Army Public Health Weekly Update, 03 July 2020

Date Published: 7/3/2020
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​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

    ​ANNOUNCMENTS

    APHC COVID-19

    This site provides Army-specific information and communication resources related to the 2019 Novel Coronavirus (COVID-19). The resources and tools available on this site may be shared with, tailored for, and/or used to create informational and educational materials for Army beneficiaries. APHC 

    Check out the latest version (3) of the COVID-19 Guidance for Clearing Personnel to Return to the Workplace

    01 July - This document provides a framework for clearing personnel to return to the workplace as operations and Installation Health Protection Conditions (HPCONs) are normalized. APHC

    Large-scale geographic seroprevalence surveys

    26 June- CDC wants to learn more about the percentage of people in the United States who have been infected with SARS-CoV-2, the virus that causes COVID-19 and to better understand how the virus is spreading through the U.S. population over time. Because infected people can have mild illness or may not get medical care or testing, CDC also wants to use this information to estimate the number of people who have been previously infected with SARS-CoV-2 and were not included in official case counts. To help answer those questions and others, CDC is collaborating with public health and private partners on a variety of seroprevalence surveys of different sizes, locations, populations studied, and purposes. CDC External Link

    U.S. MILITARY

    Cluster of COVID-19 cases in US troops emerges at Kuwaiti Air Base

    29 June- A Middle East air base where U.S. troops operate alongside Kuwaiti counterparts is experiencing a new cluster of COVID-19 cases, Military.com has learned. While the exact number is unknown, around 30 U.S. personnel have come down with the novel coronavirus in recent weeks at Ahmad al-Jaber Air Base, according to a defense official. The base primarily houses airmen, with U.S. Air Forces Central Command's 332d Air Expeditionary Wing and subsidiary units operating from the base. Forces from the 386th Air Expeditionary Wing at nearby Ali Al Salem Air Base also routinely rotate through the base for exercises and other missions, according to the Air Force. "While we will not release specific COVID-19 numbers, we can confirm that there is a cluster of cases currently on [al-Jaber], an air base in Kuwait that houses a number of U.S. Central Command personnel," a CENTCOM official said in a statement. "This cluster developed over time, and we believe social distancing and contact tracing measures has limited the size of that cluster." The command said the COVID-19 cases have not impacted day-to-day operations at the base; troops are being urged to adhere to Centers for Disease Control guidelines, such as frequent hand-washing, social distancing, and wearing masks when social distancing is not possible, CENTCOM said. Military.com External Link

    DoD trains staff to collect convalescent plasma donations

    26 June- A new training for military medical treatment facility (MTF) clinical and administrative staff has been designed to support the collection of COVID-19 convalescent blood plasma from eligible beneficiaries. The COVID-19 Convalescent Plasma Collection Program (CCP) is a Department of Defense effort to collect more than 8,000 units of blood donated by members of the military community who have recovered from the disease. Building the widest possible awareness of the CCP in the DoD patient population will help DoD accomplish this ambitious goal. "The purpose of the training is to help all clinical and administrative MTF personnel educate patients about the program," said Anita Lyons, acting chief, MTF Operations, Defense Health Agency Education and Training Directorate. "We need our staff to tell patients who are convalescing from COVID-19 about the opportunity to be donors." The DHA Education and Training Directorate, or J7, developed the training in coordination with the Armed Services Blood Program and other divisions within the DHA. Lyons notes that the training was a high priority to support the goal of CCP donor collections. "With a Department of Defense goal to have over 8,000 donated units by Sept. 30, it is critical to get MTF staff trained quickly," said Lyons. "We want all MTF staff to be able to speak knowledgably with patients about donating and point them toward further resources." The CCP training course includes a script for all clinical and administrative employees at MTFs to inform patients, and an ASBP fact sheet they can share with patients. The training aids provide clear, accurate, and standardized messaging. "With such a broad audience, we had to make sure that it was accessible for everyone," said Lyons. "We want everyone in the MTF who comes in contact with patients—from physicians to front desk staff—to help promote the CCP and identify potential donors." All MTF clinical and administrative staff must complete the course within 30 days of its assignment in their MTF training modules. MTF staff who need to take the training should log in to their Relias learning management system and look for course CCP001. "The CCP training empowers the clinical team and administrative staff to engage COVID-19 positive patients and inform them of the opportunity to donate plasma in support of the CCP Program," said Air Force Brig. Gen. Anita Fligge, chief, DHA Education and Training Directorate. "Every patient contact can lead to eligible patients donating their plasma to help others who are acutely ill with COVID-19, now or in the future." Health.mil External Link

    Military leadership warns troops against 'quarantine fatigue

    26 June- Despite the White House's public optimism about the coronavirus pandemic, US military leaders are holding firm to strict guidelines for troops and warning against "quarantine fatigue." Army Chief of Staff Gen. James McConville laid out the message clearly in a letter to Army commanders this week. "I am sending you this message to remind you that we must STAY VIGILANT and not lose the progress we have made in flattening the curve and reducing the spread of COVID-19," he wrote. He noted that as stay-at-home orders and businesses reopen across the globe, "we also see reports of quarantine fatigue. Many people are relaxing their standards on social distancing, wearing face coverings and following other COVID-19 tips." He noted that in the Army there have been recent "upticks" in the rates of cases at Fort Benning and Fort Jackson. "We've kind of held to the standards of wearing the mask, doing the testing, doing the screening, and very disciplined about it. But there's many parts of the country as we see where they're not. You go outside the gates and you, people think there's no longer a threat," he told reporters Thursday. "I think there is. And I think we need to take it seriously, and that's the guidance that we put out to our unit commanders is we have to take it seriously." Some restrictions have been lifted throughout the military with personnel able to travel. The Pentagon is expected to reduce teleworking in the coming days as well but as that happens, the message from commanders is to keep up strict precautions to control the spread of the virus. There is concern that in the next few weeks the rate of hospitalization of military patients could spike, one defense official said. The number of cases in the Army has steadily increased over the last month. For the week of May 31 to June 6, there were 1,953 cases; from June 7 to 13, there were 2,138 cases; from June 14 to 20, there were 2,439 cases, and from June 21 to 26, there were 2,780 cases. WICZ  External Link

    PTSD spikes among post-9/11 wounded warriors, WWP survey finds

    26 June-  The number of post-9/11 wounded warriors living with Post Traumatic Stress Disorder continues to climb, according to the Wounded Warrior Project's annual survey of the veterans it serves. June 27 is PTSD Awareness Day and the organization's most recent survey found that 83% of the respondents report living with PTSD. That is the highest reported percentage in the survey's 10-year history and an increase of 5% from the previous year. "This has been a challenging time for our country and the warriors we serve," said retired  Army Lt. Col. Michael Richardson, WWP vice president of independence services and mental health. "Veterans with PTSD who are experiencing additional stress need to know they are not alone, help is available and treatment works. Contrary to what stigma dictates, it shows amazing strength to seek care for the invisible wounds — just as one would for a visible injury." Connecting Vets External Link

    Summer PCS plans altered by COVID-19

    29 June- Service members move from location to location as part of the military lifestyle. Families have to juggle multiple tasks during a permanent change in station, or PCS, from the physical task of moving belongings to the paperwork involved with switching medical providers. The national emergency resulting from the COVID-19 pandemic introduced families to new PCS complications. Beneficiaries throughout the Military Health System are encouraged to take measures to protect their wellness while moving. Molly Grasso had moved multiple times with her military husband, currently stationed at Walter Reed National Military Medical Center in Bethesda, Maryland. However, the stop movement order issued for the military in March meant she and her children would make a recent move to Portsmouth, Virginia, without his help. "It's been a lot more moving parts," Grasso said. "With selling our home, buying a new one, and moving all of the kids." With the pandemic creating a new obstacle in an already difficult situation, Grasso and her family made adjustments to their PCS routine. The family packed most of their belongings themselves to reduce the amount of time strangers are in the home. The family also hired a moving company that required their staff be tested for the novel coronavirus and report any symptoms that may arise. Face masks were also mandatory for all their moving staff. These practices line up with guidance released by the United States Transportation Command to help families move during the pandemic. Moving companies attached to the United States Transportation Command have been directed to wear face coverings, minimize the number of personnel required to move families, and equip themselves to clean surfaces they frequently touch during a move. The guidance also encourages family members who aren't required to be present during a move to vacate the home during the packing or delivery process. Families that cannot vacate should prepare a dedicated room for family members to remain while movers are packing and loading. Health.mil External Link

    U.S. Commandos at risk for suicide: Is the military doing enough?

    30 June- He was one of the most elite military men in America, but his service in the Special Operations forces (S.O.F.) had taken a heavy toll. "The job I love and have committed my whole being to is creating my suicidal condition, but I'd rather die than admit to having trouble and being removed from my unit and my team," he said often, according to someone close to him. It was impossible for The New York Times to follow up with this special operator, however, because he had died by suicide. The soldier's troubling admission is found in a study of suicides among America's most elite troops, commissioned by U.S. Special Operations Command (SOCOM) and obtained by The New York Times via the Freedom of Information Act. Conducted by the American Association of Suicidology, one of the nation's oldest suicide-prevention organizations, and completed sometime after January 2017, the undated 46-page report aggregates the findings of 29 "psychological autopsies" — detailed interviews with 81 next-of-kin and close friends of commandos who killed themselves between 2012 and 2015. According to SOCOM records, there were 117 suicides among Special Operations forces from 2007 to 2015, peaking at 23 in 2012 — a rate of 39.3 per 100,000, compared with 22.9 per 100,000 for the armed forces as a whole. The rate gradually declined after that, falling to eight cases in 2017. That year, one of the largest efforts to understand military suicide ever undertaken — a study examining suicide attempts by soldiers during the early years of the wars in Afghanistan and Iraq — found that Special Operations forces might be more resilient than the Army's general-purpose forces, because of "rigorous selection, intense training, strong unit cohesion or psychological and biological characteristics." The next year, S.O.F. suicides spiked nearly threefold above 2017's total. The New York Times External Link

    GLOBAL

    Coronavirus: Hydroxychloroquine trial to restart

    30 June- UK regulators say hydroxychloroquine and a similar drug chloroquine can be given to healthcare workers in a clinical study to test the theory. Recruitment to the COPCOV trial had been paused amid concerns about side-effects raised by other research that has since been discredited. That work looked at treating Covid-19. It concluded the drug was not beneficial and increased the risk of irregular heart rhythms and death. That publication led to the WHO suspending its coronavirus treatment trials of the anti-malaria drug. Concerns were raised about the data and then some of the study's authors said they could no longer stand by their publication in The Lancet as the healthcare firm Surgisphere that was involved in the work would not allow an independent review. The New England Journal of Medicine retracted another paper that had data from Surgisphere. The cheap and widely available drug has been safely used to prevent malaria infection for years. BBC External Link

    Coronavirus led to unprecedented surge in Alzheimer's fatalities

    29 June- Information dissemination on the COVID-19 pandemic is challenging since many of the reported cases of the virus are among the older generation. How do you remember terminologies such as the enhanced quarantines, abbreviations of agencies, names of people in the news, and more? Since many of the patients of the coronavirus are older in age, the deaths also account for dementia and Alzheimer's disease. At least 15,000 more people from this age group in America have recently died from these diseases, pointing this to the rise of the pandemic cases, and the surge of deaths from the virus, The Wall Street Journal reported. As the virus disrupted millions of lives worldwide, the deadly spread is joined by the health consequences of Alzheimer's and other forms of degenerative brain disorders common among older residents in long-term health homes. Around 100,000 have died from dementia and Alzheimer's just from February to May, according to estimates from the U.S. Centers for Disease Control and Prevention. While not all of these deaths were from the coronavirus, the death rate is 18% more than the average for these disorders in recent years, Fox News added. This number started to surge sharply in the middle of March, and right around the middle of April where about 250 more people with dementia are yielding to the disease each year, the CDC compounded. There were deaths likely from COVID-19 and the coronavirus but were not accounted as such on their death certificates, the CDC told Fox News. According to health specialists, this is because of insufficient testing, especially in the earlier months of the pandemic, thus giving the undercount. Tech Times External Link

    Declining eyesight? Look at a red light! Here's what new pilot study shows

    1 July- Declining eyesight possibly be cured by looking at a red light according to a new pilot study. According to CNN's latest report, declining vision is caused by damaged mitochondria in the retina. The new simple therapy might be as easy as shaving or even brushing your teeth, but as long as it has the support of future studies, it might be effective in saving your vision. The new easy home-based therapy, which is available to millions of people, could augur a new era if it will be approved by the U.S. Food and Drug Administration or if the results are replicated in future studies. The natural aging processes that steal the eyes' ability to distinguish colors and sensitivity to light can be prevented by the new layer of protection provided by the new study. "You don't need to use it for very long to start getting a strong result," said Glen Jeffery, a neuroscience professor at University College London's Institute of Ophthalmology and the lead author of the pilot study. The report also stated that diabetes and Parkinson's, and other diseases that are implicated by the mitochondria, can have new treatments if the therapy becomes a success. Jeffery claimed that the new discovery works since the mitochondria, like batteries in the cells, are stimulated by the red light, improving its health. The Journals of Gerontology published the results of the study, showing that looking into a deep red light for a few minutes could provide a dramatic effect on preventing eyesight decline as an individual age. Tech Times External Link

    Fauci says Covid-19 vaccine may not get US to herd immunity if too many people refuse to get it

    28 June- Dr. Anthony Fauci says he would "settle" for a Covid-19 vaccine that's 70% to 75% effective, but that this incomplete protection, coupled with the fact that many Americans say they won't get a coronavirus vaccine, makes it "unlikely" that the US will achieve sufficient levels of immunity to quell the outbreak. With government support, three coronavirus vaccines are expected to be studied in large-scale clinical trials in the next three months. "The best we've ever done is measles, which is 97 to 98 percent effective," said Fauci, the director of the National Institute of Allergy and Infectious Diseases. "That would be wonderful if we get there. I don't think we will. I would settle for [a] 70, 75% effective vaccine." A CNN poll last month found one-third of Americans said they would not try to get vaccinated against Covid, even if the vaccine is widely available and low cost. CNN External Link

    Minimal link between eczema and most cancers

    30 June-  Atopic eczema wasn't tied to a significantly increased risk for most cancers, according to research from England and Denmark. In an English matched-cohort of nearly 500,000 individuals with atopic eczema, there was little evidence to suggest an association between eczema and overall cancer incidence (adjusted hazard ratio [aHR] 1.04, 99% CI 1.02-1.06), reported Kathryn Mansfield, PhD, of the London School of Hygiene and Tropical Medicine (LSHTM), and colleagues.  Similar findings were seen in a Danish matched-cohort of nearly 50,000 people with atopic eczema (HR 1.05, 99% CI 0.95-1.16), the group wrote in JAMA Dermatology. "On the whole, our findings are reassuring. For most cancers, we didn't see any increased cancer risk for people with atopic eczema compared to people without atopic eczema," Mansfield and co-author Sinéad Langan, PhD, also of LSHTM, jointly told MedPage Today. "The existing research exploring whether there is a link between having atopic eczema and cancer was conflicting, and some of the existing studies were small and weren't able to investigate whether having eczema came before a cancer diagnosis," they stated, adding that this study is of particular clinical importance because new biologic treatments for atopic eczema -- some of which may affect cancer risk -- are coming to market. However, in the English cohort, there was a modestly increased risk for developing noncutaneous lymphoma among people with eczema. Specifically, those with eczema saw a 19% (aHR 1.19, 99% CI 1.07-1.34) elevated risk for non-Hodgkin's lymphoma, as well as a 48% (aHR 1.48, 99% CI 1.07-2.04) increased risk for Hodgkin's lymphoma.  Risk of non-Hodgkin's lymphoma seemed to be dependent on eczema severity, with the highest risk seem among those with severe cases of eczema when compared to those free of eczema:

    - Mild eczema: aHR 1.06 (99% CI 0.90-1.25)

    - Moderate eczema: aHR 1.24 (99% CI 1.04-1.48)

    - Severe eczema: aHR 2.08 (99% CI 1.42-3.04)

    There were some similar associations seen among the Danish cohort, linking lymphoma risk to moderate and severe cases of eczema, though the results didn't reach statistical significance. MedPage Today External Link

    Pregnant women with coronavirus more likely to be hospitalized, CDC warns

    26 June- Pregnant women infected with the coronavirus might be at greater risk for hospitalization than women who aren't pregnant, the Centers for Disease Control and Prevention (CDC) said Thursday, a change from previous guidance that found no difference between the groups with respect to infections.  In its weekly report, the CDC said pregnant women who contract the virus are at greater risk to be hospitalized, admitted into an intensive care unit and put on a ventilator, according to a study of cases reported from January to June. From Jan. 22 to June 7, the health body reported that 326,335 women, ages 15 to 44, tested positive for COVID-19. Pregnant women were admitted to an intensive care unit at a 1.5 percent greater frequency than nonpregnant women, at 0.9 percent. A half-percent of pregnant women required mechanical ventilation, compared to 0.3 percent of nonpregnant women, the report said. Fox News External Link

    Researchers report nearly 300 cases of inflammatory syndrome tied to Covid-19 in kids

    29 June- Two U.S. research groups have reported finding nearly 300 cases of an alarming apparent side effect of Covid-19 in children, a condition called multisystem inflammation syndrome, or MIS-C. While researchers have previously reported on the condition, the papers mark the first attempt to measure how frequently the side effect occurs and how it affects children who develop it. The studies, published in the New England Journal of Medicine, describe children who develop severe inflammation affecting multiple organ systems after having had Covid-19, sometimes between two and four weeks after the infection. The majority of the children were previously healthy. In one of the studies, led by researchers at Boston Children's Hospital, 80% of the children who developed the condition required intensive care, 20% required mechanical ventilation, and four children, or 2%, died. In the second study, from researchers from New York state, a similar percentage of 99 children who developed the syndrome required ICU care and two children died. In both studies, many of the children developed cardiovascular and clotting problems and many had gastrointestinal symptoms. A high proportion also had skin rashes. Stat News External Link

    Study finds coronaviruses are sharply seasonal

    28 June- Researchers from the University of Michigan (UM) School of Public Health found 4 types of human coronaviruses that cause common respiratory infections, are sharply seasonal. Human coronaviruses (HCoV), long known to infect a wide variety of species, have been recognized as human respiratory pathogens for more than 60 years. Furthermore, coronaviruses appear to transmit similarly to influenza in the same population, according to a new study published by the Journal of Infectious Diseases, July 1, 2020, Volume 22 edition. These UM researchers said in a previous press statement: "it's not possible to tell whether the severe acute respiratory syndrome coronavirus 2 — SARS-CoV-2 — that causes COVID-19 disease, also behaves like this, but hope their findings will help better prepare for what's yet to come in the pandemic." "We do not know whether that virus will behave in the future the way these seasonal viruses behave," said Arnold Monto, the Thomas Francis Collegiate Professor of Epidemiology. Precision Vaccinations External Link

    WHO sees 'tremendous work' towards COVID-19 vaccine, but no guarantee

    29 June- The World Health Organization sees tremendous work towards finding a safe and effective vaccine to prevent COVID-19, but there are no guarantee of success, the head of its emergencies programme, Mike Ryan, said on Monday. Reuters External Link

    INFLUENZA

    CDC: Flu View - Weekly U.S. Influenza Surveillance Report

    2019-2020 Influenza Season Week 25, ending June 20, 2020:

    Influenza-Associated Hospitalizations: The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts all age population-based surveillance for laboratory-confirmed influenza-related hospitalizations in select counties in the Emerging Infections Program (EIP) states and Influenza Hospitalization Surveillance Project (IHSP) states. As in previous seasons, patients admitted for laboratory-confirmed influenza-related hospitalization after April 30, 2020 will not be included in FluSurv-NET. Data on patients admitted through April 30, 2020 will continue to be updated as additional information is received.

    Pneumonia and Influenza (P&I) Mortality Surveillance: Based on National Center for Health Statistics (NCHS) mortality surveillance data available on June 25, 2020, 5.8% of the deaths occurring during the week ending June 20, 2020 (week 25) were due to P&I. This percentage is below the epidemic threshold of 6.0% for week 25.

    Influenza-Associated Pediatric Mortality: No influenza-associated pediatric deaths occurring during the 2019-2020 season were reported to CDC during week 25. A total of 185 influenza-associated pediatric deaths occurring during the 2019-2020 season have been reported to CDC. CDC External Link

    WHO: Influenza Update

    22 June 2020 - Update number 370, based on data up to 07 June 2020:

    - The current influenza surveillance data should be interpreted with caution as the ongoing COVID-19 pandemic might have influenced to varying extents health seeking behaviours, staffing/routines in sentinel sites, as well as testing priorities and capacities in Member States. The various hygiene and physical distancing measures implemented by Member States to reduce SARS-CoV-2 virus transmission might also have played a role in mitigating influenza virus transmission.

    - Globally, influenza activity was reported at lower levels than expected for this time of the year. In the temperate zone of the northern hemisphere, influenza activity returned to inter-seasonal levels while in the temperate zones of the southern hemisphere, the influenza season has not commenced.

    - In the Caribbean and Central American countries, no or low influenza detections were reported in most reporting countries. Increased severe acute respiratory infection (SARI) activity was reported in some countries.

    - In tropical South American and tropical Africa, there were no influenza viruses detected across reporting countries.

    - In Southern Asia and South East Asia, no influenza detections were reported.

    - Worldwide, seasonal influenza A viruses accounted for the majority of detections. WHO External Link

    VETERINARY/FOOD SAFETY

    Pilgrim's Pride recalls chicken nuggets because of rubber bits

    29 June- Following a consumer complaint, Pilgrim's Pride Corp. initiated a recall of almost 60,000 pounds of chicken nuggets from retailers in four states. Although retailers are being instructed to pull the frozen chicken nuggets, there is concern about nuggets consumers may have already purchased, according to a recall notice posted by the USDA's Food Safety and Inspection Service). "Consumers who have purchased these products are urged not to consume them. These products should be thrown away or returned to the place of purchase" the recall notice says. As of the posting of the notice no injuries had been confirmed. Pilgrim's Pride reports distributing the recalled 59,800 pounds of frozen chicken nuggets to retailers in Arizona, Idaho, Oregon, and Texas. All of the recalled nuggets are marked with the Establishment number of "P-20728" printed on individual retail packages as well as product cases. Food Safety News External Link

    Walmart salad served by restaurant linked to parasitic infections; grocery store bagged salads still involved

    26 June- With another 84 patients confirmed and an eighth state involved, an outbreak of Cyclospora infections linked to Fresh Express bagged salads sold by grocery stores is now being blamed for sickening restaurant patrons. As of an update today, federal officials are reporting 206 patients have been confirmed as infected by the Cyclospora parasite in the outbreak. The microscopic organism is often found on fresh produce that is eaten raw, especially lettuces and herbs such as cilantro. Public health officials are concerned that consumers may have unused portions of the implicated salads in their homes. Four bagged salad mixes have been recalled so far. Some of the salad products have use-by dates into July. "Check your home for any of these recalled salads. Throw any remaining salad away, even if some of it has been eaten and no one has gotten sick," according to the outbreak update today from the Centers for Disease Control and Prevention (CDC). "If you live in Arkansas, Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, South Dakota, or Wisconsin and don't know whether the bagged salad mix you have in your home is one of these recalled salads, do not eat it. Throw it away." For patients with the information available, 23 people have been hospitalized. No deaths have been reported. Illnesses began on dates ranging from May 11 to June 17. Ill people range in age from 16 to 92 years old. It can take four to six weeks for confirmed lab results to reach the federal government, so outbreak investigators say it is likely that a number of patients have not yet been added to the total. The CDC update says the most accurate numbers at this time are the ones from state health departments. Food Safety News External Link

    WELLNESS

    A stronger tomorrow starts today during Men's Health Month

    29 June- Although just a guess, I believe there's a sneaky reason why there's an entire month dedicated to men's health. Besides prompting guys to focus on dealing with physical and mental morbidities, the actual reason to annually set aside an entire month is steeped in intentional, well-meaning principle. We basically need reminding – apparently a lot – to take care of ourselves. According to the U.S. Centers for Disease Control and Prevention, men are far more likely than women to go two years or longer without seeing a physician. When we do have an appointment, we are less likely to speak openly about our health with our health care provider. Even if we do share, we're generally not open and sincere about our health and wellness. Such lack of communication can lead to missing diagnoses, causing misdiagnoses and adding unnecessary tests. With 'a stronger tomorrow' the Men's Health month theme this year throughout the Department of Defense, now of course is the opportunity to take the slack out of our collective communication lack...We have this entire month as a foundation to increase our awareness about health issues that should be important to all us guys like prostate, testicular, skin, and colon cancers, along with other similar concerns like hypertension, obesity, and heart disease. That catchphrase 'increased awareness' is really a reminder for all of us guys to self-assess to determine if our daily habits are healthy or horrid. Are we eating nutritionally, being active, maintaining a healthy weight, managing stress, staying injury free, practicing safe sex, drinking in moderation, and being tobacco free? According to the Navy Marine Corps Public Health Center, there are definitely health concerns that impact men differently than women. As an example, according to the Academy of Nutrition and Dietetics, men are more likely to gain weight around our midsection(s) than women. That accumulation of fat around our waist increases our risk for heart disease, Type 2 Diabetes, high cholesterol, and high blood pressure. Men of all ages who are aware of this, whether active duty, reservist, retiree, or dependent, understand the importance of taking measures to maintain a healthy weight. Additionally, we are more likely to smoke, drink, and choose unhealthy or risky behaviors than our gender counterparts. Health.mil External Link

    USAFRICOM

    DRC: Plague cases rise in Ituri

    27 June- In a follow-up on the plague situation in the Ituri endemic focus of Democratic Republic of Congo (DRC), Djugu territory, officials with Ecohealth Alliance said in a post on ProMED-mail that the cases have risen to 29 (17 female, 12 male) with 6 deaths (CFR = 0.2). Patients are now reported from 10 villages in 5 health areas (Kpandroma 2 cases, Lokpa 23, Ngri Balo 1, Rassia 2 and Uketha 1) located within the Rethy Health zone. An investigation team been pursuing contact tracing, ensuring dignified and safe burials, and taking care of chemoprophylaxis distribution; however, multiple factors including militia in the region have slowed down and impaired a swift response. There are concerns the situation could evolve into a into a pneumonic plague outbreak. Outbreak News Today External Link

    USCENTCOM

    Saudi Arabia: COVID-19 and Hajj, CDC recommendations

    30 June- On June 22, 2020, The Saudi Ministry of Hajj and Umrah announced that only people who currently reside in country will be permitted to make the pilgrimage this year due to the ongoing COVID-19 pandemic. The Hajj, or pilgrimage, to Mecca, Saudi Arabia, is one of the world's largest annual mass gatherings. In 2020, Hajj will take place July 28–August 2. The Saudi Ministry of Hajj and Umrah is not permitting anyone who is not currently in country to attend the pilgrimage this year due to the ongoing COVID-19 pandemic. The US CDC recommends that Americans in Saudi Arabia not make the pilgrimage. It can be difficult to practice social distancing when attending mass gatherings (such as Hajj). This can increase a person's risk of becoming infected with the virus that causes COVID-19. Outbreak News Today External Link

    USEUCOM

    Finland: COVID-19 cases continue decline

    27 June- The Finnish Institute of Health and Welfare reports that assessment on COVID-19 in the country that was published on June 25 shows the number of cases reported weekly to the communicable diseases register has still continued to decrease. Now the estimated basic reproduction number is 0.40–0.75. The number is slightly lower than the previous week. This means that the coronavirus epidemic continues to slow down in Finland. During the last period (15–21 June), no new cases were reported in 14 hospital districts. Very few new cases were reported in hospital districts other than the Hospital District of Helsinki and Uusimaa (HUS). The number of new cases in the Hospital District of Helsinki and Uusimaa has also continued to decline compared to the previous week. The number of patients hospitalized due to the COVID-19 disease has decreased, and the forecast predicts that the number of new periods in hospital and intensive care continues to decline further next week. At present, the coronavirus testing capacity of laboratories is more than 13,000 samples per day. This exceeds the target set by the Ministry of Social Affairs and Health, i.e. the daily testing capacity of 10,000 samples. Last week, the number of people tested for coronavirus was again smaller than in the previous weeks. The percentage of positive COVID-19 cases of all samples taken has continued to decline. Outbreak News Today External Link

    USINDOPACOM

    Australia: To put 300,000 under lockdown- Coronavirus live updates

    1 July- Authorities in Australia will lockdown more than 300,000 people in suburbs north of Melbourne, for a month, in a bid to contain the risk of infection after two weeks of double-digit rises in new cases. Al Jazeera External Link

    Philippines: COVID-19- The fastest growing country in the Western Pacific

    28 June- The Philippines Department of Health reported an additional 653 COVID-19 cases Sunday, bringing the country total to 35,455. The death toll is now 1244 after eight additional deaths were reported today. Officials in the Philippines are stressing the importance of strict enforcement of measures and proper compliance as "crucial" in curbing the deadly disease. Data from World Health Organization (WHO) showed that the Philippines has the fastest-growing number of new COVID-19 cases among over 22 countries in Western Pacific Region. Chairman of the Senate Health and Demography Committee, Senator Christopher Lawrence "Bong" Go said, " This is why strict enforcement of existing measures and proper compliance of everyone are very crucial". "If we follow rules and help each other to avoid the spread of the virus, if we enhance our health facilities and capabilities—this is the only way we can determine if we will be able to overcome and end the crisis brought by Covid-19". Globally, the COVID-19 pandemic has topped the 10 million case mark today. Nearly 500,000 deaths have been reported.Outbreak News Today External Link 

    USNORTHCOM

    U.S.: Arizona- Reports single day high in COVID-19

    29 June- Arizona health officials reported 3,858 additional COVID-19 cases Sunday, a single-day high, bringing the state total to 73,908. This was the seventh time in the last 10 days that daily cases surpassed the 3,000 mark. Nine additional fatalities were reported, bringing the total to 1,588. Maricopa County has seen the most cases with 44,962 cases with Pima County in a distant second with 7525 cases. State health officials recently announced efforts to increase access to COVID-19 testing in partnership with healthcare providers statewide.Outbreak News Today External Link

    U.S.: Coronavirus cases rise by 47,000, biggest one-day spike of pandemic

    30 June- New U.S. COVID-19 cases rose by more than 47,000 on Tuesday according to a Reuters tally, the biggest one-day spike since the start of the pandemic, as the government's top infectious disease expert warned that number could soon double. California, Texas and Arizona have emerged as new U.S. epicenters of the pandemic, reporting record increases in COVID-19 cases. "Clearly we are not in total control right now," Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, told a U.S. Senate committee. "I am very concerned because it could get very bad."  Fauci said the daily increase in new cases could reach 100,000 unless a nationwide push was made to tamp down the resurgent virus. "We can't just focus on those areas that are having the surge. It puts the entire country at risk," he said. Fauci said there was no guarantee of a vaccine, although early data had been promising: "Hopefully there will be doses available by the beginning of next year," he said.  COVID-19 cases more than doubled in June in at least 10 states, including Texas and Florida, a Reuters tally showed. In parts of Texas and Arizona, hospital intensive care beds for COVID-19 patients are in short supply. More than 126,000 Americans have died from COVID-19 and millions have lost their jobs as states and major cities ordered residents to stay home and businesses closed. The economy contracted sharply in the first quarter and is expected to crater in the second. Reuters External Link 

    U.S.: Los Angeles- COVID-19 case count nears 100K- 'We are at a critical moment'

    28 June- In a follow-up on the COVID-19 outbreak in Los Angeles County, county health officials reported 2,169 new cases of confirmed COVID-19 Saturday. This brings the case tally to 95,371. In addition to the increase in cases, county officials report significant increases in hospitalizations and the testing positivity rate. The 7-day average of daily new cases is over 1,900; an increase from the 1,379 average two weeks ago. There are 1,698 people currently hospitalized. This is higher than the 1,350 to 1,450 daily hospitalizations seen in recent weeks. Testing results are available for over 1,037,000 individuals, with 9% of people testing positive. The cumulative positivity rate has increased from 8% to 9%, and the 7-day average of the daily positivity rate has increased from 5.8% two weeks ago to 8.6% today. 23 new deaths were reported yesterday, bringing the death toll to 3,285. Twelve people who died were over the age of 65 years old, eight people who died were between the ages of 41 and 65 years old, and one person who died was between the ages of 18 and 40 years old. Thirteen people had underlying health conditions including nine people over the age of 65 years old, three people between the ages of 41 to 65 years old, and one person between the ages of 18 and 40 years old. "So many people in our community are experiencing loss and sorrow during this pandemic. We think of you every day, and are deeply sorry for your loss," said Barbara Ferrer, PhD, MPH, MEd, Director of Public Health. "We are at a critical moment in our COVID-19 recovery journey. Over the last few weeks, businesses and public spaces have reopened, and many more people have been out and around others. Outbreak News Today External Link 

    U.S.: Mississippi reports 1st West Nile virus case of 2020

    28 June- The Mississippi State Department of Health (MSDH) reported Friday on the first human case of West Nile Virus (WNV) for 2020. The case was reported in Claiborne County. "This is a reminder that even though we are in the midst of ongoing transmission of COVID-19, West Nile virus has not gone away," said MSDH State Epidemiologist Dr. Paul Byers. "We are approaching the time of year when WNV is most active in Mississippi, so it's important to protect yourself." Byers said while most infected people recover without any long-term problems, some develop a more severe infection that can lead to complications and even death, especially in those over 50 years of age. Symptoms of WNV infection are often mild and may include fever, headache, nausea, vomiting, a rash, muscle weakness or swollen lymph nodes. In a small number of cases, infection can result in encephalitis or meningitis, which can lead to paralysis, coma and possibly death. Outbreak News Today External Link

    U.S.: Texas- Swift and dangerous turn in Texas cases, says governor

    29 June- The spread of coronavirus infections has taken a "swift and very dangerous turn" in the US state of Texas, Governor Greg Abbott has warned.
    "Over just the past few weeks, the daily number of cases have gone from an average of about 2,000, to more than 5,000," Mr. Abbott said on Sunday.
    Several southern and western states have recorded a surge in cases after lockdown restrictions were eased. The number of reported infections in the US has now surpassed 2.5 million. Over 125,000 Covid-19-related deaths have been confirmed nationwide - more than in any other country. BBC External Link

    USSOUTHCOM

    Brazil: COVID-19- 38,693 new cases, enters into partnership to produce vaccine

    27 June- Health officials in Brazil reported an additional 38,693 COVID-19 cases Saturday, bringing the total cases to 1,313,667. More than 700,000 people have recovered and the death toll has eclipsed 57,000. Today, the federal government entered into a partnership to produce vaccine against COVID-19. The agreement provides for the purchase of vaccine lots and technology transfer. If demonstrated to be effective, 100 million doses will be available to the Brazilian population. The vaccine is developed by the University of Oxford and AstraZeneca, being one of the most promising in the world. In Brazil, the technology will be developed by Fiocruz (Fundação Oswaldo Cruz), foundation of the Ministry of Health. For the executive secretary of the Ministry of Health, Elcio Franco, the bilateral partnership places Brazil in the lead in the development of the vaccine against the coronavirus. Outbreak News Today External Link

    Costa Rica: Dengue cases more than double 2019 numbers

    30 June- Through the first week of June, Costa Rica health officials have recorded 3,729 total dengue fever cases. This compares with 1,564 cases during the same period in 2019. The regions with the most cases are Huetar Caribe with 1505 and Brunca with 656 cases. There are currently active outbreaks in the Huetar Caribe and Brunca Region, with Siquirres the canton with the most reported cases of dengue at the national level with a total of 433, followed by Pérez Zeledón with 318. "Although the country is currently facing a crisis with COVID-19, we must not let our guard down in the fight against dengue, we ask the population to help us at home, with the elimination of hatcheries," he said. Dr. Rodrigo Marín Director of Health Surveillance. The Aedes aegypti mosquito, transmitter of the virus, reproduces in stagnant waters, so it is important that all kinds of nurseries such as tires, buckets, vases, canoes, jars, among others, be eliminated in homes. At the same time, the Health authorities continue to carry out control tasks throughout the country. Outbreak News Today External Link