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Fuck fuck fuck.

Not again..
I know its not "covid" but a new (as in new to the 21st century hut apparently was around in the 18th century) "walking pneumonia" is spreading in China.

Fuck

That article is a little scaremongery in my opinion. And its repeated use of ‘virus’ even when interspersed with quotes from doctors saying it’s a bacterial infection doesn’t inspire confidence. Have a look here for a rather more level-headed discussion:

 
Yes that first article is incredibly badly written and misleading.

Its not a virus that is being seen in Europe 'for the first time'.

I'll retain a somewhat open mind in regards the China outbreak just in case some new twists emerge, but in terms of mycoplasma pneumoniae in general, this sort of article will leave you with a completely different impression.


eg:

Six countries in the European Union or European Economic Area have so far reported increases in mycoplasma pneumoniae infections, which may reflect the normal recurrence of the bacteria.

It could also have been exacerbated by limited transmission during the COVID-19 pandemic, EU health officials said.

Analysing surveillance data from 24 countries between April and September 2023, they found the incidences were higher in Europe and Asia. The "most frequent detections" in Europe were in Denmark, Sweden, Switzerland, and Wales, they added in an article published in the Lancet last month.

It is unknown why these cases are rising right now, but some health officials say it could be attributed to a delay after the lifting of COVID-19 restrictions.

Beeton says there are a few theories as to why it took so long for this bacterium to reappear post-pandemic, including that it has a longer incubation period and that it’s "slow-growing".

While the magnitude of cases countries are seeing is “concerning,” he added, it’s not surprising.

Danish health officials say epidemics of mycoplasma pneumoniae have historically occurred roughly every four years, with the most recent epidemic from 2015-2018.

There was a high number of cases immediately before the COVID-19 pandemic, but they fell to an "unusually low level" amid restrictions.

I havent read the Lancet article that was mentioned yet.
 
Here are a couple of other press reports from around the start of December, via the promed list that experts keep an eye on for infectious outbreak news. These ones focus on above average number of cases in a state in the USA and try to whip things up by coming up with the terms 'white lung syndrome' even though the diseases involved seem to fit the previously reported patterns, ie not a new disease.

Although having said that, diseases that are not new can still be newsworthy if the numbers involved go beyond typical levels and cause issues for healthcare capacity, or cause more severe cases than typically seen, so I dont rule out the possibility of more stories to come.

Also when it comes to this sort of disease, pay attention to mechanisms such as first catching a virus, which then leaves some patients vulnerable to later bacterial infection. Some articles on the recent situation make this point, others fail to do so.

 
Researchers say using hydroxychloroquine killed 17,000 people in the US, Belgium, Turkey, France, Italy, and Spain during the first wave of COVID


Just to add some prior detail to this since quite some time has passed since we were watching this side of things closely, here is something from a period in June 2020 where initial trial data suggested it was useless:


Although that particular article coincided with a study suggesting serious side effects being withdrawn, its also worth noting that some of the medical complications and risks from this type of drug were understood before the pandemic. Here for example is an April 2020 article where some of this stuff was spelt out:


Obviously the likes of Trump and Bolsonaros promotion of this drug captured a lot of the attention at the time, but its sad to see how many were given it in proper medical trials, with the number of participants of this in a handful of countries forlming the basis for the death estimates in the article you mention. Speaking of which, the shithead Didier Raoult who promoted its use in research probably didnt receive as much attention as he deserved. I'm not sure how long I followed his story for at the time, he may only have come across my radar briefly at the height of the furore about this drug. But it seems that after the 2020 disaster and much attention, he was forced to retire in 2021 and there have been rumblings of investigations into unauthorised clinical trials ever since, eg this from May 2023:

 
Italian hospitals collapse: Over 1,100 patients waiting to be admitted in Rome
03/01/2024
Just a few days ago, ambulances were queuing outside hospitals in Rome. In other regions, such as Lombardy, patients are crammed into waiting rooms until a bed becomes available.

In cities such as Turin, hospital overcrowding has even led to a shortage of stretchers for patients.

Emergency departments in Italian hospitals are in chaos and on the verge of collapse.

The worst situation is in Rome and its region, where more than 1,100 patients are waiting to be admitted, according to the Italian Society of Emergency Medicine and Urgent Care (Simeu).

"We are trying to guarantee the service, but we are in an extremely difficult situation," Simeu president Fabio de Laco explained.

According to Simeu, the number of patients waiting in Piedmont has reached some 500, while in Lombardy and its capital, Milan, normal hospital admissions have been suspended in order to "free up" some beds for emergencies.
Can't find many other pieces about this and worry that something may have been lost in translation?
 
Italian hospitals collapse: Over 1,100 patients waiting to be admitted in Rome
03/01/2024

Can't find many other pieces about this and worry that something may have been lost in translation?

Outside of the acute phase of serious pandemics, press reporting and public awareness of severe winter waves of respiratory conditions has long been inconsistent and all over the place. Long before the covid pandemic I could sometimes be found going on about this, for example by going on about the lack of public memory of how large and deadly flu waves were in 1999 and 2000 in the UK.

This phenomenon returned after a few years of the current pandemic, and got mixed in with a desire to 'move on' and pay much less attention to things like hospital situations. Chuck in language issues, such as us mostly relying on the english-speaking press, and I'm afraid the current situation in regards reporting about Italy does not surprise me very much. Especially given how thin certain data and reporting becomes over the Christmas period. English-speaking press awareness could dramatically expand in the days ahead, or could remain stubbornly muted, I cannot predict.

I will attempt to use computer translation to study some Italian media in the next day or so, but in the meantime here is the one other english article that stood out:


The default assumption will be that this is a vivid example of what winter pressures we can see in countries that get a covid wave and a very nasty flu wave at the most delicately balanced time of year. Covid data is diminished these days, flu surveillance systems are well established but laggy and I dont know of Italy-specific websites that can help me with that. It is always possible that one or more other factors could be involved, eg strain changes or problems with one or more vaccination campaigns, or underlying hospital capacity and resilience issues. But it often takes time for such possibilities to emerge and speculation about such things is too easy to get in a mess over during periods where supportive facts arent leaping out at us, and where the handful of people who are keen to report on such things on twitter etc may have well established narratives that they want to weave the current situation into.

Anyway I'll let you know when I find out more.
 
The sort of thing I got via computer translation of Italian online newspapers so far is the typical stuff, telling the same story. eg:


Influenza, doctors warn: "It hurts more than Covid, peak not reached." Emergency room under stress throughout Italy

With the start of January, seasonal ailments are (always) more frequent. However, this year, also thanks to the survival of Covid , the flu season seems to worry experts, who are constantly monitoring the situation. "More than Covid, I'm worried about the flu : it's hitting hard, much more than SarS-CoV2 and the peak hasn't been reached yet." This is the alarm of Marco Falcone , secretary of the Italian Society of Infectious and Tropical Diseases , Simit, interviewed by Adnkronos Salute.

Covid and the flu that is worrying
Falcone also underlined: «The cases and hospitalizations are decreasing due to Covid, but the data on deaths are 2-3 weeks late. Those deaths - an increase of 33% compared to a week ago - are of elderly and frail people affected by the disease in the period of maximum spread of the virus that we recorded twenty days ago. Data that shows us only one thing: that Covid is still associated with the risk of death for the at-risk categories", the elderly and frail.

«However – he underlines – at the moment in hospitals we have more serious cases of flu than of Covid». From now on «I expect a progressive decline in SarS-CoV2 infections, as there has been an important epidemic phase. Conversely, for the flu we have not yet reached the peak", she concluded.

Incomplete data
«The epidemiological trend» Covid-19 «despite being affected by an inevitable delay in the provision of data by the Regions, due to the holiday period, is consolidated as having absolutely little impact on hospital admissions, an indicator which is certainly more reliable and significant today, in addition and in a decrease in contagion and transmissibility indices. As expected and in line with other countries, the flu is still growing which adds to the transmission of other respiratory viruses."

Thus the Director General of Health Prevention of the Ministry of Health, Francesco Vaia , who commenting on the bulletin with the weekly Covid data, underlined how «in this period, attention and monitoring remain high and the invitation to maintain the preventive and therapeutic aids for the most fragile".

Alarm in some regions
Meanwhile, it is reported that emergency rooms are "under siege" throughout Italy. Waiting times for patients requiring hospitalization are increasing worryingly. Fabio De Iaco , president of the Italian Society of Emergency Medicine , Simeu , recently provided an overview of the situation : «In Lazio alone, there are currently over 1,100 patients awaiting admission in emergency rooms; they reach 500 in Piedmont , while in Lombardy ordinary hospitalizations have been suspended due to overcrowding." Local newspapers give an account of borderline situations in almost all the large cities of the Peninsula, from Genoa to Taranto. After New Year's Eve the emergency did not end, on the contrary.

«At a national level – adds De Iaco – we are recording very strong pressure on all emergency rooms and in various regions plans against overcrowding by hospitals and healthcare companies have been activated».

Difficult situation in Campania
Covid, influenza and respiratory syncytial virus are also hitting hard in Campania, which in the last two weeks has ended up in the red zone in the map of the regions drawn up by the Istituto Superiore di Sanità . An impact that only in the Neapolitan area is reverberating on the front lines of hospitals, also thanks to the intermittent closure of family doctors' offices on the many holidays and pre-holidays of this period of the year.

Some examples illustrate the situation. At the moment 50% of the 46 pneumology beds at Cardarelli are currently occupied by patients with pneumonia that started with a simple flu. From midnight on January 1st to 6pm on Wednesday January 3rd, a total of 1,415 emergency accesses were recorded at the Ospedale del Mare , San Paolo and Pellegrini , of which 43 were code red, 317 were code yellow of medium severity, and 927 were code green. and 125 low or very low urgency whites. Also noteworthy are the difficulties for the ambulances of the 118 network, forced to park for hours in emergency rooms before being able to admit patients and return to the city circuit.
 
And the same sort of thing from the English version of Chinese news sites, eg:


ROME, Jan. 4 (Xinhua) -- The spread of the flu virus in Italy is "extremely worrying," the Italian Federation of Health and Hospital Companies (FIASO) has said. The number of flu-related intensive-care unit cases has nearly doubled in the last week, according to a FIASO survey.
Flu cases are rising as coronavirus cases decline, which is having a greater overall impact on the country's health care system.
"Coronavirus cases are giving way to the flu," said FIASO President Giovanni Migliore.
Meanwhile, the Italian Society of Emergency Medicine (SIMEU) said that hospitals in Rome, Milan, and Turin are becoming over-crowded, creating queues in non-emergency situations.
"We are trying to guarantee the service, but we are in a very difficult situation," said Fabio de Laco, president of SIMEU. He added that an increase in respiratory problems among the elderly is a leading factor behind the increase in flu cases.
 
Found some surveillance data for influenza-like-illnesses in Italy. As expected it is lagging some weeks behind, and this sort of surveillance isnt perfect, but it shows higher rates towards the end of last year than seen in previous seasons. Ability to unpick covid and other respiratory conditions from actual influenza varies based on surveillance type and I'm not familiar enough with the surveillance systems of Italy to comment on that in regards this particular data.

From press reports we might assume graph will show an even worse picture subsequently, although it could also be the case that a big part of the worsening picture is the infections travelling from younger age groups initially into olkder, more vulnerable populations.

Graph is from Influenza - situazione in Italia - RespiNews Italia, rapporto della sorveglianza integrata dell’influenza . The numbers at the bottom are week numbers.

ItalyILI.png
 
Try similar news gathering exercises for other countries hospital situations too. Including increasing number of UK hospitals A&E departments declaring emergencies, which is sadly a form of news that many have become numb too in this country, especially at this time of year. Plus a tendancy to falsely blend such stories into narratives about strikes.

Apparently I should be looking at France too, but havent done so yet.

What might shed further light on the situation in various European countries would be to see how bad their flu seasons were a year ago. UK had a bad one last time, not sure if other countries were the same then, and so its possible some of them may get that this time around instead. Although its also still too early in the flu season to judge how bad UKs will be this time, as opposed to last time when the bad flu wave was also a relatively early wave.
 
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A story from France on December 28th:

The number of flu cases in particular have “exploded” in France, Health Minister François Braun said during a visit to Annecy Genevois hospital in eastern France on Wednesday.

"In this triple epidemic we are entering into a period of calm concerning Covid and bronchiolitis,” Braun said, with Covid “circulating less” and what was previously a “very high" number of bronchiolitis cases among children now leveling off.

However, for the flu, "there has been an explosion of cases, including serious cases, which means that overall intensive care services are saturated”, Braun said.

“This week is full of dangers, but hospital staff have been fully mobilised and the system will manage,” he said.

 
I machine translated the new format of surveillance report that France is doing this season, where they look at bronchitis, covid and influenza. Picture matches what was said in that news article. Influenza was into its explosive growth phase during the available data period, but at the time had not yet come close to levels seen in plenty of previous seasons.

Google translated version of the pdf attached.

Original source: Infections respiratoires aiguës (grippe, bronchiolite, COVID-19). Bulletin du 3 janvier 2024.

Here is just one of the influenza graphs from the France report:

InfluenzaFrance.png
 

Attachments

  • Bulletin_IRA_20240103_vf (1).pdf
    1.6 MB · Views: 0
Last edited:
Have taken to our bed. Hovering over sweetheart like anxious hen.
campanula hope you and your partner are soon on the mend.

Highly mutated COVID variant ‘Pirola’ JN.1 is fueling the pandemic’s second highest U.S. wave—and it’s still growing
Fortune. January 5, 2024
COVID levels have reached their second-highest level of the pandemic in the U.S., according to federal wastewater data released Friday—this as related ER visits, hospitalizations, and deaths continue to rise.
National COVID wastewater levels sat at 12.85—the number of standard deviations above baseline—on Dec. 30, according to data from the U.S. Centers for Disease Control and Prevention. Until then, the pandemic’s second-highest peak had occurred on Dec. 31, 2022, during the XBB.1.5 “Kraken” surge, when levels sat at 10.16.
The pandemic’s all-time high still looms further upward at 23.34—recorded on Jan. 8, 2022, at the height of the first Omicron wave.
With COVID testing at all-time lows, wastewater is now the best and quickest way to gauge the growth of the virus, experts say. Other indicators, like hospitalizations and deaths, only reflect the most severe cases and lag by several weeks.
 
Wastewater surveillance is another example of why English authorities winds me up - as far as I was able to find out we only publicly published English data for a period of time and then stopped, unlike for example Scotland.

Though its always possible I am out of date or havent found the right webpages, tahts still my sense of things anyway.

Meanwhile if you want to look at US wastewater data for Covid, this is one of the sources with graphs over time:

 
As for JN.1, I note that WHO used the opportunity to offer sensible advice and the Royal College of Nursing asked questions of the authorities in this country in December as a result. Knowing our authorities, I bet the RCN didnt get a satisfactory response.


Earlier this week, in light of the new COVID JN.1 variant, WHO advised health care workers and health facilities to:
Implement universal masking in health facilities, as well as appropriate masking, respirators and other personal protective equipment for health workers caring for suspected and confirmed COVID-19 patients
Improve ventilation in health facilities.

The existing national infection prevention and control manuals don’t require standardised masking for COVID-19, and decisions on respiratory protective equipment are left to local risk assessments. This is now inconsistent with WHO’s latest advice.

We also have concerns about the adequacy of ventilation in general ward and outpatient areas within hospital buildings and believe that action must be taken to assess and improve this.
 
As for JN.1 in the UK, it reached over 50% of the detected strains back in a period just after mid December, as per figures at UK Variant Landscape so could be described as the dominant strain that drives the current wave here.

And this is the sort of sensible view of the implications of the wave that continues to broadly match my own opinion:

 

The United States is experiencing what's become a familiar pattern: an uptick in COVID after the holidays and the big gatherings that accompany them. Hospitalizations have risen eight weeks in a row
 
Just sayin'


Vaccinations remain one of the most effective preventative methods against severe COVID-19 outcomes and the development of long-term COVID-19. However, individuals with underlying health conditions may not mount an adequate protective response to COVID-19 vaccines, increasing the likelihood of severe symptoms, hospitalization, and the development of long-term COVID-19 in high-risk populations. This review explores the potential therapeutic role of cannabinoids in limiting the susceptibility and severity of infection, both pre- and post-SARS-CoV-19 infection. Early in the SARS-CoV-19 infection, cannabinoids have been shown to prevent viral entry, mitigate oxidative stress, and alleviate the associated cytokine storm. Post-SARS-CoV-2 infection, cannabinoids have shown promise in treating symptoms associated with post-acute long COVID-19, including depression, anxiety, post-traumatic stress injury, insomnia, pain, and decreased appetite.
 
The United States is experiencing what's become a familiar pattern: an uptick in COVID after the holidays and the big gatherings that accompany them. Hospitalizations have risen eight weeks in a row
 
The WHO has agreed on a definition for diseases spread through the air

Past disagreements also centred around whether infectious particles were "droplets" or "aerosols" based on size, which the new definition moves away from.

During the early days of COVID in 2020, around 200 aerosol scientists publicly complained that the WHO had failed to warn people of the risk that the virus could spread through the air. This led to an overemphasis on measures like handwashing to stop the virus, rather than focusing on ventilation, they said.


 
Good.

I doubt it will totally solve that sort of response failure though, because in some ways the quibbling about definitions was just something to hide behind at the time. The real issue was that various governments, institutions and businesses couldnt handle the implications, the measures you'd need to take to respond to that sort of method of spread were all just too inconvenient, expensive etc, the ramifications were too massive so reassuring bullshit was used to buy time and skimp.

And sometimes the bullshit was far more specific. For example the UK used this shit in order to reduce the recommended standard of masks for PPE in healthcare settings. It was pretty obvious that at a specific moment in time they made this change in order to make the more compatible with the stockpile of masks we actually had, and other logistics and practicalities, rather than everything genuinely being based on best practice/best science or the precautionary principal. The likes of the WHO know how this stuff works and they try to accommodate such needs by leaving wiggle room in their guidance.

And I would always expect professionals to disagree about some of the detail when these things happen. Because some professional roles have 'justifying a nation or institutions decisions' very much baked into the role, while others involve far more room to highlight inconvenient realities and safety gaps. And even if there were no conflict between these things, we'd still see plenty of varying opinion and different levels of willingness to move quickly in line with emerging facts rather than cling to prior, sometimes long-held, beliefs.

I'm still a bit haunted by the early change to UK PPE mask guidance for healthcare professionals, and a few civil servants attempts to justify the changes at a key moment. It was very much a sign of our plight on crital days as the first wave emerged.

I'm also still haunted by the UK's half-arsed approach to ventilation. We needed to go further to compensate for stuff that couldnt be properly fixed quickly, eg the physical layout of many hospital buildings and other institutions, but instead we sometimes just paid lip service to the principals in question, and wanted to make a show of doing something. I'm not convinced the lessons have been properly learnt.
 
Interesting read here on "peak denial"

A common strategy to neutralize a social problem is to make knowing about it hard, often by restricting efforts to look into it, like scaling back COVID tracking ... If the COVID situation is tracked and the public warned, things don’t feel normal. But if we don’t monitor or mention it, then things can feel “back to normal”—fine, even.

Another tactic is minimization. How we describe and measure things shapes how we feel about them. Which is why it’s important to notice when neutralizing language enters the chat. For some time now, turns of phrase like “endemic” and “during COVID” have been common vernacular. So have refrains like “lower hospitalizations than last year.” All of this gives off an “it’s just a cold,” “mission accomplished” vibe, casting the disease into a worry-free zone that’s safely behind us.

This minimization keeps the quiet part quiet: that “the world is still in a pandemic” per the WHO; that more than 73,000 Americans died of COVID in 2023, a higher number than from car accidents or influenza; among those infected, 9 percent and counting have long COVID, a serious and often disabling condition with a disease burden comparable to cancer or heart disease, and an economic cost rivaling the Great Recession, and for which there are no approved treatments. What’s more, each infection is associated with a substantially increased risk of health issues like cognitive dysfunction, autoimmune disease and cardiovascular problems, even for mild infections.

Pre-pandemic, these statistics would have been eye-popping. Now they constitute “back to normal.” We think we no longer have a problem, when actually we’ve just changed the standard by which we deem something concerning.


 
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