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COVID Has Reached North Korea, Threatening A Humanitarian Emergency

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COVID Has Reached North Korea, Threatening A Humanitarian Emergency


The World Health Organization declared COVID-19 a pandemic in March 2020. But it’s only in recent days, in May 2022, that the secretive Democratic People’s Republic of Korea (North Korea) has reported its first confirmed cases of the virus.

While it may seem somewhat astounding that a country has managed to get so far into the pandemic without an outbreak, North Korea has reportedly had its borders sealed since January 2020, with no movement in or out of the country. So it is plausible that they’ve had no COVID until now.

But now, the country, which has a population of roughly 26 million people, looks to be facing a very sizeable and rapidly-spreading outbreak of the omicron variant. As of May 17, 1.4 million cases of “fever” had been reported, with 56 deaths since late April. The country is treating fever as indicative of COVID infection owing to reported shortages of testing supplies.

Of course, we don’t know how many of these cases of fever are definitely COVID, which in theory could lead to an overestimation of case numbers. At the same time, a proportion of cases are likely to be asymptomatic, and a lack of reporting coupled with limited surveillance means there’s a likelihood of under-reporting. Either way, these numbers are unlikely to be accurate.

There has been some testing taking place, with an unspecified number of omicron cases confirmed. But ultimately, there are huge gaps in our knowledge about this outbreak. This includes the index case – the case which was the source of this outbreak.

North Korea is ill-equipped for a COVID outbreak

The COVID pandemic has highlighted the need for national and global presentations of high-quality real-time data, along with rigorous and mass-scale testing infrastructure, to underpin surveillance and healthcare decision-making. North Korea doesn’t appear to have any of that in place.

Importantly, there’s also no known COVID vaccination programme in North Korea, despite previous offers of supplies from China and COVAX, a global initiative which aims to provide equitable access to COVID vaccines. The government has previously turned down three million Sinovac doses from China, along with shipments of the AstraZeneca vaccine, the latter reportedly due to concerns around side effects. Now, South Korea has offered to donate vaccine doses, but North Korea is yet to accept.

To some extent, North Korea is in the same position the rest of the world was in early to mid 2020. The government has ordered a national lockdown. This will have socio-economic consequences for residents but, overall, is probably a sensible move, given the population will have little immunity against the virus, whether through prior infection or the safer route of vaccination.

Kim Jong-un has also ordered the army to distribute medicines and supplies, while criticising officials and the public health sector for what he has deemed an inadequate pandemic response.

The healthcare system in North Korea is reported to be fragile, especially away from the capital city of Pyongyang. An outbreak could easily overwhelm the health facilities in some areas. This would have a knock-on effect to other areas of healthcare, further limiting access to care for non-communicable diseases, for example. A lockdown will at least buy the country some time to implement other public health measures, such as vaccination campaigns.

It is thought that North Korea has a lower prevalence of some of the conditions which we know increase the risk of severe COVID, such as obesity, compared with many other Asia and Pacific countries. However, more than ten million people in North Korea are considered to be food insecure (where having access to sufficient safe and nutritious food isn’t guaranteed). And we know malnutrition increases the risk of severe disease with COVID.

Another factor which increases risk is older age. An estimated 10% of the population in North Korea is aged 65 or over, and roughly another 19% aged between 50 and 64. So there are a large number of people who may be vulnerable to severe illness if they contract COVID.

How will things play out?

New variants of concern may emerge from this outbreak, though given the lack of contact with the rest of the world, they may not be easily exported.

There have been several humanitarian catastrophes related to uncontrolled COVID outbreaks, perhaps most notably in India, where it’s likely that hundreds of thousands, if not millions, died in just a few months. With uncontrolled outbreaks on such a large scale, the true death tolls can only ever be estimated.

The situation in North Korea threatens a similar humanitarian catastrophe. We know infection numbers can get very large very quickly, particularly with omicron being even more infectious that previous variants.

Routine datasets, such as death registers and certificates indicating cause of death, are likely to be limited and of low quality. Public reporting may be non-existent, and if surveillance data is revealed, the accuracy of the findings should be given very careful consideration.

This COVID outbreak is likely to create a high burden of disease in North Korea, putting huge pressures on the health system. The population will undoubtedly suffer greatly, whether or not public reporting of health outcomes shows the full fallout.

There is an urgent need for widespread COVID vaccination, particularly of older and vulnerable people. Now would be a very good time for North Korea to overcome its usual suspicion of the outside world, and accept international offers of help.

Michael Head, Senior Research Fellow in Global Health, University of Southampton

This article is republished from The Conversation under a Creative Commons license. Read the original article.





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Multi-State Listeria Outbreak Causes 1 Death, 1 ‘Fetal Loss’

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Multi-State Listeria Outbreak Causes 1 Death, 1 'Fetal Loss'


A Listeria outbreak has caused nearly two dozen illnesses, with most of the patients living in or having traveled to Florida. One person died while a pregnant patient experienced “fetal loss.”

A total of 23 people have been infected with the Listeria monocytogenes outbreak strain as of Wednesday, according to the U.S. Centers for Disease Control and Prevention (CDC). 

The illnesses were reported from 10 states. Twelve of the cases were reported in Florida, while eight of the patients who did not live in Florida also reported traveling to the state in the month before they got sick.

That said, “the significance of this is still under investigation,” the CDC noted.

Twenty-two (96%) of the patients had to be hospitalized, with one death reported from Illinois. Five of the patients also fell ill during their pregnancy. One of them experienced a “fetal loss.”

As the CDC explained, pregnant people and their newborns, older adults and those who have weakened immune systems are most at risk of getting sick with Listeria. In pregnant people, it may result in miscarriage, stillbirth or premature delivery even though the illness itself may only be mild. Their newborns may also experience a “life-threatening infection.”

While other people can be infected with Listeria as well, they “rarely become seriously ill.”

“The true number of sick people in an outbreak is likely higher than the number reported, and the outbreak may not be limited to the states with known illnesses,” the CDC explained. “In addition, recent illnesses may not yet be reported as it usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak.”

Results of whole-genome sequencing suggest that the patients “likely got sick from the same food.” Authorities are still conducting investigations and interviews to determine what the patients may have eaten before they got sick.

“So far, a common food item has not been identified,” the CDC said.

As such, the agency is urging anyone who may have symptoms of Listeria to list the foods they remember eating in the month before they got sick to help “solve the outbreak.”

Symptoms of Listeriosis may be flu-like in pregnant people. In those who aren’t pregnant, the symptoms may include headache, fever, stiff neck, convulsions, loss of balance, confusion and muscle aches. They may also experience food poisoning symptoms such as diarrhea.

According to the CDC, symptoms of “severe illness” typically begin about two weeks after eating the contaminated food. But there are also cases in which the symptoms are reported “as early as the same day or as late as 70 days after.”

“If you are at higher risk for Listeria infection and have symptoms, especially if you recently traveled to Florida, talk to your healthcare provider,” the CDC noted.





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Who Should Get Vaccinated Against Monkeypox?

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Omicron And COVID Boosters: Everything You Need To Know


After the Centers for Disease Control and Prevention (CDC) confirmed that the United States already recorded about 300 monkeypox cases, the U.S. government has decided to roll out vaccines to contain the situation as soon as possible. 

The Biden administration has already confirmed that it will roll out 296,000 doses of the only monkeypox vaccine approved by the Food and Drug Administration (FDA). However, it’s unclear who should be getting the Jynneos vaccine doses amid the outbreak. 

Last month, the CDC issued a warning, saying members of the LGBTQ community have a higher risk of contracting the virus. The disease is technically not transmitted sexually, but initial reports on the outbreak found that gays and bisexual people accounted for most of the cases. 

Since the virus spreads via contact with body fluids and sores, it can be passed to other people through sexual intercourse, intimate contact and even shared beddings. This prompted the public health agency to issue safer sex guidelines earlier this month. 

The CDC encouraged the public not to kiss and have sex if their partner has monkeypox symptoms or recently developed unexplained rashes or sores. The agency also advised against sharing towels, fetish gear, sex toys and other personal items to avoid the spread of the disease. 

Health officials have warned that the main driver of the growing number of monkeypox cases is making close contact, especially sexual contact. They also singled out the people who should be getting jabbed with the monkeypox vaccine to prevent the outbreak from getting bigger. 

Per the CDC recommendations, the following should receive the Jynneos vaccine for monkeypox: people who have had close contact with a monkeypox patient, men who have sex with men, sexually active transgender people, health care workers who have come in contact with the virus and people who have traveled outside of the U.S. to places with confirmed monkeypox activity. 

The World Health Organization (WHO) noted that transgender people and gender-diverse people could be vulnerable in the context of the monkeypox outbreak, so they should get vaccinated. However, the organization pointed out that regardless of sexuality, everyone is at risk of contracting or passing on the virus. 

Since its detection outside Africa in May, the virus has already spread to 48 countries and infected over 3,500 people. In a new study published this week, scientists said the rapid transmission of the disease could be a product of the virus’ “accelerated evolution.”





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US Secures 105 Million Doses Of Pfizer Vaccine For Fall

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Third COVID-19 Vaccine Dose Protection Only Good For 3 Months?


The United States on Wednesday announced an agreement with Pfizer and BioNTech for 105 million doses of Covid vaccine for Americans this fall.

The $3.2 billion contract, signed between the companies and the US health and defense departments, includes vaccines for babies, young children, teens and adults, and may include Omicron-specific vaccines, which a panel of government experts recommended on Tuesday.

Delivery will begin in late summer and continue into the fourth quarter, the companies said. The contract gives the US the option to procure up to 300 million doses.

“The Biden-Harris Administration is committed to doing everything we can to continue to make vaccines free and widely available to Americans – and this is an important first step to preparing us for the fall,” Health and Human Services Secretary Xavier Becerra said in a statement.

President Joe Biden’s administration has asked Congress for $23.5 billion in additional Covid funding, but a bill has not yet been passed.

As a result, the federal government “was forced to reallocate $10 billion in existing funding, pulling billions of dollars from Covid-19 response efforts” the statement said, with the new vaccines procured through this reallocation.

White House officials have previously said that without new funding, future vaccines might only be given for free to those at highest risk.





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