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Why has Covid-19 had less of an impact in Africa?

There has been an increase in Covid-19 deaths across Africa since mid-July 2021. But the impact of the pandemic in sub-Saharan Africa remains markedly lower compared to the Americas, Europe, and Asia.

The reasons for this are not yet clear. Several factors have been suggested as potentially influencing the low burden of Covid-19 illness. These include age demographics, lack of long-term care facilities, potential cross-protection from previous exposure to circulating coronaviruses, limitations of SARS-CoV-2 testing which may have resulted in an undercounting of deaths, and effective government public health responses.

In a recent paper our team of public health researchers, led by health analyst Janica Adams, examined these possible explanations by reviewing the scientific literature. The aim was to help guide public health decision making to contain Covid-19.

Common theories for Covid-19’s impact in Africa

A number of hypotheses emerged from the literature review. In this article we explore the most common ones. More research is needed to better understand how these factors contribute to the lower burden of Covid-19 disease in the African context.

The young age demographic of sub-Saharan Africa

Age has been observed as a significant risk factor for severe Covid-19 illness. Most deaths occur in those aged 65 or older. The median age in North and South America, Europe, and Asia ranges from 32 to 42.5 years. The age demographic structure of sub-Saharan Africa is much younger—the median age is 18.

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The stark difference in age demographics can be demonstrated by comparing Canada and Uganda, which are similar in population size. In Canada, the median age is 41.1. Around 18% of the population is 65 or older. In contrast, the median age of Uganda is 16.7. Only 2% of the population is 65 or older. Canada has recorded nearly 1.5 million Covid-19 cases and 27,000 deaths compared to fewer than 100,000 cases and 3,000 deaths in Uganda. Covid-19 has a significant impact on older people. Countries with larger proportions of older people are more likely to be hardest hit.

Lack of long-term care facilities

Most elderly people in sub-Saharan Africa don’t live in long-term care facilities. These facilities pose significant risks for infectious diseases. Covid-19 has substantially affected those living in long-term care facilities. During the first wave of the pandemic, about 81% of deaths in Canada occurred in those facilities.

In sub-Saharan Africa, provision of care is mostly left to families. This limits the number of formal caregivers and thus reduces the chance of transmission. An exception to this is South Africa, which has an established long-term care sector. South Africa was the worst affected country in sub-Saharan Africa. And 33% of Covid-19 outbreaks in South Africa occurred in long-term care facilities during the first wave.

Potential cross-protection from local circulating coronaviruses

It’s been suggested that prior exposure to circulating coronaviruses could reduce the severity of Covid-19 illness if people have developed antibodies. A previous study demonstrated that prior exposure to endemic coronaviruses resulted in lower chance of death and lower disease severity compared to those who were not previously exposed. Human-bat interactions are common in some rural areas of Africa.

Limitations of SARS-CoV-2 testing

There are concerns that the limited SARS-CoV-2 testing may have resulted in an undercounting of Covid-19-related deaths in sub-Saharan Africa. Insufficient data collection may mean we don’t really know the incidence and prevalence of Covid-19. Though varying across sub-Saharan Africa, testing levels have been low compared to other areas of the world.

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Effective government public health response

The rapid response of several African governments and health organizations may have played a significant role. At the beginning of the pandemic, several measures were taken: screening, establishment of the Africa Task Force for Novel Coronavirus, suspension of flights from China, and closure of borders in 40 African nations. New programs also promote sharing of Covid-19 information across sub-Saharan Africa.

In contrast to high-income countries which focus on non-communicable diseases, health organizations in sub-Saharan Africa focus on infectious diseases. The formation of national public health institutions has been key in curbing infectious diseases in Africa through disease surveillance, diagnostics, and rapid response to outbreaks.

But stringent lockdowns have taken a serious economic and societal toll across sub-Saharan Africa. Lockdowns resulted in increased food insecurity, teenage pregnancy, gender-based violence, and disruptions in treatment of malaria, TB and HIV. Africa’s 54 nations are not all the same, and local responses should be tailored to the health, social, and economic realities in specific countries.

South Africa: the outlier

In contrast to the rest of sub-Saharan Africa, South Africa has experienced higher proportions of Covid-related hospitalizations and deaths. South Africa has a remarkably higher median age and a long-term care sector. In addition, the higher rates of HIV and TB in South Africa have been associated with higher Covid-19 death rates. The prevalence of noncommunicable disease in South Africa is higher than in other regions, which may contribute to the higher burden of Covid-19 disease. South Africa also has better diagnostic capabilities and healthcare documentation than other sub-Saharan African countries. This may contribute to higher reporting rates.

Source: qz

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FDA backs Moderna booster injection for elderly and high-risk persons

Booster injections of Moderna Inc.’s COVID-19 vaccine should be provided to the elderly and those at high risk of contracting the illness, US regulators’ advisors recommended.

Additional doses of the two-shot messenger RNA vaccine should be made available to persons 65 and older, as well as those 18 and older who are at high risk due to medical or occupational reasons, the Food and Drug Administration’s vaccine advisory council voted 19-0 Thursday.

The booster dosage, which is half of the initial dose, should be administered at least six months after the initial vaccination, the panel said.

The vote comes on the heels of a similar recommendation from the panel for a booster from Pfizer Inc. and BioNTech SE, which was later approved by the agency for use in older, higher-risk individuals. Moderna submitted evidence to the panel demonstrating that their vaccine loses efficacy over time and that a booster shot is both safe and effective at restoring protective antibody levels.

Members of the panel decided that the evidence Moderna offered to support the booster were insufficient, notably the safety statistics for the half-dose booster. However, they determined that it was sufficient in the face of a raging epidemic and evidence that at least some at-risk individuals may acquire major breakthrough cases.

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Concerning safety, the specialists were encouraged by the fact that many patients with weakened immune systems had already received a full third dose of Moderna with no obvious side effects.

“These are exceptional times, and we must deal with imprecise data,” Eric Rubin, a panelist from the Harvard T.H. Chan School of Public Health, summarized the sentiments of several panelists.

The FDA will now determine whether to give clearance or not. The agency is not required to adopt the advisory panel’s recommendations and may decide whether to license the booster and for certain groups.

Once the FDA takes action, the baton will be transferred to a separate advisory committee at the Centers for Disease Control and Prevention.

The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention is set to meet Oct. 20 and 21. The group will develop its own booster recommendations and forward them to CDC Director Rochelle Walensky, who will decide whether to accept them or shape her own.

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The FDA’s advisory group will meet again on Friday to examine booster injections from Johnson & Johnson, the third firm with an approved COVID vaccine. J&J’s single-shot vaccination has seen far less use than Moderna and Pfizer-vaccines. BioNTech’s

The conference will conclude with a discussion of combining boosters with the various injections used in initial vaccinations.

According to preliminary data from a US government-sponsored experiment announced Wednesday, pairing COVID-19 vaccinations with a different booster generates as many or more antibodies as boosting with the same injection.

Credit: Thelcn

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Wendy Williams Will Not Return to Her Talk Show Due to ‘Serious Graves’ Disease Complications

Wendy Williams, 57, is “suffering significant problems as a direct result of Graves’ illness and her thyroid condition,” according to a statement posted Tuesday on the show’s Instagram page. “It has been determined that further time would be required before she can resume her live hosting duties.” Rather than that, when the show resumes on October 18, it will include a series of guest hosts and panels.

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Although the post notes that the talk-show host is “making progress,” this is the third time Williams has delayed her return to TV since September 9, when she canceled all public appearances. Season 13 of The Wendy Williams Show was originally slated for a September 20 premiere; it was pushed to October 4, then to October 18. Now, it will return without its namesake host—for now.

“Wendy continues to be under medical supervision and meets with her medical team on a daily basis,” the announcement continues. “We want her health to be her top priority. As soon as she’s ready, she will be back in her treasured purple chair.”

Williams announced she had been diagnosed with Graves’ disease, an autoimmune disorder that causes an overactive thyroid, three years ago. She has previously taken extended breaks from her show in 2018, 2019, and 2020. The host also contracted a breakthrough COVID-19 infection in September (despite being vaccinated), although a previous announcement assured fans she has since fully recovered from the virus.

Graves’ disease causes hyperthyroidism, or an excess of thyroid hormone, leading to symptoms like chronic fatigue, trembling hands, and sleeping difficulties, per the National Institutes of Health. There is no cure, but treatment can help patients manage symptoms and avoid more serious health complications. Williams also has lymphedema, or the swelling caused by a buildup of lymph fluid, that presents as swollen legs and ankles.

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“I had a storm going in my body is the best way I can explain it,” Williams told People in 2018. “I love doing the show, but I love me more. So I’m going to take care of me, so I can be there for them.”

Though we know Williams’ health concerns are chronic (as with the case of Graves’ Disease), we hope she feels better stat, and can’t wait to see her return to her purple chair.

Source: Prevention

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Shannen Doherty shares ‘honest’ photographs of her struggle with breast cancer.

Shannen Doherty shared “honest” photographs of her stage 4 breast cancer fight in goal is to encourage her fans to be checked for the disease.

On Thursday, the former “Beverly Hills, 90210” actor shared the honest photos on Instagram, describing her grueling, multiple-diagnosis quest to “cut through the dread” of what lies ahead.

“In honor of Breast Cancer Awareness Month, I’d want to share more about my personal experience from my first to my second diagnosis.” Is everything lovely? NO, but it’s true, and my aim in sharing is that we all become more informed and comfortable with what cancer looks like,” Doherty, 50, stated.

“I hope I’ve inspired people to get mammograms, to have regular checks, to cut through the fear and confront whatever is ahead.”

The former “Charmed” actor, who was diagnosed with breast cancer for the first time in March 2015 and went into remission in April 2017, extensively recounted her treatments, which included a mastectomy, chemotherapy, and radiation.

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“I had a lot of nose bleeds from the chemo,” Doherty explained, adding that she relied on wearing humorous pajamas to help her cope with the emotional and physical anguish. “I’m not sure whether any of you have had this experience. I was also exhausted.”

Doherty then disclosed in February 2020 that she was facing stage 4 breast cancer and has since kept followers updated, most recently informing them that she is “trying to stay alive.”

“I never want to operate [as if I’m dying],” she stated on Monday’s “Good Morning America.”

“I simply want to function since I don’t have any tasks to do because I’m going to keep battling to be alive.”

Doherty also stated that she is still on her “initial protocol” of therapy.

“It’s almost as if you simply want to stay on your protocols for as long as possible so you don’t run out of protocols,” she stated.

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