The Daily Dose: COVID-19 threatens disenfranchised populations around the world

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Public health officials and human rights advocates are sounding the alarm on the potential spread of COVID-19 in tightly-packed refugee camps around the world. The lack of space means that important non-pharmaceutical interventions such as social distancing are next to impossible. As per Nature, “Although there are some reports of refugees testing positive for the virus, as of mid-April, there are no known COVID-19 outbreaks in major refugee camps, according to advocates and responders contacted by Nature. But many aid groups fear that it is only a matter of time before the disease strikes. According to advocacy groups, host nations have been slow to enforce preventative measures. And experts fear that aid organizations will struggle to rally and respond.” As with most communicable diseases, disenfranchised communities have borne the brunt of COVID-19 infections.

Very similar to the situation seen in refugee camps, prisons are emerging as major sources of COVID-19 spread. Social distancing among incarcerated individuals is simply not an option. As per the Lancet, “Prisons are epicentres for infectious diseases because of the higher background prevalence of infection, the higher levels of risk factors for infection, the unavoidable close contact in often overcrowded, poorly ventilated, and unsanitary facilities, and the poor access to health-care services relative to that in community settings. Infections can be transmitted between prisoners, staff and visitors, between prisons through transfers and staff cross-deployment, and to and from the community. As such, prisons and other custodial settings are an integral part of the public health response to coronavirus disease 2019 (COVID-19).” While some localities have taken steps to alleviate crowding in prisons in response to the current outbreak, taken in total, it has been far from adequate.

Another group health experts have been calling attention to are indigenous populations. In particular South American tribes that have lived in relative seclusion in the rain forest are susceptible. As per Science, “The state of Amazonas, where most Indigenous groups live, now has the most cases per capita in Brazil. As Science went to press, the state capital Manaus had 1772 confirmed cases and 156 deaths, and local authorities said its health care system was on the brink of collapse. The city opened two emergency hospitals in the past week.”

The promotion of unproven COVID-19 treatments has not only proven deadly, it has sapped valuable resources from other potential treatments that, in all likelihood, hold more promise. According to an article in Nature, “Hydroxychloroquine and its close chemical cousin chloroquine have attracted disproportionate attention in the coronavirus pandemic, spurred by preliminary studies and endorsement from political leaders such as Trump and French President Emmanuel Macron.” Touting scientifically unsound treatments to the public is the height of irresponsibility from world leaders and they should be held accountable for the damage they cause.

With each passing day, it seems as if researchers are identifying more ways in which SARS-CoV-2 attacks the human body. An article in Science explores the lasting effects of COVID-19 on the human body, during and after infections. “COVID-19 damages not just the lungs, but the kidneys, blood vessels, heart, brain, and other organs (see main story, p. 356). Doctors don’t yet know what lasting disabilities the virus will cause, but clues come from studies of severe pneumonia—an infection that inflames the air sacs in the lungs, as COVID-19 does.”

Since the beginning of the current coronavirus outbreak, there has been a significant amount of attention given to the uncertainty surrounding countries’ COVID-19 data. Much of the revisions have come down to the fact that scientists and healthcare workers are learning about the virus at the same time they are making decisions. A common early error seen in countries around the world was in the way potential and actual cases were defined. According to a study in the Lancet, “The case definition was initially narrow and was gradually broadened to allow detection of more cases as knowledge increased, particularly milder cases and those without epidemiological links to Wuhan, China, or other known cases. These changes should be taken into account when making inferences on epidemic growth rates and doubling times, and therefore on the reproductive number, to avoid bias.” Revisions are likely to continue even after the outbreak has subsided.

Finally, some news about another potential treatment that will surely cause a run to the local pharmacy. According to Science, “The fast-growing list of possible treatments for the novel coronavirus includes an unlikely candidate: famotidine, the active compound in the over-the-counter heartburn drug Pepcid. On 7 April, the first COVID-19 patients at Northwell Health in the New York City area began to receive famotidine intravenously, at nine times the heartburn dose.” Expect empty shelves. Guaranteed.

IMAGE SOURCE: Creative Commons

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