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Infectious Diseases

30 September 2020

Coronavirus morning recap: Evidence on diabetes, research on infants, and Africa needs $100bn

What the evidence says on Covid-19 and diabetes; reassuring research on infants; and Africa needs $100bn for pandemic aftermath.

LATEST SCIENCE AND RESEARCH

READ | Covid-19 and diabetes: What the evidence says

Diabetes has been reported to be a risk factor for severe Covid-19, the disease caused by SARS-CoV-2. This is because high blood sugar levels can weaken the immune system, making it harder for diabetic people to fight off infections such as Covid-19.

During a Covid-19 special session at the online Annual Meeting of the European Association for the Study of Diabetes (EASD), a new review of the evidence on the devastating impact of Covid-19 on people who have diabetes was presented by Professor Juliana Chan from the Chinese University of Hong Kong and Prince of Wales Hospital, Sha Tin, Hong Kong, China, according to EurekAlert.

"Major risk factors for mortality include advanced age and chronic conditions, notably obesity, diabetes, hypertension, heart and kidney disease as well as social deprivation, minority ethnic groups and those with poor access to care," said Chan, explaining that these common coexisting conditions highlight the complexity of Covid-19.

A recent report (from The Lancet Diabetes & Endocrinology), based on a UK population-based survey of more than 60 million people registered with the primary care system, showed that 0.4% had type 1 diabetes, and 4.6% had type 2 diabetes.

However, the report further highlighted that among the more than 24 000 Covid-19-related deaths, 30% occurred in diabetics.

After the researchers of the paper adjusted for several risk factors, including social deprivation, ethnicity and other chronic conditions, they found that people who had type 1 diabetes had an almost threefold (2.86) risk of death. In those who had type 2 diabetes, they found an almost two times (1.8) higher risk of death due to Covid-19, compared to those who did not have diabetes.

Chan also explained that the search term "Covid-19 and diabetes" yielded more than 1 800 publications in PubMed, a free full-text archive of biomedical and life sciences journal literature at the US National Institutes of Health's National Library of Medicine.

READ | Reassuring research shows that infants do well, even when born to mothers who have Covid-19

When Covid-19 started to spread, experts were not sure about the outcomes for pregnant women and infants.

A previous study discussed on Health24 advised that mothers who contracted Covid-19 should continue to breastfeed their infants as the benefits of breastfeeding outweigh the risk of Covid-19.

Now, a new study from researchers at the University of California, San Francisco, suggests that even when babies are born to mothers infected with SARS-Cov-2, they do well in the six to eight weeks after birth, and that there are few adverse effects. This was the case even though there were more neonatal intensive care unit (NICU) admissions of mothers who had Covid-19 up to two weeks before delivery.

The study, a pre-publication accepted by Clinical Infectious Diseases, investigated 263 infants and found that adverse outcomes, whether they were preterm birth, NICU admission or prevalence of respiratory disease, did not differ between those born to mothers with the virus and those who tested negative.

In this research, 179 of the mothers tested positive for SARS-CoV-2 and 83 tested negative.

Out of the 263 infants, 44 were admitted to NICU, but not for pneumonia or lower respiratory infection.

CORONAVIRUS CASES LATEST

SA cases update: 

The latest number of confirmed cases is 672 572.

According to the latest update, 16 667 deaths have been recorded in the country.

There have been 606 520 recoveries.

So far, more than 4.16 million tests have been conducted, with 12 011 new tests reported.

Global cases update:

For the latest global data, follow this interactive map from Johns Hopkins University & Medicine.

Late on Tuesday night, positive cases worldwide were close to 33.48 million, while deaths were now more than 1 million.

The United States had the most cases in the world - more than 7.71 million, as well as the most deaths - more than 205 000.

WHAT'S HAPPENING IN SA

Latest news:

READ | Mkhize: Covid-19 impact lays bare local govt shortcomings, lack of basic services in communities

South Africa has a high level of environmental burden of disease, with 16% of all deaths estimated to be related to the state of the environment, Health Minister Zweli Mkhize said on Tuesday, referring to a 2006 World Health Organisation (WHO) report.

"It is actually all linked, a healthier environment gives you a healthier population and everything has to be done to make sure that we keep improving the quality of our natural environment.

"The science of environmental health is based on the premise that the prevention is better than [the] cure as this profession is concerned, with the key environmental factors that are at the heart of the public health dynamics," he explained during a webinar commemorating World Environmental Health Day.

During the virtual conference, Mkhize noted that the "fight for health for all will be won or lost in the public health space, therefore it is critical that as we pause to shine a spotlight on environmental health".

He added: "The international federation for environmental health recognises the continuing threats of environmental risk factors to human health and the urgent need to adopt a preventative approach in improving the quality of the natural environment and reducing environmental disease impact on the earth, on the health of the population."

READ | Africa needs $100bn for Covid-19 aftermath, Ramaphosa tells UN

President Cyril Ramaphosa said Africa needs financing of $100 billion for "fiscal space and liquidity" for the continent's governments amid the economic fallout of the Covid-19 pandemic, which has been described as the worst shock to the global economy since World War II.

Ramaphosa addressed the UN's high-level meeting on financing the 2030 Agenda for Sustainable Development in the era of Covid-19 and beyond on Tuesday via a video message.

UN Secretary-General António Guterres described breaching the millionth Covid-19 death as a "tragic milestone".

"The economic and social consequences are as bad as we feared, and in some cases, worse. We are suffering the largest economic contraction since the Second World War," he said.

"Unless we take action now, we face a global recession that could wipe out decades of development and put the 2030 Agenda for Sustainable Development completely out of reach."

He said: "The economic and social consequences are as bad as we feared, and in some cases, worse. We are suffering the largest economic contraction since the Second World War."

WHAT'S HAPPENING IN THE REST OF THE WORLD 

Latest news:

READ | Boost for vaccine doses planned for poor as virus rages on

Up to 100 million additional doses of any eventual Covid-19 vaccines will be secured for delivery to poorer countries in 2021, health groups announced on Tuesday, as the virus showed no sign of receding after claiming more than one million lives around the world.

The announcement doubles the number of doses already secured from the Serum Institute of India by the Gavi vaccine alliance and the Bill & Melinda Gates Foundation, following an initial agreement in August.

The public-private health partnership stressed that the eventual total is "potentially several times" greater, and said the price would be capped at $3 per dose.

"No country, rich or poor, should be left at the back of the queue when it comes to Covid-19 vaccines; this collaboration brings us another step closer to achieving this goal," Gavi chief Seth Berkley said in a statement.

As nine vaccine candidates are in last-stage trials, the World Health Organization is stepping up efforts to provide faster and cheaper testing to poorer countries.

The WHO said on Monday that around 120 million rapid tests for Covid-19 will be made available to low- and middle-income countries at $5 each under a $600 million scheme - as long as funding can be secured.

READ | The number of children with Covid-19 in the US has risen 'dramatically' over the last five months

In April, children represented just 2.2% of coronavirus cases in the US. By mid-September, that proportion had risen "dramatically" to reach 10%, according to data released today by the American Academy of Paediatrics and the Children's Hospital Association.

It's unlikely the rise is due to increased testing since CDC data shows children have consistently made up 5% to 7% of all tests administered since April, the organisations report.

While 10% is still lower than the percentage of children in the population (about 20%), and children with Covid-19 tend to fare better than adults, AAP President Dr. Sally Goza said in a press release "the rising numbers concern us greatly, as the children's cases reflect the increasing virus spread in our communities".

For the study, which will be published in the December issue of Paediatrics but was pre-published online today, researchers looked at five months of reported Covid-19 cases using data from U.S. public health department websites.

In addition to finding that the cumulative total paediatric Covid-19 cases has grown from 2.2% to 10% since the beginning of the pandemic, they found the percentage has been rising on a week-to-week basis.

For instance, less than 3% of cases reported the week ending April 23 were paediatric, but in the eight weeks prior to September 10, that percentage ranged from 12%to 15.9% per week.

HEALTH TIPS (as recommended by the NICD and WHO)

• Maintain physical distancing – stay at least one metre away from somebody who is coughing or sneezing

• Practise frequent hand-washing, especially after direct contact with ill people or their environment

• Avoid touching your eyes, nose and mouth, as your hands touch many surfaces and could potentially transfer the virus

• Practise respiratory hygiene – cover your mouth with your bent elbow or tissue when you cough or sneeze. Remember to dispose the tissue immediately after use.

Image credit: Getty Images