Army Public Health Weekly Update, 02 April 2021

Date Published: 4/2/2021
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​NOTICE: There will be no Army Public Health Weekly Update next week. Publication will resume on 16 April 2021.

The Army Public Health Update is a collection of articles taken from public sources to offer awareness of current health issues and the media coverage given to them. The articles do not necessarily represent U.S. Army Medical Command opinions, views, policy, or guidance, and should not be construed or interpreted as being endorsed by the U.S. Army Medical Command.

The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the U.S. Army and is not a medical intelligence product. Medical intelligence is available from the National Center for Medical Intelligence External Link .

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Table of Contents


    COVID-19 Townhall Update

    On the dates listed below, Military OneSource will host DHA experts, allowing them the opportunity to address various topics related to COVID-19, such as:

    - Available vaccines and their distribution, safety, and efficacy

    - Scheduling appointments within the Military Health System

    - Guidance on continued protective measures to slow the spread of the virus

    - Personal/real positive outcomes from vaccines

    Join Col Jennifer Harrison on the following dates, from 12:00 to 12:30:

    - April 13, 2021

    - April 27, 2021

    - May 11, 2021

    - May 25, 2021

    - June 8, 2021

    - June 22, 2021

    Get the latest facts about the virus and DHA's response to it.  We look forward to seeing you here! External Link


    DHA implements standard practices to improve maternal outcomes

    24 March- The Defense Health Agency's Women and Infant Clinical Community has recently implemented standardized practices to improve maternal outcomes in all its military medical treatment facilities around the world. The new DHA-Procedural Instruction (DHA-PI) 6025.35, Guidance for Implementation of the Postpartum Hemorrhage (PPH) Bundle, provides instruction for implementation of the postpartum hemorrhage bundle at all MTFs providing obstetrical care. Prior to issuing the DHA-PI in January 2021, the Military Health System had many different methodologies, but not an enterprise standard for the process to evaluate risk assessment and resources to promptly treat PPH to prevent maternal complications, said U.S. Public Health Service Capt. Anne McMillan, PPH Bundle Campaign co-lead and interim lead for the DHA Women's Health Clinical Management Team (WHCMT). Considering PPH accounted for 10.7% of all maternal deaths in the United States between 2014 and 2017, according to the Center for Disease Control - Prevention's Pregnant Mortality Surveillance System, the effort is an important step in standardizing clinical practices and processes in obstetric care to reduce maternal morbidity and mortality across the MHS. "The PPH campaign implements leading practices drawn from research and national and international organizations," said McMillan. "It provides a universal set of recommendations to standardize the clinical processes and resources that have been shown to help prevent and treat PPH." The Navy Bureau of Medicine and Surgery adapted the hemorrhage safety bundle and implemented it across its medical facilities in 2016, according to McMillan. Building upon the lessons learned between 2017 and 2019, the Defense Health Agency conducted a PPH bundle pilot program at five military medical treatment facilities (MTFs). This pilot program further defines the standardized processes and develop a DHA PPH procedural instruction that would provide implementation guidance across the MHS, focusing on specific equipment, resources, and procedures required to enhance a system-level response. External Link

    Entire force may be vaccinated for COVID-19 by early summer

    26 March- Defense Department officials have said the department will be ready to offer COVID-19 vaccinations to all eligible beneficiaries by May 1, in keeping with a White House announcement  that on that date, all Americans will be able to get vaccinated if they want to. "We are committed to contributing to the president achieving his goal of 200 million shots in 100 days," said Acting Assistant Secretary of Defense for Health Affairs Dr. Terry Adirim during a briefing today at the Pentagon. Army Lt. Gen. Ronald J. Place, director of the Defense Health Agency said that depending on the rate at which the DOD can get vaccines, and the uptake rate — that's the number of personnel  who step forward to get vaccinated — it's possible that by early summer, every person in the DOD could be vaccinated. "Based on the projections that we have, both supply side and vaccination side, we do fully expect to be open to all ... of our DOD eligible populations on or before the first of May," Place said. "At current uptake rates for those who want to get it, we think by the middle of July or so ... the department will be vaccinated." Place said right now that the military health system is administering COVID vaccine at 343 sites around the world. Also, he said, there are almost 3,000 military personnel providing vaccination support to FEMA-led community vaccination sites around the country. "A special thanks goes out to our superbly trained enlisted medical forces carrying out these responsibilities with compassion and with distinction," he said. Within the department, Place said, more than 600,000 service members from all three components have gotten at least their first COVID-19 vaccine. "I want to use this opportunity to thank every service member who has gotten vaccinated," said Adirim. "They are not only protecting themselves but they're also contributing to the safety of their teammates, their families and their communities." External Link

    More troops are taking the COVID-19 vaccine, including those who rejected it before

    27 March- More than three months after the Defense Department first started administering COVID-19 vaccines to its uniformed members and affiliated civilians, take rates appear to be rising, officials told reporters on Friday. Installations are now checking more names off of their eligible lists, according to Lt. Gen. Ronald Place, director of the Defense Health Agency, though the department is not centrally tracking numbers of who has turned down the offer. "As we move through those tiers, we know who accepted, who didn't come in or didn't try to make an appointment, that sort of thing. But when we know who's gotten it, we circle back to those who haven't and offer it again, on an iterative basis," he said. "And as we offer it, many who at first declined the opportunity are now taking us up on that opportunity." For some, it's taken three or four tries before they've volunteered for the shot, he said. So for any service member or DoD-affiliated civilian who declined to get vaccinated when they were first eligible, they can call up their command health care providers and make arrangements if they've changed their minds. "Once you've been contacted, you're forever eligible," Place said. Military Times External Link


    Amazon's COVID-19 test acquires FDA authorization

    29 March- Services LLC.'s subsidiary STS Lab Holdco received an emergency use authorization (EUA202760) issued by RADM Denise M. Hinton, Chief Scientist US Food and Drug Administration, on March 25, 2021, for a Covid-19 test kit named Real-Time RT-PCR Test for Detecting SARS-CoV-2. This test is authorized for the following indications for use: Qualitative detection of nucleic acid from SARS-CoV-2 in anterior nasal swab specimens that are self-collected by any individuals (18+ yrs.), including individuals without symptoms or other reasons to suspect COVID-19, using either (1) under the supervision of a healthcare provider or, (2) the unsupervised at home. The Amazon COVID-19 Test Collection Kit includes the following in the shipped kit: a nasal swab, collection tube, biohazard bag, and instructions for kit registration, sample collection, and drop-off. Testing is limited to laboratories designated by STS Lab Holdco certified under CLIA, 42 U.S.C. §263a, and meet requirements to perform high complexity tests. California, Texas, Kentucky, and Florida are among the states eligible to perform this test. According to trademark documents, Amazon created Care Medical as a medical provider that contracts to deliver services. Precision Vaccinations External Link

    Apple watch is effective in monitoring patients with cardiovascular diseases, according to Stanford study

    28 March- Apple Watch may serve as a vital medical monitoring tool in the right circumstances. Researchers from Stanford funded by Apple have determined that the device can accurately gauge the frailty of cardiovascular disease patients while they are at home.  According to MyHealthyApple, personal smartwatch use was almost as good as an in-clinic test. The scientists from Stanford collected the data using the Apple Watch Series 3 and a VascTrac app, but the third-party software won't be necessary in the future. MacRumors reported that WatchOS 7 includes the six-minute walk test and other mobility data, and you can review your performance in the Health app on your iPhone. The findings from the researchers hint that the Apple Watch and other smartwatches could save patients the trouble of visiting the clinic to have doctors measure their functional capacity as they could just walk around their homes, gather necessary data from their smartwatches, and come in if there are any signs of bad health. This can help Apple continue pitching its wrist wear as a health device, but it also hints at a future where the tech you already have is enough to give doctors with an abundance of useful information. Tech Times External Link

    As some states open Covid-19 vaccines to all, many others are still weeks away: Here's a timeline

    26 March- John McGee, 21, told CNN on Tuesday that he was mindlessly scrolling through Twitter last Monday when he saw Mississippi Gov. Tate Reeves' post: "Starting tomorrow, ALL new appointments will be open to ALL Mississippians. Get your shot friends - and let's get back to normal!" Mississippi is one of six states that have expanded coronavirus vaccine eligibility to anyone 16 and older, and a CNN analysis finds that at least 30 more plan to open up to people 16 and older by the end of April. McGee, who lives in Columbus, Mississippi, decided to waste no time last week.  By 7 the next morning, the college student was on the phone with the Mississippi State Department of Health looking to schedule an appointment. After some trouble scheduling over the phone, he said that he secured an appointment online for 9:20 a.m. at a Lowndes County drive-through site. It took just 20 minutes for McGee to get vaccinated. By 9:40 am, he was one of the youngest people in Mississippi to have been immunized with one dose of the Pfizer/BioNTech Covid-19 vaccine. The Pfizer/BioNTech Covid-19 vaccine is authorized in the United States for ages 16 and older, and the Moderna Covid-19 vaccine and Johnson & Johnson's Covid-19 vaccine are both authorized for adults 18 and older. CNN  External Link

    Covid jab: One dose in care homes gives 'substantial' protection

    28 March- A single dose of the Pfizer or AstraZeneca vaccine was effective at stopping 62% of coronavirus infections in care homes, a study has found. A team at University College London (UCL) looked at data from 10,000 adults in England with an average age of 86. The research also suggested those who did catch the virus after vaccination may be less infectious. "Our data suggests that both vaccines are effective in frail, older adults," said UCL's Dr. Maddie Shrotri. The study analyzed coronavirus test-result data for 10,412 long-term residents, all aged over 65, at 310 care homes.  The group had routine monthly PCR tests for the virus as well as further targeted tests if an outbreak was suspected. Of the 36,352 tests carried out between December 2020 and mid-March, 1,335 came back positive for the disease. By comparing those with the number of cases before vaccination, the researchers estimated both jabs were effective at preventing 56% of infections after four weeks, rising to 62% after five weeks. BBC News External Link

    Moderna delivered 100-millionth COVID-19 vaccine to the U.S.

    29 March- Massachusetts-based Moderna, Inc. announced on March 29, 2021, it had shipped the 100-millionth vaccine dose of its COVID-19 vaccine to the U.S. Government. Additionally, the Company stated in a press release it 'expects to meet its commitment dates to the U.S. Government for all currently ordered doses of the experimental Moderna COVID-19 Vaccine, including delivery of the second 100 million doses by the end of May 2021, and the third 100 million doses by the end of July 2021. "We are encouraged by the fact that more than 67 million doses have been administered in the U.S., and we are humbled to know that we are helping address this worldwide pandemic with our vaccine," commented Stéphane Bancel, CEO of Moderna. "I would also like to thank the Moderna team, our suppliers, and our U.S. manufacturing partners, including Lonza and Catalent, for their tireless and extraordinary work in completing this important milestone." The Moderna COVID-19 Vaccine is an mRNA vaccine against COVID-19 encoding for a prefusion stabilized form of the Spike protein co-developed by Moderna and investigators from the National Institute of Allergy and Infectious Diseases Vaccine Research Center in 2020. The Moderna vaccine is recommended for people aged 18 years and older. Based on evidence from clinical trials, the Moderna vaccine was found 94.1% effective at preventing laboratory-confirmed COVID-19 illness in people who received two doses who had no evidence of being previously infected. Precision Vaccinations External Link

    Pfizer says Covid vaccine 100 percent effective in children ages 12 to 15

    31 March- Pfizer says its Covid-19 vaccine is safe and 100 percent effective in preventing the illness in teenagers ages 12 to 15. "This is exactly the news that we hoped to hear," said Dr. Buddy Creech, a pediatric infectious disease expert at the Vanderbilt University Medical Center in Nashville, Tennessee. Creech was not involved in the Pfizer research. The vaccine, given in two doses three weeks apart, is already cleared for emergency use in people ages 16 and up. The company plans to request emergency use authorization for 12- to 15-year-olds in the coming weeks, "with the hope of starting to vaccinate this age group before the start of the next school year," Pfizer CEO Albert Bourla said in a statement. "We share the urgency to expand the authorization of our vaccine to use in younger populations and are encouraged by the clinical trial data from adolescents between the ages of 12 and 15," Bourla said. The findings, which were announced Wednesday in a news release, have not been peer-reviewed. More than 2,200 young teenagers were enrolled in the Pfizer vaccine trial in the U.S. About half got the real shots, while the others got placebo shots. (The adult trial was much larger, with more than 43,000 participants.) NBC News External Link

    The difference between celiac disease & non-celiac gluten sensitivity

    26 March- Eating gluten free has become very popular in recent years. Many people who try it claim that it makes them feel healthier and have less gastrointestinal sensitivity, even when they do not have celiac disease --an autoimmune disease for which the only treatment is eating a gluten-free diet. While eating a gluten-free diet is essential for those living with celiac disease, more and more people seem to claim that they are "gluten sensitive." Contrary to popular belief, celiac disease is not a food allergy. It is an autoimmune disease that, when left untreated, can cause symptoms such as chronic or recurrent diarrhea, constipation, abdominal pain/distension, unintentional weight loss, vomiting, anorexia, dermatitis herpetiformis, dental enamel hypoplasia, anemia and hepatitis. Celiac disease is diagnosed through a blood test with the presence of higher tissue transglutaminase enzymes; and a subsequent conformational intestinal biopsy. Currently the only treatment is eating a gluten-free diet. Non-celiac Gluten Sensitivity (NCGS) is not an autoimmune disease and there is no single blood test for diagnosis. Symptoms can include abdominal pain, eczema and/or skin rash, headache, "foggy mind," fatigue, diarrhea, depression, anemia, numbness of legs/arms/fingers and joint pain. NCGS is a gluten reaction in which both allergic and autoimmune mechanisms have been ruled out. In other words, it is diagnosed by exclusion criteria including a negative immune-allergy test to wheat, a negative celiac disease blood test in which immunoglobulin, or IgA, deficiency has been ruled out, a negative intestinal biopsy, presence of biomarkers of gluten immune-reaction (AGA+), presence of clinical symptoms that can overlap with celiac disease or wheat allergy and resolution of the symptoms following a gluten-free diet. If you are have been diagnosed with celiac disease or non-celiac gluten sensitivity and need help with your diet, a registered dietitian can help you implement a gluten-free eating plan. For more information, contact your local military medical treatment facility's dietitian or nutritionist. External Link


    DoD Seasonal Influenza Summary and Reports

    Week 10 (7 Mar 2021 — 13 Mar 2021):

    NORTHCOM- ILI activity was minimal. The number of laboratory-confirmed influenza cases remained very low; the majority being Influenza A (not subtyped) and Influenza B.

    EUCOM- ILI activity was minimal. Only a small number of influenza positive specimens have been reported for the season.

    INDOPACOM- ILI activity was minimal. Only a small number of laboratory-confirmed influenza positive specimens have been reported. 

    SOUTHCOM- ILI activity was minimal. Only 2 specimens have tested positive for influenza this season (influenza B). 

    CENTCOM- ILI activity was minimal. External Link


    Pet foods in this huge Salmonella recall may also cause human illness from handling

    28 March- Human risk of illness is on the rise due to the handling of contaminated pet foods named in a massive recall by Evansville, IN-based Midwestern Pet Foods. Specific cat and food brands including   CanineX, Earthborn Holistic, Venture, Unrefined, Sportmix Wholesomes, Pro Pac, Pro Pac Ultimates, Sportstrail, Sportmix, and Meridian brands produced at its Monmouth, IL production facility because they have the potential to be contaminated with Salmonella. A full list of recalled products is included in this announcement.  In addition to the risk to humans, Salmonella can affect animals eating the products. Surfaces not thoroughly washed after having contact with the products or any surfaces exposed to these products are at risk. People infected with Salmonella should monitor themselves for some or all of the following symptoms: nausea, vomiting, diarrhea or bloody diarrhea, abdominal cramping, and fever.  Salmonella can result in serious ailments, including arterial infections, endocarditis, arthritis, muscle pain, eye irritation, and urinary tract symptoms. Consumers exhibiting these signs after having contact with this product should contact their healthcare providers. Pets with Salmonella infections may be lethargic and have diarrhea or bloody diarrhea, fever, and vomiting. Some pets will have only decreased appetite, fever, and abdominal pain. Infected but otherwise healthy pets can be carriers and infect other animals or humans. If your pet has consumed the recalled product and has these symptoms, please contact your veterinarian. No human or pet illnesses have been reported to date. Food Safety News External Link

    'Swine flu' case reported in North Carolina

    27 March- The Centers for Disease Control and Prevention (CDC) reported a case of human infection with a novel influenza A virus, or "swine flu" in North Carolina, in their latest FluView report. According to the report ending March 20, the individual was infected with an influenza A(H1N1) variant (A(H1N1)v) virus in 2020. The patient is an adult > 18 years of age, was not hospitalized, and has recovered from their illness. An investigation into the source of the infection revealed that the patient worked with and had daily contact with swine. No human-to-human transmission has been identified in association with this patient. While this variant virus infection was not identified until 2021, it represents the first influenza A(H1N1)v virus identified from a specimen collected in the United States in 2020 (during the 2020-21 season). No influenza A(H1N1)v virus infections have been identified in specimens collected in 2021 thus far. When an influenza virus that normally circulates in swine is detected in a person, it is called a variant influenza virus and is labeled with a 'v'. Outbreak News Today External Link


    Poor sleep, burnout may up coronavirus risk, study claims

    27 March- Hoping to avoid a coronavirus infection? Avoid burnout and get good sleep, suggests the findings of a new study. In a study recently published in BMJ Nutrition, Prevention & Health, researchers from July to September 2020 surveyed more than 2,800 health care workers across six countries who were considered at high-risk for a COVID-19 infection, as they worked in critical care, emergency care, or internal medicine. Study participants were asked several questions about their sleep habits, including daytime napping and severe sleep issues, as well as their work-related burnout levels. By the end, the researchers concluded that each additional 1 hour of sleep resulted in a 12% decreased risk for COVID-19. Meanwhile, those who said they were suffering from work-related burnout every day were nearly 3 times more likely — 2.6 times to be exact — to be infected with COVID-19, battle a coronavirus infection for a longer amount of time, as well as being more likely to have severe COVID-19-related symptoms. Fox News External Link


    DRC: TB cases up in Mai-Ndombe province in 2020

    28 March- The Provincial Health Division (DPS) of Mai-Ndombe province in western Democratic Republic of the Congo (DRC) reported Saturday 3,239 cases of tuberculosis, including 65 deaths in 2020. Thirteen percent of the cases were reported in children. This total is up from 2,126 cases in 2019. Dr. José Monama, coordinator of tuberculosis activities in Maï-Ndombe, said that the skyrocketing positive cases is also linked to the lack of financial means and appropriate tools for patient care. "In our daily practice, we encounter a lot of difficulties, sometimes the lack of inputs to be able to ensure the care, screening and treatment of these patients. There are health centers that are closed because of this. the lack of a microscope, the patients go there, the diagnoses remain in the presumptive for lack of new tools which can allow us to better diagnose this tuberculosis which continues to kill us", he regrets. Outbreak News Today External Link


    Shelter: Iran's race to build a life-saving COVID ward

    29 March- As one of Tehran's oldest hospitals reaches capacity during the pandemic, the urgent construction of a new ward begins. Javad is a civil engineer in charge of a large construction project – to build an extension to an old hospital in one of Tehran's most impoverished areas. As the coronavirus pandemic surges through Iran, death tolls soar and hospitals start to run out of capacity. To accommodate the growing number of COVID-19 patients, Javad is given the almost impossible task of preparing two floors of an unfinished building in just 20 days – work that would require three months under normal circumstances. Al Jazeera External Link


    Sweden: 200 people have tested positive for COVID-19 post- two dose vaccine

    30 March- A report from the Swedish Public Health Agency shows that of the several hundred thousand people in Sweden who have received two COVID-19 vaccine doses and about 200 people have so far tested positive for COVID-19. The Swedish Public Health Agency continuously monitors the number of so-called breakthrough infections in Sweden, ie cases where people have tested positive for covid-19 after they have been vaccinated. This is to gain more knowledge about the effectiveness of vaccinations in the population. In total, more than one million people in Sweden have been vaccinated with one dose and about 430,000 people with two doses. About 6,000 people have so far been found to have covid-19 after their first vaccine dose. Almost 4,000 of them tested positive within the first two weeks after the first dose, ie before the body had time to build up a protection. Only about 200 people were found to have been infected with covid-19 more than two weeks after the second dose. This corresponds to 0.07 percent of the total number of covid-19 cases since the turn of the year, and 0.06 percent of all those vaccinated with two doses. The fact that so few people are infected after receiving their second vaccine dose indicates that the vaccines used against COVID-19 in Sweden work well, says state epidemiologist Anders Tegnell. The Swedish Public Health Agency notes no vaccine provides 100% protection, and breakthrough infections occur for all types of vaccines. When it comes to vaccination against COVID-19, the first analyzes show that the number of breakthrough infections in Sweden is in line with what is expected, says Tegnell. Outbreak News Today External Link


    Philippines COVID-19 cases peak at 9K today, stricter quarantine placed on Greater Manila area

    27 March- The Department of Health (DOH) of the Philippines has tallied a new spike in COVID-19 cases in the country, with 9,595 cases adding up today, according to the department's latest health bulletin. To date, the country has 118,122 active COVID-19 cases, and total confirmed caseload in the country to 712,442. In response to the continuous rise in COVID-19 cases, the national government has announced an enhanced community quarantine (ECQ) across Metro Manila, Bulacan, Cavite, Laguna, and Rizal, known collectively as the Greater Manila Area or NCR Plus. The ECQ will take effect on March 29 at 12:01 AM to April 4, as the country nears its observance of the Catholic Holy Week. Prior to the ECQ implementation, the Greater Manila area was placed under a 'travel bubble' where there is limited movement within the area for non-essential travel. Outbreak News Today External Link

    Queensland: Officials report increase in melioidosis and leptospirosis in the Cairns and Hinterland region

    28 March- Officials with the Queensland Government are reporting increased cases of melioidosis and leptospirosis this year in the Cairns and Hinterland region in the Far North. Notifications of both infections usually increase in the wet season, but notifications are higher than usual. Melioidosis cases have been in Cairns, with several cases in Clifton Beach and Mount Sheridan. Since the beginning of the year, 17 cases have been reported. Most leptospirosis cases have occurred in the Cassowary Coast and Tablelands areas. There have been 28 cases of leptospirosis in the since the start of the year. This is a nearly 65 per cent increase on the average amount of cases that have been recorded during the same period in previous years. Dr. Annie Preston-Thomas from the Cairns based Tropical Public Health Services said there is no vaccine for melioidosis or leptospirosis that works in people, but there were simple steps everyone could follow to prevent their risk of infection. Outbreak News Today External Link


    Covid cases spiking again in Michigan, but Gov. Whitmer making no move to impose new restrictions

    29 March- Michigan was making good progress at controlling the spread of the coronavirus pandemic and getting people vaccinated this year when, as a public heath expert put it, the state began to "lift the brakes." Now, the number of Covid-19 cases is spiking and hospitalization rates have been rising, and on Sunday the state reported that its pandemic testing positivity rate had hit 15.64 percent, the highest single-day percentage since Dec. 2. Gov. Gretchen Whitmer has acknowledged that the worsening numbers do not look good. "It's a stark reminder that this virus is still very real," Whitmer, a Democrat, said last week. "It can come roaring back if we drop our guard." But as more and more Michigan residents are vaccinated — especially the most vulnerable senior citizens — Whitmer has made no move to reimpose Covid-19 restrictions on residents who are already feeling what public health expert Marianne Udow-Phillips called "pandemic fatigue." Whitmer, whose team did not immediately respond to a request for comment, needs no reminding that some of the fiercest resistance to statewide lockdowns was in Michigan — she wound up being the target of what authorities said was a right-wing kidnapping plot. Besides Michigan, Covid-19 case numbers have been rising sharply in states like Hawaii, West Virginia, Pennsylvania, New Jersey and Connecticut, prompting the director of the federal Centers for Disease Control and Prevention, Dr. Rochelle Walensky, to warn of "impending doom" if Americans fail to continue taking safety precautions. Michigan's hot spot for new cases has been the conservative counties north of Detroit, an area known as the Thumb, a bastion of Trump voters that has been especially resistant to pandemic restrictions and mask mandates. NBC News External Link


    Peru: 40% of COVID-19 cases in Lima are the P.1 Brazil variant

    28 March- Peru Minister of Health, Óscar Ugarte said a study by the National Institute of Health (INS) determined that approximately 40% of cases of the new coronavirus cases in Lima have been due to the Brazilian variant of this disease, or P.1. "This INS study is extremely important because it has made it possible to identify, through a sampling throughout Lima, that the main variant that causes COVID-19 today in a percentage of 40% is the Brazilian variant ," he said. "This is important to know, because it is the variant that we knew had arrived. We had identified in Loreto, Huánuco, weeks ago we identified a case of the Brazilian variant in Lima that was controlled ", added the head of the Ministry of Health. Minister Óscar Ugarte said that most of the cases are in East Lima, mainly in the districts of Ate , El Agustino , Lurigancho-Chosica and Santa Anita. He explained that this is because this area is the entry route for travelers arriving from the eastern part of the country to Lima. The head of the Health sector argued, in this line, that said information should serve for citizens to redouble their care in order to avoid the spread of COVID-19, while the Executive will continue to work on improving the response of the health system. "This should not cause a special alarm, but what this tells us is that we must redouble care in the population to avoid contagion and therefore redouble hand washing measures, the use of masks , to avoid concentrations, to guarantee social distancing, as well as timely care, diagnosis, early isolation, to prevent the family from being infected and this is what we must guarantee," he said. Outbreak News Today External Link