The Evening Report - Dec 13
COVID, RS virus, and influenza infections push EU hospitals into crisis.
🦠Pandemic🦠
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The BQ.1.1 variant will become the dominant coronavirus strain in Denmark within a week or two according to the Statens Serum Institute.
Professional Director Tyra Grove Krause says the BQ.1.1 strain is a sub-variant of BA.5, which is one of the variants targeted by the bivalent vaccine being used in the booster dose campaign.
“So we can see in Denmark that the risk of being infected with BQ.1.1 is slightly higher than for the other BA.5 variants when you have had a variant-updated vaccine.”
The SSI says so far there is no evidence indicating the BQ.1.1 variant causes any more severe infection. But, the agency notes it does have increased immune evasion, meaning it is more likely to dodge around immune protection from a previous infection and reinfect someone.
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COVID hospitalizations (425) keep climbing (+9) while the number of people with severe coronavirus infections in an ICU (8) has dipped (-2) of those, the number on a ventilator (5) also inched down (-1).
Infection admissions to a psychiatric institute (67) are unchanged.
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Denmark is reporting 1,074 new infections (underreported), including 473 reinfections, in the last day.
There have also been another 12 coronavirus deaths, which is high. While pandemic deaths are far from ‘peak’ territory, the increased fatalities in the last two mini-waves, and the third one that is currently building, are troubling.
With 6,685 PCR tests the daily positivity percentage is 16.06%, over the last 7 days, the rate is 19.6%.
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On the RS virus front, the good news is the massive infection wave has peaked and is continuing to decline. The bad news is there are still currently more cases than the peak of almost every previous season save one, last springs (the red line) extremely late wave.
This fall/winter RS virus wave has so far claimed 100 lives in Denmark, which is the highest number of RS virus deaths of any previous season. Considering infants are the most susceptible to severe infection, this is a pretty horrific number.
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Influenza numbers are creeping upward, but infections, so far, remain at a pretty low level. As we have reported already, concerns are rising among Danish health officials an influenza wave is sweeping through Europe and could soon arrive in Denmark.
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The Swedish Public Health Agency updates its COVID statistics once a week every Thursday.
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COVID hospitalizations continue to surge in Sweden’s capital region. There were 522 pandemic patients in hospitals across Stockholm, according to the region’s latest weekly report. That is 97 more than there were a week ago. There are 13 people in an ICU, an increase of four from the week previous.
Chief Physician Johan Bratt:
“We now have a sharp increase in the number of people being treated for COVID in Stockholm. The situation is strained at several emergency hospitals, for example Södersjukhuset is in staff mode. The pressure is very high on the healthcare system in Stockholm.”
He adds that is isn’t just the pandemic that is straining healthcare resources as hospitals are under mounting pressure on several fronts.
“In addition to COVID, influenza and the RS virus are also circulating. RS virus often affects young children and the situation in children's intensive care units is also strained. Newborns and the very youngest are often infected by older siblings. Region Stockholm therefore urges parents who have sick children to take the opportunity to consider keeping siblings of infants at home from preschool.”
Bratt is continuing to urge people to get vaccinated to protect themselves and those around them. And he emphasizes that this also applies to the seasonal flu, with plenty of opportunities for people to get their flu shots.
Region Stockholm is reporting another 1,351 confirmed infections over the last seven days. Due to Sweden’s practice of restricting PCR tests to just seniors in care and those being hospitalized, it’s case numbers are wildly underreported.
It also recorded 21 more coronavirus deaths pushing the the to-date pandemic death toll in the region to 5,723 lives lost. Of those, 1,943 deaths have been seniors in care.
The region says that Sweden continues to struggle with a backlog of reporting COVID deaths.
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At Södersjukhuset, the hospital in Stockholm not only went into staff mode but also canceled a number of planned procedures to clear the deck to deal with the current crisis. As of Tuesday morning, many of the wards at the hospital were overcrowded.
Chief Physician Sven Klaesson spoke to Posten:
“The situation has progressively worsened over the weekend. Above all, we are seeing an increase in COVID patients, even if the patients are not at all as sick as they were before during the pandemic.”
Meanwhile, the hospitals children and youth section is seeing a flood of RS virus cases.
Pediatrician Tobias Alfvén also spoke with Posten:
“The absolute majority of the children who receive inpatient care have RS. We hope that it is approaching a peak, but it is too early to say if that is the case.”
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The situation is also deteriorating in Southern Sweden. Region Skåne is reporting that COVID cases have increased for a third straight week with cases rising across all age groups. The region doesn’t provide specific numbers in its update but says that hospital admissions are rising. It also adds that infections among healthcare staff and patients have increased week to week by “roughly 50%.”
Infection Control Doctor Eva Melander says the one bright spot is ICU capacity:
“Only a few patients with COVID are still being cared for in hospital intensive care units. And it is, after all, a positive sign.”
But, Menander adds, like every where else, hospitals in the region aren’t just struggling with another coronavirus wave but also an influx of RS virus and influenza patients. The region is urging people who feel sick to stay home and avoid any contact with others to prevent any infection spreading.
“Vaccination is the best protection against serious infections. It is especially important for those who are over 65 years old or who belong to a risk group. This applies to both COVID and influenza. In most cases, it is possible to get vaccinated against coronavirus and the flu at the same time.”
The region is also imploring parents of small children to maintain regular hand-washing practices and avoid any contact with anyone who is sick in order to protect their children, especially infants, from the RS virus.
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Region Västra Götaland is also reporting a “sharp increase” in the number of COVID hospitalizations with 283 pandemic patients currently being treated.
The region says the healthcare situation is being complicated by an “extensive” spread of RS virus infections. It says hospitals across the region are under great strain and especially pediatric units.
Infectious Disease Doctor Thomas Wahlberg:
“RS virus can cause severe illness and everyone with small children under six months needs to be careful; this also applies to their siblings.”
The region has issued new RS virus recommendations. They include asking parents to keep their infants away from anyone who has a cold or cold-like symptoms. Wash hands often with soap and water. Stay home and avoid all contact when sick. Families with older siblings should keep their kids home from pre-school if at all possible.
The recommendations will remain in place until at least January 8.
🇳🇴
Norway has stopped daily COVID reports and now does a fairly extensive once-a-week pandemic assessment. It usually publishes on Wednesdays.
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A new study from the Norwegian Institute of Public Health has found that COVID vaccinations may be linked to menstrual irregularities among young girls from the ages of 12 to 15 years old. An earlier study in 2021 also found a link between COVID vaccinations and menstrual disorders in women 18 to 30 years old.
Project Manager and Doctor Lill Trogstad:
“4.7% of the participants reported that the last menstrual bleeding before vaccination was heavier than what they usually experience. After vaccination, several, 7.3%, reported that the first menstrual bleeding after the vaccine was heavier than usual.”
Women in the study also reported shorter intervals between menstrual cycles and stronger pain during menstruation.
In the study, about 80% of the girls had at least one vaccine dose. Almost all of them were vaccinated with the Pfizer/BioNTech vaccine. The study also found what it called “a hint” that unvaccinated girls who had coronavirus infections also saw an increase in menstrual disorders but adds that further studies are needed.
The study has its drawbacks. One is that is relies on mothers and parents to answer the survey on behalf of their young daughters. Study authors also wonder if media coverage of the issue may have contributed to a perception bias and reports of perceived menstrual disturbances with a “temporal relation” to vaccination.
The study also notes that menstrual disorders are very common for young girls for the first few years of menstruating. This can be due to a number of factors like stress, infections, contraception, medicines, and other factors.
The study has been published on Science Direct and can be found HERE.
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The Finnish Institute for Health updates its COVID statistics every Thursday afternoon.
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Finnish Family Affairs and Social Services Minister Krista Kiuru has tested positive for coronavirus. Kiuru made the announcement on Twitter. She has been one of the Finnish government’s key decision makers on pandemic matters.
Kiuru is currently working as a head of the working group that is putting together long-COVID treatment recommendations. The recommendations are due to be tabled by the end of the year.
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Germany logged 53,745 new infections and lost another 211 lives to the coronavirus in its Tuesday afternoon update. To date, Germany has recorded 159,177 pandemic deaths.
It added 2,824 COVID hospitalizations while ICU numbers (1,067) rose (+79). As a percentage of all intensive care beds in the country, coronavirus patients are using 5.2%.
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The RS virus wave sweeping through Europe has created what some German doctors are calling a “catastrophic situation” in the country’s hospitals. With RS virus cases impacting mostly infants under the age of two, hospital admissions are increasing, while many hospitals struggle with being short-staffed.
In Germany, some doctors are having to allocate intensive care, choosing between sick children sometimes at a terrible cost, due to a lack of space. In other cases, children are being sent to hospitals in other parts of the country.
Chief Physician of Pediatric Intensive Care at Hannover University Hospital Michael Sasse spoke to AP:
“The situation is so precarious that we have to honestly say that children are dying because we can no longer treat them.”
Germany’s Health Minister Karl Lauterbach has promised €600 million in funding help for children’s healthcare as well as changing staffing regulations to try and address the crisis.
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In France, media are calling it the “triple epidemic” as another coronavirus wave hits while rising RS virus and influenza cases complicate the situation. The country is seeing its worst ever RS virus outbreak. The French health ministry is calling it “a completely new situation.”
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Hospitals across Europe could face significant pressure as a rise in coronavirus infections is exacerbated by a huge wave of RS virus cases. That is the warning from the European Centre for Disease Prevention and Control. With a number of EU countries already reporting increasing numbers of RS virus-infected kids flooding into hospitals, the ECDC cautions there is a “high risk of significant pressure on the healthcare system in the coming weeks.”
ECDC Director Dr. Andrea Ammon:
“The end-of-year festive season is associated with activities such as social gatherings, shopping, and traveling, which pose significant additional risks for transmission of RS virus and other respiratory infections. Reinforcement of healthcare systems and support of healthcare workers should be prioritized due to the risk of severe pressure on our healthcare systems in the coming weeks and months. Vaccination against influenza and COVID should also be a priority among at risk groups.”
The ECDC says hospitals should prepare for staffing challenges as doctors and nurses have to call in sick. It says maintaining an adequate ratio of staff to patients is critical.
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The European Medicines Agency’s Emergency Task Force is warning that monoclonal antibodies used for treating severe coronavirus infections are not effective against new variants spreading across Europe. It says recent laboratory studies down that monoclonal antibodies were “poorly effective” at neutralizing Omicron variants BA.4.6, BA.2.75.2, and the recombinant XBB strain. The data also showed that monoclonal antibodies also did not significantly neutralize the BQ.1 and BQ.1.1 variants, which is a problem as they are becoming the dominant strains across Europe.
“Although it is not yet known to what extent reduced neutralizing activity translates into reduced benefits for patients, healthcare professionals will need to consider alternative treatments, especially if subvariants such as BQ.1 and BQ.1.1 become prevalent.”
The EMA says other COVID treatments like Paxlovid and Remdesivir are expected to retain their efficacy against the new variants.
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The European Centre for Disease Prevention and Control is asking EU health agencies to be vigilant for increasing numbers of invasive Group A Streptococcus, or iGAS, infections. The agency says countries like Ireland, France, the Netherlands, Sweden, and the United Kingdom have all reported an increase in iGAS infections among children under the age of 10. Several children have died.
The ECDC notes that France and the UK have seen iGAS cases “several-fold” higher than pre-pandemic levels. The agency doesn’t believe there is any new strain or mutation; rather, the flood of coronavirus, RS virus, influenza, and other respiratory infections has allowed more opportunities for iGAS to flourish.
Invasive group A Streptococcus can manifest as pneumonia, a skin or bone infection, and usually appears at the tail end of another infection. Children with chickenpox or influenza, for example, are at higher risk of developing an iGAS infection.
The ECDC says it is difficult to assess the overall level of circulation, but iGAS is easily treatable with antibiotics so the current risk assessment is low.
WHO Regional Director for Europe Dr. Hans Kluge says catching the infection early is key.
“Increase vigilance to iGAS cases, especially when respiratory viruses are widely circulating in children.”
Parents are asked to be aware of any concerning symptoms and get children who are not improving to a doctor. Getting COVID and influenza vaccinations also helps reduce the risk.
🇨🇦
The Public Health Agency of Canada is reporting 17,376 new infections in its latest weekly update. There have also been 243 pandemic deaths in the last seven days.
PHAC updates infection and fatality numbers every Monday and vaccination statistics are updated on Thursdays.
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The weekly positivity percentage across Canada is 12.2%.
⚡️Energy Crisis⚡️
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EU politicians remain at an impasse over the issue of how to deal with soaring gas prices. A European Union effort to cap prices to try and limit the fiscal hit to consumers hit a wall in Brussels on Tuesday with no deal reached.
Czech Industry Minister Jozef Sikela:
“I was hoping to open a bottle of champagne today to celebrate the deal. But unfortunately we have to keep the champagne in the fridge for a little while longer. But we have a new meeting on Monday.”
The EU Commission had been pushing to cap natural gas rates at €275 per megawatt hour on the TTF gas exchange. But countries like Spain, Greece, Belgium, and Malta were all opposed.
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There may be a good reason this winter to appreciate a blustery windy day. Calm cold weather isn’t as good for wind energy production as a good windy day. For example, in Finland electricity production is about a third less on a calm day than a windy one. Finnish energy agency, Fingrid, says with a lot of calm weather so far this fall electricity production is 32% of nominal capacity.
Winter weather matters because in the Nordics wind turbines create about 50% more electricity than during the summer months. Winter tends to be windier and the air more dense. However, statistically, winds are calmer during periods of intensely cold weather.
As the energy crisis tightens its grip on Europe, energy experts are going to be watching temperature and wind forecasts with baited breath.
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Rising costs fueled by the energy crisis and soaring inflation are forcing more and more Danish families to seek some Christmas help. Mødrehjælpen says it has received a record 21,000 applications for holiday aid. That is a 40% increase year over year. The agency says roughly a third of applicants list rising prices as the reason they are asking for help. Mødrehjælpen holiday help includes a financial subsidy of 550 Danish kroner (just over $100 Cdn) per child under the age of 18 who is still living at home.
It is not the only agency seeing a surge in requests for help. Both the Danish Red Criss and Blue Cross have both reported a surge in applicants asking for a helping hand this Christmas.
🇺🇦/ 🇷🇺 War
🇺🇸 🇨🇦 🇯🇵 🇩🇪 🇫🇷 🇮🇹 🇬🇧
The G7 countries have agreed to help strengthen Ukraine’s military capabilities. The agreement has a special focus on the Air Force. In a statement, the United States, Japan, Germany, the United Kingdom, France, Italy, and Canada decried Russia’s “irresponsible nuclear rhetoric" as being unacceptable. The G7 also warned Russia that any use of chemical, biological, or nuclear weapons would be met with “serious consequences.”
🇺🇦 🇪🇺
It is not quite the status quo at the borders between Ukraine and Europe, but there is still no indication Russia’s attempts to freeze the country into submission has triggered a new refugee wave. According to statistics from Frontex, Europe’s border agency, over the past week 203,700 Ukrainians have entered into the European Union. But, in the same seven day period, 203,700 Ukrainians left the EU to return home.
So far, since Russia’s disastrous invasion of Ukraine, 12.1 million people have fled Ukraine crossing into Europe, while 9.3 million Ukrainians have returned home.
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The European Union has donated 40 generators to 30 hospitals in Ukraine. The hospitals are in the cities of Donetsk, Dnipropetrovsk, Zaporizhzhia, Mykolayiv, and Kherson. This is in addition to the over 800 generators the EU has already sent to Ukraine. This latest package is to help hospitals continue operating despite Russian attacks on Ukraine’s energy infrastructure.
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Last week’s cyber attack may have taken the Danish Armed Forces website down for most of a day, but the hackers didn’t make off with any data. That is according to the press manager of the Defense Materiel and Procurement Agency.
Thorbjørn Nørgaard Hein spoke to Ritzau:
“As far as I am aware, at no time has there been any data from the Defense which has been in danger of being compromised. It has only been a sabotage of being able to access our websites.”
The DDOS attack, which overwhelms servers by using multiple compromised computer systems to launch simultaneous attacks, took place last Thursday. An investigation is underway into the cyber attack and who might be behind it.
🇸🇪 🇺🇦
Region Stockholm is donating medical equipment to hospitals in Ukraine. The package put together by the region includes six anesthesia stations, ten patient monitors, an ultrasound machine, 30,000 liters of hand sanitizer, and 15,000 medical overalls.
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The ongoing war in Ukraine, global uncertainty, and the energy crisis have prompted Finland's National Emergency Supply Agency to take the step of bulking up its emergency stockpiles of grain. The agency has begun procuring various types of grain with the goal of increasing stockpiles of oats, wheat, and barley to be able to cover over eight months of consumption.
Agency Director Jaakko Pekki spoke to Yle:
“The National Emergency Supply Agency is strengthening preparedness with additional backup grain stockpiles, for disruptions in a changed security situation, which can be estimated to continue to be challenging for several years. This growing season, the harvest was good and there is enough grain for backup storage as well.”
It says current stockpiles have enough grain to cover about six months of use. The agency has also increased stockpiles of fuel and other food stuff.