COVID-19 Response: The case for Phytomedicines in Africa with particular focus on Cameroon

Despite enormous efforts deployed and considerable positive results obtained in the global fight against the Coronavirus disease 2019 (COVID-19) the scourge remains a major international public health hazard. The main control measures at the onset consisted in the application of barrier and hygiene measures to stop the spread of the virus and case identification and clinical management of symptoms in the absence of widely available anti-COVOD-19 drugs. Vaccination as a major control measure became widely available in the advanced countries of the global north, but not in Africa where less than 5-10% 0f the population are vaccinated against COVID-19. However, African countries, possibly excluding South Africa, have been less impacted by COVID-19 pandemic as they registered fewer cases, hospitalizations and deaths. Herein it is postulated that the wide use of African traditional Phytomedicines (herbal medicines) has contributed, at least in part, to the better control of the COVID-19 pandemic in Africa. Abundant evidence in the literature suggests the availability of anti-viral, anti-oxidant and immune-stimulatory agents in the proposed COVID-19 herbal remedies., these activities being similar to those the standard drugs used in the standard treatment/ management of COVID-19. The review also examines a number of COVID-19 herbal medicines including COVID Organics CVO (Madagascar) ADSAR, ELISIR COVID, COROCUR (Cameroon) IHP Detox Tea (Nigeria) and COVIDEX (Uganda) and notes that though approved by the competent authorities in the respective African countries, these phytomedicines have not been approved by the WHO. It is proposed that additional studies be carried out to validate the Africa herbal remedies for possible use as stand-alone or complementary treatment of COVID-19 in addition to vaccination and barrier and hygiene control measures.

Delineation of public health risk factor associate with the mortality ratio in covid-19 pandemic situation during legislative assembly elections from Indian states

The coronavirus is an accurate disease and this virus-related pandemic is hammering human health and increased the public health emergency till now. The main objective of this study is to find out the death, mortality ratio, new cases, and recoveries case identification and correlation analysis between them using regression technique on legislative assembly elections from India. This study encompassed the present disorder of India throughout the elections time in India from 27th March 2021 to 29th April 2020. Statistical analysis was developed by the covid-19 database for monitoring and analyzing the health statutes during elections. Mortality ratio, the relation between active and death cases, active cases and recover cases in India are calculating corona affected data. The results show that death cases were high in the second wave of coronavirus in India. The correlation between daily death and new cases was strong positive (R2= 0.9306). The relationship between recoveries and death was stronger positive (R2=0.9832). The daily death and active cases collation indicated that strong positive (R2= 0.9703). The COVID-19 is dangerous to people's health. The virus is more life-threatening and if people will not follow the WHO guidelines, and it strength demonstration additional havoc very shortly.

Antibiotics Used in Covid-19 And Mucormycosis (Black Fungus)

Background: In late December 2019, Chinese health authorities reported an outbreak of pneumonia of unknown origin in Wuhan, Hubei Province. Summary: A few days later, the genome of a novel coronavirus was released. org/t/novel2019-coronavirus-genome/319; Wuhan- Hu-1, GenBank accession No. MN908947) and made publicly available to the scientific community. This novel coronavirus was provisionally named 2019-nCoV, now SARS-CoV-2 according to the Coronavirus Study Group of the International Committee on Taxonomy of Viruses. SARS-CoV-2 belongs to the Coronaviridae family, Betacoronavirus genus, subgenus Sarbecovirus. Since its discovery, the virus has spread globally, causing thousands of deaths and having an enormous impact on our health systems and economies. In this review, we summarize the current knowledge about the epidemiology, phylogenesis, homology modeling, and molecular diagnostics of SARS-CoV-2. Phylogenetic analysis is essential to understand viral evolution, whereas homology modeling is important for vaccine strategies and therapies. Highly sensitive and specific diagnostic assays are key to case identification, contact tracing, identification of the animal source, and implementation of control measures. Keywords: COVID-19 · SARS-CoV-2 · Pandemic · Phylogenesis · Protein modeling · Real-time polymerase chain reaction

COVID-19 Case Investigations Among Federally Quarantined Evacuees From Wuhan, China, and Exposed Personnel at a US Military Base, United States, February 5-21, 2020

In February 2020, during the early days of the COVID-19 pandemic, 232 evacuees from Wuhan, China, were placed under federal 14-day quarantine upon arrival at a US military base in San Diego, California. We describe the monitoring of evacuees and responders for symptoms of COVID-19, case and contact investigations, infection control procedures, and lessons learned to inform future quarantine protocols for evacuated people from a hot spot resulting from a novel pathogen. Thirteen (5.6%) evacuees had COVID-19–compatible symptoms and 2 (0.9%) had laboratory-confirmed SARS-CoV-2. Two case investigations identified 43 contacts; 3 (7.0%) contacts had symptoms but tested negative for SARS-CoV-2 infection. Daily symptom and temperature screening of evacuees and enacted infection control procedures resulted in rapid case identification and isolation and no detected secondary transmission among evacuees or responders. Lessons learned highlight the challenges associated with public health response to a novel pathogen and the evolution of mitigation strategies as knowledge of the pathogen evolves.

The Indian Lessons to be Learnt from COVID-19 Pandemic

Emerging pandemics indicate that people are not infallible and that communities need to be prepared. Coronavirus COVID-19 outbreak was first identified in late 2019, and has now been declared a World Health Organization pandemic. Countries around the world are reacting to the virus outbreak differently. On the other hand, several other nations have put in place successful measures to control the virus, reporting a relatively limited number of cases since the pandemics started. Restrictive steps such as social distancing, lockdown, case identification, isolation, touch monitoring and exposure quarantine had shown the most effective acts to monitor the spread of the disease. This review will help readers understand that this invisible and ‘omnipresent’ virus has taught a lesson for the first time in human history that whatever human power might have, it could not subjugate every living being in this world. This has been confirmed once again by the recent invasion of this human virus. Difference in the answers of the different countries and their outcomes, based on that country's experience, India responded accordingly to the pandemic. Only time will tell how well India comes up against the outbreak. We also propose the potential approaches the global community will take in handling and minimizing the emergency.

Broadening symptom criteria improves early case identification in SARS-CoV-2 contacts

IntroductionThe success of case isolation and contact tracing for the control of SARS-CoV-2 transmission depends on the accuracy and speed of case identification. We assessed whether inclusion of additional symptoms alongside three canonical symptoms (CS) - fever; cough; loss or change in smell or taste – could improve case definitions and accelerate case identification in SARS-CoV-2 contacts.MethodsTwo prospective longitudinal London-based cohorts of community SARS-CoV-2 contacts, recruited within 5 days of exposure, provided independent training and test datasets. Infected and uninfected contacts completed daily symptom diaries from the earliest possible time-points. Diagnostic information gained by adding symptoms to the CS was quantified using likelihood ratios and AUC-ROC. Improvements in sensitivity and time-to-detection were compared to penalties in terms of specificity and number-needed-to-test.ResultsOf 529 contacts within two cohorts, 164 (31%) developed PCR-confirmed infection and 365 (69%) remained uninfected. In the training dataset (n=168), 29% of infected contacts did not report the CS. Four symptoms (sore throat, muscle aches, headache and appetite loss) were identified as early-predictors (EP) which added diagnostic value to the CS. The broadened symptom criterion “≥1 of the CS, or ≥2 of the EP” identified PCR-positive contacts in the test dataset on average 2 days earlier after exposure (p=0.07) than “≥1 of the CS”, with only modest reduction in specificity (5.7%).ConclusionsBroadening symptom criteria to include individuals with at least 2 of muscle aches, headache, appetite loss and sore throat identifies more infections and reduces time-to-detection, providing greater opportunities to prevent SARS-CoV-2 transmission.

HIV index testing services in urban Lusaka: a retrospective review of medical records

Background: As the proportions of people living with HIV (PLHIV) who do not know their HIV infection status decrease, reaching the remaining few who are asymptomatic and not in contact with the health care system becomes a critical challenge. Therefore, reaching the first 90 of the UNAIDS 90-90-90 targets will require effective and efficient HIV testing approaches. The number of PLHIV who know their HIV status and who receive antiretroviral therapy could increase by the expansion of index testing services. Methods: This project was a retrospective study looking at medical records of HIV positive clients who were elicited for index testing between October and December 2019. It was conducted in three high volume health facilities in Matero Urban sub-district 3 in Lusaka, Zambia. Results: The HIV test outcomes for index contacts were as follows: 452 index contacts (53.5%) tested HIV negative, 113 index contacts (13.4%) tested HIV positive, 108 index contacts (12.8%) were known HIV positive, and 172 index contacts (20.4%) were not yet tested for HIV. Of the 113 contacts who tested HIV positive, 90 index contacts started anti-retroviral therapy within 7 days (79.6%). The total number of 845 contacts were elicited from 604 index clients, giving a low elicitation ratio of 1:1.4. There was not much difference between gender for elicited contacts (423 men and 422 women). A total number of 565 index contacts were eligible for HIV test. 113 of them tested HIV positive, representing a positivity yield of 20%. Pearson Chi-Square test value was 0.498 and the p value was 0.481. This result is not significant since p value (0.481) is greater than the designated alpha level (0.05). Conclusions: HIV programs need to explore and address barriers to HIV partner testing services to avoid over-testing and maximize HIV case identification (thus, improving HIV testing positivity yield).

A rapid review of early guidance to prevent and control COVID-19 in custodial settings

Background With over 11 million people incarcerated globally, prevention and control of COVID-19 in custodial settings is a critical component of the public health response. Given the risk of rapid transmission in these settings, it is important to know what guidance existed for responding to COVID-19 in the early stages of the pandemic. We sought to identify, collate, and summarise guidance for the prevention and control of COVID-19 in custodial settings in the first six months of 2020. We conducted a systematic search of peer-reviewed and grey literature, and manually searched relevant websites to identify publications up to 30 June 2020 outlining recommendations to prevent and/or control COVID-19 in custodial settings. We inductively developed a coding framework and assessed recommendations using conventional content analysis. Results We identified 201 eligible publications containing 374 unique recommendations across 19 domains including: preparedness; physical environments; case identification, screening, and management; communication; external access and visitation; psychological and emotional support; recreation, legal, and health service adaptation; decarceration; release and community reintegration; workforce logistics; surveillance and information sharing; independent monitoring; compensatory measures; lifting control measures; evaluation; and key populations/settings. We identified few conflicting recommendations. Conclusions The breadth of recommendations identified in this review reflects the complexity of COVID-19 response in custodial settings. Despite the availability of comprehensive guidance early in the pandemic, important gaps remain in the implementation of recommended prevention and control measures globally, and in the availability of evidence assessing their effectiveness on reducing COVID-19 disease, impact on people in custody and staff, and implementation.

“Scuola Sicura”: a school screening program to prevent the spread of COVID-19 among students in Piedmont, Italy

ObjectivesAims of “Scuola Sicura” (SS) were to monitor the rate of COVID-19 and to contain its spread within the school population through early case isolation. We report the initial process and outcome evaluation results.DesignDescriptive study of an experimental screening testing program in children in Piedmont in the period January-March 2021. We used data from the COVID-19 platform and the Local Health Units, the archives of birth certificates (CedAP) and hospital discharge files (SDO).Setting and participantsThe screening program targeted second and third grade students in first level secondary schools. Participants were subdivided into four groups; one group each week underwent screening, yielding one test per student per month.Main outcome measuresWe calculated:1. number of positive cases detected vs. total number of students tested in the SS program;2. number of positive cases detected outside the SS program vs. total number of students in the target population.We detected the number of quarantines due to SS and no-SS case identification. To investigate the spread of COVID-19 in households, the mother-child pairs were identified through record linkage between the CedAP and SDO archives, and positive mothers were identified.ResultsSixty-nine percent of schools and 19.5% of the students participated in the program. SS detected 114 positives cases for SARS-CoV-2. On 08.03.2021, the target classes started distance learning: 69 of the 114 positive students were identified before that date, leading to the activation of 67 quarantine measures. We were able to identify the mothers of 61 out of 69 of those students (88%); 46 mothers had performed a swab test after the positivity of their child with a positive result in 11 cases. Asymptomatic cases identified at screening during in-class learning period accounted for 26.5% of the total number of cases occurred in the participating classes.ConclusionsThis is one of the few studies (and the first in Italy) to describe the functioning and predictive capacity of school screening testing for SARS-CoV-2 in a real-world situation. Our findings provide data-driven suggestions for government agencies when planning large-scale school screening testing programs.