COVID 19 Covid 19/Health Covid 19/Research EMS News General News

Looking behind the European medicines data breach

Important documents may have been taken following a data breach relating to Europe’s drug regulator – the European Medicines Agency (EMA). It seems that the data breach was politically motivated.
It appears that the criminals involved not only took important documents, in December 2020, but also adulterated them (as reported by European officials). These documents were released as altered medical documents seemingly to undermine trust in the Pfizer / BioNTech vaccine, according to InfoSecurity Magazine.

The motive was either to promote an anti-vaccine message or to undermine confidence in European institutions.

To counteract this, the agency has sought to reassure the public in its statement on the matter. “Amid the high infection rate in the EU, there is an urgent public health need to make vaccines available to EU citizens as soon as possible,” the European Medicines Agency said in a statement.

Looking at the issue is Russell Haworth, CEO of Nominet.

Haworth begins by discussing the nature and thrust of the attack: “The attack on the European Medicines Agency in December and subsequent leaking of altered documents revealed late last week has highlighted the potential of disinformation campaigns to be life threatening.”

Haworth also notes that similar tactics were used in the runup to the U.S. presidential election. These other attacks “ threatened to erode public trust. Now, with global health on the line, governments around the world cannot afford to have their citizens lose trust in their ability to protect them. “

But together, such events carry “real world implications, potentially leading to people not getting vaccinated and leaving themselves and loved ones vulnerable to a dangerous virus. “

Haworth adds that “It is very important that public institutions have good breadth and depth of security to defend against these types of attacks”

As to how appropriate measures can be enacted, Haworth recommends various measures: “From identifying where education needs to take place, systems that can build a broad foundation of security into the public sector infrastructure, through to technology that works deep in the network and can identify anomalous behaviour.

Ultimately, by coordinating threat intelligence and response between governments and industry, resilience to disinformation campaigns and the subversive methods used by cyber criminals can be built.”

Original article was published in the http://www.digitaljournal.com/ and was written by Tim Sandle

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COVID 19 Features

The COVID Tracker App is Available to Download

The Covid Tracker app will help in the fight against coronavirus. Download the COVID Tracker app HERE.

We’ll protect your privacy, and you’ll help us protect everyone. Stay safe. Protect each other.

COVID Tracker is a free and easy-to-use mobile phone app that can:

  • alert you if you have been in close contact with someone who has tested positive for coronavirus

How the COVID Tracker app works


COVID Tracker is a free app for your mobile phone. It will help us to protect each other and slow the spread of coronavirus (COVID-19). The COVID Tracker app uses a number of technologies to help to speed up contact tracing in Ireland.

If you use the app you will:

  •  be told if you have been in close contact with another app user who has tested positive for coronavirus
  •  be able to track any symptoms you have and get advice on what to do
  •  be able to anonymously warn close contacts if you test positive for coronavirus
  • make contact tracing quicker for the health service
  • help map and predict the spread of the virus

Why use the COVID Tracker app

COVID Tracker is a free and easy-to-use mobile phone app that can:

  • alert you if you have been in close contact with someone who has tested positive for coronavirus
  • advise you on what to do to protect yourself and others
  • alert other app users that you were in close contact with, if you test positive for coronavirus
  • advise you on what to do to protect yourself and others
  • alert other app users that you were in close contact with, if you test positive for coronavirus

How the app protects you and others:

Speeds up contact tracing

Contact tracing identifies people who may be at risk from coronavirus because they were in close contact with someone who has the virus. If the contact tracing team identify you as a close contact, they can advise you on what action to take to protect yourself and others.

The app will help our existing contact tracing operation by:

  • reducing the time it takes to alert you if you’re a close contact to 3 hours
  • alerting contacts that you might have forgotten you met up with
  • enabling us to contact people who are unknown to each other

Contact tracing is a vital part of slowing the spread of the virus. The more people that download and use the app, the more it will help contact tracing. Read more about how the app works

Alerts you to close contacts

If the app finds that you have been in close contact with someone who has tested positive for coronavirus, you will get an app alert.

You won’t know who the contact is or where the contact happened. You’ll just know that you were close enough (within 2 metres) for long enough (more than 15 minutes), for there to be a risk that you could have been exposed to the virus.

The alert will advise you to:

The alert will appear as a notification on your phone. It will also pop up within the app. This is to make sure that you see it.

You’ll be asked if you want to receive close contact alerts when you first set up the app.

Optional follow-up call

You may decide you want a phone call as well as an app alert, if the app finds you are close contact. You can change this setting at any time.

If you share your number and become a close contact of someone who has the virus, our contact tracing team will call you. They will give you advice and arrange a coronavirus test for you.

If you choose not to share your number with us the app will provide you with:

  • text information on what to do next
  • a number to call so that you can arrange to have a test for coronavirus

You will still be contacted by our contact tracing team if someone who has tested positive for coronavirus identifies you as a close contact and provides your phone number.

Keeps others safe if you test positive

If you test positive for coronavirus, you can use the app to alert anyone you have been in close contact with.

Our contact tracing team will phone you if you test positive.

They will ask you to identify all your close contacts, including those who do not have the app. They will also ask you if you have the app.

If you have the app, they will ask you to upload the anonymous IDs that your phone has shared for the last 14 days. You do this using the app. It’s your choice if you want to do this.

If you agree, the contact tracing team will send you a unique upload code by text message. This code unlocks the upload functionality on the app.

Only the HSE can issue upload codes if someone tests positive. People who do not have the virus will not be able to use this function on the app.

Tracks your symptoms

You can use the COVID check-in function to:

Any health information you share on the app is anonymous.

Logging your symptoms each day can:

  • help you remember when you first became unwell
  • be a useful reminder if you need to later speak with your GP
  • get trusted advice quickly
  • help the HSE map and predict the spread of the virus

Read more about the COVID Check-in function

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Details found on https://covidtracker.gov.ie/why-use-covid-tracker

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EMS News Features General News

Clare Fire Service Achieves International Health and Safety Accreditation

Clare County Fire and Rescue Service has been awarded the ‘ISO 45001 Occupational Health and Safety (OH&S) Management System’ accreditation, which is the world’s first international standard for OH&S.

ISO 45001 provides a framework to increase safety, reduce workplace risks and enhance health and wellbeing at work, enabling an organisation to continually improve its OH&S performance. It is applicable to all organisations, regardless of size, industry or nature of business. It was introduced in 2018 and replaces the previous standard of OHSAS 18001 that the Fire Service had been accredited to since 2014.

The benefits of being accredited to ISO 45001 include increased confidence in all aspects of OH&S, with a specialist auditor validating policies, procedures, processes and continual improvements on an annual basis.

The Mayor of Clare, Cllr Mary Howard, congratulated the Fire Service on attaining the accreditation, stating that maintaining health and safety standards to the highest level is “of the utmost importance for Fire Service personnel and the general public whom they serve.”

“The fire-fighters and support staff of Clare County Fire and Rescue Service are to be commended for their planning and hard work in providing an efficient, reliable, year-round service to those who live in, work in and visit Clare,” Cllr Howard said.

Adrian Kelly, Chief Fire Officer, Clare County Fire and Rescue Service, said: “Clare County Fire and Rescue Service works closely with staff and contractors to ensure health and safety management systems are in place to aid employee wellbeing in the organisation. The transformation to ISO 45001 means that the organisation is internationally recognised in an elite category of businesses, one of a small number of fire services that have attained this standard in Ireland.”

To change to ISO 45001, the service has continued to provide a structured and organised framework for OH&S that relies on evidence-based data to ensure that there is reinforced leadership to proactively improve OH&S performance, and that legal and regulatory requirements are met. Delivering high OH&S standards has enhanced the reputation of the service among businesses and organisations by meeting the needs and expectations of Clare County Fire and Rescue Service’s workforce, local communities and other agencies.

Pat Dowling, Chief Executive, Clare County Council, said: “Achieving the ISO 45001 standard at Clare County Fire and Rescue Service is something we should all be proud of. Migrating to this new international standard shows our commitment to our employees, other emergency response agencies, and assures the public that we take OH&S seriously. We aim to prevent hazards and promote a positive working culture in the service.

“The ISO 45001 standard could not be implemented in depth without the support of staff across Clare County Council and Clare County Fire and Rescue Service. Without their collaboration, OH&S would not have been embedded in the organisation to the degree it has been to make accreditation successful.”

The health and safety team have ensured that proactive measures are implemented so that consistency of OH&S standards are met across the organisation. The fire service has transitioned to a new standard that continues to provide a framework to manage risks and opportunities to help prevent work-related injury and ill health to workers.

Ger Hartnett, Senior Executive Health and Safety Officer, Clare County Council, said: “In achieving ISO 45001 certification, Clare County Fire and Rescue Service is being officially recognised for demonstrating a high-quality OH&S management system. Staff from across the service can feel their needs and safety are being taken into account and that a positive corporate culture is in place.”

Pictured (Left to Right): Adrian Kelly, Clare Chief Fire Officer; Mayor of Clare, Cllr Mary Howard; JP McGrath, Wholetime Station Officer, Ennis Fire Station; Pat Dowling, Chief Executive, Clare County Council; and Carmel Kirby, Director of Services, Physical Development Directorate, Clare County Council. Photo: Eamon Ward.

More information regarding this topic can be found on https://www.clarecoco.ie/news/news-stories/default.html

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COVID 19 COVID 19/World News World News

GSK gears up for trials as it pushes ahead with three possible Covid-19 vaccines and two antibody treatments

The British drugs group is working on three possible vaccines for the deadly virus with partners, as well as two antibody treatments. 

It is also shipping record amounts of flu jabs as governments try to stop a double-whammy of diseases from overwhelming hospitals this winter. 

Despite strong demand for its established flu vaccines, however, GSK warned that the pandemic continued to disrupt other parts of its business as patients ventured out of their homes less often. 

But the company said it would still pay out a dividend, which is expected to total 80p per share for the full year. GSK boss Emma Walmsley said: ‘We have delivered a strong commercial response to the disruption caused by the pandemic. 

‘We have one of the most wide-ranging responses of the pandemic, with three different vaccines and two antibody therapies all in clinical trials. 

‘Our vaccines are progressing and, if there are positive results, we could have three vaccines in late-stage development by the end of the year.’ 

GSK has partnered with Sanofi, Medicago and Clover Pharmaceuticals to develop potential Covid-19 vaccines. It is also working with Vir Biotechnology on an antibody test for patients with the virus, as well as its own in-house antibody drug known as otilimab. 

Walmsley said ‘pivotal’ data on the Vir treatment was expected by the end of 2020, while readouts on otilimab are expected in the first half of next year. GSK provided a third quarter update to investors, revealing that revenues had fallen 8pc to £8.6 billion and profits by 14pc to £1.7 billion. 

Glaxo and development partner Sanofi also pledged 200 million doses of its potential Covid-19 vaccine to the Covax scheme, which aims to distribute 2 billion doses globally and is backed by the World Health Organisation (WHO). 

Covax aims to discourage governments from hoarding vaccine supplies and will focus instead on vaccinating the most high-risk people first in every country. 

Sanofi and GSK signed a £1.6 billion deal with the US during the summer to supply it with more than 100m doses of their vaccine candidate, and have agreed similar deals with the UK, EU and Canada. 

Original article appeared on the https://www.thisismoney.co.uk/money/markets/article-8889869/GSK-gears-trials-pushes-ahead-three-possible-Covid-19-vaccines.html, website.

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Covid 19/Health

The COVID vaccine timeline: Where the candidates are now—and what’s still to come

What you need to know about how long the winding path to a COVID vaccine will take and which companies are out in front.

The mad dash to create and manufacture a COVID vaccine isn’t quite over. But the beginning of the end may be somewhere in sight. 

By late September, four large-scale, late-stage clinical trials were underway for a COVID-19 shot. These include a candidate from Pfizer and German partner BioNTech (BNT162); Johnson & Johnson drug arm Janssen’s own experimental therapy (JNJ-78436725); one from biotech Moderna (mRNA-1273); and British drugmaker AstraZeneca’s AZD1222.

“Four COVID-19 vaccine candidates are in Phase III clinical testing in the United States just over eight months after SARS-CoV-2 was identified,” said NIAID director Anthony S. Fauci once the Johnson & Johnson trial began enrollment. “This is an unprecedented feat for the scientific community made possible by decades of progress in vaccine technology and a coordinated, strategic approach across government, industry, and academia.” 

But the road to developing a vaccine isn’t easy and comes with the risks of the scientifically unexpected, as evidenced by a Food and Drug Administration (FDA) temporary halt on Johnson & Johnson’s and AstraZeneca’s Phase III studies. Those studies have since resumed after a safety commission determined that side effects and illnesses in some study participants were unrelated to the vaccines.

These trials are massive undertakings, and the companies are fast reaching, if they haven’t already reached, their enrollment goals. For instance, last week Moderna announced it had completed enrollment of 30,000 people in its trial. Pfizer said during an earnings call on Tuesday that it had enrolled 42,000 people, 36,000 of whom have already received the necessary second dose of the vaccine. The company aims to enroll another 2,000 participants.

AstraZeneca and Johnson & Johnson have now resumed enrollment after the temporary halt, and the companies have said they’re aiming to recruit up to 30,000 adults in the U.S. and 60,000 people in multiple countries, respectively.

The coming weeks and months will be critical for these companies jockeying to be first in the COVID race. While Pfizer CEO Albert Bourla has previously said that interim data on how effective its candidate is would come before November, he admitted on Tuesday that it’s now unlikely to come before the third week of November.

Should the data prove promising, the company could apply for an FDA emergency use authorization (EUA) as soon as the fourth week of November.

“And then it is up to the FDA to examine the file and decide if they’re going to give us authorization and how long it would take them poring through this file,” Bourla said during an interview at the FortuneGlobal Forum virtual conference on Tuesday.

Other companies may take longer as the FDA has a variety of requirements before accepting applications for emergency use, including following up with patients for two months to make sure the vaccines are safe before submitting a filing. 

And even once a product has an emergency authorization, which could take at least two to three weeks after the FDA has received a drugmaker’s application, it wouldn’t be available for mass commercial distribution for just anyone. It would likely take until the middle of next year until that’s a possibility, while in the meantime a potential vaccine given emergency authorization would likely be routed to the highest-risk populations.

This article first appeared on Fortune.com

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COVID 19 Covid 19/Education Covid 19/Research

Face Masks: What The Data Says

The science supports that face coverings are saving lives during the coronavirus pandemic, and yet the debate trundles on. How much evidence is enough?

When her Danish colleagues first suggested distributing protective cloth face masks to people in Guinea-Bissau to stem the spread of the coronavirus, Christine Benn wasn’t so sure.

“I said, ‘Yeah, that might be good, but there’s limited data on whether face masks are actually effective,’” says Benn, a global-health researcher at the University of Southern Denmark in Copenhagen, who for decades has co-led public-health campaigns in the West African country, one of the world’s poorest.

That was in March. But by July, Benn and her team had worked out how to possibly provide some needed data on masks, and hopefully help people in Guinea-Bissau. They distributed thousands of locally produced cloth face coverings to people as part of a randomized controlled trial that might be the world’s largest test of masks’ effectiveness against the spread of COVID-19.

Face masks are the ubiquitous symbol of a pandemic that has sickened 35 million people and killed more than 1 million. In hospitals and other health-care facilities, the use of medical-grade masks clearly cuts down transmission of the SARS-CoV-2 virus. But for the variety of masks in use by the public, the data are messy, disparate and often hastily assembled. Add to that a divisive political discourse that included a US president disparaging their use, just days before being diagnosed with COVID-19 himself. “People looking at the evidence are understanding it differently,” says Baruch Fischhoff, a psychologist at Carnegie Mellon University in Pittsburgh, Pennsylvania, who specializes in public policy. “It’s legitimately confusing.”

To be clear, the science supports using masks, with recent studies suggesting that they could save lives in different ways: research shows that they cut down the chances of both transmitting and catching the coronavirus, and some studies hint that masks might reduce the severity of infection if people do contract the disease.

But being more definitive about how well they work or when to use them gets complicated. There are many types of mask, worn in a variety of environments. There are questions about people’s willingness to wear them, or wear them properly. Even the question of what kinds of study would provide definitive proof that they work is hard to answer.

“How good does the evidence need to be?” asks Fischhoff. “It’s a vital question.”

Beyond gold standards

At the beginning of the pandemic, medical experts lacked good evidence on how SARS-CoV-2 spreads, and they didn’t know enough to make strong public-health recommendations about masks.

The standard mask for use in health-care settings is the N95 respirator, which is designed to protect the wearer by filtering out 95% of airborne particles that measure 0.3 micrometres (µm) and larger. As the pandemic ramped up, these respirators quickly fell into short supply. That raised the now contentious question: should members of the public bother wearing basic surgical masks or cloth masks? If so, under what conditions? “Those are the things we normally [sort out] in clinical trials,” says Kate Grabowski, an infectious-disease epidemiologist at Johns Hopkins School of Medicine in Baltimore, Maryland. “But we just didn’t have time for that.”

So, scientists have relied on observational and laboratory studies. There is also indirect evidence from other infectious diseases. “If you look at any one paper — it’s not a slam dunk. But, taken all together, I’m convinced that they are working,” says Grabowski.

Confidence in masks grew in June with news about two hair stylists in Missouri who tested positive for COVID-19. Both wore a double-layered cotton face covering or surgical mask while working. And although they passed on the infection to members of their households, their clients seem to have been spared (more than half reportedly declined free tests). Other hints of effectiveness emerged from mass gatherings. At Black Lives Matter protests in US cities, most attendees wore masks. The events did not seem to trigger spikes in infections, yet the virus ran rampant in late June at a Georgia summer camp, where children who attended were not required to wear face coverings. Caveats abound: the protests were outdoors, which poses a lower risk of COVID-19 spread, whereas the campers shared cabins at night, for example. And because many non-protesters stayed in their homes during the gatherings, that might have reduced virus transmission in the community. Nevertheless, the anecdotal evidence “builds up the picture”, says Theo Vos, a health-policy researcher at the University of Washington in Seattle.

More-rigorous analyses added direct evidence. A preprint study posted in early August (and not yet peer reviewed), found that weekly increases in per-capita mortality were four times lower in places where masks were the norm or recommended by the government, compared with other regions. Researchers looked at 200 countries, including Mongolia, which adopted mask use in January and, as of May, had recorded no deaths related to COVID-19. Another study looked at the effects of US state-government mandates for mask use in April and May. Researchers estimated that those reduced the growth of COVID-19 cases by up to 2 percentage points per day. They cautiously suggest that mandates might have averted as many as 450,000 cases, after controlling for other mitigation measures, such as physical distancing.

“You don’t have to do much math to say this is obviously a good idea,” says Jeremy Howard, a research scientist at the University of San Francisco in California, who is part of a team that reviewed the evidence for wearing face masks in a preprint article that has been widely circulated.

But such studies do rely on assumptions that mask mandates are being enforced and that people are wearing them correctly. Furthermore, mask use often coincides with other changes, such as limits on gatherings. As restrictions lift, further observational studies might begin to separate the impact of masks from those of other interventions, suggests Grabowski. “It will become easier to see what is doing what,” she says.

Although scientists can’t control many confounding variables in human populations, they can in animal studies. Researchers led by microbiologist Kwok-Yung Yuen at the University of Hong Kong housed infected and healthy hamsters in adjoining cages, with surgical-mask partitions separating some of the animals. Without a barrier, about two-thirds of the uninfected animals caught SARS-CoV-2, according to the paper published in May. But only about 25% of the animals protected by mask material got infected, and those that did were less sick than their mask-free neighbours (as measured by clinical scores and tissue changes).

The findings provide justification for the emerging consensus that mask use protects the wearer as well as other people. The work also points to another potentially game-changing idea: “Masking may not only protect you from infection but also from severe illness,” says Monica Gandhi, an infectious-disease physician at the University of California, San Francisco.

Gandhi co-authored a paper published in late July suggesting that masking reduces the dose of virus a wearer might receive, resulting in infections that are milder or even asymptomatic. A larger viral dose results in a more aggressive inflammatory response, she suggests.

She and her colleagues are currently analysing hospitalization rates for COVID-19 before and after mask mandates in 1,000 US counties, to determine whether the severity of disease decreased after public masking guidelines were brought in.

The idea that exposure to more virus results in a worse infection makes “absolute sense”, says Paul Digard, a virologist at the University of Edinburgh, UK, who was not involved in the research. “It’s another argument for masks.”

Gandhi suggests another possible benefit: if more people get mild cases, that might help to enhance immunity at the population level without increasing the burden of severe illness and death. “As we’re awaiting a vaccine, could driving up rates of asymptomatic infection do good for population-level immunity?” she asks.

Back to ballistics

The masks debate is closely linked to another divisive question: how does the virus travel through the air and spread infection?

The moment a person breathes or talks, sneezes or coughs, a fine spray of liquid particles takes flight. Some are large — visible, even — and referred to as droplets; others are microscopic, and categorized as aerosols. Viruses including SARS-CoV-2 hitch rides on these particles; their size dictates their behaviour.

Droplets can shoot through the air and land on a nearby person’s eyes, nose or mouth to cause infection. But gravity quickly pulls them down. Aerosols, by contrast, can float in the air for minutes to hours, spreading through an unventilated room like cigarette smoke.

Visualization of the droplet spread when an N95 mask equipped with an exhalation port is used to impede the emerging jet.
Time-lapse images show how cough droplets spread from a person wearing an N95 mask that has a valve to expel exhaled air.Credit: S. Verma et al./Phys. Fluids

What does this imply for the ability of masks to impede COVID-19 transmission? The virus itself is only about 0.1 µm in diameter. But because viruses don’t leave the body on their own, a mask doesn’t need to block particles that small to be effective. More relevant are the pathogen-transporting droplets and aerosols, which range from about 0.2 µm to hundreds of micrometres across. (An average human hair has a diameter of about 80 µm.) The majority are 1–10 µm in diameter and can linger in the air a long time, says Jose-Luis Jimenez, an environmental chemist at the University of Colorado Boulder. “That is where the action is.”

Scientists are still unsure which size of particle is most important in COVID-19 transmission. Some can’t even agree on the cut-off that should define aerosols. For the same reasons, scientists still don’t know the major form of transmission for influenza, which has been studied for much longer.

Many believe that asymptomatic transmission is driving much of the COVID-19 pandemic, which would suggest that viruses aren’t typically riding out on coughs or sneezes. By this reasoning, aerosols could prove to be the most important transmission vehicle. So, it is worth looking at which masks can stop aerosols.

All in the fabric

Even well-fitting N95 respirators fall slightly short of their 95% rating in real-world use, actually filtering out around 90% of incoming aerosols down to 0.3 µm. And, according to unpublished research, N95 masks that don’t have exhalation valves — which expel unfiltered exhaled air — block a similar proportion of outgoing aerosols. Much less is known about surgical and cloth masks, says Kevin Fennelly, a pulmonologist at the US National Heart, Lung, and Blood Institute in Bethesda, Maryland.

In a review of observational studies, an international research team estimates that surgical and comparable cloth masks are 67% effective in protecting the wearer.

In unpublished work, Linsey Marr, an environmental engineer at Virginia Tech in Blacksburg, and her colleagues found that even a cotton T-shirt can block half of inhaled aerosols and almost 80% of exhaled aerosols measuring 2 µm across. Once you get to aerosols of 4–5 µm, almost any fabric can block more than 80% in both directions, she says.

Multiple layers of fabric, she adds, are more effective, and the tighter the weave, the better. Another study found that masks with layers of different materials — such as cotton and silk — could catch aerosols more efficiently than those made from a single material.

Benn worked with Danish engineers at her university to test their two-layered cloth mask design using the same criteria as for medical-grade ventilators. They found that their mask blocked only 11–19% of aerosols down to the 0.3 µm mark, according to Benn. But because most transmission is probably occurring through particles of at least 1 µm, according to Marr and Jimenez, the actual difference in effectiveness between N95 and other masks might not be huge.

Eric Westman, a clinical researcher at Duke University School of Medicine in Durham, North Carolina, co-authored an August study that demonstrated a method for testing mask effectiveness. His team used lasers and smartphone cameras to compare how well 14 different cloth and surgical face coverings stopped droplets while a person spoke. “I was reassured that a lot of the masks we use did work,” he says, referring to the performance of cloth and surgical masks. But thin polyester-and-spandex neck gaiters — stretchable scarves that can be pulled up over the mouth and nose — seemed to actually reduce the size of droplets being released. “That could be worse than wearing nothing at all,” Westman says.

Some scientists advise not making too much of the finding, which was based on just one person talking. Marr and her team were among the scientists who responded with experiments of their own, finding that neck gaiters blocked most large droplets. Marr says she is writing up her results for publication.

“There’s a lot of information out there, but it’s confusing to put all the lines of evidence together,” says Angela Rasmussen, a virologist at Columbia University’s Mailman School of Public Health in New York City. “When it comes down to it, we still don’t know a lot.”

Minding human minds

Questions about masks go beyond biology, epidemiology and physics. Human behaviour is core to how well masks work in the real world. “I don’t want someone who is infected in a crowded area being confident while wearing one of these cloth coverings,” says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota in Minneapolis.

Baseball players, one batting & one catching, and umpire standing behind, wearing masks during the 1918 influenza pandemic
US baseball players wore masks while playing during the 1918 influenza epidemic.Credit: Underwood And Underwood/LIFE Images Collection/Getty

Perhaps fortunately, some evidence suggests that donning a face mask might drive the wearer and those around them to adhere better to other measures, such as social distancing. The masks remind them of shared responsibility, perhaps. But that requires that people wear them.

Across the United States, mask use has held steady around 50% since late July. This is a substantial increase from the 20% usage seen in March and April, according to data from the Institute for Health Metrics and Evaluation at the University of Washington in Seattle (see go.nature.com/30n6kxv). The institute’s models also predicted that, as of 23 September, increasing US mask use to 95% — a level observed in Singapore and some other countries — could save nearly 100,000 lives in the period up to 1 January 2021.

“There’s a lot more we would like to know,” says Vos, who contributed to the analysis. “But given that it is such a simple, low-cost intervention with potentially such a large impact, who would not want to use it?”

Further confusing the public are controversial studies and mixed messages. One study in April found masks to be ineffective, but was retracted in July. Another, published in June, supported the use of masks before dozens of scientists wrote a letter attacking its methods (see go.nature.com/3jpvxpt). The authors are pushing back against calls for a retraction. Meanwhile, the World Health Organization (WHO) and the US Centers for Disease Control and Prevention (CDC) initially refrained from recommending widespread mask usage, in part because of some hesitancy about depleting supplies for health-care workers. In April, the CDC recommended that masks be worn when physical distancing isn’t an option; the WHO followed suit in June.

There’s been a lack of consistency among political leaders, too. US President Donald Trump voiced support for masks, but rarely wore one. He even ridiculed political rival Joe Biden for consistently using a mask — just days before Trump himself tested positive for the coronavirus, on 2 October. Other world leaders, including the president and prime minister of Slovakia, Zuzana Čaputová and Igor Matovič, sported masks early in the pandemic, reportedly to set an example for their country.

Denmark was one of the last nations to mandate face masks — requiring their use on public transport from 22 August. It has maintained generally good control of the virus through early stay-at-home orders, testing and contact tracing. It is also at the forefront of COVID-19 face-mask research, in the form of two large, randomly controlled trials. A research group in Denmark enrolled some 6,000 participants, asking half to use surgical face masks when going to a workplace. Although the study is completed, Thomas Benfield, a clinical researcher at the University of Copenhagen and one of the principal investigators on the trial, says that his team is not ready to share any results.

Benn’s team, working independently of Benfield’s group, is in the process of enrolling around 40,000 people in Guinea-Bissau, randomly selecting half of the households to receive bilayer cloth masks — two for each family member aged ten or over. The team will then follow everyone over several months to compare rates of mask use with rates of COVID-like illness. She notes that each household will receive advice on how to protect themselves from COVID-19 — except that those in the control group will not get information on the use of masks. The team expects to complete enrolment in November.

Several scientists say that they are excited to see the results. But others worry that such experiments are wasteful and potentially exploit a vulnerable population. “If this was a gentler pathogen, it would be great,” says Eric Topol, director of the Scripps Research Translational Institute in La Jolla, California. “You can’t do randomized trials for everything — and you shouldn’t.” As clinical researchers are sometimes fond of saying, parachutes have never been tested in a randomized controlled trial, either.

But Benn defends her work, explaining that people in the control group will still benefit from information about COVID-19, and they will get masks at the end of the study. Given the challenge of manufacturing and distributing the masks, “under no circumstances”, she says, could her team have handed out enough for everyone at the study’s outset. In fact, they had to scale back their original plans to enrol 70,000 people. She is hopeful that the trial will provide some benefits for everyone involved. “But no one in the community should be worse off than if we hadn’t done this trial,” she says. The resulting data, she adds, should inform the global scientific debate.

For now, Osterholm, in Minnesota, wears a mask. Yet he laments the “lack of scientific rigour” that has so far been brought to the topic. “We criticize people all the time in the science world for making statements without any data,” he says. “We’re doing a lot of the same thing here.”

Nevertheless, most scientists are confident that they can say something prescriptive about wearing masks. It’s not the only solution, says Gandhi, “but I think it is a profoundly important pillar of pandemic control”. As Digard puts it: “Masks work, but they are not infallible. And, therefore, keep your distance.”

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Article from nature.com/articles/d41586-020-02801-8?utm_source=pocket&utm_medium=email&utm_campaign=pockethits

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COVID 19 Covid 19/Advice Covid 19/Health EMS News

Stress Control Online

The first session of the HSE’s Stress Control Online is to be repeated again today at 2pm and 8.30pm. There was great feedback from those who participated in this the first time around.

Dr Jim White will live-stream the classes, free-of-charge. You can watch the sessions either in the afternoon or evening. Click here to get all the dates. To find out more about Stress Control click here

All you need to successfully complete this class is to watch each of the six sessions, read the booklets and use the relaxation and mindfulness. You can find the sessions on YouTube.

Click here or search for ‘Stress Control 2020’ to access the HSE YouTube channel where the classes will be available to view at the scheduled times. If you click the Subscribe button on the YouTube page, you should be kept up to date with the latest videos when logged in to YouTube.

For more information please visit https://stresscontrol.org/

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COVID 19 Covid 19/Technology

HOW COULD COVID-19 SHAPE THE FUTURE OF TECHNOLOGY?

Coronavirus, widely known by its official name COVID-19, has swooped the entire world by its feet. While we have witnessed pandemic attacks since the inception of the human race, this novel virus has gone two steps ahead in disrupting daily lives bringing down the whole world into a lockdown state. As per the World Health Organization (WHO) Research, COVID-19 virus is essentially transmitted between bodies through respiratory droplets and contact routes.

COVID-19 Shaping the Future of Technology?

Even a single affected person can transmit the virus to thousands and thousands of others. Considering such a critical nature of the virus, countries have come together as a single entity to fight this black swan crisis. As a solution, people are requested to stay at home and practice self-quarantine. But, with this approach, offices and factories are completely restricted to any employee footfall. So the prime question that arises is, how organizations can support business continuity? What happens to economic development? And, what would be the impact on technology in future?

To understand the impact of the Covid-19 Crisis on economy and technology on the whole, we have done some basic research and curated possible outcomes. How could Covid-19 impact on present and upcoming technology?

Work desks will be transformed into mobile stations: Working from home might have some drawbacks, but it also has attractive benefits that companies might not want to overlook. When teams and operations are aligned in a way to perform as individual assets of the company, they can result in a cost-saving option. Enforcing employees with remote working options will help companies save cost on the commute and infrastructure.

Considering the advancement in modern tools and technologies that facilitate digital performance at ace level, multiple people can be connected through a single screen resulting in seamless coordination. Considering these typical features, remote working is definitely a blessing in disguise.

AI, machine learning will be using more natural instincts: Disasters and unwanted occurrences give birth to cognitive behavior. And, cognitive behavior further results into scientific developments. Same would be the case with technologies like ERP, Artificial Intelligence and Machine Learning. With people becoming more aware and learned about the inevitability of unprecedented situations like Covid-19, as a consumer, they would expect sustainability as a primary clause of the decision making process.

Companies would therefore be expected to develop more intimate solutions when it comes serving its audiences. AI and ML would be designed to function in a way that it acts precisely intimate in conjunction with the decision-making process of consumers.

Supply chain management will be digitised: As per the McKinsey & Company Insights, the next generation digital supply chain will enable organisations to perform faster. It will empower businesses with more granular, accurate and efficient approaches to sustain and scale. Supply chain 4.0 digitises the end-to-end performance management right from order to delivery.

Feedback on the process and forecast of multiple parameters could be envisaged online. Moreover, integration with third-party tools will simplify eclectic business operations minimising the investment in terms of time and efforts.

Summary

Pandemics like Covid-19 have been around more than 100 years. But, the disruption caused by them is humongous. Right from the day-to-day operations to global economy management, everything gets dismantled. As a consequence, poverty, infrastructure development, business development, financial stability and employment gets deeply imprinted into the society.

Although such things are beyond control, steps to be prepared well ahead of time may mitigate the effect. Pandemics are usually transmitted through any kind of physical contact and when isolations are practiced, daily operations get hampered. In such a scenario, undergoing digital transformation is the best possible solution to continue evolving. Future of technology in the coming days would be aligned to the similar concept. It will facilitate remote working and promote every aspect of business to act as an independently profitable asset.

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Article from https://irishtechnews.ie/how-could-covid-19-shape-the-future-of-technology/

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Features General News

Communities asked to Light up for Road Safety on World Remembrance Day

Council buildings across Ireland will ‘light up for road safety’ as part of this year’s ‘World Remembrance Day for Road Traffic Victims’ on Sunday 15th November.

Local Authority Road Safety Officers are asking the public to get involved and ‘light up’ or ‘shine a light’ to remember road traffic collision victims, survivors, their families and those on the frontline who respond to collisions.

Members of the public, businesses and other organisations are being asked to join in and shine a light in their window on the evening of Sunday 15th November between 7pm and 8pm to remember those in their community who have died on the roads. 

Every year road traffic collision victims are remembered on the third Sunday in November and this year, with everything else going on in the world, road safety stakeholders are not forgetting those who have died on the roads. With an increase in people out walking, cycling and going from place to place, road safety is more important now more than ever before and road safety officers are asking the public to join them to ‘light up’ and shine a light for road safety and remember those who have died or were injured on the roads.

Cathaoirleach of Donegal County Council Rena Donaghey said  “Too many people have lost their lives in road traffic collisions in Donegal and families have had to live with the consequences of collisions. We also wish to acknowledge on this day the emergency services for their role in saving lives and to reflect on the impact of road deaths on families and communities.  I would ask families in Donegal to join us and ‘light up for road safety’ by shining a light or burning a candle in your windows from 7.00pm – 8.00pm on Sunday 15thNovember”,

Brian O’Donnell, Donegal County Council’s Road Safety Officer said: “Families who have lost loved ones involved in collisions will never forget them. This day is an opportunity annually, for everyone to remember victims and to think of the consequences associated with a collision. Organisers are hoping the public and business sector will get involved and support this year’s event by lighting up for road safety.”

Gardaí, firefighters and paramedics respond to collisions every day and witness first-hand, the consequences of a collision. Garda, fire and ambulance stations will also shine a light as emergency vehicles will turn on their blue lights outside respective stations for a period between 7pm and 8pm. 

Inspector Michael Harrison said “Everyone living in Donegal is well aware of the misery associated with a fatality as a result of a road traffic collision. Every person who dies leaves a survivor who will mourn their death. Support for the ‘Light up for Road Safety’ campaign on World Remembrance day for Road Traffic Victims is important to show the survivors that we have not forgotten their loved ones”.

On this important day, bereaved families and the seriously injured come together to acknowledge the terrible toll of road deaths and injuries and to show our thanks for the work of the emergency services.

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EMS News

Sperm DNA Fragmentation – a better biomarker

Conventional semen parameters are accepted to have limited diagnostic value for male infertility and poor prognostic value for ART success. In contrast, sperm DNA fragmentation has been shown to be a robust biomarker of male infertility, ART failure and miscarriage.

Sperm DNA fragmentation and infertility

There is a pressing need for new male fertility tests. Unlike the many tests for female infertility and oocyte quality that advance each year, the same test for male infertility has been used since the 1950s. Whilst semen analysis provides important information about sperm production, it has limited diagnostic value for male infertility. This is evident from the fact that 25-30% of couples are diagnosed as ‘unexplained’, where no cause of infertility can be detected in either the male or female partner.

Over the last decade, sperm DNA fragmentation has emerged as a robust biomarker of male infertility. We used to think that the paternal genome did not affect early embryo quality. There is now compelling evidence that this thinking is incorrect. Sperm DNA plays a vital role in fertilization, early embryo development and implantation in both natural and assisted reproduction. If sperm DNA is badly damaged, success at every fertility checkpoint is impaired. Examen research shows that sperm from fertile men have low levels of DNA fragmentation compared to sperm from infertile men (Figures 1 and 2). We have also shown that over 80% of men or couples with idiopathic infertility have levels of sperm DNA fragmentation above the fertile range (Figures 3 and 4).

Sperm DNA fragmentation and IVF, ICSI and TICSI

Examen research has shown that IVF live birth rates decrease sharply and steadily as the level of sperm DNA fragmentation increases (Figure 5). Our latest data shows that ICSI live birth rates are also impaired as sperm DNA fragmentation increases, but the impact is less than with IVF (Figure 6). This is thought to be due to the egg’s capacity to repair some of the sperm DNA damage post fertilization. New research from the USA and Spain shows that it is possible to retrieve sperm with lower levels of DNA damage from a testicular biopsy. Using testicular sperm in ICSI leads to higher success rates and at a lower cost. Understanding a man’s sperm DNA quality is therefore an important part of treatment selection and use of ejaculated versus testicular sperm.

Sperm DNA fragmentation and miscarriage

Recent meta analyses have shown that sperm DNA fragmentation doubles the likelihood of miscarriage. Good sperm DNA quality is essential for the normal functioning of paternal genes and the early development of the embryo and foetus, so it is not surprising that good quality sperm DNA is also needed to maintain a healthy pregnancy

Examen research shows that sperm from men whose partners have a history of miscarriage have higher levels of sperm DNA fragmentation than sperm from those whose partners deliver healthy babies (Figures 7 and 8). This is not just following ART. We have observed high sperm DNA fragmentation in over 85% of men whose partners had recurrent miscarriages following spontaneous conception (Figure 9).

Original article appeared on the https://examenlab.com/healthcare-professionals/sperm-dna-fragmentation/, website. Examen is a world leader in male fertility testing, based on its heritage of over 25 years in male reproductive health and fertility treatment research. They specialise in measuring sperm DNA fragmentation (known as sperm DNA damage) to help predict the likelihood of conception, miscarriage and the success of fertility treatment.

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World News

Israeli EMS Innovations

Israel’s unique experience is driving EMS innovation worldwide

It’s the hope of every EMS agency around the world to provide fast and professional treatment to those in need of medical attention. In Israel, emergency situations such as terror attacks, multi-casualty vehicle collisions and even the threat of war are daily occurrences. Because of this, Israel’s emergency response teams must always be at the forefront of innovative medical treatments and technologies that allow EMS providers to respond faster and be more effective in the field.

A geographically small country, with a continuous flow of information and personnel between military and civilian spheres of EMS, Israel is perfectly positioned to develop new medical methodologies and technologies that allow for faster and more efficient treatment of patients. The need certainly exists, and, as the adage goes, “necessity is the mother of invention.”

Israel continues to develop technology and equipment that are used by first responders around the world, and the benefits of Israeli innovations are being experienced globally. This article highlights those advances and innovations.

A Coordinated Effort

Most Israelis serve in the military for a mandatory period of time, and then continue to serve at least once a year in reserve duty. Reserve duty can include as many as five different deployments per year, depending on a person’s rank and position. Because of this, there’s ongoing crossover between the military and civilian arenas. Often, what a person learns in one area is applicable in both.

The country faces ongoing threats on three of its five borders, as well as significant terror threats, which means that medical treatment of civilian and military personnel takes place both in the field and in hospitals.

While military medics are trying to solve the problems they’re faced with in the field, civilian medics are doing the same in hospitals. With the constant flow of personnel between civilian and military sectors, technological advancements are quickly developed and transferred to other facilities and field units.

Israel’s civilian first response organizations (e.g., United Hatzalah, Israel’s national volunteer EMS organization) and ambulance services often work together with the military when there’s a need for medical treatment of soldiers. The organizations also conduct drills with the Israel defense forces and Israeli police forces on a regular basis.

The joint drills train military medics to respond to civilian-style casualties. Civilian medics receive training in the use of vehicles and aircraft in evacuations and treating injuries caused by military-grade weapons. Both civilian and military medics learn how the other coordinates operations so that both can make improvements to their systems.

After receiving training, EMS personnel are able to effectively enter warm and hot zones with their law enforcement and military colleagues. The coordination and cooperation among response agencies is invaluable, and pays dividends in mass casualty incidents (MCIs) and terrorist situations.

Israel’s civilian first response organizations and ambulance services conduct drills with the Israel defense forces and Israeli police forces on a regular basis.

Israel’s civilian first response organizations and ambulance services conduct drills with the Israel defense forces and Israeli police forces on a regular basis.

Treating Terror Victims

The continuous threat of terrorist attacks on civilians, and the pain caused by them, have built a resiliency within the populace. However, these ever-present threats also demand immediate EMS response to MCIs.

Volunteers often arrive on scene at a terror attack so quickly that they begin treating victims while there’s still an active shooter. Although training courses stress that the safety of the responder comes first, there have been many instances in which responders risk everything to save the lives of others.

Law enforcement agencies, aware of the need to respond quickly, often provide a protective barrier around the EMS providers if there’s a threat that hasn’t been neutralized.

An environment like this requires close cooperation between EMS, law enforcement and the military. This has allowed for the development and implementation of efficient techniques that hasten operations under disaster- like conditions, ranging from a unique style of triage to the creation of a psychotrauma unit that treats victims at the scene of traumatic incidents. These innovations have put Israel on the cutting edge of EMS civilian care.

Psychotrauma Unit

The psychotrauma unit’s aim is to stabilize the patient at the location of the trauma, whether it be a terror attack or a crib death, to help the patient deal with the realities of their new situation and prevent or manage the onset of psychological shock.

United Hatzalah’s psychotrauma unit is comprised of volunteers, many of whom are psychologists and social workers. Volunteers must complete a specialized psychotrauma enrichment course on how to best approach and stabilize a patient in the immediate aftermath of a traumatic event.

The unit is divided into a two-tiered system of care. The first tier consists of trained psychological professionals who provide a higher level of treatment, akin to a psychological version of ALS. At the second tier, EMTs who have taken a basic course treat patients at traumatic scenes, similar to BLS medical treatment.

Currently, the unit has a goal of training an additional 150 volunteer responders to be able to provide coverage on a national basis. Police, fire and rescue services, as well as the various EMS services in Israel, now look to United Hatzalah’s psychotrauma unit to treat patients and bystanders on scene that go into psychological shock.

During their joint drills, civilian medics receive training in the use of vehicles and aircraft in evacuations as well as treating injuries caused by military-grade weapons.

During their joint drills, civilian medics receive training in the use of vehicles and aircraft in evacuations as well as treating injuries caused by military-grade weapons.

High-Tech EMS Innovation

Perhaps the most important high-tech EMS innovation to be used in Israel to date is the Nowforce smartphone application. The application is used by United Hatzalah to locate and dispatch the responders in closest proximity, and with the proper level of EMS training, to a medical emergency.

The app has allowed United Hatzalah volunteer responders to cut their response time down from approximately 7–10 minutes to three minutes. That number also represents the current national average for EMS response time. In cities where there are a large number of volunteer responders, the average response time is now 90 seconds.

Nowforce was created and implemented in 2007, and is considered the “Uber of EMS.” Other similar applications include PulsePoint, which locates the precise location of every nearby defibrillator, and Reporty, which shortens emergency response times by using the community to report emergencies, no matter their location.

United Hatzalah’s psychotrauma unit is comprised of volunteers, many of whom are psychologists and social workers.

United Hatzalah’s psychotrauma unit is comprised of volunteers, many of whom are psychologists and social workers.

Small Country, Big Impact

With a geographic size and population comparable to the state of New Jersey, Israel is one of the smallest countries on earth, and certainly in the Western world—and it’s Israel’s size, which has allowed it to become an innovator in the field of EMS. In an emergency, regardless of where one is in the country, there’s a high probability that the person you’ll be helping is one of your family members, a neighbor, a friend—or even yourself.

Innovation is viewed as one of Israel’s major exports, and the field of medical innovation is often at the top of that list. The government promotes innovation on a direct level in educational settings (e.g., schools, pre-collegiate academies and social institutions) and through compulsory military service. These two melting pots of Israeli society create a heightened sense of community, and have resulted in a hotbed of medical innovation.

Innovative Devices Created in Israel & Used Around the World

Israeli EMS teams need to treat patients more effectively and efficiently and have developed devices that do just that. These advancements allow EMS personnel to get around hot zones faster and depart once they’re no longer needed. They allow providers to treat trauma victims faster, while also providing the highest quality of care.

People in Israel think inside the box by asking, “What do I already have that I can use to make our situation better?” If there’s no current solution, they build or create one. This is what people must do when their home is also on the front line of a conflict.

Many of the innovations created in Israel have been distributed to other countries and have been helping save lives worldwide. The more notable inventions include the following:

Israeli Bandage

The Israeli bandage, also known as “the emergency bandage” is used to stop bleeding from hemorrhagic wounds caused by traumatic injuries. The bandage was invented by an Israeli military medic, Bernard Bar-Natan, and was first used to save lives during NATO peacekeeping operations in Bosnia and Herzegovina. Subsequently, the bandages were also used during Operations Enduring Freedom and Iraqi Freedom.

The emergency bandages were nicknamed “Israeli bandage,” by American soldiers, and have been the bandages of choice for the U.S. Army. They were also included in EMS providers’ response kits and first responder individual first aid kits (IFAKs) at the 2011 shooting in Tucson, Ariz., and were used to treat several victims.

Bone Injection Gun (BIG)

Intraosseous (IO) infusion is the process of injecting IV fluids and medications directly into the marrow of a bone to provide a non-collapsible entry point into the systemic venous system.

IO infusions are used when IV access is either not available or not feasible, and have proven to be a valuable addition to prehospital care. A comparison of various routes of administration concluded that the IO route is demonstrably superior to intramuscular (IM) administration and comparable to IV administration.1

The Bone Injection Gun (BIG) was the world’s first automatic, user-friendly IO device. It’s a plastic, disposable, automatic spring-loaded infusion device, that provides safe, rapid IO access for the delivery of fluids and medications at flow rates similar to peripheral IV infusion.The BIG was designed to insert a 15 gauge needle (18 gauge in the pediatric version) to establish IO infusion within seconds.

The newest version of the BIG, the NEO, is an enhanced version of the original BIG that’s streamlined and easier to use. It presents an easy and safe “position and press” mechanism and is used by military and civilian healthcare systems around the globe.

MyMDBand

MyMDband is a durable bracelet that provides medical personnel with instant access to an individual’s emergency medical information via a personalized QR code, a matrix barcode or a two-dimensional barcode.

The HIPAA-compliant band was originally invented to enable medical responders to gain information on patients who couldn’t speak, or couldn’t speak the same language as the EMS provider.

The band’s technology allows EMS providers to quickly gain access to a person’s medical history, allergies and ailments. It works anytime, anywhere and is secure, ensuring that only providers and medical professionals can access the information.

MyMDFile displays the patient’s medical information in the local language, regardless of where the person is travelling, so that EMS and medical responders will be able to understand the person’s medical history rapidly.

Pocket BVM

The Pocket BVM (bag-valve mask) allows the user to cut down on carrying space in a medical bag or MCI cache while still delivering effective airway rescue. The Pocket BVM delivers 500–600 mL of oxygen in one squeeze and is also faster to use and connect than a regular BVM system.

It’s a disposable, collapsible, silicon resuscitator that reduces cubic carrying space by up to 75%. It never loses its shape, and can withstand extreme or unconventional storage conditions, making it perfect for military application that requires smaller and more compact devices.

Other Innovations

In addition to these medical and technology devices, Israel is noted for many other health innovations that go beyond the EMS sphere. Some of the more well-known advancements include:

>>TopClosure’s 3S System, a noninvasive alternative to staples, sutures and glue used to close wounds rapidly;

>>ApiFix’s system to correct severe curvature of the spine (i.,e., scoliosis);

>>Argo Medical Technologies’ Rewalk robotic exoskeleton;

>>IceCure Medical’s IceSense3, which has been used by doctors in the U.S. since 2011 to remove benign breast lumps in an ultrasound-guided procedure;

>>InSightec’s ExAblate OR, which uses MRI-guided, focused ultrasound to destroy tumors and uterine fibroid cysts without surgery;

>>IonMed’s BioWeld1 which bonds surgical incisions using cold plasma instead of stitches, staples or glue;

>>NanoPass Technologies’ MicronJet, a single-use needle for painless delivery of vaccines into the skin using semiconductor technology; and

>>VitalGo Systems’ Total Lift bed, a hospital-grade bed that can elevate a patient from a supine to a fully standing position.

Original article appeared on the https://www.jems.com/2017/12/31/israeli-ems-innovations/, websit. JEMS (Journal of Emergency Medical Services) and EMS Today: The JEMS Conference and Exposition are committed to being the leading providers of information for the improvement of patient care in the prehospital setting. 

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World News

COVID-19: What you need to know about the coronavirus pandemic on 29 October

France and Germany to enter new lockdowns; India passes 8 million confirmed cases; Italy with record one-day increase in cases.

1. How COVID-19 is affecting the globe

Confirmed cases of COVID-19 have now passed 44.4 million globally, according to the Johns Hopkins Coronavirus Resource Center. The number of confirmed deaths stands at over 1.17 million.

Italy has registered a one-day record number of new coronavirus cases – 24,991. Cases are spreading especially quickly in the northern Lombardy region.

Colombia will extend its so-called selective quarantine until at least the end of November.

Cases are doubling every nine days in England, according to a new study by Imperial College.

A poll of economists has warned there is a high risk that the recent rise in cases will halt the global economic recovery by the end of the year.

Gold demand has fallen to its lowest in 11 years.
Demand is down 19% from the third quarter of last year.Image: Reuters

2. France and Germany introduce new lockdowns

New lockdowns have been announced in France and Germany as a result of surging cases, with restrictions almost as severe as earlier in the year.

Germany will shut bars, restaurants and theatres throughout November. Schools will remain open, but shops will only be allowed to operate with strict limits on access.

“We need to take action now,” Chancellor Angela Merkel said. “Our health system can still cope with this challenge today, but at this speed of infections, it will reach the limits of its capacity within weeks.”

Confirmed cases in France and Germany
Cases have accelerated in both countries.Image: Our World in Data

In France, people will be required to stay in their homes except to buy essential goods, seek medical care or exercise for up to one hour a day. As in Germany, schools will remain open.

“The virus is circulating at a speed that not even the most pessimistic forecasts had anticipated,” President Emmanuel Macron said in a televised address. “Like all our neighbours, we are submerged by the sudden acceleration of the virus.”

“We are all in the same position: overrun by a second wave which we know will be harder, more deadly than the first,” he said. “I have decided that we need to return to the lockdown which stopped the virus.”

Global stock markets slumped on the news.

3. India passes 8 million confirmed cases

India has passed the milestone of 8 million confirmed COVID-19 cases, after reporting a rise of 48,881 new infections. New cases have fallen from a peak in September.

It’s the second highest cumulative total in the world, after the United States, although the death toll has been low relative to the number of infections.

120,527 deaths have been reported in total.

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Features General News

One Hundred Irish Retailers For All Your Online Christmas Shopping

From beauty and books to toys and tech, there’s a huge selection of homegrown companies to choose from

The weeks ahead are going to be incredibly hard for Irish retailers who have been forced to close to contain the spread of Covid-19. They are going to be difficult for people too, as they try to get their ducks in a row for Christmas.

Online shopping is clearly part of the answer. But it comes with a caveat. As much as 70 per cent of Irish consumers’ online spending leaves the country as people shop with multinationals. But it doesn’t have to be that way – there are many local sites that need your support this month and next.

TOYS

nimblefingers.ie

A Dublin toyshop that has been making children and their parents happy for generations. Has grown a substantial online presence in recent years.

thetoyshoponline.ie

A super cute site with a large array of toys and scooters and all the rest.

jiminy.ie

A homegrown site that focuses on environmentally-friendly toys.

worldofwondertoys.ie

Familiar to many Munster-based people, this shop is now doing the business in a big way in the online space.

smythstoys.com

Just because it is one of the biggest toyshops on the island does not make it less Irish. It stocks large ranges of all toys and operates a handy click-and-collect service.

mimitoys.ie

An ever-increasing range of environmentally-sound toys for all kids. Again, this is a site that eschews that easily-breakable plastic stuff on the market.

byrnesonline.ie

If you are looking for Lego or all manner of other toys, this Wexford shop might be able to help.

woodenheart.ie

A gorgeous little shop on Galway’s Quay St that was always worth a browse in pre-Covid times. While the shop is on the small side, there are no space issues on the website. Plenty of wooden and traditional toys.

littleones.ie

A beautiful shop based in Ennis, stuffed with the cutest of presents from Ireland and elsewhere. Definitely worth a visit, if only in a virtual sense.

kaliedy.com

A new kid on the block, this site was born out of the ashes of Mothercare Ireland and is the only Irish stockist of a wide range of developmental toys from the Early Learning Centre, making it an ideal starting point for parents of young children.

FOOD

smokehouse.ie

“Finest traditionally-smoked wild Atlantic seafood” is this Connemara-based site’s boast. What they sell looks great and we were almost as impressed by the @OldSmoky Twitter handle.

ollysfarm.ie

Looking for Dublin honey? Then look no further than this site, which has a range of 100 per cent raw Irish honeys including heather, blossom and softset honey from different apiaries around Dublin and Wicklow.

harvestday.ie

A site which has the aim of creating “transparency around the food we eat. Weekly deliveries of locally sourced, organically grown produce, direct from small-scale farms in your community”.

gourmettartco.com

A bakery beloved of Galway people for a long time, its online presence is being significantly expanded, which means more people across the country will be able to experience its delightful treats and hampers.

allirelandfoods.ie

All Ireland Foods is a family business based in Enniscorthy, Co Wexford, and its aim is “to encourage Irish food producers, growers, and cottage industries to sell and export their products online”. We like their motto: “If it’s not grown, raised or produced in Ireland, or caught on Irish-registered trawlers it will not be sold on our site.”

ardkeen.com

The Ardkeen Quality Food Store rarely goes unmentioned any time we ask people to recommend good places to shop local. The Waterford-based supermarket has moved into the online delivery space in a big way in recent times, and has widened its service to include nationwide delivery for just €6.95 per order.

hazelmountainchocolate.com

We’ve not actually tasted the chocolate from the Burren but we do love the sound of it.

essentialfoodtrails.com

We love this site which brings farmers’ markets into a virtual world and a wider Irish market.

frankhederman.com

If you want smoked fish for a special occasion, you could run into Lidl or Aldi and get something cheap – or you could go direct to an Irish business and have it delivered to your door. Sure, it will cost a bit more but it will be a whole lot better.

neighbourfood.ie

This foodie heaven is another one that brings small producers to your front door – or at least to a collection point near you. A great idea that deserves support.

calveysachillmountainlamb.ie

The name of the site gives it away. Achill Lamb delivered to your front door.

greengrocerathome.com

Full disclosure: this is Pricewatch’s local greengrocer and we have been shopping on the site almost since the start of the lockdown. We can’t sing its praises loudly enough if you’re lucky enough to live in its delivery area.

unglu-d.ie

A dedicated gluten-free food business with its own range of sauces and seasonings made locally in Co Louth. They come in handy 100ml bottles, so will make for lovely gifts. The folk behind it also do classes and help people learn more about GF.

ballymakennyfarm.com

Not all potatoes are made equal, as a quick browse here will make very clear. Alongside the potato varieties you’ll not have heard of, they also do bundles of queens and broccoli which look lovely.

buyirishfood.ie

We don’t have enough space to include more of the wonderful Irish food businesses that have moved into the online space, but this site has a whole lot more of them.

thecounterdeli.com

If you are looking for wine, sweet treats, cheese and coffee, you can find it all here.

jameswhelanbutchers.com

One of the finest butchers in Ireland, with a vast array of cuts from the high end to the everyday.

kishfish.ie

The fish folk have launched an online service with everything delivered in cooler boxes.

sheridanscheesemongers.com

All the cheese, cured meats, crackers and other accoutrements you could want straight to your door.

stuffuneed.ie

Started out at the start of the pandemic delivering essentials to people not so keen on visiting shops and has grown in recent months into an online department store offering a delivery platform for many small Irish companies.

ART/GIFTS

thebiscuitmarketplace.com

A really excellent resource for anyone in the market for presents for themselves or others in the run-up to Christmas.

thebookresort.ie

Gorgeous idea. These folk put together gift boxes with books, chocolate, fancy soaps and more, all of which is delivered to you or to someone you like a lot in a lovely scented box.

studiodonegal.ie

In the market for some homespun tweed? These folk will have you covered.

quirkyirishicons.ie

We’ll let this site speak for itself. “Like everyone right now we are muddling through and keeping a safe distance! We are keeping the online shop open for anyone looking to send a little gift or make their fridge or walls look a little brighter! Rest assured we are abiding by strict hygiene standards while doing this and delivering via the lovely staff at An Post. Stay safe everyone.”

carraigdonn.com

Always a lovely place to buy a present – for yourself or someone else – and the site was looking lovely last week draped in all sorts of autumnal colours. The site is promising free and fast delivery on orders over €49.

mycaboosestore.ie

We will hand over to the site to describe itself. “Caboose is the first online marketplace in Ireland that gathers the best Irish artisan producers together in one place. We make it easy for everyone to shop fresh ingredients, incredible flavours and rare recipes. We are proud supporters of independent producers, connecting them with food lovers. Come join our thriving Caboose community!”

putyourfeetup.com

If you are in the market for Irish produced candles that smell lovely and look even nicer then you won’t go wrong with these people.

clampandtangle.com

Galway-based shop which is selling a range of working-from-home furniture as well as natty stuff you might need for your home when you are not working. The site also has a commitment to the environment, and the designs focus on usability and extended use, while the company uses sustainable materials and finishes on all of its products and will even plant a tree when every piece is sold.

designist.ie

Pricewatch has long been a fan of this Dublin shop when in need of a fun and funky last-minute stocking filler. The website is also fantastic.

cogsthebrainshop.ie

Cogs the Brain Shop has a physical presence in the Stephen’s Green Centre in Dublin, and an excellent site for games and toys that children will love.

greenoutlook.ie

Irish-based, with more than 25 Irish suppliers offering lifestyle products including shampoo bars, safety razors, natural skincare and a whole lot more.

mymilis.com

This Waterford business was only born in March, and all the soy candles are handmade using sustainable and natural ingredients at the owner’s kitchen table.

drumgreenagh.com

Described by its owners as “a one-stop-gift-for-me shop based in Galway . . . stuff that’s a little bit different from the usual fare”. Clothes, candles, ceramics, jewellery and a whole lot more besides.

hensteethstore.com

A lovely site selling lovely things and well worth a look for anyone in the market for a present for someone they care about.

scoutdublin.com

Clothes, shoes, homewares, kids’ stuff and a whole lot more. The site’s ethos is to provide “a range of timeless products that steer clear from trends, instead offering functionality, good design and longevity” and to support “the wealth of talent in Ireland’s thriving design scene”.

slated.ie

Irish Family design studio creating (the hint is in the name) slate tableware and personalised gifts.

irishdesignshop.com

A site which prides itself on promoting the “work of Ireland’s most exciting designer makers”. It has both an online presence and a bricks-and-mortar shop in Dublin.

designireland.ie

There is a limit to the number of sites we can feature here. There is a whole lot more to be found here.

mimiandmartha.com

A new online store working with more than 40 makers and designers, with a big focus on local design. You will find tasty food, gifts, homewares and lifestyle items.

jamartprints.com

Artists fill the gallery with fresh concepts in print, using both traditional and contemporary techniques. The site stocks ceramics, textiles, jewellery and street art “in strange and wonderful forms”, with the owners saying they are “always working with the artists to create exciting new designs”.

sijewelleryireland.com

Ailish from Sí Jewellery custom makes jewellery, tie bars, pocket watches and more with images and quotes. She can also make ashes and hair-infused memorial pieces.

thewordbird.eu

This is the home of personalised and original pre-printed word art by Susan Brambell. The idea is brilliant. You provide her with a list of words and she makes them into a shape of your choice. The result is a lovely, personalised text art gift. There are also pre-done options if you’re lost for words.

marketstreet.ie

“Indulge yourself or delight a loved one with our individually crafted gifts, made to inspire and charm. Handmade with love by over 100 passionate and creative Irish makers and designers.” That is how this site describes itself and we can’t do any better than that.

thecatandthemoon.ie

In their own words, the people behind this site are “purveyors of unique studio handcrafts and jewellery. Everything we sell is designed and fully handmade by artisans living and working in Ireland”.

myshopgranny.com

This is an online platform stuffed with novel gift ideas and well worth a visit.

chupi.com

If you are in the market for something special for someone you care about you won’t go wrong with this acclaimed jeweller.

bababox.ie

A Dublin-based site which specialises in gifts for mums and babies. They tell Pricewatch that lots of their stockists are also small independent Irish businesses.

ceramicsbyetaoinoreilly.com

A small but beautiful range of hand-thrown ceramics made by Etaoin O’Reilly, with jugs, diffusers, cups and Christmas decorations.

samagusnessa.com

All manner of gifts handmade and using sustainable Irish wood.

finderskeepersthestore.ie

A design-led independent home and giftware store with a strong emphasis on sustainability.

29bridestreet. com

Sustainably designed and screen-printed lifestyle products and accessories made by hand in Dublin by Liz Walsh. There’s free shipping on all orders over €50.

thekind.co

A gorgeous online platform containing stock from more than 30 local businesses, with everything from kitchenware to kids toys. Everything is eco-friendly and ethically sourced.

blaithinennis.com

Multi-award-winning jewellery brand, with all the pieces handmade from a studio in the southeast.

etsy.com

This is not an Irish website but there are loads of Irish people selling on the platform. Here’s how you find them. You search for what you want and when the results come up you can apply a “shop location” filter which allows you to see only sellers based in this country.

alittleidea.ie

Some very brightly coloured and unusual jewellery as well as the odd mug, turbans, head scarves and loads of lovely cards.

wildatlanticliving.com

Gorgeous site on the west coast selling lovely things that will bring a smile to anyone’s face, unless they are super grumpy, like.

ailandel.com

A site which acts as a platform for design and contemporary Irish homeware. “Inspired by urban living and street art.”

artillerybrand.com

This site “aims to be among the world’s best places to find clever and distinctive wall art of universal and Irish interest. We particularly like the classic posters advertising Ireland’s National Cemetery – and not just because it features loads of popes but, thankfully, not this one yet. There are also posters and prints of dear old Dublin sayings created by “international and Irish letter-crafters”.

CLOTHES

irishsocksciety.com

We have to say we love the socks from this Galway-based company. Really high quality and really inventive to boot. The company have also moved into the face mask space in recent months and we particularly like their mask which says, simply, “howya”.

buachaill.com

Boxer shorts for boys with the word “buachaill” on them? An-mhaith ar fad.

pollyandandy.com

From jocks to socks, this site has some wonderful-looking seamless socks made from bamboo.

happiclose.ie

HappiClose is an Irish company which makes children’s clothes that are easy to fit and fasten. “Special baby-soft Velcro is used for fastening. These clothes are highly adaptive, being particularly suitable for children who are difficult to dress,” the site says.

sockcoop.com

Socks of Ireland? Yes, they’re a thing now and the world is a better place for that.

electronicsheep.com

Very cool scarves and jumpers and – more recently – masks.

siolog.ie

A collection of high-quality, ethically made childrenswear and lifestyle products from independent Irish brands.

duesouth.ie

Ethically made T-shirts and hoodies. Oh, and sunglasses made out of recycled skateboards – what’s not to love about that?

gaababy.ie

With hundreds of thousands of Irish people relying on the GAA to keep them sane during the winter lockdown, the hurling, football and camogie championships are likely to be more popular this year than ever. What better way to capture the hearts and minds of the smallest of fans than with GAA-themed babywear!

avoca.com

We could have put this shop into almost any category, really. Not an Irish-owned shop anymore, but it still sells a lot of Irish-made products. And at the time of writing – last Wednesday October 14th – it was still having a sale.

hairybaby.com

Can there be a Pricewatch reader who has not heard of this website? We have certainly plugged the T-shirt (and more recently mask) people enough. And they deserve it.

louiscopeland.com

An old-school tailor in a brave new world. If you are looking for fancy clobber or cufflinks or bags, you will find it here.

anastasiashop.com

This boutique has – in its own words –“an outfit for every occasion. We offer a great selection of stylish occasion wear for weddings, christenings, communions and confirmations from leading Irish designers including Fee G and Caroline Kilkenny. Other dressy wear ranges include Chiara Boni La Petite Robe and Stop Staring dresses”.

siopaella.com

If you are looking for a place to buy and to sell fancy clobber, you need look no further.

ohhbygum.ie

A boutique that stocks all sorts of “eco-chic” for women and children, from fairtrade and sustainable fashion labels that you will struggle to find elsewhere.

beanantees.com

This site explains what it is better than we could: “Empowering apparel and gifts celebrating wild Irish women and an Ghaeilge. Designed, embroidered and printed in the hills of Donegal. Each range supports a different rape crisis, pro-choice or LGBTQ+ organisation.”

BOOKS

thecompanyofbooks.ie

Ranelagh-based bookshop offers a click-and-collect service as well as a book postage services. It can also deliver within 2km of the shop.

charliebyrne.ie

No visit to Galway is complete without a browse in Charlie Byrne’s. This is the city’s largest and most lovely independent bookshop, with new and second-hand books on sale. Browsing online is not the same but it is still a thing of wonder. And the money stays in Ireland.

justbooksmullingar.com

Just Books describes itself as “a unique and charming bookshop located in the heart of Mullingar. We offer customers the personal touch and that’s what makes us stand apart from other bookshops. We deliver books across Ireland. If you don’t see what you are looking for, simply contact us and we will try our very best to get it for you”. Just one reason why shopping local is so much better than the alternatives.

adamscloud.com

We have long loved the books in this collection. They are full of love and warmth and while they may have been born out of great sadness, they have also given a huge amount of joy to parents and children everywhere and to children’s charities across the country.

easons.com

Easons is the bookshop where millions of Irish people spanning three centuries have learned to love books and its site is well worth a look.

getupandgodiary.com

This is a year that most of us will never forget but – fingers crossed – 2021 will be less memorable. You will find all kinds of diaries here and they are all quite lovely.

thebookshop.ie

More than 50,000 second-hand books at €2 or less, with free delivery on orders of more than €20. They have other books that cost more than that too. Lots and lots of them.

kennys.ie

Kenny’s celebrates its 80th birthday this year and has the longest-running online bookshop in the world – take that Amazon. It often matches the big boys when it comes to price and beats them when it comes to quality.

gutterbookshop.com

Lovely bookshop run by lovely people in Dublin and Dalkey.

SKINCARE

indeora.com

A lovely range of magnesium deodorant sprays which are scented with natural coconut and vanilla oils. We are promised chemical-free products which don’t stain.

thehandmadesoapcompany.ie

Natural, clean skincare and home fragrance free from synthetics. They are also vegan-friendly and sustainably made by hand in Ireland.

palmfreeirishsoap.ie

Could there be a better time to be in the soap business, when everyone is washing their hands with more vigour than Howard Hughes in a septic tank? This Clare-based family business offers an ethical and environmentally friendly alternative to mainstream options.

TECH

connectify.ie

When it comes to tech, there isn’t a lot made in Ireland, but at least by shopping with a local retailer, you are contributing to the local economy. This site is promising next-day delivery on an impressive range of kit.

connscameras.ie

Family-run business with as wide a range of camera equipment as you will find almost anywhere. Offers click-and-collect and delivery service across Ireland.

heavins.ie

It is very easy to look to the big players if you are in the market for white goods, but there are a lot of local retailers in the space too, and many of them have pretty polished online offerings, such as Heavins. When we were on the site last there was an impressive-looking sale.

compub.com

If you are in the market for some high-end tech then these guys are definitely worth a look.

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Article from https://www.irishtimes.com/news/consumer/one-hundred-irish-retailers-for-all-your-online-christmas-shopping-1.4386351?mode=amp

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COVID 19 Features General News

Ireland Becomes First Country in Europe to Introduce Second National Lockdown

The second lockdown, which will see a return to the 5km travel limit, will be in force until December 1.

On Monday night, Taoiseach Micheal Martin announced that Ireland would be placed under a Level Five lockdown for a period of six weeks.

The new measures, which will come into force from Thursday, mean that pubs, restaurants, cafes and all non-essential retail outlets will have to close.

Tens of thousands will be out of work, with the Government restoring changes made to the Pandemic Unemployment Payment and the Wage Subsidy Scheme as a result.

The second lockdown, which will see a return to the 5km travel limit, will be in force until December 1.

The Taoiseach delivered a State of the Nation address last night where he outlined the Government’s reasoning for our second national shutdown.

He called on people to knuckle-down once more, saying: “As Taoiseach, I’m asking everyone again to take this threat seriously.”

And then the country’s leader pointed out that not everybody had obeyed the rules up to now, adding: “The Government cannot stop it (Covid) on its own.

“Many people have done everything that has been asked of them, but some have not.” 

Later, Tanáiste Leo Varadkar said Ireland will be the first country in Europe to go back into a national lockdown.

Mr Varadkar said in doing so we are making a “preemptive strike” and acting “before it’s too late.”

He said the objective is to “flatten the curve” again and no one in government wanted to make the decision.

He said: “Lockdown saves lives but it comes at the human cost.”

The Tanáiste said: “We want to make sure the second wave is only a ripple.”

He added: “We want to put this virus back in its box.”

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Article from https://www.irishmirror.ie/news/irish-news/level-five-updates-ireland-covid-22867468

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COVID 19 Features

Ireland Braces for Level Five Restrictions Following NPHET Warning

Cabinet will today sign off on tighter measures for the entire country after NPHET advised a six week lockdown with the most severe restrictions.

Cabinet will today sign off on further restrictions for the country in response to Ireland’s fast growing COVID infection rate.

It comes after former health minister Simon Harris warned yesterday that “tomorrow we will have to bring in more restrictions. Level Three has not worked”.

NPHET made a six-week lockdown recommendation on Thursday, though as yet it’s unclear if the country will go into full Level Five or if it will be a mix of Level Four and Five.

The executive branch of Government meets this morning to decide on whether Ireland moves to Level Five – the most severe rung on the country’s Living With COVID plan.

Minister Harris did make it very clear that more restrictions are on the cards for the entire country.

He added: “The government will act tomorrow, the action will be decisive and it will be nationwide action.

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COVID 19 COVID 19/World News

Sweden Rejected Covid-19 Lockdown – Could Ireland Learn From its Maverick Approach?

Sweden was the only major European country to reject lockdown and leave most of its bars, restaurants and shops open during the Covid-19 crisis.

Ireland took the least maverick route – and yesterday experts said we are at the start of a second wave.

The 14-day incidence here was 68.6 per 100,000 while Sweden’s was 36 per 100,000.

A suggestion from a Swedish epidemiologist that Ireland adopt the more softly, softly strategy was among possible solutions to emerge yesterday from a brainstorming session of experts at the Oireachtas committee investigating Covid-19.

Others urged borrowing the best ideas from Finland and Taiwan.

Sweden has been dubbed the comeback kid of Europe after reversing a high infection and death rate.

Dr Johann Giesecke, a former chief epidemiologist in Sweden, said we should allow controlled spread among people below 60, but concentrate on the old and frail and have frequent testing of staff and residents in nursing homes.

Mask wearing is not mandatory but much of the secret probably emerged when he revealed the very high level of voluntary compliance to anti-Covid measures like physical distancing. “People are not stupid” he said. Sweden’s biggest failure in the early months was the high number of deaths, mostly among the elderly. He said there will be a “tolerable spread” among the over-60s. But there has been a “change” in the way people in care homes are now looked after.

Asked by Social Democrat TD Róisín Shortall how more active older people would be protected, he said they need to be more careful. “We have not changed anything for the six months whereas other countries are going in and out of lockdown” he added.

But acting chief medical officer Dr Ronan Glynn last night ruled out following Sweden’s path.

Infectious disease consultant, Professor Sam McConkey of Beaumont Hospital, said there needs to be a Covid plan for up to seven more years.

Living with Covid-19 community transmission is like having a tiger in your house – it will come back and bite you, he said. If it is not eliminated “we face multiple regular waves here, of infection, disease and death, and disability” for possibly many years.

Once there is an outbreak there should be testing and detailed contact tracing, pop-up testing and mobile teams.

Prof McConkey pointed to successes in Australia and New Zealand that should be adopted, with better control of incoming travellers using testing, home visits and quarantines.

There is not one single thing to do to stop the rise in cases, which if it continues will result in more deaths, he added.

A package of measures are needed and current test and control measures are not enough.

Physical distancing needs community buy-in.

There needs to be improvement in the quality and speed of what is being done already.

Within the EU, there should be a collective effort to get the whole group to aim for elimination.

It would mean areas gradually free of Covid-19 could be opened up. Finland, not Sweden, was held up as the European country to follow by Dr Tomás Ryan of the Institute of Neurosciences in Trinity College. He said there is no magic ingredient in Finland but they seem to be doing everything well, from mask wearing to physical distancing. He pointed out it has a sparser population than Ireland and possibly more compliance. “It is among the best-performing countries in Europe” he added.

Dr Ryan suggested blockages to foreign travel could be overcome with three-shot testing. Airline passengers would have a test before leaving and another test on arrival. This would entail a wait of around six hours at the airport. They would then self-isolate for a few days before a further test.

People in Ireland are not getting the kind of information they need on the location of outbreaks – whether they are in family homes, weddings or restaurants, said Professor Kirsten Schaffer, a microbiologist of the UCD School of Medicine.

If they did, restrictions would seem more logical and consistent, she added.

She pointed to Germany, where there is detailed tracing to find sources of infection. She said she asked public health officials here and was told they only checked what close contacts people had in the previous 48 hours. So it may not be clear whether the infection was picked up at a house party or restaurant. “I don’t have that information. The data is not there” she said. Without that information the interventions are too crude, she said.

Prof Schaffer said the issue around foreign travel has less to do with flights than on what people do on their holidays.

If they go to bars and nightclubs, they may be at risk. But if they go to a country for some sun, physically distance, wear their masks on holiday and on the plane, the risk may be lower than staying at home and going to a house party, she said.

Instead of a green list of countries, there should be a red list which would flag areas of high community transmission. Travellers from these countries should be followed up. Since masks became mandatory on planes there have been very few outbreaks associated with travel.”

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Article from https://www.independent.ie/world-news/coronavirus/explainer-sweden-rejected-covid-19-lockdown-could-ireland-learn-from-its-maverick-approach-39558142.html

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COVID 19/World News World News

COVID-19 Pandemic: Countries Urged to Take Stronger Action to Stop Spread of Harmful Information

The World Health Organization (WHO) together with the UN, specialised agencies and partners today called on countries to develop and implement action plans to promote the timely dissemination of science-based information and prevent the spread of false information while respecting freedom of expression. 

WHO, the UN, UNICEF, UNAIDS, the UN Development Programme (UNDP), UNESCO, the International Telecommunication Union (ITU), the UN Global Pulse initiative and the International Federation of the Red Cross and Red Crescent Societies  (IFRC), together with the governments of Indonesia, Thailand and Uruguay held a webinar on the margins of the 75th UN General Assembly to draw attention to the harm being done by the spread of misinformation and disinformation, the latter being deliberate misinformation to advance an agenda.

“As soon as the virus spread across the globe, inaccurate and even dangerous messages proliferated wildly over social media, leaving people confused, misled and ill-advised”, said UN Secretary-General António Guterres. ”Our initiative, called “Verified”, is fighting misinformation with truth. We work with media partners, individuals, influencers and social media platforms to spread content that promotes science, offers solutions and inspires solidarity. This will be especially critical as we work to build public confidence in the safety and efficacy of future COVID-19 vaccines. We need a ‘people’s vaccine’ that is affordable and available to all.”

“Misinformation and disinformation put health and lives at risk, and undermine trust in science, in institutions and in health systems,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “To fight the pandemic we need trust and solidarity and when there is mistrust, there is much less solidarity. False information is hindering the response to the pandemic so we must join forces to fight it and to promote science-based public health advice. The same principles that apply to responding to COVID-19 apply to managing the infodemic. We need to prevent, detect and respond to it, together and in solidarity.” 

“On top of the immediate impact on pandemic responses, disinformation is undermining public trust in democratic processes and institutions and exacerbating social divides”, said UNDP Administrator Achim Steiner. “It’s one of the most concerning governance challenges of our time. UNDP is actively collaborating with Member States, fellow UN agencies, and other partners to find holistic responses which respect human rights.”

“Misinformation is one of the fastest growing challenges facing children today,” said Henrietta Fore, UNICEF Executive Director. “It takes advantage of the cracks in trust in societies and institutions and deepens them further, undermines confidence in science and medicine, and divides communities. In its most pernicious forms, such as when it convinces parents not to vaccinate their children, it can even be fatal. Because misinformation is more a symptom than a sickness, countering it requires more than just providing truth. It also requires trust between leaders, communities and individuals.” 

“We can beat COVID-19 only with facts, science and community solidarity,” said Executive Director, Winnie Byanyima. “Misinformation is perpetuating stigma and discrimination and must not come in the way of ensuring that human rights are protected and people at risk and those marginalized have access to health and social protection services.”

“Since the start of the pandemic, UNESCO has mobilised its international networks of media partners, journalists, fact-checkers, community radio stations, and experts, to give citizens the means to fight against false information and rumours — phenomena that have been exacerbated by the pandemic,” said Audrey Azoulay, the UNESCO Director-General. ”Collective mobilisation to promote quality and reliable information, while strictly ensuring respect for freedom of expression, is essential. A free, independent and pluralistic press is more necessary than ever.”

“Trust is a cornerstone of our digital world,” said Houlin Zhao, Secretary-General of the International Telecommunication Union. “Building on the long-standing WHO-ITU BeHe@lthy BeMobile initiative, ITU has been working with national ministries of telecommunications and health and mobile network operators since the beginning of this crisis to text people who may not have access to the internet, providing them with science- and evidence-based COVID-19 health advice directly on their mobile phones.”

WHO and partners urged countries to engage and listen to their communities as they develop their national action plans, and to empower communities to build trust and resilience against false information. 

“Engaging communities on how they perceive the disease and response is critical to building trust and ending outbreaks,” said Jagan Chapagain, IFRC Secretary General. “If our response does not reflect the communities’ concerns and perceptions, we will not be seen as relevant or trusted by affected populations, and the epidemic response risks failure.  More than ever, local responders are at the forefront of this crisis. We need to recognize the incredible role they play in understanding and acting on local knowledge and community feedback.”

The co-hosts also called on the media, social media platforms, civil society leaders and influencers to strengthen their actions to disseminate accurate information and prevent the spread of misinformation and disinformation. Access to accurate information and the free exchange of ideas online and offline are key to enabling effective and credible public health responses.

“UN Global Pulse was set up a decade ago inside the UN System to pioneer the use of real-time and predictive insights to protect vulnerable communities in times of crisis”, said Robert Kirkpatrick, Director of UN Global Pulse, the United Nations Secretary-General’s initiative on big data and artificial intelligence (AI). “During this pandemic we have seen a tremendous increase in requests for advanced analytics from across the UN System and Member States. We will continue to work with WHO and other partners to help identify and combat mis- and disinformation.” 

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Article from https://www.who.int/news-room/detail/23-09-2020-covid-19-pandemic-countries-urged-to-take-stronger-action-to-stop-spread-of-harmful-information

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Covid 19/Education

Studying and COVID-19

COVID-19 your questions answered

The Government of Ireland is committed to protecting the health and safety of all people living, working and studying in Ireland during this time of unprecedented challenge. That protection extends to you, current and prospective international students.

Ireland is taking a measured, consistent and evidence-led approach to the COVID-19 situation, based on the best available international guidelines and local public health advice. The Government of Ireland’s roadmap for re-opening society and business is available on www.gov.ie We can tell you that Education in Ireland, as part of the Government of Ireland, is working with our Irish Universities and Colleges and Partner Institutions to ensure that we deliver on the commitments we made to current and prospective students. Higher education institutions will commence re-opening on a phased basis at the beginning of the 2020/21 academic year.

We’re committed to enabling you to fulfill your hopes and dreams of a third level education in Ireland. As it stands the Irish higher education institutions are continuing to make preparations to welcome new and returning students for the 2020/21 academic year. They are also considering a number of precautionary options, to ensure they are well positioned to adapt as the situation evolves. These include exploring flexible start dates and delivering courses via remote learning.

We are committed to providing you with a world-class education in Ireland. We promised you the warmest of welcomes. We are exploring all options to make this a reality.

Immigration and Visa applications

Whether you are a current international student or starting a programme in Ireland in the 2020/21 academic year, you may be concerned about how to renew, extend or apply for an Irish Residence Permit. The information on this page explains how the Government of Ireland is providing Immigration Services currently.

Current Valid Immigration Permissions extended for one month

Immigration permissions due to expire between 20th September 2020 and 20th January 2021 will be automatically extended until 20th January 2021. The renewal of permission is on the same basis as the existing permission and the same conditions attach. You’ll find more information here.

Temporary Closure of Registration Offices

The Dublin area Registration Office located in Burgh Quay will close temporarily, to allow for revised public health guidance to be issued. All renewals in the Dublin area are now being processed online only and the system has been available for all applicants since 20 July 2020 at https://inisonline.jahs.ie, and renewal applications will continue to be accepted.

All Registration Offices for non-Dublin residents operated by An Garda Síochána will also close temporarily, to allow for revised public health guidance to be issued.  

Further announcements in relation to the operation of the Registration Offices will issue on the INIS website. You’ll find more information here.

Renewing an existing Irish Residence Permit

Normal processing of re-entry visa applications will re-commence on 20th July 2020.

If you had a valid IRP card, please submit any re-entry visa applications by Registered Post as normal. All applications will be queued for processing. Due to the volume of applications expected, the processing time will be 15-20 working days. Please do not make travel arrangements until your documents have been returned. On the outside of the envelope, please write the Stamp number you are applying for plus Re-entry Visa.  You’ll find more information here.

New online registration service for students residing in Dublin

There is a new online Registration Renewal system for all non-nationals based in Dublin. This means anyone looking to renew their registration will no longer have to book an appointment and attend the registration office in person. Applicants seeking to renew their permission will now complete the application form online here, upload copies of supporting documents online, pay the applicable fee and then submit their passport and current IRP card via registered post.  Documents will be checked and, if approved, the passport will be stamped and returned by registered post and an IRP card issued by express post. You’ll find more information here.

Local Registration Office service for students residing outside Dublin

If you need to renew your Irish Residence Card (IRP) and are residing outside Dublin you must continue to renew your IRP card through your local Registration Offices. To facilitate those needing to travel and reduce processing time, rather than requiring an IRP card we will accept evidence of your having applied for and renewed your registration. You’ll find more information here.

Applying for a Stamp Visa 

If you are a student that has recently arrived to Ireland for the first time, you can now apply for your Stamp Visa electronically. You must scan copies of all your documentation and send to bqregofficeapplications@justice.ie. This is the email address for the Registration Office, Burgh Quay, Dublin. You can find out more about the application process here.

Immigration Offices and Visa Centres

Unfortunately at this moment in time we simply do not know when visa application centres will re-open. Whilst the Government of Ireland is keen for centres to re-open as soon as possible, local conditions and advice from the Government of Ireland, your own Governments and health authorities will dictate when this can safely happen.

What you can do before the visa application centres and Embassies re-open

We understand that the closure of these centres can cause delays and stress. There are teams in place to deal with visa applications quickly and in the meantime, we would encourage you to have all the necessary documentation ready. Keep the University or College you are interested in attending or have already applied to up-to-date on your Visa status. The Irish Universities and Colleges will be as flexible as they possibly can be.

How you can avail of the Third Level Graduate Scheme (stay back option)

In light of the uncertainties caused by the COVID-19 pandemic, temporary immigration arrangements are in place for all non-EEA nationals currently holding student permission (Stamp 2) who wish to avail of the Third Level Graduate Programme. This temporary measure will be kept under review in light of the restrictions arising from the COVID-19 pandemic and may be amended or withdrawn, in whole or in part, when considered appropriate to do so, but regardless will cease to apply no later than 30 September 2020.

This notice sets out the updated immigration arrangements which apply to all non-EEA nationals currently holding student permission (Stamp 2), who wish to avail of the Third Level Graduate Programme, but are unable to report to their local registration office to receive a Stamp 1G due to either:

  • The temporary closure of the Registration Office in Dublin and local Registration Offices across the country,
    OR
  • They have returned to their home countries or countries of ordinary residence due to the COVID-19 pandemic.

Rather than attending in person, as a temporary measure, applications may be submitted electronically to the Registration Office, Burgh Quay, Dublin. All required documentation should be scanned and included in the application.

Where permission has been granted, applicants will still be required to register once the Registration Office and local Registration Offices reopen and, where applicable, the applicant has returned to Ireland.

All other eligibility criteria set out in the 2017 Revision of this Scheme will continue to apply. Click here to find the latest information.

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Article from https://www.educationinireland.com/en/Studying-and-COVID-19/Immigration-and-Visa-applications/

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Covid 19/Research Features

COVID Research Updates This Month

Tests reveal silent reinfections in hospital workers.

Nature wades through the literature on the new coronavirus — and summarises key papers as they appear.

28 September — Tests reveal silent reinfections in hospital workers

Two staff members at a hospital in India who tested positive for the new coronavirus became reinfected several months later — and had no symptoms in either instance.

The hospital employees, a 25-year-old-man and a 28-year-old woman, worked in the COVID-19 ward. Both tested positive for SARS-CoV-2 in May, although neither had symptoms (V. Gupta et alClin. Inf. Dishttps://doi.org/d97d; 2020). After testing negative, they returned to work. Both tested positive again roughly three-and-a-half months after the first positive test. Neither had symptoms, but both had higher levels of virus than in May.

Genomic analysis by Vinod Scaria at the Institute of Genomics and Integrative Biology in New Delhi and his colleagues showed that the SARS-CoV-2 that infected the workers the second time was genetically different from the first virus that infected them — evidence that the workers were infected anew rather than harbouring leftover virus.

The results suggest that asymptomatic reinfections are often underreported, the authors say.

Nurses work in the intensive care unit of the Centre Hospitalier Universitaire (CHU) of Pointe-a-Pitre, Guadeloupe.
Nurses care for a person in the intensive-care unit of a hospital in the French region of Guadeloupe.Credit: Lara Balais/AFP/Getty

25 September — The immune breakdown linked to dire illness

Some severe cases of COVID-19, including those in young, healthy people, could be linked to dysfunction of immune-signalling chemicals called type-1 interferons, according to a survey of nearly 1,000 people with life-threatening SARS-CoV-2 infection.

Type-I interferons are crucial for mounting a defence against influenza and other viruses. Jean-Laurent Casanova at the Rockefeller University in New York City and his colleagues analysed DNA from people with severe COVID-19, looking for specific mutations in genes that trigger production of type-I interferons (Q. Zhang et alScience https://doi.org/d95p; 2020). The team found that 3.5% of study participants had such mutations, which rendered them unable to manufacture the signalling chemicals.

In a second study, of severely ill people, Casanova, Paul Bastard at the University of Paris and their colleagues looked for autoantibodies — antibodies that, for unknown reasons, attack the body’s own tissues and organs (P. Bastard et alScience https://doi.org/d95q; 2020). The researchers found that more than 10% of people with severe COVID-19 had autoantibodies that targeted type-I interferon activity, compared with 0.3% in the general population. Laboratory experiments confirmed that the auto-antibodies knocked out type-I interferon activity.

The researchers suggest that interferons could be used as therapies for the disease.

Aerial view showing a new area (R) cleared to accomodate new graves in the cemetery in Manaus.
A cemetery in Manaus, Brazil, has cleared ground (right) for the graves of people killed by COVID-19, which has devastated the city.Credit: Michael Dantas/AFP via Getty

24 September — Extreme infection level might have helped to quell a city’s epidemic

As much as two-thirds of the population of Manaus, a city of two million people in Brazil’s state of Amazonas, could have been infected with the new coronavirus. That’s a proportion high enough to have contributed to controlling the spread of the virus.

Ester Sabino at the University of São Paulo, Brazil, and her colleagues searched for antibodies against SARS-CoV-2 in more than 6,000 blood samples collected by a Manaus blood bank between February and August (L. F. Buss et al. Preprint at medRxiv https://doi.org/ghcm6h; 2020). From the proportion of donors who tested positive for antibodies, the authors estimate that about 66% of the population had been infected by early August — months after the epidemic in Manaus peaked in May .

The authors say that the high proportion of donors with antibodies to the virus suggests that Manaus might have reached ‘herd immunity’, the term for a scenario in which enough people are immune to an infection to control its spread.

The team says its estimate accounts for several potential sources of bias, including false positives and false negatives in antibody testing. The findings have not yet been peer reviewed.

Coloured TEM of SARS-CoV-2 coronavirus particles (red) isolated from a patient with the disease Covid-19.
Coronavirus particles (red; artificially coloured) isolated from a person with COVID-19.Credit: NIAID/NIH/SPL

22 September — Good timing might help the immune system to control COVID-19

People aged 65 and older who are infected with the new coronavirus tend to mount a disorganized immune response — a response that is also associated with severe COVID-19. This could help to explain why the disease strikes older people particularly hard.

The immune system’s ‘adaptive’ branch, which targets specific invaders, has three principle components: antibodies, CD4+ T cells and CD8+ T cells. Alessandro Sette and Shane Crotty at the La Jolla Institute for Immunology in California studied the adaptive immune response in 24 people whose COVID-19 symptoms ranged from mild to fatal (C. R. Moderbacher et alCell https://doi.org/ghbwh7; 2020).

The team found that people whose immune systems failed to rapidly launch the entire adaptive immune system tended to have more severe disease than did people in whom all three arms ramped up production simultaneously. An uncoordinated response was particularly common among older people, and could indicate that both antibodies and T cells are important weapons against the coronavirus.

21 September — Business-class passenger spreads coronavirus on flight

Genetic evidence strongly suggests that at least one member of a married couple flying from the United States to Hong Kong infected two flight attendants during the trip.

Researchers led by Leo Poon at the University of Hong Kong and Deborah Watson-Jones at the London School of Hygiene & Tropical Medicine studied four people on the early-March flight (E. M. Choi et alEmerg. Infect. Dishttps://doi.org/d9jn; 2020). Two were a husband and wife travelling in business class. The others were crew members: one in business class and one whose cabin assignment is unknown. The passengers had travelled in Canada and the United States before the flight and tested positive for the new coronavirus soon after arriving in Hong Kong. The flight attendants tested positive shortly thereafter.

The team found that the viral genomes of all four were identical and that their virus was a close genetic relative of some North American SARS-CoV-2 samples — but not of the SARS-CoV-2 prevalent in Hong Kong. This suggests that one or both of the passengers transmitted the virus to the crew members during the flight, the authors say. The authors add that no previous reports of in-flight spread have been supported by genetic evidence.

A crowd of people hanging out on the terraces of cafe bars while not wearing protective face masks, Croatia.
Bar gatherings have triggered superspreading events in the United States, Japan, Hong Kong and other places.Credit: Denis Lovrovic/AFP/Getty

18 September — Musicians and a monk are tied to superspreading in Hong Kong

An estimated 19% of SARS-CoV-2 infections in Hong Kong seeded 80% of the local transmission of the virus from one person to another, according to an analysis of the virus’s early spread. The analysis also found that viral spread in social settings caused more infections than spread within family households.

In an examination of more than 1,000 coronavirus infections in Hong Kong from late January to late April, Peng Wu at the University of Hong Kong and her colleagues found evidence of multiple ‘superspreading’ events, in which one infected person passed the virus to at least six others (D. C. Adam et alNature Medhttps://doi.org/d9c4; 2020). Musicians who performed at four Hong Kong bars are thought to have triggered the biggest cluster, which led to 106 cases. Another 19 cases were linked to a temple; one monk there had no symptoms but was found to be infected.

Nearly 70% of the cases did not transmit to anyone, the team found. The analysis also showed that more downstream cases were linked to spread in social settings such as weddings and restaurants than to household spread.

Blood plasma is prepared for delivery at a newly opened plasma donor centre in Twickenham, southwest London on June 11, 2020.
Blood plasma donated by people who have recovered from COVID-19 contains antibodies that could help to treat the disease.Credit: Ben Stansall/AFP via Getty

17 September — Immunity to common-cold coronaviruses is short-lived

Natural immunity to coronaviruses that cause the common cold might last for only a few months after infection, according to a study that monitored volunteers’ antibody levels — some for more than three decades.

Previous studies have suggested that immune responses to common-cold coronaviruses protect against reinfection for only a matter of months, although symptoms are often reduced during the second infection. Lia van der Hoek at the University of Amsterdam and her colleagues looked for coronavirus antibodies in blood samples taken every few months from ten individuals, starting in the mid-1980s (A. W. D. Edridge et alNature Medhttps://doi.org/ghbm79; 2020).

The team used a rise in antibody levels as an indicator of infection. Infections with coronaviruses were least common from June to September, a seasonal pattern that the authors suggest SARS-CoV-2 might follow. The authors found reinfections occurring as early as 6 months after the first infection, and most often at 12 months.

15 September — A groundbreaking guide to making ‘cocktails’ to treat COVID-19

A new method pinpoints every mutation that a crucial SARS-CoV-2 protein could use to evade an attacking antibody. The results could inform the development of antibody treatments for COVID-19.

The immune system produces molecules called antibodies to fend off invaders. Antibodies that bind to an important region of the SARS-CoV-2 spike protein can inactivate the viral particles, making such antibodies attractive as therapies. But over time, viruses can accumulate mutations — and some can interfere with antibody binding and allow viral particles to ‘escape’ immune forces.

James Crowe at the Vanderbilt University Medical Center in Nashville, Tennessee, Jesse Bloom at the Fred Hutchinson Cancer Center in Seattle, Washington, and their colleagues created the most detailed map so far of the spike-protein mutations that could prevent binding by ten human antibodies (A. J. Greaney et al. Preprint at bioRxiv https://doi.org/d8zm; 2020). The team then used that information to design three antibody cocktails, each consisting of two antibodies.

In laboratory tests of the cocktails against SARS-CoV-2, the virus did not develop mutations that could escape antibody binding. The findings have not yet been peer reviewed.

A member of staff receives a child in a day care centre at Moscow's secondary school No 1532.
A staffer at a childcare centre in Moscow wears mask and gloves to prevent spread of the new coronavirus.Credit: Mikhail Japaridze/TASS via Getty

14 September — Kids in US childcare centres spread coronavirus to families

Twelve children infected with the new coronavirus at childcare centres passed the virus on to at least another twelve people between them, according to an analysis of outbreaks in Utah. Among the resulting cases was a woman who had to be hospitalized after presumptive infection by her child.

Cuc Tran at the US Centers for Disease Control and Prevention in Atlanta, Georgia, and her colleagues investigated outbreaks at three childcare centres in Salt Lake County (Morb. Mortal. Wkly Repthttps://www.cdc.gov/mmwr/volumes/69/wr/mm6937e3.htm?s_cid=mm6937e3_w; 2020). At all three centres, the first known case was a staff member. Two had gone to work even though a person in their household had shown COVID-19 symptoms.

All 12 infected children, whose ages ranged from 8 months to 10 years, had either mild or no symptoms. Among the children’s close contacts who tested positive were six mothers and three siblings; one eight-month-old baby infected both parents. Not all close contacts were tested, meaning that infections associated with the childcare centres might have been missed, the authors say.

Passengers wear protective face masks as they alight a Metro train in Madrid.
Mask-wearing passengers alight from a Metro train in Madrid.Credit: Angel Navarrete/Bloomberg via Getty

11 September — Nearly half of coronavirus transmission is from people not yet feeling ill

Some three-quarters of incidents of SARS-CoV-2 transmission occur in the few days before or after the onset of symptoms in the person who passes on the virus.

Luca Ferretti at the University of Oxford, UK, and colleagues studied 191 cases of SARS-CoV-2 transmission from an infected person to an uninfected person. The team analysed the timing of the transmitting person’s initial infection and onset of symptoms, and when that person spread the infection to someone else (L. Ferretti et al. Preprint at medRxiv https://doi.org/d8ms; 2020).

They found that roughly 40% of transmission events occurred before the onset of symptoms, and around 35% took place on the day that symptoms appeared or on the following day.

The researchers say their findings underscore the importance of mass testing, contact tracing and physical distancing to prevent transmission from pre-symptomatic people, as well as self-isolation for at least two days at the first sign of symptoms such as cough, fever, fatigue and loss of smell — however mild.

Coloured transmission electron micrograph (TEM) of a cell infected with SARS-CoV-2 coronavirus particles (blue and orange).
Particles of SARS-CoV-2 (blue and orange; artificially coloured) infect a cell.Credit: Cynthia S. Goldsmith and Azaibi Tamin/CDC/SPL

10 September — Surprise! A host of tantalizing new SARS-CoV-2 proteins is unveiled

Researchers have discovered nearly two dozen previously unknown proteins encoded by SARS-CoV-2 — and their role during infection is mostly mysterious.

Until now, SARS-CoV-2’s RNA genome was known to hold the instructions for making 29 proteins, such as the spike protein that helps viral particles to infect cells, and a variety of viral proteins that become active inside cells. But scientists were uncertain whether the virus had more than those 29.

To identify further proteins, Noam Stern-Ginossar at the Weizmann Institute of Science in Rehovot, Israel, and her colleagues sequenced SARS-CoV-2 RNA bound to protein-making machines called ribosomes inside infected cells (Y. Finkel et alNature https://doi.org/d8pb; 2020). This scan turned up 23 previously unknown proteins, including some that are entirely new and others that are shortened or extended versions of known proteins.

Some of the newfound proteins might control production of known viral molecules, but the role of many is unknown.

9 September — The immune-cell traits that could predict severe COVID-19

Immune cells called neutrophils are more likely to be primed for action in people who will eventually develop severe COVID-19 than in those who are will go on to become only mildly ill, according to a machine-learning analysis of data from 3,300 people. If the results can be reproduced, they could aid early identification of the people most likely to become critically ill.

Neutrophils comprise an important part of the body’s rapid response to infection, but can also damage uninfected tissue. Hyung Chun of Yale University in New Haven, Connecticut, and his colleagues used machine learning to analyse proteins in blood plasma taken from people hospitalized with COVID-19 (M. L. Meizlish et al. Preprint at medRxiv https://doi.org/d8hm; 2020).

Several immune proteins that are associated with neutrophils were found at higher levels in the plasma of people who later became critically ill than in those whose illness did not become severe. A subsequent analysis of health records from about 3,300 people showed that high neutrophil counts were associated with increased COVID-19 mortality. The findings have not yet been peer reviewed.

A child infected with COVID-19 is comforted by a medical personnel at a hospital in Romania.
A child with COVID-19 in a hospital in Timisoara, Romania.Credit: Daniel Mihailescu/AFP/Getty

8 September — Kids ravaged by COVID-19 show unique immune profile

Most children infected with the new coronavirus show few signs of illness, if any. But a few children are struck by a severe form of COVID-19 that can cause multiple organ failure and even death. Now, scientists have begun to tease out the biology of this rare and devastating condition, called multisystem inflammatory syndrome in children, or MIS-C.

Doctors have diagnosed hundreds of cases of MIS-C, which shares some similarities with the childhood illness Kawasaki’s disease. To understand MIS-C’s biological profile, Petter Brodin at the Karolinska Institute in Stockholm and his colleagues looked at 13 children with MIS-C, 28 children with Kawasaki’s disease and 41with mild COVID-19 (C. R. Consiglio et alCell https://doi.org/d8fh; 2020). The researchers found that compared with children with Kawasaki’s disease, those with MIS-C have lower levels of an immune chemical called IL-17A, which has been implicated in inflammation and autoimmune disorders.

Unlike all the other children studied, children with MIS-C had no antibodies to two coronaviruses that cause the common cold. This deficit might be implicated in the origins of their condition, the authors say.

Iranian medical personnel wearing a protective suit takes care of an elderly woman infected with covid.
A woman receives care in the COVID-19 ward of a Tehran hospital.Credit: Morteza Nikoubazl/NurPhoto/Getty

4 September — Powerful new evidence links steroid treatment to lower deaths

People severely ill with COVID-19 are less likely to die if they are given drugs called corticosteroids than people who are not, according to an analysis of hospital patients on five continents.

Earlier findings showed that the steroid dexamethasone cut deaths in people with COVID-19 on ventilators. To examine the effects of steroids in general, Jonathan Sterne at the University of Bristol, UK, and his colleagues did a meta-analysis that pooled data from seven clinical trials; each of the seven studied the use of steroids in people who were critically ill with COVID-19 (REACT Working Group J. Am. Med. Assoc. https://doi.org/d7z8; 2020). The trials included more than 1,700 people across 12 countries.

The team analysed participants’ status 28 days after they were randomly assigned to take either a steroid or a placebo. The risk of death was 32% for those who took a steroid and 40% for those who took a placebo. The authors say that steroids should be part of the standard treatment for people with severe COVID-19.

A man wearing a personal protective equipment suit (PPE) seen disinfecting the mink company.
A worker disinfects equipment at a mink farm in the Netherlands.Credit: Robin Utrecht/SOPA Images/Getty

3 September — In a first, genomics shows that mink can pass SARS-CoV-2 to humans

An investigation of Dutch mink farms has found the first documented cases of animal-to-human transmission of SARS-CoV-2.

After SARS-CoV-2 outbreaks among farmed mink were first detected in late April, Marion Koopmans at Erasmus Medical Centre in Rotterdam, the Netherlands, and her colleagues used genome sequencing to track outbreaks among animals and workers at 16 mink farms (B. B. O. Munnink et al. Preprint at bioRxiv https://doi.org/d7xn; 2020). The team tested 97 farmworkers and their contacts, and found evidence for SARS-CoV-2 infection in 66 of them.

Genetic analysis suggested that workers had introduced SARS-CoV-2 to mink, which spread the virus back to workers, who might then have passed it on to other people. Outbreaks at mink farms have been detected in Denmark, Spain and the United States, and the researchers say unchecked spread could lead to the animals becoming a reservoir for human infections. The findings have not yet been peer reviewed.

An ambulance carries a person with COVID-19 to a hospital in Turin, Italy.

2 September — Antibodies persist for months rather than dwindling

A sweeping survey in Iceland shows that antibodies against the new coronavirus endure in the body for four months after infection, countering earlier evidence suggesting that these important immune molecules quickly disappear.

After a pathogen invades, the immune system produces proteins called antibodies to fight off the intruder. Scientists do not know whether people who generate antibodies against SARS-CoV-2 are protected from reinfection, nor do they know how long those antibodies persist.

Kari Stefansson at deCODE Genetics–Amgen in Reykjavik and his colleagues measured the levels of SARS-CoV-2 antibodies in the blood of roughly 30,000 people, including more than 1,200 who had tested positive for the virus and recovered from COVID-19 (D. F. Gudbjartsson et alN. Engl. J. Med. https://doi.org/gg9hbt; 2020). Roughly 90% of the recovered people had antibodies against the virus. Their antibody levels rose during the two months after diagnosis, plateaued and then remained at the same level for the duration of the study.

The results also show that the virus has infected only 0.9% of the population, leaving Iceland “vulnerable to a second wave of infection”, the authors warn.

1 September — Even octogenarians develop potent antibodies

As the new coronavirus ripped through several care homes in England, more than 80% of the residents mounted an antibody response to the virus, including 82% of those over the age of 80.

During outbreaks at six residential and nursing homes, Shamez Ladhani at Public Health England in London and his colleagues tested more than 500 residents and staff for SARS-CoV-2 infection (S. N. Ladhani et al. Preprint at medRxiv https://doi.org/d7p2; 2020). About five weeks later, the team tested many of the same people for antibodies to SARS-CoV-2 and in particular for neutralising antibodies, potent molecules that can block the virus from infecting cells

The team found that roughly the same proportion of staff members and care-home residents had formed antibodies to the coronavirus. And neutralizing antibodies had developed in almost 90% of both staff members and residents, including more than 80% of people over the age of 80.

The authors caution that it is not clear whether antibodies against the virus guard against reinfection. The findings have not yet been peer-reviewed.

Colorized SEM of a cell (purple) infected with SARS-CoV-2 virus particles (yellow), isolated from a patient sample.
A human cell (purple; artificially coloured) infected by viral particles (yellow).Credit: NIAID (CC BY 2.0)

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Article from https://www.nature.com/articles/d41586-020-00502-w

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Covid 19/Health

How Do Children Fight Off the Coronavirus?

The secret may lie in an “innate” immune response that targets unrecognised invaders, scientists say.

Children may be less affected by the coronavirus because of a type of immune response that helps them fight new infections, researchers found.

Why the coronavirus affects children much less severely than adults has become an enduring mystery of the pandemic. The vast majority of children do not get sick; when they do, they usually recover.

The first study to compare the immune response in children with that in adults suggests a reason for children’s relative good fortune. In children, a branch of the immune system that evolved to protect against unfamiliar pathogens rapidly destroys the coronavirus before it wreaks damage on their bodies, according to the research, published this week in Science Translational Medicine.

“The bottom line is, yes, children do respond differently immunologically to this virus, and it seems to be protecting the kids,” said Dr. Betsy Herold, a pediatric infectious disease expert at Albert Einstein College of Medicine who led the study.

In adults, the immune response is much more muted, she and her colleagues found.

When the body encounters an unfamiliar pathogen, it responds within hours with a flurry of immune activity, called an innate immune response. The body’s defenders are quickly recruited to the fight and begin releasing signals calling for backup.

Children more often encounter pathogens that are new to their immune systems. Their innate defense is fast and overwhelming.

Over time, as the immune system encounters pathogen after pathogen, it builds up a repertoire of known villains. By the time the body reaches adulthood, it relies on a more sophisticated and specialised system adapted to remembering and fighting specific threats.

If the innate immune system resembles emergency responders first on the scene, the adaptive system represents the skilled specialists at the hospital.

The adaptive system makes sense biologically because adults rarely encounter a virus for the first time, said Dr. Michael Mina, a pediatric immunologist at the Harvard T.H. Chan School of Epidemiology in Boston.

But the coronavirus is new to everyone, and the innate system fades as adults grow older, leaving them more vulnerable. In the time it takes for an adult body to get the specialised adaptive system up and running, the virus has had time to do harm, Dr. Herold’s research suggests.

Because children more often encounter viruses for the first time, their bodies respond with an “innate” immune reaction that may effectively fight off the coronavirus. 
Because children more often encounter viruses for the first time, their bodies respond with an “innate” immune reaction that may effectively fight off the coronavirus. Credit…Spencer Platt/Getty Images

She and her colleagues compared immune responses in 60 adults and 65 children and young adults under the age of 24, all of whom were hospitalized at the Montefiore Medical Center in New York City from March 13 to May 17.

The patients included 20 children with multisystem inflammatory syndrome, the severe and sometimes deadly immune overreaction linked to the coronavirus.

Over all, the children were only mildly affected by the virus, compared with adults, mostly reporting gastrointestinal symptoms like diarrhea and a loss of taste or smell. Only five children needed mechanical ventilation, compared with 22 of the adults; two children died, compared with 17 adults.

Children had much higher blood levels of two particular immune molecules, interleukin 17A and interferon gamma, the researchers found. The molecules were most abundant in the youngest patients and decreased progressively with age.

“We think that is protecting these younger children, particularly from severe respiratory disease, because that’s really the major difference between the adults and the kids,” Dr. Herold said.

In some adult Covid-19 patients, she added, the lack of a strong early response also may be setting off an intense and unregulated adaptive reaction that may lead to acute respiratory distress syndrome and death.

All viruses have tricks to evade the innate immune system, and the coronavirus is particularly adept. Produced early in the course of infection, interleukin 17A may help children thwart the virus’s attempts to evade the innate response and to ward off the later adaptive response.

“We think that also protects them from sort of making the more vigorous adaptive immune response that’s associated with that hyper-inflammation,” Dr. Herold said.

Other experts said the study was well done but suffered — as most studies of the coronavirus do — from enrolling patients too late in the infection.

The innate immune response is set off hours after exposure to a pathogen, but people generally don’t come to the hospital until about a week after infection with the coronavirus, when symptoms are severe, said Akiko Iwasaki, an immunologist at Yale University.

That’s too late to study how the innate immune system responds to the virus, she said, adding, “By the time people are sick, it’s way past that time point.”

Still, the new data negate a couple of popular theories about why children are protected from the virus, she said.

Some scientists have suspected that children may fare better because they tend to have had more recent exposure to coronaviruses that cause common colds, which might offer them some protection.

But the new study found no significant differences in the immune responses to those viruses between the groups, Dr. Iwasaki noted.

Another theory held that children generate a stronger antibody response that clears the virus more efficiently than in adults. But the new study found that the sickest older people actually produced the most powerful antibodies.

That result may confirm a nagging worry among researchers: that the presence of those potent antibodies contributes to the illness in adults, instead of helping them fight the virus — a phenomenon called antibody-dependent enhancement. Vaccine manufacturers are carefully monitoring trial subjects for signs of this problem.

“That’s a theme that everybody’s been dancing around,” said Dr. Jane C. Burns, a pediatric infectious disease expert at University of California, San Diego. “Is it possible that high titers of some antibodies actually are bad for you, as opposed to good for you?”

Researchers also must learn what happens in children after the initial immune surge, Dr. Burns said. Children produce a strong immune response, but their bodies must turn it off quickly after the danger has passed.

If this virus becomes endemic, like the coronaviruses causing common colds, children eventually will develop adaptive defenses so strong that they will not experience the problems that adults are having now, Dr. Mina said.

“We will eventually age out of this virus.”

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Article from https://www.nytimes.com/2020/09/25/health/coronavirus-children-immune.html

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COVID 19 Covid 19/Health

Face Masks: 20 Key Facts About Wearing Them Safely

The percentage of people in Ireland wearing face masks in public is quite low – far lower than the 83.4 per cent uptake reported in Italy. This is despite face masks now being mandatory on public transport in Ireland. 

A mask, says Martin McKee – who qualified in medicine in Belfast and is a professor of European public health at the London School of Hygiene and Tropical Medicine – is a “means of reducing the propensity of someone who has got Covid-19 to spread it to others. We’re not talking about protecting yourself by wearing one, but about reducing the risk to other people.”

Wearing a mask is just one measure, along with handwashing and social distancing, to try to contain Covid-19, and seems particularly useful for stopping people who have unwittingly contracted the virus, but who are not showing symptoms, from spreading (if you do have symptoms, you should be self-isolating, not going out wearing a mask).

“What you’re doing,” Prof McKee says, “is catching all the little droplets that are coming out of your mouth before they can get into the atmosphere, when they can dry out and become very small and float around as an aerosol. There is still stuff that is going to get out, but you are reducing that risk.”

With so many of us still coming to terms with this “new normal”, we asked McKee and other experts to answer some common questions.

1. Where should you wear a mask?

Wearing them indoors, including taxis, will help reduce the transmission of the virus.

“Indoors,” says McKee. “The risk of transmitting the virus outside is low. The risk is indoors, in crowded situations, where the air is not being filtered out, and particularly where people are speaking loudly, shouting or singing.” People should wear them at the supermarket and while out shopping, says Maitreyi Shivkumar, a virologist and lecturer in molecular biology at De Montfort University, and anywhere you’re “likely to come into closer contact with people you can’t really get away from”. Do you need to wear one while exercising outdoors? McKee says not, but Shivkumar says possibly. “Outdoors, if you’re staying away from people, it’s fine, but in large crowds you should wear one.”

2. Which type of mask should you choose?

The one that may provide maximum protection for the wearer, says Shivkumar, is a FFP3 respirator (a disposable, shaped mask with a valve that filters air) “but we know that the production of them is more difficult and healthcare workers are not getting access to them, so it is important to reserve those for frontline workers who come into contact with Covid-19 patients”. And anyway, masks with valves – found on dust masks and antipollution cycling masks, for instance – are not thought to be effective at stopping the spread of Covid-19. A study by researchers at the University of Edinburgh into different mask types found that the valves improved breathability for the wearer, but would not stop infectious matter being breathed out. “For the public, cloth masks are fine,” says Shivkumar. “There’s not a lot of data on the efficacy of cloth masks but they’re better than nothing.”

3. How many times can you wear a disposable mask?

Jeremy Howard, a data scientist and cofounder of the campaigning organisation Masks4All, says you should really only wear one once. “They’re not designed to be worn more than once or cleaned,” he says. “They’re not a great choice to use at all. Disposable masks are generally surgical masks: they’re designed to protect from all the stuff that might be coming out of the surgeon’s face during surgery. They have to do so many things that they’re not perfect at any of them. A cloth mask, on the other hand, can have a better fit and more absorbent materials, and can be reused as many times as you like. It really is a better approach.”

4. Do expiry dates matter?

Some disposable masks come with an expiry date. If you’re planning to wear one for everyday use, is this something to worry about? “Do you want the official answer?” says McKee with a laugh. “I’d have to say yes.” But in reality, he goes on to say, as long as you’re using the mask to nip to the chemists or on the bus, rather than caring for Covid-19 patients in hospital, “the risk of using ones past their expiry date, providing they actually look physically all right, is probably fine for this sort of circumstance”.

5) Are homemade masks effective?

You can buy lots of ready-made cloth masks now, but there are also tutorials online showing you how to make your own. “Nearly any kind of face-covering is effective at blocking droplets coming out of your mouth,” says Howard. “Shortly after they come out of your mouth, they evaporate and become much harder to block, which means it is more difficult for masks to block droplets coming into your mouth.” There isn’t good evidence that wearing a mask will prevent you from getting (as opposed to spreading) Covid-19.

6. What material should you choose?

Any kind of tightly woven fabric is a good choice, says Shivkumar. “The more tightly woven, the better.” Howard recommends using cotton of 600-thread-count (if you can find this out – it’s the number of threads an inch). “Things such as high-quality bedsheets, for example. Generally, a better-quality cotton is going to have a higher thread count.” The World Trade Organisation (WHO) advises a combination of fabrics, with an inner layer of absorbent fabric (to contain the droplets) and a more waterproof outer layer, such as polyester.

7. Is a scarf just as good?

No, although, says Howard, “it’s better than nothing”. The fabric may be too thin or, if it’s a chunkier scarf, it can be difficult to get several comfortable layers out of it. “There was some data suggesting that bandanas and scarves are not very good because the fabric has a lot of holes in it,” says Shivkumar.

8. How many layers should your mask have?

The WHO advises a minimum of three, although four layers can be up to seven times more effective than a single bit of fabric. The problem, says Howard, is “you don’t want to go overboard because it reduces breathability”. He suggests two layers of cloth with a filter inserted between them; this should be of a different material, such as a piece of paper towel or silk (Shivkumar has heard of people using coffee filters). “I use a piece of paper towel – I’ve got a little pocket for it in my mask,” says Howard. “When I come home after going out, I dispose of that, and put in a new one.”

9. How should it fit?

According to the University of Edinburgh study, masks need to have a tight fit to be really effective, though this needs to be balanced with wearability (a looser mask is better than no mask). It needs to be fairly snug to block droplets coming out of your mouth, and even though it has not been proven that a cloth mask (rather than personal protective equipment) protects the wearer from Covid-19, this may change. There is “some evidence that masks might directly benefit the wearer”, according to Paul Edelstein, emeritus professor of pathology and laboratory medicine at the University of Pennsylvania and one of the authors of a new report for the Royal Society.

There are three places to check for fit, says Howard. The first is around your nose. “It’s a good idea to use something with a mouldable nosepiece. If your mask doesn’t have one, you can get a paperclip, a pipe cleaner or even just a piece of aluminium foil that you can roll up, attach to the top of your mask and mould to your face.” It should be snug around your chin, and fit well over your cheeks. “This is where cloth masks can be quite a lot better than surgical masks,” says Howard. “You can get or make a cloth mask that goes further, closer to your ears, and then tie it up around the back of your head. Surgical masks tend not to be as wide.”

10. How clean do your hands need to be before touching your mask?

“Before you put the mask on, wash your hands,” says Shivkumar. “Only touch the straps; try to avoid touching the mask area.” Howard is a bit more relaxed: “Surface transmission through cloth is pretty much unheard of for Covid-19. Officially, the medical advice is to take it off from the straps rather than the front, and you may as well do that because it’s easier.”

11. How do you prevent your glasses from steaming up?

One tip, says Howard, is to submerge your glasses in soapy water and then let them dry by themselves, creating a thin antifog layer on the lenses. “Otherwise, you can play around with where your glasses sit – you can wear them a bit lower over your nose. If you use a mouldable nosepiece, you can make a tighter fit [at the top of the mask] so that less air comes out.”

12. Do you have to be careful how you store or carry a mask?

Even if the chance of picking up an infection from your mask is low, you’ll want to keep it as clean as possible – wearing a dirty face-covering isn’t going to be particularly pleasant. “Put it in maybe a Ziploc bag that keeps it away from everything else – that’s what I tend to do,” says Shivkumar. “It’s going to be fine if you put it in your bag and it’s wrapped in a scarf or something.”

13. Should you change your mask during the day?

Howard thinks that, for most of us, one mask a day should be sufficient. “If you’re doing extremely hot work and getting super-sweaty, you should probably change it if it gets very wet,” he says. It also depends on the material – a thin mask, or scarf, will become damp quickly. “Once it becomes damp, it’s not going to be as effective,” says Shivkumar. “But I’m hoping people are going to continue to be sensible and not spend hours together in a situation where they would have to wear masks.” McKee questions whether a damp mask is going to be less effective, but he adds it can cause other problems, such as skin irritation. “You wouldn’t want to be wearing a damp mask.”

14. How often should you wash it?

Treat your face mask “the same way as you treat your socks or underpants”, says Howard – as long as you’re the sort of person who only gets one wear out of their pants before washing. “It’s good to have a spare mask so you can have one being washed and wear the other one the next day.”

15. How should you wash it?

In your usual laundry load, ideally at a hot temperature, but handwashing every evening should also be acceptable, says Howard (although the WHO advises boiling your face mask for one minute if it has been handwashed in room-temperature water). “Anything is fine as long as you use some kind of soap that destroys the lipid layer that protects the virus,” he says. “You don’t need to wash it separately [from your other clothes].”

16. Can your household share clean masks?

Howard says you can – as long as the masks have been washed thoroughly.

17. How can you get children to wear one?

“In our house, we present wearing a mask as something that’s fun and exciting,” says Howard. “We let our daughter pick out which colour she wants.” Explain to your child why masks are a good idea. “We talked about how coronavirus is a disease that can make people sick, and we could even make her grandmother sick if we weren’t wearing a mask.” Make sure you have a mask that is child-sized and as comfortable as possible, “and particularly think about breathability”.

18. Should you wear a mask in a restaurant?

If you are sitting indoors, should you wear a mask to order from the waiter and then take it off to eat? “I can’t see how this would work,” says Shivkumar. “The thing to remember with masks is: it’s not everything – it is important along with washing your hands, not touching your face and social distancing. It’s part of the bigger picture.”

19. What about visiting someone’s home?

“If it’s a well-aired house, it’s maybe not necessary, but I would say generally if you’re indoors, stay 2m away and wear a mask, and that will reduce the risk,” says Shivkumar. “It’s about recognising the risks and working towards reducing them.” It depends on the situation, says McKee. “This is a continuum – trying to reduce it to a yes or no is problematic. If you’re going to be close to them, if you’re going to be there for a long period of time and it’s a very confined space, then you’re moving towards a point where you may think about wearing a mask. If you’re not going to be close to them, or if it’s a large room, then you’re towards the end of not needing to wear one.”

20. Who shouldn’t wear one?

As well as very young children, there are exemptions for some people with health conditions or disabilities and people who assist them. For example, if you are travelling with someone who relies on lip-reading, you are not required to wear a mask. “We need to think about people who lip-read,” says McKee. “There are transparent masks that may help, but we have to recognise it is going to be a problem. And it may be an issue for people with learning disabilities.”

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Article from https://www.irishtimes.com/life-and-style/health-family/face-masks-20-key-facts-about-wearing-them-safely-1.4303307

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PUT ME ON THE FRONTLINE: HOMEBIRTH MIDWIVES DURING LOCKDOWN

Niamh Bates is self-employed Community Midwife who works with the HSE Homebirth Service. With many expectant mothers fearful of using hospitals during the Covid-19 pandemic crisis, Niamh and her colleagues saw an increase in requests for their services. She spoke to Máirtín Breathnach earlier on the challenges her and all the other homebirth midwives faced helping women with their pregnancies throughout the crisis and ensuing lockdown.

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RNLI’s ‘Launch a Memory’ campaign to see west of Ireland lifeboat remember 10,000 loved ones

A new all-weather RNLI lifeboat, which will be permanently based at Clifden in Connemara, will proudly carry the names of up to 10,000 people, placed on it by their loved ones. The Shannon class all-weather lifeboat, which will be built in the RNLI’s All-Weather Lifeboat centre, is the second such lifeboat to be part of the charity’s ‘Launch a Memory’ fundraising campaign and the first to be based in Ireland.

Through the ‘Launch a Memory’ campaign, members of the public and supporters of the charity will be able to commemorate a loved one by making a donation online and submitting that person’s name. The name of each person being remembered will be featured within the lifeboat’s letters (RNLI) and numbers, or decal, displayed on the vessel’s hull in lettering 3-4mm in height. The first Launch a Memory lifeboat is due to go on service in Invergordon, Scotland.

Lee and Jimmy_ in lifeboat station in gear

The honour of the first name on the new lifeboat will go to a young lifeboat volunteer, Lee Early (26), from Donegal, who tragically lost his life last year when he was involved in an accident on Arranmore Island. Lee was the Deputy Coxswain at Arranmore RNLI and a Skipper of the local ferry, who loved the sea and the charity that saved lives at sea. In a tribute to him, that charity will put his name as the first one on the new lifeboat, contained in the letters RNLI, alongside others whose loved ones want to commemorate them.

Lee’s father Jimmy Early, Arranmore RNLI lifeboat Coxswain said, ‘I am so proud that my son’s name will be on the Clifden lifeboat that will be stationed off the west coast of Ireland. We live on an island off a larger island and so the sea is in our blood. I am very proud to be a lifeboat Coxswain, and I was so proud of Lee when he followed in my footsteps. He is with us always. Every time we launch the lifeboat, we think of him, and this is a very meaningful way to commemorate him.’

‘I know his name will be joined by thousands of others whose loved ones want them remembered in such a special way. That lifeboat will launch many times in its lifetime and bring many people to safety. I couldn’t think of a better way for someone to be remembered.’

Daniel Curran, RNLI Engagement Lead, said: ‘We are so pleased to be able to bring ‘Launch A Memory’ to Ireland, with a lifeboat that will save lives off our coast for generations. Everyone who supports the campaign will receive email updates about the lifeboat, keeping them informed of all major developments on its journey to going on service and saving lives at sea in Clifden.’

‘RNLI lifeboat crews are busier than ever. The ‘Launch a Memory’ campaign, while a fundraiser for the charity, is also a way for us to say thank you to those people who support the lifeboat service and our volunteer lifeboat crew.’

Donate Today

There are three ways people can get the name of a loved one on the Launch a Memory lifeboat. Donations can be made online at rnli.org/launchamemory by phone on 01-895 1800 (Monday to Friday 8am to 6pm) or alternatively by post to RNLI, Airside, Swords, County Dublin K67 WA24. There is a suggested donation of €30 with space to commemorate up to 10,000 names on the lifeboat.

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More details about the Shannon class lifeboat can be found here: https://rnli.org/what-we-do/lifeboats-and-stations/our-lifeboat-fleet/shannon-class-lifeboat

From Niamh Stephenson

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COVID 19 EMS News Features General News

National roll out of Virtual Platform for Health Appointments

Attend Anywhere is a safe, simple video conferencing tool, initially used in Scotland and now elsewhere that enables health professionals to continue to see patients, albeit virtually for a video call consultation during the current COVID 19 epidemic. This allows people to see their clinician or health care professional in a safe and timely manner.

mPower, an EU INTERREG VA Programme funded project within the HSE has been at the forefront of supporting the HSE national roll-out of Attend Anywhere. mPower uses digital interventions to enable elderly people in remote areas to live safely and independently in their own homes by introducing them to various health and wellbeing technologies. The mPower project works across the Finn Valley in Donegal, Sligo, Leitrim and Louth and South Monaghan.  The EU’s INTERREG VA Programme is managed on a cross-border basis by the Special EU Programmes Body (SEUPB).

The mPower teams based in both Community Healthcare Organisation Area 1 and of Midlands Louth Meath Community Healthcare 8 are now working as core members of the National Virtual Health Team and are providing the training on how to use the platform nationally. In the last month alone, the team have trained over 2900 clinicians and health care professionals and continue the twice-daily virtual training sessions. In addition, the team provide the support necessary to adopt Attend Anywhere at a local level, specifically within the mPower project catchment areas.

The mPower team were well versed in the use of Attend Anywhere through pioneering trials over the last several months in pockets of the service. Last November (2019) mPower set up the first trial to use the platform for a Pain Clinic in Sligo / Leitrim as well as for a ground-breaking virtual pulmonary rehabilitation exercise programme in Drogheda. In February this year, a trial of virtual physio consultations commenced in Cavan Monaghan. In March before the Covid-19 crisis, the team also set up the Physiotherapy Team at St Joseph’s Community Hospital, Donegal.

To date, CHO Area 1 (Donegal, Sligo, Leitrim, Monaghan & Cavan) now have 47 virtual waiting rooms and 155 registered professionals registered to use the Attend Anywhere platform as part of their service provision.

Julie Bellew, Deputy IT Delivery Director for the HSE said:

“This rapid growth from only 2 active waiting rooms in April 2020 shows the dedication and professionalism at play here. A key enabler for us has been the openness and support from the Scottish Technology Enabled Care (TEC) team who have supported us throughout this process whenever we have needed it. I am so very proud of the work the mPower team are doing. Their flexibility and adaptability mean that this work will have a tremendous impact across the country at this time. This is enabled by the creativity and innovation so evident from this collective partnership approach.’’

The different teams who are now set up range from the Community Physios to the Child and Adult Mental Health Services, and from Audiology service using the platform for virtual hearing aid fittings to Dietetics clinics.

The platform has been so well received that the more the sector hear about it, the more they want to access it as soon as possible.

Moya Ferguson, a Senior Physiotherapist from St.Joseph’s Hospital, Stranorlar said:

“Attend Anywhere has enabled us to actively engage with our clients face to face via video call. We have found it to be a great adjunct to physiotherapy. We have been able to check clients range of movement, their gait, provide home exercise programmes and progress their rehabs such as getting them off crutches and sticks.”

The service user experience has been hugely positive too. One service user from Donegal said “The video call was very good. It gave me reassurance that I was doing the exercises correctly and helped me feel more confident. I wouldn’t have been able to see the physio otherwise, because the department is closed due to Covid-19 restrictions.” Another said, “It was helpful that the physio could see me doing my exercises, I found it very good.” 

And a service user’s daughter commented: “Very beneficial, as the physio could see my mother in her home and was able to identify some of the issues she would have such as a step between two rooms, a chair causing an obstruction and mats on the floor that might be a trip hazard.”

Wendy Rutherford, Implementation Lead for the Finn Valley area CHO 1 said 

“It has been a very exciting, challenging and rewarding experience supporting the HSE National rollout of Attend Anywhere. The gains for service providers and service users are considerable as we are enabling effective communication and care provision through the medium of eHealth whilst under pandemic restrictions.”

Monica Ramsey, who works as Community Navigator alongside Wendy and has been working as part of the EU INTERREG VA-funded project, mPower, since July 2018 expanded to say:

“This has been a very busy time to be working on the mPower Project.  Due to our experience of trialling Attend Anywhere, my colleagues and I are now on the HSE National Virtual Health Team and have been supporting the HSE roll out of Attend Anywhere. The opportunity to bring knowledge gained through the mPower Project to a national team has been very rewarding”.

Elaine Aughey, also a Community Navigator with the project and focusing on the Drogheda area since August 2018 said:

“It has been strange being considered an expert in using the Attend Anywhere platform but using the experience, knowledge and learning I gained on the mPower project  has enabled me to play a productive part in the National rollout of this vital virtual health service.”

“Due to the rapid roll-out taking place within the HSE and in the CHO 1 area I feel that as a Community Navigator, the project beneficiaries in the Finn Valley area will be able to be directed to their clinics more expediently than if they were waiting on appointments as many of the services due to the COVID-19 pandemic are curtailed. Beneficiaries have the reassurance of being able to see their clinician via video link resulting in anxiety about their progress being reduced.”  

Underlining the importance of the project, Gina McIntyre CEO of the SEUPB said:

“As lockdown has demonstrated this new communication tool will be an invaluable resource in the delivery of much-needed treatments, like physiotherapy and mental health support services. It forms an integral part of what the EU INTERREG VA funded mPower project was set-up to do, which is to provide digital interventions for the elderly who live in remote, difficult to reach locations.  I am delighted to hear that the project staff have been at the forefront of training in the use of Attend Anywhere, and I have no doubt about the positive impact this will have for so many of our vulnerable people at this difficult time, and into the future.”Match-funding for the mPower project has been provided by the Scottish Government as well as the Departments of Health in Ireland and Northern Ireland.

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Article taken from https://www.hse.ie/eng/services/news/media/pressrel/national-roll-out-of-virtual-platform-for-health-appointments-%E2%80%93-training-delivered-by-mpower.html

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COVID 19 EMS News Features

RTE aired a documentary yesterday looking at the battle to save lives on St James’ Hospital frontline during Covid-19 fight

Filmed in one of Ireland’s busiest hospitals in the midst of lockdown, RTÉ Investigates: Inside Ireland’s Covid Battle goes behind the scenes at St James’s Hospital, Dublin

Brave Covid-19 patients, their worried families and the hardworking hospital staff who have saved lives share their experiences in a dramatic programme airing tonight.

Filmed in one of Ireland’s busiest hospitals in the midst of lockdown, RTÉ Investigates: Inside Ireland’s Covid Battle goes behind the scenes at St James’s Hospital, Dublin.

In the immediate aftermath of the peak of Covid-19 cases, RTÉ Investigates spent almost 30 days filming during May and June in St James’s Hospital.

The busy Dublin hospital has the biggest Intensive Care Unit (ICU) in the country.

From lives hanging in the balance to lives lost, the series takes viewers behind the scenes of Ireland’s battle with Covid-19, as told through the eyes of patients, staff and families.

It tells the stories behind the numbers, announced each night from the Department of Health.

Tonight’s programme, which is part one of two, will take viewers inside the ICU in James’, where doctors and nurses talk about the battles they have faced to keep people alive.

Student nurses describe what it’s like to be catapulted from the lecture halls to the frontline of a worldwide pandemic.

Patients will also give insights into the highs and lows of the infection, as Clinical Nurse Manager at the ICU Joan Leamy tells of how quickly a patient’s condition can change.

She says: “Sometimes they can appear to be improving but they can disimprove very quickly and very rapidly.”

Families describe the anguish of not being able to visit their loved ones in hospital and sitting at home nervously waiting on the phone to ring with the daily updates.

Patients who survived Covid-19 and returned to their families will also share their stories of hope and triumph.

Tomorrow night’s programme looks at the important role of ongoing infection control and the major impact a single case can have on a hospital system.

For many patients, leaving the ICU is only the first step in their very long recovery journeys. Patients will spend days, weeks and, in some cases, months recovering from the virus.

To ensure they were not drawing on scarce resources, RTÉ Investigates delivered supplies of PPE to St James’s Hospital to cover the protective equipment used by the team during the 30 days filming.

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Article taken from https://www.dublinlive.ie/news/health/rte-air-documentary-looking-battle-18505062

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COVID 19 Covid 19/Health EMS News Features World News

Epidemic of Contaminated Waste

An epidemic of contaminated waste is following the Coronavirus

The world is struggling to deal with the spread of another medical problem created by the coronavirus – a deluge of contaminated waste.

During the peak of the crisis, Wuhan, the city where the outbreak began, generated 240 tons a day of medical refuse — six times the normal level, according to the nation’s Environment Ministry. Manila in the Philippines produced an additional 280 tons a day of medical trash, while Jakarta generated 212 tons, the Asian Development Bank estimated.

Only a few countries have the capacity to handle the additional volumes, the bank said.

“A significant increase in medical waste generation is probably happening in different parts of the world as we encounter the peak of the crisis, as we’ve seen in emerging data from Wuhan and other cities in Asia” said Shardul Agrawala, head of the environment and economics integration division at the Organization for Economic Cooperation and Development.

The pandemic reignited demand for plastic packaging as well as boosted production of single-use items like masks, gloves and test kits in which plastic is a key component. That’s undone years of work by governments and environmentalists to try wean consumers off single-use plastics and cut the poisonous emissions of urban incinerators.

By April, 50 tons of infectious waste were piling up each day in Thailand’s medical centers, which only had the capacity to effectively incinerate 43 tons, according to the Thailand Environment Institute. In Wuhan, the imbalance was even worse, with only 49 tons of capacity per day to deal with nearly five times the level of contaminated waste during the peak of infection. With lockdowns in many cities hampering recycling efforts for normal municipal waste, authorities often had to rely on already overstretched furnaces to keep garbage from piling up.

“Incineration might be an emergency solution to deal with the rapid increase in medical waste, but it’s not necessarily the best solution,” Agrawala said in an interview. “Air quality and public health consequences are certainly aspects which we need to look at carefully.”

The result is that in many countries, medical waste such as used masks is ending up in landfills as mixed waste, or simply being discarded to end up in the sea or wash up on beaches. OceansAsia said it has discovered a growing number of masks on the Soko Islands, a small cluster off the coast of Hong Kong, during its plastic pollution research.

Public concern triggered by the pandemic has prompted many big retailers to also reverse other sustainability efforts. Target Corp. and Trader Joe’s Co., are among those who are not allowing shoppers to bring reusable bags, while Starbucks Corp. has suspended accepting customers’ reusable cups over fears of transmission.

In response to the growing fears of using reusable products due to the risk of contamination, Greenpeace USA Inc. said single-use plastic is not inherently safer than reusable items as the virus can remain infectious on both surfaces for varying times. As long as they are cleaned with widely used household disinfectants, reusables can be used safely even during the pandemic, it said.

The resurgence of disposable plastic is an urgent issue that governments need to include, as they plan a recovery from the economic effect of the virus to avoid wasting decades of progress in the global battle against plastic pollution, Agrawala said.

“The real environmental impact would be determined by how we emerge from the crisis,” he said. “If the virus is going to be part of our lives, we have to find longer term, more sustainable solutions.”

Article taken from https://www.bloomberg.com/news/articles/2020-06-22/an-epidemic-of-contaminated-waste-is-following-the-coronavirus

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Covid 19/Events CRISIS HANDBOOK EMS News EMS Services Features General News

Garda Colm Horkan RIP

The entire emergency services and wider public are in utter shock at the senseless loss of life of Garda Colm Horkan.

Emergencyservices.ie and its team here would like to take this opportunity to extend their condolences to Garda Horkan’s family and his colleagues in An Garda Síochána. Ar dheis Dé go raibh a anam.

Detective Garda Colm Horkan was from Co Mayo and had been a member of the police for 24 years. He is survived by his father, sister and four brothers.

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CRISIS HANDBOOK EMS News EMS Services Features

High Drama on the High Seas: Book on incredible RNLI Rescues

A new book providing a collection of first-hand accounts of some of the most dramatic rescues carried out by RNLI lifesavers around Ireland and the UK over the past 20 years, features an incredible feat of bravery by a Cork lifeboat crew.

Told in the words of Castletownbere RNLI Coxswain Dean Hegarty, it provides a first-hand account of the dramatic rescue of a fishing crew in storm force conditions after their vessel lost all power at the harbour entrance of Castletownbere in West Cork.

Six lives were saved that night and the Coxswain is set to receive a medal for gallantry, and the crew and launching authority, letters of thanks from the Institution. The book Surviving the Storms is now on sale with royalties from all sales supporting the lifesaving charity.

Surviving the Storms features 11 stories of extraordinary courage and compassion at sea, providing a rare insight into the life-or-death decisions the RNLI have to make when battling the forces of nature and saving lives.

The Castletownbere RNLI rescue from 2018 is included with those of a Northern Ireland lifeboat mechanic who swam into a cave to rescue two teenage boys when they became trapped with a rising tide in dangerous conditions and lifeguards in Cornwall saving the lives of people, moments away from drowning. This book has an abundance of drama told from the unique perspective of the RNLI lifesavers, as well as those they rescue.

In an extract from the book Dean Hegarty, who at 24-years old, had been on the lifeboat crew for five years and was a recently appointed Coxswain on his second callout in charge, explains what he saw when he and his lifeboat crew came on scene.

‘Within 10 minutes of the original mayday call, we were on the scene. What I saw when we arrived, I can’t lie; It almost gave me a heart attack. The way the tide was going out and the wind was coming in, it was churning the sea up and creating a big, watery explosion. There were huge swells reaching six metres, the height of a two-storey house, tossing the fishing boat around like a rag doll and pushing her ever closer to the sixty metre cliffs to the west of the harbour mouth. The gales were now peaking at storm force 11. My heart started to race as I watched waves crashing up against the cliffs, with the vessel only 30 or so metres away from the rocky shoreline.’Castletownbere RNLI Medal rescue crew.

RNLI Chief Executive, Mark Dowie, said: ‘Surviving the Storms is a wonderful account of selflessness and bravery although there is no book big enough to do justice to every RNLI rescue and rescuer. We have hundreds of lifeboat stations and thousands of crew members and lifeguards all dedicated to saving lives. Between them, they’ve helped so many people survive the storms and I’m proud of every one of them.’

Surviving the Storms purchased here

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Covid 19/Education Covid 19/Health Features General News

BANK HOLIDAY: CLEAN COAST INITIATIVE

With limited travel available to people this weekend, many of our country’s beautiful beaches will see heavy use as the fine weather continues. However, there remains a serious lack of understanding on the impact casual littering has on this environment by those who use our beaches.

A quick search of ‘beach litter ireland’ on Twitter will bring up a depressing number of images of refuse being dumped or left behind on our shores. There are some truly inspirationnal people out there however who have taken it upon themselves to clean up these beaches after all the daytrippers have left.

People such as Deric Ó hArtagáin, the TV weatherman, who cleans up the beach he swims on every day. There are many ‘Coastal Warriors‘ out there like them and they are helped by a super programme run by An Taisce called Clean Coasts initiative.

Clean Coasts programme works with communities to help protect and care for Ireland’s waterways, coastline, seas, ocean and marine life. 

Clean Coasts are creating a tangible and immediate improvement on Ireland’s coastal environment through, 

  • Organising 100s of beach clean-ups each year
  • Mobilising thousands of volunteers, removing large quantities of marine litter from our coastline.
  • Promoting and facilitating coastal clean-ups and marine litter surveys.

Clean Coasts has grown over the years and now includes two main national clean-up drives and has expanded to include:

  • Green Coast Award
  • Love Your Coast Photography competition
  • Clean Coasts Roadshows 
  • Ocean Talks
  • Corporate Volunteering
  • Ocean Hero Award

Approximately 10 million tonnes of litter end up in the world’s oceans and seas each year. The term “marine litter” or “marine debris” covers a range of materials which have been deliberately discarded, or accidentally lost on shore or at sea, and it includes materials that are carried out to sea from land, rivers, drainage and sewerage systems, or the wind (European Commission, 2013).

Plastics make up 80% of all marine litter from surface waters to deep-sea sediments (IUCN, 2018).

What we find on our beaches is not the full extent of the marine litter, including ocean plastics, load in the environment. It is estimated that 70% of marine litter is on the seabed, 15% is floating in the water column and 15% is what we find on our shores (OSPAR, 1995).

Sources of Ocean Plastics & Marine Litter

  • Litter dropped in towns and cities
  • Overflowing litter bins
  • Litter dropped at the beach
  • Poorly managed industrial waste discharges
  • Lost shipping containers
  • Lost/discharged fishing gear
  • Recreational litter blown by the wind
  • Poorly managed landfill sites
  • Microbeads from personal care products
  • Sewage related litter

Clean Coasts also operate several campaigns in Ireland including Think Before You Flush and international campaigns #2minutebeachclean and Beat the Microbead.

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Covid 19/Education CRISIS HANDBOOK Defence & Security EMS News Features Podcasts

Defence Forces: The Army Cadetship Podcast

The Irish Defence Forces Podcast aims to provide interesting content on all aspects of the Irish military. It is a production of the Defence Forces Public Relations Branch.

In this episode features Captain Grainne Kenneally, an Officer Instructor in the Cadet School, the Military College, Curragh Camp. We discuss the process of training an Army Officer, from tactical training, to academics, to leadership. Grainne is currently the 2ic of the 96th Cadet Class, who are currently training to become officers in the Cadet School. This episode is part of our series on the cadetships offered by the 3 services of the Irish Defence Forces, the Army, the Naval Service and the Air Corps, and coincides with the 2020 Cadetship Competition which closes on 31st May 2020.

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CRISIS HANDBOOK EMS News Features World News

How major cities are trying to keep people walking and cycling after the lockdown

  • Governing bodies are looking at ways to reduce traffic and pollution when the world eventually returns to work.
  • Countries including Italy and Colombia have increased cycle lanes and banned some roads of motorised traffic in a bid to support active travel.

COVID-19 has radically changed our travel habits in just a matter of weeks. Walking and cycling are up, as people enjoy their daily exercise or take essential journeys they might otherwise have made by public transport. Cycle-to-work schemes have seen a 200% increase in the number of bicycle orders, while car use is roughly 40% of what it was in mid-February as more people work from home. Air pollution in cities has duly fallen rapidly, with nitrogen oxide pollution down 70% in Manchester, England.

Transport is the UK’s most polluting sector, so encouraging more people to keep walking and cycling after the pandemic would benefit the environment, as well as make cities healthier for the people who live in them.

The UK government is preparing to keep social distancing intact once public transport networks resume full service by reducing the number of passengers by 90% and staggering work times. But the International Transport Forum predicts there’ll be a sudden rise in car use after the lockdown is eased, with many people opting to avoid potential exposure to the virus on buses and underground trains. So how can we ensure the positive developments in active travel become permanent features of city life?

Social distancing rules mean only one in ten passengers can board public transport.
The UK government plans to reduce the numbers of passengers on the tube by 90% by staggering work times.Image: EPA-EFE/Facundo Arrizabalaga

How cities are adapting

As people change how they work, study and enjoy free time during the pandemic, city authorities are changing how transport can be accessed. Public transport provision in London has dropped due to record low demand, and the London mayor’s office is developing a plan to enable more people to walk and cycle for essential journeys, by extending footways, restricting driving on shopping streets and adding extra cycle lanes. A £5 million fund has been proposed by the Greater Manchester Combined Authority to carry out the same work here.

Similar schemes are being implemented elsewhere. Paris has created 650km of new cycle ways, including “pop up” options which have widened cycle routes, reducing the space given to cars. In Milan 22 miles of roads, formally used by cars, have been turned into walking and cycling routes. In the Colombian capital, Bogota, officials have made 75 miles of streets free of motorised transport.

Runners, cyclists and walkers share the path between Corsico and Milan.
Cities are freeing up streets of motorised traffic for cyclists and walkers.Image: EPA-EFE/Sergio Pontorieri

These temporary changes could reduce the overall demand for motorised travel well into the future. With cleaner air and stronger social bonds, fewer than one in ten people want life to return to “normal” after the pandemic. Lowering the number of diesel and petrol vehicles, allowing people more space to walk, run and cycle through city streets and designating more green space for residents to enjoy could make urban areas permanently happier.

Barriers to change

To head off this danger of a return to heavier car use, the UK government recently pledged a £250 million emergency fund to create pop-up cycle lanes, widen pavements and create walking and cycling only streets across England. In the long term, Transport Secretary Grant Shapps promised a £2 billion national cycling plan, which includes legal changes to protect road users and at least one “zero emissions city”, where the centre would be for bikes and electric vehicles only.

Cyclists use city centre bike lanes in Bogota, Colombia.
More cyclists are beginning to use cycle lanes in Bogota, Colombia.Image: EPA-EFE/Mauricio Dueñas Castañeda

Research suggests that 58% of car journeys in the UK are shorter than 5km, so walking or cycling could be the main alternative for many city dwellers. That’s how people in Denmark got around while still maintaining social distancing. More Danes are cycling than ever, but a cycling culture had already existed in the country for a long time.

Cultural changes can take a long time to take root. A lasting transformation of city streets will need careful planning and buy-in from the public. The enjoyment that many have taken from quieter streets during their daily exercise could produce a cultural shift towards more active travel and less car use in the UK. But in coming weeks and months, clear guidance from the government on using transport safely and efforts to build the infrastructure for walkers, runners and cyclists will be critical to making it stick. Reshaping cities to allow people more space to walk and cycle will help lay the ground for permanent change.

This article first appeared on the World Economic Forum

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Covid 19/Business Covid 19/Health EMS News Features

PPE: What now for the global supply chain?

Covid-19 has turned the spotlight on healthcare supply chains, challenging 30 years of ever growing globalisation, writes Jane Feinmann

As 2020 dawned, the idea that a healthcare procurement team should maintain national supplies of personal protective equipment (PPE) at minimal cost to healthcare budgets was entirely uncontroversial.

“It involves opening a bid and giving the work to the lowest bidder, almost invariably a Chinese company because of cost,” says Willy Shih, the Robert & Jane Cizik professor of management practice at Harvard Business School. This race to the bottom in production costs means that companies have minimal incentives to maintain production in high cost locations or to worry about geographical diversity in production.1

The rapid growth of container shipping in the 1990s reduced transport costs dramatically, while China was creating a robust trade infrastructure. As a result, high income countries achieved ever greater efficiency and lower costs in producing consumer goods, through outsourcing. Shih tells The British Medical Journal, “When Nike moved its production to China, the German company Adidas had no choice but to follow suit—and the same pattern has occurred throughout manufacturing.”

PPE was no different, with most of the world’s stock made at low cost in China. Yet this apparently seamless global interdependence unravelled in just a few weeks after the covid-19 pandemic took off in Hubei province, at the centre of Chinese manufacturing.

Panic and piracy

As Chinese doctors and scientists struggled to make sense of the new virus, China became the first country to recognise that unprecedented quantities of PPE would be needed, not least to keep healthcare professionals safe. Western charities donated small quantities of protective gear to China in early spring 2020, but the obvious solution was right on its doorstep. The Chinese government soon made itself the sole customer of the major PPE making factories in its territory, while simultaneously buying up much of the rest of the world’s supply. On 30 January, the last day with available data, China managed to import 20 million respirators and surgical masks in just 24 hours, the New York Times reported.

It took the rest of the world a while to understand the downside of relying on somewhere else for lifesaving protective equipment—and the huge quantities that would be needed during a pandemic. In February the European Centre for Disease Prevention and Control, an EU agency based in Stockholm, estimated that a health service would need 14-24 separate sets of PPE every day for each confirmed coronavirus case, depending on whether symptoms were mild or severe. In March, World Health Organization modelling warned that 89 million medical masks, 76 million examination gloves, and 1.6 million pairs of goggles would be required worldwide for the covid-19 response each month, with a dire shortage putting healthcare workers at risk.

The ensuing scrum for PPE has made daily headlines as international solidarity has taken a tumble. An RAF plane was forced to sit on an airstrip in Turkey for two days in April, waiting to pick up a shipment of 400 000 protective gowns for NHS staff. Reports emerged of US purchasers brandishing cash on the runway of a Shanghai airport, buying up a cargo of masks and other PPE that was already on a plane bound for France, while in Bangkok 200,000 medical face masks ordered by Berlin were allegedly confiscated by US officials. The German interior minister has accused the US of “modern piracy”; meanwhile, France and Germany both blocked the export of masks and gloves to Italy and Spain.

Stockpiles

In the pre-covid world, stockpiling was regarded as a poor business model in both the US and the UK, with excess capacity seen as an unnecessary expense and hospitals encouraged to seek replenishment even daily. And, although countries had emergency preparations, at least on paper, these have proved unequal to demands.

The US Strategic National Stockpile—originally called the National Pharmaceutical Stockpile and established in 1999—encompasses $7bn-$8bn (£5.7bn-£6.5bn; €6.4bn-€7.4bn) worth of emergency supplies, mainly lifesaving drugs, held in strategically located secret stores around the country. It did include masks, but most were distributed to states and localities during the 2009 H1N1 pandemic, and stocks were not replenished, said Andrew Lakoff, professor of global health and disaster response at the University of Southern California, in an interview with Vox.

The UK’s emergency stockpile, created in 2006, was part of its pandemic influenza preparedness programme. It comprises 52 000 pallets of equipment—gloves, aprons, respirator masks, and anti-flu drugs—worth an estimated £500m (€567m; $617m). It had no gowns or visors, however, despite a recommendation from the New and Emerging Respiratory Virus Threats Advisory Group (Nervtag) to build up these stocks. A BBC investigation also claimed that 21 million of 33 million vitally needed FFP3 respirator masks, which were included in the original 2009 procurement list for the stockpile, had gone missing without explanation.

Moreover, management was outsourced three years ago, and the Guardian reported that Movianto, the stockpile’s current management company, was itself in the process of being sold to a large US company and subject to a legal dispute that has prevented access to the warehouse stock.9

The case against globalisation

The obvious solution to all of this is a reversal of the trend towards globalisation. Support for this comes not just from nationalist proponents of “bring manufacturing hom e” but from pragmatic health experts too. WHO’s director general, Tedros Adhanom Ghebreyesus, has called on governments to increase domestic manufacturing of PPE by 40%. Germany’s health minister, Jens Spahn, has said that public health must be the number one priority and that, with demand for PPE currently high and expected to remain so in the short and medium term, the priority for Germany must be to reduce reliance on international production.

As well as taking action to boost procurement, Germany has set up a Task Force for Production Capacity and Production Processes with the job of “building up national and European value chains for PPE and active ingredients . . . thereby making an essential contribution to the supply for the medium term.” Spahn announced on 9 April that 100 (unnamed) German companies had submitted “promising responses” to the government’s call to manufacture PPE, with contracts due to be awarded from mid-August 2020 to the end of 2021.

Yet there remains scepticism that individual states can manufacture PPE efficiently even if the will is there. For a start, says Shih, it’s not simply a matter of paying workers more by the hour, as it might be if the products were T shirts. He says, “Even something as simple as an N95 mask uses—according to the label on the box—‘globally sourced materials.’”

For instance, the Guardian revealed a global shortage of a particular plastic—a type of non-woven polypropylene known as melt-blown—that acts as a filter in masks. Previously not regarded as a strategic commodity, production of melt-blown has moved to low cost factories in Asia over the past three decades, and China produces half of all melt-blown in the world. Other crucial, low cost, raw materials include nose clips and another plastic called spun-bond polypropylene. Both are also produced in China.

It’s these materials that make up the real supply chain. Even if they could be sourced locally, “the process of scaling up production includes setting up this complex supply chain, designing an assembly process, establishing testing and quality procedures, and countless other details,” says Shih. More than two decades of reliance on globalised supply chains has left high income countries without the infrastructure and experience to manufacture and distribute PPE en masse.

Moreover, the risk with abandoning that global chain altogether, says Shih, is that more local production would lead to a more fragmented supply chain. That could lead to the bigger, more reliable suppliers disappearing because of insufficient business, leaving behind a less experienced, less stable group of suppliers that would be risky to rely on in another global emergency.

Shih draws parallels with a Bill & Melinda Gates Foundation initiative intended to simplify the manufacture of vaccines for children. Its funding enabled low income countries to build their own factories and provide affordable vaccines for their populations. But this approach could also unintentionally undermine “high standards of production and quality control procedures critical to protect the integrity of the global vaccine supply . . . while encouraging more developed countries’ manufacturers to exit the market,” says Shih.

With PPE, little can change for now. But at the very least, the pandemic, combined with recent trade wars between China and the US, has exposed the brittleness of our global supply chains and trading systems, as well as the dire state of emergency stockpiles. For the health of frontline staff, we need to build more resilience into these operations.

This article first appeared in the British Medical Journal and is reproduced here by kind permission.

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COVID 19 CRISIS HANDBOOK EMS News Podcasts

Put me on the Frontline: Ciarán Lanigan

Máirtín Breathnach interviews Ciaran Lanigan, Clinical Lead in the Croke Park testing centre.

We were delighted to catch up with Ciaran Lanigan who oversaw the testing of the potentual Covid-19 cases in the Croke Park testing centre.

Ciaran volunteered for the role immediately on hearing of it.

Ciaran would like to give a small thank you to those he worked with – the allied health professionals doing the testing with him- and the GAA and Top Security whom they worked alongside.

He’s also grateful to Meaghars Pharmacy and Intersport Elverys for the supply of goodies to the team which they were deligthted to receive.

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COVID 19 Covid 19/Research EMS News

Irish-based firm looks at blood-based alternative to a Covid-19 vaccine

Whether it’s starting from scratch to develop an entirely novel vaccine, or testing the effectiveness of an existing vaccination on Covid-19, healthcare companies across the globe have been working day and night to find an effective treatment to immunise patients against the virus.

While the vast majority of these efforts involve small-molecule drugs, Japanese pharma firm Takeda, which has base in Ireland, has opted to tackle the infection more directly using blood plasma.

The company has worked on plasma-derived therapies for more than 75 years, and for the past two months has been attempting to develop one such treatment for high-risk patients already infected with SARS-CoV-2, the virus that causes Covid-19.

Plasma-derived therapies and hyperimmune globulins
Plasma-derived therapies come from patient donations of blood plasma and can be used to treat a number of rare diseases – including bleeding disorders like haemophilia.

These therapies replace vital missing or deficient proteins associated with the disease, reducing or even curing symptoms in the process.

Hyperimmune globulins – a type of plasma-derived therapy product – are designed to give a patient passive immunity against a specific disease.

They do this by transferring the antibodies against a disease from the blood plasma of a previously infected patient to someone who is currently infected.

Hepatitis B, rabies and tetanus are among the diseases that have been successfully treated using hyperimmune globulins in the past.

How Takeda is developing a Covid-19 treatment


As one of the largest biopharmaceutical firms in the world, Takeda typically focuses on vaccine R&D, as well as its plasma-derived therapies, and works across four main therapeutic areas: Oncology, rare diseases, neuroscience, and gastroenterology.

It obtains donations of blood plasma through a global collection network called BioLife – which the company describes as a “world-class” industry leader in sourcing and storing plasma.

Takeda is now channelling its expertise in plasma-derived therapies towards developing an anti-SARS-CoV-2 hyperimmune globulin with its novel drug candidate, TAK-888.

Takeda announced this new clinical development project on 4 March, and said that convalescent plasma – blood plasma from patients who have already recovered from the virus – would be transported to manufacturing facilities to undergo proprietary processing, including effective virus inactivation and removal processes.

Because this plasma contains specific antibodies against Covid-19, it can then be purified into a hyperimmune globulin product to mitigate, or even prevent, the severity of illness in patients.

Dr Rajeev Venkayya, president of Takeda’s Vaccine Business Unit and co-lead of the company’s Covid-19 response team, said: “As a company dedicated to the health and well-being of people around the world, we will do all that we can to address the novel coronavirus threat.

“We have identified relevant assets and capabilities across the company, and are hopeful that we can expand the treatment options for patients with Covid-19 and the providers caring for them.”

Takeda’s industry collaborations


On 6 April, Takeda announced it would immediately be entering into a partnership with US biopharma firm CSL Behring to accelerate development of a Covid-19 hyperimmune globulin.

This alliance also involves several other companies in the pharmaceutical sector, UK-based plasma specialists Biotest and BPL (Bio Products Laboratory) Plasma, French biopharma firm LFB (Laboratoire Francais du Fractionnement et Des Biotechnologies), and Swiss company Octapharma.

Takeda said the collaboration would leverage “leading-edge” expertise and improve key aspects in developing a Covid-19 treatment – including plasma collections, manufacturing and clinical trials.

Julie Kim, president of Takeda’s Plasma-Derived Therapies Business Unit, noted that “unprecedented times call for bold moves” following the collaboration announcement.

“We collectively agree that by collaborating and bringing industry resources together, we could accelerate bringing a potential therapy to market as well as increase the potential supply,” she added.

CSL Behring executive vice president and R&D head Bill Mezzanotte said: “This effort aims to accelerate a reliable, scalable and sustainable option for caregivers to treat patients suffering from the impact of COVID-19.

“In addition to pooling industry resources, we will also collaborate with government and academic efforts as a single alliance whenever we can, including important activities like clinical trials. This will make it more efficient in these hectic times for these stakeholders as well.”

Takeda has invited any other companies focusing on plasma to offer support or join its alliance with CSL Behring.

Treating respiratory viruses with plasma


While hyperimmune globulins – and plasma-derived therapies generally – are more commonly used to treat rare diseases, there is also evidence they can provide an effective treatment option against respiratory viruses.

A report published online in The Journal of Infectious Diseases in 2015 concluded that convalescent plasma appears to be safe, and may reduce mortality, in patients with severe acute respiratory infections (SARIs), especially when administered early.

It also suggested that clinical trials should be the next step in investigating this type of blood-based therapy, and its effectiveness in treating MERS (Middle East respiratory syndrome).

This is particularly relevant to Takeda’s work, as Covid-19 and MERS are both respiratory infections caused by different species of coronavirus.

But while this study acknowledged that 32 different studies involving SARS (severe acute respiratory syndrome) and influenza patients had shown promising potential in hyperimmune globulins, it also noted that the majority of these studies were “low, or very low, quality”, lacked control groups, and were often at moderate or high risk of bias.

Similarly, a 2018 article published in US medical journal The Lancet stated that transferring human plasma to protect against coronaviruses had not been substantiated by controlled trials.

It also found that previous clinical studies of anti-MERS hyperimmune globulins had reported difficulties in identifying suitable plasma donors, while the risk of transmitting other pathogens to patients during treatment, and costly donor screening protocols, also present a barrier to the use of plasma-derived therapies in giving people passive immunity.

Original article appeared on Clinical Trials Arena by Jamie Bell

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Covid 19/Education EMS News Features World News

Free Emergency Medicine e-Learning Course for all medical students

The International Emergency Medicine Education Project (iEM) has been providing free emergency medicine educational resources for medical students since June 2018. Content produced by 175 contributors from 27 countries has already reached thousands of students from 197 countries around the globe.

COVID-19 has impacted many aspects of our lives and education is no exception. Because of the pandemic precautions, many medical students are missing their normal course of education.

iEM has been working rapidly to find a solution to help students and educators and have launched an e-learning platform (www.iem-course.org) designed to provide free online emergency medicine courses for medical students around the world.

Emergency Medicine Core Content Course

This course is designed according to undergraduate emergency medicine curriculum recommendations of the International Federation for Emergency Medicine and the Society for Academic Emergency Medicine (SAEM).

All students around the world are free to register and use the resources provided in this course.

The course consists of 11 main lessons covering 37 topics. Each topic has video and reading assignments to reach the expected knowledge foundation. Videos are provided by Lecturio.

Chapters were chosen from iEM Education Project 2018 eBook and SAEM CDEM Curriculum website. The iEM’s image and video archives, and other available FOAM resources were also used where appropriate.

It is a 4-week (28 days) course. Studying an average of 5 – 7 hours each week will be enough to cover video and reading assignments. After enrollment, the course content will be available for 35 days.

Other iEM project resources below: 

iem-student.org is the main hub of the iEM Education project. Students can reach 2018 eBook chaptersblog posts, video, image, audio archives through this website.

Flickr image archive is where images and short videos are provided by contributors. All photos and short videos are free to download and can be used in presentations and exams.

Youtube video archive is where clinical videos and interviews with world-renowned experts are shared.

SoundCloud audio archive is where iEM 2018 ebook chapters are recorded in audio so students can download and listen anytime and anywhere.

All iEM resources are cost and copyright free for all medical students and educators.

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Defence & Security EMS News Features General News Podcasts

The Sniper – Infantry Weapons Wing Podcast

The Irish Defence Forces Podcast speaks to Sergeant Karl Johnston of the Infantry Weapons Wing on the history, concept and uses of snipers. Karl is a sniper instructor in the Infantry Weapons Wing, Defence Forces Training Centre. He has served overseas on numerous missions, including as a sniper in Chad.

The Irish Defence Forces Podcast aims to provide interesting content on all aspects of the Irish military. It is a production of the Defence Forces Public Relations Branch.

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COVID 19 EMS News Features General News

Gardaí approach to Covid-19 policing

An Garda Síochána is putting a few challenging years of transformation behind it.

But it really is in its approach to policing the restrictions of the Covid-19 pandemic that it has come into its own.

Many of the younger members bring a great new energy the force and and the public’s perception of it also proves without doubt that it has the support of the vast majority of the public.

Emergencyservices.ie has assembled a few photos of members of an Garda Síochána in their duties throughout the pandemic.

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COVID 19 EMS News Features

Millstreet Ambulance Brave the Shave

Four Paramedics from Millstreet Ambulance Station in Cork have decided to shave their heads – in the name of charity. The charities chosen by the participants are: Marymount Hospice, Cork Penny Dinners, The Irish Guide Dogs and Our Lady’s Children’s Hospital Crumlin. All very deserving Charities.

“Millstreet Ambulance Brave the Shave” will happen on Wednesday the 6th of May.
If you would like to show your support, please visit thier Millstreet Ambulance ‘Brave the Shave’ here

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COVID 19 Covid 19/Research EMS News

What you need to know about the COVID-19 vaccine

Bill Gates in his monthly blog says humankind has never had a more urgent task than creating broad immunity for coronavirus.

One of the questions I get asked the most these days is when the world will be able to go back to the way things were in December before the coronavirus pandemic. My answer is always the same: when we have an almost perfect drug to treat COVID-19, or when almost every person on the planet has been vaccinated against coronavirus.

The former is unlikely to happen anytime soon. We’d need a miracle treatment that was at least 95 percent effective to stop the outbreak. Most of the drug candidates right now are nowhere near that powerful. They could save a lot of lives, but they aren’t enough to get us back to normal.

Which leaves us with a vaccine.

Humankind has never had a more urgent task than creating broad immunity for coronavirus. Realistically, if we’re going to return to normal, we need to develop a safe, effective vaccine. We need to make billions of doses, we need to get them out to every part of the world, and we need all of this to happen as quickly as possible.

That sounds daunting, because it is. Our foundation is the biggest funder of vaccines in the world, and this effort dwarfs anything we’ve ever worked on before. It’s going to require a global cooperative effort like the world has never seen. But I know it’ll get done. There’s simply no alternative.

Here’s what you need to know about the race to create a COVID-19 vaccine.

The world is creating this vaccine on a historically fast timeline.

Dr. Anthony Fauci has said he thinks it’ll take around 18 months to develop a coronavirus vaccine. I agree with him, though it could be as little as 9 months or as long as two years.

Although 18 months might sound like a long time, this would be the fastest scientists have created a new vaccine. Development usually takes around five years. Once you pick a disease to target, you have to create the vaccine and test it on animals. Then you begin testing for safety and efficacy in humans.

Safety and efficacy are the two most important goals for every vaccine. Safety is exactly what it sounds like: is the vaccine safe to give to people? Some minor side effects (like a mild fever or injection site pain) can be acceptable, but you don’t want to inoculate people with something that makes them sick.

Efficacy measures how well the vaccine protects you from getting sick. Although you’d ideally want a vaccine to have 100 percent efficacy, many don’t. For example, this year’s flu vaccine is around 45 percent effective.

To test for safety and efficacy, every vaccine goes through three phases of trials:

  • Phase one is the safety trial. A small group of healthy volunteers gets the vaccine candidate. You try out different dosages to create the strongest immune response at the lowest effective dose without serious side effects.
  • Once you’ve settled on a formula, you move onto phase two, which tells you how well the vaccine works in the people who are intended to get it. This time, hundreds of people get the vaccine. This cohort should include people of different ages and health statuses.
  • Then, in phase three, you give it to thousands of people. This is usually the longest phase, because it occurs in what’s called “natural disease conditions.” You introduce it to a large group of people who are likely already at the risk of infection by the target pathogen, and then wait and see if the vaccine reduces how many people get sick.

After the vaccine passes all three trial phases, you start building the factories to manufacture it, and it gets submitted to the WHO and various government agencies for approval.

This process works well for most vaccines, but the normal development timeline isn’t good enough right now. Every day we can cut from this process will make a huge difference to the world in terms of saving lives and reducing trillions of dollars in economic damage.

So, to speed up the process, vaccine developers are compressing the timeline. This graphic shows how:Global Vaccination Coverage Is at Its Highest. Read our Annual Letter –Read Bill & Melinda Gates’s full 2017 Annual LetterGlobal Vaccination Coverage Is at Its Highest

In the traditional process, the steps are sequential to address key questions and unknowns. This can help mitigate financial risk, since creating a new vaccine is expensive. Many candidates fail, which is why companies wait to invest in the next step until they know the previous step was successful.

For COVID-19, financing development is not an issue. Governments and other organizations (including our foundation and an amazing alliance called the Coalition for Epidemic Preparedness Innovations) have made it clear they will support whatever it takes to find a vaccine. So, scientists are able to save time by doing several of the development steps at once. For example, the private sector, governments, and our foundation are going to start identifying facilities to manufacture different potential vaccines. If some of those facilities end up going unused, that’s okay. It’s a small price to pay for getting ahead on production.

Fortunately, compressing the trial timeline isn’t the only way to take a process that usually takes five years and get it done in 18 months. Another way we’re going to do that is by testing lots of different approaches at the same time.

There are dozens of candidates in the pipeline.

As of April 9, there are 115 different COVID-19 vaccine candidates in the development pipeline. I think that eight to ten of those look particularly promising. (Our foundation is going to keep an eye on all the others to see if we missed any that have some positive characteristics, though.)

The most promising candidates take a variety of approaches to protecting the body against COVID-19. To understand what exactly that means, it’s helpful to remember how the human immune system works.

When a disease pathogen gets into your system, your immune system responds by producing antibodies. These antibodies attach themselves to substances called antigens on the surface of the microbe, which sends a signal to your body to attack. Your immune system keeps a record of every microbe it has ever defeated, so that it can quickly recognize and destroy invaders before they make you ill.

Vaccines circumvent this whole process by teaching your body how to defeat a pathogen without ever getting sick. The two most common types—and the ones you’re probably most familiar with—are inactivated and livevaccines. Inactivated vaccines contain pathogens that have been killed. Live vaccines, on the other hand, are made of living pathogens that have been weakened (or “attenuated”). They’re highly effective but more prone to side effects than their inactivated counterparts.

Inactivated and live vaccines are what we consider “traditional” approaches. There are a number of COVID-19 vaccine candidates of both types, and for good reason: they’re well-established. We know how to test and manufacture them.

The downside is that they’re time-consuming to make. There’s a ton of material in each dose of a vaccine. Most of that material is biological, which means you have to grow it. That takes time, unfortunately.

That’s why I’m particularly excited by two new approaches that some of the candidates are taking: RNA and DNA vaccines. If one of these new approaches pans out, we’ll likely be able to get vaccines out to the whole world much faster. (For the sake of simplicity, I’m only going to explain RNA vaccines. DNA vaccines are similar, just with a different type of genetic material and method of administration.)

Our foundation—both through our own funding and through CEPI—has been supporting the development of an RNA vaccine platform for nearly a decade. We were planning to use it to make vaccines for diseases that affect the poor like malaria, but now it’s looking like one of the most promising options for COVID. The first candidate to start human trials was an RNA vaccine created by a company called Moderna.

Here’s how an RNA vaccine works: rather than injecting a pathogen’s antigen into your body, you instead give the body the genetic code needed to produce that antigen itself. When the antigens appear on the outside of your cells, your immune system attacks them—and learns how to defeat future intruders in the process. You essentially turn your body into its own vaccine manufacturing unit.

Because RNA vaccines let your body do most of the work, they don’t require much material. That makes them much faster to manufacture. There’s a catch, though: we don’t know for sure yet if RNA is a viable platform for vaccines. Since COVID would be the first RNA vaccine out of the gate, we have to prove both that the platform itself works and that it creates immunity. It’s a bit like building your computer system and your first piece of software at the same time.

Even if an RNA vaccine continues to show promise, we still must continue pursuing the other options. We don’t know yet what the COVID-19 vaccine will look like. Until we do, we have to go full steam ahead on as many approaches as possible.

It might not be a perfect vaccine yet—and that’s okay.

The smallpox vaccine is the only vaccine that’s wiped an entire disease off the face of the earth, but it’s also pretty brutal to receive. It left a scar on the arm of anyone who got it. One out of every three people had side effects bad enough to keep them home from school or work. A small—but not insignificant—number developed more serious reactions.

The smallpox vaccine was far from perfect, but it got the job done. The COVID-19 vaccine might be similar.

If we were designing the perfect vaccine, we’d want it to be completely safe and 100 percent effective. It should be a single dose that gives you lifelong protection, and it should be easy to store and transport. I hope the COVID-19 vaccine has all of those qualities, but given the timeline we’re on, it may not.

The two priorities, as I mentioned earlier, are safety and efficacy. Since we might not have time to do multi-year studies, we will have to conduct robust phase 1 safety trials and make sure we have good real-world evidence that the vaccine is completely safe to use.

We have a bit more wiggle room with efficacy. I suspect a vaccine that is at least 70 percent effective will be enough to stop the outbreak. A 60 percent effective vaccine is useable, but we might still see some localized outbreaks. Anything under 60 percent is unlikely to create enough herd immunity to stop the virus.

The big challenge will be making sure the vaccine works well in older people. The older you are, the less effective vaccines are. Your immune system—like the rest of your body—ages and is slower to recognize and attack invaders. That’s a big issue for a COVID-19 vaccine, since older people are the most vulnerable. We need to make sure they’re protected.

The shingles vaccine—which is also targeted to older people—combats this by amping up the strength of the vaccine. It’s possible we do something similar for COVID, although it might come with more side effects. Health authorities could also ask people over a certain age to get an additional dose.

Beyond safety and efficacy, there are a couple other factors to consider:

  • How many doses will it be? A vaccine you only get once is easier and quicker to deliver. But we may need a multi-dose vaccine to get enough efficacy.
  • How long does it last? Ideally, the vaccine will give you long-lasting protection. But we might end up with one that only stops you from getting sick for a couple months (like the seasonal flu vaccine, which protects you for about six months). If that happens, the short-term vaccine might be used while we work on a more durable one.
  • How do you store it? Many common vaccines are kept at 4 degrees C. That’s around the temperature of your average refrigerator, so storage and transportation is easy. But RNA vaccines need to be stored at much colder temperature—as low as -80 degrees C—which will make reaching certain parts of the world more difficult.

My hope is that the vaccine we have 18 months from now is as close to “perfect” as possible. Even if it isn’t, we will continue working to improve it. After that happens, I suspect the COVID-19 vaccine will become part of the routine newborn immunization schedule.

Once we have a vaccine, though, we still have huge problems to solve. That’s because…

We need to manufacture and distribute at least 7 billion doses of the vaccine.

In order to stop the pandemic, we need to make the vaccine available to almost every person on the planet. We’ve never delivered something to every corner of the world before. And, as I mentioned earlier, vaccines are particularly difficult to make and store.

There’s a lot we can’t figure out about manufacturing and distributing the vaccine until we know what exactly we’re working with. For example, will we be able to use existing vaccine factories to make the COVID-19 vaccine?

What we can do now is build different kinds of vaccine factories to prepare. Each vaccine type requires a different kind of factory. We need to be ready with facilities that can make each type, so that we can start manufacturing the final vaccine (or vaccines) as soon as we can. This will cost billions of dollars. Governments need to quickly find a mechanism for making the funding for this available. Our foundation is currently working with CEPI, the WHO, and governments to figure out the financing.

Part of those discussions center on who will get the vaccine when. The reality is that not everyone will be able to get the vaccine at the same time. It’ll take months—or even years—to create 7 billion doses (or possibly 14 billion, if it’s a multi-dose vaccine), and we should start distributing them as soon as the first batch is ready to go.

Most people agree that health workers should get the vaccine first. But who gets it next? Older people? Teachers? Workers in essential jobs?

I think that low-income countries should be some of the first to receive it, because people will be at a much higher risk of dying in those places. COVID-19 will spread much quicker in poor countries because measures like physical distancing are harder to enact. More people have poor underlying health that makes them more vulnerable to complications, and weak health systems will make it harder for them to receive the care they need. Getting the vaccine out in low-income countries could save millions of lives. The good news is we already have an organization with expertise about how to do this in Gavi, the Vaccine Alliance.

With most vaccines, manufacturers sign a deal with the country where their factories are located, so that country gets first crack at the vaccines. It’s unclear if that’s what will happen here. I hope we find a way to get it out on an equitable basis to the whole world. The WHO and national health authorities will need to develop a distribution plan once we have a better understanding of what we’re working with.

Eventually, though, we’re going to scale this thing up so that the vaccine is available to everyone. And then, we’ll be able to get back to normal—and to hopefully make decisions that prevent us from being in this situation ever again.

It might be a bit hard to see right now, but there is a light at the end of the tunnel. We’re doing the right things to get a vaccine as quickly as possible. In the meantime, I urge you to continue following the guidelines set by your local authorities. Our ability to get through this outbreak will depend on everyone doing their part to keep each other safe.

Article first appeared on Gates Notes, Bill Gates personal blog. Bill Gates is founder of Microsoft and throught the Bill and Melinda Gates Foundation has funded research into curing malaria and many other diseases worldwide.

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5 Lessons From A Firefighter Life

Frédéric Jacquet is a retired volunteer firefighter based in France who has written about the shared lessons in both digital transformaton and firefighting.

A couple of years ago, on top of my work in the information technologies sector, I’ve been serving for 10 years as Volunteer Firefighter.

During the day I was working within American firms making softwares to help companies on their journey to Digital Transformation as Information Management subject matter expert (for the record, I’m still doing this job). Two nights a week, plus at least 24 hours during the week-end, I was living into a fire station to fulfill firemen’s and rescue missions.

In this context, the firefighter duty day is a microcosm of life as a whole. Based on my experience, I would like to share with you some lessons I’ve learned not only from my fellow firemen but also, more often than I could have imagined, from the victims I came to rescue.

Five key lessons.

Being a firefighter is not only a job, it’s also a second life condition. The scope of interventions and areas where firefighters are involved in France is wide: First-aid and emergency assistance to people, traffic accidents, fire, industrial risks and pollution, forest fires, contingency plans, natural disasters, … If you are asking, the answer is ‘yes’. We also rescue stuck cats out of trees and gutters.

Among all of the life teaching I got from all my experiences, there are 5 lessons which resonate particularly well, especially in my professional life.

A firefighter needs -I mean really needs- to be ready. You never know when your beeper is going to urge you to jump in a truck for a rescue mission. Whatever you are busy at -doing sport, eating, resting, swimming in a pool or maintaining the equipment- you have very few minutes to pack what you need and go.

In civil society no matter where you work or what is your field of expertise, you want yourself to be ready too. This implies that you have to learn and train your skills. Every day adds its experience and offers an opportunity to round out knowledge, to improve yourself.

It often appears that between uncertainty and expertise or know-how, there is a space that tends to gradually expand as you learn, where stands the experience. This is the reason why you can never stop.

But once we have said that, being ready is mostly a mindset. You cannot take your position for granted, but rather constantly challenge yourself.

“Once you stop learning, you start dying.” — Albert Einstein

You may know that firefighters are working as a team. Therein perhaps lies the very foundations of their effectiveness. You’ve all seen in a movie or in real life, fire trucks arriving on accident scene, and these guys get out of their truck acting as a coordinate group. There, is the team power. (Small hint: when they are getting off, if they are moving in slow motion and you hear action music, it is a movie).

In the life of an enterprise, once you are ready, you can face your mission to meet your goals. As an IT expert for instance, whatever are your strengths, your skills or your experience, you can -you must- amplify them by playing a team game.

The team not only empowers you, but you can also bring value to the team in turn.

And the beauty in all this, is that it creates a virtuous circle that increases the intrinsic value of each individual, enhances the global effectiveness of the group, strengthens professional and personal relationships between all the team members, reinforces the image that it projects outward, increases the chances of success… and the list goes on.

“Talent wins games, but teamwork and intelligence wins championships.” — Michael Jordan

Do not get me wrong — Firefighters do not deal with a customer neither with a client but with victims.

My point here, is to explain that preparing yourself and working with a team is not an abstraction. That’s clearly not about seeking an ideal of life but on the contrary, gearing up for action. An action that is addressed to people, whether you want to save their life or help them to operate digital transformation.

In our job, it should be kept in mind that the purpose for us, to prepare, learn, organize, take actions independently or in a team, is to benefit customers and their interests.

This must lead our strategy and motivate us.

“You‘ve got to start with the customer experience and work backwards to the technology.” — Steve Jobs

Being a fireman is exciting, exhilarating, inspiring, gratifying but at the same time, the firefighter life is stressful, demanding, exhausting. Sometimes you have to cope with terrible events, you can find your pair and yourself in a situation where your lives at risk…

Cohesion is always useful for teamwork. You need a glue that put you, your team and your mission together -besides dedication and workmanship. A good way to achieve this cohesion might be having fun. It helps you to relax, to tend to play down the importance of a critical situation, to stand back from your fears or your uncertainties, to take a step back from ourselves, recover from the crisis.

“People rarely succeed unless they have fun in what they are doing.” — Dale Carnegie

At this point, you understand and hopefully share the essence that have emerged from the 4 previous points.

You do your best to be ready, you empower the strengths of the team including yourself for one ultimate purpose: serving your Client. Keeping goals on track and, as you need to be in a realistic-positive frame of mind, you try, when possible and appropriate, to have fun

Then, what next?

Set aside theory, forget good advice and just get sh#!t done. At one time or another, no matter what, it is the results that count.

“A man’s got to do what a man’s got to do.” — John Wayne

This article first appeared on Medium

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COVID 19/World News World News

Coronavirus Patients Are Reporting Neurological Symptoms

As case numbers of COVID-19 continue to rise around the world, those afflicted are reporting neurological symptoms. Some studies report that over a third of patients show neurological symptoms.

In the vast majority of cases, COVID-19 is a respiratory infection that causes fever, aches, tiredness, sore throat, cough and, in more severe cases, shortness of breath and respiratory distress.

Yet we now understand that COVID-19 can also infect cells outside of the respiratory tract and cause a wide range of symptoms from gastrointestinal disease (diarrhoea and nausea) to heart damage and blood clotting disorders. It appears that we have to add neurological symptoms to this list, too.

Several recent studies have identified the presence of neurological symptoms in COVID-19 cases. Some of these studies are case reports where symptoms are observed in individuals.

Several reports have described COVID-19 patients suffering from Guillain–Barré syndrome. Guillain–Barré syndrome is a neurological disorder where the immune system responds to an infection and ends up mistakenly attacking nerve cells, resulting in muscle weakness and eventually paralysis.

Other cases studies have described severe COVID-19 encephalitis (brain inflammation and swelling) and stroke in healthy young people with otherwise mild COVID-19 symptoms.

Larger studies from China and France have also investigated the prevalence of neurological disorders in COVID-19 patients. These studies have shown that 36 percent of patients have neurological symptoms.

Many of these symptoms were mild and include things like headache or dizziness that could be caused by a robust immune response. Other more specific and severe symptoms were also seen and include loss of smell or taste, muscle weakness, stroke, seizure and hallucinations.

These symptoms are seen more often in severe cases, with estimates ranging from 46 percent to 84 percent of severe cases showing neurological symptoms. Changes in consciousness, such as disorientation, inattention and movement disorders, were also seen in severe cases and found to persist after recovery.

Crossing the blood-brain barrier

SARS-CoV-2, the coronavirus that causes COVID-19, may cause neurological disorders by directly infecting the brain or as a result of the strong activation of the immune system.

Recent studies have found the novel coronavirus in the brains of fatal cases of COVID-19. It has also been suggested that infection of olfactory neurons in the nose may enable the virus to spread from the respiratory tract to the brain.

Cells in the human brain express the ACE2 protein on their surface. ACE2 is a protein involved in blood pressure regulation and is the receptor the virus uses to enter and infect cells. ACE2 is also found on endothelial cells that line blood vessels.

Infection of endothelial cells may allow the virus to pass from the respiratory tract to the blood and then across the blood-brain barrier into the brain. Once in the brain, replication of the virus may cause neurological disorders.

SARS-CoV-2 infection also results in a very strong response by the immune system. This immune response may directly cause neurological disorders in the form of Guillain–Barré syndrome. But brain inflammation might also indirectly cause neurological damage, such as through brain swelling. And it’s associated with – though doesn’t necessarily cause – neurodegenerative diseases such as Alzheimer’s and Parkinson’s.

Not unique, but still worrying

SARS-CoV-2 is not unique in being a respiratory virus that can also infect the brain. Influenza, measles and respiratory syncytial viruses can all infect the brain or central nervous system and cause neurological disease.

Other coronaviruses have also been found to infect the brain and cause neurological disorders.

The related seasonal coronavirus, HCoV-OC43, typically causes very mild respiratory symptoms but can also cause encephalitis in humans. Similarly, the coronavirus that causes MERS and the 2003 SARS virus can cause severe neurological disorders.

Respiratory viruses getting into the brain is thankfully a rare occurrence. But with millions of COVID-19 infections worldwide, there is the risk of significant neurological disease, especially in severe cases.

It is important to be aware of the possibility of neurological manifestations of COVID-19, both during acute illness as well as the possibility of long-term effects. This also highlights the continued importance of preventing viral transmission and identifying those who are, and have been, infected.

Jeremy Rossman, is Honorary Senior Lecturer in Virology and President of Research-Aid Networks, University of Kent.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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COVID 19 Covid 19/Technology Features

Coughvid app will tell if you have Covid-19

Your smartphone will soon be able to listen to your cough and predict whether you’ve contracted COVID-19.

Coronavirus patients have a distinctive cough that sounds different than other illnesses and now researchers are building an app that can listen to coughs and use AI to tell if they have COVID-19.

Coughvid has been in development for the past month at École Polytechnique Fédérale de Lausanne and has gathered more than 15,000 audio samples of coughs to train its AI. You can log on to their website and record your cough to help the researchers.

The current oropharyngeal swab test is physically invasive and must be performed by a trained clinician which puts a strain on the resources of governments battling the spread of the virus. Ideally, testing would be performed noninvasively at no cost and administered at the homes of potential patients to minimise contamination risk.

Reports from doctors that COVID-19 patients had a cough with a distinctive sound — a chirping intake of breath at the end — that differed from other illnesses, inspired the Swiss-based researchers to use this information coupled with AI to develop the app.

The World Health Organization (WHO) has reported that 67.7% of COVID-19 patients exhibit a “dry cough”, meaning that no mucus is produced, unlike the typical “wet cough” that occurs during a cold or allergies [2]. Dry coughs can be distinguished from wet coughs by the sound they produce, which raises the question of whether the analysis of the cough sounds can give some insights about COVID-19. Such cough sounds analysis has proven successful in diagnosing respiratory conditions like pertussis [3], asthma, and pneumonia [4].

The team behind Coughvid is still collecting data to train its AI and have gathered more than 15,000 audio samples of people coughing, 1,000 of which came from people who reported being diagnosed with COVID-19. Once completed, the Coughvid app could be used as a tool to recommend whether users should seek out a coronavirus test or further treatment.

Coughvid is just one of many potential coronavirus solutions being pulled together by AI labs eager to find algorithmic solutions to the epidemic. According to the The Wall Street Journal reported last week, at least three other labs are also developing AI-powered apps that analyse subjects’ breathing, speaking, and coughing in an attempt to predict coronavirus, partnering with researchers at schools including Carnegie Mellon University and New York University.

The app is still in early development, and public health experts are being consulted to determine how best to deploy it. Data collection will likely continue for at least two months before any product is deployed.

At the Embedded Systems Laboratory (ESL) at EPFL, they propose to leverage signal processing, pervasive computing, and machine learning to develop an Android application and website to automatically screen COVID-19 from the comfort of people’s homes. Test subjects will be able to simply download a mobile application, enter their symptoms, record an audio clip of their cough, and upload the data anonymously to their servers. They will then use audio signal processing and machine learning techniques to evaluate if there is some room for automatic or assisted COVID-19 screening.

The objective of this website is to collect a large number of sample recordings from patients that are known to have COVID-19. That’s why they are asking everybody that can provide them with a few seconds of cough sound to collaborate. It’s so easy!

Disclaimer from EPFL

All the data collected by the website is anonymous, and it is stored on a private server at the premises of the École Polytechnique Fédérale de Lausanne (EPFL), Switzerland. Each recording is associated with the timestamp in which it was received, and the geolocalisation information if the user grants the corresponding permissions.

The data will be exclusively used for research purposes, and under no circumstances will they be sold or shared with third parties. Eventually, the dataset will be made publicly available to the research community.

Contact

For any questions or suggestions, please send us an email to: coughvid@epfl.ch

Additional reporting from Business Insider

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Defence & Security EMS News Features

Civil Defence commended for its COVID-19 crisis response

An Taoiseach Leo Varadkar, T.D, speaking at the Civil Defence HQ, paid tribute to the significant contribution of Civil Defence and its volunteers to the national response to COVID-19.

Nationally Civil Defence has over 3,500 volunteer members who are trained in a variety of disciplines including first aid and emergency medical services, search and rescue and communications. These skills are provided on a voluntary basis to support the Principal Response Agencies in both emergency and non-emergency events.

Since the onset of COVID-19 in mid-March Civil Defence volunteers have been involved in over 635 separate taskings throughout the country providing over 5,899 volunteer hours in support of the HSE, Local Authorities and An Garda Síochána.

The Taoiseach and Minister Paul Kehoe met with the Chief Executive of Dublin City Council, Mr. Owen Keegan, the Chief Fire Officer in Dublin, Mr. Dennis Keeley, Mr. Brian Sweeney, Chair of the Civil Defence Officers Association and the Dublin Civil Defence Officer Mr. James McConnell.

He also met with Ms Verona Fitzpatrick the Deputy National Volunteer representative and a number of volunteers from Dublin, Kildare and Meath.

“It was privilege to visit the headquarters of Dublin Civil Defence and meet some of the volunteers,’ an Taoiseach Leo Varadkar said, ‘the Civil Defence is an amazing resource, it exists in every county across the country. So far during the emergency is has provided more than 5,000 volunteer hours, helping us out with the national effort; doing everything from providing transport, to meals on wheels, to helping samples get to labs.

“It really is at times like this that we understand the value of volunteerism and the value of organisations like the Civil Defence. Both their volunteering ethos and also the enormous repository of skills which they have, which have been available to the State and society for the last few weeks. Today I had the opportunity to express my personal thanks to the Civil Defence and I know that they will be available for whatever task is needed in the weeks ahead.”

The many and varied tasks that Civil Defence Units around the country have participated in, include transporting dialysis and cancer patients from hospitals to their homes, collection of medications and delivering to patients homes, transporting COVID-19 test samples daily to Laboratories, distribution of food parcels to vulnerable persons as well as providing administrative assistance to the Irish Blood Transfusion Service at Blood donation clinics countrywide.

Commenting on the broad range of work already undertaken by Civil Defence during this crisis, Minister Kehoe outlined that “Civil Defence has an outstanding record of service to local communities and to our nation when called upon in times of emergency. It provides a unique resource to the State drawing on a nationwide grouping of trained volunteers to support the Principal Response Agencies as well as local communities”.

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Work from Home: The G2 Guide

Expect more!

G2 is giving tips to work from home.

https://learn.g2.com/hub/wfh-week

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COVID 19 COVID 19/World News CRISIS HANDBOOK EMS News EMS Services General News

TRIAGE TRENT LOGISTICS

Triage and treatment tents have become ubiquitous in the current pandemic, improving throughput and keeping infectious but relatively well patients outside of the hospital.

Emergency physician Josh Bucher, assistant professor at the Robert Wood Johnson Medical School, speaking to Hippoed ERCAST breaks down how his team has set up and uses their tent.

Triage and treatment tents have become ubiquitous in the current pandemic, improving throughput and keeping infectious but relatively well patients outside of the hospital. In this episode, emergency physician Josh Bucher, assistant professor at the Robert Wood Johnson Medical School, breaks down how his team has set up and uses their tent. Click on the link below to listen to the podcast.

Emergency physician Josh Bucher, assistant professor at the Robert Wood Johnson Medical School on Triage Trent Logisitics

Discussed here: arrival logistics, initial screening, flow through the tent, using telehealth rather than an in-person clinician, and making the decision of discharge home or send to the emergency department.

The “why” of using tents for triage and treatment of COVID-19 patients is generally the same, but the “how” differs. This episode gives insight into how one New Jersey hospital is doing it.

Tent hours, staffing and volume

  • They average 40 patients per day.
  • Open from 11am – 11pm, anticipating expansion to 9am – 1am.
    • The more patients they can see in the tent, the less time and resources they’ll need to devote to terminal cleaning of contaminated ED rooms.
    • Typical surge of patients is from 5pm – 8pm.
  • 2 nurses staff the tent at all times.
    • Nurse shifts are 4 consecutive hours without a scheduled break.

What happens when patients first arrive to the ED?

  • They go to a small triage tent outside the main entrance of the ED which is staffed with a nurse and a registrar, both in full PPE .
  • Vitals are taken (temp, pulse ox, heart rate but not BP).
  • Patients are assessed to see if they meet tent criteria:
    • Symptoms of fever (>100.4℉), URI symptoms, cough, and/or SOB.
    • Not overtly dyspneic or toxic appearing.
    • Age < 60
    • HR < 130 bpm
    • Pulse ox ≥ 95.
      • They are considering lowering that pulse ox threshhold to allow more patients through the tent process

Patients who meet tent criteria are masked and directed to walk over to the tent. Then what?

  • Visitors are not allowed to accompany them into the tent.
  • They stop at a table to get a piece of paper on which they enter their own registration info. Full registration processing takes place later.
  • A nurse guides the patient to a chair which is facing a telehealth robot device.
  • The nurse asks triage questions and gets a medical history.
    • A physician is listening (aided by the robot) and simultaneously entering information into the EMR.
    • The robot has a stethoscope attached to facilitate lung auscultation, though the audio quality is poor.
    • Facetime on a phone or tablet could be used as a substitute for a robot.
  • No diagnostic testing is done in the tent (including COVID-19 testing).
    • This is due to limited supply.
    • The only patients tested for COVID are those being admitted.

Disposition from the tent.

  • Physician makes decision about discharge from tent vs. ED admission. This is largely clinical judgement.
    • Overt dyspnea, hypoxia at rest, pulse ox dropping to the mid 80s on standing in place ambulation for 20-30 seconds are some of the factors used to decide on disposition.
  • 95% of patients are discharged.
    • Patients are told they likely have COVID and of the need to self-quarantine.
    • Return precautions stress the need to return for difficulty breathing.
    • Discharge instructions printed from printer in tent.
  • 5-6 patients per day are sent to the ED for further evaluation.

What PPE is being used?

  • Staff in the tent wear a Tyvek suit, N95 mask, multiple pairs of gloves, and a face shield.
  • The outer pair of gloves is changed between patients.
  • PAPRs and CAPRs are in short supply and reserved for the OR and ED staff performing high risk procedures (ie. intubation).

How is transmission of infection minimized in the tent?

  • The tent is completely under negative pressure.
  • Any surface touched by a patient is wiped down with a bleach wipe.
  • Throughput is typically quick, so there is less risk of spreading droplets.
    • Entire process from triage to discharge can take as little as 15 min.
  • Patients move through the tent in one direction and don’t spend a prolonged time in one spot. This minimizes exposure to the staff.

By Rob Orman and Hippo Education LLC.. Discovered EMS on Player FM — copyright is owned by the publisher, not Player FM, and audio is streamed directly from their servers.

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WORLD versus VIRUS

  • World Versus Virus is a weekly podcast from the World Economic Forum.
  • Coping with COVID if you’re blind, and other stories in our new podcast
  • WHO’s Bruce Aylward tells us how long the lockdowns could last.
  • More than 25 million jobs will be lost, says the head of the International Trade Union Confederation.

If your sense of touch is one your most important ways of dealing with the world, how to you cope with the threat of Coronavirus? YouTuber Molly Burke gives us her insights on the outbreak and urges us all not to forget people living with disabilities as we all try to protect our health.

Bruce Aylward, Assistant Director-General of the World Health Organization, tells us we can expect lockdowns to last up to two months, which he calls an optimistic scenario that depends on governments taking the right measures against the outbreak.

And, Sharan Burrow, who represents 200 million workers around the world as head of the International Trade Union Confederation, says more than 25 million people could lose their jobs due to the impact of COVID-19.

World Versus Virus is a Word Economic Forum podcast, available on Spotify.

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COVID 19 Covid 19/Education CRISIS HANDBOOK Features

Decoding Covid-19

Seven human coronaviruses in seven graphics

By the end of the day, there will be probably  550,000 Covid-19 cases , resulting in almost 24,000 fatalities worldwide. After its discovery last December, in Wuhan, China, the virus started to spread around the world, causing panic. The Antarctic is, as yet, the only continent where there are no confirmed cases.

There are seven types of coronaviruses that are contagious for humans. Four types (NL63, 229E, OC43 and HKU1) are responsible for 15 to 30% of the world’s common cold cases every year and are considered endemic.

Two other types are considered epidemic: the Sars outbreak, which affected 26 countries and first infected humans in the Guangdong province of southern China in 2002, and Mers, which was first reported in 2012 and is prevalent in the Middle East.

The seventh coronavirus is Sars-Cov-2, the novel coronavirus that causes Covid-19, whose origins are unconfirmed at the moment.

In an interview with the South China Morning Post, microbiologist Eugenia Corrales-Aguilar, who has a PhD in virology from Humboldt University in Berlin, outlined the facts on Covid-19.

The data obtained so far shows that Sars-Cov-2, ranges from mild-medium to severe. From a molecular point of view, coronaviruses have some variations in their genetic sequence as well as the cellular receptor they use.

In this case, Sars-Cov-2 uses ACE2 as receptors, which are mostly found in the respiratory tract. The virus infects the target cells causing damage. The resulting inflammatory and immune response can cause pneumonia to develop in most severe cases. The impact depends on the individual and how their body reacts.

How does Covid-19 spread?

At the moment, we know that the virus is transmitted through contaminated droplets. Droplets of saliva or mucus carrying the respiratory virus can travel one to three metres through coughing or sneezing. The virus needs to fully enter the respiratory tract for infection to happen, but that’s why the risk of infection can be reduced by avoiding close contact with sick people. Washing your hands thoroughly greatly reduces the risk of infection.

There are reports that infection is possible through faeces and recirculated air ventilation systems and air conditioners. But this has not been systematically studied, so it is hard to say with 100 per cent certainty.

How deadly is the new coronavirus compared to Sars, Mers and the four coronaviruses that cause the common cold?

We cannot determine this for certain yet as the apparent mortality rate is likely to be overestimated at the start of an outbreak, because a lot of mild cases are missed. Also, with Covid-19, some people can be asymptomatic – meaning the virus is not always detected and therefore not recorded.

The mortality rate for influenza is 0.1 per cent, but since Covid-19 is so new it remains to be seen just how many cases will turn out to be fatal.


It is commonly cited that in a given year with no complications, influenza kills 500,000 people. Compared to the four respiratory coronaviruses, the mortality rate for Sars-Cov-2 is higher. Although compared to Sars (9.6 per cent) and Mers (34.4 per cent), Covid-19 shows a low mortality rate but with a wider spread, making the total number of deaths larger.

Among those infected, how many people will develop a more severe infection?

According to current data, the percentage of people who develop a severe infection is 15 per cent and 5 per cent are critically ill– a great stress on health care systems.

How long will it take before a vaccine for the new coronavirus is publicly available? How long did it take for Sars and Mers?

After the disappearance of Sars, all financial aid and investigation programmes regarding the creation of a vaccine were cut. The Mers vaccine is a work in progress, with the syndrome still affecting people. For Sars-Cov-2, an optimistic estimate would be one to two years because it needs to go through clinical trials after it is developed in the lab and, if effective, then produced on a large scale.

Natural immunity after coronavirus infection decreases over time, which is why reinfection from the four respiratory coronaviruses takes place, making it very difficult to create a vaccine that raises a lasting protective immune response.

What could happen is that a developed vaccine might not be able to prevent infection but might be able to reduce the severity – this is the case with influenza vaccines, which should be administered once a year. Even so, this is a process that takes time.

Therefore, hygiene measures like thorough handwashing, sensible coughing and sneezing protocol and maintaining social distance are, for now, the best ways to prevent the spread of the virus.

Can a patient become infected again after successfully recovering?

If time elapses and natural immunity is no longer present or it is not effective any more, yes, they can. In the case of the four respiratory coronaviruses, cases of reinfections are observed after eight to 12 months. It has not been determined for Sars-Cov-2 yet due to its novelty.

Also, we don’t use the term “carrier”, as is the case of HIV or some hepatitis viruses, because Covid-19 is considered a “hit-and-run” virus. This means that when a person gets infected, the immune system is activated and the infection is “cleaned”.

Can summer, or warmer temperatures for that matter, help eradicate the virus?

For some respiratory viruses this does happen. Not just because of the temperature, but also thanks to the humidity and changes in social patterns of human beings. In this case, it is still premature to say if this is going to happen. Let’s hope so…

Full article with graphics available here courtesy of South China Morning Post and Pablo Robles

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Covid 19/Business CRISIS HANDBOOK World News

COVID-19: France calls unemployed to work in fields as borders stay closed

The French government has called on employees who are on temporary lay-offs to make themselves available to help farmers with seasonal harvests. But such ‘agricultural patriotism’ does not go well with the tightening of containment measures. EURACTIV France reports.

“Our farmers are running out of ‘helping hands’, help them”. This was the appeal launched by Agriculture Minister Didier Guillaume to news channels BFM and RMC. It took many French people by surprise because the containment measures that had been in place for over a week in France were tightened further on Monday (23 March).

“I want to launch a great appeal […] to the women and men who today do not work, a great appeal to those who are confined […] to those who no longer have a job, I tell them to join the great army of French agriculture, join those who will allow us to feed ourselves in a clean, healthy way,” Guillaume said.

His appeal follows a statement by the head of the FNSEA, France’s main agricultural union, warning of the lack of manpower available in the country’s agricultural sector to ensure seasonal fruit and vegetable harvests.

This shortage – estimated at around 200,000 people – was largely caused by the closure of borders following the coronavirus epidemic. As a result, seasonal workers from Morocco, Tunisia and Spain are not able to travel to France.

And the harvests of the coming months cannot wait. Asparagus, strawberries and cherries will have to be harvested in large quantities in the coming weeks. “To all those who have the time, we will need 200,000 seasonal workers within three months. We will welcome you in perfect safety conditions” announced the president of the FNSEA, Christiane Lambert.

To join the ranks of agricultural workers, the FNSEA has also set up the “Des bras pour ton assiette” (‘arms’ for your plate) website, where French people can register to make themselves available to farmers in need of workers

The only requirements are to be in good health, not be part of an at-risk group and to respect actions that could prevent spreading (sneezing in one’s elbow, regular handwashing, etc).

To encourage applications, those who volunteer will be combining their partial unemployment with the remuneration of a seasonal worker, which roughly equals minimum wage, particularly in sectors that are at a standstill, such as the catering industry.

‘Agricultural patriotism’

However, the French, who have been living in confinement for the past eight or so days, were ambivalent towards this national appeal in favour of the agricultural sector.

While the government ‘turned the screws’ on confinement even more on Monday, by banning open-air markets and further restricting non-work-related travel, the call to come and work in the fields thus appears quite surprising.

At the same time, the entire food sector pointed out the closure of outdoor markets in France. This is “an economic disaster for all traders, artisans, producers and farmers”, stressed the president of the National Federation of French markets on France Inter.

However, political and citizen mobilisation around agriculture has reached a real peak since the start of the pandemic.

With the call for ‘food patriotism’ – favouring French products – and government officials thanking farmers for their contribution in the fight against COVID-19, the reconciliation of consumers with farmers seems to be on the way.

By Cécile Barbière | EURACTIV.fr | translated by Daniel Eck | from euroactiv

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Covid 19/Health CRISIS HANDBOOK

What to eat to boost your immune system?

COVID-19 Public Education Campaign

Fruits

Most fruits are naturally low in fat, sodium, and calories. Fruits are sources of many essential nutriments that are under consumed, including potassium, dietary fiber, vitamin C, and folate (folic acid). These help to boost your body’s natural defences.

Beans & Legumes

Legumes are loaded with health benefits. They’re very low in fat, have zero cholesterol, and have the same amount of calcium as a glass of milk.

Milk & eggs

Eggs are a great source of protein, amino acids and healthy fats and milk consists of protein and calcium. Eating cooked eggs with milk is a great way to balance out the protein intake.

Grains

Whole grains as part of a healthy diet reduce the risk of some chronic diseases. Grains are important sources of many nutrients, including fiber, B vitamins and minerals.

Bread

Bread (espacially whole wheat bread) is fortified with calcium and four medium slices per day would provide over 30% of the recommended daily intake of calcium which we need every day to maintain healthy bones and teeth

Vegetables

Vegetables contain healthful vitamins, minerals, and fiber. That improve overall health and wellbeing.

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Covid 19/Business CRISIS HANDBOOK EMS News Features

Safeguarding our lives and our livelihoods

In a thought-provoking article, expert contributors to global consultancy firm McKinsey & Co outline the urgency to win the battle with Covid-19

Everything has changed. Just a few weeks ago, all of us were living our usual busy lives. Now, things normally taken for granted—an evening with friends, the daily commute, a plane flight home—are no longer possible. Daily reports of increasing infections and deaths across the world raise our anxiety and, in cases of personal loss, plunge us into grief. There is uncertainty about tomorrow; about the health and safety of our families, friends, and loved ones; and about our ability to live the lives we love.

In addition to the immediate concern about the very real impact on human lives, there is fear about the severe economic downturn that may result from a prolonged battle with the novel coronavirus. Businesses are being shuttered and people are losing their jobs. We think and hope there is a different option from the ones posed in a recent Wall Street Journal editorial that suggests that we may soon face a dilemma, a terrible choice to either severely damage our livelihoods through extended lockdowns, or to sacrifice the lives of thousands, if not millions, to a fast-spreading virus. We disagree. Nobody wants to have to make this choice and we need to do everything possible to find solutions.

Why is this the imperative of our time? From multiple sources and our own analysis, the shock to our lives and livelihoods from the virus-suppression efforts could be the biggest in nearly a century. In Europe and in the United States, the required “lockdowns” of the population and other efforts to control the virus are likely to lead to the largest quarterly decline in economic activity since 1933. We have never in modern history suggested that people not work, that entire countries stay at home, and that we all keep a safe distance from one another. This is not about GDP or the economy: it is about our lives and livelihoods.

We see enormous energy invested in suppressing the virus, while many urge even faster and more rigorous measures. We also see enormous energy go into stabilizing the economy through public-policy responses. However, to avoid permanent damage to our livelihoods, we need to find ways to “timebox” this event: we must think about how to suppress the virus and shorten the duration of the economic shock (Exhibit 1). And we must do both now!

Exhibit 1

To solve for both the virus and the economy, we need to establish behaviors that stem the spread of the virus, and work towards a situation in which most people can return to work, to family duties, and to social lives.

To date, the only proven way of containing the virus, once community transmission is widespread, is by enforcing significant lockdowns; disciplined physical distancing; testing; and contact tracing. China, Japan, Singapore and South Korea have shown that these measures can stop the virus from spreading and enable economic activity to resume, at least to some extent. Everyone is closely following the developments in Italy and many other nations to find out whether the control measures there are sufficient to slow the growth of new infections and fatalities. Our common goal must be to implement the best possible response to stop this crisis.

At the same time, global and local leaders are also considering the economic impact of such measures. What will happen if many businesses stop operating or have to significantly reduce their activity? For how long can we do that? How deep an economic shock can we sustain without causing human suffering that our societies are unable or unwilling to bear?

In the following sections, we offer ways to think about these pressing issues.

Dealing with the uncertainty related to COVID-19

  • The spread of COVID-19. How many new infections will we have? Is the mortality rate falling? Will the spread of the virus show any seasonality? Will a new strain of the virus evolve?
  • The public-health response in each country, state, municipality. Will there be lockdowns? Will it still be possible to go to work? Will factories be allowed to operate? Do we need to submit to an official quarantine center upon arrival, or can we self-quarantine?
  • The impact on the economy and our livelihoods. Will companies suffer and go bankrupt? Can the supply of essential goods and services be maintained? Will we have a job? How long will this last?
  • The consequences for our lives. Will we be able to avoid infection? Are our loved ones safe? Can we still train for the sporting event we have been preparing for? Can we earn university degrees, now that many schools are closed and exams canceled?

These and a million more questions are racing through our minds, adding stress to the already challenging reality of living in the time of the coronavirus.

Two things are reasonably certain: If we do not stop the virus, many people will die. If our attempts to stop the pandemic severely damage our economies, it is hard to envision how there will not be even more suffering ahead.

The impact of lockdowns on consumption and economic activity

We are learning what happens during a lockdown of the kind implemented in China, Italy, and increasingly across Europe and the United States: economic activity drops more sharply than any of us have experienced. People do not shop, other than for essentials; people do not travel; people do not buy cars.

We estimate that 40 to 50 percent of discretionary consumer spending might not occur. In every recession, people will cut back on purchases that can easily be postponed (such as cars and appliances), and increase precautionary saving in anticipation of a worsening crisis. What makes the coronavirus pandemic different is that people will also eliminate spending for restaurants, travel, and other services that usually fall but do not drop to zero.

A 40 to 50 percent drop in discretionary spending translates to a roughly 10 percent reduction in GDP—without considering the second- and third-order effects. That’s not only unprecedented in modern history, it has been historically almost unimaginable—until now.

Already, we have some factual evidence for an economic shock on this scale, such as the COVID-19-related economic downturn in China, and early indications in US “high-frequency data” such as credit-card spending.

The longer a lockdown is in place, the worse the impact on our lives will get. To visualize what this means for people in lockdown areas, imagine cab drivers whose customers are not allowed to go onto the streets; professional chefs whose restaurants have been forced to close; and grounded flight attendants, their planes parked at the airports—for months. With 25 percent of US households living from paycheck to paycheck, and 40 percent of Americans unable to cover an unexpected expense of $400 without borrowing, the impact of extended lockdowns for many, many people will be nothing short of catastrophic.

The answer cannot be that we accept that the pandemic will overwhelm our healthcare system, and thousands, if not millions, will die. But can the answer be that we cause potentially even greater human suffering by permanently damaging our economy?

Bounding the uncertainty around this crisis

The worst and most typical reactions for humans when confronted with high uncertainty are to freeze, or to jump to a simple answer, such as “this problem will go away as quickly as it came, it is just like the annual flu.” COVID-19 is particularly challenging in this regard because the majority of those infected will feel only minor symptoms, or none at all. It is an invisible but pernicious enemy. We must try to bound the uncertainty with reason and think about solutions within a limited number of scenarios that could evolve.

Next we describe the impact of COVID-19 on the world’s economy along two dimensions which will primarily drive the outcomes of the crisis for all of us:

  • The economic impact of the Virus Spread: the characteristics of the virus and its disease, such as transmission modes, rates, and mortality rates; and Public-Health Response, such as lockdowns, travel bans, physical distancing, comprehensive testing, contact tracing, health care provision capacity, the introduction of vaccines and better treatment methods
  • The economic impact of the Knock-on Effects of the public-health responses, such as rising unemployment, shuttered businesses, corporate failures, credit defaults, falling asset prices, market volatility, and financial system vulnerabilities; and Public-Policy Responses to mitigate these knock-on effects, such as policies to prevent widespread bankruptcies, support incomes for furloughed workers, and protect the financial system and the viability of the most affected sectors.

In terms of Virus Spread and Public-Health Response, we currently see three “archetypes” of interventions and outcomes:

  1. A strong public-health response succeeds in controlling the spread in each country within two to three months, and physical distancing can be phased out quickly (as seen in China, Taiwan, Korea, and Singapore).
  2. Public-health response succeeds at first, but physical distancing has to continue (regionally) for several additional months to prevent viral resurgence.
  3. Public-health response fails to control the spread of the virus for an extended period of time, perhaps until vaccines are available, or herd immunity is achieved.

In terms of Knock-on Effects and Public-Policy Response, we anticipate three potential levels of effectiveness:

  1. Ineffective: self-reinforcing recession dynamics kick in; widespread bankruptcies and credit defaults; potential banking crisis
  2. Partially effective: policy responses offset economic damage to some degree; a banking crisis is avoided; but high unemployment and business closures mute the recovery
  3. Highly effective: strong policy response prevents structural damage to the economy; a strong rebound after the virus is controlled returns the economy to pre-crisis levels and momentum, as justified by the economy’s fundamentals.

If we combine these three archetypes of viral spread and three degrees of effectiveness of economic policy, we see nine scenarios for the next year or more (Exhibit 2).

Exhibit 2

We believe that many currently expect one of the shaded scenarios, A1–A4, to materialize. In each of these, the COVID-19 spread is eventually controlled, and catastrophic structural economic damage is avoided. These scenarios describe a global average, while scenarios will inevitably vary by country and region. But all four of these scenarios lead to V- or U-shaped recoveries.

Other, more extreme scenarios can also be conceived, and some of them are already being discussed (B1–B5). One cannot exclude the possibility of a “black swan of black swans,” with structural damage to the economy, caused by a year-long spread of the virus until a vaccine is widely available, combined with lack of policy response to prevent widescale bankruptcies, unemployment, and a financial crisis. This would result in a prolonged L- or W-shaped economic trajectory. With the number of new cases expanding exponentially in many countries in Europe and in the United States, we cannot exclude these more extreme scenarios for now.

However, as we still have little information about the probability of more extreme scenarios, we focus on the four that are more tangible for now. Within the next week, we will add breadth and depth to this view, working closely with Oxford Economics to develop several macroeconomic scenarios for each country, and for the world.

Making it real: How this could unfold

With a little bit of luck, China will undergo a sharp but brief slowdown and relatively quickly rebound to pre-crisis levels of activity. While GDP is expected to drop sharply in Q2 2020, some signs of normal life are returning in Beijing, Shanghai, and most major cities outside Hubei. In this scenario, China’s annual GDP growth for 2020 would end up roughly flat, wiping out the growth of 6 percent we expected just three months ago. Nevertheless, by 2021, China’s economy would be on the way to regaining its pre-crisis trajectory, if not adversely affected by developments in the rest of the world.

In this scenario, the virus in Europe and the United States would be controlled effectively with between two to three months of economic shutdown. Monetary and fiscal policy would mitigate some of the economic damage with some delays in transmission, so that a strong rebound could begin after the virus was contained at the end of Q2 2020. This would place Europe and the United States in scenario A3 (Exhibit 3).

Exhibit 3

Even in this optimistic scenario, however, all countries would experience sharp GDP declines in Q2, most of which would be unprecedented. Consumer spending in most advanced economies accounts for roughly two-thirds of the economy, and about half of that is consumer discretionary spending. Real-time data suggests that spending on durable goods including automobiles in areas affected by shutdowns could fall as much as 50 to 70 percent; spending on airline flights and transportation could fall by about 70 percent; and spending on services such as restaurants could decline in affected cities by 50 to 90 percent. Overall, as mentioned earlier, consumer discretionary spending could abruptly fall by as much as 50 percent in areas subject to shutdowns.

While increased government spending would help offset some of the economic impact, it is unlikely to offset rapidly enough nor in full. We estimate that the US could see a decline in GDP at an annualized pace of 25 to 30 percent in Q2 2020; major economies in the eurozone are expected to turn in similar numbers when all is said and done. To put this in perspective, the largest quarterly decline in GDP in the 2008–09 financial crisis occurred at an annualized pace of 8.4 percent in Q4 2008. The pace of decline would far outstrip any recession since the Second World War (Exhibit 4).

Exhibit 4

A darker picture of the future

Of course, it is entirely possible that countries are not very effective in controlling the virus, or in mitigating the economic damage that results from efforts to control the virus spread. In this case, economic outcomes in 2020 and beyond would be even more severe.

In this more pessimistic scenario, China would recover more slowly and would perhaps need to clamp down on regional resurgences of the virus. It would also be hurt by falling exports to the rest of the world. Its economy could face a potentially unprecedented contraction.

The United States and Europe could also face more dire outcomes in this scenario. They could fail to contain the virus within one quarter and be forced to implement some form of physical distancing and quarantines throughout the summer. This could end up producing a decline in GDP at an annualized pace of 35 to 40 percent in Q2, with major economies in Europe registering similar performance. Economic policy would fail to prevent a huge spike in unemployment and business closures, creating a far slower recovery even after the virus is contained. In this darker scenario, it could take more than two years before GDP recovers to its pre-virus level, placing both Europe and the United States in scenario A1 (Exhibit 5).

The economic impact in these scenarios would be unprecedented for most people living today in advanced economies. Developing countries that have faced currency crises have some experience in events of this order of magnitude.

We are not writing to predict that this will happen but rather issuing a call to action: to take the measures needed to stop the spread of this virus and the damage to the economy as quickly as humanly possible. As we write this, countries in Europe and the United States have not yet taken the strong public-policy responses needed to effectively contain the virus. If we do not act to contain the virus quickly, then the scale of economic destruction that comes with extended lockdowns would become more likely, with severe consequences for our livelihoods.

Safeguarding our lives and our livelihoods

To solve the conundrum of how to save lives without destroying our livelihoods, we must find ways to make lockdowns effective, such that they break the trajectory of the virus in as short a time as possible. The effectiveness of lockdowns will be measured in their ability to control the spread of COVID-19.

East Asian nations have shown this can be done through enforcing stringent lockdowns, surveillance, and monitoring of people’s movements. As we write this, similar actions in most of Europe and the United States have so far been narrower, less vigorous, and not as effective. To be sure, these steps are challenging to enact in the West. But to break the momentum of the virus, we must act decisively.

The world’s answer to breaking the conundrum will need to be robust, no matter whether we fully control the spread of the virus and prevent resurgence (ahead of vaccines or treatment innovations), or whether we cannot fully contain the virus and need to rely on continuing interventions for some time. In both cases we must find ways to protect lives and livelihoods.

We propose to move much faster in establishing comprehensive and clear Behavioral Protocols to allow authorities to safely release some parts of the blanket lockdown measures that choke our livelihoods today. These can only work if we also find Acceptable Enforcement Mechanisms for these protocols so that we do not run the risk of placing socially unacceptable demands on people.

Behavioral Protocols

These protocols are guidelines on how to operate businesses and provide government services under pandemic conditions. Some of these protocols are already in use. Could they be more widely adopted?

  • Courageous healthcare professionals work in hospitals where the virus is rampant; they have strict rules regarding all aspects of their tasks, movements, and behaviors to keep them and their patients safe. Could your supermarket operate safely with these kinds of rules in place?
  • In high-tech factories in China today, every person must have passed a COVID-19 test. Everybody. How would you feel about entering a plane today, if you knew that every passenger, crew member, and maintenance worker in contact with the plane had tested negative for the virus?
  • Some restaurants have already shifted entirely to home delivery, changing their business model and protocols to adapt to the virus. Could you operate your own service business safely by adopting new protocols?

These protocols cannot be static. Today, lockdowns are often implemented uniformly for everybody, everywhere, regardless of specific infection risks. Imagine a world in which, based on a deep understanding of infectious risks, tailored sets of protocols with different levels of rigor could be implemented for every city, every quarter, and suburban neighborhood.

Such dynamic protocols are technically possible. Modern technologies and data analytics can help track and predict infection threat levels to vulnerable population segments and areas; protocols and public-health interventions can be dynamically adjusted to provide protection when and where needed.

With such protocols, lockdown measures could be eased faster, for more people, in more places, while still maintaining the effectiveness of public-health interventions to control the virus. Much greater availability of personal protective equipment and test kits is also essential, of course.

Acceptable Enforcement Mechanisms

This is the harder part. How do we get everybody to accept the consequences of creating and implementing such behavioral protocols? The areas of sensitivity are many, including our personal freedoms, right to privacy, and fairness in access to services. There are no uniform answers to these issues. The level of sensitivity in each of these areas differs by country, and there also are huge differences in what is socially acceptable. In each country, people will have to work together to find ways to enforce behavioral protocols that fit their specific situation and circumstances. But make no mistake, the starting point will not be pre-COVID-19 social and societal norms—it will be the blanket lockdowns now in place across many countries.

In Hong Kong, the government has extended COVID-19 testing to all arriving passengers. It will allow asymptomatic travelers with the disease to self-quarantine at home. But because of the high risk of further transmission, the country requires these people to wear electronic wristbands to “geo-fence” them in their home. Compliance is enforced with the threat of long prison terms for violations.

We will need to develop and enforce protocols that allow us, as quickly as possible, to release some of the most stringent measures in appropriate places. And for that to happen, each government will need to find effective, yet socially acceptable ways of enforcing these measures and new protocols.

We need a plan to achieve both imperatives—Now!

We will keep updating our scenarios, and we hope that in coming weeks we will have a better sense for which scenario the world is likely to follow. However, a few things are already clear:

  • This could be the most abrupt shock to the global economy in modern history.
  • There is a real risk for our lives and our livelihoods to suffer permanent and possibly irreversible damage from this crisis.
  • While we must take actions to control the spread of the virus and save lives vigorously, we must also take action to protect our livelihoods.
  • Behavioral protocols and dynamic interventions could help us release lockdowns earlier, get most people back to work, and get everybody’s lives back on track.

As Angela Merkel said last week in an appeal to Germany, and others have echoed, our ability to come through this crisis will primarily depend on the behavior of each of us. The initial and immediate lockdowns are necessary to break the spread of the virus and safe lives. We believe that with the right protocols in place, and people following these protocols, the lockdown constraints can be gradually released sooner rather than later.

The question is: Can the world work fast enough on these protocols, and can we get societal acceptance to enforce them? If so, we should be able to control the virus, soften the inevitable economic crisis to sustainable levels, and safeguard our lives and livelihoods.

That is the imperative of our time.

Copyright McKinsey & Co – the Full article can be read here

About the author(s)

Sven Smit is a senior partner in McKinsey’s Amsterdam office; Martin Hirt is a senior partner in the Greater China office; Kevin Buehler is a senior partner in the New York office; Susan Lund is a partner in the Washington, DC, office; Ezra Greenberg is an expert associate partner in the Stamford office; and Arvind Govindarajan is a partner in the Boston office.

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Covid 19/Advice CRISIS HANDBOOK EMS News

BE ON CALL – HSE OVERWHELMED

Over 50,000 people have contacted the HSE to be ‘On Call for Ireland’ over the last three days after the national health body called on those former health staff who could help were urged to get in touch.

Paul Reid, Chief Executive of the HSE said the service has been “overwhelmed” by people wanting to help in the fight against Covid-19. 

Speaking on the The Late Late Show, Mr Reid said that the interview process will begin next week and that 6,000 people will be interviewed each week.

He also said that the HSE is to double the number of beds in the health system.

Mr Reid said that there are currently 10,000 beds in the public health system and that they are now “ramping up to match that with another 10,000 across the whole system”.

#ItsInOurHands#COVID19Ireland

Those still wishing to help can do so by visiting http://hse.ie/oncall

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EMS News Features

National Pandemic Influenza Plan

This National Pandemic Influenza Plan is based on eight core elements:

  • communications strategy
  • telephone hotline
  • outlining the responsibilities of the public
  • surveillance
  • antiviral drugs
  • pandemic vaccine
  • reorganisation of health services and redeployment of health service staff
  • essential supplies.

This plan is based on the assumption that 96% of those who fall ill can be cared for in their own homes. Much of the planning effort revolves around making this possible.

It includes:

  • a communications plan to keep healthcare professionals and the public informed and advised at all times
  • provision of antiviral medicines to those who fall ill to reduce the duration and severity of their symptoms
  • a dedicated telephone hotline to provide advice and support.
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COVID 19/World News CRISIS HANDBOOK EMS News

COVID-19 CRISIS RESPONSE HANDBOOK

The Official Emergency Services Crisis Response Handbook will contain information on:

1. Getting ready: Emergency preparedness and crisis response. 

2. Protecting and empowering: community-based protection; protection interventions, specific needs, legal standards and principles

3. Delivering the response: Programme planning and management, sector guidance and good practices by operational context (urban/rural), standards and indicators, procedures for administration, finance, human resources, supply and information and communication technology (ICT)

4. Leading and coordinating: Setting strategy, coordination, emergencies, resource mobilisation and information management

5. Staff well-being: Support and advice for emergency responders, also in terms of psychological and physical well-being

6. Security: Security and risk management guidance, in view of emergency responders and persons of concern

7. Media: Working with journalists and mass media, including print, visual and digital media. 

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EMS News

Emergency Services in County Mayo Potentially Under Threat

A recent report published by The Connaught Telegraph have indicated that  Mayo’s emergency services are heading towards a point of not being viable anymore unless quick action is taken.

Speaking on the report ,independent candidate in the Castlebar area, former councillor Harry Barrett said “As it is emergency services in the county are stretched to capacity and this can be seen by the suffering of those who have to wait for hours in the emergency department and who then end up being treated on a trolley in a corridor.”

“Hospital management needs to issue an immediate statement to reassure the public that the accident and emergency service in Mayo University Hospital is fit for purpose.”

“The public need to be informed about any downgrade to the service due to staffing shortages. Any further deterioration in the already stretched service will lead to huge public anger, street protest and will not be accepted by the community.

He added “This situation is no reflection on the hard-working staff who have to work in very stressful conditions.Rather, it is the result of a failure by this government to deliver on its promises to reduce wait times, trolley numbers and to negotiate a consultants’ contract that is acceptable to staff.”

 

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Covid 19/Health

Coast Guard Helicopter Currently Not Licensed to Land at New National Children’s Hospital

The Minister for Health, Simon Harris TD has confirmed recently that an Irish Coast Guard Sikorsky S-92 helicopter will not be permitted to land on the elevated helipad at the new national children’s hospital under the current procedure in place. Mr Harris said “The Sikorsky S-92 rescue helicopters are not licenced to land on helipads”.

This means that any coast guard helicopter  that is carrying a patient transporting  to the  St. James campus  will have to land at the Royal Hospital in Kilmainham and the patient will be  have to be transferred by ambulance.

Mr. Harris told a committee meeting that ‘the majority of patient transfers to the existing three Dublin children’s hospitals are completed by road.’

The Irish Air Corps AW139 MediVac helicopter is licensed to make landings on elevated helipads and will continue to do so. A ground helipad was denied at the sight because of the required clearance to install one as well ask the awkward flight path for landings.

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EMS News

SLA’s To Ensure Continuity In Cross-Border Services In Case Of No-Deal Brexit

As reported by Valerie Ryan in the Irish Medical Times, it is not anticipated that there will be any break in services across the 30 Service Level Agreements currently in place with Northern Ireland in the event of a no-Brexit deal. This is according to both Department of Health and Health Service Executive (HSE) officials.

The Service Level Agreements between the two jurisdictions cover high profile programmes, including the 25-year agreement with the cancer centre in Altnagelvin in Northern Ireland and the primary percutaneous coronary intervention, providing an essential service for patients from Donegal.

In addition to the clinical programmes operating for patients both sides of the border, Department of Health and HSE officials have travelled to the United Kingdom to seek assurance that the current round of EU North South funding, known as Interreg, would be secured until the end of the programme of funding in 2020.

To “Brexit-proof” the current arrangements, an INTERREG 5A €30 million project was underpinned by Her Majesty’s Treasury, Health Committee members heard at their latest meeting to consider the potential impact of Brexit.

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EMS News

Latest Figures Show 11% Increase In Emergency Calls

Ireland’s 999/112 emergency call centres handled almost 2.1 million calls last year, an increase of over 11% on 2017, recent data has shown. The Emergency Call Answering Service (ECAS) has been operated by BT Ireland since July 2010.

Operators at two ECAS centres in Meath and Dongeal, transfer emergency calls to An Garda Síochána, National Ambulance Service, the fire service and Irish Coast Guard. In cases where aircraft are involved, calls are also transferred to Air Traffic Control.

Figures released by the Commission for Communications Regulation (ComReg) have confirmed that last year, ECAS operators answered 2,008,006 calls, over 200,000 (11.1%) more than in 2017. However, less than half of all calls received last year were actually forwarded to the emergency services. This is because calls are carefully screened and filtered by ECAS transferring operators.

“The ECAS service is operated from centres at Navan in Co Meath and Ballyshannon in Donegal. Staff at the two facilities handle more than 5,000 calls a day on average from the public who find themselves in emergency situations. ECAS aims to answer each call within 0.6 seconds,” a spokesperson for BT said.

While calls to 999/112 are free to the public, a call handling fee is determined by the Communications Regulator (ComReg). This is levied on communications companies so public funds are not used for the provision of the ECAS service.

A new ECAS contract for the period 2019 to 2025 was awarded to BT Ireland by the Department of Communications, Climate Action and Environment in 2018, which commenced in February 2018.

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EMS News

Air Corps Continue To Make Significant Emergency Response Contribution

The Irish Air Corps carried out more than 300 Air Ambulance missions in 2018 with the more than half of those taking place in the west of Ireland.

The primary role of the Air Corps is to provide military air defence and support to the army, as well as providing support to organisations like the HSE and government departments under their remit as an aid to the civil power.

In the past year, some 310 dispatches from the Air Corp were required under the Emergency Aeromedical support (EAS) service, which has a particular responsibility to support seriously ill patients in rural communities. The service has been fully operational since 2014, using modified versions of both the EC135 and AW139 helipcopters.

The majority of missions took place in Western counties with 49 completed missions in Mayo, 36 in Galway, followed by 30 in Roscommon and 25 in Clare. On the other end of the spectrum, there was just one mission each carried out in Kildare and Kilkenny, and no EAS missions at all in 2018 in Dublin.

Following the establishment of the EAS programme in 2012, the Air Corps has completed 2,300 missions throughout the country, headquartered at Air Corps HQ in Baldonnel in Dublin and supported by a crew in Custume Barracks in Athlone.

In addition to the ambulance service provided, latest figures also show the Air Corps completed 197 civil power operations which offer assistance to An Garda Síochana’s bomb squad, prisoner escorts, cash escorts and search operations.

Extreme weather events in 2018 also saw the Air Corps playing a major role , with military pilots mitigating the impact of events including Storm Emma and the severe drought experienced through the summer months. Some 900,000 litres of water were dropped on areas affected by wildfires in counties Dublin, Wicklow, Limerick, Tipperary and Wexford.as well as parts of Armagh and Down.

Minister of State with responsibility for Defence, John Kehoe said the support provided in Northern Ireland was a standout moment for the force this year. “These were unprecedented operations from our perspective and they are among many reasons why we are extremely proud of the work of the women and men of the Irish Air Corps.”

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EMS News

RSA Chief Wants Mobile Devices For Gardaí to Detect Disqualified Drivers

peaking yesterday on World Remembrance Day for Road victims the Road Safety Authority chief Moyagh Murdock said that mobile access to a national database is essential for gardaí in order to see if a driver is unqualified or has a suspended licence at the roadside.

In 2017, 158 people died in road traffic incidents on Irish roads and that figure for 2018 currently stands at 130 people. The total figure since 1959 when records began is a staggering 24,255 people who have died on Irish roads.

The new device would would mean that gardaí would not have to wait to return to a station to check the status which is “not an effective or an intelligent way to police the roads.”

She added “The challenge now is to get the commitment and resourcing to roll out hand-held devices to the full traffic core and gardaí in general.”

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Covid 19/Research

The History of the Ambulance Service

One of the most important services in this world is definitely the Ambulance Service. Without the hardworking paramedics providing quick aid around the clock, many of us would be helpless in medical emergencies. But like everything, ambulances have gone through hundreds of years of evolution to grow into the way they are today.

The early days

The history of the ambulance begins in ancient times, with the use of carts to transport patients. There is evidence of forced transportation of those suffering with psychiatric problems or leprosy in ancient times. The earliest record of such an ambulance was probably a hammock-based cart constructed around 900 AD by the Anglo-Saxons.

During the Crusades of the 11th century, the Knights Hospitaller set up hospitals to treat pilgrims wounded in their battles in the ‘holy land’, although there is no clear evidence to suggest how the wounded made their way to these hospitals.

The Normans used a litter suspended between horses on two poles. Variations on the horse litter and horse-drawn wagons were used until the 20th century.

Origins in the military

The first record of ambulances being used for emergency purposes was the use by Isabella I of Castile, in 1487. The Spanish army of the time was well treated and attracted volunteers from across the continent; and among their benefits were the first military hospitals or ‘ambulancias’, although injured soldiers were not picked up for treatment until after the cessation of the battle, resulting in many dying on the field.

A major change in usage of ambulances in battle came about with the ‘ambulance volantes’ designed by Dominique Jean Larrey, Napoleon Bonaparte’s chief physician. Larrey was present at the battle of Spires, between the French and Prussians, and was distressed that wounded soldiers were not picked up by the numerous ambulances until after hostilities had ceased, so he set about developing a new ambulance system. Having decided against using the Norman system of horse litters, he settled on two- or four-wheeled horse-drawn wagons to transport fallen soldiers from the battlefield after they had received early treatment in the field.

Larrey adapted the axle assembly from the French’s horse-drawn artillery that made their gun carriages especially manoeuvrable on uneven terrain, and so christened his ambulances “flying ambulances” (ambulance volantes). The flying ambulances were first used by Napoleon’s Army of the Rhine in 1793. Larrey subsequently developed similar services for Napoleon’s other armies, and adapted his ambulances to the conditions; including developing a litter which could be carried by a camel for a campaign in Egypt.

More advances in medical care for the military were made during the United States’ Civil War. Union military physicians Joseph Barnes and Jonathan Letterman built upon Larrey’s work and designed a prehospital care system for soldiers, which used new techniques and methods of transport. They ensured that every regiment possessed at least one ambulance cart, with a two-wheeled design that accommodated two or three patients.

These ambulances unfortunately proved to be too lightweight for the task, and were phased out to be replaced by the “Rucker” ambulance, named for Major General Rucker, which was a four-wheeled design, and was a common sight on battlefield of that war. Other vehicles were pressed into service during the civil war, including a number of Steamboats, which served as mobile hospitals for the troops. It was in this period that the practice of transporting wounded soldiers to treatment facilities by railroad was introduced.

Civilian ambulances

In civilian ambulances, a major advance was made with the introduction of a transport carriage for cholera patients in London in 1832. The Times newspaper said, “The curative process commences the instant the patient is put in to the carriage; time is saved which can be given to the care of the patient; the patient may be driven to the hospital so speedily that the hospitals may be less numerous and located at greater distances from each other”.

The first known hospital-based ambulance service was based out of Commercial Hospital, Cincinnati, Ohio, (now the Cincinnati General) in 1865. This was soon followed by other services, notably the New York service provided out of Bellevue Hospital. Edward Dalton, a former surgeon in the Union Army, was charged with creating a hospital in lower New York; he started an ambulance in 1869 service to bring the patients to the hospital faster and in more comfort. These ambulances carried contemporary medical equipment, such as splints, a stomach pump, morphine, and brandy.

Dalton believed that speed was essential, and at first the horses were kept in harness while awaiting a call. Within a few months this practice had been replaced with a drop harness arrangement, which was lowered by pulley from the ceiling straight onto the horse. Under either scheme, ambulances were ready to go within 30 seconds of being called. The service was very popular and grew rapidly, with the year 1870 seeing the ambulances attend 1401 emergency calls, but twenty-one years later; this number had more than tripled.

From then on, the plan was to crew the ambulances with fresh graduates of Bellevue’s surgical training program, who would serve for six-month terms and be replaced by new hires from successive graduating classes.

In 1867 the city of London received six horse-drawn ambulances for the purpose of transporting smallpox and fever patients from their homes to a hospital. These ambulances were designed to resemble private carriages, but were equipped with rollers in their floors and large rear doors to allow for a patient, to be easily loaded. Space was provided for an attendant to ride with the patient, and the entire patient compartment was designed to be easily cleaned. Anyone willing to pay the cost of horse hire could summon the ambulance by telegram or in person.

A couple years later, in 1880, the President of the Liverpool Medical Institution suggested a horse-drawn ambulance for his city. In 1884, this ambulance service was created based at the Liverpool Northern Hospital. It was the first of its kind in Britain.

In Ireland the St John Ambulance was set up in 1903 in the Guinness Brewery in St. James Gate in Dublin by Doctor John Lumsden for the workers. In 1910 the Brigade began its first public duty at the Royal Dublin Society. During the 1916 rising and (after becoming the independent St. John Ambulance Brigade of Ireland) the World War II the brigade acted as an ambulance service and remained so until the setup of Regional Ambulance Services.

In Queensland, Australia, military medic Seymour Warrian called a public meeting in Brisbane and established an ambulance service after witnessing an event at the Brisbane showgrounds during Show Week in 1892. A fallen rider, suffering a broken leg was walked off the field by well-meaning but misguided bystanders, worsening his injury. As a result, the first ambulance station in Queensland opened and operated out of the Brisbane Newspaper Company.

Officers on night duty slept on rolls of newspaper on the floor. They had a stretcher, but no vehicle and transported patients on foot, although after some time, they gained horse-drawn stretchers and eventually vehicles. A year after the establishment of the Brisbane centre, another was established in Charters Towers in north Queensland, growing to over 90 community controlled ambulance centres. In 1991 the independent QATB centres amalgamated to form the Queensland Ambulance Service which is now the fourth largest ambulance service in the world.

In the late 19th century cities, including Bahia, Brazil and St Louis, Missouri, United States started using trolley cars on their tram network which were designed to act as ambulances, transporting the sick and injured. The trolley cars in Bahia included a fumigating compartment and a two bed nurse’s work area. The design of the tram network in St Louis was such that the ambulance streetcar, introduced in 1894 was able to reach all 16 infirmaries in the city.

Switch to gasoline-powered vehicles

In the late 19th century, the automobile was being developed, and started to be introduced alongside horse-drawn models. Early 20th-century ambulances were powered by steam, gasoline, and electricity, showing the competing automotive technologies then in existence. However, the first motor-powered ambulance was brought into service at the end of the 19th century, with the Michael Reese Hospital, Chicago, taking delivery of the first automobile ambulance, donated in February 1899 by 500 prominent local businessmen. This was followed in 1900, by New York City, which extolled its virtues of greater speed and more safety for the patient. These first two automobile ambulances were electrically powered with 2 horsepower motors on the rear axle.

The first gasoline-powered ambulance was the Palliser Ambulance, introduced in 1905, and named for Capt. John Palliser of the Canadian Militia. This three-wheeled vehicle was designed for use on the battlefield, under enemy fire. It was a heavy tractor unit, encased in bulletproof steel sheets. These steel shields opened outwards to provide a small area of cover from fire for the ambulance staff when the vehicle was stationary.

The British Army followed quickly behind the Canadians in introducing a limited number of automobile ambulances. In 1905, the Royal Army Medical Corps commissioned a number of Straker-Squire motor ambulance vans. They were based on a double-decker bus manufactured by the same company, although on a shorter wheelbase. A number of them were based in Oxfordshire, serving several major encampments in the area.

But the first mass-production automobile-based ambulance was manufactured in the United States in 1909 by the James Cunningham, Son & Company, a manufacturer of carriages and hearses. This ambulance featured a proprietary 32 horsepower, 4-cylinder internal combustion engine. The chassis rode on pneumatic tires, the body featured electric lights, a suspended cot with two attendant seats, and a side-mounted gong.

During World War One, the Red Cross brought in the first widespread battlefield motor ambulances to replace horse-drawn vehicles, a change which was such a success, the horse-drawn variants were quickly phased out. In civilian emergency care, dedicated ambulance services were frequently managed or dispatched by individual hospitals, though in some areas, telegraph and telephone services enabled police departments to handle dispatch duties.

Air support

During World War I, aviation moved on from experimentation to be a powerful military force, and following the war, new uses were found for the remaining aircraft. This included the conversion of planes throughout the world into ambulance planes. Although in 1917, Lieutenant Clifford Peel, a medical student, outlined a system of fixed-wing aircraft and ground facilities designed to provide medical services to the Australian Outback, the first custom-built air ambulances did not come into existence until the late 1920s.

These ideas became reality under the guidance of the Very Reverend John Flynn in 1928 when the Australian Inland Mission service established the Aerial Medical Service, a one-year experimental program. Physicians in this program had several responsibilities, one of which was to fly out to a patient, treat the patient, and fly the patient to a hospital if the physician could not deliver adequate care on scene. Eventually, this project became the Royal Flying Doctor Service of Australia.

During the Korean War, the newly created United States Air Force produced a number of air-ambulance units for use in forward operating medical units, using helicopters for rapid evacuation of patients. The H-13 Sioux helicopter, made famous by the film and television versions of M*A*S*H, transported 18,000 wounded soldiers during the war. The work of the Medical Air Evacuation Squadrons was a big success and the use of helicopters for emergency medical evacuations extended to civilian practice by groups such as the Shock Trauma Air Rescue Society.

Modern ambulances

After the Harrow and Wealdstone rail crash in 1952, ambulances in Britain were restructured to be a “mobile hospital”, rather than just transporting patients, thus leading to modern ambulances. CPR was developed and accepted as the standard of care for out-of-hospital cardiac arrest; defibrillation, based in part on an increased understanding of heart arrhythmias, was introduced, as were new pharmaceuticals; but studies at that time showed the need for overhauling ambulance services.

These studies placed pressure on governments to improve emergency care in general, including the care provided by ambulance services. Part of the result was the creation of standards in ambulance construction concerning the internal height of the patient care area, to allow for an attendant to continue caring for the patient during transport, and in the equipment that an ambulance had to carry. Few of the then-available ambulances could meet these standards. Ambulance design therefore underwent major changes in the 1970s.

High-topped car-based ambulances were developed, but car chassis proved unable to accept the weight and other demands of the new standards; van chassis would have to be used instead. The early van-based ambulances looked very similar to their civilian counterparts.

As time went on, ambulances matured in parallel to the newly developed EMS, gaining the capacity to carry additional equipment as EMTs and paramedics added this equipment to their arsenal. Ambulance design also evolved to reflect the ergonomics and other human factors of emergency medical care. Advances in the technology and understanding of emergency vehicle equipment also continued to influence ambulance design.

Modern ambulances are now often custom built, and as well as the specialist medical equipment now built into the ambulances, industry wide improvements in vehicle design have had an impact. Including improvements in audible and visual warning equipment to help protect crews in vulnerable situations (such as at a Road Traffic Collision), and general vehicle improvements such as ABS, which are particularly valuable for ambulances, due to the speeds reached and the weight carried by them. There have also been improvements to help safeguard the health and welfare of ambulance crews, such as the addition of patient tail lifts, ramps and winches, to cut down on the amount of manual handling a crew must perform.

Ambulance design is still evolving, largely due to the growing skills and role of Paramedics and other ambulance crew, which require specialist equipment. Other factors driving improvement include the need to help protect ambulance crews from common accidents, such as traffic collisions.

History in Ireland

Initially, from the early 1900’s to the 1970’s, ambulance services in Ireland were provided by the County Councils. Ambulance drivers were recruited from the local authority pool of drivers and had no formal training until new regulations were put into place in the late 1960’s. Back then, the Ambulance driver was accompanied by a nurse from the nearest local hospital who was the first aid renderer on the vehicle.

The mid 1960’s seen the establishment of the National ambulance training board and with it, a first aid syllabus for Ambulance drivers followed in 1966. In rural areas some Ambulance services were provided by Voluntary Aid Organisations. Under the 1970 Health board’s act, the running and provision of Ambulance services became the remit of the newly formed Health boards. Initially 8 Health boards were established but this was later increased to 10 with each area Health board providing its own Ambulance service.

The National Ambulance training school was established in St. Mary’s hospital in Dublin, in 1986 and some years later the first Government review of Ambulance services came about in December 1993. And within it, the Ambulance service had for the first time been formally recognised as an Emergency service.
This was further confirmed by a letter from the then Fine Gael Minister for Health in 1995 when asked to clarify the status of the Country’s Ambulance Service by staff representative bodies.

In 1997 on foot of one of the review group’s recommendations, Ireland had its first Emergency Medical Technicians, and the year 2000 saw the inception of the pre-hospital emergency care council, an independent statutory body with responsibility for standards in education and training in the field of pre-hospital emergency care. At the beginning of the new millennium, the Irish Ambulance service was a non-regulated profession with no skill or clinical practice guidelines to adhere to.

With the establishment of the Pre-Hospital Emergency Care Council (PHECC), Irish Ambulance personnel have signed up to a regulatory body with published clinical practice guidelines which are now on their third edition.

The Republic of Ireland National Ambulance Service was established in 2005 as part of the Health Service Executive and serves a population of 4,470,700 over an area of 68,893 sq. km from 94 Ambulance stations with a staff compliment of 1400.

In 2006 two new practitioner levels were introduced onto the PHECC register, Paramedic and Advanced Paramedic although the titles and qualifications are not recognised by way of re-grading within the statutory HSE Ambulance service.

Irish Ambulance personnel are now answerable to a fitness to practice committee and bound over to hold their place and a register of pre-hospital practitioners. They have a skill matrix consisting of almost 90 potentially life-saving interventions for paramedics and 108 life-saving interventions for advanced paramedics, including invasive procedures. They also complete additional courses such as non-violent crisis intervention, pre-hospital trauma life support, paediatric education for pre-hospital providers, major incident medical management and support, and advanced driver training courses.

Irelands Pre-Hospital practitioners have evolved over the past decade in to a dynamic and competent group of medical professionals, sadly all too often their commitment to serve the public and their dedication to their profession is forgotten.

By Catherina Arndt

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Covid 19/Events

Garda Band to Play St Bridget’s Blanchardstown on Tuesday

The fantastic Garda band will be in concert at St Brigid’s Church in Blanchardstown this coming Tuesday (October 30th)

The concert will start at 8:00 pm until 10:00 pm and tickets are available at the door for €10.

All of the money raised on the night will assist with the huge costs incurred in renovating the carparks around the church and national schools.

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Covid 19/Advice

European Police Marathon in Dublin this Sunday

The European Police Championships Marathon will be held in Dublin this coming Sunday (Oct 28th). The marathon will be in conjunction with the SSE Airtricity Dublin Marathon 2018. The annual race is organised by Coiste Siamsa An Garda Síochána and Union Sportive Des Polices D’Europe (USPE) and will see over one hundred and fifty athletes from twenty-two countries taking part.

Representing An Garda Síochána and Ireland this year will be; Kieran Lees a Garda stationed at Caherconlish Garda Station in Co.Limerick, David Craig stationed at Bishopstown in Cork, David Mansfield Stationed at the Garda College in Co. Tipperary, Clive Glancy stationed at Longford, Jason Miley stationed at Terenure in Dublin and Louise Long stationed at Lexlip, Co. Kildare.

Speaking about the upcoming event, Assistant Commissioner Anne Marie McMahon the Chair of Coiste Siamsa the Garda Síochána’s sports and recreation association said, “I am delighted to welcome the athletes from all over Europe to Ireland for Sunday’s Dublin Marathon. I would also like to thank the organisers of the Dublin Marathon for all their help in facilitating the event and can I finally wish everyone taking part the very best of luck”.

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EMS News

New ‘Safe-Injecting’ Centre To Open On Dublin’s Merchant’s Quay

The planned new State-funded injecting centre for chronic heroin and cocaine addicts in Dublin’s inner city is to cater for around 60 addicts each day and is to open at 6.30 each morning.

Earlier this year, Merchants Quay Ireland won the tender from the Health Service Executive (HSE) to operate the Medically Supervised Injection Facility (MSIF) and the organisation has now lodged plans for the contentious facility with Dublin City Council.

The centre – which is the first of its kind in Ireland consisting of seven injecting rooms – is to be housed in the basement of Merchant’s Quay existing Riverbank building at 13/14 Merchants Quay.

The centre already provides a range of homeless, healthcare and drug services and the centre’s ‘Community Engagement &amp; Liaison Plan’ refers to the proximity of the centre to the school when it states: “We fully appreciate the concerns raised by staff and parents of children at St Audoen’s National School. No one wants children exposed to the sight of drug use and drug litter.

We believe that the MSIF can provide an effective response to the concerns raised. Research from abroad have shown a reduction in public injecting and drug litter.”

In the area comprising of the seven injecting booths, sterile injecting equipment will be distributed while resuscitation equipment will be located in this area and the individual injecting will be monitored in order to provide emergency care in case of overdoses or other adverse reactions.

The Operation Plan states: “Clients have to be possession of their own drugs, obtained elsewhere, before entering the facility and will not be permitted to obtain or share drugs with other clients while in the vicinity. Clients must inject themselves – staff will not be allowed to inject clients.”

Objectors to the development have until November 12th to lodge objections and already, the proposed facility has attracted two objections. Shane Cahill operates the Four Courts Hostel on Merchants Quay and has urged the Council to refuse planning permission.

In his objection, Mr Cahill states: “With the services being offered by MQI come a host of anti- social behaviour such as dealers working shifts along the quays on a 24 hour basis, beatings between them, assaults and muggings on the public, public vomiting/urine, defecation, delivery of drugs by car/taxi/bicycle to name but a fraction of the daily occurrences that we see in the area.

It is volatile to say the least. The area has become increasingly dangerous for the public and I believe that the area would be far safer if MQI not only found another suitable location for the MSIF but also reduced the current services that they offer.”

In a separate objection, Pat Coyne from Arran St East, Dublin said: “It is unacceptable that the possession of hard drugs will be allowed within a specified small radius of this centre without any sanction.”

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EMS News

Air Ambulance Close To Lift-Off

Ireland’s first community air ambulance service is set to take off before Christmas— but it won’t be a doctor-led service as had been anticipated and hoped for. The decision has been taken to launch the life-saving service with an advanced paramedic and an emergency medical technician (EMT) delivering the care. Training of the National Ambulance Service (NAS) staff is underway.

It has also been confirmed that the aircraft will be based at an airfield in north Cork, and not at Cork Airport, as had also been hoped for by those advocating for the service. The details were confirmed last week by Irish Community Rapid Response (ICRR) founder John Kearney, who has been working and lobbying for over a decade to launch a Helicopter Emergency Medical Service (HEMS) in Ireland.

Others who have long advocated for the service include the Mayo GP, Barrister and Politician Jerry Cowley. Mr Kearney’s pre-hospital care charity has a network of rapid response vehicles and volunteer doctors delivering a land-based emergency service around the country.

But the ambition has always been to launch a doctor-led air ambulance service similar to successful models across the UK and Europe. It was announced in July that a contract had been signed between ICRR and UK-based Sloane Helicopters to provide the aircraft for the service, after a massive fundraising drive for the service.

But Mr Kearney said presently it just wasn’t possible to launch a seven-day-a-week doctor-led HEMS. “Ultimately, that’s where we’d like to get to but we are aware of the shortage of doctors in the health system and we don’t want to take them away from the frontline. Hopefully, as this service builds, we will get to that point. But let’s get it up and running, and we’ll build on that,” he said.

Plans to base the service at Rathcoole Aerodrome, an Irish Aviation Authority-licensed airfield just northeast of Millstreet, are at an advanced stage. Its strategic location will mean the aircraft will be a 20-minute flight from the Dingle Peninsula to the west, Dungarvan to the east, or Crookhaven to the south.

Crucially, it will bring the population of a 10,000-sq mile area within half an hour of critical care. The new service is designed to complement existing emergency services including the Athlone-based emergency aeromedical service operated by the NAS and Irish Air Corps.

The ICRR service, which is anticipating up to 500 calls per year, is being supported by the HSE and Department of Health, will be tasked through the 999 or 112 emergency call system operated by the NAS at its National Emergency Operations Centre.

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Covid 19/Health

25% Of A&E Admissions Unnecessary According To New Study

Almost a quarter of A&E admissions could be potentially avoided in a better functioning health system, according to a new study which indicates that some of these unnecessary admissions are driven by deprivation, hospital practices, and health insurance concerns.

The new research, entitled ‘Drivers of potentially avoidable emergency admissions in Ireland: an ecological analysis’, and published in the BMJ Quality and Safety journal, estimates that 22% of A&E admissions are eminently avoidable.

The study was led by University College Cork economics lecturer Brenda Lynch and carried out under the Structured Population and Health-services Research Education (Sphere) programme. The report examined admissions data to calculate age-adjusted emergency admission rates for selected conditions by county of residence between 2014 and 2016.

According to the study: “Over the past 10 years in Ireland, emergency admissions have increased by almost 1,000 per annum from 32,000 in 2005 to 41,500 in 2016. As of 2016, emergency admissions accounted for approximately one in four of all hospital admissions.”

It said that potentially avoidable admissions include those relating to an undiagnosed or untreated underlying condition. In best case scenarios, the patient could have been treated more appropriately elsewhere, such as in the patient’s home or in a community setting.

It also considers the reconfiguration of A&E’s and the role of private health insurance, noting: “Ireland’s public hospital system is financed through a mix of both public and private spending. Older adults with private health insurance are more likely to have an overnight stay in a public hospital than those without insurance, possibly because it is financially beneficial for public hospitals to keep such patients within the health system for longer.

Population factors such as those population factors relating to age, deprivation, and rurality are included. Taking 14 selected conditions the study analyses the data and among its conclusions is that primary care resources do not seem to be a strong predictor, but “it is more likely that those counties with high unemployment will experience high emergency admissions for the 14 selected conditions”.

“This study shows that at a regional level much of the variability in emergency admission rates can be explained by socioeconomic deprivation, hospital policies and private insurance coverage.”

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EMS News

450 Calls Dealt With By Voluntary First Aid Organisations During Storm Emma

It was announced that 450 calls were dealt with by voluntary first aid organisations since last Wednesday, February 28th due to Storm Emma.

Volunteers working for the Irish Red Cross, Order of Malta and St John Ambulance all received recognition from the joint heads of their organisations for outstanding contributions made during the challenging weather conditions.

A statement by the Irish Red Cross reads:

“The joint heads of the three voluntary First Aid organisations, Irish Red Cross, Order of Malta and St John Ambulance, operating collaboratively as the Joint Voluntaries Coordinating Committee, would like to publicly thank their volunteers for their outstanding work during the recent exceptional weather conditions.

“At time of writing, over 450 calls were fielded by the JVCC Control Centre working directly with, and in response to, the National Emergency Operations Centre (NEOC) of the National Ambulance Service (NAS). With the support of their families, these volunteers have demonstrated the value of the countless hours of training and fundraising that goes into volunteering in the support of our communities.”

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EMS News

Blizzard And Stay Indoors Warnings Lifted

Met Eireann has lifted its blizzard warning and removed instructions for the public to stay indoors until 6pm this evening.

However, a status red snow-ice warning is currently in place for Munster, Leinster and Galway with strong easterly winds until 6pm.

A status orange warning is in place for the rest of the country.

The worst affected counties at this stage appear to be Cork, Waterford, Wexford, Kilkenny, Wicklow, Kildare, Dublin, Meath, Cavan, Tipperary, Offaly, Galway and Kerry.

The public are advised not to make any unnecessary journeys as many roads in Ireland remain “treacherous” and “impassable”.

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EMS News

Gardai & RSA Issue Severe Weather Warning For Motorists Not To Make Any Unnecessary Journeys

Many roads across Ireland remain “treacherous” and “impassable” today due to Storm Emma striking the country.

Both the Gardai and the Road Safety Authority (RSA) have issued severe weather warnings for motorists not to make any unnecessary journeys in light of recent events.

A Gardai spokesperson said:

“Gardaí are asking motorists to avoid unnecessary journeys. Many roads remain impassable and local authorities are prioritising national routes. If you must travel and become stuck, contact emergencies services.”

Meanwhile, a spokesperson for the RSA said:

“The Road Safety Authority (RSA) is advising road users not to make any unnecessary journeys in areas badly affected by the recent snowfall as roads are treacherous, and some impassable in many parts of the country today.

“Where travel is absolutely unavoidable road users should check local conditions and traffic reports before considering making any journey.”

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Covid 19/Health

New Trauma System for Ireland Will Lead To Better Outcomes For Patients- Harris

The Minister for Health, Simon Harris, has said that a new trauma system for Ireland will lead to better outcomes for patients.

He said it will make sure they get to the right place, for the right care, first time.

The Minister today published the report of the Trauma Steering Group, “A Trauma System for Ireland”, following Government approval.

Minister Harris said:

“The Trauma Steering Group was established by Government to bring about better outcomes for the 1,600 patients who suffer a major trauma in Ireland every year.

“The aim is to reduce death and disability, and ensure high quality trauma services are available to everyone in the country, whether they live in a city or in rural Ireland.

“The Steering Group was led by clinicians, with a key input from patients, and its recommendations are evidence based. This is about providing the right care to patients and increasing services and expertise.”

The report recommends the establishment of an inclusive trauma system which will include two regional trauma networks, one central and one south.

There will be one designated major trauma centre in each of these networks, which should treat a minimum number of major trauma patients in order to maintain a critical mass of specialist expertise.

The networks will also include a number of other trauma units and, in addition, a trauma unit with specialist services, which will also deal with trauma cases.

At the moment a trauma system in Ireland does not exist. There are Emergency Departments that are equipped to a greater or lesser extent to deal with trauma, and pre-hospital emergency care services that bring people to those hospitals, without having adequate clear protocols around trauma.

This means that currently, patients may present to any acute hospital, regardless of how much expertise and experience in trauma exists there.

“The vision for a national trauma system set out in this major report is to prevent unnecessary deaths, to reduce disabilities and to significantly improve the patient’s chances of attaining the fullest possible recovery,” said Minister Harris.

“Evidence-based and informed by population needs, it addresses the entire care pathway from prevention and pre-hospital emergency care through to rehabilitation.

“There is a relatively low incidence of major trauma in Ireland but the cost to individuals and their families can be very high. The trauma system for Ireland will enhance the chance of survival and lead to better patient outcomes.”

The Minister also noted the important role of the major trauma audit.

Patients who have used trauma services and clinicians were at the heart of the development of the report.

The full report can be read using this link.

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Covid 19/Health

Free Webinar About Women’s Hearth Health By Dr. Amy Doneen

In celebration of American Heart Month, Dr. Amy Doneen, co-founder of the BaleDoneen Method (BDM), a science-based approach focusing on preventing and treating Cardiovascular disease (CVD), will present a free webinar discussing women’s heart health.

Unlike standard care, which is based on checking patients for certain CVD risk factors, the BDM also uses advanced lab tests and imaging to directly check for hidden signs of arterial disease. It is practised by hundreds of healthcare providers globally.

“Heart disease is the leading killer of American women, claiming more female lives than all forms of cancer combined,” says Dr. Doneen, medical director of the Heart Attack & Stroke Prevention Centre in Spokane, Washington.

“CVD is under-diagnosed and undertreated in women, which is why they need to be their own best advocates for optimal heart health care,” adds Dr. Doneen. “My goal with this webinar is to empower women with a science-based action plan to keep their arteries healthy.”

Dr. Doneen will discuss “Women and Heart Disease-the REAL Deal!” this coming Friday, February 9th at 1:30am-2:30am GMT. For the public and healthcare providers, the webinar will cover what’s different about women’s hearts, surprising cardiovascular red flags, how to find out if you have hidden risk, what women can do to find out if they have arterial disease, and a personalised action plan to prevent a heart attack or stroke.

You can register for the webinar by using the following link.

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EMS News

Final Report on Rescue 116 Crash Will Not Be Completed By Anniversary of Tragedy

Ireland’s Air Accident Investigation Unit (AAIU) have released a statement informing the public that a final report on the Irish Coast Guard Helicopter Rescue 116 crash last March will not be completed by its anniversary.

The AAIU said a final report will not be completed in time due to “the depth and breadth” of the investigation.

On March 14, 2017 four crew members of the Rescue 116 tragically lost their lives after the helicopter crashed into Blackrock Island off the coast of Mayo.

Captain Dara Fitzpatrick was recovered from the water within hours and later pronounced dead in hospital. The body of one of the missing crew was found in the wreckage on 24 March and recovered by NSDS divers on 26 March after which it was formally identified as that of Captain Mark Duffy.

The bodies of winchmen Ciarán Smith and Paul Ormsby remain missing despite weeks of intensive searches.

The full statement by the AAIU reads as follows:

“The AAIU Investigation into the accident involving the loss of R116 and its four crew members at Blackrock, Co. Mayo on 14 March 2017 is still in the process of gathering factual and background information and is making steady progress.

“The AAIU again extends its condolences to the families and friends of those who lost their lives in this accident. International Convention, and associated National and European legislation, require that, if a final report cannot be made publicly available within 12 months of the date of the accident, an interim statement detailing the progress of the investigation and any safety issues raised, will be made publicly available.

“The AAIU wishes to advise that due to the depth and breadth of this Investigation, it will not be possible to issue a final report within 12 months of the date of the accident and therefore an interim statement will be published. The Investigation is endeavouring to issue this interim statement before the anniversary; however, it is not possible to say at this time when the interim statement will be published.”

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EMS News

Woman Calls Ambulance Service For Advice On A Broken Egg

An unnamed caller reached out to a UK ambulance service for advice on a broken egg in her fridge.

The operator replied:

“This is the ambulance service, we cannot advise you about eggs I’m afraid.”

The East Midlands Ambulance Service (EMAS) have released the ludicruous audio recording to the general public in a bid to remind people not to waste emergency services’ time.

A spokesperson for EMAS stated:

“We answer over 2,500 999 calls every day from people requiring emergency medical assistance for cardiac arrests, strokes, breathing difficulties and serious injuries.

“However, some of the 999 calls we receive are not for emergency situations and when one of our call handlers is on the phone to these inappropriate calls, they are not able to help someone in a real emergency.”

Recent inappropriate calls to EMAS have included someone with a broken toenail, someone who wanted a taxi home and a patient waiting to be seen at a GP surgery, but who didn’t want to wait the 30 minutes for their appointment.

The 10 most inappropriate 999 calls received by EMAS are:

  1. Person pouring milk over their body – as part of an art installation
  2. Wants sleeping tablets
  3. Toothache
  4. Dead fox
  5. At GP surgery, doesn’t want to wait 30 mins for appointment
  6. Someone had stolen their drinking glass
  7. Wants bandage changing
  8. Wants someone to make them breakfast
  9. Wants a taxi
  10. Big toenail has come off

Simon Tomlinson, general manager for EMAS’s emergency operations centres, said he wanted to remind people to only dial 999 in the event of a serious emergency.

He also urged people to remember that there are other options available if they need medical assistance, such as calling NHS 111, by contacting their GP or a pharmacist, or visiting an NHS walk-in centre.

Mr Tomlinson continued:

“Every 999 call is assessed so that the right help is provided to the right people as quickly as possible.

“You could receive the right treatment for you more quickly by contacting an alternative NHS service, such as your local pharmacy or NHS111, particularly if your call is not a serious emergency.

“Please help us to make sure we can reach the people who need us the most.”

EMAS said it received 59,349 999 calls in December 2017 – and a small proportion of these were inappropriate calls.

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Covid 19/Technology

Artificial intelligence is helping emergency services spot cardiac arrest calls in Denmark

Artificial intelligence is being used on emergency service calls in Denmark to help spot signs of cardiac arrest.

A virtual assistant called Corti is being used by some emergency service dispatchers in Copenhagen, which uses voice recognition and machine learning to help look for signals of heart attack in patients on emergency calls.

Corti chief executive Andreas Cleve has uploaded a demo video of the technology in action to YouTube, which shows Corti logging the conversation, including signals and trigger words on the state of the patient and then offering real time recommendations on how critical the situation is.

The company says early recognition of the condition is vital in increasing survival chances, with that chance said to decrease by 10% for every minute it goes undetected.

It is currently being used by emergency services in Copenhagen on the official 112 emergency number, with Corti’s technology also being used to spot any errors in the dispatch, including the address any emergency response is sent to.

For now it is only being trialled in Denmark, but according to the magazine Fast Company it is expected to make an announcement in the near future about expansion plans, possibly to the US.

AI as a monitoring tool for both spoken and written language is far from a new idea – it’s been behind the technology of predictive text for years, and is now used by many social networks to find and remove inappropriate content online.

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Covid 19/Health

Step Out And Become More Active With The Irish Red Cross

If you’re around Drogheda tomorrow (Saturday, January 20th) you may want to put on your walking shoes and join The Irish Red Cross for their first Healthy Steps walk of 2018.

The walk is one out of a planned twelve due to occur in Drogheda over the coming months.

Following on from a successful pilot programme in 2016, the Healthy Steps initiative, run by the Irish Red Cross Health and Social Care Working Group, is now a national programme.

The overall aim of the programme is to establish 10 walking groups around the country and this national initiative has been led by a volunteer with the Drogheda Red Cross branch, and Drogheda native, Paraic McGahey.

Get Ireland Walking have come on board as official partners for this initiative and Louth Sports Partnership have come on board for the Healthy Steps walks in Drogheda.

A spokesperson for the Irish Red Cross said:

“The aim of Irish Red Cross Healthy Steps is to create a low to zero cost initiative which can be rolled out nationwide to address health issues and social problems in Ireland.

“In particular, this programme aims to address the prevalence of obesity, mental health issues and social exclusion. The programme also aims to create more direct engagement between Irish Red Cross branches and local communities while it also aims to develop community resilience.”

The Irish Red Cross Healthy Steps walks will be running for 12 weeks.

Each week participants will meet at Drogheda Community Centre at 11am. The walks will be 4-5km in length but the route will vary slightly each week.

For more information on the Healthy Steps programme, you can contact healthandsocialcare@redcross.ie.

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Covid 19/Advice

The 24th Annual Coiste Siamsa Garda Sportstar Awards

The 24th annual Coiste Siamsa Garda Sportstar Awards ceremony will be held at The Midlands Park Hotel, Portlaoise tomorrow (Friday), 19th January, 2018.

The awards are presented to Garda members who have achieved success in their chosen sports, locally, nationally and internationally.

This year’s selection committee was chaired by RTE’s Marty Morrissey and this year’s winners are;

Eve McCrystal – Cycling

In August 2017 Eve and her cycling partner Katie George Dunleavy won gold in the Road Race and the Time Trial events at the World Paralympic Championships in South Africa. Eve was also a member of the Garda Cycling team which took part in the 2017 Ras Na mBan and finished as the top Irish rider in the event. As a result of these achievements she was nominated for the RTE Sportsperson of the Year Award in December. This is her 4th Coiste Siamsa award. Eve is a Garda stationed at Ballybay Garda Station and is a native of Co. Louth.

Athletics – Tom Power

Tom has been running marathons for ten years and in 2017 he decided to run the highest marathon in the world, the Everest Marathon. This event takes place at 17,000 feet and in -17 degree temperatures. In November as part of the first Irish team to compete in the event, Tom completed the race in 7 hours and 40 minutes and finished 25th out of 50 athletes who started. In doing so he also raised money for three charities. Tom is from Dublin and is a Detective Garda at The Garda Technical Bureau and lives in Lucan in Dublin.

David Clarke – Gaelic Football

David played in goal for the Mayo senior football team in 2017. He is the holder of five Connaught senior titles; as well as two Mayo County titles and one All-Ireland Club title with Ballina Stephenites. In 2017 he was awarded his 2nd GPA/GAA All-Star award. This is his third Garda Sportstar award. David is a Garda Stationed at Tubbercurry, Co. Sligo.

Boxing – Niall Kennedy

Niall is undefeated in 9 professional bouts in the heavyweight division, including 5 knockouts. In March of 2017 he won the Massachusetts State title and in September he added the New England title, Niall is a Garda attached to Wicklow Garda Station and is a native of Co. Wexford.

Ladies Gaelic Football – Martha Carter

Mayo star Martha was a member of this year’s beaten all Ireland finalists and nominated for an All Star awards for her efforts. She is the holder of 2 Division 1 League titles and one Division 2 title. Martha is a Garda stationed at Sligo Garda Station.

Declan Conlon – Fly-fishing

In August of 2017 Declan finished 2nd in the Irish Masters Fly-Fishing Championships and he will represent Ireland in Spain later this year at the World Masters Championships. Following another great performance in September in the All Ireland Qualifying Series he has been selected for the Irish Team at the European Championships in 2018. He was also a member of the Garda team that won the British and UK Fly-Fishing Championships in September 2017. Declan is a native of Rathangan, Co. Kildare and is a Garda based at Clondalkin Garda Station.

Jeff Kehoe – Shooting

Jeff has been shooting for the past 10 years and in that time he has represented An Garda Síochána and his country at many competitions. In July of 2017 Jeff became a triple world champion and set a new world record breaking his own previous record in the centrefire gallery rifle. Jeff also played a major role in helping the Irish Team capture the International Gallery Rifle Federation World Cup This is Jeff’s second Coiste Siamsa Award. Jeff is a native of Co. Wexford and is a Garda stationed at Bailieboro, Co Cavan.

Colm Boyle – Gaelic Football

Colm is one of the most outstanding and consistent players on the Mayo senior football panel. In 2017 he won his 4th Football All-star award. Colm is the holder of five Connacht titles and has also guided his club Davitts to county and provincial success. He is a Garda Stationed at Westport in Co. Mayo.

Team of the Year – Garda College Hurling Club

In 2017 the Garda College Hurling team won both the League title and the Ryan Cup, which is the Division 2 Higher Education Championship, beating IT Sligo in the final. This in only the second time the Garda College as won this championship. They were also winners of the Cup and Shield at the Seamus McIntyre Tournament and runners up in the All Ireland Garda Hurling Final.

Special Contribution Award – Garda 4 Peaks Challenge

In May 2017 over 100 Garda members took part in the 4 Peaks Challenge. The aim of the event was to raise money for the mental health charity ‘Aware’. The challenge was to climb the highest mountains in each Irish province in three days. Over €80,000 was raised from the event and it also led to the setting up of a new Hiking Club which will continue to encourage members to participate in the sport.

Hall of Fame – Paul Rayfus (Golf)

Paul has a number of notable achievements in the world of amateur golf including; between 1984 and ’87 winning the Dundalk Scratch Cup; the West and East of Ireland Championships and was runner up in Ireland Close Championships at Royal Dublin in 1986. Between the years 1986 and 1988 he represented Ireland internationally and was part of the Irish team that won the Triple Crown for the first time in 1987. Other notable achievements include representing Leinster and winning the Inter Provincial Title in 1987 for the first time. Paul also played in the Irish Open in 1987 and 1988. He also has something in common with Tiger Woods – both were beaten on the 18th at Porthcawl by Gary Walstenholm. Paul retired from An Garda Síochána in 2009.  He was born in Co. Kildare but has lived in Trim Co. Meath since the age of two.

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Covid 19/Health

Health tips for Firefighters

According to recent studies, 53% of career fire-fighters are classified as overweight or obese. This article provides some tips for fire-fighters who are looking to adopt healthier nutrition habits with heart health and weight management in mind.

According to recent studies, 53% of career fire-fighters are classified as overweight or obese. Obese fire-fighters, when compared to fire-fighters of normal weight are more likely to suffer from hypertension, abnormal blood lipid panels, continuous weight gain, lower cardio-respiratory fitness, reduced muscular strength, and more frequent fatal cardiac events (1). Heart disease alone, accounts for 45% of deaths on duty.

There are several significant factors that can contribute to excessive weight gain: shift work and irregular work hours, development of unhealthy eating patterns, sleep deprivation, and research that shows most fire-fighters get less than the recommended 150 min of moderate to high-intensity exercise per week.

If one looks a bit closer, some of these factors are related (i.e., as bodyweight increases, an inverse relationship to cardio-respiratory fitness is noted, which can increase the risk of cardiovascular disease). From a nutrition standpoint, here are a few tips for fire-fighters to incorporate into their daily routines to create healthy nutrition habits with heart health and weight management in mind:

Foster an environment within the firehouse of good health through meal choices, rather than just emphasizing quick and cheap eats for selected meal times. This can be as simple as setting a goal to create meals with less than 30% of calories coming from fat and less than 7% of those fat calories coming from unhealthy fat sources, like saturated fat.

Choose heart-healthy fat sources for cooking, like avocado, canola oil, olive oil, peanut oil, coconut, ground flax seed, salmon, and walnuts. These oils and food items contain mono- and polyunsaturated fats, and omega-3 fats which are found to be beneficial sources of fat within our diets. This is compared to saturated and trans fats found in baked or fried foods, some processed foods, hydrogenated oils, and butter.

Exchange high-fat ingredients of daily food items for lower-fat versions. For example, switch from whole milk to skim milk, eat more egg whites rather than whole eggs, and replace oil in baked foods with natural applesauce.

It is also suggested to select leaner meats. Choose skinless, boneless white meats of poultry; choose leaner red meat cuts like sirloin, 94 – 97% lean ground beef, round roast, flank steak; incorporate more game meats into the meal rotation—meats like venison and bison are lower fat options than beef; if you choose pork, stick with the boneless pork loin and remove the extra fat prior to cooking. Eat smaller, balanced meals every 2 – 3 hr for sustained energy (just in case you get called away unexpectedly for an alarm, your most recent meal may be closer than when you have 4 – 6 hr between meals). With this in mind, keep healthy snacks stocked on the truck for something to snack on to or away from the fire to keep hunger under control.

Incorporate more fresh fruits and vegetables into your day. Recommended consumption of fruit and veg is a minimum of 2 portions of fruit and 2.5 portions of vegetables per day. Fruits and vegetables are naturally low in calories, and high in fiber, vitamins, and minerals. Vary the colors and varieties of these foods within the diet to optimize your benefits from their consumption.

Choose whole grains. The USDA’s MyPlate recommends consuming 6 oz of grains per day, with 3 oz coming from a whole grain source, like oatmeal, whole wheat breads/wraps, quinoa, or whole grain cold cereals.

Stop smoking. Firefighters inhale enough smoke during fire suppression operations, so why add more of these chemicals to your body? Plus, smoking has been shown to increase your risk of cardiovascular disease.

Food items like cookies, pies, cakes, candy, and ice cream taste great, but remember that these added sugar items are “treats” and should not be consumed on a regular basis. They provide minimal benefits for the amount of calories they supply, so try to limit yourself to no more than 10% of daily calories from added sugars.

Evaluate what you are drinking. Some people would be surprised how many additional calories can be added to a daily calorie intake just through their beverage choices.

It is also recommended to get at least 150 min of moderate or high-intensity exercise per week, in addition to work. By following these basic guidelines, you will soon notice a marked improvement in your overall health and in your ability to work effectively.

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EMS News

National Ambulance Service Introduced 91 New Vehicles Into Its Services During 2017

The HSE National Ambulance Service (NAS) introduced 91 new vehicles into its services during 2017. This was enabled by a capital spend of €14.5 m.

The vehicles, along with equipment for each one, include:

  • 55 Emergency Ambulances
  • 7 Intermediate Care Vehicles
  • 25 Rapid Response Vehicles (cars/jeeps)
  • 2 Critical Care Ambulances (containing enhanced medical equipment for critically ill patients)
  • 2 Driver Training Units

Fifty-five new emergency ambulances are in service across the country with five having been assigned to Dublin Fire Brigade.

NAS recently won an ESAI sustainable energy award for the energy efficiency of the new vehicles, which include solar panels and other energy saving features.

NO REPRO FEE 17/11/2017 HSE New Ambulances. The HSE National Ambulance Service (NAS) has introduced 91 new vehicles into its services during 2017. Pictured with a selection from the HSE National Ambulance Service’s range of new energy efficient emergency care vehicles today at Dublin Castle are Martin Dunne, Director of the HSE National Ambulance Service and Simon Harris TD, Minister for Health. The capital spend of €14.5m has allowed the vehicles, and equipment for each one, to be purchased this year. They include 55 Emergency Ambulances, 7 Intermediate Care Vehicles, 25 Rapid Response Vehicles (cars/jeeps), 2 Critical Care Ambulances (containing enhanced medical equipment for critically ill patients) and 2 Driver Training Units. For more information see www.nationalambulanceservice.ie. Photograph: Sasko Lazarov / Photocall Ireland

Martin Dunne, Director of the HSE National Ambulance Service said:

‘These new vehicles will greatly reduce our carbon footprint as well as providing enhanced care to our patients.  A number of these new vehicles are already in service.  The public can see these vehicles in Dublin and throughout the country as they are rolled out to replace existing NAS fleet. They have solar panels on each vehicle as well as a number of other energy efficient features.  This has all been made possible through funding form the HSE National Service Planning process.’

NAS operates a fleet of 500 vehicles from over 100 locations across the country, which travel in excess of 20 million kilometres per annum (total kms for the fleet in one year).

NO REPRO FEE 17/11/2017 HSE New Ambulances. The HSE National Ambulance Service (NAS) has introduced 91 new vehicles into its services during 2017. Pictured with a selection from the HSE National Ambulance Service’s range of new energy efficient emergency care vehicles today at Dublin Castle are Martin Dunne, Director of the HSE National Ambulance Service and Simon Harris TD, Minister for Health. The capital spend of €14.5m has allowed the vehicles, and equipment for each one, to be purchased this year. They include 55 Emergency Ambulances, 7 Intermediate Care Vehicles, 25 Rapid Response Vehicles (cars/jeeps), 2 Critical Care Ambulances (containing enhanced medical equipment for critically ill patients) and 2 Driver Training Units. For more information see www.nationalambulanceservice.ie. Photograph: Sasko Lazarov / Photocall Ireland

The Minister for Health, Simon Harris TD welcomed the introduction of the new vehicles.

He said:

 ‘I am delighted that this investment in the fleet will improve our ambulance service.  I also want to commend the National Ambulance Service for achieving recognition for their work in the use of green technologies.  A significant reform programme has been underway in the National Ambulance Service over recent years. This initiative is yet another example of the ongoing work to deliver a safe and responsive service which strives for high performance and efficiency whilst coping with a continuously increasing demand for services.’

NO REPRO FEE 17/11/2017 HSE New Ambulances. The HSE National Ambulance Service (NAS) has introduced 91 new vehicles into its services during 2017. Pictured with a selection from the HSE National Ambulance Service’s range of new energy efficient emergency care vehicles today at Dublin Castle are (l to r) Liam Woods, National Director, Acute Hospitals, HSE; Joan Regan, Department of Health; Simon Harris TD, Minister for Health; and Martin Dunne, Director of the HSE National Ambulance Service. The capital spend of €14.5m has allowed the vehicles, and equipment for each one, to be purchased this year. They include 55 Emergency Ambulances, 7 Intermediate Care Vehicles, 25 Rapid Response Vehicles (cars/jeeps), 2 Critical Care Ambulances (containing enhanced medical equipment for critically ill patients) and 2 Driver Training Units. For more information see www.nationalambulanceservice.ie. Photograph: Sasko Lazarov / Photocall Ireland

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EMS News Features

National Day Of Rememberance For Road Crash Victims This Sunday

“World Day of Rememberance for Road Traffic Victims” occurs on the third Sunday in November each year.

This Sunday, November 19th, will draw the public’s attention to road traffic collisions, their consequences and costs, and the measures which can be taken to prevent them.

The day also provides an opportunity to remind governments and society of their responsibility to make roads safer.

Essentially, it is a day to reflect on those who have lost their lives on Irish roads and to think about their loved ones who have been left behind.

It is also important to consider those injured and rehabilitated, how their lives have become affected and in many cases, destroyed as a result of a collision on the road.

Moyagh Murdock, CEO of the Road Safety Authority said:

“This is the 11th year that we have commemorated World Day of Remembrance in Ireland. It is a day of reflection for all of those impacted by road traffic collisions. It gives us an opportunity to remember those who have died on our roads, lives cut short too soon. It is also an opportunity to remember those who have been seriously injured on our roads, who are left dealing with often very traumatic physical difficulties, whose lives have been permanently altered.

“And behind every life lost or serious injury, there are families, friends and communities who have been left devastated. We hear often about the numbers killed or hurt on our roads, but these people are more than statistics, they are fathers, mothers, sisters, brothers, they are friends, colleagues and part of our communities. And we cannot forget that.”

Every year, hundreds of people are killed or seriously injured on Ireland’s roads, and around the world, hundreds are killed each day. Every road death, however caused, leaves a family bereaved forever.

Many others remain deeply affected by the loss of a friend, colleague, neighbour or member of the community. The effect on the emergency services, who are faced with horrific scenes every day of their working lives is also profound. Road traffic injuries leave behind shattered families and communities.

A Special Memorial Mass for World Day of Remembrance is taking place in St. Michans Church, Halston Street, Dublin 7 at 11.00 am this Sunday.

On the day, family members are invited to bring along a photo of their loved one and to place the name of their loved one the Jesse Tree of Remembrance. A candle lighting service is available also.

Anyone who wishes to attend is welcome.

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Covid 19/Technology

Irish Startup Company Claims European Comission Prize At European Satellite Navigation Competition 2017

Donegal based startup, DroneSAR Ltd has won the European Commission prize announced on Tuesday night (November 7th, 2017) in Tallinn, Estonia at the awards ceremony for the 14th European Satellite Navigation Competition (ESNC) winners. DroneSAR Ltd were awarded this prize for the development of software which transforms standard “off-the-shelf” drone and mobile device pairings into enhanced search and rescue (SAR) data transmission technology that will save lives.

The European Commission Prize – the Copernicus Masters Services Challenge – is one of a range of challenges and prizes on offer to the 321 finalists in the ESNC competition. It is awarded for innovative uses of the European Commission operated Copernicus program products. The Copernicus program is a European Union Programme aimed at developing European information services based on satellite Earth Observation data and implemented in partnership with Member States, the European Space Agency (ESA) and a number of other European organisations.

DroneSAR Ltd were presented with a cheque from the European Commission, which is in addition to their award as Ireland Region Winner. The Ireland Region Competition for the annual ESNC awards has been organised and sponsored by National Space Centre Ltd since 2012.

DroneSAR Ltd is the brainchild of it’s four co-founders who each possess expertise and skill-sets specific to the world of drone technology, network and satellite communication and SAR coordination and emergency response.

CEO Oisin McGrath said:

“DroneSAR makes it possible to use affordable, “off-the-shelf” drone technology to expedite successful outcomes during emergency response incidents. It delivers the right data to the right people at the right time when agencies are faced with time and resource constraints. We are delighted to have won this award from the European Commission.

“Each member of the DroneSAR team has contributed to realise a software product that will play a major part in ensuring that emergency response time-frames, incident coordination, decisions and successful outcomes will be realised across all sectors of the emergency response and humanitarian relief environment.”

To deliver the service, DroneSAR Ltd has partnered with leading outdoor pursuit software providers Viewranger, global maritime distress software company SafeTRX and medical distress location software, Medimee, all of which will allow victim position data to be sent to DroneSAR software for automatic flight to the location.

Rory Fitzpatrick, CEO National Space Centre said:

“This is worthy recognition for an outstanding product that has both commercial and lifesaving potential. We are incredibly proud to see this young Irish company perform so strongly on the international stage.”

National Space Centre Ltd is based at Elfordstown Earthstation, Midleton and delivers uplink and downlink services to domestic and international teleport and satellite communications markets.

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Covid 19/Health EMS News

Learning How To Do CPR Could Help You Save A Life

The latest statistics show that in Ireland, an average of 10,000 people die from cardiovascular disease each year with 5,000 of these deaths from a sudden cardiac arrest.

70% of cardiac arrests in Ireland occur outside of hospital.

Irish men and women have the highest rate of death before the age of 65 from coronary heart disease in the European Union.

According to the Irish Heart Foundation, by 2020, people with cardiovascular disease is set to increase by 40%.

Cardiopulmonary resuscitation (CPR) can help save a life during a cardiac arrest.

Watch how you could save a life by learning how to do CPR:

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EMS News

A Significant Drop In Bonfire Related Incidents For Clare Emergency Services

Clare County Fire and Rescue Service answered to seven bonfire related incidents over the Halloween period for 2017.

This is a decrease of over half, in comparison to 2016, when Emergency Services responded to 19 bonfire incidents.

The overall cost associated with the call out of the Fire Service to these incidents was €5,000, while the cost associated with the clean-up of the bonfire sites is not yet known.

In response, Angela Naughton, Senior Assistant Chief Fire Officer, said:

“There was a significant reduction in the number of callouts this Halloween compared to previous years including in 2016 when the Fire Service attended 19 bonfire incidents.

“As well as being illegal, uncontrolled backyard burning and bonfires pose a significant risk to property and public safety and therefore, we would like to acknowledge the public for their cooperation and for heeding the safety advice issued during recent weeks.”

There were five bonfire related incident’s in Ennis, one in Newmarket on Fergus and one in Shannon between Sunday, October 29th and Tuesday, October 31st.

 

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Covid 19/Health

DMHG Campaign Ask The Public “Are You Winter Ready?”

The Dublin Midlands Hospital Group (DMHG) have created its Winter Ready Campaign in an attempt to promote staying healthier this winter.

DMHG is asking its staff, patients and the wider public the question, “Are You Winter Ready?”.

The campaign runs from October to the end of February and provides public information designed to empower patients of the hospital and the wider public to better manage their health.

The core message of the campaign for staff, patients and public is to Protect, Prepare and Prevent the impacts of winter illness.

It recognises that winter is the time when many people, particularly those in at risk categories such as those over 65 or those with underlying health issues, become ill from viruses or other infections.

Speaking at the launch of the campaign at Tallaght Hospital, CEO of DMHG Trevor O’Callaghan said:

“We want to encourage everyone to better manage their health and stay healthy in the first instance and thereafter, be informed of the health services available in their communities, how to access them, and where, depending on their condition, is most appropriate for them.

“This message is about ensuring that those with the greatest clinical need can be treated in our Emergency Departments, in the fastest time, and those with less severe conditions can be cared for just as well in other healthcare settings. This in no way seeks to discourage patients from attending our Emergency Departments, where clearly necessary, but rather, for some with less severe conditions to first consider, where they can best be treated.”

CEO of Tallaght Hospital David Slevin added:

“A key objective of this campaign is to implement solutions to tackle the challenges hospitals face, beyond just what happens within our hospital walls. We strongly support this objective and welcome the opportunity to contribute to this campaign.

“It supports and underpins the work Tallaght Hospital is already undertaking to build partnerships with primary and community care providers to develop healthier communities leading to reduced and shorter inpatient hospital stays.”

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EMS News

New Ambulances For Dublin Fire Brigade Fitted With Solar Panels And Re-Generative Braking

Dublin Fire Brigade’s new ambulances have been “fitted with solar panels and re-generative braking”.

According to a tweet on the Dublin Fire Brigade’s Twitter page, the adjustments will “help recharge on board batteries and lower CO2 emissions”.

Five fire stations across Dublin have received these top notch ambulances as part of Dublin Fire Brigade’s fleet replacement programme.

They are:

  • Tallaght fire station
  • Donnybrook fire station
  • Finglas fire station
  • Swords fire station
  • & North Strand fire station

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EMS News

More Than 80 Members Of Emergency Services Showcased Their Skills In Co. Donegal

More than 80 delegates from the Emergency Services took part in an innovative conference Expo on Saturday last (October 21st, 2017) at Finner camp in Co. Donegal showcasing the specialist skills and resources available from within the Voluntary Emergency Services sector.

The Northwest Regional Working Group for Major Emergency Management hosted this special event with representatives from both statutory and voluntary organisations attending including from the Fire Service; the National Ambulance Service, An Garda Síochána; the Defence Forces; Irish Coast Guard; Civil Defence; Irish Red Cross; RNLI; Blood Bikes Northwest; Community Rescue Services; Irish Cave Rescue Organisation; Search and Rescue Dog Association and Mourne River Search and Rescue.

The aim of the day was to develop and enhance the links that already exist between the Principal Response Agencies and the Voluntary Emergency Services sector and, to create a better awareness of the specialist skills and resources that are available from within the Voluntary Emergency Services sector.

Representatives from the Fire Service, the National Ambulance Service, An Garda Síochána, the Defence Forces, Irish Coast Guard, Civil Defence, Irish Red Cross, RNLI, Blood Bikes Northwest, Community Rescue Services, Irish Cave Rescue Organisation, Search and Rescue Dog Association and Mourne River Search and Rescue attending the Emergency Services Conference Expo at Finner Camp on Saturday last.
Representatives from the Fire Service, the National Ambulance Service, An Garda Síochána, the Defence Forces, Irish Coast Guard, Civil Defence, Irish Red Cross, RNLI, Blood Bikes Northwest, Community Rescue Services, Irish Cave Rescue Organisation, Search and Rescue Dog Association and Mourne River Search and Rescue attending the Emergency Services Conference Expo at Finner Camp on Saturday last.

The Conference was opened by Mr. Garry Martin, Director of Emergency Services with Donegal County Council. This was followed by presentations from each of the Voluntary Emergency Services.

Speaking following the event Garry Martin said:

“Events such as these are hugely important. They give us an opportunity to strengthen relationships between the Principal Response Agencies and the Voluntary Emergency Services operating within the area of emergency response services and to network, to share information and to highlight the specialist skills and resources that are available and that could be used in an emergency situation.”

Participating organisations displayed some of the specialist vehicles and equipment that are used in their service. The vehicles included a Class B fire engine, ambulances, decontamination units, bomb disposal unit, mobile incident command centres, rapid response vehicles, all terrain vehicles, jet skis, motor bikes, 4×4 vehicles and dog handling units.

Other equipment showcased on the day included cave rescue equipment, swift water rescue equipment and small unmanned aircraft (drones). Some live demonstrations were carried also carried out during the day.

The conference was organised under the auspices of the Framework for Major Emergency Management (2006).

This is a framework that enables the Principal Response Agencies prepare for, and make a co-ordinated response to major emergencies resulting from events such as natural disasters, technological and civil incidents etc.

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EMS News

Status Orange Wind Warning For Southern And Western Coastal Counties

A deepening depression known as Storm Brian will cause heavy winds across southern and western coastal counties in Ireland tonight.

Orange level wind warnings for coasts of Mayo, Galway, Clare, Kerry, Cork, Waterford and Wexford is valid from tonight (Friday) at 22:00 until tomorrow (Saturday) at 22:00 with gusts of up to 130km/h.

Yellow wind warnings are in effect countrywide with gusts of up to 110km/h.

Speaking to the Emergency Services about what we can expect from Storm Brian, Joan Blackburn of Met Éireann said:

“It’s going to be an extremely windy period. It’s not an ex hurricane, it’s an Atlantic depression. It’s going to be very windy later on tonight and through to tomorrow in different parts of the country at different times.

“We have a status Orange wind warning. The strongest winds are likely to be around the coastal parts of Mayo down to Waterford. Here you will see winds gusting up from mean speeds of 65km/h right up to 110/120km/h.

“One thing people need to bear in mind is that those winds could cause damage of their own but aswell as that, some structure’s could still be weakened by the storm earlier this week so there is certainly some danger involved today and tomorrow.”

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COVID 19 Defence & Security General News

Minister for Defence Officially Opens O.N.E. Veteran Support Centre and Hostel at Cobh

Simon Coveney TD, Minister for Defence and Minister for Foreign Affairs, officially opened the new Veteran Support Centre and hostel of the Organisation of National Ex-Service Personnel (O.N.E.) in Cobh, Co. Cork. O.N.E. is a limited company with charitable status that is dedicated to the welfare of ex-service personnel of the Irish Defence Forces by way of providing accommodation and advice to homeless, elderly or disabled members in need.

Minister Coveney congratulated O.N.E. on the opening of the new facility, stating, “this is a proud day for all members of Óglaigh Náisiúnta na hÉireann as the project to convert an old Social Welfare building into a facility with accommodation and a drop-in advice centre for veterans comes to fruition.”

Minister Coveney concluded by stating that O.N.E. has made a great difference to the lives of ex-service men and women who have had cause to avail of its services. He wished O.N.E. every success with the facility in Cobh and in the future.

O.N.E. currently operates a number of other residential homes and veteran support centre in Dublin, Athlone and Letterkenny. The opening of Brú na Farraige represents the first such facility provided by the organisation in the Munster region, and forms part of O.N.E.’s plans to establish a network of fifteen Veteran Support Centres around the country. The Government has provided a formal commitment to support the organisation in this regard via a Programme for Government commitment. The Department of Defence has worked with O.N.E. to secure Dormant Accounts funding to assist in the development of the Cobh facility, providing a total allocation towards the project of €210,000.

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COVID 19 Covid 19/Health EMS News

Minister for Mental Health Celebrates World Mental Health Month

This week, the Minister for Mental Health and Older People, Mary Butler TD, celebrates World Mental Health Month.

World Mental Health Month for October shines a spotlight on mental health. It provides further opportunities to raise awareness of mental health, reduce mental health stigma and promote the broad range of services and supports available to people in communities across the country.

Minister Butler commented, “while we have much more work to do, there have been significant achievements made so far this year to promote positive mental health, early intervention, and enhance access to mental health services and supports for all individuals. There have been huge strides made in the area of digital mental health services. One example is MyMind which provides free online counselling, in 17 languages, to communities nationwide. It currently delivers approximately 4,000 appointments each month.”

As part of the HSE’s digital mental health strategy, it has recently partnered with digital health company, SilverCloud Health, on a national roll out of digital cognitive behaviour therapy to address depression and anxiety in Ireland in an effort to make mental health support more widely available. Referrals can be made from Primary Care Psychology, the National Counselling Service, Jigsaw and GPs across Ireland, enabling people to access essential supports within 24 hours of referral.

Significant progress has been made on the HSE Perinatal Mental Health Model of Care, which supports the mental health needs of women before, during and after pregnancy. Further investment, announced this week, will provide for an additional four midwives and one consultant who will join an existing network of 21 senior midwifes who have specialist expertise in the area of perinatal mental health across the 19 maternity services.

This development marks a monumental milestone in mental health to ensure the full and complete resourcing and implementation of the specialist mental health teams associated with this model of care, so that women across the country can access these vital services. All posts are now in place or currently under recruitment.

Minister Butler continued, “earlier this year, the Taoiseach announced €10 million in once off mental health funding. I’m delighted to say that we are finalising work on initiatives under this funding, including enhanced signposting and access to existing mental health services and supports; initiatives for children, young people and students; and additional psychosocial responses, recognising that people will require varying levels of support.”

Work is also progressing across the country to reduce the number of children and young people waiting over 12 months to access primary care psychology, including through the recruitment of new staff and increased hours of service.

Minister Butler concluded, “I am fully committed to ensuring the continued improvement of mental health services next year, including in areas such as out of hours supports, CAMHS, the national mental health clinical programmes, including eating disorders, and many other areas.”

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COVID 19 Covid 19/Advice EMS News General News

National Fire Safety Week 2021 Launched

2021’s virtual National Fire Safety Week was officially launched via an online video by Darragh O’Brien, TD, Minister for Housing, Local Government and Heritage.

National Fire Safety Week, 4th – 11th October, jointly run with the Northern Ireland Fire and Rescue Service, is about enhancing fire safety, particularly in the home. This year’s National Fire Safety Week theme is:

“Working Smoke Alarms Save Lives – Test Yours Weekly” or “Sábhálann aláraim deataigh atá ag obair i gceart saolta – déan tástáil orthu go rialta.”

As the country responded to Covid-19 we spent more time at home. It was more important than ever that we were all aware of the steps we can take to protect ourselves and our homes from fire. Now, as society begins to open back up, and we return to work and education, it is important we don’t get complacent.

The campaign focuses on fire safety in the home, encouraging all homes to have smoke alarms and to test them weekly. We hope to help the public build and maintain good Fire Safe habits as routines return to some sort of normality.

Minister O’Brien reminds us, “most fires recorded in Ireland start in domestic settings. Since our community fire safety programmes started there has been a significant and steady decline in the number of fire fatalities, so let’s build on that success”.

Think STOP fire:

moke Alarms – Have at least one on each floor

est them every week

bvious Dangers – Look for fire risks like overloaded sockets and solve them

lan your Escape and practise it regularly

Dublin Fire Brigade Chief Fire Officer, Dennis Keeley, also spoke to highlight the part the public can play, “all of us can take meaningful steps to reduce the risk of fire in our homes. We encourage all householders to install and maintain smoke alarms, and test smoke alarms regularly.”

Minister O’Brien also took the opportunity to highlight the ERASMUS+ funded BeFireSafe@School project. BFireSafe@School is a newly developed teacher-led fire safety education resource for post-primary students in Europe, and is the first harmonised fire safety programme to be developed for schools across Europe. This new resource places student wellbeing and personal safety at the centre of learning and aims to ensure students learn the knowledge, skills and attitude necessary to keep themselves and others safe from fire.

While National Fire Safety Week marks the beginning of an intensive media advertising campaign to run until Spring 2022, it is imperative that public awareness of the dangers of fire be maintained throughout the year.

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COVID 19 Defence & Security General News

Minister Coveney Pledges Women of Honour Issues Will Be Addressed

Minister Coveney pledges to Women of Honour that issues raised will addressed. The Minister for Foreign Affairs and Defence met with participants from the Women of Honour group and with a group of serving female members of the Defence Forces.

Speaking after the meetings, Minister Coveney expressed his gratitude to the women for taking the time to meet with him for what were very informative meetings, saying, “I wish to express my deep appreciation to those women, both serving and former members of the Defence Forces for sharing their experiences with me. The issues they have raised are of the utmost seriousness and need to be addressed in the most comprehensive way possible.

“It is clear to me, the Chief of Staff Designate and the Secretary General that there are very strong views from both meetings that the culture that is pervading and the application of the current policies, systems and procedures in place for dealing with bullying, harassment, discrimination, sexual harassment and sexual assault have not and are not serving all Defence Forces personnel well. I would like to say sorry to anyone who has suffered during their time in the Defence Forces and assure them The State will now urgently carry out an Independent Review.”

Minister Coveney continued, “let me be quite clear on this. The Independent Review that will be established to examine the effectiveness of those policies and procedures, will be undertaken by external and entirely independent and unbiased experts in this field. It is additionally my intention to bring the final Report from that Review to Government.”

The Minister confirmed that the terms of the Review, which are in the process of being finalised, are being reviewed in light of recent meetings with both the Women of Honour group and serving female personnel. Other stakeholder meetings, including with the Representative Associations will also inform the terms. The Minister has confirmed that he will immediately look to establish interim solutions for supports for Defence Forces members past or present, who are affected by these issues.

The Minister paid tribute to the Women of Honour group and to those serving personnel who have spoken out today, for their service to the Defence Forces, saying, “I wish to commend the women for their service and commitment to the Defence Forces as an Organisation. I know from my discussions today that you are seeking change to ensure that the Defence Forces of the future is a place where inappropriate behaviour is not tolerated and where all individuals, both female and male, can reach their full potential.”

“I am fully committed, together with the Secretary General of my Department, and the Chief of Staff Designate, to ensuring that each and every single member of the Defence Forces has the right to be treated with respect, equality and dignity and to carry out their duties in a safe workplace, underpinned by a culture of zero-tolerance for any kind of bullying, discrimination, or harassment.”

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COVID 19 EMS News General News

IMO Welcomes Progress on Opening Pathways for International Doctors

The Irish Medical Organisation (IMO) has given a guarded welcome to the commitment by the Minister for Health in the opening of pathways to training for international doctors previously only available to EU citizens.  The IMO has campaigned on this issue for many years and want to make sure any proposal is capable of addressing the significant issues for these doctors.

Speaking today, Dr. Naveed Abbas, Chair of the IMO NCHD International Doctors Group the IMO said that the move by the Minister was welcome as a first step but key questions remain.

Dr. Abbas said the IMO would seek clarity on the timescale for the implementation of the new proposals and when the number of training places would be increased to cater for the increased numbers now eligible to participate in the programes.

Dr. Abbas said the IMO was concerned in particular that the Minister’s proposals today imply that in most cases international doctors would have to be working in Ireland for five years in order to get a Critical Skills Employment Permit which is a necessary precursor to accessing the training programmes.

He said about the opening of pathways for international doctors, “the IMO has campaigned and worked on this issue for a number of years so we are pleased with the news today as a first step forward.  However, we need to see exactly what is being proposed and whether the proposals adequately address all key issues including length of residency in the country and the number of training places being provided.  We are long past the time to ensure International Doctors are valued and respected for the invaluable service they are delivering within the Irish health services.”

Source: Irish Medical Organisation

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COVID 19 EMS News General News

Essential First Aid Tips Everyone Should Know

Everyone should be aware of the essential first aid tips that could potentially save a person’s life. Jonathan Lynch is a community engagement officer and paramedic with the National Ambulance Service. Here he gives some first aid tips and emergency advice.

Cardiac Arrest

When someone collapses it could be cardiac arrest. This can happen at any age. If they are unresponsive, call 999 or 112, then check for breathing. Tilt the head back and listen for about five-10 seconds. If they are not breathing, and you are alone, start chest compressions. Place your hands at the centre of the chest, between the two nipples. Push down hard and fast. The emergency call-taker will advise you.

If there is somebody else with you ask them to find the nearest Automated External Defibrillator (AED). Many communities have them. It’s important to know the location of your closest one. Once it arrives, switch it on, and it will tell you what to do.

Burns

  • Put the injured area under cool water for a full 20 minutes. This really reduces the risk of complications. A few minutes is not enough. Don’t use burn gels over water. Only use them if cool water is not available, or after water.
  • Remove clothes and jewellery in and around the injury, but not if they are already stuck to skin.
  • Cover the burn area loosely. Cling film is ideal, or a non-fluffy cloth. If it is a large area, like a forearm, keep the person warm to prevent hypothermia.
  • A visit to the emergency department may be required for even minor burns on the face or hand, if the burn appears white or chalky, or for chemical or electrical burns.
  • Call 999 or 112 if the burn is above the neck; it covers a large area; they have difficulty breathing or become unresponsive.

Hypothermia

Hypothermia happens when body temperature drops too low. It is often a secondary injury, for example when waiting for assistance on cold or wet ground. If they can’t be moved, cover them. If the injury allows, place something under them for insulation.

First aid kits often have foil blankets, but you need to make a sandwich of heat with the foil. A layer of coats or blankets, the foil and then another layer. And remember: 30 per cent of heat loss is through the head. Don’t leave them alone. If they are fully alert give warm drinks. If you can get them to a place of warmth, take off any wet clothes and replace with dry ones.

Possible Spinal Injury

With falls from heights, car crashes, sporting accidents or anywhere there’s a high impact at velocity, the greatest risk is that the spinal cord will be affected. Don’t move the patient until they can be assessed, unless they are in immediate danger.

Call 999 or 112, while waiting for help, kneel behind the person, rest your elbows on the ground or on your knees to keep your arms steady and hold their head in place. Explain to the person what you are doing and encourage them not to move. If they are trying to move don’t force their head down, as you could cause more damage.

Suspected Fracture

  • Look for deformity or swelling around the site, and pain or difficulty moving. If it’s an open fracture you may see the bone.
  • Advise the person to keep as still as possible. To stop movement hold the joint above and below the injured area.
  • Place padding around it for support. For an open fracture with bleeding, cover the area with a sterile dressing and apply pressure, but not on the protruding bone itself.
  • If they are in significant pain, particularly with lower limb fractures, call 999 or 112. Avoid moving unless they are in immediate danger.

Seizures

Sudden loss of responsiveness, a rigid body and jerking uncontrolled movements are seizure-type behaviours, usually associated with epilepsy, but not always. They can appear very scary but usually resolve quickly:

  • Clear the area around the person to make it safe. Do not restrain or hold them down, or put anything into their mouth.
  • Pop something under their head, like a towel or a coat, and loosen clothing around the neck.
  • Most seizures only last a couple of minutes, but make a note of how long it is.
  • Afterwards, place them on their side, and keep the airways open by tilting their head back.
  • Call 999 or 112 if: they stop breathing; it is their first seizure; they have repeated seizures; the seizure lasts longer than five minutes; or they injure themselves.
  • Children can have seizures associated with fever. Cool them down by taking off bedding and clothing, and get fresh air circulating.

Nose Bleeds

These are usually treated at home. Sit or stand upright. Don’t lie down or tilt your head back. Lean forward a little, pinch your nose just above the nostrils for about 10-15 minutes. Go to the ED or call 999 or 112 if: a nose bleed goes on longer for 15 mins; there is excessive bleeding; the patient has swallowed large amounts of blood; they have had a blow to head; they are feeling weak or dizzy or have difficultly breathing.

Hyperventilation

This is unnaturally fast or deep breathing caused by anxiety, emotional upset or panic attacks. The person may become faint and feel tingling and cramps in their hands and legs or in the mouth. Reassure them that this is normal. Get them to a quiet place and help them to slow breathing down by repeating: “big deep breath in. Big deep breath out.” Don’t breathe into a paper bag as this can worsen certain conditions.

Choking

If an airway is partially blocked – the common one is food – encourage them to cough as much as possible to try and move the object. They are still getting air in and out, so it’s important not to panic. If that doesn’t work go to the ED or call 999 or 112.

If somebody has a full obstruction, where they can’t breathe, cough or speak, deliver five blows with the heel of the hand between the shoulder blades. If that doesn’t work stand behind the person. Put their arms around their waist. Place one hand as a clenched fist between their belly button and the bottom of the chest, and with the other hand grasp that fist and pull sharply and inwards up to five times, checking their mouth each time to see if anything came out. Repeat these actions and have someone call 999 or 112.

Cuts/Wounds

If blood is flowing very quickly, or it won’t stop, call 999 or 112. For standard cuts and wounds, clean under running water or with sterile wipes. Dry and put on pressure by covering with a sterile dressing. Raising the wounded area above the level of the heart also reduces blood flow. If there is a foreign object in the wound, or it is from a bite – either human or animal – seek further assistance.

Source: The Irish Times

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