Tag Archives: coronavirus infections

Ontario hospitals may have to withhold care as COVID-19 fills ICUs

By Allison Martell and Anna Mehler Paperny

TORONTO (Reuters) – Doctors in the Canadian province of Ontario may soon have to decide who can and cannot receive treatment in intensive care as the number of coronavirus infections sets records and patients are packed into hospitals still stretched from a December wave.

Canada’s most populous province is canceling elective surgeries, admitting adults to a major children’s hospital and preparing field hospitals after the number of COVID-19 patients in ICUs jumped 31% to 612 in the week leading up to Sunday, according to data from the Ontario Hospital Association.

The sharp increase in Ontario hospital admissions is also straining supplies of tocilizumab, a drug often given to people seriously ill with COVID-19.

Hospital care is publicly funded in Canada, generally free at the point of care for residents. But new hospital beds have not kept pace with population growth, and shortages of staff and space often emerge during bad flu seasons.

Ontario’s hospitals fared relatively well during the first wave of the pandemic last year, in part because the province quickly canceled elective surgeries.

The College of Physicians and Surgeons of Ontario told doctors last Thursday that the province was considering “enacting the critical care triage protocol,” something that was not done during earlier waves of the virus. Triage protocols help doctors decide who to treat in a crisis.

“Everybody’s under extreme stress,” said Eddy Fan, an ICU doctor at Toronto’s University Health Network. He said no doctor wants to contemplate a triage protocol but there are only so many staff.

“There’s going to be a breaking point, a point at which we can’t fill those gaps any longer.”

In a statement, the health ministry said Ontario has not activated the protocol. A September draft suggested doctors could withhold life-sustaining care from patients with a less than 20% chance of surviving 12 months. A final version has not been made public.

Ontario’s Science Advisory Table had been forecasting the surge for months, said member and critical care physician Laveena Munshi. During a recent shift she wanted to call the son of a patient only to discover he was in an ICU across the street.

“The horror stories that we’re seeing in the hospital are like ones out of apocalyptic movies,” she said. “They’re not supposed to be the reality we’re seeing one year into a pandemic.”

(Reporting by Allison Martell and Anna Mehler Paperny; Editing by Denny Thomas and Grant McCool)

‘How can we not be tense?’ Turkey’s coronavirus infections soar

By Daren Butler and Tuvan Gumrukcu

ISTANBUL/ANKARA (Reuters) – The red letters scrolling across the front of Fikret Oluk’s bus say: “Stay Home Turkey.” But the Istanbul driver said passengers are ignoring rules and overcrowding, sometimes without masks, even as coronavirus infections rocket.

Turkey – which has the highest level of daily new COVID-19 cases in Europe and the Middle East – again tightened measures last week to contain the rapid spread after calls for action by doctors and opposition politicians.

Among the rules are a limit of 69 passengers on Oluk’s busy urban bus route. When 89 are aboard, he says he draws the line.

“But unfortunately people do not listen. They attack us and put us in a difficult position,” said the driver of 10 years.

“How can we not be tense? Our lives are currently dependent on these masks. But unfortunately, just like people don’t think about themselves, they don’t think about us either,” he said.

Interviews with Turks who have received a vaccine and those waiting for one show a mix of fear and frustration with record COVID-19 deaths and infections, which neared 56,000 on Thursday alone, and an uneven adherence to the rules.

The head of the Turkish Medics Association told Reuters she believed the biggest misstep of President Tayyip Erdogan’s government was broadly easing restrictions in March as daily case numbers fell below 10,000. She said this sacrificed the gains made over the winter, calling the approach “social murder.”

“We called this a ‘social murder’ because they already know what will cause these deaths, they do not have any preventative measures,” Sebnem Korucu Fincanci said, adding that intercity travel, manufacturing and public transportation should be halted.

Erdogan and his government came under fire last month for a party congress with thousands of people, many of whom were seen violating social distancing rules and not wearing or improperly wearing masks. Opposition parties and critics accused Ankara of undermining efforts to curb infections.

‘BE REALISTIC’

Nurettin Yigit, head doctor at a specially-built pandemic hospital in Istanbul, said the impact on the health system of the latest surge had been less than in previous waves and called the timing “unlucky.”

“The moment we began this controlled normalization, the entry of other mutations from other countries started,” he told Reuters as medical staff administered vaccines to patients. He attributed the rise partly to people travelling domestically.

Ankara has blamed coronavirus variants for the surge in infections, saying some 85% of total cases across the country are from the variant first identified in Britain, as well as a lack of commitment to measures such as social distancing and mask wearing.

On Friday, Health Minister Fahrettin Koca told the Hurriyet daily that the solution to the “serious rise” in infections was to speed up vaccinations, adding he aimed to have all citizens over 20 years old vaccinated by July.

Fincanci called Ankara’s vaccination goals unrealistic and criticized what she called the inaccurate reporting of case and death numbers. “They have to be realistic, they have to be transparent,” she said.

Turkey has administered around 18 million doses of COVID-19 vaccines so far, roughly enough to cover about 11% of the population, according to a Reuters tally.

The government has dismissed criticisms over its handling of the pandemic and the measures it has implemented, saying public health is the priority.

It has adopted fresh stay-at-home orders for weekends and will halt dining at restaurants starting Tuesday for the Islamic fasting month of Ramadan.

But the country has remained largely open for business since last June and many have hit the streets and cafes as the weather has warmed – worrying some who have stayed home.

“I haven’t drank tea in a café for 11 months. I don’t leave the house,” said Mehmet Tut, 62, sitting outside a hospital treatment room after receiving his first vaccine shot on Friday.

“We will still be careful as we wait for the second dose” even as others are not taking enough precautions, he said. “They expect everything from the state but it is up to us. If we are careful we won’t get sick.”

(Additional reporting by Yesim Dikmen, Bulent Usta and Mert Ozkan; Writing by Jonathan Spicer; Editing by Rosalba O’Brien)

India AstraZeneca shot delay could be ‘catastrophic’ for Africa: health official

ADDIS ABABA (Reuters) – India’s temporary hold on major exports of AstraZeneca’s COVID-19 shot will undermine Africa’s vaccination plans, and could have a “catastrophic” impact if extended, the head of the continent’s disease control body said on Thursday.

India decided to delay big exports of the shots made in its territory by the Serum Institute of India (SII) to make sure it could meet local demand, two sources told Reuters last week.

The hold “will definitely impact our ability to continuously vaccinate people,” the director of the Africa Centers for Disease Control and Prevention, John Nkengasong, told a news conference in Addis Ababa.

The African Union had planned to vaccinate 30-35% of the continent’s population by the end of the year he said. “If the vaccines are delayed we are unlikely to meet our target,” he added.

That AU target primarily relies on supplies from the global COVAX vaccine-sharing facility, through which 64 poorer countries including many in Africa are supposed to get doses from the SII. COVAX aims to provide enough shots for African countries to inoculate at least 20% of their populations.

“If the delay continues, I hope it’s a delay and not a ban, that would be catastrophic for meeting our vaccinations schedule,” Nkengasong said.

African countries have reported 4.25 million coronavirus infections and 112,000 related deaths, though experts have said the actual numbers could be higher.

The AU has also been negotiating with manufacturers to help member states secure the additional doses they will need to achieve 60% coverage.

On Monday, Johnson & Johnson announced it would supply the AU with up to 400 million doses of its COVID-19 vaccine. Delivery of those doses is due to begin in the third quarter of this year and will continue through 2022.

Those doses are separate from the GAVI/WHO-backed global COVAX facility.

Nkengasong said on Thursday the AU has “pivoted” towards the J&J shot in part as a result of the delay in the delivery of AstraZeneca shots, and also because it is a single-dose shot.

The J&J doses will begin to arrive in June or July, which will ease any shortage caused by the delay in the AstraZeneca doses, Nkengasong said. The gap until the arrival of the J&J doses is a concern, he added.

(Reporting by Addis Ababa newsroom; Writing by Maggie Fick; Editing by Andrew Heavens)

Options dwindling, Trump faces likely setback in Georgia recount

By Andy Sullivan and Susan Heavey

WASHINGTON (Reuters) – The U.S. presidential election battleground state of Georgia is expected on Thursday to affirm Joe Biden’s victory over Donald Trump after a painstaking recount, which would deal yet another setback to the president’s attempts to cling to power.

Georgia’s top election official, a Republican, has said the manual recount of almost 5 million votes is unlikely to erode Biden’s initial 14,000 winning margin by enough to hand Trump victory in the state.

That would leave Republican Trump with a dwindling number of options to overturn the results of an election in which Democrat Biden won 5.8 million more votes nationwide. Barring a series of unprecedented events, Biden will be sworn in on Jan. 20.

In the state-by-state Electoral College that determines the winner, Biden has captured 306 electoral votes to Trump’s 232, well ahead of the 270 needed for victory. The winner in each state is awarded that state’s electoral votes, a number roughly proportional to the population.

Flipping Georgia’s 16 votes would still leave Trump at least two closely contested states away from overturning Biden’s victory. Georgia officials say they expect to release results on Thursday ahead of a certification deadline on Friday.

In Pennsylvania, where Biden won by 82,000 votes, the Trump campaign is asking a judge to declare him the winner there, saying its Republican-controlled legislature should choose the state’s slate of 20 Electoral College voters.

In Wisconsin, the Trump campaign has paid for a partial recount, even though election officials there say that will likely only add to Biden’s 20,000-vote advantage in a state that carries 10 electoral votes.

‘A DEEPER PROBLEM’

Trump’s campaign has filed lawsuits in a number of other states, including Michigan, with scant success so far.

Those legal motions, sprinkled with factual errors, have been dismissed by Biden’s campaign as “theatrics” that are not based on sound law.

Several prominent law firms have pulled out of the operation, leaving Trump’s personal lawyer Rudy Giuliani to spearhead the efforts.

Trump said on Twitter on Thursday that lawyers would discuss a “viable path to victory” at a news conference at noon ET (1700 GMT).

State and federal election officials, as well as outside experts, say Trump’s argument that the election was stolen from him by widespread voter fraud has no basis in fact.

However, it does appear to be affecting public confidence in American democracy. A Reuters/Ipsos opinion poll released on Wednesday found about half of Republicans believe Trump “rightfully won” the election.

Arizona’s top election official, Democrat Katie Hobbs, said she and her family had been getting violent threats and urged Trump to stop casting doubt on the result, in which he lost by just over 10,000 votes.

“(The threats) are a symptom of a deeper problem in our state and country – the consistent and systematic undermining of trust in each other and our democratic process,” Hobbs said in a statement.

Trump, who has largely stayed in the White House and kept out of public view since the election, has no public events scheduled for Thursday.

His administration has so far refused to recognize Biden as the winner, which has held up funding and security clearances to ease the transition from one president to another ahead of the Jan. 20 inauguration.

Biden said on Wednesday that the delay was preventing his team from planning a new assault on surging coronavirus infections, which is straining the U.S. healthcare system.

(Writing by Andy Sullivan and Daniel Trotta; Editing by Ross Colvin, Lincoln Feast and David Clarke)

U.S. surpasses grim milestone of 200,000 COVID-19 deaths

By Sangameswaran S

(Reuters) – The death toll from the spread of the coronavirus in the United States exceeded 200,000 on Tuesday, by the far the highest number of any nation.

The United States, on a weekly average, is now losing about 800 lives each day to the virus, according to a Reuters tally. That is down from a peak of 2,806 daily deaths recorded on April 15.

During the early months of the pandemic, 200,000 deaths was regarded by many as the maximum number of lives likely to be lost in the United States to the virus.

The University of Washington’s health institute is forecasting coronavirus fatalities reaching 378,000 by the end of 2020, with the daily death toll skyrocketing to 3,000 per day in December.

Over 70% of those in the United States who have lost their lives to the virus were over the age of 65, according to CDC data.

The southern states of Texas and Florida contributed the most deaths in the United States in the past two weeks and were closely followed by California.

California, Texas and Florida – the three most populous U.S. states – have recorded the most coronavirus infections and have long surpassed the state of New York, which was the epicenter of the outbreak in early 2020. The country as a whole is reporting over 42,000 new infections on average each day and saw cases last week rise on a weekly basis after falling for eight weeks in a row.

Deaths rose 5% last week after falling for four weeks in a row, according to a Reuters analysis.

Six out of every 10,000 residents in the United States has died of the virus, according to Reuters data, one of the highest rates among developed nations.

Brazil follows the United States in the number of overall deaths due to the virus, with over 137,000 fatalities. India has had the world’s highest daily death rate over the last week with total deaths now approaching 100,000.

(Reporting by Sangameswaran S in Bengaluru; Additional reporting by Susan Heavey in Washington; Editing by Lisa Shumaker and Rosalba O’Brien)

How many Americans have coronavirus? New Reuters poll might offer a hint

By Maurice Tamman

NEW YORK (Reuters) – The official count of coronavirus infections in the United States sits at about 70,000 cases, but a chronic shortage of tests means only a fraction of the people infected are being counted. So how can we know how many Americans actually might have the disease?

A Reuters/Ipsos poll conducted in the past several days could offer what one behavioral health expert called a “fascinating” hint of the possible numbers.

In the nationwide poll, 2.3% of Americans surveyed said they’ve been diagnosed with the coronavirus, a percentage that could translate to several million people.

Of course, it’s impossible to know if the answers are a result of misinformed self-diagnoses, untested professional diagnoses or test-confirmed infections. But Carnegie Mellon University professor Baruch Fischhoff, who studies risk perception and analysis, said that the poll results shouldn’t be viewed as merely a collective neurotic reaction to the pandemic.

Given the shortage of coronavirus test kits, it may well be a broadly accurate estimate of the extent of the infection across the United States, he said. “It may be the best available data,” he said.

A further 2.4% of those polled said they have been in close contact with someone who has tested positive. And in an illustration of the degrees of separation with the deadly virus, a further 2.6% said they knew someone who has been in close contact with a person who has tested positive.

The poll, which surveyed 4,428 adults between March 18 and 24, shows a dramatic increase in those saying they have tested positive for the virus from a similar poll conducted just a few days earlier. In the Reuters/Ipsos poll of 1,115 Americans conducted March 16 and 17, about 1% said they were infected.

The latest poll also suggests that Latinos are far more likely to come in contact with people who may be infected than whites; the same appears true for younger people compared to older Americans. The disease appears to be concentrated in the Northeast, according to the poll, but the survey also suggests it’s widespread throughout the country.

David Cates, director of behavioral health at Nebraska Medical Center in Omaha, was intrigued by the results.

“Going back to that concept of the wisdom of crowds, you’re getting a response that may actually be closer to reality than confirmed testing,” he said. “And that is just absolutely fascinating.”

But he said the conflicting information from officials and in the media, as well as the shortage of testing, may also explain some of the response to the poll.

“They are listening to the news and thinking, ‘Yeah, you know, that’s what my father has, and that’s what I have,'” he said. “And this is probably what’s going on with the neighbor.”

Still, the poll results may fill some gaps in knowledge in the face of limited testing.

For example, Fischhoff said, on March 15, Ohio Gov. Mike DeWine estimated there were about 100,000 infections in his state, which represents about 1% of the state’s population, despite there only being a handful of confirmed cases at the time. The governor’s office declined to comment on the estimate.

“You know, with the doubling rate in the country, it’s not implausible that the infected rate was 1% and now it’s 2.3%,” he said.

He commented on another finding in the poll, the difference in proximity between rural and urban areas. In rural communities, according to the poll, about 9% of people said they were either infected; had contact with someone infected; or knew someone infected in their extended social network. In denser urban areas, that rate rose to 13%.

“As you would expect, as you’ve got greater density, you’d expect a higher rate,” he said.

Northwestern University economics professor Charles Manski said he was gratified to see that older Americans may have less exposure to infected people than other age groups. The disease poses a particular risk for the elderly.

Only 6% of Americans 55 and over said they were either infected; had contact with someone infected; or knew someone infected in their extended social network, the poll showed. That compares to 19% for adults under 35.

He said older people tend to have smaller social circles, which might explain part of the results, but he also thinks older Americans are being more careful than their younger counterparts.

Monica Schoch-Spana, a medical anthropologist with the Johns Hopkins Center for Health Security in Baltimore, Maryland, said the results also illustrate the risk to some ethnic communities as the broader economy shrinks and many retreat into their homes.

High-risk, low-paying jobs that have not been shut down – such as hospital custodial workers, farm laborers, delivery drivers and warehouse workers – tend to have a high percentage of minority workers.

The poll shows that about 16% of Latinos said they were either infected; had contact with someone infected; or knew someone infected in their extended social network, compared to about 9% for whites.

She also noted that the poll is a rare example of a subject that doesn’t have a massive partisan divide: About 14% of Democrats said they are infected or know of someone infected, compared to about 10% of Republicans.

(Reporting by Maurice Tamman; editing by Kari Howard)