By Deandrea Hamilton
#TurksandCaicos, January 20, 2022 – Five medical treatments for Covid-19 patients are in use in the United Kingdom according to National Health Service, (NHS) yet Turks and Caicos has employed only one Covid-19 therapeutic and with the surge in new deaths due to the virus, it is a wonder if more can be done in this country to save lives.
Dexamethasone was approved by the NHS in June 2020, less than a month later, Turks and Caicos Hospitals began use of the therapeutic said to offer ground-breaking coronavirus treatment.
“Dexamethasone, an anti-inflammatory drug, has been immediately approved to treat all UK hospitalised COVID-19 patients requiring oxygen, including those on ventilators, from today.
The drug has been proven to reduce the risk of death significantly in COVID-19 patients on ventilation by as much as 35% and patients on oxygen by 20%, reducing the total 28-day mortality rate by 17%,” informed a media statement from the NHS on June 16, 2020.
Ever so quietly, and despite repeated media questions to the Ministry of Health about therapeutics, Dexamethasone was added to the Covid-19 response arsenal without a word.
The TCI Hospitals informed of its use late 2021, due to Magnetic Media questions on the issue.
Four other therapies are employed in the United Kingdom in an effort to save lives; they are: Tocilizumab and sarilumab (for REHAB); Tocilizumab (for RECOVERY); Inhaled budesonide (for PRINCIPLE care) and Ronapreve (for RECOVERY).
No surprise the effort is varied and fervent as the UK sadly reports one of the highest death tolls to COVID in the world at 153,000 people lost to the virus.
By January 2021, the UK, which was also the first country to approve emergency use of the Covid-19 vaccines, added a new drug: Tocilizumab and sarilumab.
Tocilizumab and sarilumab is administered to the sickest Covid-19 patients, said the NHS.
“This is a significant finding which could have immediate implications for the sickest patients with COVID-19,” said Professor Anthony Gordon, Chair in Anaesthesia and Critical Care at Imperial College London and a Consultant in Intensive Care Medicine at Imperial College Healthcare NHS Trust.
“We found that among critically ill adult patients – those receiving breathing support in intensive care – treatment with these drugs can improve their chances of survival and recovery,” explained Professor Gordon. “At a time when hospitalisations and deaths from COVID-19 are soaring in the UK, it’s crucial we continue to identify effective treatments which can help to turn the tide against this disease.”
The NHS, which ran studies on all of the drugs before introducing them for medical care to its residents reported that: “Treatment with tocilizumab significantly reduced deaths: 596 (29%) of the patients in the tocilizumab group died within 28 days compared with 694 (33%) patients in the usual care group (rate ratio 0·86; [95% confidence interval [CI] 0·77 to 0·96]; p=0·007), an absolute difference of 4%. This means that for every 25 patients treated with tocilizumab, one additional life would be saved.”
By April 2021, the UK was offering a therapeutic which was administered to people presenting with COVID but not yet hospitalised for the virus.
Inhaled budesonide, was given before Covid-19 turned severe.
“This asthma drug shortens recovery time said the National Health Service. The statement published on April 12, 2021 said, “Inhaled budesonide, a common corticosteroid, is the first widely available, inexpensive drug found to shorten recovery times in COVID-19 patients aged over 50 who are treated at home and in other community settings, reports the PRINCIPLE trial in 1,779 participants. The drug is now available to treat COVID-19 on a case-by-case basis in UK primary care.”
The final approved “effective treatment” listed on the UK Government’s website is Ronapreve, sanctioned as effective in September 2021.
Health and Social Care Secretary Sajid Javid said: “We have secured a brand new treatment for our most vulnerable patients in hospitals across the UK and I am thrilled it will be saving lives from as early as next week.
The UK is leading the world in identifying and rolling out life-saving medicines, particularly for COVID-19, and we will continue our vital work to find the best treatments available to save lives and protect the NHS.
Ronapreve is the first neutralising antibody medicine specifically designed to treat COVID-19 to be authorised by the Medicines and Healthcare products Regulatory Agency (MHRA) for use in the UK.”
Given the Turks and Caicos, as a UK Overseas Territory has been extraordinarily supported from the onset of the pandemic by the United Kingdom, it is unclear why only one of five options, approved by Mother England has been activated locally.
While all messages from the NHS reveal a zeal to have as many possible options for the people of the UK in the fight against COVID-19. Turks and Caicos seems stuck and lacking the motivation it needs to offer more life-saving treatments to the people – vaccinated or unvaccinated – of the territory.
Perhaps the knowledge of the cold corpses of six beloved people from January 2022 deaths due to COVID, including a special needs young woman, may get the government spending public money on the other drugs and treatments, which give Covid-19 patients an extra fighting chance at life.
#TurksandCaicos, May 19, 2022 – Due to the recent rainfall throughout the Turks and Caicos Islands, the Environmental Health Department (EHD) hereby advises residents, home owners, apartment owners and businesses to remove all debris & refuse/garbage from their premises and dispose appropriately at the public landfill/solid waste disposal sites on your respective island. The removal of debris & refuse/garbage from your premises will reduce mosquito breeding and prevent mosquito borne and other vector borne diseases such as Dengue fever.
As the Vector Control Unit of the Environmental Health Department continues to monitor and treat mosquito breeding sites, home owners, apartment owners and business owners are advised to treat standing water on their premises by using cooking oil or any other environmentally friendly oils to prevent mosquito breeding.
It is anticipated that mosquito populations and activities will increase over the coming weeks and it is important to remind residents that mosquito control is a shared responsibility. Residents and businesses can help reduce the growth and reproduction of mosquitoes in and around their homes, businesses and communities by taking the following precautionary measures:
- Check around buildings for anything that could hold water, inspect your home and yard weekly
- Turn containers over or cover them
- Get rid of or cover old tires
- Properly dispose of all garbage/refuse
- Cover boats, children’s pools, etc.
- Clean rain gutters and make sure they are flowing properly
- Check screens for holes
- Tightly cover water drums and rain barrels
For further information, contact the Environmental Health Department via telephone numbers 649-338-2143/44
[Excerpt] from an Mental Health & Well Being Open Consultation; United Kingdom
May 19, 2022 – “Approximately 1 in 6 people aged 16 and over in England were identified as having a common mental health condition in 2014, according to survey data. In 2020 to 2021, there were around half a million people with more severe mental illness such as schizophrenia or bipolar disorder. We have seen worrying trends for children and young people, with rates of probable mental health disorders in 6 to 16-year-olds rising from 11.6% in 2017 to 17.4% in 2021. More people than ever are receiving support for a mental health crisis and, tragically, the numbers of those ending their life through suicide have broadly increased over the past decade. We know that two-thirds of people who end their life by suicide are not in contact with NHS mental health services.
For many of us, the experience of the coronavirus (COVID-19) pandemic – and its wide-ranging impacts on individuals, families, society and the economy – have brought these issues into sharper focus. Around 1 in 5 adults in Britain experienced some form of depression in the first 3 months of 2021, over double pre-pandemic figures.
These problems aren’t felt equally by all of us. We know there is an uneven distribution of mental ill-health across society. People facing social and economic disadvantage are at a much higher risk of developing mental health conditions. They are also more likely to receive care and support much later as their conditions escalate to crisis point. In 2020 to 2021, people living in the most deprived areas of England were twice as likely to be in contact with mental health services than those living in the least deprived areas.
There are also disparities by ethnicity, age, sexuality, and sex, and for people with learning disabilities, neurodiversity, and long-term physical health conditions. Risks of mental ill-health are also higher for people who are unemployed, people in problem debt, people who have experienced displacement, including refugees and asylum seekers, people who have experienced trauma as the result of violence or abuse, children in care and care leavers, people in contact with the criminal justice system (both victims and offenders), people who sleep rough or are homeless, people with substance misuse or gambling problems, people who live alone, and unpaid carers. People may belong to several disadvantaged groups at once, which is likely to compound the risk of experiencing mental ill-health. Addressing these disparities is critical to deliver the government’s ambition to level up the country and tackle disparities in health. We will set out more detail on our plans to reduce the gap in health outcomes between different places and communities across the country in our forthcoming health disparities white paper. See Annex A below on mental health disparities for more detail, which can be used as a point of reference when responding to our questions.
The impacts of mental ill-health on individuals, communities, society and the economy are substantial. Children and young people’s mental health conditions incur annual short-term costs estimated at £1.58 billion and annual long-term costs estimated at £2.35 billion.
Around 50% of mental health conditions are established by the time a child reaches the age of 14, and 75% by age 24.
Adults with mental health conditions are much more likely to be out of work, to have lower incomes, increased problems with their physical health, and increased involvement in the criminal justice system, both as victims and perpetrators.
The total annual cost of mental ill-health in the workplace to government has been estimated at between £24 billion and £27 billion. The overall annual loss to the economy has been estimated at between £70 billion and £100 billion. Losses are greater in places and among groups that experience mental health disparities.
Health is essential to a stable and functioning economy.
Our strong economic foundation going into the pandemic and the support provided throughout means we have made good economic progress.
However, we must continue to build back better as we begin to rebuild the economy. By improving mental health across the country, we can improve lives and livelihoods whilst reducing the demand on the NHS and pressure on other public services, and at the same time supporting economic growth.
A healthier and happier population is also more likely to access employment opportunities, which will reduce inactivity and improve productivity.
Reducing disparities in mental health between local areas is therefore critical to ensuring more equal access to opportunities and supporting the government’s Levelling Up agenda.”
Natural Immunity less powerful against new Omicron strains in South Africa as Fifth Wave looms
By Dana Malcolm
#Africa, May 19, 2022 – South Africa is undergoing a massive covid surge with cases jumping by 50 percent in just 24 hours on May 5th. 9,757 new cases were reported on the 5th, 3,587 more positive results than the 6,170 recorded the day before. For context, on April 5th, a month earlier 1538 new infections were recorded.
Since that 50 percent increase on May 5th daily new infections have consistently been above 2,900 reaching as high as 10,017 on May 11th. South Africa recorded over 86,000 new cases and over 550 deaths between May 5th and 16th in a time frame of less than 2 weeks.
Vaccine uptake in South Africa is below slightly above 50 percent with only 35 million fully vaccinated individuals in a population of more than 59 million.
Shabir Mahdi, a scientist leading vaccine trials in the country had suggested that natural immunity was what was helping with lower hospitalizations when omicron initially appeared in the country.
This latest increase however, is being driven by the BA.4 and BA.5 Omicron sub variants, which may be more adept at evading natural immunity.
In a study carried out by the Africa Health Research Institute blood samples from people infected with omicron but unvaccinated, when tested against BA.4 and BA.5, neutralizing antibodies which fight Covid were eight times lower. In people who contracted omicron and were vaccinated it was three times lower.
The study has not yet been peer reviewed but the researchers say, “The low absolute neutralization levels for BA.4 and BA.5, particularly in the unvaccinated group, are unlikely to protect well against symptomatic infection,”
“This may indicate that… BA.4 and BA.5 have potential to result in a new infection wave.”
That study was carried out back in January when the variants were first detected.
When the Omicron fueled fourth wave hit South Africa in 2021 cases in the United States, Canada and parts of Europe quickly followed. BA.4 and .5 have been detected in the US, Canada, China and parts of Europe.
On May 12th the BA.4 and.5 variants were both upgraded to variants of concern by the European Centre for Disease Control.
The ECDC says variants of concern are ones for which, “clear evidence is available indicating a significant impact on transmissibility, severity and/or immunity that is likely to have an impact on the epidemiological situation in the EU/EEA.”
The possible spike in cases comes one year and five months since the first COVID jabs in the world were administered in the UK and the US, one year and four months since the first vaccine was administered in the Turks and Caicos.
Though boosters have been available in many countries worldwide booster campaigns have not been as effective as initial vaccination campaigns. Without the stretched protection of boosters many more people may remain vulnerable to this building wave of BA.4 or BA.5 vaccines.
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