Older Children Spread New Coronavirus as Easily as Adults: Study

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MONDAY, July 20, 2020 (HealthDay News) — Children older than 10 can spread the new coronavirus as readily as adults do, according to a South Korean study that included nearly 65,000 people.

It also found that children younger than 10 are about half as likely as adults to spread the virus, The New York Times reported.

The findings, published by the U.S. Centers for Disease Control and Prevention, come as debate about reopening schools in the fall rages across the United States

“I fear that there has been this sense that kids just won’t get infected or don’t get infected in the same way as adults and that, therefore, they’re almost like a bubbled population,” Michael Osterholm, an infectious diseases expert at the University of Minnesota, told The Times.

“There will be transmission,” Osterholm said. “What we have to do is accept that now and include that in our plans.”

Along with physical distancing, hand hygiene and masks, Osterholm and other experts say schools have to decide when and how to test students and staff, when and how long people need to quarantine, and when schools should be closed and reopened, the Times reported.


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Pooled Sampling Approved for COVID-19 Test

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MONDAY, July 20, 2020 (HealthDay News) — An emergency use authorization has been issued for the Quest Diagnostics’ Quest SARS-CoV-2 rRT-PCR test for use with pooled samples containing up to four individual swab specimens collected under observation, the U.S. Food and Drug Administration said Saturday.

The test is the first COVID-19 diagnostic test to be authorized for use with pooled samples.

Sample pooling is an important public health tool because it allows for more people to be tested quickly using fewer testing resources, according to the FDA.

“This EUA for sample pooling is an important step forward in getting more COVID-19 tests to more Americans more quickly while preserving testing supplies,” FDA Commissioner Dr. Stephen Hahn said in an agency news release. “Sample pooling becomes especially important as infection rates decline and we begin testing larger portions of the population.”


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When a Nurse Becomes a COVID Patient: Her Tough Road Back

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By Dennis Thompson
HealthDay Reporter

MONDAY, July 20, 2020 (HealthDay News)

Nurse case manager Sharon Tapp recalls laying in a Bethesda, Md., hospital bed, feverishly ill from COVID-19, asking for a bedpan.

Then, in what seemed to be the very next moment, she found herself in another bed in an unfamiliar room at what seemed to be a different hospital, surrounded by people she didn’t know.

“It was like, why am I here? I woke up and I was like, Johns Hopkins? I didn’t come here,” Tapp, 60, said in a voice still raspy from a healing tracheotomy. “I was looking around at all the people, and I was like, why am I here?”

Tapp was there because she’d just survived a months-long battle with COVID-19, a fight that required doctors to put her in a medically induced coma after flying her by helicopter to Johns Hopkins Hospital in Baltimore.

Tapp’s illness was so severe that at one point she needed a heart bypass machine to provide oxygen to her disease-battered body, said Dr. Alba Azola, a physical medicine and rehabilitation resident at Hopkins.

“It’s basically the bypass machine they use for open heart surgery,” Azola said. “They have to circulate the blood outside your body to oxygenate it because your lungs are not capable of oxygenating your blood.”

Tapp spent a month on the machine, “which is really unheard of. It’s a really long time,” Azola said.

“COVID pneumonia completely prevented her lungs from being able to provide oxygen,” Azola said. “The inflammation of her lungs was such that she could not oxygenate her blood through her lungs.”

  Tapp and Dr. Azola on hospital discharge day

Tapp’s ordeal started in early March, while she was on the job at Veterans Affairs Medical Center in Washington, D.C.

She suspects she contracted COVID-19 from a patient with whom she spent about 10 minutes “delivering my spiel” about her role in his medical care. Soon afterward, the patient was transferred to an isolation room and tested positive for coronavirus.

About two weeks later, on March 18, Tapp started experiencing fatigue, weakness, chest pain, a high temperature and headache. Her local urgent care center tested her for COVID-19 and told her to quarantine for 14 days at her home in Lanham, Md., based on her flu-like symptoms.

Five days later, the urgent care center called her to let her know that she’d tested positive for coronavirus. With a temperature of 102 degrees, Tapp asked her boyfriend to drive her to the emergency room at Suburban Hospital, a Johns Hopkins medical center in Bethesda.

“The folks saw me walking in and they knew. They said, ‘This girl needs help.’ They took me in right away,” Tapp said.

Tapp’s condition continued to worsen, and within 10 days of her admission she was transferred to Johns Hopkins Hospital in Baltimore — not that she knew it, because she was out of it by then.

Tapp wound up spending a total 117 days in the hospital, including two months in a medically induced coma.

Doctors transferred Tapp between intensive care and cardiac care units, keeping her alive with various equipment as she fought off double pneumonia and heart and lung failure. At one point she was on a ventilator, the bypass machine, and a dialysis machine because her kidneys had shut down.

Tapp awoke with a tracheal tube in her throat and a feeding tube in her stomach.

Tapp laughs when she recalls how, right after she woke up, none of the medical staff wanted to break the news about how long she’d been unconscious and deathly ill.

“A lot of people walked through the room, doctors and everybody. They said, ‘Miss Tapp, you look so good!’ I would say to myself, well, how was I looking before?” she chuckled. “Everybody’s coming through, the physical therapists, the respiratory specialists: ‘Oh, Miss Tapp, you look SO good!'”

Then her family came in and broke the news about what she’d been through during the past couple of months.

Tapp has spent the weeks since her awakening going through rehabilitation. She had to relearn how to perform basic tasks like standing, walking, swallowing, chewing and sipping from a straw.

She still needs a walker to get around and oxygen if she exerts herself too much, but she’s no longer on dialysis.

“Considering where she came from to where she is today, it’s just a miracle,” Azola said.

Tapp has worked at the VA Medical Center for 13 years, where she coordinates and assist veterans with their discharge from the hospital. She plans to return, but “not this year! Not in 2020,” Tapp said. “I really got to get myself together. It’s a long recovery road.”

Her advice to the healthy?

“Wear a mask. Wash your hands. Social distance. Those are the three things I would tell people,” Tapp said. “It’s no joke. It’s a serious thing. You know, I really don’t still have a taste. People ask me, what are you going to eat when you get home? Right now, I don’t have a taste.”

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References


SOURCES: Sharon Tapp, R.N., Lanham, Md.; Alba Azola, M.D., physical medicine and rehabilitation resident, Johns Hopkins Hospital

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Commission approves support for production of electricity from renewable sources in Ireland

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The European Commission has approved, under EU state aid rules, a scheme to support electricity production from renewable sources in Ireland. Ireland intends to introduce a new aid measure, called the Renewable Electricity Support Scheme (“RESS”), to support electricity production from renewable sources, including solar photovoltaic and wind.

The RESS, with an estimated total budget of between €7.2 billion and €12.5bn, will run until 2025. During this time, aid for the production of electricity from renewable sources granted under the RESS will be allocated through auctions. All eligible technologies will compete for subsidies in these auctions, which should ensure the cost-effective achievement of renewable electricity targets by encouraging competition.

However, Ireland has justified preferential treatment for a small quantity of energy from solar, as well as from offshore wind on the basis of the longer term potential of these technologies for the country. Successful applicants of the RESS will receive support over 15 years in the form of a premium on top of the market price.

The communities hosting projects supported by the RESS will benefit from a fund to which all RESS beneficiaries will contribute to and that will invest in certain technologies and ‘sustainable goals’ including education, energy efficiency, sustainable energy and climate action initiatives in the area surrounding the RESS projects. The Commission assessed the scheme under EU State aid rules, in particular under the 2014 Guidelines on State aid for environmental protection and energy.

The Commission concluded that the Irish RESS is in line with EU state aid rules, as it promotes the generation of electricity from renewable sources, in line with the European Green Deal, without unduly distorting competition.

Executive Vice President Margrethe Vestager, in charge of competition policy, said: “This Renewable Electricity Support Scheme will contribute to Ireland’s transition to a low carbon and environmentally sustainable economy, in line with the European Green Deal and our state aid rules.”

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Masks, Video Calls: Pandemic Is Hampering Communication for Those With Hearing Problems

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By Serena McNiff
HealthDay Reporter

FRIDAY, July 17, 2020 (HealthDay News)

Face masks help prevent the spread of COVID-19, but they have a huge downside for people with hearing problems: They muffle sound and prevent lip-reading.

But that’s only one of several ways that pandemic-related safety precautions are making communication more challenging for those who are deaf or have hearing problems, researchers say.

Limits on visitors in medical settings bar interpreters who help foster dialogue between doctors and patients, and the rise of telemedicine has added yet another hurdle with its lags in video transmission and poor image quality.

“Sometimes, we just forget how some of these additional safety guidelines can create problems,” said Dr. Michael McKee, an associate professor at the University of Michigan Medical School in Ann Arbor. “So we have to remind people to take a moment to think about solutions that will help not only keep us safe but also allow for communication access to still take place.”

While safeguards are necessary to protect health care workers and patients, they also interfere with the right to accessible and effective communication for patients who are deaf or have hearing problems. That right is guaranteed in the Americans With Disabilities Act, the study authors noted.

Poor communication in health care settings can be risky, and adults with hearing loss are more likely to be less satisfied with their care, experience longer stays and be readmitted to a hospital after being discharged, according to a report published online July 16 in JAMA Otolaryngology — Head & Neck Surgery.

In the report, McKee’s team detailed some workarounds — both high- and low-tech — that can help remove some of the communication barriers.

The new guidelines emphasize six ways to help people with hearing problems communicate clearly in health care settings:

  • Clear face masks: Use clear face masks to make lip-reading possible. Though only one is approved for medical use, the authors expect others to be on the market soon. Until then, a powered, air-purifying respirator could allow patients to see a speaker’s lips.
  • Interpreters: When in-person sign language interpreters are barred from hospitals and clinics, videoconference services can be used to involve remote interpreters.
  • Captioning apps: Use automated captioning apps to transcribe voices. These can be used on a patient’s personal device or on institutional devices.
  • Virtual visits: Use video-captioning or include a remote interpreter via three-way conferences during virtual visits.
  • Signage: Place signs outside and around the room of any patient who is deaf or has hearing problems to inform health care workers of communication barriers.
  • Communication boards: Use basic communication boards to facilitate dialogue with a patient via written messages.

McKee noted that many of these strategies could improve doctor-patient communication overall, not just for those with hearing difficulties. He and his colleagues have already adopted many of them.

For instance, they mounted tablet computers in clinics and hospital settings to provide live captioning or facilitate video conferences with remote interpreters. They have also expanded telemedicine visits to include an interpreter, if necessary.

Tricia Ashby-Scabis, director of audiology practices at the American Speech-Language-Hearing Association, said “flexibility” is the key to ensuring that patients with hearing problems are treated properly in medical settings.

“People have to understand that communication is a universal right for everybody,” she said. “You’ve got to think outside of the box.”

Clear and open dialogue between doctors and patients is essential, and miscommunications can have serious consequences, Ashby-Scabis pointed out.

“In health care, we look at these issues like noncompliance and hospital readmissions, but we’re fairly confident that a large portion of that is due to patients not being able to hear effectively or understand the directives that they’ve been given,” she said.

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What is hearing loss?
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References


SOURCES: Michael McKee, MD, MPH, associate professor, department of family medicine, University of Michigan Medical School, Ann Arbor; Tricia Ashby-Scabis, AuD, director, audiology practices, American Speech-Language-Hearing Association, Rockville, Md.; JAMA Otolaryngology Head & Neck Surgery, July 16, 2020, online

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‘Jeopardy’ Host Alex Trebek Tells Fans Cancer Treatments Are ‘Paying Off’

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By E.J. Mundell
HealthDay Reporter

FRIDAY, July 17, 2020 (HealthDay News) — Fans of “Jeopardy” host Alex Trebek got a health update for the first time in months on Thursday when he told followers that his treatments for pancreatic cancer are “paying off.”

“I’m doing well,” the 79-year-old host said in a video recorded at his home. “I’ve been continuing my treatment and it is paying off, though it does fatigue me a great deal. My numbers are good. I’m feeling great.”

Trebek also took the opportunity to tell fans that he has written a book, titled The Answer Is… Reflections on My Life, that will be out July 21. He also announced he plans to return to the studio to film new episodes of his wildly popular game show in September. The show’s filming has been in hiatus during the coronavirus pandemic.

Trebek first announced he was diagnosed with stage 4 pancreatic cancer in March 2019. Through several rounds of chemotherapy, he has kept fans of the show updated on his progress. He beat the one-year survival rate for stage 4 pancreatic cancer patients in March, which stands at only 18%, CBS News reported.

Here is Trebek, delivering the latest health update in his own words:

Back in October, Trebek partnered with the World Pancreatic Cancer Coalition to issue a public service announcement aimed at heightening awareness of the killer disease.

The aim was to “help raise global awareness of the risks and symptoms of pancreatic cancer,” Trebek said at the time.

“I wish I had known sooner that the persistent stomach pain I experienced prior to my diagnosis was a symptom of pancreatic cancer,” he noted in the one-minute video. “Other common symptoms can include mid-back pain, unexplained weight loss, new-onset diabetes and the yellowing of the skin or eyes.”

It’s been a rocky road for Trebek since he first announced his diagnosis.

Two months later, he and his doctors announced that he appeared to be winning his battle against the disease.

“It’s kind of mind-boggling,” Trebek told People at the time. Even though the overall survival rate for pancreatic cancer is just 9%, Trebek responded well to chemotherapy.

“The doctors said they hadn’t seen this kind of positive result in their memory — some of the tumors have already shrunk by more than 50%,” he told the magazine.

In late August 2019, Trebek seemed to be doing so well that he returned to taping the 35th season of “Jeopardy!”

But his health again took a turn for the worse.

“Yup, [I] went all the way down to numbers that correspond with a normal human being without cancer,” he told the Canadian television network CTV at the time. “[But] then all of a sudden, it blew up and went 50% higher than when it was first diagnosed. Go figure.” So, Trebek resumed chemotherapy in September 2019.

Trebek credits the warmth and support of fans for any inroads he’s made against the cancer.

“I’ve got a couple million people out there who have expressed their good thoughts, their positive energy directed towards me and their prayers,” he told People. “I told the doctors, this has to be more than just the chemo, and they agreed it could very well be an important part of this.”

Because it is so often symptomless until it reaches an advanced stage, pancreatic cancer has a high fatality rate. According to the American Cancer Society, about 57,600 Americans will be diagnosed with the disease in 2020, and the illness is expected to claim over 47,000 lives.

In addition, pancreatic tumors are particularly aggressive “due to a mutational profile that makes it resistant to therapies that work better for other tumor types,” explained Dr. Angela Alistar. She directs gastrointestinal medical oncology at Morristown Medical Center, in Morristown, N.J.



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Trebek is philosophical about his chances, and said death doesn’t frighten him.

“I’m not afraid of dying,” the 79-year-old told CTV. “I’ve lived a good life, a full life, and I’m nearing the end of that life — if it happens, why should I be afraid of that? One thing they’re not going to say at my funeral, as a part of a eulogy, is ‘He was taken from us too soon.'”

Born in 1940 in Sudbury, Ontario, Canada, Trebek initially was a TV journalist before hosting a Canadian quiz show, “Reach for the Top.” That led to being hired to host U.S. game shows such as NBC’s “The Wizard of Odds” in 1973 and “The $128,000 Question,” before moving to “Jeopardy!” a decade later.

He’s been a spokesperson for charities such as World Vision and Smile Train, and has entertained troops on numerous USO tours.

Trebek married twice — to Elaine Callei in 1974 (the marriage lasted seven years) and then to Jean Currivan in 1990, with whom he has two children, Emily and Matthew.

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SOURCES: World Pancreatic Cancer Coalition PSA; Oct. 4, 2019, CTV; Aug. 29, 2019, NBC News; March 29, 2019, People; Angela Alistar, M.D., director, gastrointestinal medical oncology, Morristown Medical Center, Morristown, N.J.

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Will CPR Save Your Life? Study Offers a Surprising Answer

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FRIDAY, July 17, 2020 (HealthDay News)

The success of CPR is vastly overrated by patients, a new study suggests.

Not only does the general public consider CPR more effective than it really is, they tend to discount the negative effect it can have, the researchers said.

Doctors should discuss CPR’s success rate, benefits and risks with patients and their loved ones, the study authors suggested. CPR is an emergency procedure for someone whose heart has stopped or who is no longer breathing.

Emergency doctors often talk to patients or their families about end-of-life care and the process of resuscitation. Patient and family expectations for CPR can affect the medical care that’s given, according to Dr. Norkamari Shakira Bandolin, of the University of California, Davis, and colleagues.

In earlier studies, patients have pegged CPR survival rates at between 19% and 75%. But the real rate of survival is about 12% for cardiac arrests that occur outside hospitals and between 24% and 40% for those that happen in the hospital, according to the report published online July 13 in the Emergency Medicine Journal.

For the new study, Bandolin’s team surveyed 500 emergency department patients and their companions.

Fifty-three percent said they had done or witnessed CPR, and 64% had taken a CPR course. Ninety-five percent said their main source of CPR information was television.

About half said the success rate of CPR topped 75%. And nine out of 10 said they wanted to receive CPR if it was needed.

But only 28% had discussed CPR with a doctor, the investigators noted in a journal news release.

“These findings should prompt emergency department physicians to initiate discussions about resuscitation with their patients while also providing them with key information to help facilitate informed decision-making,” the researchers wrote.

The study authors said that discussion should focus “on true rates of survival and outcomes” and should not assume that a patient or companion with health care experience will have realistic expectations.

— Steven Reinberg

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SOURCE: Emergency Medicine Journal, news release, July 13, 2020



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Even People With Lung Disease Should Wear Masks: Experts

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Latest Prevention & Wellness News

FRIDAY, July 17, 2020 (HealthDay News)

People with chronic lung disease may worry about being able to breathe freely with face masks, but they should wear the coverings if possible, four leading medical groups say.

“Individuals with normal lungs and even many individuals with underlying chronic lung disease should be able to wear a non-N95 facial covering without affecting their oxygen or carbon dioxide levels,” the American College of Chest Physicians, the American Lung Association, the American Thoracic Society and the COPD Foundation said in a statement released Thursday.

The groups acknowledged that some people with lung diseases might not be able to tolerate breathing with a mask and will seek a mask exemption from their doctor.

“However, the individual’s concerns should be weighed against societal needs to mitigate spread of the virus,” the groups noted. “In some instances, physician reassurance regarding the safety of the facial coverings may be all that is needed. Trying a variety of facial covering types may improve tolerability.”

The U.S. Centers for Disease Control and Prevention recommends face masks to curb the spread of coronavirus, and many states, cities and national retailers have issued mask mandates in recent weeks as coronavirus cases surge across the country.

The medical groups noted that tight-fitting N95 masks are reserved for health care professionals in high-risk environments and, to ensure there are enough for frontline workers, the general public should not be using them.

“There are limited studies analyzing the effects of wearing facial coverings on the wearer’s oxygen level … or carbon dioxide levels. Studies that have been done are primarily on heavy-duty N95 masks where there is a statistically insignificant percentage drop in oxygen levels and an even smaller increase in carbon dioxide levels noted among health care workers using masks for prolonged periods of time,” the groups said.

However, the use of N95 masks by members of the general public should be discouraged, except for certain immunocompromised patients who should discuss the issue with their doctors, the statement noted. Even for these patients, physical distancing should be the main method of protection.

“There are multiple facial covering options that may be more comfortable than others. Something is likely better than nothing when intolerant of certain facial coverings,” the groups said.

And there is another option: “Though face masks and face shields should not be viewed interchangeably, available data suggest face shields can reduce the amount of inhalation exposure to another droplet-spread respiratory virus, namely influenza,” their statement said.

Still, everyone, especially those with severe lung disease, should remember that the best way to avoid infection is to maintain strict physical distancing, along with frequent hand-washing, the groups said.

— Robert Preidt

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QUESTION


COPD (chronic obstructive pulmonary disease) is the same as adult-onset asthma.
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References


SOURCE: American College of Chest Physicians, news release, July 16, 2020



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Intellasia East Asia News – Asia Today: New restrictions coming for Australian hot spot

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Australia’s hot spot Victoria state on Tuesday reported 374 new cases of COVID-19, its second-highest daily tally.

Victoria Premier Daniel Andrews also announced three more deaths, bringing the national death toll 126.

Andrews said a lockdown in Australia’s second-largest city Melbourne, which began two weeks ago, was having an impact.

“You’d like to see numbers coming down. At the end of the day though, we’re not seeing the doubling and doubling again” of cases, Andrews said. “So what that says to me… is that the sorts of measures we’ve put in place are having a direct impact.”

Australian prime minister Scott Morrison said military personnel were helping Victorian health authorities deal with the growing caseload.

“We’re still very much in the hard part of this fight, as you can see from the daily case numbers and I’m not expecting that to change a lot in the short term,” Morrison said. “And we just need to keep working the problem.”

Tighter regulations will come into force on the Victoria-New South Wales border on Wednesday that will only allow border communities to cross for essential work, health and education reasons.

Face masks will become compulsory from Thursday for residents in lockdown regions when they leave their homes.

In other developments in the Asia-Pacific region:

Numbers of new cases in China’s latest coronavirus outbreak fell on Tuesday, with just eight reported in the northwestern region of Xinjiang. Another three cases were brought from outside the country, according to the National Health Commission, bringing China’s total to 83,693 with 4,634 deaths. Xinjiang cases have been concentrated in the regional capital and largest city of Urumqi, where around 50 people and possibly more have been infected. China responded swiftly to the Xinjiang outbreak by reducing subway, bus and taxi service in Urumqi, closing some communities, imposing travel restrictions and ordering widespread testing. Elsewhere in China, containment measures continue to be relaxed while mask wearing, temperature taking and social distancing remain the norm. Movie theaters reopened in many cities on Monday and Beijing has downgraded its emergency response level after seeing no new cases of local infection for two weeks. Conferences, exhibitions, sports events, performances and cinemas in the capital are expected to reopen gradually after passing risk appraisals.

South Korea’s new virus cases have bounced back to above 40, a day after it reported its smallest daily jump in local COVID-19 transmissions in two months. The Korea Centers for Disease Control and Prevention reported 45 new cases Tuesday, bringing the country’s total to 13,816 with 296 deaths. The agency says 20 of the newly recorded cases were locally infected patients while the rest 25 were associated with international arrivals. Two-week quarantines are enforced on all travellers arriving from abroad in an attempt to contain the spread of the virus.

https://www.yahoo.com/lifestyle/asia-today-restrictions-coming-australian-025108515.html

 

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Intellasia East Asia News – COVID-19 in the Philippines: 1500 new cases reported, Expert says it’s ‘not comparable to other diseases’

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The Philippines Department of Health recorded another 1521 COVID-19 cases today, including 1237 from the National Capital Region, bringing the country total to 68,898.

In addition, four additional deaths were reported putting that total to 1835.

UP COVID-19 Pandemic Response Team member Dr Darwin Bandoy said a decrease in the positive rate and reproductive number means improvement in the national response to the COVID-19 pandemic.

“When the positivity rate goes down it means the detection of cases has improved and less are getting sick, and the reproductive number goes down, less than one, we’re able to control the) pandemic,” Bandoy said.

Dr Bandoy also reminded the public that comparing COVID-19 to other diseases can be misleading. “For example, they’ll say only such percent died from a certain disease and then they’ll compare it with Covid-19 deaths. They don’t notice that it is one year worth of data, and Covid-19 hasn’t been around for a year, Covid-19 data are fairly new, so there are improper comparisons influence people to ignore the severity of Covid-19″, Bandoy added.

COVID-19 in the Philippines: 1500 new cases reported, Expert says it’s ‘not comparable to other diseases’

 

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