Army Public Health Weekly Update, 15 April 2022

Date Published: 4/15/2022
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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 

    DHA Director outlines vision for health care readiness at HIMSS

    11 April- Army Lt. Gen. (Dr.) Ron Place, the Director of the Defense Health Agency, spoke recently about the vital role that communications and data systems can play in supporting the Military Health System. Speaking at the annual Healthcare Information and Management Systems Society conference in Orlando, Florida, Place outlined his views on the connections between medicine, national security, and technology-driven solutions for better patient treatment. His speech highlighted military medical education and training and ways to improve it in the future. He emphasized the essential role of unit-level medical teams across the force. “The lives of America's sons and daughters are saved by medics and by corpsmen," Place affirmed. Supporting those medical teams is a key component of medical readiness, he said. “Readiness means you never let your guard down. You think about it. You're prepared for the worst-case scenario so you can better prevent it from ever happening. And to do that, you demand agility from your people, from your equipment, and from your systems – and in particular your information systems from which your people rely on to make decisions." Place said the title of his presentation, “Clear and Present Danger: Lessons from the Military Healthcare System," was “willfully borrowed," from Tom Clancy's best-selling political thriller novel. “First, what are the clear and present dangers facing the Department of Defense, at least from my present vision within the Military Health System?" he asked. “And second, what are the solutions that I, and my colleagues, are looking for to help us best prepare to meet those challenges?" Place drew an analogy from aviation, describing a scenario that pilots might experience while flying through a storm. He pointed to the important distinction between dangers that are present versus those that are clear. Place pointed to the different techniques that pilots rely on to navigate their aircraft, including “Visual Flight Rules," or VFR, which pilots use in good weather when they can clearly see the ground and other obstacles. He compared VFR to “Instrument Flight Rules," or IFR, which is the technique pilots use in bad weather when they cannot see clearly from the cockpit and have to rely on data provided by instruments on their control panels to navigate the aircraft. “Given a choice, most pilots will avoid that storm and choose to veer off to the right, into the clear, where they will follow the Visual Flight Rules, or VFR. Better weather, safer, more comfortable," he said. But sometimes that's not an option, Place explained, and aviators might have to turn into the storm and rely on instrument flight rules. The systems and instrumentation on the aircraft help pilots when they must fly blind. In medicine and the military, we may not always have the option to choose the safe route, he said. “We don't always get to choose an easier path," Place said. In these scenarios, mission control plays a critical role by providing a perspective that may include vital information that the flight crew cannot immediately access. “While the air crew is performing its assessment, there may be other risk factors that would lead mission control to have them go left into that storm," Place said. Health.mil External Link

    U.S. MILITARY

    Dr. Jay Montgomery details importance of the immunization healthcare division

    8 April- Dr. Jay Montgomery is a medical director for the Defense Health Agency's Immunization Healthcare Division's North Atlantic Region Vaccine Safety Hub. Montgomery helps address vaccine and immunization questions and concerns, both clinical and administrative. Previously, he also served as specialty consultant to the White House Medical Unit from 2003 to 2016. As a retired Navy captain, Montgomery continues to play a key role in ensuring vaccine safety and efficacy within the DOD. 

    Q: Describe your role in DHA's Immunization health care. 

    Montgomery: I provide supervisory support to my staff and clinical expertise to the Immunization Healthcare Division, providers, service members, their families, and geographic combatant commands. My Hub's area of responsibility spans the North Atlantic from Virginia to Wisconsin as well as the U.S. European Command's and U.S. Africa Command's area of operations. I also participate in influenza and COVID-19 vaccine trials. 

    Q: Why are immunizations an important part of public health? 

    Montgomery: Vaccines, by presenting our body's immune system with a weakened germ or piece of the germ, allow us to become resistant to the effects of a serious disease without the risk of actually contracting the disease. Vaccination, along with sanitation and clean water, are undeniably responsible for improving and prolonging people's lives, especially in the case of children. 

    Q: What are some major components of your position?  

    Montgomery: I provide specialized medical support to those with immunization concerns or who experience adverse events following immunizations. As a member of the Immunization Healthcare Division's Immunization Support Center, this can be a 24/7 responsibility. Along with the office's team of clinicians, educators, administrators, and remote immunization health care specialists, I provide a range of immunization health care education from grand rounds to vaccinator training. And, I am pleased to be able to contribute to vaccine knowledge in a broader sense through the publishing of vaccine-related research made possible by the unique opportunities available to the Immunization Healthcare Division. Health.mil External Link

    For physicians at Womack Army Medical Center, readiness is the mission

    6 April- Doctors play an important role in the lives of patients and the fulfillment of the hospitals overall mission, but what is the driving force behind their work? For Womack Army Medical Center (WAMC) physicians, service is the key. Army Col. (Dr.) Jennifer Bager is the deputy commander of Surgical Services at Womack. Her ambition to become a doctor first blossomed when she was in the first grade. "What keeps me in the Army as a doctor is the fact that I enjoy the patients that I work with and I like supporting the units," Bager said. "The Department of Surgery has been absolutely amazing. These are some of the strongest personnel I have worked with in my career. I am very fortunate." Taking care of patients is only one part of what doctors do; they participate in the improvement and addition of other services. Bager said, "The thing that is most gratifying to me is WAMC has started two new residencies, a General Surgery Residency and an Orthopedic Surgery Residency." Bager believes that WAMC plays a vital role in the Fort Bragg/Fayetteville community. “We are on our way to becoming a level two trauma center, and that supports the Army's bigger mission of readiness, as well as serving the local community," said Bager. Army Maj. (Dr.) Omici Uwagbai, served as the medical director and officer-in-charge of Robinson Health Clinic "Robinson Health Clinic is the best clinic on Fort Bragg, which is a testament because of the nurses, providers and administrative staff," Uwagbai said. “That's what motivates me, being of service to others." Uwagbai continued an annual musculoskeletal course, initially created by Col. Matthew Hing, deputy commander of Primary Care Services at Robinson. “We created a curriculum for our unit providers to become subject matter experts in musculoskeletal, because that is probably the number one injury when it comes to Soldiers." Uwagbai said. DVIDS External Link

    VA says telehealth curbed suicide risk among rural vets in pandemic

    8 April- A new study finds that rural veterans with mental-health issues were likelier to get online treatment after receiving smart devices from the Department of Veteran Affairs, reducing their risk of suicide during the COVID-19 pandemic. The VA-sponsored study of 471,791 rural veterans with a history of mental health care was published last week in the Journal of the America Medical Association. It found that 13,180 rural veterans who received a video-enabled tablet during COVID-19 were 36% less likely to make a suicide-related visit to an emergency room and 22% less likely to show suicidal behavior. Veterans who received tablets made an average of 1.8 more psychotherapy visits per year and 3.5 more telehealth psychotherapy visits per year than before, the study found. “These findings suggest that the VA and other health systems should consider leveraging video-enabled tablets for improving access to mental health care via telehealth and for preventing suicides among rural residents," researchers wrote in the study published last Wednesday. Of the 106,451 tablets with data plans in circulation as of September, the VA issued 93% during the pandemic and sent one-third of those to rural areas. Only veterans who did not own a device with broadband or cellular internet service, could not travel easily to the VA, and were able to operate a tablet were eligible to receive one. The report noted that U.S. suicide rates are at their highest since World War II, and veterans are one-and-a-half times more likely to commit suicide than nonveterans. Rural areas are particularly at risk because of higher unemployment and lack of health care resources in rural areas, problems the VA said have been exacerbated by the COVID-19 pandemic. Kritee Gujral, a health economist at the VA Palo Alto Health Care System, conducted the study with five other researchers. The analysis of VA health care data, conducted from November to February, focused on the veterans who received tablets between March 16, 2020, and April 30, 2021. Washington Times External Link

    GLOBAL

    Allergies, asthma linked to heart disease, study says

    12 April- If you have a history of asthma or allergies, you may be at increased risk of developing high blood pressure and coronary heart disease, new research finds. Adults between the ages of 18 and 57 who have suffered from an allergic disorder had a higher risk of high blood pressure, according to the research, which will be presented at the American College of Cardiology and Korean Society of Cardiology's spring conference in Gyeongju, South Korea. The highest risk for high blood pressure was found among people with asthma, researchers said. High blood pressure and cholesterol, along with a lack of exercise, obesity, diabetes, smoking and a family history of cardiovascular issues, are all key contributors to heart disease, according to the US Centers for Disease Control and Prevention. Previous studies have also found a correlation between allergic disorders and heart disease, but the link was controversial, the researchers said. In this latest research, scientists tested their hypothesis using data on over 10,000 people with allergies who participated in the 2012 National Health Interview Survey, a government-led survey of the United States population. Each person had asthma or at least one allergic disorder, such as a respiratory, food or skin allergy. In addition to the risk for high blood pressure, the research also found a higher risk for coronary heart disease for people between the ages of 39 and 57 with allergies. Coronary heart disease occurs when plaque builds up in the walls of the arteries that supply blood to the heart. Based on their findings, researcher encouraged clinicians to add a cardiovascular risk assessment to clinical examinations of people with asthma and allergies. CNN External Link

    COVID-19 home tests have more shelf-life than you think: report

    6 April- Don't throw away your home COVID-19 tests just because it says it's expired, according to a recent New York Times report. Even though the test kits use similar technology to detect pieces of the viral proteins called antigens, their expiration dates may differ because of how they are regulated – not because of inherent differences in the tests themselves, said Dr. Michael Mina, an expert in home-test technology and chief science officer for eMed, a healthcare company that provides home test kits. When the Food and Drug Administration (FDA) regulates a product, it sometimes allows manufactures to perform "accelerated dating" where it accelerates simulated conditions to determine how long a product lasts, said Mara Aspinall, biomedical diagnostics expert at Arizona State University who is also on the board of OraSure, a company that makes COVID-19 rapid tests. Fox News External Link

    COVID vaccine program prevented millions of US deaths, study finds

    8 April- Despite a recent increase in COVID-19 breakthrough infections, an updated report illustrates the significant impact the nation's vaccine campaign has had in preventing millions of virus-related deaths, hospitalizations and infections. The U.S. COVID-19 vaccine program is now estimated to have prevented 2.2 million deaths, 17 million hospitalizations and 66.1 million additional infections through March 2022, according to updated modeling from the Commonwealth Fund, an organization advocating for improved healthcare for marginalized communities. In the analysis of recent trends, researchers estimated that the daily peak of deaths pre-omicron, and without vaccination, would have exceeded 24,000 per day, far surpassing the actual peak of 4,300 per day, experienced by the country during the winter of 2021. Without the vaccines, the omicron wave could have been substantially larger, the study suggested. In addition, the researchers estimate that without vaccines, there would have been nearly $900 billion in associated health care costs. The model accounts for waning immunity and changes in population behavior over time, as schools and businesses have reopened and travel has increased. As immunity wanes, researchers stressed that "redoubling efforts to increase vaccine uptake, especially among the elderly and other vulnerable groups, will be critical to avert outbreaks as pandemic restrictions are lifted," particularly as the omicron subvariant, BA.2, spreads. "Our findings point to the tremendous power of vaccination to reduce disease burden from COVID-19. This may be even more important if newer variants arise or population immunity ebbs. Without continued funding, the lifesaving impact of vaccinations are at risk," researchers said. ABC News External Link

    Maternal flu shots unrelated to allergic or autoimmune disease diagnosis

    12 April- The PLOS Medicine journal recently published a peer-reviewed study that supports the safety of seasonal inactivated influenza vaccine during pregnancy concerning allergic and autoimmune diseases in early childhood. Published on April 5, 2022, this information from Australia is reassuring and reinforces current maternal vaccine programs and policies, said these researchers. 'While we identified a negative association for asthma and anaphylaxis when the flu shot was administered later in pregnancy, our findings are only generalizable to more severe events requiring hospitalization or presentation to the emergency department.' 'We observed no other associations between prenatal exposure to seasonal IIV and allergic or autoimmune diseases in children up to five years.' 'These results contribute to the gap in knowledge of the potential child health impacts of maternal influenza vaccination on the development of allergic or autoimmune diseases in childhood and support the safety and continuation of existing maternal vaccination programs and policies.' In the U.S., the CDC suggests flu shots are appropriate for most people over the age of six months. An updated listing of influenza vaccines, vaccine candidates, and related research is posted at PrecisionVaccinations.com/Flu. This research was supported in part by funding received from the National Health and Medical Research Council and other non-industry sources. The researchers did not disclose material industry conflicts. Precision Vaccinations External Link

    Revolutionary leukemia treatment offers 'a hopeful moment' in fight against solid tumors

    10 April- On Wednesday, 5-year-old Mary Stegmueller will reach a major milestone. She will have outlived her predicted life expectancy. Twice. At age 4, Mary, a rambunctious animal lover from Northglenn, Colorado, was given nine months to live. A devastating brain tumor was spreading its tentacles through her brain stem, the area that controls breathing, heartbeat and other essential functions. The tumor, called a diffuse intrinsic pontine glioma strikes 300-400 Americans each year, mostly children, and several thousand more worldwide. The standard treatment for DIPG hasn't changed since it killed astronaut Neil Armstrong's 2-year-old daughter in 1962. But Mary, patient No. 007 in a research trial at Stanford University, may be among the first to redefine the future of DIPG. The trial already is changing the story of a type of cancer immunotherapy called CAR-T, which has revolutionized the treatment of blood cancers, but so far hasn't been effective in 90% of cancers, like DIPG, that are considered solid tumors. Scientific theory and a few isolated examples have suggested CAR-T should be able to fight solid tumors. But Stanford's latest results, presented this weekend at a cancer conference in New Orleans, are the first to show consistent effectiveness. "It's an enormously hopeful moment," said Dr. Crystal Mackall, a Stanford immunologist who helps lead the work. Some trial participants have seen their tumors shrunk by 95% or more – a dramatic achievement never before seen in DIPG. Though some have since died, most survived far longer than expected. "It tells you you're on (right) the path, keep digging," said Dr. Nabil Ahmed, a CAR-T expert at Baylor College of Medicine in Houston, who is not involved in the study but is following it closely. Dr. Marcela Maus, a CAR-T and brain tumor expert at Massachusetts General Hospital and Harvard Medical School, said the work has inspired the entire CAR-T field. "This is building up the case for hope," she said. USA Today External Link

    U.S. FDA places COVID-19 vaccine on clinical hold

    12 April- Pennsylvania-based Ocugen, Inc. today announced that the Company was informed by the U.S. Food and Drug Administration (FDA) that the agency placed its Phase 2/3 immuno-bridging and broadening study for Covaxin™ on clinical hold. As of April 12, 2022, the FDA has not Authorized or Approved Covaxin's use in the U.S. This action results from the Company's decision to voluntarily implement a temporary pause in dosing participants of the OCU-002 clinical trial while it evaluates statements made by the World Health Organization (WHO) following their inspection of a Bharat Biotech International Limited's (BBIL) manufacturing facility. On April 2, 2022, the WHO confirmed the suspension of the supply of Covaxin through UN procurement agencies and recommended that countries using the vaccine take action as appropriate. The suspension is in response to the outcome of a WHO inspection in mid-March 2022 and the need to conduct process and facility upgrades to address recently identified deficiencies in good manufacturing practices. The WHO's risk assessment to date does not indicate a change in Covaxin's risk-benefit ratio. And the data available to WHO indicate the vaccine is effective, and no safety concerns exist. Covaxin is an inactivated COVID-19 vaccine that uses adjuvant Alhydroxiquim-II to boost immune response and is available in various countries. Precision Vaccinations External Link

    Zika virus may be one step away from explosive outbreak

    12 April- A new outbreak of Zika virus is quite possible, warn researchers, with a single mutation potentially enough to trigger an explosive spread. The disease caused a global medical emergency in 2016, with thousands of babies born brain-damaged after their mums became infected while pregnant. US scientists say the world should be on the lookout for new mutations. Lab work, described in the journal Cell Reports, suggests the virus could easily shift, creating new variants. Recent infection studies suggest those variants may prove effective at transmitting the virus, even in countries which have built up immunity from previous outbreaks of Zika, say the team from the La Jolla Institute for Immunology. Experts said the findings, although theoretical, were interesting - and a reminder that viruses other than Covid could pose a threat. Zika is spread by bites from infected Aedes mosquitoes. The insects are found throughout the Americas - except for Canada and Chile, where it is too cold for them to survive - and across Asia. While for most people Zika is a mild illness, with no lasting effects, it can have catastrophic consequences for babies in the womb. If a mother contracts the virus during pregnancy, it can harm the developing baby, causing microcephaly (unusually small head) and damaged brain tissue. BBC News External Link

    INFLUENZA

    CDC: Weekly U.S. Influenza Surveillance Report

    Key Updates for Week 13, ending April 2, 2022:

    -Influenza activity increased nationally this week. Influenza activity is highest in the central and south-central regions of the country and is increasing in the northeastern regions.

    -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 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 increased slightly this week compared with last week and remains 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 each week for the past nine 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.

    -Two influenza-associated pediatric deaths were reported this week. There have been 16 pediatric deaths reported this season.

    -CDC estimates that, so far this season, there have been at least 3.8 million flu illnesses, 38,000 hospitalizations, and 2,300 deaths from flu.

    -An annual flu vaccine is the best way to protect against flu. Vaccination can prevent serious outcomes in people who get vaccinated but still get sick. CDC continues to recommend that everyone ages 6 months and older get a flu vaccine as long as flu activity continues.

    -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. CDC External Link

    VETERINARY/FOOD SAFETY

    More oysters recalled in Canada as norovirus outbreak numbers grow

    12 April- Intercity Packers Ltd. is recalling Intercity Packers Ltd. brand Oyster N/Shell Royal Miyagi Ow because of possible norovirus contamination. This recall was triggered by findings by the Canadian Food Inspection Agency during its investigation into a foodborne illness outbreak. According to the Canadian Food Inspection Agency, as of April 8, 2022, there have been 328 cases of norovirus and gastrointestinal illness linked to consumption of British Columbia oysters reported in the following provinces: British Columbia (293), Alberta (3), Saskatchewan (1), Manitoba (15) and Ontario (16). The recalled product has been sold in British Columbia and may have been distributed in other provinces and territories. Food Safety News External Link

    Testing finds Salmonella in meat department at Utah grocery store

    12 April- Utah officials announced today that they issued a cease and desist order on the meat department of a grocery store and have embargoed all products after testing found Salmonella enterica on March 31. A foodborne illness investigation is currently underway. Additional testing was done on March 31, and products tested presumptive for Salmonella at the International Marketplace in Midvale, UT, Based on the Utah Department of Agriculture and Food laboratory results, any ground beef products produced by International Marketplace in Midvale from March 22 through March 31 are deemed under suspicion of contamination. Consumers who purchased ground beef products from this location between the suspected dates are urged not to consume them. These products should be thrown away or returned to the place of purchase. Individuals may also report suspected illness to igotsick.health.utah.gov. UDAF and the Utah Public Health Laboratory are currently testing other products from the International Marketplace to determine the scope of the contamination. Food Safety News External Link

    WELLNESS

    Screening for anxiety and depression may be useful for kids as young as 12

    12 April- Routine screening for anxiety and depression may be useful for older children and teenagers, the U.S. Preventive Services Task Force said Tuesday. But despite a growing mental health crisis among children of all ages, the group said it could not find enough scientific evidence to support regular screening for anxiety among children younger than 8 years old or screening for depression in kids under 12. What's more, the influential panel of doctors and scientists was unable to find evidence to support screening tools that look for suicidal thoughts in children of any age. “We do not have the evidence to tell us whether or not it's beneficial to screen younger children for depression and anxiety and all youth for suicide risk," USPSTF member Lori Pbert, a clinical psychologist and behavioral scientist, said in a statement. “More research on these important conditions is critical." Indeed, mental health screening itself may not be enough to combat these issues, said Julie Cerel, a licensed psychologist and director of the Suicide Prevention and Exposure Lab at the University of Kentucky. She is not a USPSTF member. One problem with screening, she said, “is that people feel like it rules out the possibility of future issues. You've screened negative, so we don't have to worry about it." Cerel said in reality, symptoms of depression and anxiety can change quickly. “Just because a teen passes a depression screening does not mean the adults around them should not get them help if they see extreme changes in mood or behavior," she said. Today External Link

    USAFRICOM

    Botswana detects new Covid Omicron sub-variant

    12 April- The Botswana health ministry says it has detected a new lineage of the Covid-19 Omicron variant. The infected are currently being monitored to establish more information on the potential impact of the disease and its severity. The new sub-variant, designated as Omicron BA.4 and BA.5 has already been detected in three other countries and on four people in Botswana. The four people were fully vaccinated and had been experiencing mild symptoms. So far, no conclusions have been made to establish whether this sub-variant is more transmittable than the known Omicron variant. This happens as the World Health Organization announces it is tracking a few dozen cases of the two new sub-variants of the highly transmissible Omicron strain to assess whether they are more infectious or dangerous. BBC External Link

    USCENTCOM

    Iran reports scores of measles cases, Blamed on the influx of Afghan refugees

    6 April- According to the Iran Front Page, Iran's deputy health minister says 164 measles cases have been detected in the country blaming it on the influx of Afghan refugees into Iran. Kamal Heidari said the entry of Afghan nationals into Iran and their presence in different cities have caused concern and cases of measles have been reported in those areas. Heidari said the outbreak is threatening the efforts of Iran to contain measles, adding that a vaccination plan must be put in place for foreigners to boost the level of inoculation against the disease. Afghanistan has been experiencing a measles resurgence that started at the beginning of 2021. From January 2021 to 13 March 2022, there have been 48,366 cases and 250 deaths. In 2022 alone, there have been over 18,000 cases and 142 children have died of measles in the country. The low routine measles immunization coverage of 66% and a longer interval since the measles follow-up campaign in 2018 have resulted in accumulation of the high number of children aged less than 5 years old with no measles immunization. Measles is an extremely contagious viral disease. Unvaccinated young children are at highest risk. Severe measles is more likely among poorly nourished young children, especially those with insufficient vitamin A, or those whose immune systems have been weakened by other diseases. The best way to protect people – especially children – from measles is to strengthen routine immunization to ensure that at least 95% of the population has received 2 doses of the vaccine. Outbreak News Today External Link

    USEUCOM

    Ukraine presses for more weapons

    10 April- Russian forces bombarded several towns in eastern Ukraine on Sunday, destroying an airport and damaging several civilian targets, as the war careens toward a pivotal new phase. The shift of the war and fears of full-scale military confrontation on open terrain prompted Ukrainian officials to again call for Western alliances to step up weapons supply efforts to strengthen Ukraine's position on the battlefield. Ukraine is preparing for a “massive attack in the east," its ambassador to the United States, Oksana Markarova, warned Sunday on CBS's “Face the Nation." Of the Russian forces, she said: “There are so many of them and they still have so much equipment. And it looks like they're going to use all of it. So we are preparing for everything." Military analysts have been predicting the movement of the war toward the eastern border that Ukraine shares with Russia in an area known as Donbas. The energy-rich region includes territory where pro-Russian forces have been battling the Kyiv government since 2014. Ukraine's foreign minister, Dmytro Kuleba, cautioned that although leaders have been trumpeting success in driving Russian forces out of Kyiv, “Another battle is coming, the battle for Donbas," he said Sunday on NBC's “Meet the Press." The expected Russian offensive could resemble World War II, Kuleba recently told NATO, with large military maneuvers involving thousands of tanks, armored vehicles, artillery and aircraft. With the atrocities mounting in Ukraine, calls have grown to provide the country with offensive weapons that would allow forces to strike inside Russia. Several foreign allies, including the United Kingdom, have pledged new weapons shipments in recent days to help Ukraine in what is expected to be a tougher battle ahead.  Ukrainian President Volodymyr Zelensky on CBS's “60 Minutes" again called on Western countries to step up in providing arms. “They have to supply weapons to Ukraine as if they were defending themselves and their own people," he said in an interview recorded Wednesday and broadcast Sunday. “If they don't speed up, it will be very hard for us to hold on against this pressure." Washington Post External Link

    USINDOPACOM

    Why Shanghai has done a U-turn on its 'relaxed' Covid approach

    11 April- Some 25 million people in Shanghai are in the second week of a strict lockdown, after a surge in Omicron cases. It's the first time Shanghai has imposed such strict restrictions - until last month, it had taken a more relaxed approach than other Chinese cities. People in the city are confined to their homes, and most have to order in food and water and wait for government drop-offs of vegetables, meat and eggs. Videos shared on social media show complaints by angry residents about food shortages and inadequate medical supplies. It's Shanghai's first experience of a city-wide lockdown. Up till last month, it had tackled growing infection rates through smaller localized lockdowns. This typically meant individual residential complexes, each housing several hundred people, were locked down - instead of the entire city. And for a while, it looked like this method was working. Even when case numbers rose to nearly 1,800 in March 2021, Shanghai did not impose a full lockdown. By comparison, Xi'an, which is home to nearly 13 million people, sealed the entire city after less than 100 cases in December 2021. The city of Yuzhou, in Henan province, locked over 1.1 million people at home due to just three Covid cases. BBC News External Link

    USNORTHCOM

    Covid could be surging in the U.S. right now and we might not even know it

    10 April- The rise of Covid cases in some regions of the U.S., just as testing efforts wane, has raised the specter that the next major wave of the virus may be difficult to detect. In fact, the country could be in the midst of a surge right now and we might not even know it. Testing and viral sequencing are critical to responding quickly to new outbreaks of Covid. And yet, as the country tries to move on from the pandemic, demand for lab-based testing has declined and federal funding priorities have shifted. The change has forced some testing centers to shutter while others have hiked up prices in response to the end of government-subsidized testing programs.  People are increasingly relying on at-home rapid tests if they decide to test at all. But those results are rarely reported, giving public health officials little insight into how widespread the virus truly is.  “There's always more spread than we can detect," said Abraar Karan, an infectious disease physician at Stanford University.  “That's true even more so now than earlier in the pandemic." Despite groundbreaking scientific advances like vaccines and antivirals, public health experts say the U.S.'s Covid defenses appear to be getting weaker as time goes on, not stronger. "We're in a worse position," said Julia Raifman, an assistant professor of health law, policy and management at Boston University School of Public Health. "We've learned more about the virus and how to address it, and then we haven't done what we need to do to address it." Bloomberg External Link

    USSOUTHCOM

    Brazil: Leptospirosis cases rise in Petrópolis, Rio de Janeiro state

    12 April- Heavy rains in Petrópolis (Rio de Janeiro) in February has caused cases of leptospirosis to rise dramatically, according to the State Secretary of Health (SES). In the first three months of the year, Petrópolis registered 99 probable cases of the disease, compared to only three notifications in the same period last year. With the storms of recent days, the Prefecture issued an alert for the possibility of new cases of the disease. People who have had contact with water or mud from floods and who have a fever associated with headaches or muscle aches should go to a health unit, reinforced the SES. “It is very important that the population seek medical attention immediately if they present symptoms compatible with the disease. Health services must also pay attention to the inclusion of leptospirosis in clinical suspicion and differential diagnosis of cases suspected of dengue and chikungunya fever. Historically, notification of leptospirosis increases after the rainy seasons", said the Secretary of State for Health, Alexandre Otavio Chieppe. Outbreak News Today External Link