COVID-19 Coronavirus and other virus UK and World News Update 11th October 2024

COVID-19 Coronavirus and other virus UK and World News Update 11th October 2024

England's hospital admissions with COVID rose by 69% over September, so the wave did continue, and alas it seems it's not peaked yet. Cases are a mystery, as hardly anyone tests, but I know it is running around our local area at the moment, which is a lot rarer than it was when we were in Manchester.  

"10,096 deaths were registered in England and Wales, week ending 27 September 2024 (Week 39):

· 10.7% lower than the expected number (1,215 fewer deaths)

· 12.8% involved influenza or pneumonia (1,291 deaths)

· 1.4% involved COVID19 (143 deaths)"

It's absolutely great that we have sustained the lower losses of life, but 143 people still officially died from COVID last week - it realy isn't 'over'. 

There is a very important and somewhat grounding point to note, as Stuart McDonald of the COVID Actuaries explains:

"Mortality rates for young adults are still higher than any recent pre-pandemic year.

The CMI quarterly mortality monitor published yesterday shows that only 2021 and 2023 had higher death rates than we’ve seen so far in 2024."

We are still losing far too many people too early. It's hard to pull apart exactly why, but cardiovascular mortality is the main driver - heart and blood conditions such as heart attacks, strokes, aneurysm etc. These are areas we know can often sustain damage from COVID infection. 

The UK COVID Inquiry continues. I missed it last report, but a couple of weeks ago the inquiry heard from Dr Lisa Ritchie, who chaired the group which wrote the Covid infection control guidance for UK hospitals, and is currently still the Head of Infection Prevention Control for NHS England.

- They had a plan in place for a SARS outbreak, but didn't follow it.

- Clinicians working in high risk areas wore FFP3 masks and died less often than those on wards or other 'safer' roles in surgical masks, but they didn't think that warranted changing all staff to FFP3 masks.

- Under repeated and very clear questioning, she still doesn't feel COVID is generally caught via aerosol particles floating in the air. She still believes most people catch it via close contact from droplets (e.g. sneezing near someone or breathing into their face) and touch (e.g. snotty fingers on a door handle or tending to a patient).

- Prof Susan Hopkins, UKHSA Chief Medical Officer, also testified that she didn't think FFP3 masks should be recommended, although she does at least appreciate aerosol transmission is a big part of how COVID spreads. 

Good news for anyone worrying about catching COVID on the bus then, eh (no it isn't, that was a joke). It's been over 3 years since even the UK Government began running public adverts explaining COVID floats in the air. I honestly despair. 

Huge thanks to CatInTheHat on Twitter for collating video evidence for this one. 

This week Dr Catherine Finnis has been giving evidence to the UK COVID inquiry on behalf of clinically vulnerable families. 

She talked about errors in the shielding lists, meaning some people who should have been protected were expected to go to work, and some people were told several weeks in that they needed to shield. 

There was a lack of understanding about how long shielding might go on, the difficulties raising and entertaining children while shielding, and worry over them attending school/not atrending school, and not being vaccinated.

When shielding ended 'normal' life was meant to just resume, then shielding returned, then it ended again. Masks were on, then off, and almost half of people surveyed reported serious verbal abuse about their masks. 

Shielding annoyed and/or confused some employers. Clinically vulnerable people were more often chosen for redundancies. Self employed clinically vulnerable people had a harder struggle to keep businesses afloat. Statutory sick pay left many in a dire financial situation, and with higher costs, as they needed good masks, home deliveries and to avoid busier places. A lot of people couldn't afford to shield.

Clinically Extremely Vulnerable people of varying ages were told Do Not Resuscitate notes were being put on their medical files.

The messaging around shielding and other protective measures was disjointed and mixed, and the general public needed clearer understanding and empathy. Understandably the entire situation had a massive negative effect on mental health, and the vulnerable and extremely vulnerable populations are little better off even now.   

A new study out last week in Nature scientific journal has yet more evidence that COVID infection causes lasting brain injury. 

351 hospitalised COVID patients with an average age of 54 completed cognitive tests, MRI and blood sampling around a year after infection. ALL performed worse than anticipated in the cognitive tests (memory and logic questions and that kind of thing). Blood tests showed brain injury markers and MRI showed reduced grey matter in the brain. Although there was clear improvement in the recovery phase, after discharge it seems to plateau - meaning any further recovery is incredibly slow, or doesn't happen. 

(Do NOT lose hope. My partner's brain recovery after Meningitis was very quick at first, then very slow, but even 7 or 8 years later we were still able to pinpoint specific improvements.)

Previous studies have found, as has this study, that the more severe the COVID, the worse the damage. The better the mental health after illness, the better the recovery. 

"The findings suggest immune-mediated brain injury and highlight the need for targeted therapies." (The body does the damage trying to protect itself and beat the COVID, and treatment needs to reflect this.)

Following on from this, a study led by University of Cambridge has used ultra high-resolution scanners, known as 7-Tesla or 7T scanners, to look at the living brain in fine detail that is only usually possible once someone has died. 

They studied 30 hospitalised COVID patients, compared to 51 people with no history of infection. They found that weeks after hospitalisation, regions of the brainstem had abnormalities associated with a 'neuroinflammatory' response (brain swelling). These areas included those responsible for breathing control - which can obviously affect shortness of breath and fatigue or tiredness. The patients with most severe effects also showed higher levels of depression and anxiety. 

This is yet more visible, measurable proof of lasting brain injury after COVID, or Long COVID. Bittersweet, but it gives us some more to work on as regards treatment. 

The UK has launched The Generation Study. In partnership with the NHS, and after an opt-in by parents, the whole genomes of up to 100,000 newborn babies will be sequenced to look for over 200 rare conditions in early childhood. Only treatable conditions are included, so hopefully it will have positive impact for anyone affected.

It's great to see research into the differences made by long-term vision and proactive healthcare. If successful, it could be the future... 

The US Centers for Disease Control and Prevention (CDC) has confirmed California's 3rd human H5 bird flu case, and test results are still pending on another two people.

All 3 of California's confirmed cases have been mild, with patients suffering severe conjunctivitis among other symptoms, but not needing to be hospitalised. 

As of Wednesday 9th October, 18 human cases of H5 bird flu have been reported in the United States since 2022; 17 of those during 2024.

12 of the 17 have been confirmed as H5N1 - the Avian flu strain affecting US dairy cattle. There 'wasn't enough virus to confirm the N' in the remaining cases.

The CDC reassure the US public:

"The identification of H5 in people with exposure to infected animals is not unexpected and does not change CDC's risk assessment for the general public, which continues to be low."

At latest count, as of yesterday, 300 herds have been confirmed infected across 14 states. 

Remember the random Missouri man who got bird flu and no-one knows how? The CDC has had to develop a new test to look for antibodies in the blood of his contacts... hopefully the results will NOT help solve the mystery. If human to human contact is discovered, it will be a first. Fingers crossed it isn't, and he was just unlucky (bird flu can spread through bird poop). 

Over 16 million people in the UK are eligible for an NHS Health Check, but only around 40% of those invited book one. This is especially true for men. The UK Government have rolled out workplace health checks for over 130,000 people - none of whom will be able to use the excuse "I haven't got time to go to the doctor"...

"Of the 36 confirmed Marburg cases in Rwanda so far, 29 are healthcare workers, says Rwanda's minister of health Sabin Nsanzimana.

Good reminder that nurses and doctors are on the frontlines every day all over the world - and often without access to adequate protection."

Science Journalist Kai Kupferschmidt earlier this week.

Latest figures released today by WHO show that the outbreak has now risen to 58 cases and 13 losses of life since the first fatality on 8th September. Contact tracing is underway, with over 700 contacts under follow-up. The good news is that 15 people have recovered. 

More good news, as of Wednesday, ALL cases are linked to the hospital cluster in Kigali, and there is NO evidence of community transmission. 

WHO have classified the Marburg outbreak as a grade 3 emergency, the highest level for a single country outbreak, and explain very succinctly what Marburg is:

"Marburg virus disease is highly virulent and causes haemorrhagic fever, with a fatality ratio of up to 88%. It is in the same family as the virus that causes Ebola virus disease. Illness caused by Marburg virus begins abruptly, with high fever, severe headache and severe malaise. Many patients develop severe haemorrhagic symptoms within seven days. The virus is transmitted to people from fruit bats and spreads among humans through direct contact with the bodily fluids of infected people, surfaces and materials."

Haemorrhagic disease damages the walls of tiny blood vessels, making them leak, and can affect the blood's ability to clot. Patients are severely weakened. 

Two travellers, including a medical student who had contact with Marburg patients in Rwanda while wearing PPE, became sick while on a train in Hamburg. Both tested negative, but isolated anyway. It gave everyone a bit of a wobble regarding international spread. 

There is currently no licensed vaccination against Marburg. Last weekend the US sent Rwanda 700 doses of an experimental vaccine & doses of a monoclonal antibody treatment. This week another 1,000 vaccine doses have been sent. Vaccination of frontline healthcare workers began on Wednesday.

The Rwandan outbreak offers the chance to trial vaccines that have been in development for years, not only to prevent Marburg, but as therapeutics. That is, you can offer them to people who have been exposed and suspected to have caught Marburg, and hope they work to quickly teach the body what to fight, before the virus has a chance to really start attacking. It isn't always too late - therapeutic vaccines work really well for some other virus, Rabies being a very longstanding example. 

These vaccinations have passed safety controls, but obviously you can't purposefully expose or infect people with Marburg to test how well it works. Faced with such a high mortality rate, any level of efficacy is welcome, and what is learned will help more people in the future.

"October is Breast Cancer Awareness Month 

Breast Cancer is the most common cancer among women globally and represents approximately a quarter of all cancers that occur in women every year."

The World Health Organisation 

Go on people, you know what to do now (and every month). Arms up and cop a feel - get permission first if they aren't yours.

If you are called for breast screening, rest assured it's a 5 minute job and very different from 20 years ago. Shouldn't hurt a bit, and it's not even very uncomfortable (1st hand experience). 

Boris Johnson (ex UK Prime Minister) has published his COVID-times memoirs.

In it he recounts how he first thought COVID was caused by unsanitary conditions at the Wuhan market, and despite mounting supporting evidence for that theory, he's now changed his mind and believes it's a lab leak of a man-made virus.

Boris is unhappy that apparently during COVID, people with an agenda to 'bring him down' told on him for his lockdown parties - which were rubbish anyway. The meanies.

Most surprising revelation for me is the news that he genuinely looked into the feasibility of a raid on a Netherlands warehouse, because they had the 5 million vaccine doses we'd ordered and weren't releasing them quickly for export to the UK. 

Being Prime Minister was a terrible disappointment to him wasn't it? He had to do live press conferences all the blinking time, the parties were rubbish and it wasn't actually anything like James Bond. (2/10 would not recommend.)  

You may remember me covering HPV vaccinations a couple or so years ago, and how I said "we really do have a chance to eradicate cervical cancer. Our granddaughters might never have to worry about it". 

The news is good. In fact the news is spectacularly great. 

Scotland has detected no cases of cervical cancer in women born between 1988-1996 who were fully vaccinated against HPV between the ages of 12 and 13.

It isn't yet eradicated completely, but the incidence across the UK is so low that it is less  1 per 100,000. As HPV-related malignancies account for 4.5% of all human cancers, this can save the health and the lives of a lot of people.

Vaccinations haven't only changed our lives compared to our great grandparents, they are changing the lives of our children as we watch. 

Crikey that was a long one, but hurrah - it's Friday again! That's the weekend and for us a 2 week school holiday. I'm not exactly sure what my 2 weeks will include, except for more unpacking and emptying of containers into my house (bookcases and shoe tidy are high on the list!). I'm also hoping to see at least one of our older kids, so I'll be back in 3 weeks instead of 2. I won't forget my treat (as if getting my books back on shelves isn't exciting enough!), and you shouldn't forget to treat yourself too. We all need something to look forward to, and something special for ourselves. Be kind to you, and look after your own mental health the same as (or better than) your physical health. It was World Mental Health Day this week - a reminder to us all to take time to check in with friends and relatives, and make time to ask "are you doing okay?", and then listen properly to the answer. Simply being there can be enough to make the difference. 

See you in November! Until then... Take Time To Talk, Be Your Brave Self And Ask For Help If You Need It, Save The NHS... 

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Sources: 

https://www.worldometers.info/coronavirus/

https://coronavirus.data.gov.uk/

https://ourworldindata.org/covid-vaccinations

https://www.gov.uk/coronavirus

Images

CMI young people and image 

https://x.com/ActuaryByDay/status/1844277004973244755?t=U0j7gYY_tYu0oftc4R86yA&s=09

Hospital admissions and image 

https://x.com/ActuaryByDay/status/1844301050033078731?t=WUnZJI0TLQcHto5epmkZbw&s=19

Baby loss certificate image

https://x.com/DHSCgovuk/status/1843928591584899203?t=wGjCOLTtOda9mHsyqrn8hw&s=09

WMHD2024 images

https://x.com/samaritans/status/1844063563519844495?t=b3XVoJN-K5ZDttlaqgdm_g&s=09

https://x.com/MindCharity/status/1844233899104403935?t=llVusF9cj0NNBtsfps7dag&s=19

https://x.com/YoungMindsUK/status/1844275158929797315?t=WaA_nDeL5qBfhNRkbmrW1g&s=19

https://x.com/allontheboard/status/1844273364145406282?t=PYE4-IlkJsIig3nYijH2tA&s=19

https://x.com/theRCN/status/1844273430868165083?t=4HZ_uVLARGTbmO5M5Azgkg&s=19

NHS 111 Image

https://x.com/DHSCgovuk/status/1843573319875940624?t=exaRoK4MAXVjpu6yXJHRHw&s=09

Flu vaccine bookings open image uk nhs 

https://x.com/UKHSA/status/1843681046073684059?t=T0SjBmbMJz2KYESlNXTXLg&s=09

Workplace health checks image 

https://x.com/DHSCgovuk/status/1840300521971712409?t=y5Ygxvsyad2LN9JSkotXkQ&s=09

Breast cancer month and image

https://x.com/WHO/status/1841096489101136336?t=e7zsC22qfxIqh7ZqfmdChg&s=09

Breast cancer month uk image signs and symptoms 

https://x.com/NHSuk/status/1841055774828618065?t=c1pkqqHVo3wq8prdIfLtcw&s=19

Latest stats UK

https://x.com/ONS/status/1843932372393439655?t=tQ_PB9pSglLno9N5jC8HLQ&s=09

https://www.actuaries.org.uk/learn-and-develop/continuous-mortality-investigation/other-cmi-outputs/mortality-monitor

https://x.com/chrischirp/status/1844696550510850057?t=wk887RYqFCNXQug6zLEyFg&s=19

Covid inquiry airborne

https://x.com/_CatintheHat/status/1842895616868786395?t=Fcsnpsi8X3MvGJjEpmw9pg&s=09

https://x.com/_CatintheHat/status/1842895853733683531?t=4COw78loSc1FNSRR-OqAIQ&s=19

Dr Ritchie’s session at the Covid Inquiry is available on YouTube here:

MORNING SESSION (from 1:33:00): 

youtu.be/m1c5AYORCH4

AFTERNOON SESSION:

youtu.be/OMA1uAk0F_U

You can also find a full transcript of her testimony here (from text block 62):

covid19.public-inquiry.uk/wp-content/upl… module 3 16th September 

https://x.com/_CatintheHat/status/1836392922213646556?t=JRyntEql5dxlmiUtnmzZZQ&s=19

Covid inquiry CV, CEV

https://x.com/cathy_finnis/status/1844150891298910507?t=bnQHbvGT186XzFEIYRJibg&s=19

Covid brain

https://www.news-medical.net/news/20240926/COVID-19-causes-lasting-cognitive-impairment-tied-to-brain-injury-markers.aspx

https://www.nature.com/articles/s41591-024-03309-8

Brainstem Long COVID

https://www.cam.ac.uk/research/news/ultra-powered-mri-scans-show-damage-to-brains-control-centre-is-behind-long-lasting-covid-19

Human H5N1

https://x.com/HelenBranswell/status/1844118010296140245?t=mbuOZOSnhkJlSwVpuSjcMg&s=09

https://www.cdc.gov/media/releases/2024/s1009-human-case-bird-flu.html

https://x.com/HelenBranswell/status/1841584781089505678?t=eufyVinmzCr0L1D4Su0WiQ&s=09

https://www.statnews.com/2024/10/02/missouri-bird-flu-virus-transmission-concerns/

Avian flu latest stats

https://www.aphis.usda.gov/livestock-poultry-disease/avian/avian-influenza/hpai-detections/hpai-confirmed-cases-livestock

Workplace health checks

https://www.gov.uk/government/news/over-130000-people-to-benefit-from-life-saving-health-checks

Genomics study UK 

https://www.genomicsengland.co.uk/news/first-newborn-babies-tested-for-over-200-genetic-conditions-as-world-leading-study-begins-in-nhs-hospitals

https://x.com/GenomicsEngland/status/1841757680274141292?t=271XKhg_IaSsUKeYfU5GvQ&s=09

Boris Johnson memoir 

we considered ‘aquatic raid’ on Netherlands to seize Covid vaccine | Coronavirus | The Guardian

https://www.theguardian.com/world/2024/sep/27/boris-johnson-considered-raid-dutch-warehouse-seize-covid-vaccine

Also changs mind on covid origins 

https://www.independent.co.uk/news/uk/home-news/boris-johnson-covid-vaccine-netherlands-memoir-b2620775.html

And people were lying to make him look bad

https://inews.co.uk/news/most-shocking-lines-boris-johnsons-memoir-unleashed-3299992?srsltid=AfmBOop9uQJ4Pb14dFNbDKfIfBuWCPhgz_bugAy2MX2GrXFGTHKTv_Zb

HPV

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9729511/

https://x.com/johnthejack/status/1839750751414886514?t=nNEw1QziQaW_QXQv_Gcikw&s=09

https://www.statnews.com/2024/01/25/hpv-vaccine-prevent-cervical-cancer-cervarix-gardasil-study/

https://academic.oup.com/jnci/advance-article-abstract/doi/10.1093/jnci/djad263/7577291?redirectedFrom=fulltext&login=false#no-access-message

https://www.gov.uk/government/collections/hpv-vaccination-programme

https://academic.oup.com/jnci/article-abstract/116/6/857/7577291#no-access-message

Marburg

https://www.mayoclinic.org/diseases-conditions/viral-hemorrhagic-fevers/symptoms-causes/syc-20351260

https://x.com/HelenBranswell/status/1840159103899054551?t=hcAGHxttgkBIyrMueJrXQQ&s=09

https://www.afro.who.int/countries/rwanda/news/rwanda-reports-first-ever-marburg-virus-disease-outbreak-26-cases-confirmed

https://www.statnews.com/2024/09/30/marburg-virus-outbreak-rwanda-concern-about-spread/

https://x.com/angie_rasmussen/status/1841834323969819028?t=kWJ9AsHhddPK1xZ1lXVuTA&s=09

Therapeutic vaccinations 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9729511/

https://www.sciencedirect.com/topics/medicine-and-dentistry/therapeutic-vaccine

German students

https://x.com/COVID19_disease/status/1841504444103451102?t=Z0D18jpfUyX-LBR9hlOCNw&s=19

No travel or trade restrictions 

https://www.who.int/news-room/articles-detail/who-advises-against-any-travel-and-trade-restrictions-with-rwanda-in-the-context-of-the-ongoing-marburg-virus-disease-(mvd)-outbreak

https://x.com/kakape/status/1841841914326188465?t=6mwQbNHClIA_dxtWFTYxnQ&s=19

Quote Kai Kupferschmidt 

https://x.com/kakape/status/1841836947754434635?t=lm1lvDvqk93Y9CxTTPJhdA&s=19

WHO health briefing Thursday week1

https://x.com/WHO/status/1841839731488829954?t=hbOraseIpXLsgTXKvPm-8A&s=19

https://x.com/kakape/status/1843166225658155360?t=EOuubRa5g9uP06RDpLsn6w&s=09

https://x.com/RwandaHealth

"Many remember and appreciate Brussels Airlines for maintaining flights to Sierra Leone and Liberia, when all other European carriers stopped because of Ebola in 2014."

https://x.com/InfectiousDz/status/1843057083484450891?t=BvlKHpkiUZMUVKed2qWvjw&s=19

US vaccinations 

https://x.com/HelenBranswell/status/1842321560385831000?t=yc50_hGvtQV2gRYSUGzoZA&s=19

https://www.statnews.com/2024/10/04/marburg-virus-rwanda-outbreak-vaccines-therapeutics/

This will make 1,700 doses sent.

https://x.com/HelenBranswell/status/1844000493502373975?t=31djSuNFgUaIvlf8DhJ4xA&s=19

Marburg wednesday update - 0 cases and note on all cases connected - and more vaccine

https://x.com/kakape/status/1844114618144391230?t=ulY9i9cCa9ZlSMljPiPVRg&s=09

Latest Marburg update from WHO, 11th October 

https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON539

 

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COVID-19 Coronavirus and other virus UK and World News Update 27th September 2024

COVID-19 Coronavirus and other virus UK and World News Update 27th September 2024

The UK's 'cumulative mortality' continues to run at a level lower than would be expected historically. Summed up by COVID Actuary Stuart McDonald:

"Age-standardised death rates this year have tracked the best year on record (2019) very closely, except during the Covid-19 waves in June and July when death rates were a bit higher."

It's a very sad victory, but after so many people died early due to COVID, we would expect death rates to be lower than averages once stability returns. Last year it was clear that hadn't happened, this year looks more promising (unless XEC ruins it). 

It looks like XEC will be the next COVID variant to become dominant, and potentially cause a significant wave across Europe, and beyond. It may well already be having a quiet assault on the UK, as in England the numbers of hospital patients with respiratory problems who test positive (almost 12%) are creeping up towards where they were in the Summer wave (around 13%).

Hospitalisations are also up (3.71 per 100,00), almost doubling where they were in August (2.0), but not yet as high as during the worst of the Summer wave in July (4.7). 

XEC is a 'recombinant', a mix of strains KS.1.1 and KP.3.3 which likely happened inside a single person's body while they were infected with both at the same time. From the Omicron lineage and first detected in Germany just 3 weeks ago, XEC is spreading out throughout Europe, and showing an advantage to other strains. It now accounts for around 1 in 6 cases in Germany, 82 cases have been detected in the UK, and it has already been spotted in 27 countries, including the USA. 

Because XEC is a mix of 2 known strains, vaccinations and previous immunity should be as effective as before, and there are no signs that it is more severe - just easier to spread and likely to infect a lot of people. 

The UK's Autumn booster vaccination programme begins next week. If you have been invited, you can book your jab now. Eligible people include:

- adults aged 65 years and over

- residents in a care home for older adults

- individuals aged 6 months to 64 years in a clinical risk group (a much smaller group than previously, that doesn't include immunosuppressed people or their households)

- frontline NHS and social care workers, and those working in care homes for older people

“We find a very consistent story in terms of this pointing to the market as being the very likely origin of this particular pandemic.”

Professor Kristian Andersen, Scripps Institute. 

Researchers from the United States and France feel it is now "far beyond reasonable doubt" that COVID originated at the Huanan seafood market.

Thats probably as close to definite you'll ever get from a scientist. 

In a newly released paper they analysed hundreds of samples collected by Chinese authorities in 2020, including 800 collected on 1st January at the market. The researchers were able to identify areas of the market with particularly high levels of COVID, and finally we have a list of the potential animals which could have passed the infection to humans - raccoon dog, hoary bamboo rat, dog, European rabbit, Amur hedgehog, Malayan porcupine, Reeves’s muntjac, Himalayan marmot and masked palm civet. 

The scientific community have responded. All available scientific data supports the suggestion the market was 'ground zero', and genetic testing of the strains of COVID found in samples around the market matches the first known human cases. Genetic testing also shows some of the animals found were not from the areas they were supposed to be from, and some of the 'farmed' animals were actually wild. Very naughty, and as it turns out, the world may have paid a very high price for that deceit. Rules really are there for a reason...  

No more UK rail strikes - for now at least. 

Train Drivers have voted by 96% in favour of a new pay deal. They will receive around 15% over 2 years. 

Members of RMT union have voted 99% in favour of a new pay offer. Train operators will receive 4.75% for the last year and 4.5% for 2024/25, Network Rail will receive 4.5% this year. 

Doctors in training (previously Junior Doctors) have voted 2 to 1 to accept the latest pay deal. It is tricky maths, as it is involves 'pay scale uplifts' and percentage rises on top of previously promised percentage rises, but basically amounts to around 22.3% on average over the next 2 years.

A new NHS doctor in Foundation Training will see a rise from around £32,400 to £36,600, and a full-time doctor training for a specialty will see a rise from about £43,900 to £49,900.  

English Nurses who are in the Royal College of Nursing (RCN) union have rejected a pay offer of 5.5%.

5.5% has already been accepted by other union members, but there was a massive turnout for this vote, and RCN members voted 2 to 1 against. They feel '10 years of neglect' can't be put right with a single pay award matching current inflation rates. 

Bad luck Mr Streeting... can't win them all first try...

Just when UK Health Secretary Wes Streeting thought it was safe to go back in the water... Pharmacists have raised their head above the parapet. 

It seems every single part of the UK health system was expected to deliver 2024 service at 2014 prices, and that wasn't going to last forever. Pharmacists say they are struggling to operate a viable business if they open for the 40 hours they are required to open, let alone paying staff and costs to open for extended hours. The Pharmacy First scheme, where people get help from their pharmacy for simple ailments, has added extra workload and prescriptions, bumping costs even more, when in reality it should mean extra earnings. Like Dentistry and GPs, the payment system was invented by some evil genius, and is not in the best interests of patients, healthcare facilities or workers, or even the taxpayer. It does need a massive overhaul. 

H5N1 Avian Influenza in US cattle, and California's bulk testing found another 7 infected herds last week.

It is still unclear how a random Missouri man with no links to livestock or wild birds caught H5N1, and even more worrying, it has been disclosed today that a total of 6 (six) healthcare workers who looked after the man became ill. Only 1 has been tested. So, okay, at the time they didn't realise he had H5N1, but really, this is incredibly remiss as regards looking after healthcare workers. They deserve better. The healthcare workers are now being tested, so hopefully we'll be told if they did manage to catch H5N1 from another human sometime very soon. If so this is massive bad news, or they could just have had nasty colds. 

Current total since April 2024 stands at 14 human cases of avian influenza A(H5) in the US. 4 were associated with sick cows, 9 poultry, and Missouri man.

Current herds infected stands at 239 herds across 14 states. 

Risk to the wider public (and wider world) is still considered LOW. 

Latest available data still shows no cases of the more dangerous and transmissible Clade 1b Mpox in the UK, however the Government are readying themselves. More than 150,000 more doses of Mpox vaccine have been ordered from supplier Bavarian Nordic.

Although Mpox Clade 1b is spreading throughout the general population in DRC, and mainly affecting children (around 70% of cases), the UK Government and NHS will continue to offer vaccinations to those previously affected by the 2022 Mpox Clade 2 outbreak - at-risk health workers and carers, and men who sleep with other men. 

Still on Mpox, last week WHO delivered 3,500 GeneXpert testing cartridges to the DRC.

"These vital supplies will enhance Mpox testing in the hardest-hit provinces and strengthen the overall response."

The UK COVID Inquiry continues. Yesterday Professor Kevin Fong gave heartbreaking testimony about his time in hospital intensive care units at the height of the second wave in late Dec 2020. If you want to be reminded just how terrifying, traumatic and soul-destroying it was watching patient after patient die, unable to help them breathe, his testimony is available online. 

Earlier we heard from Chief Nurses, who talked about the fact it was nurses who bore the brunt. Not only did they have to watch their patients die in spite of their best efforts, but they were doing it in unsuitable PPE and masks, for very long hours, avoiding their own loved ones and often terrified they themselves one day may not go home. 

Last week the UK COVID Inquiry looked at one of the biggest pieces of erroneous information from back in 2020. COVID was always airborne, but most of the major Government-advising scientists got that wrong. For several months we were all told COVID had large droplets that couldn't spread easily without coughs or sneezes, when in fact the virus droplets were so tiny they could float around the room in the air. 

One of those frustrating occasions when the evidence in front of our eyes (e.g. classrooms full of infected kids) didn't match up with what our Governments and even the World Health Organisation were saying.

Jim Reed of BBC Radio has done an excellent piece on this 'misunderstanding', which I believe may be a podcast, as well as on his blog. 

After compiling his damning report on the state of the nation's health, Lord Darzi was in The Guardian with his ideas for how to fix it, and in my view he is a sensible and very clever chap. For a long time UK Government have led as if they only have this week to think of, never in the best interests of the country long term. I'm actually quite surprised they didn't all board a shuttle for Mars because they behaved like they were off any minute...

Lord Darzi advises:

1. "...make healthy life expectancy a central focus of everything they do in government." Have aspirational long term targets, like we do with other things, such as net zero and phasing out less green cars.

2. "...make health a cross-society endeavour." For example bring businesses on board because employees off sick are costly all round. We should all be concerned about everyone having the best health we can.

3. "...use the revenue from health levies to invest in the foundations of good health."

Look after our children now, start them off well, and reap the benefits in the decades to come. He even suggests Sure Start and free school meals are proven ways to improve children's health, as well as better promotion of vaccinations and dietary health.

PA News Agency have been delving into the latest UK figures for 'economically inactive' people. These are people of working age who don't work or earn any money. It includes folk like students, early retired people, unpaid carers and those who are unable to work because of a temporary condition or illness.

In 2014 2.03 million people in the UK were 'economically inactive' due to long-term sickness. In 2019 it was 2.05 million people (possibly reflecting overall population growth). The ONS as we know have adjusted the way they count population trends, but even so, in May -July 2024 there were 2.79 million economically inactive people not working because of long-term sickness.

Long COVID is something China and a few other countries took incredible steps to minimise - mainly by preventing infections and repeat infections, at least until after vaccinations, which reduces Long COVID massively. It would be really interesting to be able to find similar stats (I tried, I failed) and see how much of a difference it has made. It won't all be about Long COVID. A lot of people decided to stop working after COVID, or chose not to go back. COVID made all of us much more aware of what is truly important in our lives. 

And on that note, we have a 16th birthday here today, so I shall leave it there and go off to eat cake and play games with balloons. I hope you are doing something nice, treat yourself - you've earnt it!! 

Play Outdoors If You Can, Catch The Last Of The Year's Sun, Save The NHS... 

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Sources: 

https://www.worldometers.info/coronavirus/

https://coronavirus.data.gov.uk/

https://ourworldindata.org/covid-vaccinations

https://www.gov.uk/coronavirus

CMI death rates and Image 

https://x.com/ActuaryByDay/status/1838952581994787294?t=JXnYT5GYLvf0JK9e83X7UQ&s=09

Jr Doctors Image 

https://x.com/BMA_JuniorDocs/status/1835736780366065752?t=oq5yPmABILsoCTXsaiSCvw&s=09

https://x.com/WHO/status/1839576065615782235?t=-nnobMZfdJrPciTi6I-nUw&s=09

https://x.com/WHO/status/1839560810248479020?t=OdEziqjoyt6MDgl-xlnvNA&s=19

XEC and UK data 

https://inews.co.uk/news/health/covid-hospitalisations-soar-xec-variant-waning-immunity-3296985

Week1

https://www.coventrytelegraph.net/news/tv/new-covid-variant-xec-spreading-29936933

Week 2 tuesday 

New XEC Covid variant spreading 'more easily' as cases rise - CoventryLive

https://www.coventrytelegraph.net/news/health/new-xec-covid-variant-spreading-29988557

Week 2 thursday

XEC Covid variant and the 'distinctive' new strain symptoms revealed - Wales Online

https://www.walesonline.co.uk/news/wales-news/xec-covid-variant-distinctive-new-30005642

https://www.manchestereveningnews.co.uk/news/health/covid-xec-variant-symptoms-29997371

https://ukhsa.blog.gov.uk/2024/08/02/whos-eligible-for-the-2024-covid-19-vaccine-or-autumn-booster/

RCN nurses refuse pay offer 

https://www.upday.com/uk/nurses-reject-governments-pay-offer-of-5-5-rise

Mpox vaccinations 

https://www.upday.com/uk/uk-stocks-mpox-jabs-as-government-prepares-for-new-strain

https://ukhsa.blog.gov.uk/2024/09/16/how-are-we-tracking-mpox-in-the-uk/

https://www.gov.uk/government/news/uk-secures-more-vaccines-to-help-boost-resilience-against-mpox

Mpox testing supplies

https://x.com/WHOAFRO/status/1837125776388272238?t=Qg4gCzwE08a5muEetKt7hg&s=09

Wuhan market 

https://www.independent.co.uk/news/health/covid-wuhan-origin-china-food-market-souce-b2616112.html

https://www.cnn.com/2024/09/19/health/huanan-animal-market-analysis-covid-19/index.html

https://www.sciencemediacentre.org/expert-reaction-to-study-on-genetic-tracing-at-the-huanan-seafood-market-to-investigate-possible-covid-virus-origins/

Train strikes over 

https://www.upday.com/uk/no-more-rail-strikes-as-workers-vote-to-accept-pay-offers

https://www.upday.com/uk/train-drivers-vote-to-accept-pay-offer-ending-two-year-dispute

Doctors in training 

https://www.upday.com/uk/junior-doctors-in-england-accept-pay-deal-after-two-year-dispute

RCN nurses refuse pay offer 

https://www.upday.com/uk/nurses-reject-governments-pay-offer-of-5-5-rise

Pharmacists 

https://www.bbc.co.uk/news/articles/c1e8755xv01o?s=09

Covid inquiry 

https://x.com/chrischirp/status/1839257368435019881?t=85G4EEamHQib-GpHQucHSg&s=19

https://x.com/jim_reed/status/1837387859398979767?t=YC4pFPPx4hFJBkLGqYjlXw&s=09

Covid is airborne

https://x.com/jim_reed/status/1835380652226519414?t=0tjawkG50PFgweOMJ2S8EQ&s=09

Avian flu

https://x.com/HelenBranswell/status/1837158544933601345?t=3eCiMQOC_NXPZ3IcYXWxsA&s=09

https://www.cdc.gov/bird-flu/spotlights/h5n1-response-09272024.html

Lord Darzi

https://www.theguardian.com/commentisfree/2024/sep/18/report-nhs-healthy-life-expectancy-government-policy-health-service?s=09

Long-term sickness in the UK workforce:

https://f7td5.app.goo.gl/qGo7JB

COVID-19 Coronavirus and other virus UK and World News Update 13th September 2024

COVID-19 Coronavirus and other virus UK and World News Update 13th September 2024

The UK had a fairly small but significant COVID wave over early Summer due to the arrival of the FLIRT variants. As expected it then dropped down during the last few weeks of the English school Summer holidays, but it has started to creep back up already. No rest for the wicked. 

This peak and drop was reflected in hospital admissions with COVID, which peaked in England in July at their highest level since January, but fell by 45% in August.

The latest round of the UK COVID Inquiry has begun, focussing on the impact of the pandemic on healthcare systems - and the reality for all of those involved. The humans.

It will look at patients, NHS staff, and delivery of healthcare - including vaccinations, management, GPs, backlogs and Long COVID.

Chair Baroness Heather Hallett we must learn from the inquiry, otherwise the next pandemic will "bring with it immense suffering and huge financial cost, and the most vulnerable in society will suffer the most".

Proceedings began with a 20 minute "impact video" featuring patients, families, the NHS staff and other caregivers. 

Author and broadcaster Michael Rosen was shown discussing his time in intensive care.

He recalled being asked by staff to "sign a piece of paper to let us put you to sleep".

When he asked whether he would wake up, he was told he would have a "50/50" chance.

I think that probably gives us all a sharp slap of reality.

They're all people. 

Staying with the COVID Inquiry, and the fallout from it... 

"The report Behind the Masks; Corruption red flags in COVID-19 public procurement identifies 135 contracts that we believe carry a high risk of corruption. Altogether, these contracts represent a staggering £15.3 billion of public funds—nearly a third of all  pandemic procurement by value. To put this into perspective, that figure is almost equivalent to the entire annual Home Office budget."

Transparency International UK have released a report into COVID pandemic spending. 

Over the first 3 years of the pandemic the UK spent £41.8 BILLION on the response.

£4.1bn was given to suppliers with political connections to the Tory party. Many of these contracts did not go through 'due diligence' checks and and instead were fast tracked through the infamous 'VIP' and 'high priority lanes' which have since been deemed illegal.

The Department for Health wrote off £15bn on unused personal protective equipment (PPE), COVID tests and vaccines. This includes at least £1 billion worth of substandard unusable PPE.

We weren't told about at least 141 high-value contracts (worth a total of £5 billion) until a year after they were awarded – far beyond the 30-day legal requirement.

They wasted our money, and now we are in a financial hole it will take years to climb out from. 

In "more reports to tell us how messed up and underfunded the NHS has become" professor Lord Darzi has completed a report on NHS, which will be used to inform the government’s 10-year plan to reform the health service.

(Spoiler, it's pretty damning.) 

Lord Darzi is an independent peer and practising surgeon with 30 years’ experience in the NHS, so he isn't someone sitting in an office talking about something he knows nothing about. He examined over 600 pieces of analysis from DHSC, NHS England and external organisations during his investigation. 

Lord Darzi says he's shocked by what he's found out, not only the state of the NHS, but also the nation's health as a whole. 

Key points include:

- NHS and other healthcare staff are working harder than ever, but productivity is going down and patients are waiting far too long, far too often.

- Operational processes are overwhelmed. Care, nursing and clinical staff spend hours trying to find beds using out of date I.T., or discover beds and wards have been axed, leaving patients spending hours or days waiting in limbo for the care they actually need. 

"In the last 15 years, the NHS was hit by three shocks - austerity and starvation of investment, confusion caused by top-down reorganisation, and then the pandemic which came with resilience at an all-time low. Two out of three of those shocks were choices made in Westminster."

- The "top down" approach has to end, and care needs to be put back into the hands of NHS staff and patients (too many managers and not enough actual healthcare).

His 3 main recommendations for change are:

1. We need to move from analogue to digital and create a smooth, intelligent digital service...

Paperwork and computer data don't work well in unison (details of one of my failed operations still only exist on paper in a hospital storeroom, so looking at my computer files or even my paper notes suggests it never even happened). By investing in technology there are a million possibilities for spotting oddities, risks and illnesses we don't need to miss, sending out letters, appointments and requests, organising schedules and appointments, and then medical staff can get on with their real jobs.

2. We’ve got to shift more care from hospitals to communities… 

We have become too reliant on hospitals for things which should be cared for before that point. Social care, health centres and GP's are a much better place to catch ailments early when they aren't so serious or expensive to deal with, or prevent them happening at all. 

3. We’ve got to be much bolder in moving from sickness to prevention... 

We need to look long. Short term sticking plaster solutions might give great looking headlines, but don't actually help anyone. A great example is teeth. No-one can get an NHS dentist, but bad mouth health can lead to, or increase risk of, Cancers, heart disease, strokes, premature births, dementia, pneumonia, kidney disease, low self esteem and depression, and about a million other things. Prevention is always better than cure. 

Lord Darzi makes the point that just throwing money randomly won't fix this, but the NHS still has a heartbeat and can recover. 

"It took more than a decade for the NHS to fall into disrepair so it’s going to take time to fix it. But we in the NHS have turned things around before, and I’m confident we will do it again."

Teachers in Scotland have voted to accept a new pay offer of 4.27%. Teachers in England accepted 5.5% in July, they accepted 5.5% in Wales this week, and in Northern Ireland they came to an agreement in April. 

We hear lots on the news about Western countries at war, or countries with which our Governments have close arrangements, but less about poorer nations. Civil war broke out in Sudan on 15th April 2023, when Government, military and paramilitary forces began fighting. 

"Currently, 3.6 million children in Sudan are acutely malnourished, with 730,000 suffering from severe acute malnutrition.

The ongoing conflict has exacerbated food insecurity, making it increasingly difficult to deliver essential nutrition and health services to vulnerable populations."

World Health Organisation (WHO)

In light of the Mpox outbreak in DRC and beyond, today the World Health Organisation announced they've established an access and allocation mechanism for over 3.6 million pledged Mpox vaccines, plus treatments and testing. They believe if the correct people are targetted, this outbreak can still be contained and halted before it spreads worldwide or kills many more people.

It is incredibly hard to get any sort of clear figures regarding Mpox, as many of the patients and medical staff involved do not have access even to basic testing. All they can really do is count all known or suspected Mpox cases, including more severe Clade 1 and endemic Clade 2. All evidence suggests the mutated (easier to pass human to human) Clade 1b variant is responsible the current outbreak. 

Moderna are currently working on an mRNA Mpox vaccine. First round lab-based trials have been successful and a phase 1 and 2 human trial is now underway. 

The HPAI H5N1 (Highly Pathogenic Avian Influenza) outbreak in US dairy herds continues, and you may have seen in the news that a human patient in Missouri has been diagnosed with H5N1, but has "no immediate known animal exposure" - no contact with dairy herds, poultry or wild birds. They are the 14th human to be infected with H5 variant bird flu virus in the US this year. So far we still have no indication there is human to human transmission, but obviously that is what all the scientists are watching for. This patient could simply be a random one-off, the needle in the haystack. 

The current total infected dairy herds stands at 203 across 14 states. 

California is still the only state which appears to be taking a proactive approach. They are bulk testing tanks of milk, and revisiting infected herds to look at whether any of the herd were sold to different farms prior to positive tests, and whst equipment or staff moved between infected and other farms. They are actively looking for H5N1 in order to stop the virus spreading. It means their stats don't look great right now, with 8 infected herds reported in the last 2 weeks, but ultimately it has to be the sensible thing to do.

Remember kids, if you don't test, you are only pretending you don't have cases

"The polio vaccination campaign in south Gaza has concluded with over 446,000 children being vaccinated since the start of the campaign on 1st September.

Five health facilities will continue offering polio vaccination to make sure no child is missed. 

We are grateful to the families for their cooperation, and to all vaccinators and health workers for their dedication. 

Continuation of humanitarian pauses is key to complete the campaign successfully across the Gaza Strip. The preparation for the start of the vaccination campaign in northern Gaza are ongoing.

The children in Gaza deserve lasting peace, not just polio vaccines."

Dr Tedros, WHO.

After a child became severely ill and Polio was discovered in a water source, they moved quickly. WHO vaccinated 446,000 children in under 10 days. 44,600 each day. That is staggering, well done to whoever organised that. 

The UK NHS has rolled out their new RSV (Respiratory Syncytial Virus) jab. RSV causes breathing problems and hospitalises 20,000 of our most vulnerable people each year. Pregnant women and older adults aged 75 to 79 will be offered the jab along with your flu jab.

On 10th September it was World Suicide Prevention Day. This is a subject which is very important to me and my family, so some of the images included reflect that. Every person is important, including you. The world is better with you in it. 

It is the weekend - hurrah! It's just over 2 weeks since I fell down the loft stairs and I still cannot sit straight due to my swollen and bruised derriere - so let that be a warning to you. Thankfully I can sit in the car without a pillow now, and I no longer look like I'm attempting to smuggle a couple of beach balls, so normality is returning. I think I've earned a treat, and I think you have too - don't forget to spoil yourself. I've got some luscious deep conditioner to put on my hair tomorrow evening, and I'm going to light a fire and watch movies in my pyjamas. We moved house 5 weeks ago and have hardly had a moment off since, so it'll be a welcome break. A treat doesn't have to be expensive or complicated, sometimes it just has to be what you really need. 

Have a good weekend, I'll be back in a couple of weeks...

Be Careful On Stairs. Start Preparing Your Home For Winter. Save The NHS.  

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Sources: 

https://www.worldometers.info/coronavirus/

https://coronavirus.data.gov.uk/

https://ourworldindata.org/covid-vaccinations

https://www.gov.uk/coronavirus

Images

Rsv image

https://x.com/UKHSA/status/1830628776289481197?t=oZQn9yJoaU0TPoNnTk565Q&s=09

World Suicide Prevention Day Images

https://x.com/MindCharity/status/1833369815224094943?t=vA4UzKl5EWsB67eDi8-4nQ&s=09

https://x.com/mentalhealth/status/1833445261823156669?t=vA4UzKl5EWsB67eDi8-4nQ&s=19

https://x.com/chris_davison1/status/1833462839144570908?t=BxsGlb9UWkDXWMMkZrQ16A&s=19

It can't be the best of times forever, nor can it be the worst of times forever.

You WILL be missed.

Needing help doesn't make you unusual, and it definitely doesn't make you a burden.

We can spend infintely longer worrying about something than we can spend doing it.

No-one can cope with everything at once. Nibble at it in bitesize pieces.

You are enough.

The world is better with you in it.

I can give you a million reasons to stay, but you have to be able to see they are true. 

Hospital admissions and cases

https://x.com/chrischirp/status/1834288960459166114?t=PRsujm9zcWRTdnsK5YcdSg&s=19

https://x.com/ActuaryByDay/status/1834152226069099003?t=ZXzVvSwN3S8jTRZGZPF4kw&s=09

https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity/

Covid inquiry 

Covid inquiry: Author Michael Rosen

https://x.com/MichaelRosenYes/status/1833082766172315720?t=BTG9vI57bhNYMASn1AEncQ&s=09

https://www.upday.com/uk/covid-inquiry-michael-rosen-says-he-was-given-50-50-chance-of-survival-in-intensive-care

https://covid19.public-inquiry.uk/modules/impact-of-covid-19-pandemic-on-healthcare-systems-in-the-4-nations-of-the-uk/

https://www.upday.com/uk/uk-covid-19-inquiry-to-examine-impact-of-pandemic-on-healthcare

https://covid19.public-inquiry.uk/documents/transcript-of-module-3-public-hearing-on-09-september-2024/

https://www.nursingtimes.net/news/coronavirus/covid-inquiry-turns-focus-to-impact-on-nurses-and-healthcare-10-09-2024/

https://www.bbc.co.uk/news/live/cm2n3vp24jet?page=3

Campaigners highlight corruption concerns over Covid contracts

https://www.transparency.org.uk/new-research-raises-corruption-questions-over-billions-covid-public-spending

https://www.upday.com/uk/campaigners-highlight-corruption-concerns-over-covid-contracts-as-inquiry-returns

Lord Darzi NHS report

https://x.com/BBCHughPym/status/1834107850739581209?t=Gl0uWP6M6okQfkcZi11Nwg&s=09

https://www.gov.uk/government/news/pm-major-surgery-not-sticking-plaster-solutions-needed-to-rebuild-nhs

Oral health

https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/dental/art-20047475

Teachers

https://www.independent.co.uk/news/uk/teachers-cabinet-secretary-scottish-government-cpi-rpi-b2611088.html

https://www.upday.com/uk/teachers-vote-to-accept-improved-pay-offer

Sudan

https://x.com/WHO/status/1833179958610370772?t=8YKCqOoptLfBb0D854rSDg&s=09

Mpox

https://x.com/HelenBranswell/status/1831348249950564848?t=HlyhNayCu6NzGjmQ1lPSZA&s=09

https://www.statnews.com/2024/09/04/moderna-mpox-vaccine-study-results/

https://www.who.int/news/item/13-09-2024-who-and-partners-establish-an-access-and-allocation-mechanism-for-mpox-vaccines--treatments--tests

https://worldhealthorg.shinyapps.io/mpx_global/

Bird flu pandemic warning amid case with no animal exposure

H5N1

https://www.gbnews.com/health/bird-flu-symptoms-cases-pandemic

And thursday Helen Branswell's opinion 

https://x.com/HelenBranswell/status/1834276697790673233?t=MHY9UJlIzcHdB2GmAUogHg&s=19

https://www.statnews.com/2024/09/12/h5-bird-flu-human-infection-missouri-cause-remains-unknown/

Bird flu latest:

https://www.aphis.usda.gov/livestock-poultry-disease/avian/avian-influenza/hpai-detections/hpai-confirmed-cases-livestock

https://x.com/HelenBranswell/status/1834293820441133149?t=ntoKnCPjiiMkS1w2nqSl7Q&s=09

Polio vaccination, Gaza 

https://x.com/DrTedros/status/1833139192479494319?t=0YAY5KiBNZaF_HT9NlNekw&s=09

https://x.com/DrTedros/status/1831251117935595998?t=_4P1Y26ixscOVL7DQSH2Ng&s=09

now add measles 

https://www.statnews.com/2024/09/06/gaza-polio-measles-vaccine-drive-who-unicef/

https://www.bbc.co.uk/news/live/c75nekwkd4yt

RSV

https://www.upday.com/uk/nhs-rolls-out-new-jab-for-respiratory-virus#google_vignette

COVID-19 Coronavirus and other virus UK and World News Update 30th August 2024

Children in England and Wales will be going back to school any time now, and parents are being reminded that we have a measles outbreak in the UK.

It has slowed down over Summer, but there were still 153 cases in the 4 weeks to 5th August (mostly in London), and 2,278 cases across England since the start of the year.

Measles is nasty and almost entirely preventable by vaccination. Babies, infants and people with less robust immune systems are most at risk of serious illness, permanent damage and death. By taking your child for their MMR, or catching up with your own, you aren't only protecting one person, you are protecting all of those they come into contact with. The MMR has been considered safe and used around the world since 1971 (1988 in the UK). 

The world is anticipating a substantial number of Mpox cases in light of the subclade 1b outbreak in Africa.

In 2024 up to 23rd August the Democratic Republic of the Congo (DRC) reported 19,667 cases (16,706 suspected and 2,961 confirmed) including 575 deaths. Confirmed Mpox cases due to the more catchy and dangerous subclade Ib, and the 'original' subclade 1a have also been reported in 5 of the 8 countries neighbouring DRC: 

- Congo (21 confirmed/141 suspected

- Central African Republic (45 confirmed)

- Burundi (190 confirmed/512 suspected)

- Rwanda (4 confirmed)

- Uganda (3 confirmed)

Additionally cases of Mpox 1b have been confirmed in the following countries: Kenya (2), Gabon (1), Sweden (1) and Thailand (1).

Testing is very limited in poorer nations, so case numbers and even fatalities will not show the whole picture. 

Health Authorities in several countries have moved to 'high alert', watching for Mpox symptoms in arrivals to their country and generally just being more aware of a disease that previously was virtually non-existent outside DRC. Spanish authorities are taking it very seriously, hoping to prevent Mpox entering, rather than deal with it if and when it happens. Putting their money where their ideals are, Spain have pledged to send 500,000 vaccinations to Africa.

Mpox vaccinations are a modified version of the first ever vaccine, which was created in 1796 by Edward Jenner to treat Smallpox. Smallpox is the only human disease to have been completely eradicated.

Mpox vaccines are currently very expensive, around £50-£75 ($70-$100) each, mainly because they haven't been made in huge numbers for some time, and richer countries are already stockpiling what there is. The World Health Organisation has put together a Strategic Preparedness And Response Plan, expecting US$135 million is needed to fight Mpox over the next 6 months. They estimate 10 million doses of vaccine given to the right people can nip this thing in the bud.

As well as Spain's vaccine pledge, Japan has pledged a massive 3 million doses of their Mpox vaccine LC16m8, which is also recommended for children. The European Commission has pledged 215,000 doses, Germany and France 100,000 doses each, and the US 50,000 doses. The UK Government has pledged a package worth £3.1 million. 

If we play fair and sensible, we can shut this down before it spreads around the world. In truth, we should always have been fair and sensible, this is a preventable disease, and when we already had all the tools we needed, we shouldn't ever have let it continue anywhere on Earth. 

Talking of prevention, bit late but tourists to Greece are being warned to avoid mosquito bites whenever possible, as West Nile Virus is affecting a lot more people this year. If bitten by an infected mosquito around 1 in every 5 people will become quite ill, and in rare cases it can be more serious. At least 12 people have died from West Nile Virus in Greece this Summer. 

As of 29th August Highly Pathogenic Avian Influenza (HPAI) or bird flu has been confirmed in 193 US dairy cattle herds across 13 states. 3 herds in California are currently suspected to be infected and awaiting test results - which will be the first for the largest milk producing state in the USA. As cases elsewhere seem to be slowing down, it probably wouldn't be wise to just pretend you don't have a problem and avoid testing, not as I'm accusing California of any such move. Honest. 

Right through 2020, 2021, 2022 and 2023 the UK lost more people than anticipated. That has stabilised finally, although metrics have changed to reflect our aging community and changes to population, so it's harder to make a direct comparison. We aren't the only ones, this is worldwide.

Bloomberg had a financial article last week looking at the US stock market in regards to funerals, cremations and burials - they're doing incredibly well.

In 2019 there were roughly 869.7 deaths for every 100,000 Americans. That went well above 1,000 in 2020 and 2021, before dropping to 984 in 2022. In 2023 it dropped further, but was still at 927.4 deaths per 100,000 people.

COVID has directly and indirectly fuelled excess deaths. It led to increased alcohol consumption and drug use, less physical exercise and more stress, and obviously the physical damage to the body when people catch COVID. One of the striking points - and again this is true around the world, including in the UK and Australia - is that unlike at the height of the pandemic, a lot of the excess deaths more recently are in younger age groups. Middle aged people and younger adults are having more strokes, heart problems and diabetes. Health services are still under pressure, and that isn't changing, nor is it likely to very quickly. 

As we've said many times, COVID is incredibly costly. 

"The cumulative global incidence of Long COVID is around 400 million individuals, which is estimated to have an annual economic impact of approximately $1 trillion—equivalent to about 1% of the global economy."

Ziyad Al-Aly, Director of the Clinical Epidemiology Center, Clinical Epidemiologist at Washington University, and possibly the world’s most knowledgeable person on the subject of Long COVID. He is being proven correct with his warnings time and time again.

The Federal Reserve Bank of St Louis released an analysis using data from the US Current Population Survey (CPS) last week, and Mr Al-Aly had some very clear comments:

"Since 2019, the number of disabled individuals has surged beyond the expected trend by nearly 2 million. This isn't just a statistical anomaly—it's a huge indicator of a deeper, underlying health crisis."

These people are not all very elderly, once again  younger age groups have the big jumps - the working age population. 

"Most alarming is the rise in cognitive disabilities. The population reporting only a cognitive disability has grown by nearly 1 million—a 43% increase since 2019."

Cognitive disabilities include permanent, long or short term problems with a person's ability to think, learn, remember, use judgement and make decisions. Usual examples and causes would be things like intellectual disability, Alzheimer’s and dementia, traumatic events, brain injury and stroke.

"To put this in context: from 2014 to 2019, the average annual growth in cognitive disabilities was about 28k. Since 2019, that number has skyrocketed by more than one million. This is a huge increase and deserves attention."

Is it due to Long COVID, or is something else happening? Either way, it is going to place increased stress on governments, social care and health infrastructure, the individuals affected and the people they live and work with. The upside is that once the big guns start to worry about their profits shrinking, they may start putting more effort into finding out what's going on and how to fix it. 

The number of people in England and Wales who took their own lives in 2023 was the highest since 1999. 10 years ago we lost one of our teenagers and it has taken us 10 years to pick ourselves up to a level of normal. We are never without her loss, every minute of the day and night, she is always missing.

It won't be the worst of times forever, and it won't be easier without you. Don't be scared or embarrassed to ask for help. You matter.

I for one am very glad you are still here. 

In better news (in fact fantastic news), masking, distancing and generally being a lot more aware of how viruses spread isn't just helpful for COVID. On the advice of the World Health Organisation and the FDA, the US flu vaccination this Autumn will be trivalent 3 pronged rather than quadrivalent 4 pronged. This is because one of the world's major flu strains, Influenza B/Yamagata, hasn't been positively detected since 2020. 

This is a major win for the world. 

It's the weekend and I'll be having a lie in. I finally finished the third coat of woodworm treatment in my loft yesterday morning and promptly fell all the way down the stairs, so sitting down is not very relaxing at the moment! I didn't break anything though, so bruised and swollen as I am, it's a win - and we can put things in the loft again. Woohoo. (Obviously when I say "we", I mean everyone else. None of my family are going to let me back up there for a while, nor am I very speedy just now).

My main job this weekend is cutting grip tape for the wooden loft staircase, but I'll also make time for something nice - I very much think I've earned it. Hopefully you haven't injured yourself, but I'm sure you've earnt it too - so don't forget to spoil yourself. 

I'll be back in 2 weeks, when the academics and the Government return from Summer holidays, so there'll no doubt be more to tell you and some fresh research results - and hopefully more good news. Until then...

Watch Your Step, Play Outdoors While You Can, Save The NHS. 

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Sources: 

https://www.gov.uk/coronavirus

Cardiac arrest image 

https://x.com/DHSCgovuk/status/1829058906292642220?t=899EqPlOWER2atCtZGFb8g&s=09

Measles warning as children head back to school

https://www.nhsinform.scot/campaigns/mmr-against-measles/

https://www.upday.com/uk/measles-warning-as-children-head-back-to-school

Mpox

Spain put on 'high alert' and 'everyone should get prepared'. 

https://www.who.int/news-room/spotlight/history-of-vaccination/history-of-smallpox-vaccination

https://www.birminghammail.co.uk/travel/spain-put-high-alert-over-29793947

https://www.ecdc.europa.eu/en/news-events/epidemiological-update-mpox-due-monkeypox-virus-clade-i

https://www.coventrytelegraph.net/news/coventry-news/suspected-mpox-cases-mapped-international-29782850

https://www.theguardian.com/commentisfree/article/2024/aug/30/worldwide-alert-mpox-spreading-three-steps-gordon-brown

https://www.gbnews.com/health/mpox-virus-outbreak-lockdown

https://x.com/UNICEF/status/1829096919055917089?t=OeVHn4qDtcKWrRT_-uoR9g&s=09

https://worldhealthorg.shinyapps.io/mpx_global/#1_Overview

West Nile Virus

https://www.birminghammail.co.uk/travel/uk-tourists-greek-issued-urgent-29793193

https://www.who.int/news/item/26-08-2024-global-strategic-preparedness-and-response-plan-launched-by-who-to-contain-mpox-outbreak/

https://x.com/WHO/status/1828080641348440156?t=e1bXKPZBBi8aTo92uMUk7Q&s=09

HPAI in dairy cows

https://www.statnews.com/2024/08/29/california-nations-largest-milk-producer-discloses-possible-bird-flu-outbreaks-in-three-dairy-cow-herds/

https://x.com/HelenBranswell/status/1829295685965115756?t=QCLO_KPNloBRlivDb_nbFA&s=09

https://www.aphis.usda.gov/livestock-poultry-disease/avian/avian-influenza/hpai-detections/hpai-confirmed-cases-livestock

Post COVID deaths

https://www.thelancet.com/journals/landia/article/PIIS2213-8587%2824%2900159-1/fulltext

https://www.bloomberg.com/news/newsletters/2024-08-19/deaths-are-up-post-covid-and-so-are-funeral-stocks-prognosis?s=09

Long COVID Ziyad Al-Aly 

https://www.nature.com/articles/s41591-024-03173-6?s=09

https://www.cancer.gov/publications/dictionaries/cancer-terms/def/cognitive-impairment

https://www.fcc.gov/cognitive-disabilities

https://www.stlouisfed.org/on-the-economy/2024/aug/changing-composition-of-disability-among-workers#authorbox

https://x.com/zalaly/status/1828080885478183323?t=zYWjtVxTeKxfWlIe8FJ7Fw&s=09

Flu vaccinations US

https://www.instagram.com/reel/C_K_Q-IREQ9/?igsh=cjBrMGh1Zm42ank1

https://www.cdc.gov/media/releases/2024/s-t0627-vaccine-recommendations.html

England and Wales

https://x.com/ONS/status/1829080194390352075?t=tOlPsfY36wgdklElM__oOA&s=09