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COVID-19’s impact on overall health care services in Africa

In addition to directly causing the deaths of at least 200,000 people in Africa, the COVID-19 pandemic is also disrupting critical health services and undermining years of progress fighting other deadly diseases, such as human immunodeficiency virus (HIV)

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By Leo Holtz

In addition to directly causing the deaths of at least 200,000 people in Africa, the COVID-19 pandemic is also disrupting critical health services and undermining years of progress fighting other deadly diseases, such as human immunodeficiency virus (HIV), tuberculosis (TB), and malaria, which continue to be the leading causes of death in the region. In order to better understand the extent of this impact, a recent report by The Global Fund utilizes data from urban and rural health care facilities in 24 African countries and seven Asian nations to investigate and compare the spillover impacts of the pandemic on essential health care services for HIV, TB, and malaria.

In 2020, access to health care services declined significantly throughout the world compared to 2019. The authors attribute this unprecedented decline in patient attendance to challenges facing both medical facilities and the patient community (Figure 1). For patients, the fear of contracting COVID-19 from their visit was the most cited reason for not seeking medical care. The inability to reach health care facilities due to disruptions in public transportation and stay-at-home orders was also a prominent challenge for patients looking to access health care—a problem, according to the authors, that has been more relevant for urban residents.

Figure 1. Reasons for disruption to health care services from the perspective of medical facilities and patients

Source: “The Impact of Covid-19 On HIV, TB and Malaria Services and Systems For Health: A Snapshot From 502 Health Facilities Across Africa And Asia,” The Global Fund, 2021.

For medical facilities, the focus on COVID-19 reduced access to standard health care services overall, as some facilities either reduced or stopped offering some standard medical services or were overwhelmed with treating COVID-19 patients presenting acute symptoms of respiratory infection. While noting that the reduction in overall services is detrimental to all patients’ well-being, the authors warn that hampering access to health care may specifically elevate the mortality rate of children under 5.

Because COVID-19 remains the dominant focus of medical practitioners, international donor organizations, and governments, The Global Fund posits that this shift in focus to COVID-19 resulted in a reduction of “general health communication campaigns … [that] encourage people to seek out health care.” As a consequence, testing and treatment of diseases like HIV/AIDS, TB, and malaria have dipped.

More specifically, regarding HIV, the authors argue that the interruptions in testing and treatment of the disease, paired with prospective patients’ increased wariness in seeking medical care, may have heightened the risk of individuals unknowingly spreading it. Although Asia experienced the most severe disruptions to HIV health care services, the significant declines in preventive health care services for HIV in Africa pose particularly devastating consequences for the region, as it accounts for 67 percent of the global population living with HIV/AIDS

Figure 2. Impact of COVID-19 on HIV treatment referrals (left) and testing (right)

Figure 2. Impact of COVID-19 on HIV treatment referrals (left) and testing (right)

Note: The line graph describes service delivery for the same period in 2020 (left y-axis).The gray blocks represent the number of COVID-19 cases diagnosed per surveyed facilities (right y-axis).
Source: “The Impact of Covid-19 On HIV, TB and Malaria Services and Systems For Health: A Snapshot From 502 Health Facilities Across Africa And Asia,” The Global Fund, 2021.

Drug-sensitive TB was the most severely affected infectious disease, with a nearly 60 percent decline in diagnoses and a nearly 80 percent decline in treatment referrals relative to 2019 (Figure 3). In Africa, treatment referrals returned to near pre-pandemic levels by September 2020; however, drug-sensitive TB diagnosis in Africa remains off-track, recovering only to roughly 20 percent of 2019 levels in September 2020. Both metrics for TB depict much more severe disruptions to TB health care services in Asia.

Figure 3. Impact of COVID-19 on TB diagnosis (left) and referrals (right)

Figure 3. Impact of COVID-19 on TB diagnosis (left) and referrals (right)

Note: The line graph describes service delivery for the same period in 2020 (left Y axis).The gray blocks represent the number of COVID-19 cases diagnosed per surveyed facilities (right Y axis).
Source: “The Impact of Covid-19 On HIV, TB and Malaria Services and Systems for Health: A Snapshot From 502 Health Facilities Across Africa And Asia,” The Global Fund, 2021.

The global death rate from malaria has declined 60 percent since 2000, but Africa still accounts for 94 percent of the world’s annual malaria cases and deaths. Importantly, the reduction of malaria treatment in Africa (Figure 4), where the disease is endemic, poses a serious threat to large numbers of susceptible Africans—especially children under the age of 5, who comprise the vast majority of annual malaria deaths.

Figure 4. Impact of COVID-19 on malaria diagnosis (left) and treatment (right)

Figure 4. Impact of COVID-19 on malaria diagnosis (left) and treatment (right)

Note: The line graph describes service delivery for the same period in 2020 (left y-axis).The gray blocks represent the number of COVID-19 cases diagnosed per surveyed facilities (right y-axis).
Source: “The Impact of Covid-19 On HIV, TB and Malaria Services and Systems for Health: A Snapshot From 502 Health Facilities Across Africa And Asia,” The Global Fund, 2021.

The authors warn that the disruption to critical health care services poses a serious threat to undiagnosed individuals, their local communities, and global health security. The risk that undiagnosed individuals will infect others with HIV or TB—or succumb to malaria without pursuing treatment—is now much higher than before the pandemic. Moreover, the authors warn that the pandemic has effectively derailed years of progress in reducing the disease burden in Africa and the rest of the developing world. In response to these challenges, The Global Fund recommends health care facilities implement adaptive measures to reduce the volume of visits to clinics and improve health services delivery. Such actions include providing long-term drug prescriptions to ensure uninterrupted access to medication, door-to-door decentralized distribution of long-lasting insecticidal nets, and incorporating TB screening in digital health screenings for COVID-19.

For more on supporting health care systems in Africa, read Africa CDC Director Dr. John Nkengasong’s Foresight Africa 2021 essay, “Building a new public health order for Africa—and a new approach to financing it.” For more on innovative and technological solutions to complex health care challenges, see AGI Senior Fellow Landry Signé’s recent paper, “Strategies for effective health care for Africa in the Fourth Industrial Revolution.”

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Low Iron Levels In Blood Could Trigger Long COVID: Study

Low Iron Levels In Blood Could Trigger Long COVID: Study

Authored by Amie Dahnke via The Epoch Times (emphasis ours),

People with inadequate…

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Low Iron Levels In Blood Could Trigger Long COVID: Study

Authored by Amie Dahnke via The Epoch Times (emphasis ours),

People with inadequate iron levels in their blood due to a COVID-19 infection could be at greater risk of long COVID.

(Shutterstock)

A new study indicates that problems with iron levels in the bloodstream likely trigger chronic inflammation and other conditions associated with the post-COVID phenomenon. The findings, published on March 1 in Nature Immunology, could offer new ways to treat or prevent the condition.

Long COVID Patients Have Low Iron Levels

Researchers at the University of Cambridge pinpointed low iron as a potential link to long-COVID symptoms thanks to a study they initiated shortly after the start of the pandemic. They recruited people who tested positive for the virus to provide blood samples for analysis over a year, which allowed the researchers to look for post-infection changes in the blood. The researchers looked at 214 samples and found that 45 percent of patients reported symptoms of long COVID that lasted between three and 10 months.

In analyzing the blood samples, the research team noticed that people experiencing long COVID had low iron levels, contributing to anemia and low red blood cell production, just two weeks after they were diagnosed with COVID-19. This was true for patients regardless of age, sex, or the initial severity of their infection.

According to one of the study co-authors, the removal of iron from the bloodstream is a natural process and defense mechanism of the body.

But it can jeopardize a person’s recovery.

When the body has an infection, it responds by removing iron from the bloodstream. This protects us from potentially lethal bacteria that capture the iron in the bloodstream and grow rapidly. It’s an evolutionary response that redistributes iron in the body, and the blood plasma becomes an iron desert,” University of Oxford professor Hal Drakesmith said in a press release. “However, if this goes on for a long time, there is less iron for red blood cells, so oxygen is transported less efficiently affecting metabolism and energy production, and for white blood cells, which need iron to work properly. The protective mechanism ends up becoming a problem.”

The research team believes that consistently low iron levels could explain why individuals with long COVID continue to experience fatigue and difficulty exercising. As such, the researchers suggested iron supplementation to help regulate and prevent the often debilitating symptoms associated with long COVID.

It isn’t necessarily the case that individuals don’t have enough iron in their body, it’s just that it’s trapped in the wrong place,” Aimee Hanson, a postdoctoral researcher at the University of Cambridge who worked on the study, said in the press release. “What we need is a way to remobilize the iron and pull it back into the bloodstream, where it becomes more useful to the red blood cells.”

The research team pointed out that iron supplementation isn’t always straightforward. Achieving the right level of iron varies from person to person. Too much iron can cause stomach issues, ranging from constipation, nausea, and abdominal pain to gastritis and gastric lesions.

1 in 5 Still Affected by Long COVID

COVID-19 has affected nearly 40 percent of Americans, with one in five of those still suffering from symptoms of long COVID, according to the U.S. Centers for Disease Control and Prevention (CDC). Long COVID is marked by health issues that continue at least four weeks after an individual was initially diagnosed with COVID-19. Symptoms can last for days, weeks, months, or years and may include fatigue, cough or chest pain, headache, brain fog, depression or anxiety, digestive issues, and joint or muscle pain.

Tyler Durden Sat, 03/09/2024 - 12:50

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Walmart joins Costco in sharing key pricing news

The massive retailers have both shared information that some retailers keep very close to the vest.

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As we head toward a presidential election, the presumed candidates for both parties will look for issues that rally undecided voters. 

The economy will be a key issue, with Democrats pointing to job creation and lowering prices while Republicans will cite the layoffs at Big Tech companies, high housing prices, and of course, sticky inflation.

The covid pandemic created a perfect storm for inflation and higher prices. It became harder to get many items because people getting sick slowed down, or even stopped, production at some factories.

Related: Popular mall retailer shuts down abruptly after bankruptcy filing

It was also a period where demand increased while shipping, trucking and delivery systems were all strained or thrown out of whack. The combination led to product shortages and higher prices.

You might have gone to the grocery store and not been able to buy your favorite paper towel brand or find toilet paper at all. That happened partly because of the supply chain and partly due to increased demand, but at the end of the day, it led to higher prices, which some consumers blamed on President Joe Biden's administration.

Biden, of course, was blamed for the price increases, but as inflation has dropped and grocery prices have fallen, few companies have been up front about it. That's probably not a political choice in most cases. Instead, some companies have chosen to lower prices more slowly than they raised them.

However, two major retailers, Walmart (WMT) and Costco, have been very honest about inflation. Walmart Chief Executive Doug McMillon's most recent comments validate what Biden's administration has been saying about the state of the economy. And they contrast with the economic picture being painted by Republicans who support their presumptive nominee, Donald Trump.

Walmart has seen inflation drop in many key areas.

Image source: Joe Raedle/Getty Images

Walmart sees lower prices

McMillon does not talk about lower prices to make a political statement. He's communicating with customers and potential customers through the analysts who cover the company's quarterly-earnings calls.

During Walmart's fiscal-fourth-quarter-earnings call, McMillon was clear that prices are going down.

"I'm excited about the omnichannel net promoter score trends the team is driving. Across countries, we continue to see a customer that's resilient but looking for value. As always, we're working hard to deliver that for them, including through our rollbacks on food pricing in Walmart U.S. Those were up significantly in Q4 versus last year, following a big increase in Q3," he said.

He was specific about where the chain has seen prices go down.

"Our general merchandise prices are lower than a year ago and even two years ago in some categories, which means our customers are finding value in areas like apparel and hard lines," he said. "In food, prices are lower than a year ago in places like eggs, apples, and deli snacks, but higher in other places like asparagus and blackberries."

McMillon said that in other areas prices were still up but have been falling.

"Dry grocery and consumables categories like paper goods and cleaning supplies are up mid-single digits versus last year and high teens versus two years ago. Private-brand penetration is up in many of the countries where we operate, including the United States," he said.

Costco sees almost no inflation impact

McMillon avoided the word inflation in his comments. Costco  (COST)  Chief Financial Officer Richard Galanti, who steps down on March 15, has been very transparent on the topic.

The CFO commented on inflation during his company's fiscal-first-quarter-earnings call.

"Most recently, in the last fourth-quarter discussion, we had estimated that year-over-year inflation was in the 1% to 2% range. Our estimate for the quarter just ended, that inflation was in the 0% to 1% range," he said.

Galanti made clear that inflation (and even deflation) varied by category.

"A bigger deflation in some big and bulky items like furniture sets due to lower freight costs year over year, as well as on things like domestics, bulky lower-priced items, again, where the freight cost is significant. Some deflationary items were as much as 20% to 30% and, again, mostly freight-related," he added.

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Walmart has really good news for shoppers (and Joe Biden)

The giant retailer joins Costco in making a statement that has political overtones, even if that’s not the intent.

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As we head toward a presidential election, the presumed candidates for both parties will look for issues that rally undecided voters. 

The economy will be a key issue, with Democrats pointing to job creation and lowering prices while Republicans will cite the layoffs at Big Tech companies, high housing prices, and of course, sticky inflation.

The covid pandemic created a perfect storm for inflation and higher prices. It became harder to get many items because people getting sick slowed down, or even stopped, production at some factories.

Related: Popular mall retailer shuts down abruptly after bankruptcy filing

It was also a period where demand increased while shipping, trucking and delivery systems were all strained or thrown out of whack. The combination led to product shortages and higher prices.

You might have gone to the grocery store and not been able to buy your favorite paper towel brand or find toilet paper at all. That happened partly because of the supply chain and partly due to increased demand, but at the end of the day, it led to higher prices, which some consumers blamed on President Joe Biden's administration.

Biden, of course, was blamed for the price increases, but as inflation has dropped and grocery prices have fallen, few companies have been up front about it. That's probably not a political choice in most cases. Instead, some companies have chosen to lower prices more slowly than they raised them.

However, two major retailers, Walmart (WMT) and Costco, have been very honest about inflation. Walmart Chief Executive Doug McMillon's most recent comments validate what Biden's administration has been saying about the state of the economy. And they contrast with the economic picture being painted by Republicans who support their presumptive nominee, Donald Trump.

Walmart has seen inflation drop in many key areas.

Image source: Joe Raedle/Getty Images

Walmart sees lower prices

McMillon does not talk about lower prices to make a political statement. He's communicating with customers and potential customers through the analysts who cover the company's quarterly-earnings calls.

During Walmart's fiscal-fourth-quarter-earnings call, McMillon was clear that prices are going down.

"I'm excited about the omnichannel net promoter score trends the team is driving. Across countries, we continue to see a customer that's resilient but looking for value. As always, we're working hard to deliver that for them, including through our rollbacks on food pricing in Walmart U.S. Those were up significantly in Q4 versus last year, following a big increase in Q3," he said.

He was specific about where the chain has seen prices go down.

"Our general merchandise prices are lower than a year ago and even two years ago in some categories, which means our customers are finding value in areas like apparel and hard lines," he said. "In food, prices are lower than a year ago in places like eggs, apples, and deli snacks, but higher in other places like asparagus and blackberries."

McMillon said that in other areas prices were still up but have been falling.

"Dry grocery and consumables categories like paper goods and cleaning supplies are up mid-single digits versus last year and high teens versus two years ago. Private-brand penetration is up in many of the countries where we operate, including the United States," he said.

Costco sees almost no inflation impact

McMillon avoided the word inflation in his comments. Costco  (COST)  Chief Financial Officer Richard Galanti, who steps down on March 15, has been very transparent on the topic.

The CFO commented on inflation during his company's fiscal-first-quarter-earnings call.

"Most recently, in the last fourth-quarter discussion, we had estimated that year-over-year inflation was in the 1% to 2% range. Our estimate for the quarter just ended, that inflation was in the 0% to 1% range," he said.

Galanti made clear that inflation (and even deflation) varied by category.

"A bigger deflation in some big and bulky items like furniture sets due to lower freight costs year over year, as well as on things like domestics, bulky lower-priced items, again, where the freight cost is significant. Some deflationary items were as much as 20% to 30% and, again, mostly freight-related," he added.

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