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Polio and Measles Could Surge After Disruption of Vaccine Programs Polio and Measles Could Surge After Disruption of Vaccine Programs
(3 days later)
The widespread interruption of routine immunization programs around the world during the coronavirus pandemic is putting 80 million children under 1 year old at risk of contracting deadly, vaccine-preventable diseases, according to a report Friday by the World Health Organization, UNICEF and Gavi, the Vaccine Alliance.The widespread interruption of routine immunization programs around the world during the coronavirus pandemic is putting 80 million children under 1 year old at risk of contracting deadly, vaccine-preventable diseases, according to a report Friday by the World Health Organization, UNICEF and Gavi, the Vaccine Alliance.
The groups surveyed 129 poor and middle-income countries and found that 68 had some degree of disruption of vaccine services through clinics and through large inoculation campaigns.The groups surveyed 129 poor and middle-income countries and found that 68 had some degree of disruption of vaccine services through clinics and through large inoculation campaigns.
Measles initiatives, for example, have been suspended in 27 countries, including Chad and Ethiopia, and polio programs are on hold in 38, including Pakistan and the Democratic Republic of Congo.Measles initiatives, for example, have been suspended in 27 countries, including Chad and Ethiopia, and polio programs are on hold in 38, including Pakistan and the Democratic Republic of Congo.
Many public health experts say they are worried that deaths from diseases including cholera, rotavirus and diphtheria could far outstrip those from Covid-19 itself.Many public health experts say they are worried that deaths from diseases including cholera, rotavirus and diphtheria could far outstrip those from Covid-19 itself.
The report highlighted warnings about polio, which had recently been all but eradicated, a hard-won victory that resulted from mass immunization programs that reached millions of children.The report highlighted warnings about polio, which had recently been all but eradicated, a hard-won victory that resulted from mass immunization programs that reached millions of children.
Dr. Seth Berkley, chief executive of Gavi, said that developing countries had made big gains in immunizations against numerous diseases in recent years. Before the pandemic hit, he said, more children in more countries had been protected against more vaccine-preventable diseases than ever before.Dr. Seth Berkley, chief executive of Gavi, said that developing countries had made big gains in immunizations against numerous diseases in recent years. Before the pandemic hit, he said, more children in more countries had been protected against more vaccine-preventable diseases than ever before.
“Due to Covid-19, this immense progress is now under threat, risking the resurgence of diseases like measles and polio,” he said.“Due to Covid-19, this immense progress is now under threat, risking the resurgence of diseases like measles and polio,” he said.
Restarting immunization programs is crucial not just for preventing more outbreaks of life-threatening diseases, he said: “It will also ensure we have the infrastructure we need to roll out an eventual Covid-19 vaccine on a global scale.”Restarting immunization programs is crucial not just for preventing more outbreaks of life-threatening diseases, he said: “It will also ensure we have the infrastructure we need to roll out an eventual Covid-19 vaccine on a global scale.”
The problem of slipping vaccine rates is not limited to developing countries. This week, the Centers for Disease Control and Prevention reported that coverage rates among Michigan infants had dropped below 50 percent for all childhood immunizations. New York City announced that during a six-week period of pandemic lockdown, the number of vaccine doses administered to children dropped 63 percent, compared with the same period last year.The problem of slipping vaccine rates is not limited to developing countries. This week, the Centers for Disease Control and Prevention reported that coverage rates among Michigan infants had dropped below 50 percent for all childhood immunizations. New York City announced that during a six-week period of pandemic lockdown, the number of vaccine doses administered to children dropped 63 percent, compared with the same period last year.
According to health ministers and medical providers in the countries surveyed, there are a number of reasons for the disruptions.According to health ministers and medical providers in the countries surveyed, there are a number of reasons for the disruptions.
In late March, up to 80 percent of flights to Africa that deliver vaccines and syringes were canceled. The health care workers who administer vaccines have been afraid to proceed with the supplies they have on hand, because they lack sufficient protective gear. Parents have been afraid to take children to health clinics. Many areas are in lockdown altogether. And thousands of health care workers who might otherwise be engaged in vaccination are being diverted to respond to Covid-19.In late March, up to 80 percent of flights to Africa that deliver vaccines and syringes were canceled. The health care workers who administer vaccines have been afraid to proceed with the supplies they have on hand, because they lack sufficient protective gear. Parents have been afraid to take children to health clinics. Many areas are in lockdown altogether. And thousands of health care workers who might otherwise be engaged in vaccination are being diverted to respond to Covid-19.
International public health experts, including the W.H.O., had initially recommended that mass vaccine programs in particular be halted while the pandemic raged to protect against further spread occasioned by long lines of children waiting for shots.International public health experts, including the W.H.O., had initially recommended that mass vaccine programs in particular be halted while the pandemic raged to protect against further spread occasioned by long lines of children waiting for shots.
But officials are now moving toward a cautious risk-benefit analysis. Noting that Covid-19 has flared inconsistently worldwide, varying not only from country to country but also within national borders, the Global Polio Eradication Initiative, a consortium of international organizations, is urging countries to evaluate their own situations closely and devise alternative, pandemic-safe vaccination strategies as soon as possible.But officials are now moving toward a cautious risk-benefit analysis. Noting that Covid-19 has flared inconsistently worldwide, varying not only from country to country but also within national borders, the Global Polio Eradication Initiative, a consortium of international organizations, is urging countries to evaluate their own situations closely and devise alternative, pandemic-safe vaccination strategies as soon as possible.
Because of the pandemic, Nigeria, which had been well on track to be certified as free of wild polio virus, had to cancel two polio vaccine campaigns in targeted areas that would have otherwise immunized a total of 37.6 million children.Because of the pandemic, Nigeria, which had been well on track to be certified as free of wild polio virus, had to cancel two polio vaccine campaigns in targeted areas that would have otherwise immunized a total of 37.6 million children.
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.
The Nigerian campaigns required that health care workers go door-to-door. “We couldn’t expose vaccinators,” explained Dr. Anis Siddique, the head of immunization for UNICEF in Nigeria, about why the programs were suspended.The Nigerian campaigns required that health care workers go door-to-door. “We couldn’t expose vaccinators,” explained Dr. Anis Siddique, the head of immunization for UNICEF in Nigeria, about why the programs were suspended.
A similar report last month that focused just on the suspension of measles and rubella immunization campaigns already sounded an alarm.A similar report last month that focused just on the suspension of measles and rubella immunization campaigns already sounded an alarm.
Before the coronavirus pandemic, measles cases were already rising. In 2017, there were 7,585,900 estimated measles cases and 124,000 estimated deaths, according to the World Health Organization. In 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 cases were already rising. In 2017, there were 7,585,900 estimated measles cases and 124,000 estimated deaths, according to the World Health Organization. In 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.In 2019, the United States reported 1,282 measles cases, its highest in more than 25 years.
“Prior to Covid, measles was moving across the world as people flew,” said Dr. Frank Mahoney, an immunization expert and medical epidemiologist with the International Federation of Red Cross and Red Crescent Societies. “With more and more children becoming susceptible to it, it could be amplified and become a major international problem.”“Prior to Covid, measles was moving across the world as people flew,” said Dr. Frank Mahoney, an immunization expert and medical epidemiologist with the International Federation of Red Cross and Red Crescent Societies. “With more and more children becoming susceptible to it, it could be amplified and become a major international problem.”
Henrietta Fore, the executive director of UNICEF, addressed the terrible calculus countries must make in determining how to proceed. “While circumstances may require us to temporarily pause some immunization efforts,” she said, “these immunizations must restart as soon as possible, or we risk exchanging one deadly outbreak for another.”Henrietta Fore, the executive director of UNICEF, addressed the terrible calculus countries must make in determining how to proceed. “While circumstances may require us to temporarily pause some immunization efforts,” she said, “these immunizations must restart as soon as possible, or we risk exchanging one deadly outbreak for another.”