High flow Nasal oxygen treatment instead of ventilators see COVID-19 recoveries in Cape town

Joining Stephen Grootes on The Pulse, ICU Head at Tygerberg Hospital, Dr. Usha Lalla explains the use of a high flow breathing apparatus as opposed to a ventilator for COVID-19 patients. Lalla says this system does not need equipment and is used when patients are awake.

Has COVID-19 subverted global health?

For the first time in the post-war history of epidemics, there is a reversal of which countries are most heavily affected by a disease pandemic. By early May, 2020, more than 90% of all reported deaths from coronavirus disease 2019 (COVID-19) have been in the world's richest countries; if China, Brazil, and Iran are included in this group, then that number rises to 96%. The rest of the world—historically far more used to being depicted as the reservoir of pestilence and disease that wealthy countries sought to protect themselves from, and the recipient of generous amounts of advice and modest amounts of aid from rich governments and foundations—looks on warily as COVID-19 moves into these regions.

Despite this reversal, however, the usual formula of dispensing guidance continues to be played out, with policies deemed necessary for the hardest-hit wealthy countries becoming a one-size-fits-all message for all countries. Two centrepieces of this approach are the use of widespread lockdowns to enforce physical distancing—although, it is notable that a few wealthy countries like Sweden and South Korea have not adopted this strategy—and a focus on sophisticated tertiary hospital care and technological solutions. We question the appropriateness of these particular strategies for less-resourced countries with distinct population structures, vastly different public health needs, immensely fewer health-care resources, less participatory governance, massive within-country inequities, and fragile economies. We argue that these strategies might subvert two core principles of global health: that context matters and that social justice and equity are paramount.

The cost of inaction: COVID-19-related service disruptions could cause hundreds of thousands of extra deaths from HIV

A modelling group convened by the World Health Organization and UNAIDS has estimated that if efforts are not made to mitigate and overcome interruptions in health services and supplies during the COVID-19 pandemic, a six-month disruption of antiretroviral therapy could lead to more than 500 000 extra deaths from AIDS-related illnesses, including from tuberculosis, in sub-Saharan Africa in 2020–2021. In 2018, an estimated 470 000 people died of AIDS-related deaths in the region.

There are many different reasons that could cause services to be interrupted—this modelling exercise makes it clear that communities and partners need to take action now as the impact of a six-month disruption of antiretroviral therapy could effectively set the clock on AIDS-related deaths back to 2008, when more than 950 000 AIDS-related deaths were observed in the region. And people would continue to die from the disruption in large numbers for at least another five years, with an annual average excess in deaths of 40% over the next half a decade. In addition, HIV service disruptions could also have some impact on HIV incidence in the next year.

Responding to COVID-19: New courses and languages available

OpenWHO is pleased to share 3 brand new courses that were recently launched to support the response to COVID-19:

Chloroquine and Hydroxychloroquine for the Prevention or Treatment of Novel Coronavirus Disease (COVID-19) in Africa: Caution for Inappropriate Off-Label Use in Healthcare Settings

Novel coronavirus disease (COVID-19), caused by the novel severe acute respiratory syndrome-coronavirus-2 (SARSCoV-2), has rapidly spread into a global pandemic. Africa initially appeared spared, but as of this writing, all countries except Lesotho have confirmed cases. As of April 15, 2020, there were 11,367 confirmed COVID-19 cases, with 523 deaths (4.6% case fatality) reported across the WHO African region. In other settings such as the United States, Europe, and China, morbidity and mortality have been highest in those older than 60 years and with underlying comorbidities such as arterial hypertension, heart disease, diabetes, and chronic lung disease; young adults and children seem to have relatively mild disease and low mortality.
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The SARS-CoV-2 pandemic: An urgent need to relook at the training of the African health workforce

To the Editor: As of 11 March 2020, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic had infected over 120 000 people in more than 90 countries, of whom 4 369 had died.[1] As recent modelling analysis highlights, the evolving impact of SARS-CoV-2 will be as a large outbreak in sub-Saharan Africa (SSA) that may rapidly overwhelm existing health services.[2] To avoid the worst of outcomes, African health systems must act quickly and decisively. Investing in health professions education will be essential to both containing and managing the pandemic and any other new infections in the future. Here we describe how a transnational HIV training project, implemented by the African Forum for Research and Education in Health (AFREhealth)[3] and the University of California, San Francisco (UCSF), offers a template for how we can deploy African-bred approaches to address this emerging threat.

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Title: “COVID-19 Outbreak in Africa: What You Need to Know and How to Keep Safe"

Thursday, March 19th
9:00-10:00 am US Eastern Time,
1:00-2:00 pm Dakar/Accra; 3:00-4:00 pm Johannesburg; 4:00-5:00 pm Kampala/Nairobi

Facilitators/Moderators:

Jean B. Nachega, MD, PhD, MPH (Professor, AFREhealth/Stellenbosch Univ)
Quentin Eichbaum, MD, PhD, MPH (Professor, CUGH/Vanderbilt Univ)

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WHO Declares Coronavirus Disease a Pandemic as Increasing Case Numbers

COVID-19 Epidemiologic Status in AfricaThe outbreak of thecoronavirus disease(COVID-19)started with the report of a first suspected case on December 8, 2019 in Wuhan, China.The virus has been named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).On 11 March 2020, the Director-General of the World Health Organization (WHO) declaredCOVID-19a pandemic.

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The Infection Control Africa Network (ICAN) ECHO online free access training on COVID-19 with minimal resources by Professor Shaheen Mehtar

(10 March 2020, but updated monthly)