namita Mittal gave birth to twins during the lockdown and says that balancing looking after her newborn babies, helping her daughter do school from home and handling the pandemic without her family’s support caused her a great deal of anxiety. “None of my family could fly to visit me from India. Having a family member come to stay with you 24/7 to help with the babies is important to me and different from hiring help. There was extra work for me to do and not having that family support was the main thing that caused me anxiety,” Ms Mittal said.

“When my daughter was born my mum came, so I had no experience of how to handle everything myself. Recovering from a cesarean section with two newborns and one child doing school from home, I was really anxious having to do this without my mum.”

Dr Amita Bansal, from ANU, said mothers and babies have been disproportionately affected, and the long-term impact of bushfires, bushfire smoke and COVID-19 on the health of mothers and their babies is unknown.

“If a majority of women felt that exposure to smoke was severe, this may influence their stress levels. Isolation from COVID-19 most likely will add to this stress. Pregnancy itself is an overwhelming period for many women, and any additional stress can be detrimental for health of the mother and her child.”

Dr Bansal said it is important researchers get results that more accurately reflect the population to better prepare our emergency response and health care systems in the future.

“We want to hear the unheard, uncover the unknowns and best represent our diversity, so that we can better inform clinical practice and make policies that are more inclusive; inclusive of our women and children, and inclusive of our diverse perspectives and community,” she said.

“Through our study, we want to uncover if our multicultural community was indeed disproportionately impacted, so that we can improve our clinical practices and policies to reduce health disparities between ethnic groups.”

The survey is available to anyone who was pregnant or had a baby no older than three months on 1 February 2020 or became pregnant by 30 April 2020 in Canberra and Southeastern New South Wales.

The four-part survey asks mothers a series of questions about how the bushfires and pandemic impacted their pregnancy care, birthing and early months of having a new baby, including on their own mental and physical health, as well as the health of their baby.

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Iran announces its virus death toll passes 30,000

Iran announced Saturday that its death toll from the coronavirus has passed the milestone of 30,000, in what has been the Mideast region’s worst outbreak.

Health Ministry spokeswoman Sima Sadat Lari announced that the total death toll from the outbreak had reached at least 30,123.

She said that 4,721 virus patients are in critical condition.

Iran has been struggling with the coronavirus since announcing its first cases in February, with more than 526,000 confirmed cases to date.

In recent weeks, Iran has seen daily death tolls spike to their highest-ever levels, sparking increasing concern even as government officials continue to resist a total lockdown for fear of cratering the economy, which has been hard-hit by U.S. sanctions.

On Wednesday, Iranian officials announced a travel ban to and from five major cities, including the capital of Tehran and the holy city of Mashhad, that they said aimed to contain the virus’ spread.

The coronavirus has also spread to some of the highest levels of Iran’s government, which includes many older men. Among those recently infected is the head of the country’s atomic energy organization, while Iran’s vice president in charge of budget and planning tested positive on Sunday.

After downplaying the outbreak in its first weeks, Iranian officials have more recently begun to admit the scope of the epidemic within the country.

Deputy Health Minister Iraj Harirchi, who had tested positive for the virus in March after playing down its threat and refuting reports of mass deaths, told state TV on Wednesday that the country’s true death toll is about double the reported figures.

According to officials, there are also large numbers of patients in hospitals being treated as COVID-19 cases but who have not been tested, whose tests came out as false negatives or whose symptoms are not the same as those listed by the World Health Organization and who are therefore not counted in the official case numbers.

Like in many other countries, the spiraling outbreak in Iran reflects the government’s contradictory virus response. This week, as the daily recorded death toll hit the record for three times, authorities announced tighter restrictions for the hard-hit capital of Tehran.

Recently reopened universities and schools, as well as libraries, mosques, cinemas, museums and beauty salons, shut down. In the past week, the government mandated that all Tehran residents wear face masks outdoors and in public places, warning violators would be fined. Officials promised those who tested positive would be closely tracked.

Movement restrictions this spring somewhat checked the spread of the disease. Then the government swiftly reopened the country, desperate to boost its stricken economy. Since June, the case count has steadily increased—and spiked to new heights in recent weeks.

Long before the virus hit, Iran’s economy was ailing, pummeled by U.S. sanctions after the Trump administration’s unilateral withdrawal in 2018 from Tehran’s nuclear accord with world powers. As the death toll soared this week, the nation’s currency plunged to its lowest level ever, following the U.S. administration’s decision last week to blacklist Iranian banks that had so far escaped the bulk of re-imposed American sanctions.

As Iran approaches winter, the seasonal influenza could be an added and serious issue for the country, as it has had purchasing the flu vaccine amid new American sanctions on Iranian banks.

Iran’s Red Crescent Society said in a tweet on Tuesday that they were in charge of importing two million flu vaccine doses into the country, but that new U.S. sanctions prevented the import.

Meanwhile on Saturday, the United Arab Emirates has announced its highest single-day total of new cases of the coronavirus amid a spike in the Gulf nation that is home to Abu Dhabi and Dubai.

The country’s Health Ministry said tests found 1,538 new cases of the virus, pushing the overall number of cases to 114,387.

The ministry said another four people died from the virus, pushing the overall death toll to 459. Overall recoveries are at 106,354.

Recorded infections have soared again in recent weeks, as authorities have relaxed restrictions and resumed schools for in-person instruction. Dubai has reopened its airport for international travelers and embarked on an active campaign promoting itself as a tourism destination amid the pandemic.

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COVID-19 Taking Huge Toll in Excess U.S. Deaths

TUESDAY, Oct. 13, 2020 — A pair of new studies assert that the U.S. response to the COVID-19 pandemic has been a disaster, causing more deaths than thought and prolonging Americans’ suffering more than any other country.

The United States experienced a 20% increase over expected deaths between March and August 2020, with more than 225,500 people needlessly dying, said the lead researcher on the first study, Dr. Steven Woolf. He’s director of the Virginia Commonwealth University Center on Society and Health, in Richmond.

All of those excess deaths can be laid at the feet of the COVID-19 pandemic and the inadequate U.S. response to it, Woolf said.

According to Dr. Amesh Adalja, a senior scholar with the Johns Hopkins Center for Health Security in Baltimore, “The research on excess mortality from COVID-19 really underscores what many of us have seen on a day-to-day basis. This pandemic was earth-shattering for this country, and the reverberations of the pandemic were felt everywhere and extended even to those who were never infected with the virus.”

As a result, the United States is first among developed nations in the number of citizens per capita who have died due to COVID-19.

Worse, the U.S. pandemic continued on through the summer even as other countries managed to gain control over the new coronavirus, the second study reports.

Between May and September, the United States experienced more than 31 excess deaths per 100,000 people, Dr. Ezekiel Emanuel, of the University of Pennsylvania in Philadelphia, and his colleague found.

By comparison, other countries who have lost many people to COVID-19 — Spain, the United Kingdom, Belgium, France, Sweden — had much lower excess death rates due to the pandemic over the summer, as they adopted tactics to halt transmission of the virus.

For example, Sweden had about 15 excess deaths per 100,000, half as many as the United States, and the United Kingdom had about 14 excess deaths per 100,000.

“We knew it was bad. It’s actually even worse,” said Dr. Harvey Fineberg, president of the Gordon and Betty Moore Foundation in Palo Alto, Calif.

The two new studies and an editorial by Fineberg were published online Oct. 12 in the Journal of the American Medical Association.

The 20% increase in U.S. deaths were all related to the pandemic, but not all were caused by the virus, Woolf said. COVID-19 was a documented cause in only 67% of those cases.

“The calculation of excess deaths shows that for every two Americans that we know are dying from COVID-19, an additional American is dying from causes other than COVID-19,” Woolf said.

The other pandemic-related deaths are due to:

  • People not getting care in emergency situations — for example, “the patient with chest pain who’s scared to call 911 because they don’t want to get the virus, and dies of a heart attack,” Woolf said.
  • Patients dying from chronic conditions like diabetes, cancer and heart problems, because they didn’t have access to the medical care that had helped them control their health problems.
  • People suffering from pandemic-related anxiety, depression or stress who either die by suicide or die from an accidental overdose.

“The opioid epidemic hasn’t gone away,” Woolf said. “People under stress trying to cope with the strains of this pandemic may have taken a drug overdose and died. We suspect some of those excess deaths are from these other causes.”

It’s also likely that at least some of these unexplained excess deaths really are due to undetected COVID-19 infections, Woolf added.

Woolf and his team also found that the U.S. struggle with COVID-19 was compounded by decisions in some states to emerge from lockdown prematurely, without any good plan to control virus transmission.

“States like Florida, Texas, Arizona and others that made the choice to reopen early, like in late April or early May, their curves look very different,” Woolf said. “You see a pattern of initially slowly rising and then surging excess deaths in the summer. That dragged out the length of their epidemic.”

By comparison, U.S. states hit hardest early on — such as New York and New Jersey — had an early spike in mid-April that then fell rapidly “because they did a very good job of controlling community spread,” Woolf said.

Combined with the second study’s global comparison, the studies “together say something very important,” Woolf said.

Other countries have taken effective steps to control the pandemic — comprehensive travel bans, production of personal protective equipment (PPE), access to testing, and public health work like contact tracing.

“You find that the U.S. faltered in each of those steps in a rather dramatic way,” Woolf said.

He pointed to the early travel ban that President Donald Trump often cites as proof that his administration effectively responded to the pandemic.

The ban only applied to Chinese nationals, while other countries “really locked down arrivals into their country in a way that the U.S. did not do,” Woolf said.

“U.S. citizens were still flying in from China, but more importantly the virus was coming from Europe and there was no ban imposed there until March,” Woolf said. “Those kinds of shortcomings in our response have led the U.S. to end up with a mortality rate that is exceeding those of other countries.”

Adalja agreed.

“It is also important to remember that we did not have to have this trajectory with the pandemic,” Adalja said. “There were clear actions that could’ve been taken in January, February and March but were not and are still not.”

The United States failed to swing its industrial might behind an effort to develop a testing strategy, Adalja noted.

The United States “also failed to fortify our public health infrastructure despite the fact we knew that this virus is going to come here and it would be a huge burden on case investigators and contact tracers,” he added. “There was also no effort to augment [personal protective equipment] until it became too late. Imagine if we would’ve started thinking about PPE in January and making strategic buys at that point in order to increase supply.”

All of this has added up to a staggering loss of life that, not coincidentally, has ravaged the U.S. economy, Fineberg said.

“The economic consequences of this pandemic are stunning,” he said. “They estimate it has essentially stripped away almost a full year of the whole nation’s productivity, in their estimate a cost of $16 trillion. That’s made up of both direct health costs and other costs to the economy.”

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UK records lowest daily virus death toll since start of lockdown

This scanning electron microscope image shows SARS-CoV-2 (yellow)—also known as 2019-nCoV, the virus that causes COVID-19—isolated from a patient, emerging from the surface of cells (blue/pink) cultured in the lab. Credit: NIAID-RML

Younger children went back to schools in England on Monday as Britain began to stir back to life, while the government reported the lowest coronavirus death toll since the start of the national lockdown in late March.

Outdoor markets also swung open their gates and car showrooms tried to lure back customers and recoup losses suffered since Britain effectively shut down for business to ward off a disease that has now officially claimed 39,045 lives in the country.

Health Secretary Matt Hancock said Britain was making “significant progress” against the virus after its daily toll dropped to 111—the lowest since the stay-at-home order was issued on March 23.

Reporting of virus cases and fatalities is often lower after a weekend and many people still appeared hesitant to start using public transport or shop.

“It’s very different from usual,” Danish Londoner John Jellesmark said on a visit to the usually bustling Camden Market in the north of the capital.

“It’s still pretty slow. It looks like the market is basically waking up.”

Too much, too soon?

Prime Minister Boris Johnson has set out a timeline that allows two million younger children in England to return to school on Monday and older ones from June 15.

The devolved governments in Scotland and Northern Ireland are eyeing a return in August and September, while Wales is still weighing the benefits of human contact against the dangers of children catching the disease and bringing it home.

A survey conducted by the National Foundation for Educational Research found that primary school leaders expect about half the families to keep their children home.

Principal Claire Syms at the Halley House School in east London said children who do turn up need to feel comfortable in an unfamiliar setting where the desks are spaced out and many around them wear masks.

“We’ve been really conscious about keeping things as normal and as consistent as we can for our children,” Syms told AFP.

“We’re really mindful of their wellbeing and their mental health.”

The UK government has been encouraged by the positive experience of other European countries that have started to return to something resembling normal life.

The House of Commons will debate a government push to get everyone to start voting in person instead of remotely when parliament returns from a break on Tuesday.

But critics of the easing believe the so-called R rate of transmission—estimated nationally at between 0.7 and 0.9—was still dangerously close to the 1.0 figure above which the virus’ spread grows.

‘Unenforceable’

Scientists and lawmakers are not the only ones to express concern that the government’s “cautious and phased” reopening is moving too quickly.

“We’re only able to take these steps because of what we have achieved together so far,” finance minister Rishi Sunak said as he toured Tachbrook Market in central London.

London’s Metropolitan Police Federation chairman Ken Marsh said current rules such as those allowing people to gather in groups of six in England were unenforceable.

“I don’t think the public are taking much notice of what is laid down in front of them,” Marsh told The Daily Telegraph. “They are doing it how they want to do it.”

English parks and beaches have been inundated with people over two successive May weekends that came on the sunniest month ever recorded in Britain.

Police had warned after seeing growing numbers ignore social distancing measures a week ago that they were serious about sanctioning those who gather in large groups.

But some London parks looked like one giant party on Sunday and police issued just a tiny fraction of the fines they had handed out before people were allowed to leave their homes more freely on May 13.

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