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Italy's Prime Minister almost broke in tears as virus infection seems uncontrollable; death toll reaches 10,023

March 29, 2020

COVID-19 OUTBREAK SEEMS UNCONTROLLABLE IN ITALY * Prime Minister almost broke in tears seeing hundreds of his people die everyday.    ITALY - Prime Minister Giuseppe Conte almost broke in tears as he saw how hard it is to contain the coronavirus pandemic in his own country, with the death now rises to 10,023 and the total number of infected persons reached to a staggering 92,472.   The worldwide death toll now reached to 30,848, while the total infected persons globally also hit a record high of 664,924 people. The health ministry in Spain also reported the fatality in the country jumped to 5,982 from a total of 73,235 infections, with a total of 832 patients fighting for death in the last 24 hours. The United States also felt the deadly onslaught of covid-19 pandemic with its total virus infection hit a smashing 124,665 Americans, based on Johns Hopkins University tally. The fatality toll in the U.S. also hit a record high of 2,191. In China, the virus continued to slow down - with the country's National Health Commission reporting only 45 new cases of the coronavirus disease in the last ten days. Those 45 cases, the NHC reported, were all imported from travellers overseas. There were alsoa reported 5 new deaths in Wuhan, a big city in China populated by 11 million people, and where the virus was firt reported to have started in its market. As the outbreak becomes controllable and contained now in the country, Wuhan City now reopens railway and subway stations Generally, according to the NHC report, life in Wuhan is starting to go back to normal. There was only 1 new case according to the state media that occured in the last ten days in Wuhan. A China-Europe cargo train on Saturday also travelled from Wuhan to Germany to deliver medical supplies.  The total infections in China halted to 82,000 including its death toll to 3,000 plus, a clear manifestations that the imposed lockdowns in Hubeu Province and Wuhan City contributed to the containment of the deadly virus believed originated from bats or snakes. MORE OLDER PEOPLE IN ITALY According to the World Bank, Italy is the second oldest population after Japan, and based on recent observations of the virus attack, older people are most vulnerable to coronavirus disease than the younger generation who are perceived as still having strong immune system and strong antibodies.  A total lockdown was earlier implemented in the Lombardy region and Venice - which included some cities like Rimini and Parma. People in these places were not allowed to leave quarantine and lockdown zones. And this lockdown affected an estimated population of 15 million. Unfortunately, just as the leaders realized the deadly virus, the Lombardy Region has already been infected and attacked by the deadly coronavirus disease. Until, dead bodies filed one morning in Italy, as thousands upon thousands of people were infected in the country.   (Editor's note: We are posting here the top 10 countries where the onslaught of the deadly coronavirus is gaining momentum in the past few days.) Based on John Hopkins' tally of the top countries severely hit by the deadly virus based on fatalities, we are posting here the top 11 countries as follows: 1. Italy - 92,472 confirmed cases - 10,023 deaths - 12,384 recovered 2. Spain - 73,235 confirmed cases - 5,982 deaths - 12,285 recovered 3. China - 82,057 confirmed cases - 3,304 deaths - 75,576 recovered 4. Iran - 35,408 confirmed cases -   2,517 deaths - 11,679 recovered 5. France - 38,105 confirmed cases - 2,317 deaths - 5,724 recovered 6. United States - 124,664 confirmed cases - 2,191 deaths - 1.095 recovered  7. UK - 17,312 confirmed cases - 1,021 deaths - 151 recovered  8. Netherlands - 9,819 confirmed cases - 640 deaths - 6 recovered 9. Germany - 57,695 confirmed cases - 433 deaths - 8,481 recovered 10.Belgium - 9,134 confirmed cases - 353 deaths - 1,063 recovered 11. Switzerland - 14,076 confirmed cases - 264 deaths - 1,595 recovered  

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8 dead as chartered plane bound for Japan crashes at NAIA

March 29, 2020

PLANE CRASH AT NAIA UPDATED MARCH 29 11:44PM... BREAKING: Eight people are now confirmed dead after a chartered aircraft figured in an accident and caught fire at around 8 p.m. Sunday at the Ninoy Aquino International Airport, the Manila International Aviation Authority reported. The aircraft was bound for Haneda, Japan and it has a registration number RPC 5880 owned by Lion Air aircraft (General Aviation aircraft). The plane was about to take off when suddenly caught on fire and exploded at Runway 24.  Ed Monreal, MIAA General Manager, during a press conference, confirmed there were no survivors on the flight. The eight passengers on board, which include two foreign nationals and 6 Filipinos have all died on the spot. Mindanao Daily News got hold of the Lion Air Declaration of Passengers and those on board include Ken Edward Ungson, Melvin de Castro, Marjo Medina, Jr - all Capt; Edmark Jael, Cenomer Bautista and Conrado Tomeldan, Jr - all six of them were Filipinos. While those two foreign nationals were John Richard Hurst, a male Canadian; and Marilyn de Jesus, a female American. Monreal said they are now investigating why the aircract was bound for Japan and why are six Filipinos among the passengers of said chartered flight. But the Civil Aviation and Aeronatics Board (CAAB) has initially told the media the plane encouneterd a technical problem while taking off on Runway 6.  The MIAA said during the incident, members of their fire and rescue were immediately dispatched to extinguish the flame but failed. The fire had already engulfed the aircraft when they arrived at the scene. “The runway has been temporarily closed, as investigators from the Aircraft Accident Investigation Board of the Civil Aeronautics Authority of the Philippines are now on site to determine the cause of the incident,” MIAA said.   Photo shows the wreckage of the chartered plane that crashed at Ninoy Aquino International Airport Sunday, March 29, around 8:00 in the evening. Eight people onboard said plane died on the spot, including two foreign nationals ( a male Canadian and female American) - photo credit to owner.   

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DA-10’s Integrated Lab formulates 70% ethyl alcohol for frontline personnel

March 28, 2020

To mitigate the spread of the highly contagious Corona Virus Disease 2019 (COVID-19), the Department of Agriculture - Regional Field Office 10 through its Integrated Laboratory Division has produced 70 percent ethyl alcohol with moisturizer for its frontline personnel.   Recognizing the limited supply and high cost of disinfectants in light of the COVID-19 crisis in the country, the agency’s chemist prepared the World Health Organization’s (WHO) recommended handrub formulation.   DA-10 OIC-Regional Executive Director Carlene C. Collado said that the alcohol will be used by DA-10 frontline personnel and eventually, will expand its beneficiaries to other frontliners aside from the agency.   According to Johanna C. Pichay, Chemist III, the WHO formulation requires the use of glycerol as humectant.   In which, DA-10 owes to Pilipinas Kao, Inc. through their Vice-President Resident Head for Plant Operation Engr. Alexander Y. Linog for donating glycerol to the agency.   Pichay added that the first batch of formulation she has prepared will be made available after 72 hours .

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CDO approves supplemental Annual Investment Program

March 28, 2020

Cagayan de Oro City legislators headed by Vice Mayor Raineir Joaquin V. Uy during a special session on Wednesday, March 25, approved the Supplemental Annual Investment Program of the city in the total amount of P5.1 billion.        The city has earmarked P550 million for COVID-19 response, which will be used to provide financial assistance to persons and workers displaced by the coronavirus (COVID-19) pandemic, as well as for other equipment or construction projects necessary.        The supplemental budget also includes a P 9.3 million budget for the city’s Community-Based Monitoring System-Accelerated Poverty Profiling and P1.5 million for the purchase of a dropside truck to be used for the city’s cleanliness drive.        Infrastructure projects implemented under the AIP also include the redevelopment of Bolonsiri Park, rehabilitation of Cogon Public Market, rehabilitation of drainage canal, installation of plate drainage and manhole covers and pavement resurfacing at the Carmen Public Market.        The city is also implementing the construction of a transient lodging facility and kiosk at the East-Westbound Terminal and Public Market and terminal perimeter fence, and gate entrance and exist for public utility jeepneys and buses, among others at the East-Westbound Terminal and Public Market.

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Covid-19: Survival of the fittest

March 28, 2020

The more intelligent would rule the less intelligent, or those who were less fit (Victorian England, 1820–1914) Covid-19 outbreak has spread throughout the world.  It reminds us of Darwin’s theory. Survival of the fittest. Corona virus has made the world public panic. Every nation gets suddenly terrorized. The people in any country should keep themselves at home. They have to apply social distancing. The family at home must lockdown. It causes chaoes everywhere. In micro-level—among the families—we can see the affluent families and the poor ones. They have different conditions in reacting to Covid-19. Let us imagine the real situation between the two different economic conditions of the families. And, also in macro-level—among the nations throughout the globe. They have different panorama in tackling the problem and surviving. There is no more beautiful panorama around the world but mentally blurring and dark scenery of the environment. People get mentally stressed. As if Covid-19 both made all the same. No! It makes us all people different in reacting and feeling. For the poor, in micro-level--it is different. When going out, we get scared. When still keeping at home, we get tired. Tired of thinking about how to get a meager meal every day. How to keep the family served with them enough food. Unfortunately, when looking at the fluent families— while keeping themselves at home—they always look to enjoy life. The affluent families can enjoy the beautiful scenery behind their houses. They can enjoy the green and peaceful home yard. On the contrary, the ordinary, and very specifically the poor family, they cannot do it. They have to pursue a meager meal, selling things: food or anything as street vendors, working hard to be public transport drivers, Gojeck as well.  What happens when they lockdown and stay at home? Noone can imagine in such a chaos, panic with Covid-19. For poor families, it is either to die or to live. The alternative is balanced: either A or B. A refers to save themselves by keeping at home. They must stay at home, doing nothing and getting nothing. No, it is the same as when going out. Therefore, they may choose B, to go out. They have to work, for finding a meager meal for their families. That is in  family lives with the different conditions of economic background. On a much wider scale, we can see globally among the nations throughout the globe. Which one is the more intelligent among the people in any country? Which one is the more intelligent among the nations around the globe? They are the winners. They are the quick survivors. They are—of course—the fittest. Technology and the advancement of science dominates. Those that are supported by high technology and superb medical infrastructures quickly flat their Covid-19 outbreak peak. They could detect quickly. They could treat their environment and the victims quickly. And, that is the evidence of looking at the scary Covid-19. In that situation, we can see who will be the winners in the world. Survival of the fittest. Though Darwin’s theory was along time ago introduced, today, it is in practice. It is in reality. Survival of the fittest. The more intelligent, they will control the less intelligent. However, all can be the same when humanity is uphold right. Otherwise, the world will be dominated—if not occupied-- by the most intelligent— and that is the fittest. We will vanish. **** Editor's Note: Dr. Djuwari is the director of language laboratory at STIE Perbanas Surabaya, the editor of some research journals in the Philippines and Indonesia. He is also a journalist in some newspapers in Indonesia; the president of International Association of Scholarly Publishers, Editors, and Reviewers (IASPER).

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Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations

March 28, 2020

Scientific brief 27 March 2020 - According to current evidence, COVID-19 virus is transmitted between people through respiratory droplets and contact routes. Droplet transmission occurs when a person is in in close contact (within 1 m) with someone who has respiratory symptoms (e.g.  coughing or sneezing,) and is therefore at risk of having his/her mucosae (mouth and nose) or conjunctiva (eyes) exposed to potentially infective respiratory droplets (which are generally considered to be > 5-10 μm in diameter). Droplet transmission may also occur through fomites in the immediate environment around the infected person.7 Therefore, transmission of the COVID-19 virus can occur by direct contact with infected people and indirect contact with surfaces in the immediate environment or with objects used on the infected person (e.g. stethoscope or thermometer). Airborne transmission is different from droplet transmission as it refers to the presence of microbes within droplet nuclei, which are generally considered to be particles < 5μm in diameter, and which result from the evaporation of larger droplets or exist within dust particles. They may remain in the air for long periods of time and be transmitted to others over distances greater than 1 m. In the context of COVID-19, airborne transmission may be possible in specific circumstances and settings in which procedures that generate aerosols are performed (i.e. endotracheal intubation, bronchoscopy, open suctioning, administration of nebulized treatment, manual ventilation before intubation, turning the patient to the prone position, disconnecting the patient from the ventilator, non-invasive positive-pressure ventilation, tracheostomy, and cardiopulmonary resuscitation). In analysis of 75,465 COVID-19 cases in China, airborne transmission was not reported. There is some evidence that COVID-19 infection may lead to intestinal infection and be present in faeces. However, to date only one study has cultured the COVID-19 virus from a single stool specimen. There have been no reports of faecal−oral transmission of the COVID-19 virus to date. Implications of recent findings of detection of COVID-19 virus from air sampling To date, some scientific publications provide initial evidence on whether the COVID-19 virus can be detected in the air and thus, potentially involve airborne transmission. These initial findings need to be interpreted carefully. A recent publication in the New England Journal of Medicine has evaluated virus persistence of the COVID-19 virus. In this experimental study, aerosols were generated using a three-jet Collison nebulizer and fed into a Goldberg drum under controlled laboratory conditions. This is a high-powered machine that does not reflect normal human cough conditions. Further, the finding of COVID-19 virus in aerosol particles up to 3 hours does not reflect a clinical setting in which aerosol-generating procedures are performed—that is, this was an experimentally induced aerosol-generating procedure. There are reports from settings where symptomatic COVID-19 patients have been admitted and in which no COVID-19 RNA was detected in air samples. In addition, it is important to note that the detection of RNA in environmental samples based on PCR-based assays is not indicative of viable virus that could be transmissible. Conclusions Based on the available evidence, including the recent publications mentioned above, WHO continues to recommend droplet and contact precautions for those people caring for COVID-19 patients and contact and airborne precautions for circumstances and settings in which aerosol generating procedures are performed. These recommendations are consistent with other national and international guidelines, including those developed by the European Society of Intensive Care Medicine and Society of Critical Care Medicine and those currently used in Australia, Canada, and United Kingdom. At the same time, other countries and organizations, including the US Centers for Diseases Control and Prevention and the European Centre for Disease Prevention and Control, recommend airborne precautions for any situation involving the care of COVID-19 patients, and consider the use of medical masks as an acceptable option in case of shortages of respirators (N95, FFP2 or FFP3). Current WHO recommendations emphasize the importance of rational and appropriate use of all PPE, not only masks, which requires correct and rigorous behavior from health care workers, particularly in doffing procedures and hand hygiene practices. WHO also recommends staff training on these recommendations, as well as the adequate procurement and availability of the necessary PPE and other supplies and facilities. Finally, WHO continues to emphasize the utmost importance of frequent hand hygiene, respiratory etiquette, and environmental cleaning and disinfection, as well as the importance of maintaining physical distances and avoidance of close, unprotected contact with people with fever or respiratory symptoms. References Liu J, Liao X, Qian S et al. Community transmission of severe acute respiratory syndrome coronavirus 2, Shenzhen, China, 2020. Emerg Infect Dis 2020 doi.org/10.3201/eid2606.200239 Chan J, Yuan S, Kok K et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 2020 doi: 10.1016/S0140-6736(20)30154-9 Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med 2020; doi:10.1056/NEJMoa2001316. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497–506. Burke RM, Midgley CM, Dratch A, Fenstersheib M, Haupt T, Holshue M,et al. Active monitoring of persons exposed to patients with confirmed COVID-19 — United States, January–February 2020. MMWR Morb Mortal Wkly Rep. 2020 doi : 10.15585/mmwr.mm6909e1external icon World Health Organization. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19) 16-24 February 2020 [Internet]. Geneva: World Health Organization; 2020 Available from: https://www.who.int/docs/default- source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf Ong SW, Tan YK, Chia PY, Lee TH, Ng OT, Wong MS, et al. Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a symptomatic patient. JAMA. 2020 Mar 4 [Epub ahead of print]. Zhang Y, Chen C, Zhu S et al. [Isolation of 2019-nCoV from a stool specimen of a laboratory-confirmed case of the coronavirus disease 2019 (COVID-19)]. China CDC Weekly. 2020;2(8):123–4. (In Chinese) van Doremalen N, Morris D, Bushmaker T et al. Aerosol and Surface Stability of SARS-CoV-2 as compared with SARS-CoV-1. New Engl J Med 2020 doi: 10.1056/NEJMc2004973 Cheng V, Wong S-C, Chen J, Yip C, Chuang V, Tsang O, et al. Escalating infection control response to the rapidly evolving epidemiology of the Coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in Hong Kong. Infect Control Hosp Epidemiol. 2020 Mar 5 [Epub ahead of print]. Ong SW, Tan YK, Chia PY, Lee TH, Ng OT, Wong MS, et al. Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a symptomatic patient. JAMA. 2020 WHO Infection Prevention and Control Guidance for COVID-19 available at https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/infection-prevention-and-control Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19). Intensive Care Medicine DOI: 10.1007/s00134-020-06022-5 https://www.sccm.org/SurvivingSepsisCampaign/Guidelines/COVID-19 Interim guidelines for the clinical management of COVID-19 in adults Australasian Society for Infectious Diseases Limited (ASID)  https://www.asid.net.au/documents/item/1873 Coronavirus disease (COVID-19): For health professionals. https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-professionals.html Guidance on infection prevention and control for COVID-19 https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings. https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html Infection prevention and control for COVID-19 in healthcare settings https://www.ecdc.europa.eu/en/publications-data/infection-prevention-and-control-covid-19-healthcare-settings Infection Prevention and Control (IPC) for Novel Coronavirus (COVID-19) Course. https://openwho.org/courses/COVID-19-IPC-EN

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