ANNOUNCMENTS
3rd Annual One Health Day Seminar Day - Now a 2 Day Virtual Event!
In celebration of One Health Week 2020, the Veterinary One Health Division is hosting the 3rd Annual One Health Day Seminar Day as a 2 Day Webinar Event on Microsoft CVR Teams. Come join us for part of the day or the entire event to listen, learn, collaborate and discuss One Health topics. APHC
2019 Health of the Force
Through annual reporting of key indicators that impact readiness and Soldier well-being, Health of the Force improves awareness and understanding of the health status of the Army. Results are communicated through an online digital platform and traditional reports. The Health of the Force suite of products gives leaders tools to advance programs and strategies that improve performance and reduce illness and injury. APHC
U.S. MILITARY
ACFT won't be a graduation requirement in Initial Military Training for the next year
6 October- The new Army Combat Fitness Test will not be used as a graduation requirement for soldiers going through initial enlisted and officer training courses in fiscal 2021. The move brings the Army's Center for Initial Military Training in line with the rest of the force, where service leadership already said the six-event ACFT scores won't count until 2022. Army CIMT spokeswoman Megan Reed said the new policy applies to all soldiers in Basic Combat Training, Advanced Individual Training, One Station Unit Training, Warrant Officer Basic Course and the Basic Officer leader Course. Soldiers are still challenged to train for and pass the ACFT, but "no adverse administrative actions will be taken" against troops who fail it, Reed explained in an email to Army Times.
Additionally, "scores or comments on performance will not be used administratively during the data collection timeframe," Reed added. The ACFT officially became the Army's physical test of record Oct. 1. However, there have been challenges with the test's implementation because the service is still dealing with quarantine and social distancing requirements brought by the global coronavirus pandemic. In fiscal 2020, trainees had to pass the ACFT to graduate from basic, with one event allowed to be waived if needed. That waiver policy was also in place for the older fitness test that the ACFT replaced, CIMT commander Maj. Gen. Lonnie G. Hibbard told Army Times in a recent interview. Army Times 
MEDCoE's new Ready and Resilience Council finds support throughout JBSA
2 October- JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas–The U.S. Army Medical Center of Excellence, or MEDCoE, conducted their inaugural Ready and Resilience Council, or R2C, meeting on September 21, 2020. The meeting, chaired by Maj. Gen. Dennis LeMaster, MEDCoE Commander, consisted of key leaders from all subordinate commands throughout MEDCoE down to the company level, key special staff, and various Joint Base San Antonio mission partners who play a role in combating organizational issues and concerns that affect Soldier readiness. The event was held in Blesse Auditorium, a large auditorium, using control measures like social distancing and masks to mitigate risk of the 2019 Coronavirus. To kick off the meeting, Col. Caryn Vernon, MEDCoE G3, outlined why the R2C construct plays a vital role in the readiness of our Soldiers and the success of our training mission. "The MEDCoE Ready and Resilience Council is an important entity that will advocate for the health, safety, and readiness of the total force," said Vernon. "This group of leaders, some resident to the MEDCoE and others from across the installation, will identify needs and concerns across the MEDCoE, make recommendations, share best practices, and assess the strengths and weaknesses of our current health promotion initiatives and programs." The focus of the MEDCoE R2C is on the Army's "three corrosives": suicide, racism/extremism, and sexual assault/harassment. Vernon explained, "The group will examine how the health, readiness, and spiritual fitness of the force lessen the effects of the corrosives and determine the best ways to combat them before they may erode the organization." The intent of the inaugural R2C meeting was to introduce the mission, purpose, current proposed membership, and general construct of the council. Organizational leadership at all the levels were afforded the opportunity to see the importance being placed by Army Senior Leaders on issues and trends surrounding the "three corrosives." Also during the meeting, various installation programs and mission partners shared how they can help play a role in combating the unit corrosives. There were presentations from the JBSA Military and Family Readiness Center, Vogel Resiliency Center, Army Wellness Center, R2 Performance Center, Family Advocacy, Suicide Prevention, Substance Abuse Prevention, and Risk Reduction programs. Brooke Army Medical Center Behavioral Health Services also spoke about the services they provide. DVIDS
The pandemic's pressure on military spouses
4 October- At the beginning of the pandemic, military wives across the country were circulating a smug meme: Some of you have never had the government ruin your plans and it shows. Ouch. What a kick in the knees. But I had to admit, I did feel oddly prepared for a world-upending crisis. "Nothing ever goes according to plan," my husband once said to me of the missions he does overseas. This is equally true of the larger mission that is military life, which is defined by uncertainty. In March, when we first took the kids out of preschool and day care, my husband worked from home and we traded shifts. In the afternoons, I edited book manuscripts while my kids shouted on the other side of our bedroom door. This arrangement felt like a gift, my husband was home. I knew it wouldn't last long, so I wasn't surprised when my husband returned to base a month into the pandemic, training hard to make up for lost time. We barely saw him for weeks. Then there was a Covid outbreak at his work, and he was forced into quarantine. I felt like screaming, but I got through it. The Army has trained my husband to weather chaos and hardship, and it has trained me too. But then, in mid-August, with just a month's notice, my husband deployed. We are no strangers to separation. My husband is in a rapidly deployable combat unit, and they are frequently sent overseas. My daughter, Fiona, will be 4 at the end of October, and this is the third deployment she's gone through. He will miss her birthday, like he missed her last, and my son, Will, turned 2 the day after he left. We were told a deployment was off the table right now, but nothing ever goes according to plan. Since my husband and I married eight years ago, I have come to know this in my bones. Life is tenuous, plans are made to be broken, all we can count on is this early-autumn afternoon. The New York Times
Walter Reed annual symposium focuses on substance use disorder
6 October- In September, Walter Reed National Military Medical Center (WRNMMC) held its annual Substance Use Disorder Symposium, better known as SUDS. Due to COVID-19 restrictions on gathering size and social distancing, the event was held virtually. The symposium, developed and coordinated by the National Capital Region Pain Initiative, brought together speakers and attendees from all over the world to share insights and participate in workshops on how the Department of Defense is fighting substance use disorder, or SUD. The course director, Dr. Christopher Spevak stressed the need for education for all members of the health care team on substance use disorders; especially in light of COVID-19. "We have been tracking the civilian data that shows an increase in alcohol consumption during the pandemic," said Spevak. Speakers at the symposium shared their experience and insight into SUD. Jennifer Zumwalde, a recreational therapist with the Psychiatric Continuity Services clinic at WRNMMC, stated, "It was beneficial to gain from other people's knowledge." Dr. Marthinus Zeeman, an Army veteran who served on a deployment in Afghanistan, spoke about his experience while serving in 'a combat zone.' While deployed, Zeeman found that he and other fellow soldiers all experienced significant stress levels, which led to compensation through different addictive behaviors. Zumwalde, who works with active duty service members who have experienced extreme trauma of some kind, explained why this presentation was impactful. "I thought it was very powerful for [Dr. Zeeman] to talk about his firsthand knowledge with addiction. Having someone able to share their experience with others is a huge aspect used to encourage future patients to speak out and get help." While SUD is found to be a heritable disorder, anyone can become afflicted. Stress, a major contributing factor to SUD, can lead to an individual seeking instant relief through drug use. Stress could be related to combat, sexual assault, trauma, and other factors. The symposium also shared measures that the DoD is taking to combat SUD. By utilizing drug tests, and being proactive about which substances are most abused, the DoD has seen a significant decrease in drug use amongst service members from it's all time high during the Vietnam War era. Health.mil
GLOBAL
5-Day course of remdesivir (Veklury) found effective
5 October- A Living Systematic Review for an American College of Physicians Practice Points published on October 5, 2020, concluded 'In hospitalized adults with COVID-19, remdesivir (Velury) probably improves recovery and reduces serious adverse events and may reduce mortality and time to clinical improvement.' 'For adults not receiving mechanical ventilation or extracorporeal membrane oxygenation, a 5-day course of remdesivir (Veklury) may provide similar benefits to and fewer harms than a 10-day course.' Precision Vaccinations
CDC revises guidance, says COVID-19 can spread through virus lingering in air
5 October- U.S. Centers for Disease Control and Prevention (CDC) on Monday said COVID-19 can spread through virus lingering in the air, sometimes for hours, acknowledging concerns widely voiced by public health experts about airborne transmission of the virus. The CDC guidance comes weeks after the agency published – and then took down – a similar warning, sparking debate over how the virus spreads. In Monday's guidance, CDC said there was evidence that people with COVID-19 possibly infected others who were more than 6 feet away, within enclosed spaces with poor ventilation. Under such circumstances, CDC said scientists believe the amount of infectious smaller droplet and particles, or aerosols, produced by the people with COVID-19 become concentrated enough to spread the virus. The CDC has long warned of transmission through small droplets that shoot through the air and generally fall to the ground, which resulted in the six-feet social distancing rule. Aerosol droplets are much smaller still, and can remain suspended in the air, like smoke. While CDC stresses close-contact transmission is more common than through air, a group of U.S. scientists warned in an unrelated open letter published in medical journal Science on Monday that aerosols lingering in the air could be a major source of COVID-19 transmission. (bit.ly/34pSPbH) "The reality is airborne transmission is the main way that transmission happens at close range with prolonged contact," the researchers said in a press call. Reuters
HPV vaccine 'substantially' reduces cervical cancer risk: study
2 October- Human papillomavirus (HPV) vaccination substantially lowered the risk of cervical cancer, especially when administered early, according to a new study. Researchers in Sweden published their findings on Thursday in the New England Journal of Medicine, and said evidence was otherwise lacking on the issue. The study found that those vaccinated before age 17 had an 88% lower risk of cervical cancer than those never vaccinated. "HPV is the most common sexually transmitted infection," according to the Centers for Disease Control and Prevention (CDC). Those with weakened immune systems may have more difficulty fighting the virus, which can lead to health issues like genital warts and cancers. The CDC recommends two doses of the HPV vaccine for boys and girls aged 11 to 12, though vaccination can start as young as age 9. Pushing off vaccination may result in needing three doses instead of two, the agency said. The study followed nearly 1.7 million females ages 10 to 30 living in Sweden from 2006 through 2017 to find the association between HPV vaccination and the risk of cervical cancer. Among those vaccinated, 438,939, or 83%, started vaccination before age 17. Fox News
Identify the different symptoms of the Flu and Covid-19
3 October- As influenza season approaches, some Americans, and especially parents, are worried that, if they or their children should become ill, it may not be easy to know which disease they have — the flu or Covid-19. They are correct. Most symptoms of the two diseases are so similar that, short of a test — or two or three tests — it won't be possible to know for sure. But there are some clues. (And it is possible to have both infections at the same time; some patients in China this year were found to have both.) It is not yet clear whether the United States will have much of a flu season this year. Flu activity in the Southern Hemisphere, which is often predictive of activity in the United States, was 99 percent below normal during its winter. Epidemiologists believe that is because Australians, New Zealanders, South Africans, Chileans and other residents of the southern half of the globe were wearing masks, staying several feet apart and washing their hands to prevent transmission of the coronavirus. Those same precautions also prevent flu transmission. Because there are very few flights between the Southern Hemisphere and the United States right now, there may be no opportunity for the usual four seasonal influenza strains to "reseed" themselves among Americans. If they do, masks and social distancing should limit their spread. Nonetheless, experts urge all Americans to get flu shots. Before it ended abruptly during lockdown, last year's flu season was on track to be one of the worst in recent memory. The number of children who died was equal to that in the 2017-18 season, which was the worst since the Centers for Disease Control and Prevention began tracking flu-season deaths in 1976. If you catch the flu, experts say, having had the shot makes it much less likely that you will be hospitalized or die...There are at least 100 viruses that can cause the common cold, but only four that cause seasonal flu. Many people who catch colds assume they have the flu, but experts consistently say the same thing about how to tell the difference: "Flu makes you feel as if you were hit by a truck." The fever, aches and headaches of a bad case of influenza are generally worse than a case of respiratory syncytial virus, rhinovirus or other common cold viruses. Everyone knows the symptoms of the flu: fever, headaches, body aches, sore throat, runny nose, stuffed sinuses, coughing and sneezing — and, for infants, ear infections. Some victims, especially children, get diarrhea or vomiting too...Knowing whether you have Covid-19 is much more complicated because there are so many different — and sometimes pretty wacky — symptoms, many of which echo those of the flu. The most common symptoms are high fever, sometimes with chills, a dry cough and fatigue. The one sign that really distinguishes the two infections is that many Covid-19 victims suddenly lose their sense of smell — not because they have a stuffy nose, but because they don't register even strong odors like onions or coffee. Not all virus victims get anosmia, the formal name for loss of smell, but one study found that 87 percent did. Less common symptoms include a sore throat, congestion, runny nose, vomiting, diarrhea, stomach pain and feeling somewhat out of breath when exerting yourself. Some victims have red or itchy eyes, and some get redness or blisters on their fingers or toes — so-called Covid toes, which resemble chilblains. The New York Times
Maintaining positive social media interactions during COVID-19
2 October- As the Department of the Air Force's chief of chaplains, Maj. Gen. Steve Schaick has seen firsthand the power of social media to forge connections during the COVID-19 pandemic. For example, airmen have signed onto Facebook Live events in increasingly higher numbers, said Schaick, who's also a chaplain. Participation has been so strong that the Air Force likely will continue to incorporate aspects of social media into religious outreach efforts even after physical distancing restrictions are lifted. But sometimes, Schaick said, nothing beats IRL – in real life. "I think social media is kind of like having plastic plants in the house," he said. "From a distance, they look good. And of course, they don't need to be watered so there's nothing to maintain." But the rewards of caring for live plants are exponentially more satisfying, Schaick said. "Social media creates an illusion that we're having the meaningful connections our souls long for. And during this pandemic, even introverts have discovered their inherent need for actual social interactions, and the emptiness that comes with social media alone." "People who used to think they were fine with just, you know, a good book and a comfortable chair are now saying, 'There's something missing in my life.' Humans are wired as social creatures. It's a piece of our DNA." As the pandemic stretches into eight months and counting, more and more people are turning to social media as a substitute for risky in-person interactions. Facebook and other social media platforms have reported record use, compared to a year ago. But is that always a good thing? Social media "allows us to maintain connections with [far-flung] family members, and to reengage with people we may have lost touch with," said Nancy Skopp, Ph.D., a research psychologist with the Defense Health Agency's Psychological Health Center of Excellence. "Social media also may serve as a creative outlet, as a means of self-expression," she said. "It can impart a sense of belonging for some and promote offline interactions." But Skopp also recognizes the potential harmful effects. She was lead author of a 2018 study of Facebook use among 166 active-duty U.S. service members deployed to Afghanistan. For all of social media's benefits, "It makes it easier for people to make social status comparisons," she said. "This could be a risk factor for anxiety and depression among vulnerable people." Social media engagements also may lead to aggression and exposure to bullying, she said, noting a study that found almost 25% of Facebook users felt regret about something they posed online. Skopp also points to another study of social media that was conducted before the pandemic. It found that over the course of 10 days, greater everyday use of social media resulted in lower feelings of overall well-being. Health.mil
Pandemic tops 35 million cases, disrupts mental health services
5 October- Over the weekend, the pandemic total topped 35 million infections, as European countries experiencing second waves of activity dialed up their COVID-19 measures and the World Health Organization (WHO) said that the virus has disrupted services for mental health, neurologic conditions, and substance abuse. The global total today reached 35,333,085 cases, and 1,039,000 people have died from their infections, according to the Johns Hopkins online dashboard. CIDRAP
Race for Covid-19 vaccine slows as regulators, top Warp Speed official tap the brakes
6 October- The race for a Covid-19 vaccine slowed on Tuesday, as both U.S. regulators and the head of the Trump administration's Operation Warp Speed initiative tapped ever so softly on the brakes. The Food and Drug Administration released strengthened rules for authorizing any Covid-19 vaccine on an emergency basis. And Moncef Slaoui, co-chair of Operation Warp Speed, revealed that the government's vaccine fast-tracking effort has urged manufacturers not to apply for emergency use authorization until they have significant amounts of vaccines to deploy. That could push back even the first such authorization — expected to be for a vaccine being made by Pfizer and BioNTech, if it proves to be effective — into sometime in mid- to late November. "The one learning message that we came to … was to recommend to the companies that we are supporting that if they achieve efficacy demonstration [of their vaccine] while there are no vaccine doses available at industrial scale … to be able to immunize at least a relevant fraction of the population, that they should refrain or at least consider refraining for filing for an EUA," Slaoui said during a Covid-19 vaccines symposium on Tuesday. STAT News
The toll of the COVID-19 pandemic threatens to extend its reach to childhood cancer
30 September- THE COVID-19 PANDEMIC forced us to shelter in place and cover our faces to protect ourselves, our families and our communities. While staying at home saved lives, it also caused a number of troubling consequences that may add to the devastating toll of COVID-19 – chief among them a sharp drop in the number of preventive medical visits and cancer screenings, which are critical to maintaining our health and well-being. Indeed, a recent survey from the Centers for Disease Control and Prevention found that 40% of adults in the U.S. have delayed or avoided medical treatment during the pandemic. Another recent study found a significant decline in the number of children receiving routine scheduled vaccinations. Avoiding the doctor or not getting necessary vaccinations can mean a missed opportunity to identify and prevent serious medical issues – for adults and children alike. The good news is that as states reopen, patients are becoming more willing to visit hospitals and clinics – a shift that will undoubtedly help resume a focus on prevention and early disease detection. As we approach the end of Pediatric Cancer Awareness Month, however, Memorial Sloan Kettering Cancer Center is working hard to spread the word about a lingering effect of the pandemic: the significant threat to cancer research stemming from COVID-19's impact on philanthropy. Indeed, the pandemic has already impacted the research that ensures the highest quality care while gradually improving outcomes for patients with cancer. Because of COVID-19, many labs closed temporarily, and many clinical trials were put on pause. As labs and research programs ramp back up, inadequate funding threatens to impede the important progress we have made in fighting childhood cancer. Today, around 84% of children with cancer are cured, compared to around 58% in the 1970s. This improvement is a result of a continual investment in research. What's more, many important breakthroughs in pediatric cancer care – including the very first chemotherapy and living immune cell treatments – paved the way for advances in general cancer care, thus benefiting patients of all ages. Health.usnews
INFLUENZA
WHO: Influenza Update
28 September 2020, based on data up to 13 September 2020:
- The current influenza surveillance data should be interpreted with caution as the ongoing COVID-19 pandemic have influenced to varying extents health seeking behaviors, 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 have likely played a role in reducing influenza virus transmission.
- Globally, influenza activity was reported at lower levels than expected for this time of the year. In the temperate zones of the southern hemisphere, the influenza season has not started. Despite continued or even increased testing for influenza in some countries in the southern hemisphere, very few influenza detections were reported.
- In the temperate zone of the northern hemisphere, influenza activity remained below inter-seasonal levels.
- In the Caribbean and Central American countries, there were sporadic, or no influenza detections reported. Severe acute respiratory infection (SARI) activity, likely due to COVID-19, remained elevated in some reporting countries.
- In tropical South America, tropical Africa and Southern Asia there were sporadic or no influenza detections across reporting countries.
- In South East Asia, sporadic influenza detections were reported in Lao People's Democratic Republic and Thailand.
- Worldwide, of the very low numbers of detections reported, seasonal influenza B viruses accounted for the majority of detections. WHO
VETERINARY/FOOD SAFETY
Salmonella patient count up as outbreak traced to wood ear mushrooms continues
6 October- Federal officials continue to report new illnesses in a 10-state Salmonella outbreak linked to imported, contaminated wood ear mushrooms, also known as kikurage or black fungus. Officials reported yesterday there have been 43 patients confirmed in the outbreak, up from 41 in previous reports from the Centers for Disease Control and Prevention's epidemiologists and investigators at the Food and Drug Administration. No one has died, as far as agency authorities know. Four outbreak patients have been admitted to hospitals. Inc., Santa Fe Springs, CA, has recalled Shirakiku brand imported dried fungus, also known as wood ear mushrooms, black fungus or kikurage, from restaurants in 31 states, the District of Columbia and one Canadian province. The recall came following the California Department of Public Health's discovery of the presence of Salmonella in the product. The manufacturer has been made aware of the issue, and is conducting an investigation to determine the cause of the issue so corrections can be implemented, according to a recall notice posted by the FDA. Officials with Wismettac Asian Foods Inc. reported distributing the fungus to restaurants in Arkansas, California, Colorado, Connecticut, Delaware, Washington DC, Florida, Georgia, Hawaii, Iowa, Illinois, Indiana, Louisiana, Massachusetts, Maryland, Michigan, Minnesota, Missouri, Mississippi, North Carolina, Nevada, New Jersey, New York, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Washington, Wisconsin and British Columbia in Canada. "Wood ear mushrooms imported by Wismettac Asian Foods Inc. were only sold to restaurants and were not available directly to consumers. Although these items have been recalled, concerned or high-risk individuals should check with their restaurant to confirm that any wood ear mushrooms that have been used or are being used are not part of this recall," the FDA advised in its previous outbreak update. Wood ear mushrooms are also commonly referred to as Kikurage, Dried Black Fungus, Dried Fungus, or Mu'er/Mu Er/Mu-Err, according to the CDC. The public health agency is advising anyone who has such food on hand to throw it away unless they know for sure it is not subject to the recall. The company reports that the mushrooms were distributed to restaurants in six packs of 5-pound bags labeled as Shirakiku brand Black Fungus (Kikurage) with Universal Product Code (UPC) bar code 00074410604305, item #60403, and imported from China. Food Safety News
Seneca recalls apple chips for Salmonella risk in ingredient
5 October- Seneca Snack Co. is recalling Seneca Cinnamon Apple Chips and Clancy's Cinnamon Apple Chips because of possible Salmonella contamination. This recall is for Clancy's product sold by ALDI and Seneca products sold through Amazon and Gemline. This recall was prompted after Seneca was notified by an ingredient supplier that one lot of ingredients containing cinnamon was potentially contaminated with Salmonella. In response to that notification, Seneca is now recalling Cinnamon Apple Chips from its distribution system and removing them from stores. Food Safety News
WELLNESS
These are the vitamins and minerals older adults need
2 October- As you age, the amount of vitamins and minerals your body needs to function at optimal health changes. As you reach your 60s and 70s, for example, your body may need more of certain vitamins and minerals. Vitamins and minerals are two types of nutrients that help support the body's function. Vitamins are essential micronutrients that come from plants or animals and that your body needs in small amounts each day. Some examples of vitamins include:
- Vitamin A.
- The B vitamins.
- Vitamin C.
- Vitamin D.
The minerals needed by the body also help it to function properly, but minerals come from the soil and water, not plants and animals. Your body needs all types of vitamins, but not all types of minerals. Examples of minerals your body needs include:
- Calcium.
- Magnesium.
- Potassium. U.S. News
USAFRICOM
Sudan reports another polio case, Vaccination campaign planned for 8.6 million children
4 October- One additional circulating vaccine-derived poliovirus-2 (cVDPV2) case was reported in the Red Sea province, Sudan, bringing the total cases reported in to 23 since the first cases were reported in early August. The initial viruses were linked to the ongoing outbreak in Chad followed by local transmission, according to the Global Polio Eradication Initiative. Close to 10 million doses of polio vaccine arrived Thursday in Khartoum, which will be used during the National Polio Campaign planned for October to immunize 8.6 million of the country's children under the age of five. "We must protect children from the threat of polio, and the best way to do that is to increase the polio vaccination coverage and urge parents and communities to bring their children for vaccination to save them from the crippling disease", said UNICEF Representative, Abdullah Fadil. "A little effort now can give children the best health care service that they need in their first years of life," he remarked. "Vaccinating every child is the only way to stop this outbreak spreading further," said Dr. Ni'ma Saeed Abid, WHO Representative. "The pandemic has led to lower rates of routine immunization, placing children at even greater risk. We are committed to working with parents and caregivers to deliver vaccines, and urgently raise immunity levels." "This is a multi-country outbreak has been active in 4 out of 7 neighboring countries with Sudan. In addition to in-country efforts we started coordination with outbreak countries bordering Sudan to have holistic and comprehensive response," said Dr.Ni'ma. Outbreak News Today
USCENTCOM
With 239 deaths, Iran hits its highest daily COVID-19 toll
7 October- Iranian state TV said the country has hit its highest number of daily deaths from the coronavirus, with 239 new fatalities reported on Wednesday. The report quoted the spokesperson of the country's health ministry, Sima Sadat Lari, as saying that the 239 died since Tuesday. Iran has in the past had 235 daily deaths. The latest death toll brought the total number of fatalities to 27,658. The ministry spokesperson said healthcare professionals recorded 4,019 new confirmed cases since Tuesday, brining the total number of confirmed cases in Iran to 483,844. Lari said 4,274 patients are in critical conditions and that 397,109 have recovered so far. The Islamic Republic has been struggling with both the region's largest outbreak and the highest number of fatalities in the Middle East. Authorities have blamed the high death toll on rampant disregard of health measures by people, especially those traveling between cities and large gatherings at ceremonies, though they have closed many public places such as cafes and gyms. Health officials said some 50% of the fatalities have been recorded in the capital, Tehran, with a population of 10 million. Iran also suffered the region's first major outbreak, with top politicians, health officials and religious leaders in its Shiite theocracy stricken with the virus. It has since struggled to contain the spread of the virus across this nation of 80 million people, initially beating it back only to see a spike in cases again, beginning in June. The first coronavirus cases and deaths were reported in Iran on the same day in February — the Mideast's first outbreak of the virus — yet it only saw its highest single-day spike in reported cases in June. The highest daily death toll was reported in July. Federal News Network
USEUCOM
Coronavirus: Paris poised for maximum Covid alert
2 October- French authorities could place Paris under maximum Covid alert from Monday, the country's health minister warned. Olivier Véran said infection rates in the capital and its suburbs are rising and a decision on imposing new restrictions will be made on Sunday. He added that a "total closure of bars" could be needed in the capital. France, one of many European countries that are seeing a rise in cases, recorded more than 13,000 infections on Thursday. The World Health Organization (WHO) has warned that surging figures in Europe should serve as "a wake up call". In a news conference on Thursday, Mr. Véran said the Paris region passed three thresholds qualifying for a maximum alert on Thursday. One of these was the number of infections, which has now surpassed 250 per 100,000 people. "We need a few days to confirm the trends, but if they are confirmed, we'll have no choice but to put it on maximum alert, from Monday," he said. According to Mr. Véran, more than 30% of beds in Paris's intensive care units have been filled with Covid-19 patients. He warned that if the maximum alert was put in place, there would be no more family reunions and bars would be closed. Bars and restaurants in the region already have to close by 22:00. BBC News
Spain: COVID-19 cases rise, lockdown restrictions return
1 October- Health officials in Spain are reporting an increase in COVID-19 cases, prompting the government to reinstitute lockdowns in cities like Madrid. During the past two weeks, Spain has recorded nearly 130,000 new cases, bringing the country total to 778,607 cases, making it one of the hardest hit countries in the world and the most cases seen in any European country. In Madrid, 1,586 new infections were reported Wednesday, or 40 percent of the country's total for that day. The Spanish Ministry of Health announced Wednesday new coordinated actions in public health to respond to the increases in the outbreak: Specifically, it is established that it is necessary to implement new measures in populations with more than 100,000 inhabitants that have an incidence greater than 500 cases per 100,000 people in the last 14 days, a positivity of diagnostic tests for active infection greater than 10% and who are in autonomous communities with an ICU bed occupancy by Covid-19 patients greater than 35% of the usual staff. Outbreak News Today
USINDOPACOM
Philippines COVID-19 update: 2,291 new cases Monday, WHO donates PPE, medical supplies
5 October- The Philippines Department of Health reported an additional 2,291 new COVID-19 infections Monday, bringing the country total to 324,762. The majority of the newly confirmed cases were from the National Capital Region (NCR) with 825, the provinces of Batangas with 140, Laguna with 128, Rizal with 114, and Cavite with 102 infections. Sixty-four additional fatalities were reported putting the total at 5,840. Health Secretary Francisco T. Duque III received various health commodities donated by the World Health Organization (WHO), at the Department of Health (DOH) Central Office today. WHO Country Representative in the Philippines, Dr. Rabindra Abeyasinghe, turned over $3.1 million worth of personal protective equipment (PPEs) consisting of gowns (230,900 pcs), KN95 masks (405,000 pcs), face shields (187,800 pcs), goggles (159,540 pcs), gloves (489,000 pairs) and surgical masks (1,600,000 pcs). The WHO also handed over 350 units of oxygen concentrators, a medical device used for breathing-related disorders caused by low oxygen concentration in the blood. "The recent decline in cases in Metro Manila does not mean the pandemic is over, and now is not the time to relax. We must continue to build on this success in Metro Manila and support the control in newly emerging hotspots in other regions of the Philippines as we continue to save lives and ensure a gradual opening of the economy," said Dr Abeyasinghe. "As we support the COVID-19 response of the Philippines, we need to ensure we detect cases early, quarantine close contacts and continue to expand healthcare pathways. WHO stands in solidarity with the Philippine government's response to COVID-19 to protect the Filipino people. Secretary Duque expressed his thanks to WHO's continued support to the country'sCOVID-19 National Action Plans and in managing pre-covid outbreaks like polio and measles "The way to defeat any pandemic is to collectively work and fight against it. With the WHO and other partner organizations, both from the public and private sector, fighting this battle alongside us, we are confident that we can beat this pandemic and we will recover as one," said the Health Chief. Outbreak News Today
USNORTHCOM
U.S.: Michigan- Eastern equine encephalitis death reported in Montcalm County
4 October- Following the first human Eastern Equine Encephalitis (EEE) case in a Barry County resident in mid-September, Michigan state health officials reported a second case in Montcalm County. According to a local media account, the individual has died from the mosquito-borne virus. The state has confirmed 36 EEE cases in animals across 15 counties this year–(1 Allegan, 1 Baraga,1 Barry, 1 Calhoun, 5 Clare, 3 Ionia, 1 Isabella, 2 Jackson, 3 Kent, 2 Livingston, 1 Mecosta, 8 Montcalm, 2 Newaygo, 4 Oakland, and 1 Tuscola). The Mid-Michigan District Health Department says Eastern Equine Encephalitis is a disease found in birds, and spread between birds by mosquitos. Certain species of mosquitos can also spread the disease from birds to some mammals, like horses, deer, and humans. The disease cannot be passed between mammals, such as from horse to horse or horse to human. People younger than age 15 and over age 50 are at greatest risk of severe disease following infection. Signs of EEE include the sudden onset of fever, chills, body and joint aches which can progress to severe encephalitis (inflammation of the brain). Outbreak News Today
U.S.: New York City- Plans to reverse reopening's in some neighborhoods as coronavirus cases climb
5 October- Schools, daycares and restaurants may again be forced to close in some New York City neighborhoods as the city tries to get ahead of a worrisome spread of Covid-19. Mayor Bill de Blasio on Sunday proposed temporarily closing all schools and nonessential businesses in nine ZIP codes with high test positivity rates beginning Wednesday, pending state approval. The decision to roll back reopening's in those areas highlights the challenge facing cities, states, universities and businesses as they try to balance the need to reopen the economy with ensuring public health and safety during the pandemic. By any measure, the US has failed this challenge: temporary layoffs have become permanent, the President is in the hospital after a White House outbreak and more than 40,000 Americans are newly diagnosed with Covid-19 every day. "I am certainly not pleased (or) satisfied, but I'm actually disturbed and concerned about the fact that our baseline of infections is still stuck at around 40,000 per day," Dr. Anthony Fauci told CNN on Monday. "That's no place to be when you're trying to get your arms around an epidemic." In all, more than 7.4 million have been infected with the virus in the US and 209,810 have died, according to data from Johns Hopkins University. The US hit its highest daily rate of new cases in almost two months on Friday. CNN
USSOUTHCOM
Saint Lucia dengue fever update: Cases eclipse 500 to date
3 October- In a follow-up on the dengue fever outbreak in Saint Lucia, a total of 503 confirmed dengue cases have been reported since the outbreak was declared in August. Although cases have been identified throughout the island, most of the confirmed cases are concentrated in the northern region in areas such as Castries, Bexon and Central Babonneau. A total of 128 confirmed dengue cases have been hospitalized. Dengue serotypes 2 and 3 have been identified in the population accounting for 14 percent and 3 percent of the cases respectively in 2020. Outbreak News Today
