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New COVID-19 infections fall globally for first time since September

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Last week saw the first global decline in newly reported cases of COVID-19 since September, the head of the UN World Health Organization (WHO) said on Monday, advising that the news, while welcome, must be interpreted with “extreme caution”. 

Updating reporters during his regular briefing from Geneva, Director-General Tedros Adhanom Ghebreyesus described the global decline as fragile: brought on by falling cases in Europe, thanks to the difficult but necessary measures countries put in place in recent weeks.

“Gains can easily be lost,” the agency chief said, noting that COVID-19 is still on the rise in most other world regions, with an attendant increase in deaths.

Holidays – no time for complacency

He cautioned against complacency, especially with the holiday season approaching in many cultures and countries. Being with family and friends is not worth placing anyone at risk. “We all need to consider whose life we might be gambling with in the decisions we make.”

To be sure, the pandemic will change the way people celebrate, Tedros said. It will be important to follow local and national guidelines. For many, this is a season for staying home, avoiding crowded shopping centres, or ideally, making use of online shopping if possible. “Avoid gatherings with many different households and families coming together,” he said.

If travelling is essential, take precautions, he said: maintain distance from others and wear a mask in airports and train stations, as well as on planes, trains and buses. Cary hand sanitiser or wash hands frequently with soap and water. If feeling unwell, “don’t travel,” he insisted.

Disrupted services, increased risks for people living with HIV

For millions, COVID-19 is only one health they face, he said. People living with HIV also may have an increased risk of severe disease or death from COVID-19, he said.

A record 26 million people are on antiretroviral treatment – but the pace of increase has slowed, leaving 12 million people who are living with HIV without treatment. “12 million is big,” he assured.

A WHO survey of 127 countries earlier this year found that more than one quarter reported partial disruption to antiretroviral treatment.

However, with support from WHO, the number of countries reporting disruptions in HIV services has declined by almost 75 per cent since June. Only nine still report disruptions and only 12 report a critically low stock of antiretroviral medicines.

Such successes are mainly due to countries implementing WHO guidelines, he said, including providing longer antiretroviral prescriptions for 3 to 6 months, so patients can avoid health facilities. WHO also has worked closely with manufacturers and partners to ensure adequate supply of treatment.

Innovation, Innovation, Innovation

Moreover, he said countries also have introduced adaptations and innovations during COVID-19.  In Africa, for example, many have built their testing system for COVID-19 on the existing lab infrastructure for HIV and tuberculosis. In Thailand, the Government has maintained pre-exposure prophylaxis services and tele-health counselling for men who have sex with men. And many countries have introduced more self-testing for HIV to support self-care.

WHO is urging all countries to maintain these innovations as part of the “new normal”, Tedros said, and to help expand testing and treatment.

With Worlds AIDS Day approaching on 1 December, he called for preserving the “incredible” gains made over the past 10 years: New HIV infections have declined by 23 per cent since 2010, and AIDS-related deaths have fallen by 39 per cent.

Hope above all

“If the pandemic has taught us anything, it is that in the face of an urgent health threat, the world can come together in new ways to defeat it,” he assured.

The world can defeat the pandemic using existing tools and the vaccines now in the pipeline. “The most important thing is, we need to have hope,” he said. And solidarity to work together.

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Time to address mental health issues in the workplace

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With an estimated 12 billion workdays lost annually due to depression and anxiety, costing the global economy nearly $1 trillion, more action is needed to tackle mental health issues at work, the World Health Organization (WHO) and the International Labour Organization (ILO) said on Wednesday. The UN agencies have launched two publications which aim to prevent negative work situations and cultures while also offering mental health protection and support for employees.  

Performance and productivity affected 

“It’s time to focus on the detrimental effect work can have on our mental health,” said Tedros Adhanom Ghebreyesus, Director-General at WHO, which has issued global guidelines on the issue. 

“The well-being of the individual is reason enough to act, but poor mental health can also have a debilitating impact on a person’s performance and productivity.” 

The WHO guidelines contain actions to tackle risks to mental health at work such as heavy workloads, negative behaviours, and other factors that can create distress. 

For the first time, the UN health agency recommends manager training, to build their capacity to prevent stressful work environments and respond to workers’ needs. 

A workplace taboo 

WHO’s World Mental Health Report, published in June, revealed that of one billion people estimated to be living with a mental disorder in 2019, 15 per cent of working-age adults experienced a mental disorder.  

The workplace amplifies wider societal issues that negatively affect mental health, including discrimination and inequality, the agency said.

Bullying and psychological violence, also known as “mobbing,” is a key complaint of workplace harassment that has a negative impact on mental health. However, discussing or disclosing mental health remains a taboo in work settings globally. 

The guidelines also recommend better ways to accommodate the needs of workers with mental health conditions and proposes interventions that support their return to work. 

Increasing opportunities 

They also outline measures to ease entry into the jobs market, for those workers with severe mental health conditions. 

Importantly, the guidelines call for interventions for the protection of health, humanitarian, and emergency workers. 

A separate policy brief with ILO explains the WHO guidelines in terms of practical strategies for governments, employers and workers, and their organizations, in both the public and private sectors.  

The objective is to support the prevention of mental health risks, protect and promote mental health at work, and support those with mental health conditions, so they can participate and thrive at work.  

“As people spend a large proportion of their lives in work – a safe and healthy working environment is critical,” said, Guy Ryder, the ILO Director-General. 

“We need to invest to build a culture of prevention around mental health at work, reshape the work environment to stop stigma and social exclusion, and ensure employees with mental health conditions feel protected and supported.” 

ILO’s Convention on occupational safety and health, and a related recommendation, provide legal frameworks to safeguard workers.  

Lack of national programmes 

However, only 35 per cent of countries reported having national programmes for work-related mental health promotion and prevention. 

The COVID-19 pandemic triggered a 25 per cent increase in general anxiety and depression worldwide, according to a WHO study published in March. 

The crisis exposed how unprepared governments were for its impact on mental health, as well as a chronic global shortage of mental health resources.  

In 2020, governments worldwide spent an average of just two per cent of health budgets on mental health, with lower-middle income countries allocating less than one per cent. 

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A good night’s sleep is a tonic to remember

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BY ANTHONY KING

Everyone suffers restless nights from time to time. Chewing over failures or worries at the end of the day undermines rest, especially deep sleep. ‘A ruffled mind makes a restless pillow,’ wrote author Charlotte Brontë.  

A good night’s sleep serves as a tonic. What’s more, it is long recognised that shuteye gives learning and memory a boost. More recently, scientists revealed that the early phase of deep slow-wave sleep is especially important.

‘When you learn something in the evening, that information becomes reactivated during sleep,’ said Dr Bjoern Rasch, who took part in the Horizon-funded MemoSleep project and is a professor at the University of Fribourg.

The Swiss researcher added that ‘Ruminations and negative thoughts increase our awakenings during sleep, make us wake earlier than we want and make us sleep less deeply.’ 

Reactivated thoughts

But there is good news too. Positive thoughts can also be reactivated in brain circuits and, in the process, improve sleep, according to Dr Rasch. He organized an experiment around the whole idea.  

His test was a small boon to students in his university who received 50 Swiss francs (EUR 52) for every night they spent snoozing in a comfortable four-bed sleeping laboratory.

The students were connected to an electroencephalogram that monitored their brain waves. They also had their muscles monitored to record when they fell into slumber and what sleep-state they were in.

Some relaxation strategies allow people to fall asleep faster, but don’t change the quality of sleep afterwards, according to Dr Rasch. He played hypnotic tapes with imagery such as a fish swimming in deep water, and with words suggestive of safety and relaxation, for the students.

‘The subjects spent more time in the deeper slow-wave sleep stage after listening to the hypnotic tape,’ said Dr Rasch. ‘We would explain this by an increased reactivation of relaxing and reassuring thoughts during sleep, heard previously during the hypnosis tape.’

In future studies, Dr Rasch hopes to help patients who suffer from insomnia. 

‘It could not only help them fall asleep but could actually make their sleep more restful,’ he said. Furthermore, this could aid people with psychological illnesses, such as post-traumatic stress disorder, who sleep poorly.

Seahorses and learning

The seahorse-shaped part of the brain called the hippocampus (from the Greek word for seahorse) is especially important for learning and memory. Scientists often use rodents to investigate their hippocampus in learning and sleep.

Rats, for example, are masters at remembering paths through mazes to find foods. The hippocampus is key to this recall.  

Dr Juan Ramirez-Villegas uses rodents to probe how mammalian brains store memories – work that could eventually contribute to fighting human illnesses such as Alzheimer’s. 

As part of the Horizon-funded DREAM project, he discovered that another part of the brain – the brainstem – plays a crucial role along with the hippocampus and becomes active beforehand.

‘It seems like the brainstem is setting up some scenery so that the hippocampus can reactivate memories across different stages of sleep,’ said Dr Ramirez-Villegas, who is a postdoctoral fellow at the Institute of Science and Technology Austria. 

He has attached electrodes to record activity in the brains of rats as they navigate a maze and afterwards as they sleep. Sleeping allows the brain to replay daytime events and etch them as long-term memories. 

‘It is very striking that the cells fire in the same order during sleep that they did during learning, but they are more compressed in time during sleep,’ said Dr Ramirez-Villegas.

How we remember

The discovery was surprising because it suggests that the brainstem has an overlooked function in stimulating and changing memory formation. This seems to be true for rodents as much as for primates and, as a result, is likely to be a basic mechanism of the brains of mammals, including people. 

The research, while crucial to understanding the basic operation of the brain, could have clinical benefits too. ‘We are untangling the basic principles of memory processes, but we can also use these to ameliorate the effects of memory-related illnesses,’ said Dr Ramirez-Villegas.

The research in this article was funded via the EU’s European Research Council and the Marie Skłodowska-Curie Actions (MSCA). This article was originally published in Horizon, the EU Research and Innovation Magazine. 

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Noncommunicable diseases now ‘top killers globally’

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From heart disease to cancer and diabetes, noncommunicable diseases (NCDs) now outnumber infectious diseases as the “top killers globally,” the UN health agency said in a new report, released on Wednesday, with one person under 70 dying every two seconds from an NCD.

The report and new data portal, was launched on the sidelines of the 77th session of the General Assembly, at an event co-organized by the World Health Organization (WHO) together with Bloomberg Philanthropies.

Report assets

NCDs constitute one of the greatest health and development challenges of this century, according to WHO.

Chief among them are cardiovascular diseases, such as heart disease and stroke; cancer; and diabetes and chronic respiratory diseases – as well as mental health illnesses.

Together they account for nearly three-quarters of deaths in the world, taking 41 million lives every year. 

The report, Invisible numbers: The true extent of noncommunicable diseases and what to do about them, highlights NCDs statistics to illustrate the true scale of the threats and risk factors they pose. 

It also shows cost-effective and globally applicable interventions that can lower those numbers and save lives and money.

“This report is a reminder of the true scale of the threat posed by NCDs and their risk factors,” said WHO chief Adhanom Ghebreyesus.

Country-specific portal

Sharing the latest country-specific data, risk factors and policy implementation for 194 countries, the NCD data portal brings the numbers in the report to life. 

Moreover, it allows data exploration on cardiovascular diseases, cancer, diabetes and chronic respiratory diseases along with their main drivers and risk factors, which include tobacco, unhealthy diet, harmful use of alcohol and lack of physical activity. 

The portal spotlights patterns and trends throughout countries and allows comparison across nations and/or within geographical regions.

Important timing

To date, only a handful of countries are on track to meet the 2030 Sustainable Development Goal (SDG) target of reducing early deaths from NCDs by a third.  

And yet, NCDs are at the heart of sustainable development and their prevention and treatment is a prime opportunity for investment that would have myriad impacts on economic growth, far outweighing the money spent.

“It is a misconception” that they are “diseases of high-income countries”, said Bente Mikkelsen, WHO’s Director of Noncommunicable Diseased, adding that a full 85 per cent of all premature deaths happen in low and middle-income countries.

At a critical juncture for public health, WHO said that the new information offers a chance to address the issue and recommends spending more on prevention.

Investing $18 billion a year across all low and middle-income countries could generate net economic benefits of $2.7 trillion by 2030.

At the event, the WHO chief called on global leaders to take urgent action on NCDs and renewed the two-year appointment of Michael R. Bloomberg as WHO Global Ambassador for Noncommunicable Diseases and Injuries – his  third reappointment since 2016.

“As we continue to respond to this pandemic and prepare for the next, we have seen the critical importance of addressing a major risk factor in COVID-19 hospitalizations and deaths – noncommunicable diseases,” said Mr. Bloomberg.

He maintained that they can often be prevented with investment in “proven, cost-effective interventions” and looked forward to continuing to make “life-saving investments in NCD and injury prevention” alongside WHO.

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