Category: Medical

The primordial days of the COVID-19 outbreak led to a rapid surge in demand — and subsequent shortage — of many consumables, from household goods and protective equipment to the ingredients and substances needed to test for the virus. As the world grappled with the newfound need to mass-test for COVID-19, laboratories turned to real-time reverse transcription–polymerase chain reaction (real-time RT–PCR). Real-time RT–PCR is the most accurate laboratory method to detect, track and study COVID-19; however, its widespread use strained resources and led some laboratories to seek more readily available and cheaper alternatives.

A study to test the performance and quality of some of these alternative resources was recently conducted by the IAEA and the Food and Agriculture Organization of the United Nations (FAO), in collaboration with the Austrian Agency for Health and Food Safety (AGES). Its results have implications for the ongoing fight against COVID-19 in developing countries and beyond.

A Scientific Forum on ‘Preparing for Zoonotic Outbreaks: the Role of Nuclear Science’ will take place from 21-22 September 2021 in conjunction with the 65th IAEA General Conference. The detection of zoonotic diseases – infectious diseases transmitted from animals to humans, such as COVID-19 – is one of many topics that will be discussed at the Scientific Forum, taking into consideration the role of nuclear and nuclear derived techniques.

Reagents for reaction

Reagents are the substances, compounds, primers, probes, enzymes and buffers needed in laboratory tests. Like the essential ingredients of a recipe, they are key to facilitating a chemical reaction and ensuring the proper final result — the salt and butter, so to speak.

“In a situation of increased demand such as during the COVID-19 crisis, many laboratories might quickly find themselves in a situation where they can no longer obtain reagents from their usual sources and are forced to switch to other providers of reagents or other ad hoc molecular diagnostic kits than the ones they are used to,” said Adi Steinrigl, Deputy Head of the Molecular Biology Department at AGES. “Labs doing real-time RT–PCR tests rely on trusted sources of reagents, usually in the form of a master mix or ready-to-go diagnostic kit solutions, called ad hoc molecular diagnostic kits.”

A master mix is a premixed solution that has all of the components for a real-time RT–PCR reaction and is not sample-specific, meaning the same reagents used to detect COVID-19 can also be used to detect other viruses. Ad hoc kits are for specific diseases and pathogens.

In April 2020, in collaboration with AGES, the Joint FAO/IAEA Centre of Nuclear Techniques for Food and Agriculture launched a study to assess and compare eight master mixes and three ad hoc kits developed by companies based in Austria, Germany, Japan, the Republic of Korea, the United Kingdom and the United States of America.

The study included the most common types of master mixes used and available on the international market among the many molecular assays, or tests, that are commercialized for the diagnosis of COVID-19. As of July 2021, 388 were listed by the Foundation for Innovative New Diagnostics.

Promising results

At the FAO–IAEA laboratories in Seibersdorf, Austria, IAEA experts tested 178 clinical samples provided by AGES, using each of the 11 commercial kits and master mixes. The results of the study established that all the tested master mixes and ad hoc kits can be used for the routine detection of the COVID-19 virus.

“The bottom line is that the tested products provided results that are similar to what can be obtained if using the reagents recommended by the World Health Organization (WHO),” said Giovanni Cattoli, Head of the Animal Production and Health Laboratory at the Joint FAO/IAEA Centre. “In a country where reagents for the recommended protocols are not available or are extremely expensive, laboratories can replace them with some of the other reagents included in the study and achieve similarly accurate results. With this study, we validated alternatives so that laboratories around the world can utilize available reagents to mass-test populations for COVID-19, therefore making the tests more accessible.”

The time needed for and costs of carrying out a real-time RT–PCR test vary, especially among different countries. A real-time RT–PCR test typically takes a couple of hours to complete, from receiving samples to issuing results, and the costs of reagents depend on the company and reagent type. Overall, excluding human resource costs, tests can cost from around €7 to €20, Cattoli added.

Steinrigl agreed that reagents and ad hoc molecular diagnostic kits might differ considerably in their costs: “Comparing the performance of reagents can actually save money. We can see cheaper solutions are not necessarily any less accurate than the more expensive ones.”

The procedures and results of the study have been shared with the IAEA Veterinary Diagnostic Laboratory (VETLAB) Network, in which some labs have been requested by national authorities to provide testing for COVID. The VETLAB network includes 46 countries in Africa and 19 in Asia. The study was also published online by the Journal of Virological Methods in June 2021.

“These types of studies are needed for other transboundary animal and zoonotic diseases,” Cattoli said. The IAEA is conducting a similar study for African swine fever. “It is important to have an idea of what type of reagents can be used to run real-time RT–PCR testing for these diseases and ensure that the results are equal to the those produced by the recommended protocols.”

Source: International Atomic Energy Agency

The COVID-19 pandemic has heightened problems of conflict, terrorism, and scarce resources in Central Africa to plunge millions of people deeper into poverty. That’s according to members of the regional bloc CEMAC. CEMAC heads of state Wednesday called for solidarity to improve living conditions in the six-nation economic bloc.

During a virtual heads of state summit Tuesday, the central African leaders said the advent of COVID-19 forced the closure of many businesses and caused millions of workers to lose their jobs.

Cameroon’s President Paul Biya is chairman of the CEMAC heads of state conference. He says it is regrettable that many people are reluctant to be vaccinated against COVID-19.

Biya says it is not possible for CEMAC to attain herd immunity when fewer than 5% of its close to 60 million people have agreed to be vaccinated against COVID-19. He says CEMAC member states should make sure all their people are vaccinated against COVID-19 so that the economic bloc can get to the crucial point of revamping its economy to fight against hardship.

Christophe Mbelle is an economist at the University of Yaounde. He says the COVID-19 crisis increased unemployment by between 60% and 70% across CEMAC countries.

Not even pharmaceutical companies were immune to the effects of the pandemic.

Mbelle says local companies only produced 5% of medicines needed by central African countries last year. He says in 2020, CEMAC countries invested more than $269 million to import drugs from Europe and America. Mbelle says if not for COVID-19, he is sure the $269 million would have been invested in home industries to create jobs and improve the well-being of suffering civilians.

The six nations of CEMAC are dealing with multiple crises within their borders in addition to COVID-19. Cameroon and Chad are fighting Boko Haram terrorism on their common borders with Nigeria.

Cameroon is fighting armed separatists in its English-speaking western regions. The U.N. also says that rebels have continued to challenge authorities in the Central African Republic with unending clashes since 2014.

The region is also dealing with the effects of climate change. This week, CEMAC said several thousand people fled intercommunal violence sparked by conflicts over water from the Logone River that separates Cameroon from Chad. The Lake Chad Basin Commission says the lake’s water resources have diminished by 70% within the past 50 years, and several million people in the area lack water and food.

Kristalina Georgieva, the managing director of the International Monetary Fund, issued a statement Tuesday after her virtual participation in the CEMAC summit from Washington. She said in 2020, COVID-19, combined with an ensuing decline in oil prices and security issues, had led to a deep recession and imposed a heavy toll on CEMAC member states.

She said the countries’ fiscal positions were weakened and external reserves depleted.

Georgieva said CEMAC must accelerate the vaccination campaign to ensure a sustainable economic recovery.

CEMAC anticipated a 2.8% economic growth rate in 2021. In April, though, the Bank of Central African States, which serves as the central bank for CEMAC countries, cut the anticipated growth rate to 1%, saying COVID-19 was slowing the economy.

Source: Voice of America

too often could only stand by and watch their patients die.

“When COVID-19 pandemic came it laid bare how bad the situation was in Somalia. For example, the response by the government was wholly inadequate. There was only one hospital in Mogadishu that managed COVID-related cases and that one hospital lacked essential equipment. Health workers who worked in that hospital… they really struggled with patients. They did not have enough equipment; they did not have oxygen supply,” said Hassan.

Amnesty says the Somali government allocates only 2% of its budget to healthcare while security services got the largest share, with 31%.

Officially, Somalia has had more than 16,000 infections and almost 900 deaths from COVID.

But, the country’s chief medical officer, Dr. Mohamed Mohamud Ali, told Amnesty the death toll was certainly far higher.

Dr. Ali said only those who managed to get to health facilities and get tested were included in official data.

“The figure is just a tip of the iceberg,” Amnesty quoted him saying, “many more were infected and died at home,” he said.

Amnesty notes that only 15% of Somalia’s rural population have access to medical care and the country has only one surgeon for every one million people.  

Abdiqadir Abdirahman Adan is the founder of the Amin ambulance service, the only such service for Mogadishu residents.

Adan says they have only two ambulances to serve people, the ambulance workers get exhausted, and it is challenging to get oxygen. Since they provide a free service to people, and the companies producing oxygen want money, he says, they have problems with oxygen supply. Adan says their ambulance workers are also not very well trained to handle some health issues.

The Amnesty report, based on interviews with 33 medical and aid workers, as well as officials and experts, calls on Somalia to use debt relief to invest more in healthcare.

In March 2020, the International Monetary Fund and the World Bank reduced Somalia’s debt from $5.2 billion to $557 million over three years.

The debt relief aims to bring the Horn of African nation back into the global economy after 30 years of conflict and unstable governments.

Amnesty’s Hassan says the debt relief also offers an opportunity to improve Somali hospitals. 

“All this money that is going to be received through debt relief should be managed in a manner that is transparent, that is accountable, and it should be used to improve the health sector in the country,” he said,

Ambulance service operator Adan says the health sector desperately needs more medical experts to revive it.

He said this sector requires knowledge. “The people leading the health sector and working on policies must be people who have a background in health and medicine. If you are going to have people in the health sector who are not familiar with the health system, then it’s difficult to improve the health system,” he said.

Amnesty notes only 0.6% of Somalis have been fully vaccinated against the coronavirus.

While a shortage of vaccines is partly to blame, Amnesty says that 19 of the 33 healthcare workers it interviewed in the report refused to take the vaccine, despite having it offered.

It blamed widespread vaccine hesitancy, in part, on lack of public information.

Source: Voice of America

The Himalayan country of Bhutan, with a population of about 800,000, has fully vaccinated 90% of its eligible citizens against COVID-19, according to UNICEF.

More than 2,400 health workers fanned out from July 20 to July 26 to administer second doses, said a release Tuesday from the U.N. Children’s Fund.

“The Royal Government of Bhutan made exhaustive efforts to reach all target groups,” according to UNICEF. “Health workers organized vaccinations at community centers but also conducted home-visits to vaccinate the elderly and people with disabilities and trekked to higher altitudes to reach the nomadic herders.”

The agency said children between ages 12 and 17 in high-risk areas were also vaccinated.

Bhutan gave most residents their first doses of vaccine in March and April.

Two weeks ago, the country received 500,000 U.S.-donated vaccine doses through COVAX, a World Health Organization effort to distribute vaccine to poor countries. Other vaccine doses came from China, Denmark, India, Bulgaria and Croatia.

The small country now has one of world’s highest percentages of people vaccinated against COVID-19.

“The success is mainly due to the efforts that went into securing the second dose of COVID-19 vaccines and extensive preparations for the roll out of the vaccines using all forms of resources available in the country, including training health workers, and making people aware about the campaign in advance,” UNICEF said.

Source: Voice of America