Scientists who compared the genes of thousands of patients found that those who had Type A blood were more likely to have severe cases of COVID-19.
Scientists who compared the genes of thousands of patients found that those who had Type A blood were more likely to have severe cases of COVID-19.
Mask-wearing — anathema to many in the U.S. — is one reason why Japan has avoided the heavy coronavirus death tolls seen in many parts of the world, according to the government’s expert panel on the pandemic.
While face-coverings have sparked angry confrontations in some parts of the world and were initially dismissed as ineffective by the World Health Organization, they have long been part of everyday life in Japan. But they won’t be enough for the country to maintain its strong record on containing the virus.
As of Wednesday, Japan had confirmed more than 16,000 infections and about 850 deaths from the virus, by far the lowest figures among the Group of Seven major economies. But in a reminder that the crisis is far from over, an uptick in cases in Kitakyushu this week sparked enough concern for the government to send a team to investigate, public broadcaster NHK said.
Even as the nation inches toward resuming activities, experts need to stamp out clusters faster than ever to fend off a more serious second wave of infections, according to written responses provided by the panel. That means a combination of PCR and antigen testing, and urging people to avoid risky situations.
Prime Minister Shinzo Abe ended the national state of emergency Monday, as cases had tailed off. He laid out plans for a gradual resumption of economic and social activities, in tandem with precautions against another major outbreak.
While Japan is currently held up as having dealt with COVID-19 relatively well, its health care system came close to collapse. There was no legally enforceable lock down, but social distancing caused severe economic pain, according to the comments provided via Mikihito Tanaka, an associate professor of journalism at Waseda University, who liaises with media for the panel.
The following is an edited translation of the panel’s responses to written questions:
The vice chairman of the expert panel, Shigeru Omi, has said that strong health consciousness among the Japanese helped keep the outbreak under control. What did he mean by health consciousness, and how does this differ from other countries?
There’s strong awareness of public hygiene, starting with the habit of washing our hands. And, due to historical experiences, there is widespread knowledge about preventing infections.
Another social factor is that Japanese people feel comfortable wearing masks on a daily basis. Many people are allergic to pollen, so they do this during the cedar pollen season from the beginning of the year until spring, as well as to protect against influenza.
What lessons have you learned for preventing a second wave?
Cluster surveillance has enabled us to ascertain what situations and places present a high risk. We have found out that wearing masks, hand hygiene, physical distancing and avoiding talking loudly are effective in preventing transmission.
A second wave is very possible, so we need to detect clusters faster than before. We also need to use the antigen testing we have developed, alongside PCR testing, to find cases before symptoms become serious.
Would you rate Japan’s virus policy as a success?
Japan’s health care system was on the brink of collapse, and we just barely managed to avoid that, thanks to an all-Japan effort. Even though we didn’t go as far as a lockdown like those seen in the U.S. and Europe, there has been great social and economic sacrifice. It’s difficult to find a balance between preventing the spread of the disease and social and economic activity.
Japan didn’t have a legal means of imposing a lockdown, but modeling showed that reducing social contacts by 80 percent would reduce infections, and many citizens cooperated. Of course, we weren’t 100 percent confident that everyone would comply, but we hoped and trusted that they would.
Do you have enough testing capacity? How much PCR and antibody testing is needed?
Japan’s initial policy was to test people when doctors considered it to be necessary. But the spread of the disease in mid-March meant that we weren’t able to provide testing for all citizens who needed it. PCR testing capacity didn’t expand fast enough to keep pace.
The absolute number of tests has been far lower than in other countries, but in fact the number of tests per reported death has been higher in Japan. In addition, the proportion of tests that yield a positive result was at one point more than 30 percent and has now fallen below 1 percent. It’s below 1 percent for the entire country, which is low compared with other nations, so we think the testing system is reasonable.
At this point, we are still not sure of the accuracy, especially in terms of sensitivity and specificity, of antibody tests. While we haven’t greatly misread the spread of the infection so far, in order to relieve the underlying anxiety of the Japanese people, we need to be able to carry out more antibody tests more quickly. It’s also important to have a communication system to listen to the views of the people.
GENEVA – More than 1 billion young people risk damaging their hearing through excessive use of smartphones and other audio devices, the U.N. warned Tuesday, proposing new safety standards for safe volume levels.
In a bid to safeguard hearing, the World Health Organization and International Telecommunications Union issued a non-binding international standard for the manufacture and use of audio devices.
Young people are particularly prone to risky listening habits.
Around half of those between the ages of 12 and 35, or 1.1 billion people, are at risk due to “prolonged and excessive exposure to loud sounds, including music they listen to through personal audio devices,” the UN health agency said.
WHO chief Tedros Adhanom Ghebreyesus pointed out that the world already has “the technological know-how to prevent hearing loss.”
“It should not be the case that so many young people continue to damage their hearing while listening to music,” he said in the statement.
Young people, he said, “must understand that once they lose their hearing, it won’t come back.”
Currently, about 5 percent of the global population, or some 466 million people, including 34 million children, suffer from disabling hearing loss.
WHO said it remained unclear how many of them had damaged their hearing through dangerous use of audio devices.
It insisted though that the new standard developed with ITU would go a long way to “safeguard these young consumers as they go about doing something they enjoy.”
WHO considers a volume above 85 decibels for eight hours or 100 decibels for 15 minutes as unsafe.
The Safe listening devices and systems standard calls for a “sound allowance” software to be included in all audio devices, to track the volume level and duration of a user’s exposure to sound, and to evaluate the risk posed to their hearing.
This system could alert a user if they have dangerous listening habits.
WHO is also calling for parental as well as automatic volume controls on audio devices to prevent dangerous use.
While some smartphones and other audio devices already offer some of these features, the U.N. would like to see a uniform standard used to help protect against disabling hearing loss.
“Think of it like driving on a highway, but without a speedometer in your car or a speed limit,” Shelly Chadha of the WHO told reporters in Geneva.
“What we’ve proposed is that your smartphones come fitted with a speedometer, with a measurement system which tells you how much sound you’re getting and tells you if you are going over the limit.”
The campaign targets elderly people and urges them to speak up
People with worries about their health, especially those over 60, should seek help quickly, according to NHS England.
A new eight-week campaign – called The Earlier, The Better – is aimed at reducing “unnecessary” hospital stays.
Last year a review warned of a rise in avoidable emergency hospital admissions and NHS England said too many people simply “soldiered on”.
The online, radio and poster campaign, launched on Monday, will urge people to get help without going to hospital.
It is being targeted at older people in particular because they often present themselves later, when conditions are more serious and are harder to treat.
Chronic conditions such as respiratory disorders can also be made worse by immobility, the cold and viral illnesses.
To try to combat the issue, the campaign encourages over-60s and their carers to use self-care information to deal with minor health problems, such as a bad cough or sore throat.
Greater use of the local pharmacy, and calling the NHS 111 advice line, is also being encouraged.
“We see in our hospitals so many people who have not had or sought the help they need early enough,” said Prof Keith Willett, NHS England’s director for acute care.
“We have to do better at helping people stay well, not just picking up the pieces when they fall seriously ill.”
He added: “Too many people make the mistake of soldiering on, losing the opportunity to nip things in the bud.
“Unfortunately this can lead to an unnecessary stay in hospital, particularly for the more frail elderly, and those with long-term conditions.”
Clare Howard, the organisation’s deputy chief pharmaceutical officer, said: “Pharmacists and their teams are well trained and well placed to be able to offer advice to people seeking help.
“They can provide medicines’ advice and support for minor ailments, advise you about how to manage a long-term condition and tell you if something needs more urgent medical attention from your GP, or even your local hospital.”
Early research shows that only one dose of the vaccine is needed to prevent cervical cancer.
A single dose – rather than the recommended three – of a vaccine against the sexually transmitted disease HPV may be enough to ward off cervical cancer, researchers said this week.
The findings may lead to simpler delivery and lower costs, possibly increasing the number of young people who get vaccinated, said the report in the journal Cancer Prevention Research.
The HPV vaccine is recommended for girls and boys before they become sexually active, but US research from 2012 showed that only one third of US female teens and fewer than 7% of US boys got the recommended three doses.
“Our findings suggest promise for simplified vaccine administration schedules that might be cheaper, simpler, and more likely to be implemented around the world,” said Mahboobeh Safaeian, an investigator in the Division of Cancer Epidemiology and Genetics at the National Cancer Institute in Maryland, the United States.
The study focused on a population of nearly 7,500 women aged 18-25 in Costa Rica. Although all were supposed to get the recommended three doses of the HPV vaccine at different times, about 20% of participants did not.
So researchers analysed blood samples from a group of 78 who got one dose, compared to groups of 120 to 192 that received two or three doses as planned.
They found that all the women in all three groups had antibodies against virulent strains of HPV, known as 16 and 18.
These antibodies persisted in their blood for up to four years, which is about as long as researchers have expected the vaccine to be effective.
The levels of antibodies also appeared stable over time, even though they were slightly lower in the single dose group, suggesting “these are lasting responses”, said the study.
The vaccine used in the study was Cervarix, made by the British pharmaceutical giant GlaxoSmithKline.
“GSK is continuing to review findings from this trial and is committed to ensuring regulatory authorities and public health officials have access to this information,” a company spokesman told AFP.
Study authors said antibody responses after a single dose have not been evaluated for Gardasil, the quadrivalent HPV vaccine made by Merck that is more widely used in the United States and many other countries.
More research is needed before any formal changes can be decided, but Safaeian said the findings could have far-reaching impact in low income nations.
“Vaccination with two doses, or even one dose, could simplify the logistics and reduce the cost of vaccination, which could be especially important in the developing world, where more than 85% of cervical cancers occur, and where cervical cancer is one of the most common causes of cancer-related deaths,” she said.
HPV can cause oral, anal, and cervical cancer.
According to the World Health Organisation, cervical cancer is the second most common cancer in women worldwide, and causes 500,000 new cases and 250,000 deaths each year. — AFP Relaxnews
AMANDA travelled all the way from China to get her new look in South Korea.
She’s having her first consultation with seven plastic surgeons at a renowned clinic in Seoul, shopping around to choose her new nose, jaws and eyes.
Like Amanda, thousands of Chinese, South-East Asian and Japanese patients are choosing to get their plastic surgery in South Korea.
Many of them are fans of the Korean pop culture, hoping to look like their idols.
The overall medical spending by foreign visitors hit a record US$116mil (RM359.6mil) last year. Out of them, 14% sought plastic surgery or skin treatments such as botox.
Nose jobs, facelifts, jawbone reductions or tummy tucks are popular among Chinese tourists.
Thanks to the boom, there are now more than 400 plastic surgery and skin clinics in the affluent Gangnam district in Seoul.
The authorities are actively behind the medical tourism boom – easing regulations and helping promote Korean plastic surgery overseas.
They hope the country can cash in on the success of K-pop – and foreign fans’ bid to be beautiful. – AFP Relaxnews
Many people are unaware that being diagnosed with hepatitis B and C is a lifelong sentence.
MANY ancient civilisations rightfully believed that the liver is one of the most crucial organs in our body.
Although their understanding was not based in scientific fact – for example, the Babylonians, Estrucans, Romans and Greeks believed that the liver was the seat of all emotions and the organ closest to divinity, while in traditional Chinese medicine, it purportedly helps to regulate the flow of qi and blood in the body, and governs anger – the liver is indeed vital to our existence.
Like the heart, we cannot function without our liver.
It is one of the most hardworking organs in our body, performing over 500 different functions, including processing and storing nutrients, manufacturing proteins and hormones, neutralising toxins, breaking down drugs and removing waste from our body.
It is the second largest organ in the body after the skin, and the only one that has significant regenerative capabilities, being able to grow back to full size from as little as a quarter of its cells.
However, even this ability cannot overcome the insidious presence of the two hepatitis viruses that cause chronic infection in the liver.
These viruses work silently – often residing in the infected person’s body quietly, slowly damaging the liver without causing any outward signs of illness, until it is too late.
Passed on through bodily fluids, they can be contracted through sex, the sharing or reuse of unsterilised sharp objects like needles, razors, and even earrings, from mother to child in the womb, and basically, any activity that can result in the transference of blood, semen, vaginal fluid and saliva directly from the infected person to someone else.
The virus usually gains access into the body via the bloodstream through minor wounds, like nicks or cuts, that one may not even notice.
But because these viruses rarely cause any specific symptoms during the acute stage, people are unaware that they have been infected, and may go on to infect other people unknowingly.
This is why, according to consultant hepatologist Dr Syed Mohd Redha Syed Nasir, the most important form of transmission is perinatal or early childhood transmission.
He explains: “If someone in the family has hepatitis B, it is likely that someone else will have it too; that’s why we have to screen everyone in the house.”
This is especially in the case of children whose immune systems have not completely matured yet.
As a rule, hepatitis is usually only picked up upon screening, or when patients have already developed complications from the disease.
A chronic problem
Despite being considered a major global health threat – it is one of only four diseases that the World Health Organisation (WHO) considers crucial enough to mark with an international World Day, the awareness of hepatitis is still disturbingly low among the general population.
This infectious disease, which causes inflammation of the liver, is caused by five viruses: hepatitis A, B, C, D and E.
Of these, hepatitis B and C are the most worrisome as they can become chronic infections, which may result in liver cirrhosis (also known in layman’s terms as scarring or hardening) and liver cancer. (See Acute infections for more information on the three other viruses.)
These two viruses are also the main focus of the World Hepatitis Day campaign.
According to the World Hepatitis Alliance website, “The long-term objective of the campaign is to prevent new infections and to deliver real improvements in health outcomes for people living with hepatitis B and C.”
In Malaysia, hepatitis B is an important enough health concern that the vaccine is part of the compulsory national immunisation programme for all babies.
Despite that, Dr Syed says that around 5% of the population still has hepatitis B.
There is no vaccine for hepatitis C; neither is there any local data on the spread of hepatitis C or the three other hepatitis viruses in the country, according to him.
“In our setting, from my experience, we often encounter patients, who are diagnosed to have hepatitis B in particular, many years ago.
“Little do they realise that hepatitis B is a chronic infection that has the potential to cause long-term damage to the liver,” he says.
The doctor, who was previously with the national referral centre for liver diseases at Hospital Selayang and is now in private practice, adds that this often results in the patient being unaware of the importance of long-term follow-up, and creates the tendency for them to skip their annual check-ups.
“For these patients, you can’t be sure whether their infection will become active again, or develop into liver cancer.
“A few years down the road, they will come and you discover they have liver cirrhosis, and it is already a lost battle.”
He says that most patients tend to come in when they already have decompensated liver cirrhosis, which presents with abdominal swelling, with or without accompanying leg swelling, and either vomiting or passing motion with blood.
Some may also come in with a yellowish complexion (jaundice), episodes of losing awareness of their surroundings (hepatic encephalopathy), and other bacterial infections, as the liver is part of the immune system.
Too late to treat
While treatment is available for both hepatitis B and C, Dr Syed cautions that patients need to be carefully evaluated before the decision to start treatment is made.
This evaluation is to determine the degree of viral activity, as well as the level of liver damage. Both these factors need to be carefully balanced in order for treatment to be fully effective.
“When we give treatment, we must make sure it is indicated, because it is for life. For example, if a patient is 25 years old, he has to take it for the next 40 to 50 years (until he dies),” he says.
The development of resistance to the antiviral medication given for the disease is also another reason why doctors need to make the decision to treat judiciously.
Aside from oral antiviral drugs, patients may also be treated with interferon injections, which are typically given for the period of one year.
Dr Syed explains: “Interferon modulates your immune system, as well as clears the virus, so there is an added effect. After one year, your immune system will be able to clear the virus on its own.”
According to studies, the percentage of patients on interferon in which the virus can no longer be detected increases from 3-5% in the first year to 12% five years after completing their treatment.
However, he adds that this treatment is often not an option for most Malaysian patients, as the damage to the liver is already too advanced by the time they go see the doctor.
Unfortunately, the reality of the situation in Malaysia is that most patients with chronic hepatitis only see the doctor when their condition is so advanced that they are already well on the way to requiring a liver transplant.
Prof Dr Awang Bulgiba Awang Mahmud.
KUALA LUMPUR: Doctors should be rewarded for promoting good health and keeping people out of hospital, in addition to treating those who are already sick.
A public health expert said any new healthcare model should consider this as preventive care is more cost effective than curative care.
Universiti Malaya deputy vice-chancellor (Research and Innovation) Prof Dr Awang Bulgiba Awang Mahmud noted that under Britain’s National Health Service, general practitioners are rewarded for keeping patients out of hospital.
“I hope a Malaysian model will be less likely to reward the use of (health services) but more likely to reward doctors for keeping their patients healthy and out of hospitals.”
In Britain, GPs are paid cash incentives to improve healthcare. The “pay-for-performance” scheme is designed to pay work by doctors that previously wasn’t funded, such as managing conditions like hypertension as well as monitoring smokers and obese patients.
Prof Awang Bulgiba said there were three grand challenges facing the healthcare system – the rise in lifestyle diseases, an ageing population and rapidly spreading infectious diseases. He said any new healthcare model must address these factors.
“The rise in lifestyle diseases such as cardiovascular conditions, cancer and diabetes is due to our sedentary lifestyles and environmental changes.
“The cost of statins and lipid lowering drugs is getting higher. Healthcare is getting more expensive because more people are affected by these non-communicable diseases,” said Prof Awang Bulgiba, adding that the private sector must play a role in preventive care, which until now has almost exclusively been the preserve of the Government.
He noted that the top cause of deaths in government hospitals was heart disease. The increase in the rate of diabetes prevalence is worrying too. In the National Health and Morbidity Surveys, it increased from 8% in 1996 to more than 14% in 2006. In the fourth survey in 2011, the rate of diabetes was an alarming 20.8%.
Other than the rise in lifestyle diseases, Prof Awang Bulgiba also noted Malaysia’s ageing population would put stress on the country’s healthcare.
“By 2035, more than 7% of Malaysia’s population will be 60 years or older. Healthcare must recognise this fact and take steps to prepare for it,” said Prof Awang Bulgiba, who was the first Malaysian doctor to gain a PhD in Medical Informatics.
He said that with cheap air travel, infectious diseases like SARS and H5N1 can spread faster than ever before.
“What used to take months, now takes days to spread,” he said, noting that Chikungunya, a viral disease from Africa, has been detected in Malaysia.
Prof Awang Bulgiba also highlighted the disparity in the allocation of resources between the public and private healthcare sectors.
In 2011, public healthcare providers had 41,616 beds compared to 13,568 in private facilities.
“Although government institutions provide 75% of beds, only 40% of doctors work in the public sector with the majority in private practice,” he noted.
Prof Awang Bulgiba said there was also an imbalance of resources in healthcare. For example, there are far too many MRIs (magnetic resonance imaging machines) in the Klang Valley, “probably more than in the whole of Australia.”
He was speaking at a lecture on The Evolution of Public Healthcare in Malaysia held at UM recently after his election as a fellow of the Academy of Sciences Malaysia (ASM).
Prof Awang Bulgiba also talked about the rapid growth of private healthcare in Malaysia.
There has been a proliferation of private healthcare facilities, from 174 in 1992 to 660 in 2011. In 1980, there were only 50 private hospitals but in 2011, the number had grown to 220.
The share of private healthcare expenditure has been rising and is almost on par with government spending, from 5.8% in 1981 to 45.4% in 2009.
Looking at the bigger picture, Malaysia’s total expenditure on health was RM33.7bil or 4.96% of Gross Domestic Product. This is below the World Health Organisation’s recommended level of not less than 5% of a country’s GDP.
“As a comparison, the United States spends 15% of its GDP on healthcare,” said Prof Awang Bulgiba.
He noted that although Malaysia has made great strides in healthcare, there is concern on whether the current model is sustainable.
Rising costs would eventually force the government to evaluate how a national healthcare financing scheme can be implemented. Previous attempts, including the 1Care for 1Malaysia plan, have failed to get off the ground following opposition from stakeholders.
“I hope the new model will integrate the public and private healthcare facilities to promote equitable access,” said Prof Awang Bulgiba.
Going organic is simply healthier for your body and good for the family.
I was mid-lather in the shower when it hit me, the realisation that I had no idea what I was putting on my body. I just knew it couldn’t be real strawberries or lush tropical rainforests. It was chemicals. And I had been putting them on my body every single day for 40-plus years. That’s when I stopped and became organic.
So, maybe your organic epiphany happened in a less lathered way. Maybe everyone you know is talking about organic and you’re afraid to let anyone accidentally see the non-organic, non-healthy lunches you pack for your kids. Maybe you’re overwhelmed on how to start or think it’s too expensive or difficult. Here are some reasons why you may want to switch, along with five easy tips on how to begin.
According to a slew of reports, going organic is simply healthier for your body. Studies have shown that organic food may have higher levels of antioxidants. The chemicals and pesticides in nonorganic foods have been shown to cause a reduction in fertility, may harm your immune system and the added hormones could be a cause for weight gain.
Genetically modified foods have yet to be fully tested, so the potential effects are still unknown. Dr Mehmet Oz notes on his site: “Eating organic protects you from potentially harmful chemicals such as pesticides.”
Joanna Runciman, who runs ActualOrganics.com, offers five easy ways to get started down the organics path:
1) Eat broccoli or kale: “Try it, even if you haven’t in the past. Don’t assume you won’t like these foods. Give them a go and see! Broccoli and kale are rich in the vital nutrients our bodies use to maintain health.
Tip: Try roasting them with a little sea salt and olive oil.
2) Skip synthetic household cleaners: You live in your house and breathe the air all day and touch everything. Wouldn’t it be better if all that was cleaned naturally? Runciman adds: “Remember that what we use in our home gets washed down the drain and ends up in our water supply. We need pure water, so please don’t pollute it!”
Tip: Make your own all-purpose cleaner using white vinegar to clean while you simmer a pot of water and cinnamon sticks for homemade air refreshers.
3) Eat fresh: Pass by the brightly coloured boxes and boxed meals that have a dozen or more ingredients and focus on whole foods that are made with one or two real ingredients, like fruits, vegetables, organic meats and beans. “Nature doesn’t make labels; stick to freshly grown foods,” Runciman says.
Tip: Try eating only fresh foods for one week and see if you feel any differently. You will.
4) Try one new thing a week: Head to the closest farmers market and explore something new. Did you know that if you halve a spaghetti squash and bake it for an hour, fluff the squash using a fork and – viola! – you’ve got healthy spaghetti. Top it with organic tomatoes, stewed with olive oil, and enjoy.
Tip: For dessert, cut a whole watermelon in two, stick in two spoons and savour the natural sweetness.
5) Be prepared: Take healthy options with you wherever you go: To work, driving the kids around, running errands, etc. “Carrots, peeled and chopped,” Runciman suggests, “or some sunflower seeds, dates, an organic apple for example. That way when you feel hungry in the day you won’t be tempted to eat processed foods from the vending machine!”
Tip: Pour yoghurt into an ice cube tray. Add Popsicle sticks and in a few hours your kids will be cheering.
Going organic isn’t difficult, and it doesn’t always have to expensive. You can start slowly and simply finish what you have in the house while replacing with healthier, safer versions over time. – McClatchy-Tribune Information Services