Nearly 37,000 Americans died of COVID-19 in November, the most in any month since the dark early days of the pandemic, engulfing families in grief, filling newspaper obituary pages and testing the capacity of morgues, funeral homes and hospitals.
Amid the resurgence, states have begun reopening field hospitals to handle an influx of patients that is pushing health care systems — and their workers — to the breaking point. Hospitals are bringing in mobile morgues. And funerals are being livestreamed or performed as drive-by affairs.
Health officials fear the crisis will be even worse in coming weeks, after many Americans ignored pleas to stay home over Thanksgiving and avoid people who don’t live with them.
“I have no doubt that we’re going to see a climbing death toll ... and that’s a horrific and tragic place to be,” said Josh Michaud, associate director of global health policy at the Kaiser Family Foundation. “It’s going to be a very dark couple of weeks."
November's toll was far lower than the 60,699 recorded in April but perilously close to the next-highest total of almost 42,000 in May, according to data compiled by Johns Hopkins University. Deaths had dropped to just over 20,000 in June after states closed many businesses and ordered people to stay at home.
The fast-deteriorating situation is particularly frustrating because vaccine distribution could begin within weeks, Michaud said.
At Mercy Hospital Springfield in Missouri, a mobile morgue that was acquired in 2011 after a tornado ripped through nearby Joplin and killed about 160 people has been put into use again. On Sunday it held two bodies until funeral home workers could arrive.
At the Bellefontaine Cemetery in St. Louis, burials are up by about one-third this year compared with last year, and the cremated remains of about 20 people are sitting in storage while their families wait for a safer time to hold memorial services. The dead include a husband and wife in their 80s who succumbed to COVID-19 five days apart.
“You want to be safe at the gravesite so you don’t have to do another graveside service" for another family member, said Richard Lay, Bellefontaine Cemetery’s vice president.
The Star Tribune in Minneapolis-St. Paul saw a 40% increase in the number of pages dedicated to paid obituaries in November, largely because of COVID-19, a spokesman said. By Nov. 29, the newspaper had 11 pages of obituaries, compared with about half that many on a typical Sunday.
In Worcester, Massachusetts, the National Guard trucked in cots, medical supplies, tables and other items needed to operate a 250-bed field hospital in the event the state's medical centers become overwhelmed.
Rhode Island opened two field hospitals with more than 900 beds combined. The state's regular hospitals reached their coronavirus capacity on Monday. New York City, the epicenter of the U.S. outbreak earlier in the year, reopened a field hospital last week on Staten Island. Wisconsin has a field hospital in West Allis ready to take overflow patients. A Nevada hospital has added hospital bed capacity in an adjacent parking garage.
“Hospitals all around the country are worried on a day-to-day basis about their capacity ... and we’re not really even into winter season and we haven’t seen the impact of Thanksgiving travel and Thanksgiving gatherings,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security.
The number of hospital beds is just one concern. Many hospitals are scrambling to find enough staff to care for patients as the virus surges almost everywhere at once, Adalja said.
“You can’t just say we’ll have doctors and nurses from other states come because those other states are also dealing with COVID patients," he said.
The virus is blamed for over 268,000 deaths and more than 13.5 million confirmed infections in the United States. A record 96,000 people were in the hospital with the virus in the U.S. as of Monday. The U.S. is seeing on average more than 160,000 new cases per day and almost 1,470 deaths — equal to what the country was witnessing in mid-May.
State and local officials also are responding with shutdowns, curfews, quarantines and mask mandates.
Joining more than 30 countries, New Zealand on Wednesday took the symbolic step of declaring a climate emergency.
Lawmakers voted 76-43 in favor of the motion, in a split that followed party lines.
The government also launched a new initiative requiring many public agencies to become carbon neutral by 2025, in part by getting rid of coal boilers and buying electric cars.
Prime Minister Jacinda Ardern said the government usually declares emergencies only for things like natural disasters, but that if it doesn't address climate change, such disasters will continue to happen.
She said the declaration was an acknowledgment of the burden the next generation faces.
“For them, it is instinctual, it is tangible, it is real,” Ardern said. “It is about the country they will inherit. And it's about the burden of debt they will inherit unless we make sure that we demonstrate leadership on this issue.”
The declaration comes without any newly assigned statutory powers or money, making it purely symbolic. But Ardern and other lawmakers promised to back up the declaration with ongoing action.
The declaration states that climate change is one of the greatest challenges facing humanity and promises a commitment to minimize global warming. It says climate change will have a devastating impact on New Zealand through flooding, wildfires, sea-level rise and water availability.
Ardern said climate change was an important consideration in rebuilding the economy from the downturn caused by the coronavirus, and it was important to "build it back in a sustainable way, with a focus on carbon neutrality."
Opposition climate change spokesperson Stuart Smith said the declaration was hollow and lacked substance.
“Today’s performance from the government was a triumph of politics over practical solutions, and of slogans over substance," said another opposing lawmaker, David Seymour.
Ardern has previously announced plans for the nation to plant 1 billion trees, phase out offshore oil and gas exploration, and to make the electricity grid run from 100% renewable energy by 2030.
The government last year passed a bill for the country to become carbon neutral by 2050, although it carved out some exemptions for farmers, who bring in much of the country’s foreign income.
Noting that the new Covid-19 infection declined globally for the first time since September, the World Health Organization (WHO) urged people to deal the things with ‘extreme caution’.
Updating reporters during his regular briefing from Geneva, Director-General Tedros Adhanom Ghebreyesus described the global decline as fragile, brought on by falling cases in Europe, thanks to the difficult but necessary measures countries put in place in recent weeks, reports UN News.
“Gains can easily be lost,” the agency chief said, noting that COVID-19 is still on the rise in most other world regions, with an attendant increase in deaths.
No time for complacency
Tedros cautioned against complacency, especially with the holiday season approaching in many cultures and countries. Being with family and friends is not worth placing anyone at risk.
“We all need to consider whose life we might be gambling with in the decisions we make,” he said.
To be sure, the pandemic will change the way people celebrate, Tedros said. It will be important to follow local and national guidelines. For many, this is a season for staying home, avoiding crowded shopping centres, or ideally, making use of online shopping if possible.
“Avoid gatherings with many different households and families coming together,” he said.
If travelling is essential, take precautions, he said maintain distance from others and wear a mask in airports and train stations, as well as on planes, trains and buses. Carry hand sanitiser or wash hands frequently with soap and water. If feeling unwell, “don’t travel,” he insisted.
A mother carries her daughter as they wearing face masks wait to receive a coronavirus antibody test from health workers at a village in Bali, Indonesia.AP File Photo
Disrupted services, increased risks for people living with HIV
People living with HIV also may have an increased risk of severe disease or death from Covid-19, he said.
A record 26 million people are on antiretroviral treatment – but the pace of increase has slowed, leaving 12 million people who are living with HIV without treatment. “12 million is big,” he assured.
A WHO survey of 127 countries earlier this year found that more than one quarter reported partial disruption to antiretroviral treatment.
However, with support from WHO, the number of countries reporting disruptions in HIV services has declined by almost 75 percent since June. Only nine still report disruptions and only 12 report a critically low stock of antiretroviral medicines.
Such successes are mainly due to countries implementing WHO guidelines, he said, including providing longer antiretroviral prescriptions for 3 to 6 months, so patients can avoid health facilities. WHO also has worked closely with manufacturers and partners to ensure adequate supply of treatment.
'Innovation, Innovation, Innovation'
Moreover, he said countries also have introduced adaptations and innovations during Covid-19. In Africa, for example, many have built their testing system for Covid-19 on the existing lab infrastructure for HIV and tuberculosis. In Thailand, the Government has maintained pre-exposure prophylaxis services and tele-health counselling for men who have sex with men. And many countries have introduced more self-testing for HIV to support self-care.
WHO is urging all countries to maintain these innovations as part of the “new normal”, Tedros said, and to help expand testing and treatment.
With Worlds AIDS Day on December 1, he called for preserving the “incredible” gains made over the past 10 years: New HIV infections have declined by 23 percent since 2010, and AIDS-related deaths have fallen by 39 percent.
Hope above all
“If the pandemic has taught us anything, it is that in the face of an urgent health threat, the world can come together in new ways to defeat it,” he assured.
The world can defeat the pandemic using existing tools and the vaccines now in the pipeline.
“The most important thing is, we need to have hope,” he said. And solidarity to work together.
New Zealand has joined Australia in denouncing a graphic tweet posted by a Chinese official that shows a fake image of a grinning Australian soldier holding a bloodied knife to a child’s throat.
Prime Minister Jacinda Ardern said Tuesday that New Zealand has voiced its concerns directly with Chinese authorities.
“This is an image that wasn’t factual. It wasn’t correct. And so in keeping with our principled position where images like that are used, we will raise those concerns and we’ll do it directly,” Ardern told reporters.
China has not backed down from the tweet and said there will be no apology.
Ardern’s criticism was more muted than Australia’s. She faced an awkward choice of how far to get involved in a conflict between New Zealand’s closest ally, Australia, and its biggest trading partner, China.
Australian Prime Minister Scott Morrison on Monday called the image “repugnant” and demanded an apology from the Chinese government. The post took aim at alleged abuses by Australian soldiers during the conflict in Afghanistan.
The incident is further souring already tense relations between Australia and China.
The image, which appeared to show the soldier slitting the child’s throat, was posted by Zhao Lijian, a spokesman for China’s foreign ministry. He wrote a caption with his tweet: “Shocked by murder of Afghan civilians & prisoners by Australian soldiers. We strongly condemn such acts, & call for holding them accountable.”
He was referring to a disturbing report by Australia’s military earlier this month which found evidence that elite Australian troops unlawfully killed 39 Afghan prisoners, farmers and civilians during the Afghanistan conflict. The report recommended that 19 soldiers be referred to federal police for criminal investigation.
Asked about the issue at a daily briefing, foreign ministry spokesperson Hua Chunying cast blame on the Australian side.
“What Australia should do is to reflect deeply, bring the perpetrators to justice, make a formal apology to the Afghan people, and solemnly promise to the international community that they will never commit such terrible crimes again,” Hua said.
Morrison said Zhao’s tweet was “utterly outrageous” and a terrible slur against Australia’s military.
It “is truly repugnant. It is deeply offensive to every Australian, every Australian who has served in that uniform,” he told reporters in Canberra. “The Chinese government should be totally ashamed of this post. It diminishes them in the world’s eyes.”
Morrison said his government contacted Twitter asking it to take the post down. The post had a warning tag on it on Tuesday but could still be viewed. Zhao’s account comes with a Twitter label stating that it’s a Chinese government account.
Despite China blocking Twitter and other U.S. social media platforms within the county, Chinese diplomats and state media have established a strong presence on them.
Zhao was criticized by the U.S. in March after tweeting a conspiracy theory that U.S. soldiers may have brought the coronavirus to China. He is considered a leading representative of China’s high-pitched new strain of assertive foreign relations.
Morrison acknowledged there were tensions between China and Australia.
“But this is not how you deal with them,” he said. “Australia has patiently sought to address the tensions that exist in our relationship in a mature way, in a responsible way, by seeking engagement at both leader and ministerial level.”
The rift between the two nations has grown since the Australian government called for an independent inquiry into the origins of the coronavirus pandemic. China has since imposed tariffs and other restrictions on a number of Australian exports.
The U.N. humanitarian office says needs for assistance have ballooned to unprecedented levels this year because of COVID-19, projecting that a staggering 235 million people will require help in 2021.
This comes as a result of the coronavirus pandemic and global challenges including conflicts, forced migration and the impact of global warming.
The U.N. Office for the Coordination of Humanitarian Affairs, or OCHA, expects a 40% increase in the number of people in need of such assistance in 2021 compared to this year — a sign that pain, suffering and torment brought by the coronavirus outbreak and other problems could get worse even if hopes of a vaccine are rising.
OCHA made the projections in its latest annual Global Humanitarian Overview on Tuesday, saying its hopes to reach 160 million of those people in need will cost $35 billion. That’s more than twice the record $17 billion that donors have provided for the international humanitarian response so far this year — and a target figure that is almost certain to go unmet.
“The picture we’re painting this year is the bleakest and darkest perspective on humanitarian needs we’ve ever set out, and that’s because the pandemic has reaped carnage across the most fragile and vulnerable countries on the planet,” said U.N. humanitarian chief Mark Lowcock, who heads OCHA.
“For the first time since the 1990s, extreme poverty is going to increase, life expectancy will fall, the annual death toll from HIV, tuberculosis and malaria is set to double,” he said. “We fear a near doubling in the number of people facing starvation.”
Lowcock told a U.N. briefing in New York on the overview that he thinks the U.N. appeal will probably raise a record $20 billion by the end of the year -- $2 billion more than last year. But he said the gap between needs and funding is growing and the U.N. is looking to “new players” coming on the scene in 2021, including U.S. President-elect Joe Biden’s new administration.
The U.N. aims to reach about two-thirds of those in need, with the Red Cross and other humanitarian organizations trying to meet the rest, Lowcock explained.
U.N. Secretary-General Antonio Guterres said humanitarian aid budgets are now facing dire shortfalls as the impact of the COVID-19 pandemic continues to worsen, and said extreme poverty has risen for the first time in more than a generation.
“The lives of people in every nation and corner of the world have been upended by the impact of the pandemic,” he said. “Those already living on a knife’s edge are being hit disproportionately hard by rising food prices, falling incomes, interrupted vaccination programs and school closures.”
The overview, which is billed as one of the most comprehensive looks of the world’s humanitarian needs, has put together nearly three dozen individual response plans for a total of 56 “vulnerable” countries.
Lowcock said the biggest problem is in Yemen where there is danger of “a large-scale famine” now, saying a prime reason is lack of funding from Gulf countries that were major donors in the past which has led to cuts in aid and the closing of clinics.
He said the biggest financial request is for the Syrian crisis and its spillover to neighboring countries where millions of Syrians have fled to escape the more than nine-year conflict.
OCHA said other countries in need include Afghanistan, Congo, Haiti, Nigeria, South Sudan, Ukraine and Venezuela. Newcomers to this year’s list are Mozambique, where extremist activity has increased in the north, Pakistan and Zimbabwe.
Lowcock said it’s not the pandemic, but its economic impact that’s having the greatest effect on humanitarian needs.
“These all hit the poorest people in the poorest countries hardest of all,” he said. “For the poorest, the hangover from the pandemic will be long and hard.”
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