Army Public Health Weekly Update, 21 August 2020

Date Published: 8/21/2020
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​The Army Public Health Update is a collection of articles taken from public sources to offer awareness of current health issues and the media coverage given to them. The articles do not necessarily represent U.S. Army Medical Command opinions, views, policy, or guidance, and should not be construed or interpreted as being endorsed by the U.S. Army Medical Command.

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

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Table of Contents

    ANNOUNCMENTS

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    U.S. MILITARY

    Defeat shelter fatigue with these strategies

    13 August- When will the COVID-19 pandemic end? Since March, many Soldiers and Civilians have been practicing social distancing and wearing masks when they go out to purchase essential goods. At this point, some people may feel like they are ready to get out there and start participating in the activities they enjoyed prior to COVID-19, such as traveling, attending barbeques with friends, or going to concerts, without taking any special precautions. This temptation to relax adherence to public health guidelines is called shelter fatigue – and it's real. People may feel impatient with the rules and restrictions of the pandemic. Even if those rules and restrictions were designed to protect individuals and their community, feeling this kind of "shelter" fatigue is understandable. Studies of prolonged isolation show environmental conditions can have an impact on your psychological and physical health. When people live in a confined space or don't have access to in-person social connections, they may feel disengaged and their stress levels rise. Even not being able to engage in daily habits like going to the gym or to the workplace may increase stress and fuel a sense of "shelter" fatigue. Yet as tempting as it is to return to life as it was, the reality is that the pandemic hasn't waned enough to let us relax our guard. Public health experts warn about the dangers of being complacent, but there are things you can do to help reduce your stress and reduce "shelter fatigue" so that you can stay vigilant and continue to do your part in the battle against COVID-19. Army.mil External Link

    DoD mental health care programs leave thousands of families in need, IG finds

    14 August- More than 4,000 active-duty troops and family members who need outpatient mental health care each month aren't getting it, and the Defense Department's Military Health System (MHS) can't come up with an explanation, the Defense Department's Inspector General said in a scathing report. "An average of 53% (4,415 of 8,328 per month) of all active-duty service members and their families, identified as needing mental health care and referred to the [Tricare] purchased care system, did not receive care and the MHS did not know why," according to the report, released Wednesday.  In addition, seven of 13 military treatment facilities (hospitals and clinics) and their supporting Tricare network programs "did not meet the specialty mental health access to care standard each month," the report states. Overall, "We determined that the DoD did not consistently meet outpatient mental health access to care standards for active-duty service members and their families, in accordance with law and applicable DoD policies," it adds. "This happened because the Defense Health Agency [DHA] lacked a Military Health System-wide model to identify appropriate levels of staffing … published inconsistent and unclear mental health care policies, and did not have visibility of patients who had attempted but failed to obtain mental health appointments," the report states. "As a result, thousands of active-duty service members and their families may have experienced delays in obtaining mental health care, which increase the risk of jeopardizing patient safety and affecting the readiness of the force."  The IG recommended that the DHA develop a single, system wide model "to identify appropriate staffing levels, update and clarify DoD and DHA policies, develop a method to book patient appointments in the purchased care system, and develop standardized mental health access to care measures." In response, Army Lt. Gen. Ronald Place, the DHA director, agreed with the IG's recommendations on staffing, measuring access and treatment outcomes, and developing centralized appointment and booking procedures. In a letter to the IG, Place disagreed with a recommendation to track the reasons for mental health referrals, saying it "would require invasive questioning of beneficiaries, which could increase stigma and reluctance to seek needed care." Military.com External Link

    DoD warns troops not to catch fire from hand sanitizers

    14 August- To help prevent the spread of COVID-19, officials say you should wash your hands frequently, using hand sanitizer if necessary. Just try not to catch fire. Even as officials urge troops and their families to take precautions against the novel coronavirus, they warn that hand sanitizers are flammable and should be stored appropriately. The Safety Office at Fort Jackson, South Carolina, issued a warning Aug. 11, illustrating the dangers of alcohol-based sanitizers.  "An employee at the Department of Energy Federal Contractors Group used an alcohol-based hand sanitizer, as advised by hygiene recommendations. Shortly after the application to his hands, but before the liquid disinfectant had evaporated and completely dried, the employee touched a metal surface which [had] accumulated a static electrical charge, resulting in an ignition source. The ethyl-alcohol based disinfectant flashed, resulting in an almost invisible blue flame on both hands," states a Federal Drug Administration bulletin distributed by the safety office. "We can never be too cautious. Please exercise vigilance when using these gel sanitizers to ensure it is completely evaporated before touching any metal object and/or other items that often harbor static electricity," said Ron Ross, safety manager with Fort Jackson's Installation Safety Office. The Centers for Disease Control and Prevention recommends using hand sanitizers containing at least 60% ethanol or ethyl alcohol. Military.com External Link

    On the frontlines against COVID: Veterinary food inspection specialist

    18 August- Spc. Monesha Burton plays a key role in the Army Health System's fight against COVID-19. Burton, a veterinary food inspection specialist, spends her days inspecting food facilities throughout the Kaiserslautern military community. "I already knew the importance of my job," said Burton. "But COVID-19 has really put an emphasis on how important my job is and that I need to do it thoroughly and make sure facilities are following guidelines." Burton jokingly added that while mask usage has become the standard due to coronavirus, it's always been part of the job for her. "It's the norm for us to basically suit-up before an inspection." Burton, originally from Hammond, Louisiana, joined the Army because of family. "My dad, uncle and cousins have all served," said Burton. "I was inspired by everything they did. Right now, I plan on doing twenty years." Veterinary food inspection specialists play a crucial role in keeping the food for Department of Defense personnel and their families' safe through inspections and testing of all consumable products used by the military. They are responsible for ensuring all food is safe for human consumption by evaluating packaging, packing and marking requirements, identifying unsanitary conditions in food storage facilities and commissary stores, evaluating vendor supply contracts and deliveries to ensure compliance, and operating and maintaining inspection equipment. "What I enjoy most about my job is being able to help people by making sure they have a credible source for their food," said Burton. "My job is food defense and food safety."  Public Health Command Europe is responsible for providing comprehensive military public health programs in support of garrisons, training areas, and contingency/combat forces operating in the U.S. European Command, U.S. Central Command, and U.S. Africa Command areas of operation to sustain force health protection and readiness. Those programs include medical entomology, environmental health engineering, food and water sanitation, veterinary care, industrial hygiene and occupational health, and preventive medicine readiness planning and training. Regional Health Command Europe is responsible for the health care, public health, dental and veterinary services for Soldiers, their families and Department of Defense beneficiaries throughout Europe. Army.mil External Link

    GLOBAL

    Coronavirus: Spanish regions ban smoking over Covid-19 risk

    13 August- The Spanish region of Galicia has effectively banned smoking in public places over concerns it increases the risk of Covid-19 transmission.
    It issued a blanket ban on smoking in the street and in public places, such as restaurants and bars, if social distancing is not possible. The north-western region is the first to introduce such a measure, but the Canary Islands has since followed suit. It comes as Spain faces the worst infection rate in western Europe.
    Daily cases have risen from fewer than 150 in June to more than 1,500 throughout August. It recorded 1,690 new cases in the latest daily count on Wednesday, bringing the country's total to almost 330,000. Galicia's smoking ban was announced in a news conference on Wednesday after experts recommended the measure to the regional government. The move is supported by health ministry research, published last month, that outlined the link between smoking and the increased spread of coronavirus. It said the risk was heightened because people project droplets - and potentially Covid-19 - when they exhale smoke.
    It also said smokers risked infection in other ways, such as by touching their cigarette before bringing it to their mouth and by handling face masks when taking them on and off. The research also pointed to the wider negative health effects of smoking. "It has been proven that tobacco use, in any of its forms, worsens the course of respiratory diseases," it said. BBC News External Link

    COVID-19: An opportunity to improve infection prevention and control in LMICs

    13 August-  We congratulate Paul Sonenthal and colleagues (July 2020) for the timely assessment of COVID-19 preparedness in Malawi. The authors highlight clear gaps in infection prevention and control, including the availability of personal protective equipment, but cautiously suggest that these findings might not be generalizable to other low-income and middle-income countries. We did detailed surveys before the COVID-19 pandemic to evaluate water sanitation and hygiene, and infection prevention and control preparedness at 14 Kenyan public hospitals. From the surveys, we noted that, even for these large facilities, there were challenges in providing adequately treated water. Additionally, there were scarce resources available to install new hand hygiene and waste disposal structures, especially in locations where they were absent. We found that the responsibility for water sanitation and hygiene, and infection prevention and control in hospitals is often poorly defined. Working with stakeholders, we developed a framework to assign responsibility to specific groups within the hospital and regional governments on the basis of their capacity for action. This framework allowed us to identify the specific groups who were best placed to tackle the problems we had highlighted. One of the important groups identified was the hospital's infection prevention and control committee. Our prepandemic survey suggested that these committees were inactive and poorly constituted. The low status and awareness of infection prevention and control in the hospitals contributed to these committees being largely dormant. However, from our interviews with health-care workers done during the COVID-19 pandemic in April, 2020, we found that these infection prevention and control committees are playing a crucial role in training medical staff on personal protective equipment use and infection prevention and control procedures (Maina M, unpublished). The Lancet External Link

    Dementia patients often get psychotropic drugs, opioids

    18 August- Psychotropic drugs and opioids were prescribed frequently to adults with dementia, an analysis of community-dwelling Medicare beneficiaries showed. Nearly 75% of older adults with dementia had at least one prescription for a central nervous system (CNS)-active medication -- antidepressant, opioid painkiller, epilepsy drug, anxiety medication, or antipsychotic drug -- filled in a 1-year period, reported Donovan Maust, MD, MS, of the University of Michigan in Ann Arbor, and co-authors in JAMANone of these drugs are approved in the U.S. to treat dementia or its behavioral symptoms and all are associated with adverse events among older adults, including falls, sedation, and increased risk of death, the researchers noted. "There has been a lot of research and regulatory attention on use of these medications for patients with dementia in long-term care settings, but their use in the community has been a real blind spot," Maust told MedPage Today. "We find that use is basically just as high as in long-term care and far exceeds the evidence base supporting use for patients with dementia." "This is an important research letter that highlights an under-recognized problem," said Jennifer Watt, MD, PhD, of the University of Toronto, who was not involved with the study. "Like persons with dementia living in nursing homes, older adults with dementia living in community settings are commonly prescribed medications for which we don't have strong evidence of benefit and we have growing evidence of potential harm," she told MedPage Today. MedPage Today External Link

    Depression doubles during coronavirus pandemic

    18 August- Twice as many adults in Britain are reporting symptoms of depression now compared with this time last year, Office for National Statistics figures suggest. One in five people appeared to have depressive symptoms compared with one in ten before the pandemic. The conclusions are based on a survey of more than 3,500 adults followed up over a 12-month period. They were asked the standard set of questions used to assess depression. People were asked to consider the previous two weeks and say how often they had experienced a range of symptoms, including changes in sleep or appetite, a loss of interest and pleasure in doing things, and difficulty concentrating. Almost 20% of people met the criteria for depression, based on their responses, in June 2020 compared with just under 10% between July 2019 and March 2020. While the measure of depression used is a well-known screening questionnaire though, Prof Elaine Fox at the University of Oxford, said: "It is important to remember that this does not give a diagnosis but rather an indication of everyday depressive feelings and behaviors". BBC News External Link 

    Fearing a 'twindemic,' health experts push urgently for flu shots

    16 August- As public health officials look to fall and winter, the specter of a new surge of Covid-19 gives them chills. But there is a scenario they dread even more: a severe flu season, resulting in a "twindemic." Even a mild flu season could stagger hospitals already coping with Covid-19 cases. And though officials don't know yet what degree of severity to anticipate this year, they are worried large numbers of people could forgo flu shots, increasing the risk of widespread outbreaks. The concern about a twindemic is so great that officials around the world are pushing the flu shot even before it becomes available in clinics and doctors' offices. Dr. Robert Redfield, director of the U.S. Centers for Disease Control and Prevention has been talking it up, urging corporate leaders to figure out ways to inoculate employees. The C.D.C. usually purchases 500,000 doses for uninsured adults but this year ordered an additional 9.3 million doses. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, has been imploring people to get the flu shot, "so that you could at least blunt the effect of one of those two potential respiratory infections." The New York Times External Link

    Instead of lockdowns, teach people how to socialize safely in the time of coronavirus

    13 August- In response to the rising Covid-19 death toll and case counts in the U.S., calls for a national lockdown have been escalating. In an open letter to America's decision-makers, more than 150 medical professionals urge them to "shut it down now, and start over." In the letter, they argue that people should "stay home, going out only to get food and medicine or to exercise and get fresh air." I empathize with the urgency in their plea for people to stay home. I felt helpless watching patient after patient die from Covid-19 while working in a New York hospital in April. In the Northern California Covid-19 clinic I work in, I continue to see patients infected with and harmed by the virus. I, too, am desperate for this pandemic to end. But I believe that telling people to stay home and avoid all nonessential social interactions is the wrong way forward. We should instead focus on educating people and helping them socialize safely. Lessons from sex education indicate that this will be a more effective approach. STAT News External Link 

    More evidence heartburn drug may help COVID-19 patients

    17 August- More data from observational studies, this time in hospitalized patients, indicated that famotidine (Pepcid AC), which is used to treat heartburn, was associated with improved clinical outcomes in COVID-19 patients. Use of famotidine in a small group of 83 patients was associated with a lower risk of in-hospital mortality and a combined outcome of death and intubation, reported Jeffrey Mather, MS, of Hartford Hospital in Connecticut, and colleagues. Moreover, famotidine use was also associated with lower levels of serum markers indicating severe disease, the authors wrote in the American Journal of Gastroenterology. Famotidine is a histamine-2 receptor antagonist. The authors noted the mechanism by which famotidine might improve COVID-19 outcomes is currently unknown, but hypothesized it might work via "inverse-agonism" of the histamine-2 receptor, which implies SARS-CoV-2 is "at least partially mediated by pathological histamine release," the authors said. The drug was tied to significant reductions in in-hospital death and a combined death and intubation outcome in hospitalized patients in China, as well as an improvement in symptoms in a small case series of non-hospitalized patients, mostly in the U.S. Researchers performed a propensity-matched analysis using electronic data from patients testing positive for SARS-CoV-2 from February 24 to May 13 in a single medical center. "Use of famotidine" was defined as either oral or intravenous famotidine, at any dose, within 7 days of COVID-19 screening and/or hospital admission. MedPage Today External Link

    Researchers discover microplastic trapped in human organs: Liver, lungs, and spleen

    17 August- United States (U.S.) scientists found microplastic and nano plastic particles trapped in human organs such as samples of liver, lungs, spleen, kidneys. They added that about 47 human organs contained tiny plastics. Earth has been dramatically affected by microplastic pollution. The Alpine soils, Arctic snow, and even the deepest oceans are polluted by the human-made plastics, which carry harmful microbes and toxic chemicals that harm marine mammals and other sea creatures. Animals are not the only ones affected by the pollutants; even humans are in danger since it can be consumed through breathing, eating, and drinking water. However, there are currently no studies that explain the impact of plastic pollutants on human health. The researchers acquired the human organ samples from a tissue bank, which was built to study neurodegenerative diseases. They identified a dozen types of plastic, including the polyethylene used in plastic bags and polyethylene terephthalate (PET) used in plastic drinks bottles. Tech Times External Link

    Study finds no race difference in COVID-19 hospital deaths

    18 August- After adjusting for sociodemographic factors and underlying conditions, black COVID-19 patients were no more likely than white patients to die of any cause in hospitals, a retrospective study published today in JAMA Network Open has found. Researchers at Ascension Health in St. Louis analyzed data from 11,210 adults with COVID-19 in 92 hospitals in 12 states from Feb 19 to May 31. The death rate from any cause was 23.1% in white patients and 19.2% in black patients. After adjusting for age, sex, insurance, underlying conditions, neighborhood deprivation, and site of care, the risk of death was not significantly different between blacks and whites (hazard ratio [HR], 0.93; 95% confidence interval [CI], 0.80 to 1.09). CIDRAP External Link 

    INFLUENZA

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

    2019-2020 Influenza Season Week 32, ending August 8, 2020:

    Influenza-Associated Hospitalizations: The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts all age population-based surveillance for laboratory-confirmed influenza-related hospitalizations in select counties in the Emerging Infections Program (EIP) states and Influenza Hospitalization Surveillance Project (IHSP) states.

    Pneumonia and Influenza (P&I) Mortality Surveillance: Based on National Center for Health Statistics (NCHS) mortality surveillance data available on August 13, 2020, 6.2% of the deaths occurring during the week ending August 8, 2020 (week 32) were due to P&I. This percentage is above the epidemic threshold of 5.5% for week 32.

    Influenza-Associated Pediatric Mortality: No influenza-associated pediatric deaths occurring during the 2019-2020 season were reported to CDC during week 32. CDC External Link 

    VETERINARY/FOOD SAFETY

    200,000 pounds of meat, poultry products recalled over undeclared allergens

    13 August- Some 200,000 pounds of meat and poultry products are facing recall because they contain undeclared — and for some, possibly life-threatening — allergens. The U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) on Monday announced the recall of meat and poultry products from Las Vegas, Nev.-based company Mr. Wok Foods, Inc. because the products are said to contain undeclared allergens including milk, wheat, soy, peanuts, or oysters. "The problem was discovered by FSIS in-plant personnel during routine label reviews, when they found that one or more allergens were not listed on labels for various products," according to the FSIS, which noted that no adverse reactions associated with the recalled products have been reported to date. The frozen meat and poultry items were produced from Aug. 6, 2019, through Aug. 6, 2020. The products bear establishment number "EST. 20783" or "P-20783" inside the USDA mark of inspection. Fox News External Link

    Farms growing red cabbage and iceberg lettuce for Fresh Express are suspects in Cyclospora outbreak

    14 August- A  traceback investigation by the Food and Drug Administration (FDA) has identified several farms in the U.S. that may have provided products used in the Fresh Express salads that were recalled over Cyclospora. Multiple farms in Florida were identified in the FDA traceback. FDA analyzed water samples from two public access points along a regional water management canal (C-23), located west of Port St. Lucie, Florida. These samples tested positive for Cyclospora cayetanensis using FDA's validated testing method. Given the emerging nature of genetic typing methodologies for this parasite, the FDA was unable to determine if the Cyclospora detected in the canal is a genetic match to the clinical cases, therefore, there is currently not enough evidence to conclusively determine the cause of this outbreak. Nevertheless, the current state of the investigation helps advance what the FDA knows about the Cyclospora outbreak and offers important clues to inform future preventive measures. FDA is working with the state of Florida and the local water district in the area to try to further determine the source and impact of Cyclospora in the canal. As of August 14, 2020, CDC is reporting a total of 690 cases across 13 states. Food Safety News External Link

    WELLNESS

    Biking your way to better health: How to reboot your workout routine

    17 August-  If you've been following along, we're well into the reboot of your workout routine. If you're just joining now, take a moment to review how we've set the foundation for establishing a sustainable exercise habit, mastered how to move properly and learned how to use free weights to increase strength and boost our metabolism. And last week in Part IV, we covered why and how to add cardiovascular exercise into your workouts. Cycling is also cardio, but, due to its popularity, I wanted to give it special attention. During lockdown, both indoor and outdoor bike purchases rose dramatically, and for good reason. Cycling offers all the mental and physical health benefits of other forms of cardio, including weight loss, without many disadvantages. Remember, in the last article, we talked about how too much long-distance running can lead to muscle loss and decrease in bone density? Comparatively, biking burns the same number of calories as running without diminishing returns. That said, the rounded posture and repetitive pedaling motion of cycling can create tension in your back and hips that, over time, can lead to chronic issues if not adequately addressed. Utilizing the right exercises in your overall training, which I share below, can counteract the potential for bike-related aches and pains. CNN External Link

    USAFRICOM

    Ebola outbreak: New cases reported in Lotumbe and Monieka health zones

    15 August- Officials with the UN Office for the Coordination of Humanitarian Affairs (OCHA) reported (computer translated) two new confirmed cases of Ebola Virus Disease (EVD) on August 13 in the health zones of Lotumbe and Monieka in Equateur province, Democratic Republic of the Congo (DRC).  This brings the outbreak total to 88 cases reported (including 84 confirmed and 4 probable) and the death toll remains at 36. The number of health zones affected by the outbreak is now up to 10. The current EVD outbreak, the country's 11th, began at the beginning of June 2020. Outbreak News Today External Link

    USCENTCOM

    Coronavirus: Iran's death toll goes past 20,000

    19 August- Iran's death toll from the new coronavirus has surpassed 20,000 with 153 deaths in the past 24 hours, according to the country's health ministry. Iran is one of the worst-hit countries from the outbreak in the Middle East. "The death toll has reached 20,125 ... with 2,444 new infections in the past 24 hours, the total number of cases has reached 350,279," ministry spokesperson Sima Sadat Lari said on Wednesday. The announcement came as Iran, which has been struggling with both the region's largest outbreak and the highest number of related deaths, went ahead with university entrance exams for more than one million students. Iran is also preparing for mass Shia commemorations later this month when the Islamic new year begins. Iran suffered the region's first major outbreak, seeing top politicians, health officials and religious leaders in the country diagnosed with the virus. Al Jazeera External Link

    USEUCOM

    Finland reports increase in COVID-19, Face masks recommended

    16 August- The Finnish Institute for Health and Welfare (THL) reported that the number and incidence of new coronavirus infections has clearly increased compared to the low figures at the beginning of July. Despite the increase, officials say the number of cases remains relatively small at national level.  The increased number of new cases is most evident in Helsinki and the Uusimaa region. During the latest period (3–9 August 2020), a total of 139 new cases were reported to the communicable diseases register. In the previous week (27 July–2 August 2020) the number of reported cases was 81. In the weeks before, the numbers were smaller than this. Currently, the estimated basic reproduction number is 1.20-1.60, with a 90 per cent probability. The incidence of new cases during week 32 was 2.5 per 100,000 inhabitants. The incidence of new cases in the two-week period (weeks 31–32, 27 July–9 August) was 4.0 per 100,000 inhabitants and in the preceding two-week period (weeks 29–30, 13–26 July) it was 1.8 per 100,000 inhabitants. On Aug. 16,  the total number of cases in Finland was 7731, including 333 deaths.  It is estimated that over 90 per cent of all confirmed cases have recovered from the disease. Outbreak News Today External Link

    USINDOPACOM

    COVID-19: New Zealand- Cluster rises to 35, Auckland lockdown extended

    15 August- In a follow-up on the COVID-19 situation in New Zealand, the Ministry of Health reported seven new confirmed cases of COVID-19 to report in the community today. Six are already linked to previous cases in the cluster, and one remains under investigation. This adds to the case from yesterday which also remains under investigation to firmly establish the link to the current outbreak. To date, 54 people linked to the cluster have now been moved into a quarantine facility, including 24 people who have tested positive. The seven new confirmed cases to report today brings the total number of confirmed cases to 1,258 which is the number we report to the World Health Organization. The total number of active cases in New Zealand is 56, of which 37 are from the recent community outbreak, and 19 are imported cases in managed isolation and quarantine facilities. Of the 37 cases, 35 are linked to the cluster, and two remain under investigation, but are believed to be linked to the same cluster. Outbreak News Today External Link

    COVID-19: Philippines reports 3,314 new cases, Center for Emerging and Re-emerging Infectious Disease unveiled

    17 August- Philippines health officials reported Monday that 3,314 new COVID-19 cases were recorded, bringing the total in the country to 164,474. The bulk of the new cases were reported from the Metro Manila area (1,918), followed by Laguna with 274 cases, Cavite with 219 cases, Rizal with 118 cases and Bulacan with 105 cases. 18 additional deaths were recorded, bringing the total to 2,681. In addition, the Department of Health (DOH) and the East Avenue Medical Center (EAMC) today unveiled the six-story Center for Emerging and Re-emerging Infectious Disease (CERID) to address the need to manage severe and critical cases of COVID-19 in Metro Manila. According to EAMC Medical Center Chief Dr. Alfonso Nuñez, the CERID will have its own independent Emergency Room that can accommodate up to 40 patients. It will also have its own Operating Room plus Labor and Delivery Room to cater to COVID19 patients that need to be treated for other medical conditions. Moreover, it will also have two Intensive Care Units (ICU) that can accommodate up to 30 critical patients, equipped with 8 – 10 Hemodialysis units. Ward type rooms and isolation rooms are available to ensure that these patients meet the minimum health standards to prevent further spread of the infection. The new building will also have an infirmary to cater to the needs of the Health Care Workers who may inadvertently contract the disease. CERID was constructed with the help and support of the Inter-Agency Task Force, headed by Health Secretary Francisco T. Duque III, the National Implementation Task Force, headed by Secretary Carlito Galvez, and COVID-19 treatment czar Health Undersecretary Leopoldo Vega. Outbreak News Today External Link

    USNORTHCOM

    U.S. : Eastern Equine Encephalitis- Massachusetts reports 2nd human case, Connecticut reports 1st positive mosquitoes

    16 August- State health officials confirmed the second human case of Eastern Equine Encephalitis (EEE) virus infection in a female in her 60s who was exposed to EEE in Hampden County. As a result, the EEE risk level in Wilbraham has been raised to critical, and the EEE risk level in Hampden and Monson has been raised to high. Across the Commonwealth, three municipalities are at critical risk critical, eight are at high risk, and 20 are at moderate risk for EEE. All residents are reminded to use mosquito repellent any time they are outside, and those in high and critical risk communities are advised to schedule their outdoor activity to avoid the dusk to dawn hours to reduce exposure to the mosquitoes most likely to spread EEE. EEE is a rare but potentially fatal disease that can affect people of all ages. There has already been one other human case identified this year. In 2019, there were 12 human cases of EEE in Massachusetts with 6 deaths. Outbreak News Today External Link

    U.S.: Florida- Dengue fever and West Nile virus updates

    18 August- In an update on the dengue fever situation in the Florida Keys, the Florida Department of Health in Monroe County reported three additional cases that were identified through retrospective case finding efforts. State health officials now report 46 locally acquired dengue fever cases (45 for Monroe County and 1 for Miami-Dade County).

    West Nile virus: The Florida Department of Health in Miami-Dade County reported two additional two asymptomatic West Nile virus (WNV)-positive blood donors. In Palm Beach County, health authorities reported one neurologic case of WNV infection. Statewide, there are now a total of 35 WNV infections in 2020 (33 with exposures in Miami-Dade County and two with exposures in Palm Beach County). Nine were symptomatic cases and 26 were asymptomatic blood donors. Outbreak News Today External Link

    U.S.: Plague in California- 1st human case reported in 5 years

    17 August- El Dorado County health officials have been notified by the California Department of Public Health (CDPH) that a South Lake Tahoe resident has tested positive for plague. The individual is currently under the care of a medical professional and is recovering at home. It's believed that the person, an avid walker, may have been bitten by an infected flea while walking their dog along the Truckee River Corridor north of Highway 50 or the Tahoe Keys area in South Lake Tahoe. Health officials are investigating the situation. According to El Dorado County Public Health Officer, Dr. Nancy Williams, "Plague is naturally present in many parts of California, including higher elevation areas of El Dorado County. It's important that individuals take precautions for themselves and their pets when outdoors, especially while walking, hiking and/or camping in areas where wild rodents are present.  Human cases of plague are extremely rare but can be very serious." Several areas of South Lake Tahoe have signs posted to advise the public of the presence of plague and ways to prevent exposure. Plague is caused by the bacterium, Yersinia pestis. Plague bacteria are most often transmitted by the bites of fleas that have acquired the bacteria from infected squirrels, chipmunks and other wild rodents. Dogs and cats may also bring plague-infected fleas into the home. People can get plague when they are bitten by infected fleas. Plague can be prevented by avoiding contact with wild rodents, and by keeping pets away from rodent burrows. Symptoms of plague usually show up within two weeks of exposure to an infected animal or flea and include fever, nausea, weakness and swollen lymph nodes. Plague can be effectively treated with antibiotics if detected early. CDPH routinely monitors rodent populations for plague activity in California and closely coordinates with county health officials. Surveillance activities in El Dorado County from 2016 to 2019 found a total of 20 rodents (ground squirrels or chipmunks) with evidence of exposure to the plague bacterium. These rodents were identified in the South Lake Tahoe area, at or near the Tallac Historic Site, Fallen Leaf Campground and/or Taylor Creek Visitor Center. There were no recent reports of plague-associated illness to people in El Dorado County prior to the current case. The last reported cases of plague in California were two human cases which were exposed to infected rodents or their fleas in Yosemite National Park in 2015. Both people were treated and recovered. These were the first reported human cases in the state since 2006. Outbreak News Today External Link

    USSOUTHCOM

    Colombia: COVID-19 cases now 489K, Bogotá's El Dorado airport is scheduled to officially reopen

    19 August- The Colombia Ministerio de Salud y Protección Social that the outbreak of COVID-19 in the country has reached 489,122 confirmed cases since the pandemic reached the country in Bogotá in March. 12,462 cases were reported on Tuesday and officials say the death numbers decreased for the third consecutive day with 247 reported. This is much lower than the high of 380 fatalities reported in late July. Bogotá has seen the most cases in this pandemic with 171,312, followed by Antioquia with 64,679. The improvement in conditions has prompted the Colombian government to reopen flights at Bogotá's El Dorado airport, which has been closed for some 5 months. The country's civil aviation authority presented the government of President Iván Duque 14 domestic routes ready to resume operations. The destinations with direct flights to Bogotá are Rionegro, Medellín, Cali, Bucaramanga, Barranquilla, Cartagena, Santa Marta, Monteria, Pereira, Cucuta, Pasto, Villavicencio and San Andrés. Outbreak News Today External Link

    Paraguay reports most dengue cases in it's history, COVID-19 pandemic has complicated the situation

    14 August- In 2020, Paraguay has reported 220,050 dengue fever cases and 73 deaths, the highest number of cases in its history, with the cities of Asunción, Mariano, Roque Alonzo and Capiatá most affected.  Since the beginning of the year, a number of actions have been taken to battle the mosquito borne emergency. And then came COVID-19. The Paraguayan Red Cross says the COVID-19 pandemic has complicated the dengue work. "Due to mobility restrictions and social distancing measures, we were unable to continue with the activities we were carrying out in the communities," said Magali Paredes, Health Officer for Dengue and COVID-19 of the Paraguayan Red Cross. Much of the work with the community was done through community meetings, where workshops were used to share information. One of the most important tasks was the creation of community brigades to work on the prevention and response to dengue outbreaks at the local level. Some of the families living in affected areas work in garbage recycling. Many of the recycled items are stored by people in their backyards or in places close to where they live. This is where rainwater collects and where mosquito breeding takes place. Because of this direct link to people's ability to have income, the Red Cross projects were aimed at informing and training community members on how to prevent the spread of mosquito larvae without affecting economic activity. "We felt that there was always an important involvement and interest from community members because they knew that we are aware of this and that we want to work with them to find solutions," said Magali. Outbreak News Today External Link