Brazil's hospitals running out of sedatives as COVID-19 rages

RIO DE JANEIRO (Reuters) – Hospitals in Brazil were running out of drugs needed to sedate patients on Thursday, with reports of the seriously ill being tied down and intubated without effective sedatives.

FILE PHOTO: Medical workers take care of patients in the emergency room of the Nossa Senhora da Conceicao hospital that is overcrowding because of the coronavirus outbreak, in Porto Alegre, Brazil, March 11, 2021.  REUTERS/Diego Vara

The scenes playing out across Brazil, one of the countries hardest hit by the COVID-19 pandemic, are placing growing international pressure on President Jair Bolsonaro.

Aid group Médecins Sans Frontières (MSF) said Brazil’s “failed response” had led to thousands of avoidable deaths and created a humanitarian catastrophe that could still get worse.

Brazil has recorded a total of 361,884 coronavirus deaths – only the United States has more – and 13,673,507 confirmed cases.

More Brazilians are currently dying of the virus each day than anywhere else in the world. Bolsonaro has opposed lockdowns and held large events in which he often does not wear a mask. He has only recently embraced vaccines as a possible solution.

Brazil’s hospitals are struggling to cope.

Rio de Janeiro and Sao Paulo have both sounded the alarm over shortages of sedatives, with Sao Paulo’s Health Secretary saying the city’s ability to care for seriously ill COVID-19 patients is on the verge of collapse.

“I never thought that I would be living through something like this after 20 years working in intensive care,” Aureo do Carmo Filho, an ICU doctor in Rio, told Reuters.

“Using mechanical restraints without sedatives is bad practice…the patient is submitted to a form of torture,” he said.

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Seriously ill COVID-19 patients struggling for breath are sedated in order to put them on ventilators, an intrusive practice the body can naturally resist.

With ICU beds at or near capacity across the country, hospitals are being forced to create improvised intensive care beds which often lack equipment or professional expertise.

Globo television network on Wednesday reported cases from a Rio hospital in which patients were intubated with a lack of sedatives, tied to beds.

The Albert Schweitzer hospital, through the press office of the city of Rio which runs it, said there was a shortage of intubation drugs but that substitutes were being used to ensure medical assistance was not compromised. It said mechanical restraints were only used when prescribed by a doctor.

The city of Rio added that a batch of intubation drugs was set to arrive on Thursday.

“FAILED RESPONSE”

Médecins Sans Frontières said Bolsonaro’s government had not done enough to prevent the tragedy.

“More than one year into the COVID-19 pandemic, the failed response in Brazil has caused a humanitarian catastrophe,” said Christos Christou, a medical doctor and president of MSF, called Doctors Without Borders in English.

“Each week there is a grim new record of deaths and infections – the hospitals are overflowing and yet there is still no coordinated centralized response,” Christou said in a briefing with reporters, adding that the situation was expected to become even worse in the weeks ahead.

Bolsonaro has openly fought against state and local governments seeking to institute lockdowns, saying Brazilians need to get on with normal life and that job losses are more dangerous than the virus.

MSF Director-General Meinie Nicolai said the surge in cases cannot be blamed only on the contagious Brazilian COVID-19 variant, known as P.1.

“The P.1 variant is certainly a problem, but this doesn’t explain the situation in Brazil,” she said.

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Virus variants inciting India's second surge, epidemiologists say

NEW DELHI (Reuters) – The second surge of COVID-19 cases in India has swamped hospitals much faster than the first because mutations in the virus mean each patient is infecting many more people than before, epidemiologists and doctors say.

A patient lies in a bed as she is being shifted to a hospital for treatment, amidst the spread of the coronavirus disease (COVID-19) in Ahmedabad, India, April 15, 2021. REUTERS/Amit Dave

India’s daily infections skyrocketed more than 20-fold to more than 200,000 on Thursday since a multi-month-low in early February, though the government has played down the role of mutants in the latest rise, the worst anywhere this month.

The world’s hardest-hit country after the United States has reported about 950 cases of people contracting the variants first detected in the United Kingdom, South Africa and Brazil.

“The point is that these variants of concern are still not on top of the discourse,” said epidemiologist Rajib Dasgupta of New Delhi’s Jawaharlal Nehru University.

“Even if it is a new variant, you need to do the same things” to control it and treat patients “but it requires a different urgency to recognise that”, he said.

Doctors at New Delhi’s All India Institute of Medical Sciences have found that one patient is now infecting up to nine in 10 contacts, compared with up to four last year.

Scientists in Britain say the B.1.1.7 variant here, widely known as the British mutant, is 70% more transmissible than previous variants, and much deadlier.

The northern Indian state of Punjab, which has reported one of the highest recent fatality rates in the country, said late last month 81% of 401 COVID-19 samples it sent for genome sequencing were found to be the British variant.

“This virus is more infectious and virulent,” said Dhiren Gupta, a senior consultant at New Delhi’s Sir Ganga Ram Hospital.

“More children are reporting high-grade fever compared to last year. We have 35-year olds with pneumonia in intensive care, which was not happening last year.”

India has recorded 14.1 million infections and 173,123 deaths in total.

MASS GATHERINGS

The government has mainly attributed the big rise in cases to a reluctance to wear marks and crowding.

Still, it has refused to call off a mass gathering of Hindu devotees for a festival and its ministers are addressing tens of thousands of largely mask-less people in election rallies.

A scientist at the National Institute of Epidemiology said more evidence was needed to directly link the rise in cases to the variants, but that anecdotally that seemed to be the case.

“There are in-vitro experiments which can also tell us about the infectivity, the severity, how lethal it is, etc, but those are not completed yet, they are ongoing,” said Tarun Bhatnagar.

“We haven’t had a virus that has spread so rapidly, and we haven’t had the time to study it. Everything is on the go. We are dealing with it, being affected by it and studying it. The pace of every thing is too fast.”

But with crowding still common in many regions of India, “we are about to find out just how dangerous this strain is”, said Om Srivastava, head of infectious diseases at Mumbai’s Jaslok Hospital who also advises India’s worst-hit Maharashtra state.

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Magic mushroom compound at least as good as antidepressant in UK study

LONDON (Reuters) – Psilocybin, the psychedelic active compound in magic mushrooms, may be at least as effective as a leading antidepressant drug and could help more patients into remission from severe depression, a small study by British scientists has found.

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The findings, in the first-of-a-kind head-to-head comparison of psilocybin therapy and the antidepressant escitalopram, suggests the psychoactive ingredient has promise as a potential mental health treatment, the researchers said.

“Remission rates were twice as high in the psilocybin group than the escitalopram group,” Robin Carhart-Harris, who designed and led the study as head of the centre for psychedelic research at Imperial College London, told a briefing.

“One of the most important aspects of this work is that people can clearly see the promise of properly delivered psilocybin therapy by viewing it compared with a more familiar, established treatment,” he said. “Psilocybin performed very favourably in this head-to-head.”

Depression is one of the leading causes of ill health worldwide, and existing treatments are often ineffective or have adverse side effects that lead patients to stop taking them.

Carhart-Harris warned that while these findings – published in the New England Journal of Medicine – were encouraging, patients with depression should not try to self-medicate with magic mushrooms. “That would be an error of judgment,” he said.

The research involved 59 patients with moderate to severe depression who got either a high dose of psilocybin and a placebo, or escitalopram plus a dose of psilocybin so low as to be classed as non-active and unlikely to have an effect.

This design was aimed at ensuring the two arms of the trial were as alike as possible for those taking part.

Treatment response, defined as a reduction of at least 50% in depression scores from baseline, was seen in 70% of people in the psilocybin group and 48% in the escitalopram group.

Results also showed that remission of symptoms – measured as a score of 0 to 5 at week six – was seen in 57% of the psilocybin group compared with 28% in the escitalopram group.

Carhart-Harris said participants’ reports suggested the psilocybin had a more “fundamental” effect than antidepressants.

“I think it’s getting more at the root causes of suffering,” he said. “There’s a kind of epistemic quality to the treatment, a revelatory quality, where people report feeling that they understand more fully why they’re depressed.”

The Imperial team, co-led by David Nutt, a professor of neuropsychopharmacology, has been exploring the potential of psilocybin for many years.

In 2016 they published a small study showing psilocybin could help ease a severe condition known as treatment-resistant depression.

The latest study was conducted under specific controlled conditions with two therapists and a regulated dose formulated in laboratory conditions, Nutt told the briefing, and taking magic mushrooms without such safeguards could be dangerous.

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U.S. pauses J&J COVID-19 vaccine over rare blood clots

(Reuters) -U.S. federal health agencies on Tuesday recommended pausing the use of Johnson & Johnson’s COVID-19 vaccine after six women under 50 given the shot developed rare blood clots, dealing a fresh setback to efforts to tackle the pandemic.

FILE PHOTO: A woman receives a dose of the Johnson & Johnson coronavirus disease (COVID-19) vaccine during a visit of U.S. Vice President Kamala Harris to a vaccination center in Chinatown, in Chicago, Illinois, U.S., April 6, 2021. REUTERS/Carlos Barria

Following the news, Johnson & Johnson (J&J) said it was delaying the rollout of the vaccine to Europe, a week after regulators there said they were reviewing rare blood clots in four recipients of the shot in the United States.

The moves come after European regulators said earlier this month they had found a possible link between AstraZeneca’s COVID-19 vaccine and a similar rare blood clotting problem that led to a small number of deaths.

J&J’s single dose vaccine – most COVID-19 shots are delivered over two doses – and AstraZeneca’s low-cost vaccine are seen as vital tools in the fight against a pandemic that has claimed more than three million lives.

The White House said the pause would not have a “significant” impact on its plan to administer about three million shots per day and a total of 200 million shots before President Joe Biden’s 100th day in office.

The U.S. Food and Drug Administration (FDA) said one person had died from the rare blood clotting condition after taking the J&J vaccine and another was in a critical condition.

Immunology experts stressed the risk posed by the J&J vaccine appeared extremely low, and that the shot remained a valuable tool against the risks of COVID-19. However they acknowledged the need for health officials to proceed with caution to understand the best ways to mitigate any risk.

“Even if causally linked to the vaccine: 6 cases with about 7 million doses (lower than the risk of clots with oral contraceptives) is not something to panic about,” Dr. Amesh Adalja, an infectious disease expert at the Johns Hopkins Center for Health Security in Baltimore, said in an email.

“People are asking me if they should cancel their J&J vaccine appointments and I have told them not to but I know many will and this will stall progress in controlling the pandemic.”

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FDA acting commissioner Janet Woodcock said it expected the pause to be a matter of days, and it was aimed at providing information to healthcare providers so that they can diagnose, treat and report such blood clots.

FDA official Peter Marks said that part of the reason for the pause was to warn doctors that administering the standard treatments for clots can cause tremendous harm, or be fatal.

‘LESS THAN ONE IN A MILLION’

Most of the available J&J vaccine has been used in the United States due to production issues that have limited the company’s supply. As of April 12, more than 6.8 million doses of the J&J vaccine had been administered in the United States, compared with more than 180 million shots combined of the Moderna and Pfizer/BioNTech shots.

U.S. health officials said during a press briefing there had been no similar blood clot cases reported among recipients of the Pfizer/BioNTech of Moderna vaccines.

An advisory committee to the U.S. Centers for Disease Control and Prevention (CDC) will meet on Wednesday to review the cases, and the FDA will review the analysis, the agencies said in a joint statement.

All six cases involved women between the ages of 18 and 48, and the symptoms occurred six to 13 days after vaccination.

In the cases, a type of blood clot called cerebral venous sinus thrombosis (CVST) was seen in combination with low levels of blood platelets (thrombocytopenia).

J&J said it was working closely with regulators and noted no clear causal relationship had been established between the cases and the COVID-19 vaccine made by its Janssen unit.

“Even if all of the cases were caused by the vaccine, the risk of less than one in a million would have to be set against the benefits of protection from COVID-19 disease; a disease which, in itself, causes clotting in many cases,” said Peter English, a retired consultant in communicable disease control and a vaccine expert.

‘ABUNDANCE OF CAUTION’

“The FDA recommendation to pause the administration of the Johnson and Johnson vaccine out of an abundance of caution makes sense in terms of the nature of the unusual and serious side effect not seen with the other vaccines,” said Dr. Robert Klugman at the UMass Memorial Medical Center in Massachusetts in an email.

J&J’s shares were down 2.6% in early New York trade.

The J&J and AstraZeneca vaccines both use an adenovirus vector – a harmless cold virus that instructs human cells to produce a protein found on the surface of the coronavirus, thereby spurring the immune system to prepare an arsenal against the COVID-19-causing virus.

Among leading global COVID-19 vaccine developers, China’s CanSino Biological and Russia’s Gamaleya Institute with its Sputnik V vaccine are also relying on this approach. The Pfizer/BioNtech and Moderna vaccines use mRNA technology.

The rollout of J&J’s vaccine has been slowed by issues at production plants.

The company has supplied the United States with at least 20 million doses but is behind schedule on its deliveries. Problems at a Baltimore, Maryland plant run by outside contractor Emergent BioSolutions forced the companies to trash a batch of vaccine substance.

J&J only began delivering its COVID-19 vaccine to European Union countries this week. It has committed to delivering 55 million doses to the bloc by the end of June and another 120 million in the third quarter.

J&J has been doing vaccinations in South Africa to study the effects on health workers, and had vaccinated just under 300,000 people there as of Monday, according to data from the country’s health department. J&J recently struck a deal with the African Union for up to 400 million doses.

Europe’s drugs regulator continues to recommend the use of AstraZeneca’s COVID-19 vaccine, saying the benefits outweigh the risks. Several EU countries, however, have limited its use to certain age groups.

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AstraZeneca has not reacted yet to EU letter on vaccines – Corriere

MILAN (Reuters) – AstraZeneca has yet to react to a letter sent by the European Commission to complain over below-contract supplies of COVID-19 vaccines, Italian daily Corriere della Sera said, adding the Anglo-Swedish group missed a deadline indicated by Brussels.

FILE PHOTO: Empty vials of Oxford/AstraZeneca’s COVID-19 vaccine are seen at a vaccination centre in Antwerp, Belgium March 18, 2021. REUTERS/Yves Herman/File Photo

The European Union member states and the pharmaceutical company are at odds over the delivery of the shots after the group shipped to the block less than indicated in the initial agreement.

“AstraZeneca has breached and continues to breach its contractual obligations on the production and supply of the initial 300 million doses for Europe,” EU Head of Health and Food Safety DG Sandra Gallina said in a letter sent to the company on March 19, according to Corriere.

The Italian daily said that Brussels had asked AstraZeneca to “remedy the material breaches of contract within 20 days of the letter”, but added that the deadline expired two days ago without any reaction from the company.

AstraZeneca has not replied to a request for comment from Reuters.

A spokesman for the European Commission confirmed that Brussels on March 19 sent a written message to AstraZeneca, calling it “a notice for dispute settlement”, adding this was a first step to engage in an dialogue to resolve the issue.

“At this stage we are still waiting for the necessary elements … we remain in contact with AstraZeneca to ensure timely delivery of a sufficient number of doses,” the spokesman told Reuters, without elaborating.

According the contract signed between EU and the company, which is public, if a dispute arises one of the parties shall first notify the problem with a letter. Then, after 20 days from the written notice, they “shall meet and attempt to resolve the dispute by good faith negotiations”.

Under the contract signed on COVID-19 vaccines, the European Union states had expected to receive 120 million doses by the end of March from AstraZeneca, but the company had supplied only 30.12 million doses, Corriere said.

With contagion still rising in many European countries and vaccination campaigns hitting hurdles, some governments are shown increasing irritation against the pharma group.

“Manifestly, they (AstraZeneca) did not honour their commitments and thus, in a certain way, they were mocking us Europeans,” France’s European Affairs Minister Clement Beaune said on Sunday, speaking to LCI television news channel.

Beaune said that the EU letter to the Anglo-Swedish group could even lead to a battle in court.

“We sent a formal notice in recent days, it is the beginning of a possible judicial procedure if the company doesn’t fix things,” he said, adding that putting pressure on the company to accelerate production in Europe appeared to be a better option compared with starting a legal process, which would take time.

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New York grandmother receives first windpipe transplant in the US

New York grandmother receives first windpipe transplant in the US after spending six years ‘trying to catch every breath at every moment’

  • Sonia Sein, 56, underwent the first trachea transplant in the U.S. in January 
  • The procedure may even be a world-first, but this was not confirmed by UNOS
  • Sein said she spent the past six years ‘trying to catch every breath at every moment’ after being intubated during an asthma attack damaged her trachea
  • The trachea, or windpipe, is difficult to transplant due to its complex system of blood vessels and tiny hairs that are key to its function 
  • Sein is recovering and so far doing well, and breathing easily 
  • As many as half of Covid patients put on ventilators sustain trachea damage, according to one Italian study 
  • Transplants could help these patients down the road if their breathing problems due to damage from ventilators become chronic  

America’s first trachea transplant has been performed on a 56-year-old woman from the Bronx in New York City. The procedure may even be the first in the world. 

Sonia Sein said she spent the last six years ‘trying to catch every breath at every moment’ after extensive treatment for her severe asthma damaged her windpipe.

She is breathing freely again after getting an unusual transplant. In January, doctors at New York’s Mount Sinai replaced her windpipe with one taken from a donor. 

Doctors say this drastic operation could potentially help other people including COVID-19 patients left with serious windpipe damage from breathing machines and former smokers. 

‘We’ve talked for 100 years about just putting in a new windpipe,’ said University of Washington surgeon Dr Albert Merati, who had no role in the recent transplant.

But hooking up a trachea from a donor to a recipient’s blood supply is challenging and would only be considered as a last resort, experts say.

‘It is just technically extremely difficult,’ said Dr David Klassen, chief medical officer for the United Network for Organ Sharing, or UNOS, which oversees the nation’s transplant system. 

‘It’s been a very difficult thing to crack.’ 

Sonia Sein, 56, became the first person in the U.S. to receive a trachea transplant – and it may be a world first. She says she struggle to breathe every after being put on a life-saving breathing machine during a severe asthma attack in 2014 

Sein says she had spent the last six years ‘trying to catch every breath at every moment’ after extensive treatment for her severe asthma damaged her windpipe. Pictured: Sein gives a blood sample during a checkup visit at Mt. Sinai hospital in New York on Monday, March, 22, 2021.

Experts say it’s too soon to deem Sein’s transplant a total success – which UNOS said is the first of its kind in the U.S.

WHAT IS A TRACHEA AND WHY ARE TRANSPLANTS DIFFICULT?  

The trachea is a four-inch, tough tube that carries air to and from the lungs. 

But it’s much more than a cylinder. 

Also known as the windpipe, the trachea is lined with rings of cartilage – a tough but flexible tissue – that keep it soft enough to move as we breathe, but rigid enough to stay open and upright. 

It is also lined with a slimy mucosal layer and tiny hairs know as cilia. 

These features help to catch debris, viruses and bacteria and prevent them from entering the lungs. 

It is also fed blood by a complex and delicate web of blood vessels. 

The complicated features of the trachea make it difficult to keep all the components alive and working in harmony when it is transplanted from donor to recipient.  

Sein has to take powerful drugs to prevent organ rejection, but doctors hope to try to wean her off in a few years. 

Less than three months after the operation, there haven’t been complications or signs of rejection.

‘If it was going to be a failure, we would know by now. It’s quite promising,’ said Dr Alec Patterson, a transplant surgeon at Washington University in St Louis who was not involved in the operation. 

‘It’s a major step forward.’

Sein’s ordeal started in 2014 when doctors put a tube in her throat to help her breathe during a severe asthma attack. 

It saved the 56-year-old social worker’s life but damaged her trachea.

Several surgeries to reconstruct her windpipe didn’t help and left Sein in despair at constant risk of suffocation.

Until now, doctors have had few good options to treat serious trachea damage.

The windpipe is much more than a simple tube. 

‘Every breath we take has to be expertly conveyed from the tip of the nose to the last air sac in the lungs,’ Merati said.

Over the years, various methods have been used to repair or reconstruct damaged windpipes. 

Doctors can remove damaged sections, or fix or replace them with prosthetics, lab-grown tissue or self-supplied tissue from a patient’s skin and rib cartilage. 

But these techniques may not restore full function to the organ, which uses tiny hairs to move mucus around and has the perfect flexibility to expand and collapse as we breathe, swallow and cough.

Sein’s trachea transplant took 18 hours and was performed at Mount Sinai in New York in January 

And these methods are not possible in the most dire situations where a patient’s entire windpipe is damaged. Something as extreme as a transplant could be their only hope, said Dr Eric Genden, a Mount Sinai surgeon who led the team.

‘Right now, we don’t talk much about those patients because there is no option for them,’ Genden said. 

‘We’re hoping that this procedure will…help not only the patients that are teetering on disaster, but also the patients that are currently kind of deemed hopeless.’

In an 18-hour operation, a team of more than 50 specialists transplanted a donor trachea, carefully reconnecting it to a complex web of tiny blood vessels.

For the next several years, Sein (center) will have to be on intense drugs to keep her immune system from rejecting the new trachea, but her physicians Dr ERic Genden (left) and Dr Sandy Florman (right) hope to wean her off the medications

‘When we saw the organ come to life, we knew we had jumped the first hurdle,’ said Genden said.

Doctors say the procedure could help others with tracheal birth defects, untreatable airway diseases or extensive damage from ventilators.

‘This could help care for COVID-19 patients,’ Merati said. 

‘Without a doubt we are already seeing some impact’ from patients being on breathing machines.

Sein is now recovering at home and ‘is breathing wonderfully,’ Genden said.

The surgery has already allowed her to do things she couldn’t before.

‘Now I feel good,’ Sein said. 

‘I dance with my granddaughter, we chase each other around the house. I jump on my grandson. We play, we watch a movie together. I cook for them. We´re making the memories together.’

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New Zealand could open border with Australia from end of week: 1NEWS

SYDNEY (Reuters) – New Zealand could open its borders to Australian travellers as soon as the end of the week, New Zealand broadcaster 1NEWS reported on Tuesday without saying where it obtained the information.

FILE PHOTO: People jog past a social distancing sign on the first day of New Zealand’s new coronavirus disease (COVID-19) safety measure that mandates wearing of a mask on public transport, in Auckland, New Zealand, August 31, 2020. REUTERS/Fiona Goodall

The report comes as New Zealand Prime Minister Jacinda Ardern is scheduled to announce the date for quarantine-free travel with Australia later on Tuesday, after facing mounting pressure from businesses to open the border.

The so-called ‘travel bubble’ would restrict travellers from certain areas in the event of an outbreak in Australia and is expected to run on a state-by-state basis, the broadcaster said.

Australian tourists visiting the country during the ski season and school holidays would “really matter” to struggling industries in New Zealand, Deputy Prime Minister Grant Robertson said during a breakfast show also on 1News.

Robertson, however, did not give any indication of when the border will open.

Both Australia and New Zealand have managed the COVID-19 crisis more successfully than most other developed nations after closing their international borders to non-citizens and permanent residents very early during the pandemic.

Most Australian states have opened their borders to New Zealanders since last October but New Zealand has delayed returning the favour due to sporadic outbreaks in some Australian cities.

Meanwhile, The Australian newspaper reported on Tuesday citing government and industry sources that quarantine-free travel between the countries could begin on April 12 or 19.

Airlines have started bookings with “the 19th pretty much definite”, the Australian Chamber of Commerce and Industry tourism chief John Hart was quoted as saying in the report.

Australia’s foreign ministry did not immediately respond to requests seeking comment.

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Italy reports 296 coronavirus deaths on Monday, 10,680 new cases

A Venice resident receives a coronavirus disease (COVID-19) vaccine on board a traditional ‘vaporetto’, a ferry normally used for public transportation in Venice, Italy, April 5, 2021. REUTERS/Manuel Silvestri

MILAN (Reuters) – Italy reported 296 coronavirus-related deaths on Monday against 326 the previous day, the health ministry said, while the daily tally of new infections decreased to 10,680 from 18,025.

Italy has registered 111,326 deaths linked to COVID-19 since its outbreak emerged in February last year, the second-highest toll in Europe after Britain and the seventh-highest in the world.

The country has reported about 3.6 million cases to date.

Patients in hospital with COVID-19 – not including those in intensive care – totalled 28,785 on Monday, slightly up from 28,432 a day earlier.

There were 192 new admissions to intensive care units, from 195 on Sunday. The total number of intensive care patients rose to 3,737 from a previous 3,703.

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Ontario to enter third COVID-19 lockdown as cases, hospital rates rise

Nurses from Humber River Hospital’s mobile vaccine clinic administer the Moderna COVID-19 vaccine at Toronto and Region Islamic Congregation Centre as part of the coronavirus disease (COVID-19) vaccination campaign, in Toronto, Ontario, Canada April 1, 2021. REUTERS/Carlos Osorio

TORONTO (Reuters) – The Canadian province of Ontario will enter lockdown for at least four weeks on Saturday as COVID-19 cases and hospital intensive care unit occupancy rises, Premier Doug Ford said on Thursday.

The third such lockdown in Canada’s most populous province will shutter all indoor and outdoor dining but allow retailers to remain open with capacity limits, Ford said.

Schools will remain open, the province’s education minister said on Twitter.

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Poles scramble to sign up for COVID-19 jabs after surprise policy shift

WARSAW (Reuters) – Poles rushed to sign up for COVID-19 vaccinations on Thursday morning after the government unexpectedly opened registrations for people aged over 40 overnight, in a sudden shift that led to so many applications that an online system crashed.

FILE PHOTO: A health worker in protective suit waits for people at a test center in front of a hospital, amid the coronavirus disease (COVID-19) outbreak, in Warsaw, Poland October 27, 2020. REUTERS/Kacper Pempel

Over 2 million Poles have so far received both shots of a vaccine, but the prime minister’s top aide, who has been put in charge of the vaccination programme, said slower rates of registration among older Poles meant the government had decided to widen access.

“At the moment, we have registration open for all people over 60 years of age,” Michal Dworczyk told private radio station RMF FM.

“In the last two days, this registration for people over 60 years old has slowed down, so we decided to start the registration of people who reported their readiness to register in January,” he said.

He added that people aged 40 to 60 who had declared their readiness to be vaccinated had been sent referrals overnight.

Opposition lawmakers criticised the unexpected nature of the move.

“Dear ministry, such changes should be announced publicly at the time of launch! People shouldn’t find out about this from your reply on my Twitter,” tweeted left-wing lawmaker Adrian Zandberg.

Reuters reporters attempted to register after 0700 GMT for vaccinations, but the online system had stopped working.

Dworczyk said at a news conference that the registration of 40 to 59-year-olds would be suspended for a few hours to correct a technical glitch.

The nation of 38 million people is in the grip of a damaging third wave of the COVID-19 pandemic, which has pushed its health service to its limits, with some regions close to running out of ventilators.

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