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Our world in dataUploaded 11-06-23https://ourworldindata.orghttps://ourworldindata.org/grapher/excess-mortality-p-scores-average-baselinehttps://ourworldindata.org/excess-mortality-covidExcess mortality is a term used in epidemiology and public health that refers to the number of deaths from all causes during a crisis above and beyond what we would have expected to see under ‘normal’ conditionsExcess deaths = Reported deaths – Expected deathshttps://ourworldindata.org/excess-mortality-covid#excess-mortality-our-data-sourcesThe Human Mortality Database is maintained by a team of researchers based at the University of California, Berkeley, USA and the Max Planck Institute for Demographic Research in Rostock, Germany. Learn more about your ad choices. Visit megaphone.fm/adchoices Learn more about your ad choices. Visit megaphone.fm/adchoices
More from Dr. John Campbell
the medical people I interact with at the hospital are far more optimistic than I've seen them since this all began in April last year
The Lancet Commission on lessons for the future from the COVID-19 pandemic Uploaded 16-09-2214th September 2022https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01585-9/fulltexthttps://covid19commission.orgWHO responseWHO acted too cautiously and too slowlySeveral important mattersTo warn about human transmissibility of the virusTo declare a Public Health Emergency of International ConcernTo support international travel protocols designed to slow the spread of the virus(This delay contributed to the spread of the virus and limited the possibilities for risk mitigation.)To endorse the public use of face masks as protective gearTo recognise the airborne transmission of the virus.(These delayed and vague recommendations from WHO continued until late April, 2021.) Just 1 example, after receiving an open letterFrom 238 scientists in July, 2020,asking the organisation to address airborne transmissionWHO did not change until April 30, 2021.Multiple failures of international cooperationToo many governments have failed to adhere to basic norms of institutional rationality and transparency, and the world's major powers have failed to collaborate to control the pandemic.Specific pointsLack of timely notification of the initial outbreak of COVID-19Costly delays in acknowledging the crucial airborne exposure pathway of SARS-CoV-2, and in implementing appropriate measures at national and global levels to slow the spread of the virus.Lack of coordination among countries regarding suppression strategiesFailure of governments to examine evidence and adopt best practices for controlling the pandemic,and managing economic and social spilloversShortfall of global funding for low-income and middle-income countries (LMICs)Failure to ensure adequate global supplies and equitable distribution of key commodities,protective gear, diagnostics, medicines, medical devices, and vaccinesLack of timely, accurate, systematic dataInfections, deaths, viral variants, health system responses, and indirect health consequencesAgain the report raised lab leak possibilityPoor enforcement of appropriate levels of biosafety regulations in the lead-up to the pandemic, raising the possibility of a laboratory-related outbreakFailure to combat systematic disinformationLack of global and national safety nets to protect populations experiencing vulnerability.As of May 31, 2022There were 6·9 million reported deaths and 17·2 million estimated deaths from COVID-19Institute for Health Metrics and Evaluationhttps://covid19.healthdata.org/global?view=cumulative-deaths&tab=trendThis staggering death toll is both a profound tragedy and a massive global failure at multiple levels. Sustainable development processSet back by several years, Deep underfinancing, Sustainable Development Goals and,aims of the Paris Climate Agreement. Previous publicationsLancet 2021https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02833-6/fulltextLancet Jan 2022https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02871-3/fulltexthttps://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01585-9/fulltext Learn more about your ad choices. Visit megaphone.fm/adchoices Learn more about your ad choices. Visit megaphone.fm/adchoices
Dr. Melissa McCann is a general practitioner in Queensland, Australia
Monkeypox virus, seldom reported outside African until now, Uploaded 27-07-22https://www.nejm.org/doi/full/10.1056/NEJMoa2207323?emp=marcom&utm_source=nejmlist&utm_medium=email&utm_campaign=aomev2&utm_content=version-a&ssotoken=U2FsdGVkX19dsxXEVZT5ggLZ3zieDxejeViMkwTigM4Q7ECfBTJmfTXUrKWkbZ3up0jDhhQjYR6OydzgkC%2F1LL8S5l7OuFDLsP2LiBwfKJ3ymNN4hp0Z%2FNASEYMuetIqeQIQ9ETL8BABCQut7e8xEQeWPlduFdyPMYgAugUePHtSEs5rFR%2BGWfFOCIPZs9Wb7aJf%2FyzhvvLSrzqDKmNt4Q%3D%3D&cid=DM1289135_Notable_Articles_Engaged&bid=1085207852Endemic in AfricaCases now worldwideMETHODSFormed an international collaborative group,international case series, presentation, clinical course, outcomes of PCR confirmed infectionsRESULTSWe report 528 infections diagnosed between April 27 to June 24, 2022Cases, 528, at 43 sites in 16 countries98% in gay or bisexual men, 75% were White, 41% had HIVmedian age 38Transmission suspected to have occurred through sexual activity95% of casesPresentation in this series95% rash (with 64% having less than 10 lesions)73% anogenital lesions41% had mucosal lesions(with 54 having a single genital lesion)Common systemic features preceding the rashfever (62%)lethargy (41%)myalgia (31%)headache (27%)lymphadenopathy (56%)Concomitant sexually transmitted infections109 of 377 (29%)Among the 23 people with a clear exposure historymedian incubation period, 7 days (range, 3 to 20)Monkeypox virus DNADetected in 29 of the 32 (in whom seminal fluid was analyzed)ManagementAntiviral treatment given to 5% of cases70 (13%) were hospitalizedMostly for pain managementsevere anorectal pain (21)soft-tissue superinfection (18)pharyngitis limiting oral intake (5)eye lesions (2)acute kidney injury (2)myocarditis (2)infection-control purposes (13)No deaths were reportedCONCLUSIONSMonkeypox manifested with a variety of dermatologic and systemic clinical findings. Need for rapid identification and diagnosis of cases to contain further community spread. Learn more about your ad choices. Visit megaphone.fm/adchoices Learn more about your ad choices. Visit megaphone.fm/adchoices
Detection of Messenger RNA COVID-19 Vaccines in Human Breast MilkUploaded 08-10-22https://jamanetwork.com/journals/jamapediatrics/fullarticle/2796427?guestAccessKey=1c13d17c-1c25-4828-b261-9f321e5126a1&utm_source=twitter&utm_medium=social_jamapeds&utm_term=7701881843&utm_campaign=article_alert&linkId=183092079JAMA Pediatrics(September 26, 2022)Initial messenger RNA (mRNA) vaccine clinical trials excluded several vulnerable groups, young children and lactating individualsCurrent FDA website, re children over 6 monthshttps://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-moderna-and-pfizer-biontech-covid-19-vaccines-childrenToday, the U.S. Food and Drug Administration authorized emergency use of the Moderna COVID-19 Vaccine,and the Pfizer-BioNTech COVID-19 Vaccine,for the prevention of COVID-19 to include use in children down to 6 months of age. From the JAMA paperThe US Food and Drug Administration deferred the decision to authorize COVID-19 mRNA vaccines for infants younger than 6 months,until more data are available,because of the potential priming of the children’s immune responses that may alter their immunityThe Centers for Disease Control and Prevention, re breast feeding mothershttps://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.htmlCOVID-19 vaccination is recommended for all people 6 months and older. This includes people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future. Back to the JAMA studyThe Centers for Disease Control and Prevention recommends offering the COVID-19 mRNA vaccines to breastfeeding individualsalthough the possible passage of vaccine mRNAs in breast milk resulting in infants’ exposure at younger than 6 months was not investigated. This study investigated whether the COVID-19 vaccine mRNA can be detected in the expressed breast milk (EBM) of lactating individualsreceiving the vaccination within 6 months after delivery.N =11Moderna mRNA-1273 vaccine (n = 5)Pfizer BNT162b2 vaccine (n = 6)Samples of EBM were collected before vaccination (control),and for 5 days postvaccination. 131 EBM samples were collected(1 hour to 5 days after vaccine administration)The presence of COVID-19 vaccine mRNA in different milk fractionsassayed using 2-step quantitative reverse transcriptase–polymerase chain reaction. ResultsTrace amounts of BNT162b2 and mRNA-1273 COVID-19 mRNA vaccines were detected in 7 samples from 5 different participants,at various times up to 45 hours postvaccinationNo vaccine mRNA was detected in prevaccinationDiscussionThe sporadic presence and trace quantities of COVID-19 vaccine mRNA detected in EBM suggest that breastfeeding after COVID-19 mRNA vaccination is safe,particularly beyond 48 hours after vaccination. These data demonstrate for the first time the biodistribution of COVID-19 vaccine mRNA to mammary cells,and the potential ability of tissue EVs to package the vaccine mRNA that can be transported to distant cells. In ratshttps://www.sciencedirect.com/science/article/abs/pii/S0168365915300535?via%3DihubUp to 3 days following intramuscular administration, low vaccine mRNA levels were detected in the heart, lung, testis, and brain tissues, indicating tissue biodistributionVaccine administration ---- lipid nanoparticles containing the vaccine mRNA ----- mammary glands (hematogenous and/or lymphatic routes)Vaccine mRNA released into mammary cell cytosol ---- recruited into developing EVs ------ secreted in EBMCaution is warranted about breastfeeding children younger than 6 months in the first 48 hours after maternal vaccination until more safety studies are conducted. COVID-19 medical misinformation policyhttps://support.google.com/youtube/answer/9891785Claims about COVID-19 vaccinat Learn more about your ad choices. Visit megaphone.fm/adchoices