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Millions of Children Are at Risk for Measles as Coronavirus Fears Halt Vaccines Millions of Children Are at Risk for Measles as Coronavirus Fears Halt Vaccines
(3 days later)
More than 100 million children could be at risk for measles because countries around the world are suspending national immunization programs in order to reduce the risk of coronavirus infection, international public health leaders warned on Monday.More than 100 million children could be at risk for measles because countries around the world are suspending national immunization programs in order to reduce the risk of coronavirus infection, international public health leaders warned on Monday.
So far, 24 low- and middle-income countries, including Mexico, Nigeria and Cambodia, have paused or postponed such programs, according to the Measles and Rubella Initiative, a consortium whose members include UNICEF, the American Red Cross, the World Health Organization, the United Nations Foundation and the Centers for Disease Control and Prevention.So far, 24 low- and middle-income countries, including Mexico, Nigeria and Cambodia, have paused or postponed such programs, according to the Measles and Rubella Initiative, a consortium whose members include UNICEF, the American Red Cross, the World Health Organization, the United Nations Foundation and the Centers for Disease Control and Prevention.
Unlike wealthier countries, where parents typically make appointments to follow a routine vaccine schedule at clinics or private pediatric offices, these countries inoculate large numbers of infants and children in communal settings, like marketplaces, schools, churches and mosques.Unlike wealthier countries, where parents typically make appointments to follow a routine vaccine schedule at clinics or private pediatric offices, these countries inoculate large numbers of infants and children in communal settings, like marketplaces, schools, churches and mosques.
Dr. Robin Nandy, the chief of immunization for UNICEF, acknowledged that finding the balance between guarding against the spread of Covid-19, the illness caused by the coronavirus, and preventable diseases like measles was delicate and difficult.Dr. Robin Nandy, the chief of immunization for UNICEF, acknowledged that finding the balance between guarding against the spread of Covid-19, the illness caused by the coronavirus, and preventable diseases like measles was delicate and difficult.
“In our quest to vaccinate kids, we shouldn’t contribute to the spread of Covid-19,” he said. “But we don’t want a country that is recovering from an outbreak of it to then be dealing with a measles or diphtheria outbreak.”“In our quest to vaccinate kids, we shouldn’t contribute to the spread of Covid-19,” he said. “But we don’t want a country that is recovering from an outbreak of it to then be dealing with a measles or diphtheria outbreak.”
Dr. Nandy said that public health organizations had endorsed new immunization guidelines from the W.H.O., which recognize that while campaigns advocating mass inoculations should be sustained as long as safely possible, temporary suspensions might occur because of reasonable concerns about transmission of Covid-19 to patients and health care workers.Dr. Nandy said that public health organizations had endorsed new immunization guidelines from the W.H.O., which recognize that while campaigns advocating mass inoculations should be sustained as long as safely possible, temporary suspensions might occur because of reasonable concerns about transmission of Covid-19 to patients and health care workers.
“We have to acknowledge the disruption, whether we like it or not,” Dr. Nandy said. But he urged countries to plan for shipments of vaccines and syringes to be available as soon as an easing of Covid-19 restrictions permitted and, given the limited number of international flights, even to be prepared to charter planes.“We have to acknowledge the disruption, whether we like it or not,” Dr. Nandy said. But he urged countries to plan for shipments of vaccines and syringes to be available as soon as an easing of Covid-19 restrictions permitted and, given the limited number of international flights, even to be prepared to charter planes.
Countries should be compiling immunization registries, tracking earlier campaigns and doing risk assessments, to prioritize regions where outbreaks would be most likely and children most vulnerable, he added.Countries should be compiling immunization registries, tracking earlier campaigns and doing risk assessments, to prioritize regions where outbreaks would be most likely and children most vulnerable, he added.
But Dr. Beate Kampmann, director of the Vaccine Centre at the London School of Hygiene and Tropical Medicine, said many countries that already have weak and fragmented health care systems would not be able to collect reliable immunization data.But Dr. Beate Kampmann, director of the Vaccine Centre at the London School of Hygiene and Tropical Medicine, said many countries that already have weak and fragmented health care systems would not be able to collect reliable immunization data.
“There are virtually no registers for vaccinations in West Africa other than parent-held records,” she said, adding that an entire “birth cohort of infants could miss out on vaccinations altogether with serious consequences.”“There are virtually no registers for vaccinations in West Africa other than parent-held records,” she said, adding that an entire “birth cohort of infants could miss out on vaccinations altogether with serious consequences.”
Before the coronavirus pandemic, measles was already making a resurgence in some places. In 2017, there were 7,585,900 estimated measles cases and 124,000 estimated deaths, according to the World Health Organization. By 2018, the last year for which international figures have been compiled, there were 9,769,400 estimated measles cases and 142,300 related deaths.Before the coronavirus pandemic, measles was already making a resurgence in some places. In 2017, there were 7,585,900 estimated measles cases and 124,000 estimated deaths, according to the World Health Organization. By 2018, the last year for which international figures have been compiled, there were 9,769,400 estimated measles cases and 142,300 related deaths.
In 2019, the United States reported 1,282 measles cases, its highest in more than 25 years. The measles vaccine has been available for more than 50 years.In 2019, the United States reported 1,282 measles cases, its highest in more than 25 years. The measles vaccine has been available for more than 50 years.
Countries including Brazil, Bangladesh, the Democratic Republic of Congo, South Sudan, Nigeria, Ukraine and Kazakhstan are currently fighting outbreaks of measles. Among the countries that have postponed their vaccination programs are Bolivia, Chad, Chile, Colombia, Djibouti, the Dominican Republic, Ethiopia, Honduras, Lebanon, Nepal, Paraguay, Somalia, South Sudan and Uzbekistan.Countries including Brazil, Bangladesh, the Democratic Republic of Congo, South Sudan, Nigeria, Ukraine and Kazakhstan are currently fighting outbreaks of measles. Among the countries that have postponed their vaccination programs are Bolivia, Chad, Chile, Colombia, Djibouti, the Dominican Republic, Ethiopia, Honduras, Lebanon, Nepal, Paraguay, Somalia, South Sudan and Uzbekistan.
Dr. Kampmann was also concerned about potential outbreaks in wealthier countries in North America and Europe, which do not have national inoculation programs. Because of Covid-19 fears, American pediatric practices are beginning to report significant drops in well-child visits, including those for routine vaccines.Dr. Kampmann was also concerned about potential outbreaks in wealthier countries in North America and Europe, which do not have national inoculation programs. Because of Covid-19 fears, American pediatric practices are beginning to report significant drops in well-child visits, including those for routine vaccines.
Updated June 5, 2020 Updated June 12, 2020
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
“Even in resource-rich settings there is a danger of measles raising its ugly head in the not-too-distant future,” Dr. Kampmann added, “hence it is even more important to sustain routine immunizations.”“Even in resource-rich settings there is a danger of measles raising its ugly head in the not-too-distant future,” Dr. Kampmann added, “hence it is even more important to sustain routine immunizations.”
Dr. Melinda Wharton, director of the C.D.C.’s Immunization Services division, said that one upside of current social distancing measures was that if outbreaks of measles occur, transmission might be limited. She said that in recent years, many cases entered the United States from common travel destinations and that the sharp decreases in air travel because of the pandemic might also keep a lid on measles cases.Dr. Melinda Wharton, director of the C.D.C.’s Immunization Services division, said that one upside of current social distancing measures was that if outbreaks of measles occur, transmission might be limited. She said that in recent years, many cases entered the United States from common travel destinations and that the sharp decreases in air travel because of the pandemic might also keep a lid on measles cases.
As of last week, there were 12 confirmed cases of measles in seven jurisdictions in the United States. The C.D.C. is monitoring vaccination rates, Dr. Wharton said.As of last week, there were 12 confirmed cases of measles in seven jurisdictions in the United States. The C.D.C. is monitoring vaccination rates, Dr. Wharton said.
“We will work with state and local health departments to ensure children who were not able to get vaccinated because of the Covid-19 response get the necessary catch-up vaccinations,” she said.“We will work with state and local health departments to ensure children who were not able to get vaccinated because of the Covid-19 response get the necessary catch-up vaccinations,” she said.