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Person under 18 dies of coronavirus in Los Angeles, health experts report



Los Angeles County on Tuesday confirmed four more deaths linked to the coronavirus, including the first of a person under the age of 18.

The number of deaths in the county from the virus is now 11. Tuesday’s update also included a previously reported death in Long Beach. The young person who died was from Lancaster. No further details were immediately available.

“This is a devastating reminder that COVID-19 affects people of all ages,” L.A. County Public Health Department director Barbara Ferrer said.

Two of the people who died were between the ages of 50 and 70. One had underlying health issues and resided in the West Adams neighborhood, health officials said.

Officials also confirmed an additional 128 cases of coronavirus infections, bringing the county’s total to 662. Of those positive cases, 42% occurred in individuals between the ages of 18 and 40, and 39% were in people ages 41 to 65.

At least 119 residents, or 18% of all positive cases in the county, have been hospitalized for the virus.

In Orange County, officials announced 27 new coronavirus cases, bringing the total to 152. There have not been any deaths linked to COVID-19.

San Mateo County saw a jump of 19 new cases and its second fatality, pushing the county’s overall total to 161 positive tests. The number of cases increased by more than 10% in one day, according to Preston Merchant, a public information officer working in the county’s joint information center.

The county’s second death occurred Monday at the Atria Senior Living facility in Burlingame. The facility received news of confirmed COVID-19 cases in their community on March 15. A number of residents tested positive for the virus, and Monday’s fatality was the senior facility’s first coronavirus-related death at its Burlingame location.

“Our thoughts are with their family during this difficult time,” Atria said in a statement. “We remain in close communication with all our residents and their families and continue to provide our support as we navigate this unprecedented situation together.”

Atria said it is working closely with the San Mateo County Health Department, and officials have been on site to confirm proper health and safety measures are in place.

The number of coronavirus cases in California surged to nearly 2,500 Tuesday afternoon and the death toll climbed to 50 as officials issued urgent warnings about the need for more hospital beds and equipment as medical facilities begin to fill up.

Gov. Gavin Newsom says he believes California will need 50,000 hospital beds for patients suffering from the illness caused by the coronavirus. That marks a significant increase from the 20,000 beds his administration forecast last week. The Democratic governor said the state’s 416 hospitals were doubling their “surge plans,” a move that will result in 30,000 new beds across the system.

San Francisco officials warned that a surge in coronavirus infections was expected to come within a week or two, and voiced dismay over images of the public crowding beaches and parks across California.

“The worst is yet to come,” said Dr. Grant Colfax, San Francisco’s director of public health, at a news conference Monday.

San Francisco has already taken steps to decompress the healthcare system — banning almost all visitors to hospitals and long-term-care facilities, canceling elective surgeries and routine medical visits, ordering that appointments be done by phone or video if possible, and opening up tents to care for patients who have mild symptoms in order to keep hospital beds free for those more seriously ill.

A steep rise in people being hospitalized with COVID-19 in Los Angeles County likely signals the approach of a wave of extremely sick patients that could overwhelm hospitals in the coming weeks, experts say.

As of March 6, five people in the county had been hospitalized at some point with COVID-19. Two weeks later, on Friday, that figure had jumped to 48. By Monday, the total had climbed to 90.

Though the raw numbers remain relatively low, the rate of increase has set many doctors and nurses on edge after watching the disease’s alarming trajectory in China, Italy and, most recently, New York City.

Two Cal State Long Beach students tested positive for the virus and were in self-isolation off campus, the university announced in an email to students Tuesday morning.

One student had not been on campus for two weeks, the university said. In the second case, public health officials determined there was no opportunity for on-campus exposure. Students who might have come into close contact with the patients were being notified by health officials, according to the email.

As the number of cases continues to rise, officials throughout the state kept up their call for an increase in testing capacity and reporting.

Frustrated public health directors in six Bay Area counties have ordered an assortment of commercial, university and pop-up testing sites that are screening residents for COVID-19 to begin reporting not just the positive cases, but the negative results too.

Dr. Sara Cody said testing remains woefully inadequate as Santa Clara County wrestles with mounting deaths. As of Tuesday, 16 people had died in the county, more than half of the virus fatalities in California.

Santa Clara County’s Sheriff’s Office confirmed four cases among staff, including a deputy who is self-isolating at home.

California requires labs and hospitals to report known cases of COVID-19, but not the number of negative tests. Cody said that information is critical to tracking the spread of the virus. She warned that Santa Clara County’s current critical situation is a window into what will be seen in San Francisco and other Bay Area communities in the next one to two weeks.

Contra Costa County is one of the six counties that ordered new requirements. On Friday, health officer Chris Farnitano said the county would issue an order for negative tests to be reported as well.

Meanwhile, California remains largely shut down under state and local orders. L.A. County officials have cracked down on nonessential businesses, which Sheriff Alex Villanueva declared Tuesday includes gun stores. If gun sellers don’t close their doors, he said, they will be cited and face penalty, including the loss of their business licenses.

Officials previously closed beach parking lots, parks and hiking trials amid concerns some people were not staying at least six feet apart while in public. Laguna Beach took the restrictions a step further and closed its beaches entirely on Monday.

On Tuesday, Los Angeles City Councilman David Ryu called for the closure of Runyon Canyon Park and Lake Hollywood Park on weekends.

“Making this request pains me greatly. I grew up in a two-bedroom apartment off the 101 Freeway, and our city’s parks were my only access to outdoor space,” Ryu said of his recommendation to Michael Shull, the general manager of the city’s Department of Recreation and Parks. “I don’t make this recommendation easily, but closing Runyon Canyon Park on weekends, when we have seen the highest volume of visitors, should follow to keep everyone safe.”

In Sonoma County, all parks and open spaces were closed indefinitely, public health officials announced this week.

The closure includes city, county, state and federal parklands and recreational lands operated by private groups and nonprofits, according to a news release.

“Closing parks is a difficult decision, but it is the right decision at this time,” Sundari Mase, the county’s interim health officer, said in a statement. “Allowing crowded conditions in parks is not in our best interest during this health crisis. The best action we can take is to stay close to home and limit our outdoor time to our yards and neighborhoods.”

Mase announced the closure Monday after too many visitors flocked to outdoor spaces over the weekend.

Criminal and civil trials were discontinued in California for at least two months after a sweeping order was issued late Monday by the state’s chief justice that aimed to sharply reduce public traffic in state courthouses.

Chief Justice Tani G. Cantil-Sakauye said in her order that court facilities were “ill-equipped to effectively allow the social distancing and other public health requirements” that had been imposed across California to prevent the spread of the novel coronavirus.

“Even if court facilities could allow for sufficient social distancing, the closure of schools means that many court employees, litigants, witnesses, and potential jurors cannot leave their homes to attend court proceedings because they must stay home to supervise their children,” Cantil-Sakauye said in the order.

The 60-day delay — which puts the courts in California’s 58 counties on a uniform trial delay schedule — came the same day that the presiding judge of Los Angeles County Superior Court, Kevin C. Brazile, blocked public access to county courthouses except for attorneys, staff, defendants and “authorized persons,” a vague category that includes news reporters. The clerk’s office will still be available to accept filings and assist people by phone or electronically.

The California National Guard on Monday provided details about how personnel would be deployed across the state to assist in coronavirus aid. Officials said the guard was being used purely for humanitarian purposes, such as distributing food and medical supplies as well as helping at food banks and working with officials on the Grand Princess cruise ship, which docked in California after an outbreak of the virus on board.

With the coronavirus pandemic further stifling the efforts of California and other states to issue Real ID licenses, President Trump on Monday said he would extend the Oct. 1 deadline for people to apply for the identification cards to board domestic flights in the United States.

Times staff writers Priscella Vega, Paige St. John and Luke Money contributed to this report.





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900,000 Public Health Workers Going Door To Door Without Masks Or Hand Sanitizer



Dibyangshu Sarkar / Getty Images

Local residents make homemade facemasks in Kolkata, March 20.

The journalists at BuzzFeed News are proud to bring you trustworthy and relevant reporting about the coronavirus. To help keep this news free, become a member and sign up for our newsletter, Outbreak Today.


NEW DELHI — Every morning for the past week N.K., a 35-year-old community health activist, has received a WhatsApp message from her supervisor with the names of the latest group of travelers returning to India from countries affected by the coronavirus. Once she has the list of names, N.K. tracks down their addresses. By noon, she’s at someone’s doorstep, armed with a list of do’s and don’ts for people suspected of carrying the virus.

Over the phone, she reeled off the list of instructions she gave people: “Wash your hands, clean your living spaces. Avoid: crowds, religious gatherings, weddings, elderly people and eating food from outside. If you have a cough, cough into a mask. If you have fever or any other symptoms, call me. Even if you don’t, I’ll be here.”


Sam Panthaky / Getty Images

A volunteer distributes masks in Ahmedabad, March 20.

Women like N.K. are known as ASHAs — an acronym for Accredited Social Health Activists, which also spells the Hindi word for “hope” — and have been deployed as India’s first line of defense to track down “imported cases” of the coronavirus. These are Indian travelers who might be bringing the virus home from China, Europe or the Gulf countries, where a large section of Indians work as migrant labour. According to the latest Indian health ministry advisory, India currently only has “imported cases” of the novel coronavirus and no recorded cases of community transmission — which makes the ASHAs’ work of monitoring travelers and their families even more crucial.

India has so far appears to have escaped the worst of the coronavirus pandemic, with 194 cases and four deaths, and has been praised by the World Health Organization for its response so far. But while the government has launched an aggressive airport screening program, it is not carrying out widespread testing, and Indians returning from Europe have raised concerns about the quarantine centers they were held in.


Peter Aldhous / BuzzFeed News

Total cases and deaths by country

Several Indian state governments, such as in Punjab, Karnataka, Andhra Pradesh, Kerala, and Maharashtra, have deployed community health workers to do the work N.K. is doing — track down returnees, monitor them and their families for 14 days to check whether they develop any symptoms of the coronavirus, and go door to door teaching people how to practice social isolation, and to protect themselves.

It’s crucial but dangerous work. In Italy, where coronavirus has killed more people than in any other country in the world, one in 12 people infected by the virus so far have been health workers. In the US, the CDC recommends that public health professionals who do the work that the ASHAs are doing in India, conduct interviews over the phone or on video chat. In the event that they are checking for symptoms in person, health workers should wear full personal protective equipment (PPE) before entering homes of possible patients. Recommended PPE includes a gown, gloves, face shield, goggles and a respirator mask like the N-95.

Do you have questions you want answered? You can always get in touch. And if you’re someone who is seeing the impact of this firsthand, we’d also love to hear from you (you can reach out to us via one of our tip line channels).

But BuzzFeed News spoke to ASHAs in four different states — Punjab, Haryana, Karnataka, and Andhra Pradesh — who said they had not even been given masks or hand sanitizer while conducting house calls to potential coronavirus carriers. Several had spent their own money to buy masks and sanitizers, others were making them at home. None of them were able to follow the WHO or Indian health ministry’s guidelines on masks: to wear a new one every six hours, and get rid of used masks by burning or deep burial. An ASHA from Haryana told BuzzFeed News that her state government had organized a training program to teach community health workers about precautions to take while conducting surveys of coronavirus patients, but the training was canceled due to fears of the organizers contracting COVID-19, the disease caused by the coronavirus.

Most women refused to speak on the record fearing professional retaliation from their supervisors, N.K. agreed on the condition that she was identified only by her initials.


Nishita Jha

ASHAs from Uttar Pradesh pictured in 2016.

On Thursday evening, Indian Prime Minister Narendra Modi finally addressed the nation about the growing threat the coronavirus posed. He urged citizens to dismiss the idea that the virus could not affect them and to follow guidelines on social distancing. While he did not go into the details of how the government was responding to the coronavirus, he encouraged people to stand at their doorways or balconies at 5 p.m. on Sunday to clap, ring bells, or clank cooking utensils, so everyone could express their gratitude and appreciation for public health workers.

It’s unclear however how the sound of cooking pans being whacked with metal spoons will help the ASHAs, who form the backbone of India’s public health care system.

State governments have routinely failed to take the safety of ASHA workers into account. Even before the pandemic, ASHAs across the country have gone on strike for being severely underpaid (approximately $80 per month), having no worker rights (they are considered “honorary volunteers” instead of government employees), and frequently finding themselves on the frontlines of both disease and violence and burdened with extra hours of labor each time state governments want a survey carried out.


Uma Shankar Mishra / Getty Images

A man wearing a face mask watches Prime Minister Narendra Modi’s address to the nation, March 19.

There is almost no clear state-wise data on the number of COVID-19 cases in India, only aggregated press releases sent out twice a day. The health ministry is slow to update information received about positive cases, and there is a complete information vacuum on several people who have no travel history to foreign countries but have still contracted the virus — the Indian government is still not testing for community transmission. In this environment, ASHAs are in danger of contracting the disease and spreading it further.

Susana Barria, who works for the global union federation, Public Services International, said that community health workers across the world, who are almost always women, are told that the work they do qualifies as “care or volunteer work,” not a proper job. This is why they rarely get the benefits of employment, like protection against disease, maternity leave, paid sick leave, all of which will be especially crucial now.

“It’s never been clearer that public healthcare needs community health workers,” Barria said. “The skills and the capacity these women have, the way in which they are familiar with each community’s members — the sick, the elderly, the children — the ASHAs are the most likely to know when someone is displaying symptoms of coronavirus, has been traveling abroad or is missing from the home. Without them, doctors will be operating blind,” Barria said.


Getty Images

A woman wearing a protective mask walks in a market in New Delhi, March 19.

But there are other systemic challenges to ASHA workers that the unions and governments must resolve together — it’s not as easy as just handing out an endless supply of masks

“A big concern is that if ASHA workers show up at people’s homes wearing masks, it might create panic in the community,” Barria said. “On the other hand, if they contract the disease and fall ill, there is no guarantee from state governments that they will receive paid leave, whether they will be tested and treated free of cost, if they will be quarantined, whether they will still be able to work, if the governments will help their older family members who might get the virus from them,” (ASHAs are usually between 25-45.)

What it all comes down to, said Barria, is whether the government will finally recognize community health workers as actual workers and not “honorary volunteers.”

“The state governments love to describe the ASHAs as ‘volunteers’ and encourage them to get other paying jobs — but who can work another job with a 12-hour shift of going door to door, monitoring people’s health? It’s hard, back-breaking work which has only increased with their new coronavirus-related duties,” she said.

Repeated calls and emails from BuzzFeed News to ASHA supervisors in Punjab, Karnataka, and Andhra Pradesh to inquire about the status and safety of community health workers went unanswered. One supervisor in Punjab hung up after saying: “Is your story about the women’s rights or coronavirus? It can’t be about both.”


Stringer / Getty Images

A man uses hand sanitizer after leaving a metro station in New Delhi, March 16.

Punjab is one of several Indian states that is afraid of coronavirus casualties growing as migrant laborers return home, particularly from the Gulf countries, where thousands of Indians go to earn a living and send money back home. Despite this, Punjab has tested only 110 people for the coronavirus so far, while at least another 335 people who returned home after traveling abroad are still untraceable.

“I’m doing the same thing I always do — spending my own money and time for this,” N.K. told BuzzFeed News, adding that she has followed similar protocols going door-to-door in the past, including when she made visits to check on tuberculosis and SARS patients. “I buy a fresh mask whenever the chemist gets a supply, otherwise I use my dupatta,” she said, referring to a type of scarf. “I have a bath as soon as I get back and wash my hands as often as I can.”

Even as the pandemic panic began and Modi endorsed appeals to work from home, N.K. has continued to work her 12-hour shifts, which now include making daily house calls to eight different homes where she said people have returned from coronavirus-affected countries. She said she has been instructed by her supervisors to visit their homes every day for two weeks, in order to monitor their symptoms.

In addition to visiting potential coronavirus carriers, N.K. and other ASHA workers are also performing their usual duties: assisting in deliveries, teaching young mothers how to care for newborns, helping the elderly and administering basic first aid. Usually, an ASHA looks after 1,000 to 2,500 families in a district.

“Most people believe that the coronavirus will go away if they drink warm fluids and get enough rest,” N.K. said. “Others believe they have stronger immunity than people in the West. The big fear is that they will be locked up if they show symptoms — I’ve seen family members hide sons who used to work as laborers abroad until last month. They are afraid that once their sons are locked away for a sneeze or a cough, there will be no one left to earn for the family.”●



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Anxious about the coronavirus? Here are 5 tips from mental health experts


TORONTO —
Between the worrisome headlines and the drastic measures meant to limit the spread of COVID-19, the virus can be an added stressor for anyone.

Mark Henick, a mental health advocate and public speaker, said major public health events can be especially troublesome for someone with mental illnesses such as anxiety, depression or obsessive compulsive disorder.

“The problem when you have a mental illness like anxiety is that it interferes with their life, that you overcompensate in many ways, so they might be self-isolating, which is not good for your mental health at all,” he said in a recent phone interview with CTVNews.ca.

There have been 153 cases of COVID-19 in Canada, primarily in Ontario and British Columbia. One person has died thus far.

Keith Dobson, a researcher with the Mental Health Commission of Canada and a professor at the University of Calgary, said the COVID-19 outbreak has shown itself to be particularly anxiety inducing because of its unpredictability, uncontrollability and salience.

“This condition is a triple threat from a psychological perspective,” he said. “It’s not surprising there’s a lot of anxiety and lots of perceived threat.”

There are, however, several strategies that can be effective to help cope with the stresses associated with an outbreak, regardless of whether you have a mental illness.

UNDERSTAND THIS WILL PASS

While the situation might seem increasingly dire, Henick said it’s important to understand the outbreak will inevitably pass and there are some already simple ways to mitigate your risk, such as washing your hands and avoiding close contact.

“If people are dwelling on this, if it’s making them extremely anxious and that anxiety is impacting their health, I think it’s an important reminder that they’re probably going to be fine,” he said.

“Like all challenging public health events, we will get through this and we’ll learn from it.”

UNDERTAND EVERYONE’S BEING AFFECTED

With so much flux, someone with a mental illness might find it hard to deal with changes to their routine, but Mark Ferdinand, co-chair of the Canadian Alliance on Mental Illness and Mental Health, suggests it’s important for the people to understand that everyone is dealing with these same challenges.

“It’s important for people to know that this unprecedented situation that we’re experiencing right now with regards to how COVID-19 is affecting everyone in terms of what their daily lives are looking like,” he said.

When it comes to anxiety, Dobson argued those with an anxiety disorder might even be better off than the general public.

“Putting this on top of other issues in some ways might even be less severe than people with lower levels of anxiety, because the relative difference isn’t so much,” he said. “I actually think that for people with anxiety, it may not be too bad.”

AVOID SELF-ISOLATING IF NOT SICK

Henick suggests the biggest issue people with a mental illness might face during a pandemic is they might self-isolate out of fear, which can be particularly troublesome.

“It’s important to maintain contact with people in whatever way makes sense to do that, whether it’s online, by phone or by other means,” Henick said.

Henick added that mass cancellations of social gatherings such as concerts, sporting events and religious gatherings can only add to this feeling of isolation among people with mental health issues.

“While those are smart preventative measures from a public health perspective, it limits the opportunity for people who are already isolated to reach out and connect with others,” he said.

Family and friends of someone with a mental illness also play a part in making sure they don’t feel alone. Henick said something as simple as phone call can go a long way toward helping someone.

“One of the great parts of living in such a highly connected world now is that we have many ways of connecting with people and I think that we need to make the effort to do that,” he said.

FOLLOW THE NEWS IN MODERATION

As COVID-19 dominates the international headlines, the concerning news can lead to increased anxiety among some people, while others might fixate on the latest developments.

“Something that people do when they’re anxious, especially in times like this, is to overconsume media about it,” Henick said. “That’s just the way our brain works. We’re looking for answers, we’re looking for reassurance.”

Henick suggests it’s important for people to keep abreast about what’s going on in the world, but to do so responsibly.

Dobson agreed that it might be a good idea to stay away from the headlines, though it might not be entirely possible.

“This is a public health concern,” he said. “It’s appropriate, I think, that everybody has some degree of appropriate anxiety here about the issues.”

FIND A ‘COPING STRATEGY’

Ferdinand suggests “coping strategies” can be effective when it comes to keeping someone’s mind off a stressful and potentially problematic situation.

These activities can include anything that makes the person happy, such as reading, listening to music, chatting with a friend or playing an instrument.

“I think the idea is to find the coping strategy that either works for you, that makes you happy or to keep the connection alive with someone that you like talking to,” he said.



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U.S. President’s Global Gag Rule is Having Negative Impact on the Health of Malawians: Report — Global Issues


A Malawian nurse at a training session. A report looking into the discontinuation of U.S. global health assistance to foreign non-governmental facilities providing abortion or abortion-related services, says that the ban is affecting the population in Malawi. Credit:Claire Ngozo/IPS
  • by Samira Sadeque (united nations)
  • Wednesday, February 19, 2020
  • Inter Press Service

The report, titled ‘A Powerful Force: U.S. Global Health Assistance and Sexual and Reproductive Health and Rights in Malawi’ was released on Feb. 10 by Washington, D.C.-based sexual and reproductive health rights organisation CHANGE, the Center for Health and Gender Equity. 

Serra Sippel, president of CHANGE, told IPS they chose to study Malawi in part because the country is a recipient of U.S. assistance in the three key fields of sexual and reproductive health: family planning, maternal and child health, and HIV and AIDS. 

“The GGR impacts health structures and when health structures are impacted, it is often the marginalised and criminalised groups who bear the brunt of the impact,” Sippel told IPS. “This includes people living in rural areas, adolescent girls and young women, and female sex workers.”

The report details the numerous ways in which GGR affects the fabric of a country where many communities are already averse to abortion, often owing to religious concerns. This means that when a young woman needs to get an abortion, they might do so in unsafe ways in order to keep them secret. 

One partner organisation is quoted in the report as saying, sometimes a girl “would drink a potion like a solution of washing powder and some will use sticks” to engineer her own abortion. 

In the Sub-Saharan country, where abortion is a taboo and can even lead to 14 years in prison in cases where there is no “life endangerment” of the pregnant person, more than 50,000 women suffer annually from unsafe abortion practices, according to the report. 

Marie Stopes International (MSI), which doesn’t have direct services in Malawi, estimates that about 78,000 women undergo unsafe abortion practices in the country, according to the report. Abebe Shibru, MSI’s country director in Zimbabwe, shared with IPS the general effect it’s having in sub-Saharan Africa.  

“The GGR continues to aggravate the situation of undermining women’s right for choice,” Shibru told IPS. “Lack of adequate services for family planning, increasing rate of teen age pregnancy and increasing maternal mortality, mostly from unsafe abortions, are some of the issues that the GGR contributes to.”   

Sippel told IPS that the local MSI affiliate Banja La Mtsogolo (BLM) was “forced to end their participation in the U.S. PEPFAR DREAMS Partnership, a highly effective HIV prevention programme, because of the GGR”.

Some of the impact is top-down from the government. In 2015, the Termination of Pregnancy Bill, introduced in Malawi to ensure safe abortion in cases of incest, rape, fetal anomaly, was “slowed down” by the Minister of Health given their fears that it would affect U.S. foreign aid in the country while President Trump is in office, according to the report. 

“We also met with the International Planned Parenthood Federation affiliate Family Planning Association of Malawi (FPAM) who was forced to stop their participation in the LINKAGES project which provides HIV and AIDS prevention, care, and treatment services for key populations. Because of the GGR they were forced to close four clinics,” Sippel added. 

There is also a further effect on a community that’s hard hit by climate change, and vulnerable to a range of climate concerns such as intense rainfall and droughts, among many other issues. These issues, although not directly related to GGR, further amplify the negative effects such foreign policy has on those at the center of the crisis, according to advocates.

“When women are displaced because of climate change, their risk of exposure to gender-based violence often increases,” Sippel told IPS. “They are walking longer distances to get water and firewood. Also, as women enter camps post-disaster, their access to SRHR services can often be limited.”

 

© Inter Press Service (2020) — All Rights ReservedOriginal source: Inter Press Service

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