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How a Digital Algorithm is Helping Doctors Treat COVID-19 Patients

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Moscow’s backup hospitals and inpatient clinics for treatment of the coronavirus infection have started using a new solution as part of the unified digital healthcare platform. The News2 app, which is integrated into the Unified Medical Information and Analysis System (EMIAS), helps physicians assess the severity of a patient’s COVID-19 symptoms and risks of deterioration, and suggests adjustments to treatment tactics where necessary.

The system is operated on tablets with specialized software. These allow medics to read the QR codes on a patient’s hospital identification bracelet or on an identification sheet in an inpatient clinic and enter data on their condition: heart rate, blood oxygen saturation level, blood pressure, body temperature, and respiration rate. The system then calculates the result and assigns the patient to a risk group, highlighting the relevant category with a specific color.

The patient’s risk score is entered in their electronic medical record. Physicians can then review both the patient’s current integrated risk score on the international NEWS2 scale and any changes to it at any time, together with the baseline data used to generate the information. Use of this clinical scale significantly improves patient safety, ensuring that examinations are conducted at predetermined time intervals and that specific indicators are measured, resulting in timely and optimal adjustments to patient therapy.

The benefits of the system for physicians are obvious: when the risk score increases from 3 to 5, for instance, the clinician can simply decide whether more treatment is necessary or, conversely, satisfy himself that the treatment is effective if the score subsequently falls.

The NEWS2 scale is used around the world to assess the severity of a patient’s condition by interpreting results based on a sum of scores. These are used to generate a final score for assigning the patient to a specific risk group.

Digital solutions in Moscow’s healthcare sector are being implemented jointly by the city’s Department of Health and Department of Information Technology.

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Health & Wellness

Study Finds That India Might Have Half Of All Covid-19 Deaths Worldwide

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© UNICEF/Vinay

On July 20th, an analysis that was published of India’s “excess mortality estimates from three different data sources from the pandemic’s start through June 2021 … yields an estimate of 4.9 million excess deaths.” As-of July 20th, the total number of deaths that had been officially reported worldwide from Covid-19 was 4,115,391, and only 414,513 (10%) of those were in India. If this new study is correct, then the possibility exists that around half of all deaths that have occurred, thus far, from Covid-19, could be in India, not merely the currently existing 10% that’s shown in the official figures.

This study doesn’t discuss why the actual number of deaths in India from Covid-19 might be around ten times higher than the official Indian figures, but one reason might be a false attribution of India’s greatly increased death-rate from the Covid-19 epidemic not to Covid-19 but to other causes, such as to Covid-19-related illnesses.

The new study is titled “Three New Estimates of India’s All-Cause Excess Mortality during the COVID-19 Pandemic”, and the detailed version of it can be downloaded here.   The study was funded by U.S.-and-allied billionaires and their foundations and corporations, and by governments that those billionaires also might control. However, this doesn’t necessarily mean that its methodology is in any way unscientific or otherwise dubious. The study raises serious questions — it does not, in and of itself, answer any. It’s a serious scientific study.

On 1 August 2020, I headlined “India and Brazil Are Now the Global Worst Coronavirus Nations”, and reported that, “India and Brazil have now overtaken the United States as the world’s worst performers at controlling the cononavirus-19 plague. The chart of the numbers of daily new cases in India shows the daily count soaring more than in any other country except Brazil, whereas in the United States, the daily number of new cases has plateaued ever since it hit 72,278 on July 10th, three weeks ago.” At that time, there was great pressure upon India’s Government to stop the alarming acceleration in the daily numbers of people who were officially counted as being patients (active cases) from the disease, and of dying from it. One way that a government can deal with such pressures is by mis-classifying cases, and deaths, from a disease, as being due to other causes, instead.

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Sharp rise in Africa COVID-19 deaths

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A volunteer carer called Trinity is working in a COVID-19 field hospital in Nasrec, Johannesburg. IMF/James Oatway

COVID-19 deaths in Africa have risen sharply in recent weeks, amid the fastest surge in cases the continent has seen so far in the pandemic, the regional office for the World Health Organization (WHO) said on Thursday. 

Fatalities are rising as hospital admissions increase rapidly as countries face shortages in oxygen and intensive care beds. 

COVID-19 deaths rose by more than 40 per cent last week, reaching 6,273, or nearly 1,900 more than the previous week. 

The number is just shy of the 6,294 peak, recorded in January. 

Reaching ‘breaking point’ 

“Deaths have climbed steeply for the past five weeks. This is a clear warning sign that hospitals in the most impacted countries are reaching a breaking point,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.  

“Under-resourced health systems in countries are facing dire shortages of the health workers, supplies, equipment and infrastructure needed to provide care to severely ill COVID-19 patients.” 

Africa’s case fatality rate, which is the proportion of deaths among confirmed cases, stands at 2.6 per cent compared to the global average of 2.2 per cent.  

Most of the recent deaths, or 83 per cent, occurred in Namibia, South Africa, Tunisia, Uganda and Zambia. 

Six million cases 

COVID-19 cases on the continent have risen for eight consecutive weeks, topping six million on Tuesday, WHO reported. 

An additional one million cases were recorded over the past month, marking the shortest time to reach this grim milestone. Comparatively, it took roughly three months for cases to jump from four million to five million. 

Delta, variants drive surge 

The surge is being driven by public fatigue with key health measures and an increased spread of virus variants.  

The Delta variant, the most transmissible, has been detected in 21 countries, while the Alpha and Beta variants have been found in more than 30 countries each. 

Globally, there are four COVID-19 virus variants of concern.  On Wednesday, a WHO emergency committee meeting in Geneva warned of the “strong likelihood” of new and possibly more dangerous variants emerging and spreading. 

Delivering effective treatment

WHO is working with African countries to improve COVID-19 treatment and critical care capacities.  

The UN agency and partners are also delivering oxygen cylinders and other essential medical supplies, and have supported the manufacture and repair of oxygen production plants. 

“The number one priority for African countries is boosting oxygen production to give critically ill patients a fighting chance,” Dr Moeti said. “Effective treatment is the last line of defence against COVID-19 and it must not crumble.” 

The rising caseload comes amid inadequate vaccine supplies. So far, 52 million people in Africa have been inoculated, which is just 1.6 per cent of total COVID-19 vaccinations worldwide.  

Meanwhile, roughly 1.5 per cent of the continent’s population, or 18 million people, are fully vaccinated, compared with over 50 per cent in some high-income countries. 

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Health & Wellness

Child mental health crisis ‘magnified’ by COVID

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A seven-year-old child looks out the window in Istanbul, Turkey, during the COVID-19 emergency. Closure of schools, disruption of health services and suspension of nutrition programmes, due to the coronavirus pandemic, have affected hundreds of millions of children globally. Photo: UNICEF

Half of the world’s children experience violence on and offline in some form every year, with “devastating and life-long consequences” for their mental health, the UN chief warned a symposium on the issue on Thursday.

In a video address to an event organized within the on-going High-Level Political Forum (HLPF), on mental health and wellbeing, he said that mental health services have long suffered from neglect and underinvestment, with “too few children” accessing the services they need.

Services cut

“The COVID-19 pandemic has magnified the problem. Millions of children are out of school, increasing their vulnerability to violence and mental stress, while services have been cut or moved online.

“As we consider investing in a strong recovery, support for children’s mental wellbeing must be a priority”, said Secretary-General António Guterres.

“I also urge governments to take a preventive approach by addressing the determinants of mental well-being through robust social protection for children and families”, he added, saying that mental health and psychosocial support, together with community-based approaches to care, are “integral to universal health coverage. They cannot be its forgotten part.”

Child’s view paramount

He also urged authorities everywhere to take the views and lived-experiences of children themselves, exposed to increasing on and offline threats, into account when formulating policies and protection strategies.

“Children play an important role in supporting each other’s mental wellbeing. They must be empowered as part of the solution. Let’s work together for sustainable, people-centered, resilient societies, where all children live free from violence and with the highest standards of mental health”, he concluded.

Children contribute

The meeting co-organized with the Permanent Mission of Belgium to the United Nations, and the Group of Friends on mental health and wellbeing, featured a video with contributions from children from 19 countries who took action to support one another.

UN Special Representative on Violence Against Children, Maalla M’jid, highlighted the devastating impact of violence on the mental health of children: “Exposure to violence and other adverse childhood experiences can evoke toxic responses to stress that cause both immediate and long-term physiological and psychological damage.

“In addition to the human cost, the economic cost of mental illness is significant”, she added.

Opportunity for change

The recovery phase of the pandemic, provides an opportunity for countries to invest in this field, she said, emphasizing that “we cannot go back to normal. Because what was ‘normal’ before the pandemic was not good enough, with countries spending on average only 2% of their health budgets on mental health.

“In addition to more investment, we need to change our approach to mental health. Building on the lessons of the pandemic, mental health and child protection services must be recognized as life-saving and essential.

“They must be incorporated into both emergency preparedness and longer-term planning and children must also shape the design, delivery and evaluation of responses”, she added.

The meeting contributed to raising awareness of the impact of violence on the mental health of children, both before and during the COVID-19 pandemic.

Examples were shared of effective approaches to supporting children’s mental health from different regions and in different settings; to identify what steps are needed to embed mental health best practices; put child protection and social protection services into action to build back better after the pandemic, while also supporting the Decade of Action to deliver the SDGs by 2030.

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