WHO
Clean hands may make the difference between life and death: WHO
When good hand hygiene and other infection prevention and control (IPC) measures are followed, 70 percent of infections can be prevented in health care settings, according to a new World Health Organization report.
The coronavirus pandemic and other disease outbreaks have highlighted the extent to which healthcare settings can contribute to the spread of infections.
The Covid-19 pandemic has exposed many challenges and gaps in IPC in all regions and countries, including those which had the most advanced IPC programmes, said Tedros Adhanom Ghebreyesus, director-general of the World Health Organization (WHO).
Today, out of every 100 patients in acute care hospitals, seven in high-income countries and 15 in low and middle-income nations will acquire at least one healthcare associated infection (HAI) during their hospital stay – one in 10 of whom will die.
Newborns and patients in intensive care are particularly at risk, the report reveals, and almost half of all sepsis cases with organ dysfunction in adult intensive-care units are linked to healthcare.
The first Global Report on Infection Prevention and Control published Friday brings together evidence from scientific reports, and new data from WHO studies.
Also Read: Nearly 15M deaths associated with COVID-19: WHO
The impact of healthcare linked infections and antimicrobial resistance on people's lives is incalculable, says the WHO.
Over 24 percent of patients affected by healthcare associated sepsis and 52.3 percent of those treated in an intensive care unit die each year.
Moreover, deaths are increased two to threefold when infections are resistant to antimicrobials.
In the last five years, the WHO conducted global surveys and country joint evaluations to assess the implementation status of national IPC programmes.
Comparing data from the 2017-18 to 2021-22 surveys, the percentage of countries with a national IPC programme did not improve; and in 2021-22, only 3.8 percent of countries had all IPC minimum requirements in place at the national level.
In healthcare facilities, only 15.2 percent met all the IPC minimum requirements, according to a 2019 WHO survey.
Also Read: WHO estimates pandemic’s death toll in Bangladesh almost 5 times higher than official figures
However, some encouraging progress has been made, with significantly more countries appointing IPC focal points; dedicated budgets for IPC and curriculum for front line healthcare workers' training; national IPC guidelines and programmes for HAI surveillance; and hand hygiene compliance established as key national indicators.
Strongly supported by the WHO and others, many countries are scaling up actions to put in place minimum requirements and core components of IPC programmes.
Sustaining and further expanding this progress in the long-term is a critical need that requires urgent attention and investments.
"Our challenge now is to ensure that all countries are able to allocate the human resources, supplies and infrastructures this requires," said Tedros.
WHO estimates pandemic’s death toll in Bangladesh almost 5 times higher than official figures
Almost 141,000 people died in Bangladesh as a result of the COVID-19 pandemic in 2020 and 2021, the World Health Organization estimates - much higher than the official count that still hovers below 29,000.
New estimates from the WHO show that the full death toll worldwide associated directly or indirectly with the COVID-19 pandemic (described as “excess mortality”) between 1 January 2020 and 31 December 2021 was approximately 14.9 million (range 13.3 million to 16.6 million), more than double the current official death toll of over 6 million. At the end of last year, only 5.4 million were reported.
The U.N. health agency’s director-general, Tedros Adhanom Ghebreyesus, described the calculated figure as “sobering.”
Excess mortality is calculated as the difference between the number of deaths that have occurred and the number that would be expected in the absence of the pandemic based on data from earlier years.
The number includes deaths either due to the coronavirus directly or because of factors somehow attributed to the pandemic’s impact on health systems, such as cancer patients who were unable to seek treatment when hospitals were full of COVID patients. It also accounts for poor record-keeping in some regions, and sparse testing at the start of the crisis.
The estimated number of excess deaths can be influenced also by deaths averted during the pandemic due to lower risks of certain events, like motor-vehicle accidents or occupational injuries as a result of lockdowns and working from home.
Most of the deaths occurred in Southeast Asia, Europe and the Americas, according to the WHO report issued Thursday.
In India, there were 4.7 million Covid deaths, it says - 10 times the official figures - and almost a third of Covid deaths globally. The New York Times reported in mid-April that the release of the WHO’s report was being delayed due to objections from the Indian government. It was due to be released in early April.
The Indian government has said it has "concerns" about the methodology, but other studies have come to similar conclusions about the scale of deaths in the country, and estimates for worldwide excess mortality have been even higher than the WHO’s.
Probably the most influential of these studies, published in the Lancet, estimates there were 18.2 million excess deaths globally between 1 January 2020 and 31 December 2021.
That study, by a team from the influential Institute of Health Metrics and Evaluation (IMHE), put the Bangladeshi death toll from COVID-19 at a whopping 413,000 - 15 times higher than the official figure. A Bangladeshi government official at the time dismissed it as “speculative.”
The WHO’s estimates include a breakdown of excess mortality by age and sex for the 24-month period from January 2020 to December 2021. They confirm that the global death toll was higher for men than for women (57% male, 43% female) and higher among older adults. The absolute count of the excess deaths is affected by the population size.
“Measurement of excess mortality is an essential component to understand the impact of the pandemic. Shifts in mortality trends provide decision-makers information to guide policies to reduce mortality and effectively prevent future crises. Because of limited investments in data systems in many countries, the true extent of excess mortality often remains hidden,” said Dr Samira Asma, Assistant Director-General for Data, Analytics and Delivery at WHO.
The methods were developed by the WHO’s Technical Advisory Group for COVID-19 Mortality Assessment, co-chaired by Professor Debbie Bradshaw and Dr. Kevin McCormack with extensive support from Professor Jon Wakefield at the University of Washington.
The methods rely on a statistical model derived using information from countries with adequate data; the model is used to generate estimates for countries with little or no data available. The methods and estimates will continue to be updated as additional data become available and in consultation with countries, the WHO said.
In Bangladesh, excess mortality was found to first spike particularly in the June-July-August period of 2020, when the WHO estimates an extra 30,000+ people died than would have been expected under normal circumstances.
At the end of Year 1 of the pandemic, there were 46,041 excess deaths in Bangladesh.
In Year 2, the months of April (14,276 excess deaths), June (13,013), July (20,030) and August (18,915) were the most difficult. April 2021 is when the dreaded Delta variant of the virus is suspected to have entered Bangladesh.
By December 2021, the excess deaths in Bangladesh had accumulated to reach 140,764, according to the WHO’s estimates.
Also read: Nearly 15M deaths associated with COVID-19: WHO
Kinder chocolates linked to salmonella poisoning in 11 countries: WHO
Eleven countries have reported salmonella food poisoning, linked to Kinder chocolate products produced in Belgium, according to the UN health agency.
There have been more than 150 suspected cases of salmonellosis – from Belgium to the US – after UK regulators flagged a cluster of salmonella typhimurium cases a month ago, leading to a global recall, the World Health Organization (WHO) said recently.
By April 25, 151 genetically related cases of salmonella typhimurium suspected to be linked to the consumption of the implicated chocolate products were reported from Belgium (26), France (25), Germany (10), Ireland (15), Luxembourg (1), the Netherlands (2), Norway (1 case), Spain (1 case), Sweden (4), the UK (65) and the USA (1).
Children under 10 have been most affected – comprising around 89 percent of cases – and available data indicates that nine patients were hospitalised. There have been no fatalities.
The risk of spread in the WHO European region and globally is assessed as moderate until the information is available on the full recall of the products, the WHO said.
Genetic sequencing of the salmonella bacteria which sparked the food scare showed that the pathogen originated in Belgium.
At least 113 countries across Europe and globally have received Kinder products during the period of risk, the UN agency said, adding that salmonella bacteria matching the current human cases of infection were found last December and January, in buttermilk tanks at a factory run by chocolate makers Ferrero, in the Belgian city of Arlon.
The factory was ordered to temporarily close earlier this month.
The outbreak strain of salmonella is resistant to six types of antibiotics, according to the WHO.
Symptoms of salmonellosis are relatively mild and patients will make a recovery without specific treatment, in most cases.
However, the risks are higher for some children and elderly patients where dehydration can become severe and life-threatening.
Although there are around 2,500 strains of salmonella bacteria, the majority of human infections are caused by two serotypes – typhimurium and enteritidis.
Salmonellosis is characterised by acute fever, abdominal pain, nausea, vomiting, and diarrhoea that can be bloody as in most of the current cases of infection.
Symptoms typically begin between six and 72 hours after ingestion of food or water contaminated with salmonella, and sickness can last from two to seven days.
Salmonella bacteria are widely found in domestic and wild animals, such as poultry, pigs, and cattle.
Pets are not immune either, and salmonella can pass through the entire food chain from animal feed, primary production, and to households or food-service establishments and institutions.
In humans, salmonellosis is generally contracted after eating contaminated food of animal origin – mainly eggs, meat, poultry, and milk.
Also read: Chocolate, Candy, Wafer Companies, Brands in Bangladesh: An Overview
Baby formula industry must end 'misleading' online marketing: WHO
The $55 billion baby formula industry must end exploitative online marketing targeting parents, particularly mothers, the UN health agency said in a new report published Friday.
The study found companies are paying social media platforms and influencers to gain direct access to pregnant women and mothers at some of the most vulnerable moments in their lives, through personalised content that is often not recognisable as advertising.
Methods used include apps, virtual support groups or "baby clubs," promotions and competitions, as well as advice forums or services.
This pervasive marketing is increasing purchases of breast-milk substitutes, the World Health Organization (WHO) said, dissuading mothers from breastfeeding exclusively, as recommended by the agency.
The promotion of commercial milk formulas should have been terminated decades ago, said Dr Francesco Branca, director of the WHO's nutrition and food safety department.
Read: WHO recommends Pfizer's Covid pill Paxlovid
"The fact that formula milk companies are now employing even more powerful and insidious marketing techniques to drive up their sales is inexcusable and must be stopped," he added.
The report "Scope and impact of digital marketing strategies for promoting breast-milk substitutes," is the second in a series and follows an initial study, published in February, on how the marketing of formula milk influences people's decisions on infant feeding.
It summarises findings of new research that sampled and analysed four million social media posts about infant feeding published between January and June 2021 using a commercial social listening platform.
The posts reached nearly 2.5 billion people and generated more than 12 million likes, shares, or comments.
Formula milk companies post content on their social media accounts around 90 times per day, reaching 229 million users – three times the number of people reached by informational posts about breastfeeding from non-commercial accounts – according to the study.
The authors compiled evidence from social listening research on public online communications and individual country reports of research that monitors breast-milk substitute promotions.
They drew on a recent international study of mothers' and health professionals' experiences with formula milk marketing.
Read: WHO says global COVID cases, deaths declined again last week
Studies revealed how misleading marketing reinforces myths about breastfeeding and breast milk and undermines women's confidence in their ability to breastfeed successfully.
The proliferation of global digital marketing of formula milk blatantly breaches a landmark international code on the marketing of breast-milk substitutes, adopted 40 years ago, the WHO said.
The agreement is designed to protect the general public and mothers from aggressive marketing practices by the baby food industry that negatively impact breastfeeding practices.
The WHO said the fact that these forms of digital marketing can evade the scrutiny of national monitoring and health authorities, shows new approaches to code-implementing regulation and enforcement are required.
Despite clear evidence that exclusive and continued breastfeeding are key determinants of improved lifelong health for children, women, and communities, far too few children are breastfed as recommended.
The proportion could fall further if current formula milk marketing strategies continue, the WHO said.
WHO recommends Pfizer's Covid pill Paxlovid
The UN health agency Friday "strongly recommended" the use of nirmatrelvir and ritonavir, sold under the name Paxlovid, for mild and moderate Covid patients at the highest risk of hospital admission.
The oral antiretroviral drug was developed by Pfizer and is "the best therapeutic choice for high-risk patients to date," the World Health Organization (WHO) said.
The recommendation is based on new data from two randomised controlled trials involving more than 3,000 patients that found an 85 percent reduction in the risk of hospitalisation.
Read: WHO says global COVID cases, deaths declined again last week
However, the WHO said availability, lack of price transparency in bilateral deals made by the producer, and the need for prompt and accurate testing before administering it are turning this life-saving medicine into a major challenge for low- and middle-income countries.
One obstacle for low- and middle-income countries is that the medicine can only be administered while the disease is at its early stages, making prompt and accurate testing essential for successful outcomes.
99% of world's population breathes poor-quality air: WHO
The WHO says 99 percent of the global population breathes air that exceeds its air-quality limits and is often rife with particles that can penetrate deep into the lungs, enter the veins and arteries, and cause disease.
The UN health agency, about six months after tightening its guidelines on air quality, on Monday issued an update to its database on air quality that draws on information from cities, towns, and villages across the globe.
Air quality is poorest in WHO's eastern Mediterranean and southeast Asia regions, followed by Africa.
The database, which has traditionally considered two types of particulate matter known as PM2.5 and PM10, for the first time has included ground measurements of nitrogen dioxide.
Nitrogen dioxide originates mainly from human-generated burning of fuel, such as through automobile traffic, and is most common in urban areas.
Exposure can bring respiratory diseases like asthma and symptoms like coughing, wheezing and difficulty in breathing, and more hospital and emergency-room admissions, WHO said.
The highest concentrations were found in the eastern Mediterranean region.
Particulate matter has many sources, such as transportation, power plants, agriculture, the burning of waste and industry – as well as from natural sources like desert dust.
READ: Efforts being made to improve country’s air quality, says minister
The developing world is particularly hit hard – India had high levels of PM10, while China showed high levels of PM2.5, according to the database.
Particulate matter, especially PM2.5, is capable of penetrating deep into the lungs and entering the bloodstream, causing cardiovascular, cerebrovascular (stroke) and respiratory impacts, the UN health agency said.
There is emerging evidence that particulate matter impacts other organs and causes other diseases as well, it added.
WHO advises Ukraine to destroy high-risk pathogens in labs
The World Health Organization (WHO) has advised Ukraine to destroy high-threat pathogens stored in the country's labs to prevent "any potential spills," the UN agency said on Thursday.
In an emailed response, the WHO told Reuters that it has "strongly recommended the Ministry of Health in Ukraine and other responsible bodies" to destroy those disease-causing pathogens or toxins, but provided no specifics about their kinds.
According to Reuters, Ukraine has public health laboratories working on disease research, and received support from the United States, the European Union and the WHO.
Read: Russians keep pressure on Mariupol; massive convoy breaks up
With no reference to biowarfare, the WHO said it encourages all parties to cooperate in "the safe and secure disposal of any pathogens they come across, and to reach out for technical assistance as needed."
Also on Thursday, Dmitry Polyanskiy, first deputy permanent representative of Russia to the UN, tweeted that the United Nations Security Council would convene on Friday to discuss the United States' alleged military biological research in Ukraine at Russia's request.
Govt seeks WHO nod for vaccinating children aged 5 and above: Health Minister
In an effort to contain the spread of Covid-19, vaccination for primary school students aged five and above will start soon after WHO approval, said Health Minister Zahid Maleque on Monday.
“We have asked the Education Ministry to prepare a list of the students. We also have contacted the World Health Organisation for its approval,” he told reporters after an emergency on nationwide vaccination situation at Bangladesh Secretariat.
The start of the drive for vaccinating primary school students depends on WHO approval, he said in reply to a question.
Besides, the mega vaccination drive for administering second dose will begin on March 28 and will continue till March 30.
Also read: Bagerhat's shining success in vaccinating students
Some 2.25 crore people are likely to receive the second dose during the mega drive, he said.
Maleque said 22 crore doses of Covid vaccines so far have been administered in the country covering 75 per cent of the population.
An amount of Tk 40,000 crore has been spent for purchasing and administering covid doses, he added.
Also read: No decision yet on vaccinating the under-18: DGHS
Since the inauguration of the mass inoculation drive in Bangladesh on February 7 last year, some 8,68,44,218 people have been fully vaccinated with two shots and12,54,90,996 people received their first doses till Sunday (March 6).
Besides, 42,53,378 people have received booster doses, the minister said.
Global Covid cases top 417 million
The overall number of Covid cases has now surged past 417 million as Omicron infections keep rising across the globe.
According to Johns Hopkins University (JHU), the total case count mounted to 417,488, 213 while the death toll from the virus reached 5,849,213 Thursday morning.
The US has recorded 78,169, 874 cases so far and 928,490 people have died from the virus in the country, the university data shows.
India's Covid-19 tally rose to 42,723,558 on Wednesday with 30,615 new cases in 24 hours across the country, showed the federal health ministry's latest data.
Read: WHO: New COVID cases drop by 19% globally, deaths stable
Besides, 514 more deaths have been reported from the pandemic since Tuesday morning, taking the total death toll to 509,872.
Meanwhile, Brazil, which has been experiencing a new wave of cases since January last year, registered 27,819,996 cases as of Wednesday, while its Covid death toll rose to 641,096.
The number of new coronavirus cases globally fell by 19% in the last week while the number of deaths remained stable, according to the World Health Organization, reports AP.
The UN health agency said late Tuesday in its weekly report on the pandemic that just over 16 million new Covid-19 infections and about 75,000 deaths were reported worldwide last week.
The Western Pacific was the only region to report a rise in new weekly cases, an increase of about 19%, Southeast Asia reported a decrease of about 37%, the biggest drop globally. The number of deaths rose by 38% in the Middle East and by about one-third in the Western Pacific.
The biggest number of new Covid-19 cases was seen in Russia. Cases there and elsewhere in Eastern Europe doubled in recent weeks, driven by a surge of the hugely infectious Omicron variant.
WHO said that all other coronavirus variants, including Alpha, Beta and Delta, continue to decline globally as Omicron crowds them out.
Situation in Bangladesh
Bangladesh logged 15 more Covid-linked deaths with 3,929 fresh cases in 24 hours till Wednesday morning, indicating a downtrend in both cases and fatalities.
The daily positivity rate slightly decreased to 12.20% from Tuesday’s 13.77% after testing 34,175 samples during the period, according to the Directorate General of Health Services (DGHS).
On Tuesday, Bangladesh reported 34 more Covid-linked deaths with 4,746 fresh cases.
The fresh numbers took the country’s total fatalities to 28,887 while the caseload mounted to 1,923,031.
Meanwhile, the mortality rate remained static at 1.50%.
However, the recovery rate slightly rose to 89.24% with the recovery of 12,757 more patients during the 24-hour period.
Read: Covid-19: Fatalities, cases drop in Bangladesh
On January 28, Bangladesh logged its earlier highest daily positivity rate at 33.37% reporting 15,440 cases and 20 deaths.
On December 9 last year, Bangladesh again logged zero Covid-related death after nearly three weeks as the pandemic was apparently showing signs of easing.
The country reported its first zero Covid-related death in a single day on November 20 last year along with 178 infections since the pandemic broke out in Bangladesh in March 2020.
Besides, the country registered the highest daily caseload of 16,230 on July 28 last year, while the highest number of daily fatalities was 264 on August 10 last year.
WHO recommends 2 new drugs for Covid patients
The UN health agency has recommended two new drugs for Covid patients.
The drug Baricitinib, also known as a Janus kinase (JAK) inhibitor and used to treat rheumatoid arthritis, has been strongly recommended for patients with severe or critical covid-19 in combination with corticosteroids.
The World Health Organization (WHO) Guideline Development Group of international experts gave the advice in the British Medical Journal Thursday.
Also read:Moderna jab will be given as booster doses: DGHS
Their recommendation is based on moderate certainty evidence that it improves survival and reduces the need for ventilation, with no observed increase in adverse effects.
The WHO experts note that Baricitinib has similar effects to other arthritis drugs called interleukin-6 (IL-6) inhibitors so, when both are available, they suggest choosing one based on cost, availability, and clinician experience.
It is not recommended to use both drugs at the same time.
However, the experts advise against the use of two other JAK inhibitors (ruxolitinib and tofacitinib) for patients with severe or critical Covid-19 because low certainty evidence from small trials failed to show benefit and suggests a possible increase in serious side effects with tofacitinib.
Also read: Anti-Covid pill likely to get approved in India soon, DCGI reviewing data
In the same guideline update, the WHO also makes a conditional recommendation for the use of the monoclonal antibody Sotrovimab in patients with non-severe Covid-19, but only in those at highest risk of hospitalisation, reflecting trivial benefits in those at lower risk.
The experts also note that there was insufficient data to recommend one monoclonal antibody treatment over another. And they acknowledge that their effectiveness against new variants like omicron is still uncertain.
They say guidelines for monoclonal antibodies will be updated when additional data become available.
Today's recommendations are based on new evidence from seven trials involving over 4,000 patients with non-severe, severe, and critical Covid-19 infection.
They are part of a living guideline, developed by the WHO with the methodological support of MAGIC Evidence Ecosystem Foundation, to provide trustworthy guidance on the management of Covid-19 and help doctors make better decisions with their patients.
Living guidelines are useful in fast-moving research areas like covid-19 because they allow researchers to update previously vetted and peer-reviewed evidence summaries as new information becomes available.
To make their recommendations, the panel considered a combination of evidence assessing relative benefits and harms, values and preferences, and feasibility issues.
Today's guidance adds to previous recommendations for the use of interleukin-6 receptor blockers and systemic corticosteroids for patients with severe or critical Covid-19; conditional recommendations for the use of casirivimab-imdevimab (another monoclonal antibody treatment) in selected patients; and against the use of convalescent plasma, ivermectin and hydroxychloroquine in patients with covid-19 regardless of disease severity.