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COVID Fourth Wave Epidemiological Report from TCI Ministry of Health on January 20, 2022

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Delivered by Dr. Nadia Astwood, Chief Medical Officer

 

#TurksandCaicos, January 28, 2022 – “As it stands, the TCI has recorded 5442 cases of COVID 19 since the start of the pandemic with 1882 cases being identified in January 2022 alone.

The TCI has reported a total 32 COVID 19 related deaths since the start of the pandemic with 6 deaths occurring in January 2022. The fourth wave which the TCI is currently experiencing began at the end of December 2022 and since then 2272 cases have been detected.

To put this into perspective, a similar number of cases was reported for the TCI over the first 11 months of the pandemic between March 23 – Feb 25.

123 cases were identified in October,

117 in November

451 in December 2021.

Cases reported in January 2022 ranged in age from a newborn to 91 years with 53% being female, 73% residents and 64% of individuals being symptomatic.

The highest proportion of cases were observed in the 30-39 years age group which represented 23% of cases. While 8.3% of cases were aged above 60 years, this still accounted for 142 persons. Persons in this age group are more likely to have other comorbidities or underlying chronic non-communicable diseases such as hypertension, diabetes or cancer and are therefore at greater risk of severe disease and poor outcomes.

During this fourth wave and for the first time since the beginning of the epidemic in the TCI, cases have been detected on all inhabited islands in the TCI.

The positivity rate remains consistently high based on testing carried out at the National Public Health Laboratory, this is the percentage of people who test positive for the virus of those overall who have been tested. Although the vast majority of affected individuals reported mild symptoms such as cough and fever, the high overall numbers have translated into hospital admissions when compared to previous months.

As many as 30 hospital admissions in January 2022 had a COVID19 diagnosis which is a reflection of the widespread community transmission the TCI is currently experiencing. Dr Braithwaite Tennant will further expand on the impact of the current COVID19 wave on the TCI Hospitals.

Unfortunately, since December 20th 2021, the TCI has reported 7 COVID19 related deaths with 6 deaths being recorded in January 2022 alone.

Of the deaths in January 2022 (up to January 20)

4 (over 60) 1 (20 – 59)

1 (less than 20)

The most recent COVID19 vaccine report which was submitted on 16th January 2022 reported that:

82% of the eligible population is fully vaccinated (28639)

87% having received the first dose (30526)

14% booster coverage (4859)

Children aged 12 to 15 years:

1st dose 99

2nd dose 622

Overall, the MOH has noted breakthrough infections for those who have been fully vaccinated however the majority of persons experiencing severe disease are either unvaccinated or unboosted.

It is evident that the vaccine is effective in reducing the severity of the illness in the vast majority of cases, however the are many persons in the TCI who are eligible for the booster who have not taken it.

This is also reflected in the hospital admissions where persons who are experiencing more severe disease and are vaccinated are all unboosted. The policy has recently changed whereby persons who have completed their second dose of the vaccine are eligible for the booster as opposed to 6 months.

I would therefore continue to recommend that for those who are unvaccinated to get vaccinated and for those who are vaccinated to get boosted.  This is the best way to protect yourselves, your loved ones and those who you may come into contact with.

Reinfections- The MOH has noted a substantial number of persons who have been re-infected with some persons having been infected last year and are now presenting again with symptoms of COVID19.

Since December 20th 2021, 98 reinfections have been identified.

What we are seeing in the TCI is likely to be the result of the omicron variant which is highly transmissible meaning that it can spread more easily from person to person than previous variants. This variant is responsible for the surges in cases being experienced all over the world and the TCI is no different.

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Cleveland Clinic Performs First-In-World Full Multi-Organ Transplant to Treat Rare Appendix Cancer

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#USA, August 13, 2022 – Cleveland Clinic has successfully performed a first-in-the-world full multi-organ transplant to treat a patient with a rare form of appendix cancer called pseudomyxoma peritonei (PMP). Upon completion of the lifesaving transplant surgery, the patient received five digestive organs: liver, stomach, pancreas, duodenum, and small intestine.

Anil Vaidya, M.D., Cleveland Clinic’s Intestinal Transplant Program co-director, led the seven-surgeon team that completed the pioneering operation on a 32-year-old man in September 2021.

“The patient had one of the more advanced cases of PMP I have seen,” said Dr. Vaidya. “While about 80% of patients with the condition can be treated with traditional therapies, what do you do with the 20% for whom the traditional therapy isn’t successful? In some cases, the answer may be a multi-organ transplant.”

During the 17-hour operation, surgeons removed the patient’s diseased organs. He then received the following deceased donor’s organs all together and at the same time: liver, stomach, pancreas and duodenum (pancreaticoduodenal complex), spleen, small intestine, and right colon. The donor spleen was initially transplanted to boost the immune protection of the newly transplanted organs and improve blood flow to the pancreas until fully transplanted. The donor right colon was initially transplanted to help protect the new intestine from infection and improve its ability to absorb nutrients.  Both the donor spleen and donor right colon were removed prior to the completion of the transplant after they successfully served to protect the other organs during the operation.

“As far as we know, it is the first time in the world that a full multi-organ transplant, including the liver and four other digestive organs, is performed to treat PMP,” said Dr. Vaidya.

Prior to joining Cleveland Clinic in 2020, Dr. Vaidya performed in England the world’s first modified multi-organ transplant (excluding the liver) to treat a patient with PMP who had exhausted all other management strategies.

PMP is a rare cancer that typically originates as a tumor in the appendix. When the slow-growing tumor ruptures, its jelly-like content spreads to other digestive organs, with additional tumors developing that impair gastrointestinal function. Malnutrition and life-threatening complications ultimately occur.

Following the diagnosis in 2019, the patient began a long odyssey of treatments. He was one of the 20% of patients with PMP for whom the traditional treatments were ineffective. Often, this population of patients is left with few to no treatment options.

The patient was referred to Cleveland Clinic in 2021 in the end stage of his disease. He was receiving hospice care at that time. The patient had stopped working and could no longer eat solid foods. He was receiving nutrients intravenously through total parenteral nutrition (TPN).

“We needed to perform an evaluation to determine if transplantation in his case was safe, feasible and could provide long-term benefits,” said Dr. Vaidya.

Dr. Vaidya completed a thorough assessment of the patient’s case and received approval from Cleveland Clinic’s Intestinal Transplant Selection Committee to proceed. The patient was placed on the national transplant waiting list in July 2021.

“The patient – who needed a liver and four other digestive organs – had started to deteriorate quite rapidly,” said Dr. Vaidya. “It was touch-and-go that he would make it.”

In September 2021, a donor was found, and less than 24 hours later, the patient was undergoing the groundbreaking

surgery. The first three hours were preparatory, in essence removing the diseased abdominal organs. Next, the donor organs were inserted into the abdominal cavity, all the necessary vascular connections were completed and a left-sided ileostomy was created to handle bodily waste and let the body recover from the surgery.

“The operation was well planned and went like clockwork,” said Dr. Vaidya. “The team members knew exactly what they were going to do, and the timing was perfect. It went really well.”

Following the transplant, the patient remained in the hospital for 51 days.  Soon after he was discharged, he returned because he was suffering from a case of graft-versus-host disease, a common occurrence following intestinal or bone marrow transplants where the donated organs’ immune cells recognize the recipient’s tissues as foreign and attack the recipient.

The patient underwent a procedure perfected and performed by Amy Lightner, M.D., colorectal surgeon and director of Cleveland Clinic’s Center for Regenerative Medicine and Surgery. Dr. Lightner administered three doses of mesenchymal stromal cell (MSC)-derived exosomes, a first ever, novel treatment in solid organ transplants — another first for a patient who received a full multi-organ transplant to treat PMP.

According to Dr. Vaidya, “The patient’s recovery was absolutely amazing. His symptoms abated within two hours of the first dose.”

Nine months post-transplant, the patient, now 33, can eat and digest solid foods again and has energy to do what he loves, including walking and biking outdoors.

“There is currently no evidence of cancer recurrence,” said Dr. Vaidya.

 

Photo Captions: 

Header: Masato Fujiki, MD, (center) and the Cleveland Clinic surgical team, led by Anil Vaidya, MD, performing the first-in-world multi-organ transplant to treat a rare type of appendix cancer. (Photo courtesy of Cleveland Clinic)

1st insert: Anil Vaidya, M.D.

2nd insert: From left: Anil Vaidya, M.D., Shannon Jarancik, physician assistant, Amy Lightner, M.D., Andy Voge, patient, Rachel Voge, Andy’s wife, and Anita Barnoski, transplant coordinator.

Release: Cleveland Clinic / DPA media

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Bahamas News

Polio is back; 65 million missed shots in another COVID fall out

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By Dana Malcolm

Staff Writer

 

#USA, August 4, 2022 – For the first time in almost a decade a new case of polio was recorded in the United States. The case which ended in paralysis emphasizes the danger the region faces as vaccination levels drop to 30-year lows.

The World Health Organization warned in early July explained that vaccination in the region of the Americas and the rest of world was dropping rapidly because of various spin off effects precipitated by the Coronavirus Pandemic.

Over 65 million infants missed out on basic vaccines in the last three years thanks to disruptions in routine healthcare, lockdowns and other circumstances. The effects are already being felt as once eradicated disease like measles and polio are once again emerging.

The Pan American Health Organization announced earlier this year the Americas are now facing another measles outbreak after having been declared free of the disease in 2016.

Dr. Jarvis Barbosa, Assistant director of PAHO said vaccination levels are now as low as they were in 1994 for measles and polio and Brazil has had several outbreaks of measles.

In the case of the United States an unvaccinated young adult developed the disease after contact with another individual vaccinated with a live version of the vaccine.

The breakout polio case in the US sent shockwaves across the country because of the severe nature of the disease. Polio is an extremely dangerous disease with no known cure. It causes paralysis in as many as 1 in 200 infected and that paralysis is permanent.

Normally very few school age children would be at risk in the Americas as the vaccine is required to start school but with the gap in vaccinations many more children are now at risk.

Polio was one of the most feared diseases of the 20th century, paralyzing and killing hundreds of thousands, especially children. Thankfully vaccinated individuals are not at risk and as such the WHO is advising that the best way to protect against polio is vaccination.

 

Photo Caption:  Child in Benin takes Polio vaccine, UNSDG

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Health

Kansas first to establish Roe v Wade Laws following US Supreme Court decision to remove ABORTION as a right from Constitution

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By Dana Malcolm

Staff Writer

 

#Kansas, USA, August 5, 2022 – Voters in the state of Kansas have moved to uphold abortion rights in their state. Kansas legislators will now be prevented from putting restrictions or bans on abortion. In order to do so they would have to call for a constitutional review, a lengthy drawn out process.

“Kansans stood up for fundamental rights today. We rejected divisive legislation that jeopardized our economic future & put women’s health care access at risk,” Laura Kelly, Kansas’ Democratic Governor tweeted on Wednesday.

Kansas is the first state to put the issue on the state ballot since Roe v Wade the case making abortion a constitutional right was overturned at the Supreme Court level and US media

President Biden proclaimed his support for the bill encouraging congress to write Roe v Wade into law.

Roe v Wade was overturned on June 24, nearly 50 years after it was won.

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