We at Medscape Professional Network' would like to share with you the most impactful and clinically relevant articles across our network from around the world over the past few weeks. Some of the information below may also be contradicted by local or global health authorities.
EUROPE
In the UK, the NHS launched its Spring COVID-19 booster programme this week, only targeting the most vulnerable for coronavirus infection. Those invited for the free jab will be people that are immunocompromised, those aged over 75, those living in older adult care homes, and children that are at clinical risk aged 6 months to 4 years. The vaccination programme will continue until the end of June this year.
Meanwhile, while support for a nationalised health service that is tax-funded is still strong, the public's satisfaction with its performance fell to the lowest level in 40 years. This was mostly due to long waiting times for GP and hospital appointments, as well as the shortage of healthcare staff and concern that the healthcare service is underfunded. While the public is awaiting the new NHS long-term workforce plan, the health service's Chief Strategy Officer gave interviews saying that the NHS could fix some of the staffing issues by working "smarter" and more efficiently.
Analysis has shown that people in the UK increasingly turned to Google for health questions, with diabetes being the most searched health topic. Lastly, a safety report highlighted the "life-threatening" danger of using haemodialysis central venous catheters. There is a risk of an air embolism if the catheter is left 'uncapped and unclamped" without attaching a syringe when used to access a patient's blood supply, which in turn can lead to heart failure and cardiac arrest.
In France, after 4 months of reflection, the Citizens' Convention on the End of Life has declared itself favourable by a large majority to access, under certain conditions, to active assistance in dying in the form of assisted suicide and euthanasia. Emmanuel Macron announced that a bill would be proposed by the end of the summer.
Also, the French National Authority for Health (HAS) has just published new recommendations on vaccination requirements and recommendations for professionals in the health and medico-social sectors. In particular, the HAS recommends lifting the obligation of vaccination against COVID-19. The government says it is ready to follow this advice.
The French Observatory of Drugs and Addictive Tendencies (OFDT) has just published a report on the evolution of the supply and consumption of cocaine in France between 2000 and 2022. It shows that the circulation of cocaine has increased in France since the 2010s, leading to an increase in its consumption, whatever its form (powder or cocaine base: wafer, crack) and a diversification of user profiles. While cocaine use used to be more common among the most affluent social categories, it has now spread to other social groups.
During the COVID-19-pandemic, it was possible in Germany to obtain a certificate of incapacity to work from a doctor's office by telephone in the event of minor cold complaints. This special regulation now ended on March 31, prompting criticism.
"We should not only continue the regulation, but also extend it beyond respiratory illnesses to other acute complaints," says Janosch Dahmen, the health policy spokesman for the Green Party. Also, Federal Minister of Health Karl Lauterbach considers the telephone sick note meaningful, the decision authority lies however with the common Federal committee of physicians, hospitals, and health insurance companies. Consumer centers and family doctor associations also criticised the end of the regulation. They see patient care at risk without the special regulation and see family doctors' practices under additional pressure.
In a conference, the health ministers of the federal states are calling on the federal government to quickly and more strongly promote research into COVID-19 vaccine damage. COVID-19 vaccination saved many lives and was important and right, the conference chairman said. Nevertheless, research is needed on the symptomatology, diagnostics, and treatment of health consequences of vaccination.
In Germany, the tick season has begun with the onset of the warmer season - specimens were already discovered in a Munich park in February. In general, there is a forward shift in activity, experts say. Cases of tick-borne encephalitis (TBE) are thus also appearing earlier. In March, the Robert Koch Institute (RKI) designated three new German TBE risk areas in the states of Bavaria and Saxony-Anhalt. The climate crisis could be responsible for the fact that TBE cases are now accumulating at higher altitudes. In addition, global warming is also enabling new species to gain a foothold in Germany, such as the Hyalomma tick.
In Spain, José Manuel Miñones Conde was appointed new Minister of Health on March 27. On March 30, the European Medicines Agency (EMA) recommended marketing authorisation for Bimervax, the COVID-19 vaccine developed by Hipra. The time change took place in the early hours of March 25-26, which could be the last as the issue is still under debate. In response to the debate generated by this decision, Spanish researchers published an article that analyses the naturalness and usefulness of the seasonal time change.
The Myocarditis Working Group of the Heart Failure Association of the Spanish Society of Cardiology, with the collaboration of the Spanish Agency of Medicines and Health Products (AEMPS), has produced a consensus document to provide guidelines on how to approach the diagnosis and treatment of cases of myocarditis associated with SARS-CoV-2 infection or messenger RNA vaccine.
A new document aims to help understand what self-harm is and how it develops in adolescence, how to identify and treat it, to improve the care given to it in the National Health System, due to the fact that after the COVID-19 pandemic, an increase in mental disorders and suicides among children and adolescents has been observed.
AMERICAS
In the United States, one of the key pillars to the Affordable Care Act, the preventive services mandate, was struck down by a federal judge in Texas on March 30. The mandate requires insurers and health plans to cover dozens of preventive health services with no cost to patients for things like early detection of cancer, hypertension, diabetes, and sexually transmitted infections, according to American Medical Association President Jack Resneck Jr, MD.
The ruling will also impact coverage of preexposure prophylaxis medication, or PrEP, taken daily by patients to prevent HIV. One expert estimates the decision could result in at least 2000 new HIV infections a year.
The US Food and Drug Administration has approved over-the-counter sales of the overdose reversal agent Narcan (naloxone, Emergent BioSolutions). Easier access to the drug is expected to help save lives. The drug’s manufacturer said it plans to make the OTC spray available by late summer but did not yet commit to a price.
A new Centers for Disease Control and Prevention report shows that autism rates in the US have risen again, from an estimate of 1 in 44 (2.3%) 8-year-old children in 2018 to 1 in 36 (2.8%) now. The CDC's director of its National Center on Birth Defects and Developmental Disabilities said the disruption in timely evaluations during the early months of the pandemic "could have long-lasting effects".
In Mexico, residence in the Texas-Mexico border area is associated with lower survival in the pediatric population diagnosed with acute lymphoblastic leukemia, a retrospective study concluded. The Durango State Prosecutor's Office reported the arrest of two more people related to the meningitis outbreak that caused 80 cases and 36 deaths in Mexico. With these arrests, 10 people have now been detained, including the owners and administrators of four hospitals linked to the meningitis cases, as well as an anesthesiologist and two former officials.
A report in which 1100 Mexican doctors from 29 specialties participated, indicates that 60% of the doctors claimed to have between 1-10 friends, and more than half said that their best friends are their colleagues, a higher tendency in those aged over 45 years and in those who work in the hospital field. Most physicians reported having a sufficient number of friends, with university being where they made most of their friends.
Another human case of avian influenza has been confirmed in Latin America so far this year. After a 9-year-old girl in Ecuador in January, on Wednesday, 29 March, the Chilean Ministry of Health reported a 53-year-old man who became seriously ill after being infected with the H5N1 virus.
A study revealed that adrenaline is used in less than half of the episodes of anaphylaxis; the research, which analyzed the treatment of this type of episodes in Mexico, Spain, and 10 Latin American countries, detected the underuse of the treatment, as well as a deficient management after the resolution of the symptoms.
Uruguay's screening program for the prevention and early detection of colorectal cancer is emerging as a model to follow in Latin America. The program was launched between 1996 and 1998 for those over 50 years of age and is based on an immunochemical screening test of fecal occult blood, if the result is positive then a video colonoscopy is performed.
In Brazil, Campinas (SP), São Paulo (SP), Belo Horizonte (MG), São José dos Campos (SP), São Luiz Gonzaga (RS), and other cities have reported recent outbreaks of hand-foot-mouth syndrome in children. Although benign and self-limited, the viral infection causes fever and skin lesions that can be a nuisance for children and their families. The outbreak has led some Brazilian local Health Departments to close city schools and kindergartens to control the spread of the disease.
On Tuesday, 28 March, Brazil reached the mark of 700,000 deaths from COVID-19 since the first death, 3 years ago. The data were released by Brazil's Ministry of Health. On March 12, 2020, the first death from the disease in the country was reported in São Paulo. In 5 months, Brazil reached 100,000 deaths from the disease, second only to the US. The nonconformity of policies to contain the pandemic, the turnover of Health Ministers during the pandemic, and the slowness to start vaccination are among the factors that led to so many deaths.
ASIA
New Delhi will ramp up testing for COVID-19 and encourage the increased use of masks, a local minister said on Thursday, after India recorded its highest daily case count in nearly 6 months. An estimated 3016 new cases of the coronavirus were reported on Thursday 30 March.
Chinese officials plan random and spot checks at medical facilities in the country to track incomplete and under-reported COVID-19 data, the country's health authority said.
As of Tuesday, Japan had reported 80 cases of mpox with the country seeing a gradual increase in new cases this year. Also, the 7-day average of new cases of COVID-19 stood at 859, up 21.8% from a week earlier (data from April 3, 2023).
AFRICA
In Africa, as of 29 March 2023 the cholera outbreak in the WHO African Region continues to evolve, with an upsurge in cholera cases in Mozambique, meanwhile the other 12 countries observed reduction in new cases.
The African region is recording around 4% annual decline rate in tuberculosis cases and tuberculosis deaths in the region fell by 26% between 2015 and 2021.
On 22 March, Equatorial Guinea confirmed eight more cases of Marburg, to a total of nine since the outbreak started on 13 February, 2023. Meanwhile, on 21 March, Tanzania confirmed its first-ever cases of Marburg Virus Disease.
