Covid Infections in Animals Prompt Scientific Concern

November 10, 2020 0 Comments



Covid Infections in Animals Prompt Scientific Concern James Gorman 1 day ago US Coronavirus: Expert predicts US could soon hit 200,000 daily cases as the

… ‘Follow Me on Parler’ Is New Mantra for Users Aggrieved by Facebook The New York Times logoCovid Infections in Animals Prompt Scientific Concern 

 The decision this week by the Danish government to kill millions of mink because of coronavirus concerns, effectively wiping out a major national industry, has put the spotlight on simmering worries among scientists and conservationists about the vulnerability of animals to the pandemic virus, and what infections among animals could mean for humans. Mink were collected for processing on a farm in Naestved, Denmark.© Mads Claus Rasmussen/EPA, via Shutterstock Mink were collected for processing on a farm in Naestved, Denmark. The most disturbing possibility is that the virus could mutate in animals and become more transmissible or more dangerous to humans. In Denmark, the virus has shifted from humans to mink and back to humans, and has mutated in the process. Mink are the only animals known to have passed the coronavirus to humans, except for the initial spillover event from an unknown species. Other animals, like cats and dogs, have been infected by exposure to humans, but there are no known cases of people being infected by exposure to their pets. 

 Danish veterinary and emergency management officials removed minks for culling at a farm in Gjol, Denmark.© Henning Bagger/Ritzau Scanpix, via Agence France-Presse/Getty Images Danish veterinary and emergency management officials removed minks for culling at a farm in Gjol, Denmark. The versions of the virus that have mutated in mink and spread to humans are not more transmissible or causing more severe illness in humans. But one of the variants, found in 12 people so far, was less responsive to antibodies in lab tests.

 Danish health authorities worried that the effectiveness of vaccines in development might be diminished for this variant, and decided to take all possible measures to stop its spread. This included killing all of the country’s mink and effectively locking down the northern part of the country, where the mutated virus was found. The United Kingdom has banned travelers from Denmark who are not U.K. citizens. an animal sitting on a branch: Chimpanzees in Kibale National Park in Uganda.© Nature Picture Library/Alamy Chimpanzees in Kibale National Park in Uganda. The World Health Organization and scientists outside of Denmark have said they have yet to see evidence that this variant will have any effect on vaccines. They have not, however, criticized Denmark’s decision to cull its mink population. Mink are not the only animals that can be infected with the coronavirus. Dogs, cats, tigers, hamsters, monkeys, ferrets and genetically engineered mice have also been infected. Dogs and cats, including tigers, seem to suffer few ill effects. The other animals, which are used in laboratory experiments, have exhibited varying responses. Farmed mink, however, have died in large numbers in Europe and in the United States, perhaps partly because of the crowded conditions on those ranches, which could increase the amount of exposure. Public health experts worry, however, that any species capable of infection could become a reservoir that allowed the virus to re-emerge at any time and infect people. The virus would likely mutate in other animal species, as it has been shown to do in mink. Although most mutations are likely to be harmless, SARS-CoV-2 conceivably could recombine with another coronavirus and become more dangerous. Conservation experts also worry about the effect on animal species that are already in trouble. One approach to studying susceptibility has been to look at the genomes of animals and see which ones have a genetic sequence that codes for a protein on cells called an ACE2 receptor, which allows the virus to latch on. One team of researchers studied the genomes of more than 400 animals. Another group did a similar study of primates, which are often infected with human respiratory viruses. “One of the premises for doing this research was that we thought that great apes would be very at risk because of their close relationship to humans, genetically,” said Amanda D. Melin, an anthropologist at the University of Calgary and an author of the primate study. But, she added, she and her colleagues also wanted to consider “all of the other primates and their potential risk.” In addition to investigating genomes, the team also did computer modeling of the interaction of the virus spike protein with different ACE2 receptors. The findings of both papers reinforced each other, revealing old world monkeys and all apes to be most at risk. Both papers were released as non-peer-reviewed studies earlier this year. Dr. Melin and her colleagues have been talking to representatives of wildlife sanctuaries and zoos about the need for caution. Many of these facilities have increased restrictions for the interactions between people and the primates. Zarin Machanda, of Tufts University, who studies chimpanzee behavior at the Kibale Chimpanzee Project in Uganda, said that the preserve had increased its safety precautions because of the pandemic. “We’re always cautious about respiratory viruses,” she said, because such viruses are the leading cause of death in the chimps at Kibale. Even the human common cold can be lethal. Chimpanzees have suffered from outbreaks of other coronaviruses. Normally, humans at Kibale maintain a minimum distance of two dozen feet from chimpanzees; that has been increased to 30 feet or more. Local workers have been staying at the reserve, rather than commuting back and forth to their communities. And the project has reduced the hours for field studies. All these measures were directed by the Ugandan government. Tony Goldberg, a veterinarian at the University of Wisconsin, Madison, and the head of the Kibale EcoHealth Project, said that he has seen the devastation wrought by respiratory diseases among chimpanzees. A deadly outbreak in 2013 at the reserve turned out to be the result of human rhinovirus C, the most common cause of the common cold worldwide. Until then, it had never been seen in chimps. “The last thing we need is for SARS-CoV-2 to move into an animal reservoir from which it could re-emerge,” Dr. Goldberg said. Other researchers are studying species from Beluga whales to deer mice for signs of the coronavirus. Kate Sawatzki, the animal surveillance coordinator for a testing project in pets and other animals at the Cummings School of Veterinary Medicine at Tufts University, said: “To date, we have tested 282 wildlife samples from 22 species, primarily bats in New England rehabilitation facilities, and we are happy to report that none have been positive.” They have also tested 538 domestic pets, including from households with people with Covid-19, and none have shown signs of active virus. However, Dr. Sawatzki said, the lab also conducted blood tests for antibodies, showing exposure, and there they did find antibodies, as is common in humans. The pets seemed to be getting infected but not getting sick or passing the virus on. So far, the mink in Denmark are the only known instance of the virus infecting an animal, mutating, and transferring back to humans. Emma Hodcroft of the University of Basel, Switzerland, traces various mutated versions of the coronavirus as it has spread through Europe and has reviewed scientific information released by Danish health authorities. She said she applauded the government’s decision to take swift action and cull the mink: “Many countries have hesitated and waited before acting, and it can be incredibly detrimental in the face of SARS-CoV-2, as we see.” But she did not approve of the way the information was released, particularly in the government’s Wednesday news briefing, which warned of a dire threat to potential human vaccines but offered no detail for the concern. “The communication of the science could have been much clearer and led to less worry around the world,” Dr. Hodcroft said.

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Free Primary Healthcare: A path to more meaningful social inclusion and sustainable development

November 06, 2020 1 Comments



It is election season once again, and as usual, there is an ongoing debate on promises made by politicians and which individuals, or political parties are most trustworthy or capable of delivering on the promises they make to us. 

 As a medical doctor and public health practitioner, I have been particularly interested in the promise by former President John Dramani Mahama of the NDC to provide free primary healthcare if elected president.

 This promise, as captured on page 62 and repeated on pages 74 and 112 of the NDC manifesto is an audacious one, which if successfully and sustainably implemented will lead to multiple benefits such as a reduction in overall healthcare costs, increased growth and productivity in multiple sectors, and lessons for other countries in the global south on what is possible with strong will and audacity. 

 The concept of primary health care has been repeatedly reinterpreted and redefined, based on what periods we live in or where in the world we find ourselves. Some have referred to it as the provision of ambulatory or first-level of personal healthcare services. Others have understood it as a set of priority health interventions for low-income populations (also called selective primary health care). 

 Other actors have understood primary health care as an essential component of human development, focusing not only on health but on the economic, social and political aspects of people’s lives. Of all the definitions, I prefer the following: 

Primary health care (PHC) is essential health care made universally accessible to individuals and acceptable to them, through full participation and at a cost the community and country can afford it.

 The World Health Organization (WHO) expands on this definition with key three key components, applying not only to the health of a population but addressing multiple determinants and empowering all stakeholders with a high level of agency and ownership of processes that ultimately affect not only their healthcare but all aspects of their lives. 

The three components are as follows: Meeting people’s health needs through comprehensive promotive, protective, preventive, curative, rehabilitative, and palliative care throughout the life course, strategically prioritizing key health care services aimed at individuals and families through primary care and the population through public health functions as the central elements of integrated health services;

 Systematically addressing the broader determinants of health (including social, economic, environmental, as well as people’s characteristics and behaviors) through evidence-informed public policies and actions across all sectors; and Empowering individuals, families, and communities to optimize their health, as advocates for policies that promote and protect health and well-being, as co-developers of health and social services, and as self-carers and care-givers to others. Based on these considerations, strengthening primary healthcare, and placing it at the center of efforts to improve health and wellbeing are critical for three reasons: 

 1. It is well-positioned to respond to rapid economic, technological and demographic changes, all of which impact health and wellbeing; It has been proven to be highly effective and an efficient way to address the main causes and risks of poor health and wellbeing

 2. Primary health care has been proven to be a highly effective and efficient way to address the main causes and risks of poor health and well-being today, as well as handling the emerging challenges that threaten health and well-being tomorrow 

 3. Solid investments in primary healthcare provide benefits that go beyond health. This expanded definition, with all its appeal, cannot be achieved without accessibility and affordability, which in my experience working as a doctor in both rural and urban parts of Ghana would be synonymous with free.

 This is because of the existence of pervasive poverty and the inability of the National Health Insurance Scheme (NHIS) to fully respond to many of our healthcare needs. This inability has been mainly because of exemptions in what services can be accessed, as well as the occasional lack of products in health facilities which are signed on to the NHIS. 

 This pushes back the burden of buying health products to patients, who often cannot afford them, sometimes leading to an exacerbation of their conditions and the eventual need for even more expensive specialist care.

 Multiple analyses have found that approximately half of the gains in reducing child mortality from 1990 to 2010 were due to factors outside the health sector (such as water and sanitation, education, economic growth).

 This approach draws in a wide range of stakeholders to examine and change policies to address the social, economic, environmental, and commercial determinants of health and well-being. Furthermore, primary healthcare has been shown to be a good value investment, as there is evidence that quality primary health care reduces total healthcare costs and improves efficiency by reducing hospital admissions. 

 The WHO in a recent scoping review found that an investment in preventive services provided huge economic benefit for countries. 

For example, in low and middle-income countries, the return on investment from childhood immunization is estimated to be as high as $44 for every dollar spent. Other reviews estimate the return on investment from community health workers to be $10 for every dollar.

 In addition, it is known that compared with providers of specialist care, primary care physicians use fewer resources in terms of hospitalizations, prescriptions and common tests and procedures. 

 A well-run, accessible, and effective primary healthcare system will reduce the incidence of health conditions becoming complicated before they are attended to. 

This translates to an overall reduction in the time spent in hospital, leading to more time at school, in economic ventures or with family. 

 Addressing increasingly complex health needs requires a multisectoral approach that integrates health-promoting and preventive policies, solutions that are responsive to communities, and health services that are people-centered. 

 Primary health care also includes the key elements needed to improve health security and prevent health threats such as epidemics and antimicrobial resistance, through such measures as community engagement and education, rational prescribing, and a core set of essential public health functions, including surveillance.

 Strengthening systems at the community and peripheral health facility level contributes to building resilience, which is critical for withstanding shocks to the health system. 

 Stronger primary healthcare is essential to achieving the health-related Sustainable Development Goals (SDGs) and universal health coverage. It will also contribute to the attainment of other goals beyond the health goal (SDG3), including those on poverty, hunger, education, gender equality, clean water and sanitation, work, and economic growth, reducing inequality and climate action. Strengthening primary healthcare will require prioritization of health needs, with significant investments in health infrastructure, service delivery, human resources, access to essential medicines, among others. This process of strengthening primary healthcare and making it accessible can be envisaged in two possible ways:

 1. Firstly, trying to provide the requisite quality and quantity of health infrastructure, training and employing enough health workers, securing funding and then implementing free primary healthcare after all the prerequisites are in place.

 2. Boldly increasing access and affordability, learning whilst doing this whilst working with relevant stakeholders to strengthen the different components simultaneously. 

 In the Ghanaian context, the first approach will not work, as it will take us a few decades to train the needed number of health workers, develop the required infrastructure and ensure that all other pre-requisites are in place. Even then, we may not be ready as new innovations will already be in play in other countries.

 This policy is very feasible, and if the annual cost of $1.4 billion from our oil and non-taxed revenue estimated by the NDC will be significantly less than the benefits we will accrue from Free Primary Healthcare. The second option is therefore the only option we have, to make enhanced primary healthcare a possibility and reap all the stated benefits of such a system. Given all its benefits, for all areas of our lives, I believe the promise and possibility of Free Primary Healthcare in Ghana is a potential game-changer and one that must be supported to become a certainty in our country. The author is a Ghanaian medical doctor and Public Health expert Send your news stories to newswires@ghanaweb.com and features to features@ghanaweb.com . Chat with us via WhatsApp on +233 55 2699 625. Join our Newsletter Your email address... Comments: 

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