Britain’s coronavirus infection rate could be almost 10 times worse than official figures show, a world health expert has warned.
There were 3,991 new cases confirmed on Wednesday, about 50 per cent more than a week ago. At the height of the pandemic in April the numbers peaked at between 6,000-7,000.
Antony Costello, a former director at the World Health Organisation, spoke out as new local lockdown measures are expected for England’s north east and new restrictions to close restaurants early are considered.
“I’m hearing from a well-connected person that government now thinks, in absence of testing, there are 38,000 infections per day,” he tweeted.
Initially, he tweeted that Chief Medical Officer Chris Whitty is advising a new two-week national lockdown but he later stepped back that comment.
Publicly, government leaders are not speaking about a second lockdown but they are talking about ways to reduce the rising number of new cases.
But Prime Minister Boris Johnson said a rise in deaths would follow the infection spike. He also said tough action was needed now to avoid a second wave and to save Christmas from lockdowns.
If coronavirus is allowed to rip across the country it will kill “an awful lot of people”, he warned.
In the north-east, about two million people live in the area being considered for a local lockdown that could be in place as early as today.
Josep Figueras and Anna Sagan from the European Observatory on Health Systems and Policies focus here on antimicrobial resistance and ponder whether or not this could be the next big pandemic
The sudden emergence of the COVID-19 pandemic brought the world to its knees in 2020. To date, over 800,000 people across the globe have succumbed to the deadly virus and, sadly, the count keeps on rising. With national economies plunging into contractions following many weeks of lockdowns, the full societal cost of the pandemic is yet to unravel.
Despite the existence of International Health Regulations (IHRs), national pandemic preparedness plans, and some high-profile warnings in recent years, COVID-19 has caught us all largely off guard.
After over nine months since the first case was reported, the virus remains present in most countries around the world and uncontrollable in some. With children back at schools and with health systems in the northern hemisphere preparing for the winter influenza season, it is unsurprising that COVID-19 continues to captivate the attention of the general public and public decision-makers alike.
The danger of antimicrobial resistance
Yet, there are other challenges that we must not forget about. Antimicrobial resistance (AMR) is one of the urgent global health challenges of our times. AMR is the natural ability of microorganisms such as bacteria to become resistant to antimicrobial medicines. This Darwinian ability has always been present, and, in the past, we have responded to it by developing novel antibiotics and other antimicrobials. However, as global consumption of antibiotics in both humans and animals has increased and the antibiotic pipeline has dried up, AMR has increasingly put modern medicine under threat. In the relatively near future, AMR may render operations as easy as a wisdom tooth extraction, let alone hip replacement, organ transplant or cancer chemotherapy, impossible. The consequences of this may potentially be more severe and more difficult to contain than that of COVID-19.
But unlike COVID-19, the danger of AMR has been creeping up on us silently and gradually and it has taken time for the seriousness of this threat to trickle down to the public consciousness. Further, the complexity of the problem and the need for an integrated response across human, animal and environmental sectors can prove challenging. In many countries, AMR is still perceived more as a human health problem and there is insufficient coordination across sectors. Yet, international and national efforts to combat AMR have increased substantially over the past two decades, and a number of important positive developments can be noted.
COVID-19 is known to be caused by a virus called SARS-CoV-2, which is similar in structure to two other viruses that have caused recent outbreaks. SARS-CoV, which caused an outbreak of SARS in 2003, and MERS-CoV, the cause of a 2012 outbreak of Middle East Respiratory Syndrome.
In the Journal of Chemical Physics, scientists from the University of Maryland School of Pharmacy report molecular-level investigations of these three viruses, providing a possible pathway to new antiviral drugs to fight all three diseases. At the present time, no effective treatment or drugs exist for any of these coronavirus diseases.
The investigators looked at a viral protein that plays a key role in the ability of the virus to replicate itself once inside the body. This protein also plays a role in defeating the host’s immune system, so it provides a particularly attractive target for potential drug treatments.
The protein, an enzyme known as the papainlike protease, PLPro, is nearly identical in SARS-CoV-2 and SARS-CoV but is slightly different in MERS-CoV. Very recently, the first structural X-ray of this enzyme revealed a shape in the catalytic domain somewhat like a hand with a “thumb,” “palm,” and “fingers.”
As more commercial and institutional spaces begin to reopen around the country, health experts have repeatedly warned of the potential dangers of sharing close quarters with others, which has encouraged renewed questions regarding the safety of public restrooms. Commercial restrooms have often been approached from a strictly utilitarian perspective, starkly designed and commonly lacking the space required to develop the programming necessary for privacy, cleanliness, and comfort –– not to mention, the complexities associated with gendered restrooms, which have long been the subject of debate. Facility managers now face the daunting task of keeping these restrooms clean and safe through short-term and long-term changes to their design and maintenance.
Automated technologies are easy to retrofit into a current space, offering quick and easy hands-free alternatives to improve hygiene and minimize the number of surfaces people come into contact with. TED MOUDIS ASSOCIATES
Convenience and durability were once the two most important considerations in restroom design, according to Patrick Ventker, team principal, and Rachel Robinson, design director, of Ted Moudis Associates, an architectural interiors firm headquartered in New York City.
“Now, user health and wellbeing have become equally important, touching as few surfaces as possible and ensuring the ability to deep clean those surfaces,” Robinson says.
Sepsis is a life-threatening condition and can occur when the body develops an infection which then affects the organs such as the heart, lungs, brain and kidneys.
It affects approximately 15,000 people in Ireland each year, and can prove fatal if not treated quickly.
“Sepsis is a common time-dependent medical emergency which can affect a person of any age and can strike irrespective of underlying good health or medical conditions.,” said Helen Donovan, Sepsis Lead at Galway University Hospitals.
“However, early recognition and timely treatment can have a major impact and this is the message we want to get out, ‘Think Sepsis’.”
“Sepsis awareness is an on-going project to increase awareness for all healthcare staff, patients and the wider community.”
Rory Donnelly, clinical research director of Copper Clothing, examines copper’s potential for wound dressings after a randomised study showed they created a significant reduction in postpartum surgical site infection following a caesarean section.
Wound and surgical site infections (SSI) pose a significant problem in healthcare today. In fact, according to NICE, SSIs have been shown to account for up to 16% of all healthcare-associated infections in the UK.
Not only do they threaten the lives of patients, they also increase the threat of antibiotic resistance. This alone is expected to kill more people than cancer by 2050. That equates to over 10 million people a year worldwide. It’s therefore clear we need to find new and innovative ways of reducing infections in hospitals across the globe.
Copper can be the solution. The material has been around for millennia. As early as 2600-2200 BC, the Egyptians used green copper rust for the treatment of chest wounds and to sterilise drinking water. But its use in the modern medical space is yet to be fully realised.
So how exactly can copper be applied in a clinical setting to prevent infection?
Research into copper infused medical devices.
In 2012, Copper Clothing made a breakthrough when Professor Bill Keevil, University of Southampton, carried out in-vitro testing on our copper and bamboo fabric, highlighting that the copper ions kill MRSA on contact. The initial kill rate for the first 30-40 minutes of contact on the copper nylon fabric was actually faster than 100% pure copper metal.
This year, a team of experts from NHS Croydon University Hospital conducted a study in partnership with our team at Copper Clothing. The double blind randomised controlled trial involved 324 women. 159 were randomised to the study group and 165 to the control group. The studies aim was to investigate the effect of copper impregnated wound dressings on the surgical site infection (SSI) rate following caesarean section (CS).
The findings were published in the European Journal of Obstetrics & Gynaecology and Reproductive Biology. It found that copper caesarean wound dressings not only demonstrated a significant 38.7% reduction of overall Surgical Site Infection (SSI) rate, but also a significant 80.3% reduction of organ/space SSI.
This is outstanding. It is the first study of its kind that demonstrates a significant reduction in SSI rates following caesarean section with the use of copper impregnated wound dressings.
Sepsis, the presence of bacteria in the blood, is a medical emergency and can be initiated practically by any infectious pathogen. The European Sepsis Academy (ESA-ITN) worked to address existing limitations in sepsis diagnosis and treatment.
Sepsis is a life-threatening condition that affects millions of individuals worldwide. It is characterised by a complex interplay between pathogen and host immune responses and evolves very rapidly. Effective sepsis treatment depends on early recognition and identification of the pathogen, the type of the infection and the stage of disease.
A sepsis research training network
The ESA-ITN project was designed to assist in the prompt diagnosis of sepsis through biomarker diagnostics and clinical trial models. The project was undertaken with the support of the Marie Skłodowska-Curie programme and involved leading institutions and pharmaceutical companies. ESA-ITN offered an extensive sepsis-oriented training programme to early-stage researchers encompassing courses and research training in advanced research methodologies and technologies central to sepsis research. Research projects exhibited an interdisciplinary nature and combined product development, economics and medical practice. They focused on three research pillars: the pathogenesis of sepsis-induced immune suppression, the identification and validation of diagnostic biomarkers, and the development of diagnostic platforms. “ESA-ITN was a life-changing experience, seeing a team of young scientists forming a strong collaborative network that can change the sepsis field in the future,” emphasises project coordinator Joost Wiersinga, Professor of Medicine at the University of Amsterdam.
Innovations in sepsis diagnosis and management
Particular emphasis was given to the regulatory mechanisms that drive inflammation and immunosuppression during sepsis. Researchers investigated the role of various immune regulatory molecules and DNA methylation marks, providing valuable knowledge on the pathogenesis of sepsis. An immune profiling tool holds great potential in providing patients at high risk with accurate and precise management. Such a panel was developed and assessed within ESA-ITN for its ability to semi-quantify immune markers from whole blood. This was undertaken by polymerase chain reaction, or PCR, on whole blood using bioMérieux’s FilmArray® platform. The automated nature of the assay and the ability to provide results within the hour render it suitable for bedside implementation and for immune profiling of critically ill patients in the ICU. In another ESA-ITN subproject, scientists discovered a panel of 12 markers to be associated with hospital-acquired infections. These biomarkers can be employed to quantitate sepsis-induced immunosuppression and to identify patients at risk of developing infection and sepsis after admission to the hospital ward or ICU. This panel of biomarkers demonstrated a good predictive performance of clinical outcome when validated in patients.
Project significance and future prospects
Overall, ESA-ITN contributed to the innovation value chain for sepsis diagnostics through novel biomarkers and technology platforms. Collectively, these will help develop and implement personalised treatment strategies targeted at the immunosuppressive phase of sepsis. While in-hospital sepsis mortality has improved in recent years, survivors are often faced with debilitating symptoms that result in considerable personal, family and healthcare costs. According to Wiersinga: “This is due to various clinical gaps especially acute care deficits to prevent or mitigate post-sepsis sequelae and post-sepsis pathways to optimise treatment. The European Sepsis Academy plans to address this important topic in the near future.”
Researchers are examining the risk of sea swimmers and surfers harbouring antibiotic-resistant superbugs which could cause life-threatening infections.
A team of researchers at NUI Galway are exploring whether recreational waters are carrying potentially deadly bacteria that is not routinely tested for.
While Ireland has some of the cleanest bathing waters in Europe, raw sewage is still being discharged at more than 30 locations.
The deadly superbugs are recognised as one of the greatest threats to human health.
Once a superbug gets into a wound, into the bladder or into the blood, it can cause an infection that can be difficult to treatProfessor Dearbhaile Morris, PIER project
The Antimicrobial Resistance and Microbial Ecology Research Group at the university is launching the PIER study (Public Health Impact of Exposure to antibiotic Resistance in recreational waters), funded by the Environmental Protection Agency (EPA).
Researchers are hoping to recruit 300 people to take part – one group of 150 sea swimmers, surfers and people who regularly use the sea, lakes or rivers for recreation, along with a second group of 150 people who rarely take to the water.
A key part of the project is to understand how superbugs get into human populations to help scientists learn how to control the spread of antibiotic-resistant bacteria.
Professor Dearbhaile Morris, principal investigator on the PIER project, said: “In healthy people, antibiotic-resistant bacteria behave very similarly to other common bugs, they live harmlessly on the skin, in the nose or in the bowel. This is called colonisation.
Hospitals in Greater Manchester have employed dedicated Covid-19 safety officers.
They are believed to be the first such NHS staff in the country.
The 24 new recruits will work to ensure Northern Care Alliance hospitals inlcuding Fairfield in Bury, Salford Royal, Rochdale Infirmary and Oldham Royal meet stringent infection prevention measures.
Their jobs will include helping doctors, nurses and other clinical teams put on and take off their PPE correctly and ensuring public, patients, visitors and staff adhere to the hospitals’ coronavirus prevention measures.
They’ll also advise staff on hand washing, support social distancing and advise on the correct use of face masks.
Mark O’Leary, a furloughed cabin crew member at Virgin Atlantic, has been recruited as the infection prevention and control safety officer at The Royal Oldham Hospital.
The 36-year-old said: “It’s a great honour to be one of the first of a new breed of hospital infection prevention and control safety officers.
“I am excited to be using my background in safety, all be it in a different sector, to help fight covid and keep hospitals safe for patients, staff and the public.”
Being able to eradicate the SARS-CoV-2 virus at the flip of a switch is about as attractive a concept as they come. UVGI (ultraviolet germicidal irradiation) technology, chiefly UV-C, has a proven record at killing or deactivating a variety of pathogens. And the technologies which can emit these wavelengths have been used in facilities for decades. However, facility managers must still be judicious in selecting and applying the UVGI technology in their facility for a variety of factors, including achieving maximum efficacy while reducing harm to facility occupants, and the facility itself.
There is a range of wavelengths which can kill or deactivate pathogens. The more potent effect is found in the UV-C range, but all UV and even some blue light has a degree of germicidal effect. Understanding that is one of the first steps of being an educated consumer of germicidal technologies. To begin with “germicidal” just means it kills microscopic pathogens. Whether it kills the tiny thing you’re interested in killing depends. For example, radiation in the 405 nm range creates a creepy blue glow and also deactivates bacteria, spores, and microbes. It’s used primarily in unoccupied healthcare settings, to combat hospital acquired infections. But it has no impact on viruses.
The Earth’s ozone layer blocks the UV-C radiation coming from the sun, but it can be emitted by four lamp technologies. Pulsed xenon lamps put out a boatload of UV-C as well as visible light, but they are expensive and not commonly used, says Robert Karlicek, director of the Center for Lighting Enabled Systems & Applications at Rensselaer Polytechnic Institute. Mercury vapor lamps are commonly used in commercial facilities, in everything from HVAC coil defouling, to sanitizing air in ducts or through upper room disinfection fixtures, to disinfecting surfaces in rooms via robots. UV-C LEDs have a longer wavelength (265 to 280 nm versus the 254 nm of mercury vapor), and they are not as effective or powerful, says Karlicek, but they’re really good at disinfecting in enclosed spaces, like a cabinet for cleaning tools or devices. Lastly, there are lamps being developed that emit in the 222 nm range, colloquially called “far UV,” though UV purists are not fans of the term, Karlicek says.