Army Public Health Weekly Update, 04 March 2022

Date Published: 3/4/2022
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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

    ANNOUNCEMENTS

    A slew of states, cities and schools are ditching mask mandates this week. But the fate of one big mandate is still up in air

    28 February-  Even some of the most ardent supporters of Covid-19 precautions are ditching mask mandates as health officials release new guidelines and hospitalizations plummet. Across the country, more governors are letting go of mask rules -- including in states that have long held on to school mask mandates. California, Oregon and Washington state will shift from mask requirements to mask recommendations in schools starting at 11:59 p.m. March 11, according to a statement from the governors Monday. California is also dropping its requirement for unvaccinated people to wear masks in most indoor settings starting Tuesday, Gov. Gavin Newsom's office said. But masks will still be strongly recommended for everyone in most indoor settings. And face masks will still be required for everyone in high transmission settings such as public transit, emergency shelters, health care settings, correctional facilities, homeless shelters and long-term care facilities in California, the statement said. According to California's top health official, the state's case rate has dropped 66%. Dr. Mark Ghaly, state Health and Human Services Agency secretary, said he's "pleased with how the data has come down." CNNExternal Link

    White House ends mask mandate for vaccinated

    28 February- The White House is ending a mask requirement for employees who have been fully vaccinated against COVID-19, a White House spokesman confirmed to The Hill. NBC News first reported Monday that the White House would end its mask requirement for fully-vaccinated employees beginning Tuesday. The decision came three days after the Centers for Disease Control and Prevention (CDC) significantly eased its recommendations for mask use. Under the new guidelines, over 70 percent of Americans are in an area of “low" or “medium" risk for COVID-19 transmission and do not need to wear masks. This includes Washington, D.C., where an indoor mask mandate expires on Tuesday. Prior to the announcement, the Biden administration had been under pressure from governors and some in the public health community to release updated mask guidance, as coronavirus cases fell and the omicron wave subsided. A number of governors, both Republican and Democratic, have moved to end mask mandates for businesses or other gathering spaces, like schools, in recent weeks as COVID-19 cases have declined. The White House's move follows similar actions in Washington. The U.S. Capitol's attending physician said Sunday that masks would be optional in the halls of Congress beginning Monday. The HillExternal Link

    U.S. MILITARY

    Answering your questions about COVID-19 testing

    25 February- COVID-19 continues to spread, now as the Omicron variant. Getting vaccinated is the most effective way to protect you and your family from getting seriously ill, getting hospitalized, or dying. You should also make sure you're up to date with your vaccines Stay Up to Date with Your Vaccines page on the CDC website. Testing is another important step you can take to protect yourself and others. "Testing is critically important to help reduce the spread of COVID-19," said Dr. Kenneth Yale, interim director of the TRICARE Health Plan. "If you've been exposed to a person with COVID-19 or are experiencing COVID-19 symptoms, you should get tested. We encourage TRICARE families to follow currently approved TRICARE requirements for coverage of COVID-19 testing at TRICARE.mil to ensure your test is covered. "Check out the below Q&As for guidance on COVID-19 testing and how TRICARE covers tests.

    Q: Can I pick up free at-home COVID-19 tests at a military hospital or clinic?

    A: Most military hospitals and clinicsopens the MTF Locator are distributing at-home COVID-19 rapid antigen tests to eligible TRICARE beneficiaries. However, check on their availability at your local military hospital or clinic. Your military hospital or clinic can give you up to 8 tests every 30 days. To receive a test, you must visit your military hospital or clinic in person, and be sure to bring your Uniformed Services ID card. Each person who needs a COVID-19 at-home test must visit the distribution site in person. This means one member of the family can't pick up at-home tests for everyone in their household.

    Q: How does TRICARE cover COVID-19 tests administered by a provider?

    A: TRICARE will cover your COVID- 19 testTRICARE.mil and waive the cost of the office visit if a TRICARE-authorized provider or a provider at a military hospital or clinic deems your test medically necessary. The provider can decide you need a test based on your symptoms, exposure risk, and guidance from the Centers for Disease Control and Prevention (CDC).

    To find a TRICARE-authorized provider who can perform a COVID-19 test, use the Find a DoctorTRICARE.mil tool. You can also reach out to your local military hospital or clinic Find a Military Hospital or Clinic on the TRICARE.mil website directly regarding the availability of COVID-19 testing. Health.milExternal Link

    Guard members reflect on health during Black History Month

    25 February- When Army Capt. Whennah Andrews submitted a nine-minute video in 2016 to the Army's Uniform Policy Board to change the Army's official regulation on grooming and appearance standards to include locked hair, or locks, she had one thing in mind: helping people. “I was able to recognize that me, and so many other African Americans, were being affected by the regulation that wouldn't allow us to wear our hair in locks," said Andrews. “Also, having to wear your hair in a bun, or have it cut to a certain length, could cause health problems due to strain and tension." Andrews, now at the National Guard Bureau as the executive officer of the Army National Guard's Office of the Chief Surgeon, focuses on Army Guard health care policy. Her presentation laid the groundwork for changes to the policy on authorized hairstyles that went into effect in 2017. “I appreciate that there's more flexibility with how we can wear our hair," said Andrews. “Now, women don't have to worry about possibly getting traction alopecia due to the tension of wearing their hair in a bun. Simple changes like that contribute to overall health and wellness." The change also reflected the importance of diversity. “The change is important in terms of representation," Andrews said. “Being an African American in the medical field, I thought that making this change was important, and I was in a position to do so." She said her work to make this change reminded her of her time as an undergraduate at Howard University. There, she studied health science with the goal to work in public health because she is passionate about making a difference in the community. “I always had an interest in health care and global health," Andrews said. “I have a love for people, and I wanted to impact people's lives in a remarkable way through health care." While attending Howard, she met an Army Medical Department recruiter, and an opportunity to do just that presented itself. National GuardExternal Link

    GLOBAL

    New research suggests Wuhan market was COVID-19 pandemic epicenter

    28 February- One of the studies found that two early lineages of the coronavirus have a “clear association" with the Huanan Seafood Market and noted that “beyond the Huanan market, no other proposed or hypothesized origin narrative has been supported by any data. "The other study found at least two instances where the virus spilled over from another species to humans with the first occurring in late November or early December 2019, concluding that COVID-19 “emergence likely resulted from multiple zoonotic events." The studies didn't offer definitive conclusions as to what animal species hosted the virus before spreading it to humans, but one suggested that raccoon dogs were previously sold in an area of the market where several coronavirus-positive environmental samples were taken. Neither study has been peer reviewed. Maria Van Kerkhove of the World Health Organization said of the research that “many more studies are needed" and said that finding the first human cases of a new disease is “extremely difficult, if not impossible." U.S. NewsExternal Link

    People with better physical fitness are less likely to develop Alzheimer's disease

    28 February- People who are more physically fit are less likely to develop Alzheimer's disease than people who are less physically fit, according to a preliminary study released today, February 27, 2022, that will be presented at the American Academy of Neurology's 74th Annual Meeting being held in person in Seattle, April 2 to 7, 2022 and virtually, April 24 to 26, 2022. The study involved 649,605 military veterans in the Veterans Health Administration database with an average age of 61 who were followed for an average of nine years. They did not have Alzheimer's disease at the start of the study. Researchers determined participants' cardiorespiratory fitness. Cardiorespiratory fitness is a measure of how well your body transports oxygen to your muscles, and how well your muscles are able to absorb oxygen during exercise. The participants were divided into five groups, from least fit to most fit. Fitness levels were determined by how well participants did on a treadmill test. This test measures exercise capacity, the highest amount of physical exertion a person can sustain. For people who are middle-aged and older, the highest level of fitness can be achieved by walking briskly most days of the week, for two and a half hours or more per week. News MedicalExternal Link

    Pfizer's bacterial infection vaccine fails main goal in study

    1 March- Pfizer Inc. (PFE.N) said on Tuesday its vaccine to prevent infections from a bacteria that mainly spreads through hospitals and doctors' offices and can even prove fatal, failed to meet the main goal of a late-stage study. There are no vaccines yet to prevent the illness caused by Clostridioides difficile (C. diff) bacterium, which has been classified as an urgent public health threat by the U.S. Centers for Disease Control and Prevention. The infection is associated with diarrhea that may progress to a severe and debilitating illness and even result in death. Most C. diff cases occur when patients have been taking antibiotics, which wipe out friendly bacteria in the colon that normally keep C. diff under control. The Pfizer vaccine only showed an efficacy of 31% in preventing the infections after the third dose, and 28.6% following the second dose in the study. ReutersExternal Link

    Pfizer Covid vaccine is less effective in kids 5 to 11, study finds

    28 February- Newly emerging data suggest the Pfizer-BioNTech Covid vaccine works substantially less well at preventing infection and hospitalizations in children aged 5 to 11 than it does in those aged 12 to 17 — a finding that is raising questions about whether the companies chose the wrong dose for the younger children. The data, from New York state, show a rapid and substantial decline in protection after vaccination in children in the younger age group, with efficacy against infections dropping off more quickly and dramatically than the declines seen in children aged 12 to 17. The study also found a significant, but less steep, decline in protection against hospitalizations. The findings, compiled by researchers working for the New York State Department of Health, were posted Monday on a preprint server; the study has not yet undergone peer review. The New York findings, along with data from several other databases, were recently presented to the Covid vaccine work group of the Advisory Committee on Immunization Practices, independent vaccine experts who advise the Centers for Disease Control and Prevention, sources told STAT. The data come on the heels of disappointing results from Pfizer trials of an even lower vaccine dose in children under the age of 5. And they will raise questions about whether, in trying to find doses that were both protective and tolerable in children, the companies failed to hit the mark for both age groups. STAT NewsExternal Link 

    Rare multisystem inflammatory syndrome appears in some teenagers after COVID-19 vaccination: study

    24 February- Young people between the ages of 12-20 have reported several cases of a multi-system inflammatory syndrome, otherwise known as MIS-C, where the immune system goes on overdrive after being vaccinated for COVID-19, according to a recent Lancet report. The report noted MIS-C is a rare condition that can happen two to six weeks after COVID-19 infection with patients complaining of fever and showing signs and symptoms of multi-organ involvement with systemic inflammation. "Patients with MIS-C usually present with persistent fever, abdominal pain, vomiting, diarrhea, skin rash, mucocutaneous lesions and, in severe cases, with hypotension and shock," the Centers for Disease Control and Prevention (CDC) said on their website. The agency added the illness "may begin weeks after a child is infected with SARS-CoV-2. The child may have been infected from an asymptomatic contact and, in some cases, the child and their caregivers may not even know they had been infected." First recognized in April 2020, 5973 cases were reported to the CDC between May 2020 to November 2021, with the study's authors hypothesizing the illness develops because of a hyperactive immune response to COVID-19 infection in susceptible patients who have a genetic predisposition for the syndrome. Fox NewsExternal Link

    Researchers develop machine learning prescriptions and reduce 'antibiotic resistance' by half

    27 February- Researchers have developed a new machine learning technology that will help prescribe the proper drug needed by a person to fight off bacterial infection. The new tech would help determine the adequate medicine for a person and avoid having the unnecessary one that will trigger an "antibiotic resistance" to a person. An employee of French innovative biotech company NG Biotech manufactures "Carba" tests, an antibiotic resistance test in Guipry, western France on April 6, 2020. (Photo by Damien MEYER / AFP) Researchers from the Technion - Israel Institute of Technology developed a new machine learning technology that will help in providing the right prescription for a person. Drugs are sensitive for people, and they may trigger different unwanted side effects that will be out of the control of the professionals that give them to patients. The research is a collaboration between Technion and Henry and Marilyn Taub Faculty of Computer Science, along with several participants in the study. The group's focus is to give the people the proper medication they need to fight bacterial infection and help them heal faster. The tech will provide a more accurate prescription to ensure that patients would not develop something worse from within their bodies. Tech TimesExternal Link

    Teeth grinding: You won't believe how harmful it really is

    28 February- Are you a teeth grinder or a jaw clincher? You might not even realize that you're doing it, especially while you're sleeping. But your jaw can grit and grind with as much as 250 pounds of force. Ouch! Chronic, involuntary teeth grinding – technically called bruxism – can lead to all sorts of health problems. You could crack or fracture your teeth, which may require crowns or dental implants. You could also wear down the enamel on your teeth, leading to periodontal disease or lost teeth. Teeth grinding can cause chronic pain in your head, neck and ears. It can lead to migraines, noise sensitivity and tinnitus, said Navy Capt. (Dr.) Cecilia Brown, director of dental services at Naval Hospital, Jacksonville, Florida. In the most severe cases, you might need a total joint replacement for the hinge on your jaw. Surgeons can implant a titanium joint. That's needed when bruxism wears down the jaw cartilage so that moving your mouth grinds bone against bone, Brown said. Bruxism, to varying degrees, is common. Up to 30% of people grind their teeth in some way, and estimates suggest that about 10% to 15% of adults suffer painful bruxing during sleep, according to Air Force Lt. Col. Preston Duffin, director of orofacial pain at the 59th Dental Training Squadron-Joint Base San Antonio-Lackland. “Most people have some degree of clenching, grinding, muscle guarding or other jaw activity during the day and night that is not associated with normal functioning like eating, talking, or swallowing," Duffin said. Any “evidence of excessive tooth wear" could warrant some treatment, he said. Many people don't fully understand how harmful teeth grinding can be. “It's very difficult to manage, and difficult to get patients to understand" the possible consequences, Brown said. Health.milExternal Link

    Will Omicron BA.2 become the next dominant variant?

    27 February- The rapid outbreak of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has resulted in the coronavirus disease 2019 (COVID-19) pandemic. Since its emergence in 2019, SARS-CoV-2 has evolved due to multiple genomic mutations. The newly emerged SARS-CoV-2 variants have been classified as variants of concern (VOC) or variants of interest (VOI) in accordance with their virulence and transmissibility by the World Health Organization (WHO). The SARS-CoV-2 Omicron variant (B.1.1.529) was first reported from South Africa and subsequently classified as a VOC by the WHO. An artificial intelligence (AI) model predicted the Omicron variant to be nearly 2.8 times more infectious than the Delta variant, which was the previously dominant circulating strain of SARS-CoV-2. The model also predicted that the Omicron variant could most likely escape vaccine-induced immune protection, as well as severely compromise the efficacy of currently approved monoclonal antibodies (mAbs). More studies quickly supported these predictions and revealed that the Omicron variant is highly transmissible and is associated with a high vaccine breakthrough rate and enhanced antibody escape rate. As a result of these factors, the Omicron variant quickly replaced the Delta variant to become the dominant circulating strain in many countries around the world. News MedicalExternal Link

    Yogurt is good for your heart, VA study finds

    28 February- Yogurt might hold answers to better heart health, according to a study based on data from over 190,000 Veterans. Heart disease is the leading cause of death among both men and women in the United States, accounting for 1 in every 4 deaths. The same holds true in the VA health care system, where cardiovascular disease is the leading cause for hospitalizations and many major disabilities. One way to improve heart health is to eat a healthy diet with low-fat dairy products. But which ones help the most, and how much is the right amount? Are some dairy products healthier for certain people more than others? Dr. Kerry Ivey, a dietitian and nutritional epidemiologist at the Boston VA and Harvard School of Public Health, was on a quest for answers. The best place to look was the Million Veteran Program (MVP), VA's largest research program with health, lifestyle and genetic data from more than 870,000 Veteran volunteers. “Good cholesterol was higher in 192,564 Veterans in MVP who reported eating any amount of yogurt in their daily diet," reported Dr. Ivey, who was the lead author on the study with other VA and Harvard researchers. This good cholesterol, also known as HDL, can reduce one's risk of heart disease and increase longevity. How much yogurt is the right amount to eat? “We saw just a little bit is better than none for improving cardiovascular health," Dr. Ivey said. Essentially, yogurt in any amount is helpful. BlogsExternal Link

    INFLUENZA

    CDC: Weekly U.S. Influenza Surveillance Report

    Key Updates for Week 7, ending February 19, 2022:

    - Sporadic influenza activity continues across the country. In some areas, influenza activity is increasing.

    - The majority of influenza viruses detected are A(H3N2). H3N2 viruses identified so far this season are genetically closely related to the vaccine virus. Antigenic data, now included in FluView, show that the majority of the H3N2 viruses characterized are antigenically different from the vaccine reference viruses. While the number of B/Victoria viruses circulating this season is small, the majority of the B/Victoria viruses characterized are antigenically similar to the vaccine reference virus.

    - The percentage of outpatient visits due to respiratory illness remained stable nationally compared to last week and is below baseline. Influenza is contributing to levels of respiratory illness, but other respiratory viruses are also circulating. The relative contribution of influenza varies by location.

    - The number of hospital admissions reported to HHS Protect has increased for the past three weeks.

    - The cumulative hospitalization rate in the FluSurv-NET system is higher than the rate for the entire 2020-2021 season, but lower than the rate seen at this time during the four seasons preceding the COVID-19 pandemic.

    - One influenza-associated pediatric death was reported this week. This is the sixth pediatric death reported this season.

    - CDC estimates that so far this season there have been at least 2.4 million flu illnesses, 23,000 hospitalizations, and 1,400 deaths from flu.

    - An annual flu vaccine is the best way to protect against flu and its potentially serious complications. CDC continues to recommend that everyone ages 6 months and older get a flu vaccine as long as flu activity continues.

    - Flu vaccination coverage remains lower this season compared to last.

    - Flu vaccines are available at many different locations, including pharmacies and health departments. Visit www.vaccines.gov to find a flu vaccine near you.

     -There are also flu antiviral drugs that can be used to treat flu illness. CDCExternal Link 

    VETERINARY/FOOD SAFETY

    Officials investigating another death in outbreak linked to infant formula

    28 February- The report of an additional death in an outbreak linked to powdered infant formula has resulted in an expansion of a recall by Abbott Nutrition. The most recent patient was reported to have consumed Abbott Nutrition's Similac PM 60/40 product with the lot code 27032K800 prior to Cronobacter sakazakii infection. The Food and Drug Administration and the Centers for Disease Control and Prevention informed the company of these findings and today Abbott Nutrition voluntarily recalled the implicated Similac product. “This is a specialty formula for certain infants who would benefit from lowered mineral intake and was not included in the previous recall. At this time, Similac PM 60/40 with lot code 27032K80 (can) / 27032K800 (case) are the only type and lots of this specialty formula being recalled," according to an outbreak update from the FDA. The CDC reported that the additional illness of Cronobacter sakazakii is linked to powdered infant formula produced at Abbott Nutrition's Sturgis, MI, facility. Cronobacter infection may have been a contributing cause of death for this patient, according to the agency. Food Safety NewsExternal Link

    WELLNESS

    New CDC Covid-19 metrics drop strong mask recommendations for most of the country

    25 February- Most people in the United States live in areas where those who are healthy do not need to wear masks indoors, according to new US Centers for Disease Control and Prevention guidance -- a sweeping change from what earlier Covid-19 metrics recommended. New CDC metrics indicate that about 28% of people in the United States live in a county where they need to wear masks indoors. Previously, CDC pointed to levels of coronavirus transmission within communities as a key metric for restrictions and recommended that people in areas with high or substantial levels of transmission -- about 99% of the population -- should wear masks indoors. Now, the CDC's "Covid-19 community level" metrics are based on three pieces of data in a community: new Covid-19 hospitalizations, hospital capacity and new Covid-19 cases. The CDC's website includes a list of US counties and their current Covid-19 levels. Under the updated guidance, more than 70% of the US population is in a location with low or medium Covid-19 community levels. For those areas, there is no recommendation for indoor masking unless you are at potential "increased risk" for Covid-19 and if so, the CDC recommends to talk to your health care provider about wearing a mask. CNNExternal Link

    USAFRICOM

    Lassa fever in Nigeria: 91 more confirmed cases last week

    25 February- The Nigeria Centre for Disease Control (NCDC) reported an additional 91 confirmed Lassa fever cases the week ending February 20, bringing the total confirmed cases in 2022 to 450. The latest cases were reported from Ondo, Edo, Bauchi, Ebonyi, Kogi, Taraba, Enugu, Benue, Gombe, Nasarawa, and Delta States. Cumulatively from the beginning of the year, 86 deaths have been reported, with the addition of 21 last week,  with a case fatality rate (CFR) of 19.1%. The number of confirmed cases in the first seven weeks of 2022 is more than a four fold increase compared to the same period in 2021 (102). Outbreak News TodayExternal Link

    USCENTCOM

    Iraq: Anthrax outbreak kills dozens of cattle in Kurdistan region

    7 February- The spread of anthrax in Duhok province in the Kurdistan region has resulted in the death of dozens of cattle, according to a Rudaw report. The sudden spread of the disease has put fear in the heart of local farmers and authorities, as they are worried that the disease may spread to other parts of the Region. Anthrax is a bacterial pathogen in livestock and wild animals. Ruminants such as bison, cattle, sheep and goats are highly susceptible, and horses can also be infected. Anthrax is a very serious disease of livestock because it can potentially cause the rapid loss of a large number of animals in a very short time. Affected animals are often found dead with no illness detected. Outbreak News TodayExternal Link

    USEUCOM

    Poland: COVID-19 vaccines for Ukrainian nationals

    27 February- The Poland Ministry of Health reported Friday in response to the increased crossing of borders by people of Ukrainian nationality, in connection with the armed conflict on the territory of Ukraine, from February 25, 2022, the Minister of Health introduced the possibility of vaccinating foreigners of Ukrainian nationality under the National Vaccination Program against COVID-19. The condition for acquiring the right to vaccination is possession of a document confirming your identity. The recommended vaccine is Vaccine Janssen J&J (single dose vaccine) for people over 18 years of age. In the recommended vaccination schedules, it is also possible to use other preparations available under the National Vaccine Program against COVID-19. mRNA vaccines should be used for persons under 18 who are eligible for vaccination (children and adolescents). Outbreak News TodayExternal Link

    USINDOPACOM

    Vietnam reports 94K COVID-19 cases today, Single day record

    28 February- The Vietnam Ministry of Health reported today, February 28, 94,385 new COVID-19 infections, a new single day high. Provinces and cities reporting the most cases today include Hanoi (12,850), Quang Ninh (9,105), Nghe An (3,958), Bac Ninh (3,572), Hung Yen (3,309) and Lao Cai (3,233). 108 deaths were recorded today, bringing the total fatalities to 40,522, accounting for 1.2% of the total number of infections. Since the beginning of the epidemic, Vietnam has had 3,443,485 infections. Localities with a high cumulative number of infections during this outbreak: Ho Chi Minh City (534,093), Binh Duong (297,448), Hanoi (271,950), Dong Nai (101,236) and Tay Ninh (90,425). Outbreak News TodayExternal Link

    USNORTHCOM

    U.S.: Equine Herpes Virus-1 outbreak in California

    27 February- US Equestrian released a Frequently Asked Questions (FAQ) Friday to answer questions about the Equine Herpes Virus-1 (EHV-1) outbreak at the Desert International Horse Park (DIHP) in Thermal, California:

    What is Equine Herpes Virus?
    Equine Herpes Virus-1 (EHV-1) is a virus that is present in the environment and found in most horses all over the world. Horses are typically exposed to the virus at a young age with no serious side effects.

    Are there different strains of EHV-1?
    There are two strains of EHV-1:

    The wild-type (aka non-neuropathogenic) strain; and

    The mutant-type (aka neuropathogenic) strain of EHV-1. It is important to note that neurologic symptoms have been identified with both strains of the virus. Outbreak News TodayExternal Link

    USSOUTHCOM

    Peru: Mental health counseling offered for Ukrainian community

    27 February- The Peru Ministry of Health announced today a free nationwide service for mental health services to the Ukrainian community and families of Peruvians affected by the armed conflict in Ukraine. Considering the impact on mental health caused by wars, the Ministry of Health (Minsa) through the Infohealth Directorate of the General Directorate of Telehealth, Reference and Emergencies (DIGTEL), has arranged, through line 113, option 5 , attention in orientation and counseling in mental health for the Ukrainian community in our country and for compatriots who are in the area of the war conflict and their families. The psychologists will provide mental health support to Peruvian-Ukrainian families who are facing this difficult situation, using crisis intervention protocols and techniques and psychological first aid. The World Health Organization (WHO) reports that being or having been in an armed conflict zone is associated with symptoms of anxiety, depression, post-traumatic stress, bipolarity and psychosis, among others. This new care system provided by Line 113 Health, in option 5, will be available 24 hours a day and run by a team of mental health professionals. Outbreak News TodayExternal Link