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13th March, 2020 - ST. JOHN’S, Antigua and Barbuda – 13th March, 2020Prime Minister the Hon. Gaston Browne today announced that the country has recorded its first confirmation of someone who has contracted the coronavirus (COVID-19). “I want to emphasize that there is no need for fear or panic, arising from this case. The person concerned is in self isolation at home, and a regime has been put in place today, not only to continue such isolation, but also to treat the condition,” noted the Prime Minister. He called on the nation to be more sensible in their behaviour and be their brother’s keeper. “Let us conjoin our efforts to prevent the spread of Covid 19 within the domestic population,” he said. “Considering the challenges of Covid 19, to include the economic impact and potential threat to our food security, we have to work diligently and collectively as a nation, of one people, with a common destiny to confront these challenges,” PM Browne concluded.

Background: The COVID-19 pandemic is the greatest public health crisis of the last 100 years. Countries have responded with various levels of lockdown to save lives and stop health systems from being overwhelmed. At the same time, lockdowns entail large socio-economic costs. One exit strategy under consideration is a mobile phone app that traces close contacts of those infected with COVID- 19. Recent research has demonstrated the theoretical effectiveness of this solution in different disease settings. However, concerns have been raised about such apps because of the potential privacy implications. This could limit the acceptability of app-based contact tracing among the general population. As the effectiveness of this approach increases strongly with app take-up, it is crucial to understand public support for this intervention. Objectives: The objective of this study is to investigate user acceptability of a contact-tracing app in five countries hit by the pandemic. Methods We conducted a multi-country, large-scale (N = 5995) study to measure public support for digital contact tracing of COVID-19 infections. We ran anonymous online surveys in France, Germany, Italy, the UK and the US. We measured intentions to use a contact-tracing app across different installation regimes (voluntary installation vs. automatic installation by mobile phone providers), and studied how these intentions vary across individuals and countries. Results: We found strong support for the app under both regimes, in all countries, across all sub-groups of the population, and irrespective of regional-level COVID-19 mortality rates. We inves- tigated the main factors that may hinder or facilitate take-up and found that concerns about cyber security and privacy, together with lack of trust in government, are the main barriers to adoption. Conclusions: Epidemiological evidence shows that app-based contact-tracing can suppress the spread of COVID-19 if a high enough proportion of the population uses the app and that it can still reduce the number of infections if take-up is moderate. Our findings show that the willingness to install the app is very high. The available evidence suggests that app-based contact tracing may be a viable approach to control the diffusion of COVID-19.

[Introdução]: A OMS desenvolveu esta nota de aconselhamento rápido para atender à necessidade de recomendações sobre atendimento domiciliar seguro para pacientes com suspeita de infecção pelo novo coronavírus (2019-nCoV), apresentando sintomas leves e medidas de saúde pública relacionadas ao manejo de contatos assintomáticos. O documento é adaptado das orientações provisórias relativas ao MERS-CoV, publicado em junho de 20181, e está constituído pelas diretrizes com base em evidência publicadas pela OMS, incluindo Prevenção e controle de infecções de doenças respiratórias agudas propensas a epidemias e pandemias nos cuidados de saúde e com base nas informações atuais disponíveis sobre a infecção pelo 2019-nCoV. Esta orientação rápida destina-se a profissionais de saúde pública e de prevenção e controle de infecção (PCI), gestores e profissionais de saúde, ao abordar questões relacionadas ao atendimento domiciliar de pacientes com suspeita de infecção pelo nCoV que apresentem sintomas leves e o tratamento de contatos assintomáticos.

Introduction: Conflict-induced displacement makes affected populations more vulnerable to HIV transmission. However, this vulnerability does not always necessarily translate into more HIV infections. The extent to which conflict and displacement affect HIV transmission depends upon numerouscompeting and interacting factors such as loss of livelihoods; availability of education; the type and the length of conflict; the living arrangements and conditions of internally displaced persons (IDPs), whether formal or informal settlement; the context of their new location; and access to health services, including HIV and sexual and reproductive health programs. These factors also have direct implications for HIV vulnerability. Vulnerability results from individual and societal factors that affect adversely one’s ability to exert control over one’s own health. The factors pertaining to the quality of coverage of services and programs also influence HIV vulnerability. The characteristics of the HIV epidemic, the prevalence in the local populations, the interactions with armed forces, the occurrence of sexual violence and the risk behaviours associated with the new situations conditions of IDPs directly affect the risk of HIV transmission. HIV risk is defined as the probability that a person may acquire HIV infection by, for example, unprotected sex with partners or injecting drug use with shared needles and syringes...

Antecedentes El 30 de enero de 2020, la OMS declaró que el brote de COVID-19 constituía una emergencia de salud pública de importancia internacional. Inicialmente, la mayoría de los casos se notificaron en China y en personas que habían viajado a China. La situación más reciente puede consultarse en los informes de situación sobre la COVID-19 (en inglés). La COVID-19 es una enfermedad respiratoria aguda causada por un nuevo coronavirus humano (SARS-CoV-2, también conocido como virus COVID-19), que provoca una mayor mortalidad en mayores de 60 años y en personas con afecciones previas como enfermedades cardiovasculares, enfermedades respiratorias crónicas, diabetes o cáncer. Los centros de atención de larga estancia, tales como residencias geriátricas y centros de rehabilitación, son establecimientos que prestan cuidados a personas — en algunos casos de edad avanzada— con discapacidades físicas o mentales. Los residentes en centros de atención de larga estancia constituyen un grupo de población vulnerable que presentan un mayor riesgo de desenlaces adversos e infecciones al convivir en estrecha proximidad con otras personas. Por consiguiente, los centros de larga estancia han de adoptar precauciones especiales para proteger a sus residentes, empleados y visitantes. Debe tenerse en cuenta que las actividades de prevención y control de infecciones (PCI), en particular el uso de equipos de protección personal (EPP) y las restricciones de las visitas y actividades de grupo, pueden afectar a la salud y el bienestar mentales de los residentes y el personal. Para más información sobre la resiliencia durante el brote de COVID-19, véanse las consideraciones sobre la salud mental y la atención psicosocial durante el brote de COVID-19 (en inglés)...

BACKGROUND Person to person spread of COIVD-19 in the UK has now been confirmed. There are limited case series reporting the impact on women affected by coronaviruses (CoV) during pregnancy. In women affected by SARS and MERS, the case fatality rate appeared higher in women affected in pregnancy compared with non-pregnant women. We conducted a rapid, review to guide management of women affected by COVID -19 during pregnancy and developed interim practice guidance with the RCOG and RCPCH to inform maternity and neonatal service planning METHODS Searches were conducted in PubMed and MedRxiv to identify primary case reports, case series, observational studies or randomised-controlled trial describing women affected by coronavirus in pregnancy and on neonates. Data was extracted from relevant papers and the review was drafted with representatives of the RCPCH and RCOG who also provided expert consensus on areas where data were lacking...

On 21 January 2020, the first case of COVID-19 imported into the region of the Americas was identified in the United States of America in the state of Washington. A few days later, on 25 January, Canada reported their first confirmed case of novel coronavirus COVID-19 in Toronto, Ontario Province. Since then and to date, there have been twenty-two (22) confirmed cases of novel coronavirus in the Region of the Americas – fifteen (15) in the United States of America and seven (7) in Canada. The 15 cases in the United States of America were reported from six (6) states – Arizona, California, Illinois, Massachusetts, Texas and Washington between 21 January and 13 February 2020. Of the total cases, thirteen (13) had a history of travel to China and two (2) were among close house-hold contacts of previously confirmed cases. The latest two cases with travel history to China were among federally quarantined individuals in the states of Texas and California. In Canada, the seven (7) confirmed cases were reported from two (2) provinces – Ontario (3) and British Colombia (4). Of 7 cases, six had a travel history to China and one is currently under investigation regarding the site of transmission. Canada is the second country within the Region to report a confirmed case (following USA).

El Ministerio de Salud de Costa Rica establece como obligatorio la aplicación de estos lineamientos en los lugares donde se brindan funciones de atención directa e indirecta de personas, en los servicios de salud públicos y privados, así como en los tres niveles de gestión del Ministerio de Salud. Debido a que los conocimientos generales y la situación epidemiológica de este nuevo coronavirus se encuentran en una condición evolutiva y dinámica, tanto en el contexto local como internacional, estos lineamientos se revisarán de forma periódica y se publicará la versión vigente en la página web del Ministerio de Salud.

Background: Interleukin-6 (IL-6) is known to be detrimental in coronavirus disease 2019 (COVID-19) because of its involvement in driving cytokine storm. This systematic review and meta-analysis aimed to assess the safety and efficacy of anti-IL-6 signaling (anti-IL6/IL-6R/JAK) agents on COVID-19 based on the current evidence. Methods: Studies were identified through systematic searches of PubMed, EMBASE, ISI Web of Science, Cochrane library, ongoing clinical trial registries (clinicaltrials.gov), and preprint servers (medRxiv, ChinaXiv) on August 10, 2020, as well as eligibility checks according to predefined selection criteria. Statistical analysis was performed using Review Manager (version 5.3) and STATA 12.0. Results: Thirty-one studies were included in the pooled analysis of mortality, and 12 studies were identified for the analysis of risk of secondary infections. For mortality analysis, 5630 COVID-19 cases including 2,132 treated patients and 3,498 controls were analyzed. Anti-IL-6 signaling agents plus standard of care (SOC) significantly decreased the mortality rate compared to SOC alone (pooled OR = 0.61, 95% CI 0.45–0.84, p = 0.002). For the analysis of secondary infection risk, 1,624 patients with COVID-19 including 639 treated patients and 985 controls were included, showing that anti-IL-6 signaling agents did not increase the rate of secondary infections (pooled OR = 1.21, 95% CI 0.70–2.08, p = 0.50). By contrast, for patients with critical COVID-19 disease, anti-IL-6 signaling agents failed to reduce mortality compared to SOC alone (pooled OR = 0.75, 95% CI 0.42–1.33, p = 0.33), but they tended to increase the risk of secondary infections (pooled OR = 1.85, 95% CI 0.95–3.61, p = 0.07). A blockade of IL-6 signaling failed to reduce the mechanical ventilation rate, ICU admission rate, or elevate the clinical improvement rate. Conclusion: IL-6 signaling inhibitors reduced the mortality rate without increasing secondary infections in patients with COVID-19 based on current studies. For patients with critical disease, IL-6 signaling inhibitors did not exhibit any benefit.

Objetivo: Establecer lineamientos de prevención y control para la atención de casos sospechosos o confirmados de infección por el virus SARS CoV-2 / COVID-19 en diferentes ámbitos de acción.