Saturday, February 27, 2021

CDC: US To Begin Screening Passengers From Guinea & DRC Due To Ebola Outbreaks


 

#15,837

While  disruptive, and generally ineffective, airport screening is often the first - and most visible - response by governments anxious to do `something'  to protect the populace when there is an outbreak of a highly infectious disease somewhere in the world (see 2014's Why Airport Screening Can’t Stop MERS, Ebola or Avian Flu).

While it may limited in its effectiveness, airport screening isn’t without value, as it can:
  • identify acutely ill individuals (and any traveling companions/contacts) when they are likely to be the most contagious so they can be promptly isolated
  • it provides an opportunity to educate travelers about how, and when, they should contact public health officials if they fall ill post arrival
  • it can provide important disease surveillance and tracking information for local health depts
  • And it might even help slow the rate of entry of an emerging disease into a region, allowing additional time to mount public health interventions.
Even without the reduction in air travel due to the COVID pandemic, the risk of introducing Ebola into the United States from these outbreaks is very low.  And even if that happened (as it did in 2014), community spread would be highly unlikely. 
 
But low is not zero.  

So overnight the CDC released a media statement on how they will respond to the twin Ebola outbreaks recently reported in Africa (see ECDC Risk Assessment); starting next week passengers with recent travel history to Guinea and/or the DRC will be routed through six U.S. airports to allow for screening and tracking.


Media Statement
For Immediate Release
Friday Feb. 26, 2021
Contact: CDC Media Relations
(404) 639-3286
USG to Initiate Public Health Measures to Respond to Ebola in Guinea and DRC

CDC is closely following the outbreaks of Ebola Virus Disease (EVD) in the Democratic Republic of Congo (DRC) and Guinea.

The outbreaks are centered in remote areas of these countries. The risk of Ebola to the United States is extremely low. The Biden Administration is committed to working closely with the affected countries to end these outbreaks before they grow into epidemics.

Air travel has the potential to transport people, some of whom may have been exposed to a communicable disease, anywhere across the globe in less than 24 hours. Therefore, out of an abundance of caution, the U.S. government will institute public health measures for the very small number of travelers arriving from the DRC and Guinea.

Beginning next week, the U.S. government will funnel travelers from DRC and Guinea to six U.S. airports. Airlines will collect and transmit passenger information to CDC for public health follow-up and intervention for all passengers boarding a flight to the U.S. who were in DRC or Guinea within the previous 21 days. This information will be shared with U.S. state and local health departments to appropriately monitor arrivals in their jurisdiction.

###


ECDC Update: Avian Influenza Epizootic In Europe - December 2020 - February 2021


 The last 5 Avian Flu Seasons Compared - Credit ECDC


#15,836

After three years of relatively little avian flu activity in Europe (blue in chart above), the fall/winter of 2020-2021 has produced Europe's second largest avian influenza epizootic on record. The record setting avian epizootic of 2016-2017 (Light grey in chart above) was larger, but then, the season isn't over yet. 

Both of these major outbreaks were caused by clade 2.3.4.4  HPAI H5N8 and its reassortants (H5N5, H5N3, H5N1, etc.), which until very recently (see Russian Media Reports 7 Human Infections With Avian H5N8) had never been associated with human infection.

While the risk of human infection with HPAI H5N8 remains LOW or VERY LOW, the more the virus spreads, the more opportunities it has to evolve and adapt into a bigger threat.  Beyond the public health concerns, HPAI H8N8 is highly lethal in poultry, and in some types of wild birds, and the losses (either directly, or through culling) in both categories has been substantial. 

While today's report deals only with Europe and the UK, HPAI H5N8 has been burning through East Asia (particularly South Korea and Japan) the past few months, and can also be found in Russia, China, the Middle East, and Africa (see OIE map below)



The EDC scientific report runs an impressive 74 pages, and so I've only reproduced the Executive Summary below. Follow the link to download and read the report in its entirety.  I'll have a brief postscript when you return. 
Surveillance report
26 Feb 2021
Publication series: Avian influenza overview
 
Between 8 December 2020 and 23 February 2021, 1,022 highly pathogenic avian influenza (HPAI) virus detections were reported in 25 EU/EEA countries and the UK in poultry (n=592), wild (n=421) and captive birds (n=9).
Executive summary

The majority of the detections were reported by France that accounted for 442 outbreaks in poultry, mostly located in the Landes region and affecting the foie gras production industry, and six wild bird detections; Germany, who reported 207 detections in wild birds and 50 poultry outbreaks; Denmark, with 63 detections in wild birds and one poultry outbreak; and Poland, with 37 poultry outbreaks and 24 wild bird detections.

Due to the continued presence of HPAI A(H5) viruses in wild birds and the environment, there is still a risk of avian influenza incursions with the potential further spread between establishments, primarily in areas with high poultry densities.

As the currently circulating HPAI A(H5N8) virus can cause high mortality also in affected duck farms, mortality events can be seen as a good indicator of virus presence. However, also subclinical virus spread in this type of poultry production system have been reported. To improve early detection of infection in poultry within the surveillance zone, the clinical inspection of duck establishments should be complemented by encouraging farmers to collect dead birds to be pooled and tested weekly (bucket sampling).

Six different genotypes were identified to date in Europe and Russia, suggesting a high propensity of these viruses to undergo multiple reassortment events. To date, no evidence of fixation of known mutations previously described as associated to zoonotic potential has been observed in HPAI viruses currently circulating in Europe based on the available sequences.

Seven cases due to A(H5N8) HPAI virus have been reported from Russia, all were poultry workers with mild or no symptoms. Five human cases due to A(H5N6) HPAI and 10 cases due to A(H9N2) LPAI viruses have been reported from China.

The risk for the general population as well as travel-related imported human cases is assessed as very low and the risk for people occupationally exposed people as low. Any human infections with avian influenza viruses are notifiable within 24 hours through the Early Warning and Response System (EWRS) and the International Health Regulations (IHR) notification system.

While the Americas have been spared so far this year, we've seen large epizootics in the United States and Canada in the past, with the largest and most damaging coming in the spring of 2015 (see map below).



All of which means that while it is currently Europe and Asia who are battling another avian epizootic, we in North America are far from immune. The USDA has some advice on how to Defend The Flock at the website below.



And for more on how avian flu strains from Asia and Europe might make their way back into North America - either now or in the future - you may wish to revisit:


PLoS One: North Atlantic Flyways Provide Opportunities For Spread Of Avian Influenza Viruses


Friday, February 26, 2021

WHO Statement & Risk Assessment On Human Infection with Avian H5N8 – the Russian Federation




#15,835

Six days ago we saw the announcement by Anna Popova - Chief State Sanitary Physician of the Russian Federation - of the first detection of human infection with avian H5N8 (see Russian Media Reports 7 Human Infections With Avian H5N8).

While the most ubiquitous HPAI H5 virus around the globe for the past 6 years, unlike its more worrisome cousins H5N1 and H5N6, H5N8 had never been known to infect humans.

Two days ago we saw the first official reaction from a ECDC Threat Assessment Brief On 1st Identified Human Infections With Avian H5N8which ranked the risk to the general public as being VERY LOW and to occupationally exposed persons as LOW.

Today the World Health Organization has published a lengthy statement and risk assessment, which similarly finds the risk of human-to-human transmission remains low.


Human infection with avian influenza A (H5N8) – the Russian Federation

Disease Outbreak News
26 February 2021

On 18 February 2021, the National IHR Focal Point for the Russian Federation notified WHO of detection of avian influenza A(H5N8) in seven human clinical specimens. These are the first reported detection of avian influenza A(H5N8) in humans. Positive clinical specimens were collected from poultry farm workers who participated in a response operation to contain an avian influenza A(H5N8) outbreak detected in a poultry farm in Astrakhan Oblast in the Russian Federation. The laboratory confirmation of the seven specimens were performed by the State Research Centre for Virology and Biotechnology VECTOR (WHO H5 Reference Laboratory). The age of seven positive cases ranged between 29 to 60 years and five were female.

Between 3 and 11 December, a total of 101 000 of 900 000 egg laying hens on the farm died. This high mortality rate prompted an investigation. Samples were collected from these birds and an initial detection of avian influenza A(H5N8) was performed by the Russian regional veterinary laboratory. On 11 December, the outbreak was confirmed by the World Organisation for Animal Health (OIE) Reference laboratory, and the Federal Centre for Animal Health (FGBI-ARRIAH), in Vladimir, the Russian Federation. Outbreak containment operations started immediately and continued for several days due to the large size of the poultry farm.

The cases remained asymptomatic for the whole follow up duration (several weeks). Follow-up nasopharyngeal swabs were collected during medical observation period and were tested negative for avian influenza A(H5N8). No obvious clinical manifestations were reported from any farm workers under medical surveillance, their family members, or other close contacts of the seven cases. Additionally, acute and convalescent sera was collected from the seven positive human cases for serological testing. The results were suggestive of recent infection.

Influenza A(H5N8) viruses isolated from this poultry outbreak in Astrakhan belonged to clade 2.3.4.4b of avian influenza A(H5Nx) viruses. In 2020, avian influenza A (H5N8) viruses were also detected in poultry or wild birds in Bulgaria, the Czech Republic, Egypt, Germany, Hungary, Iraq, Japan, Kazakhstan, the Netherlands, Poland, Romania, the United Kingdom, and the Russian Federation.
 
Public health response

On receiving the initial signal of a probable outbreak of highly pathogenic avian influenza (HPAI) at the poultry farm on 3 December 2020, the national authorities took immediate measures including cessation of poultry production cycles, and product transportation from the affected farm.

Between 11 and 18 December, several measures including culling and disposing of poultry, eggs, litter and disinfection of contaminated premises were taken as part of outbreak response activities

During and after the culling of all the poultry, nasopharyngeal swabs and serum samples were collected from poultry farm workers and personnel involved in outbreak response at the farm. The surveillance activities, both within and outside of the containment area, was intensified. A total of 24 close contacts of the confirmed cases have been identified and traced. In total, 150 individuals were monitored for clinical indication of respiratory disease and received antiviral prophylaxis therapy. No symptoms were reported among these individuals.

Whole Genome Sequencing of avian influenza A (H5N8) viruses isolated from poultry and from one of the seven human cases was performed and were uploaded to the Global Initiative on Sharing All Influenza Data (GISAID) database on 20 February 2021. Genetic and phenotypic characterization of the virus is ongoing.

WHO is following up with the public health authorities in the Russian Federation, including implementation of public health measures warranted by such events, and with the WHO Global Influenza Surveillance and Response System (GISRS) on further analysis and assessment of the virus materials and serum samples. On 20 February, a special briefing by the head of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing was organized for the state Russian media to inform the public about these cases and the implications.
WHO risk assessment

Since 2004, avian influenza A(H5) viruses have spread from Asia to Europe via wild birds. The genetic clade 2.3.4.4 H5 viruses have often reassorted among other avian influenza viruses, resulting in avian influenza A(H5N1), A(H5N2), A(H5N3), A(H5N5), A(H5N6) and A(H5N8) viruses, some of which have been detected in birds in many countries .

In the Russian Federation, avian influenza A(H5N8) of clade 2.3.4.4 was isolated for the first time in 2014 in a wild bird in the northern region of Russian Far East.

As mentioned earlier, all the seven cases with PCR-positive results were clinically asymptomatic. All close contacts of these cases were clinically monitored, and no one showed signs of clinical illness. Infections with avian influenza viruses of the same clade (H5 clade 2.3.4.4) have been reported from China since 2014 in people with exposure to infected birds. The likelihood of human infections with influenza A(H5N8) viruses has been considered to be low.

Further genetic and antigenic characterization and information on seroconversion among contacts of the positive cases is required to fully assess the risk.

The development of zoonotic influenza candidate vaccine viruses for potential use in human vaccines, coordinated by WHO, remains an essential component of the overall global strategy for influenza pandemic preparedness.

Based on currently available information, the risk of human-to-human transmission remains low.
WHO advice

These cases do not change the current WHO recommendations on public health measures and surveillance of animal and seasonal human influenza, which should continue to be implemented. Respiratory transmission occurs mainly by droplets, disseminated by unprotected coughs and sneezes. Short-distance airborne transmission of influenza viruses may occur, particularly in crowded enclosed spaces. Hand contamination, direct inoculation of virus, exposure to infected birds or virus-contaminated materials or environments are potential sources of infection.

When avian influenza viruses are circulating in an area, the people involved in specific, high-risk tasks such as sampling sick birds, culling and disposing of infected birds, eggs, litter and cleaning of contaminated premises should be trained on how to protect themselves, and on proper use of personal protective equipment (PPE) . People involved in these tasks should be registered and monitored closely by local health authorities for seven days following the last day of contact with poultry or their environments.

Due to the constantly evolving nature of influenza viruses, WHO continues to stress the importance of global surveillance to detect virological, epidemiological and clinical changes associated with circulating influenza viruses that may affect human (or animal) health and timely virus sharing for risk assessment.

Thorough investigation of all potential novel influenza human infections is warranted. All human infections caused by a novel influenza subtype are notifiable under the International Health Regulations (IHR), and State Parties to the IHR are required to immediately notify WHO of any laboratory-confirmed case of a recent human infection caused by new influenza A subtype with the potential to cause a pandemic (please see case definitions for diseases requiring notification under the IHR ). Evidence of illness is not required.

In the case of a confirmed or suspected human infection, a thorough epidemiologic investigation of history of exposure to animals, of travel, and contact tracing should be conducted, even while awaiting the confirmatory laboratory results. The epidemiologic investigation should include early identification of unusual respiratory events that could signal person-to-person transmission of the novel virus. Clinical samples collected from the time and place that the case occurred should be tested and sent to a WHO Collaboration Center for further characterization.

Travelers to countries with known outbreaks of avian influenza should avoid farms, contact with animals in live animal markets, entering areas where animals may be slaughtered, or contact with any surfaces that appear to be contaminated with animal feces. Travelers should also wash their hands often with soap and water. Travelers should follow good food safety and good food hygiene practices.

Based on the currently available information, WHO advises against any special traveler screening at points of entry or restrictions on travel and/or trade with the Russian Federation.

CDC: COVID Variant Map Update (Feb 25th)


 

#15,834

The CDC has been posting updated interactive maps of the detection of COVID Variants within the United States since the first week of January, and updated those numbers against last night posting more than a 25% increase since Sunday night's update
 
Despite recent reports suggesting that variants detected in New York (B.1.526) and in California (B.1.427/B.1.429) (see CIDRAP's New COVID-19 variants found in New York, California) may be of equal concern, these maps for now continue to focus on the `three international' variants of greatest concern.
  • B.1.1.7 aka `UK' variant
  • B.1.351 aka `South African' variant
  • P.1 ak `Brazilian' variant
Florida, with just over 500 variant detections, continues to lead the nation while 4 states report none. But the reality is, many states are doing very little genomic testing.  Regardless, the numbers reported by the CDC should be assumed to represent a tiny fraction of actual cases in the population.




The emerging variants CDC is closely monitoring have mutations in the virus genome that alter the characteristics and cause the virus to act differently in ways that are significant to public health (e.g., causes more severe disease, spreads more easily between humans, requires different treatments, changes the effectiveness of current vaccines). It’s important to understand that genetic mutations are expected, and some variants can spread and become predominant while others subside.

02/11/21 – To maintain a limited number of colors and allow for an easier comparison between states, the data ranges have changed from 1-50 to 1-100.

*The cases identified above are based on a sampling of SARS-CoV-2-positive specimens and do not represent the total number of B.1.1.7, B.1.351, and P.1 lineage cases that may be circulating in the United States and may not match numbers reported by states, territories, tribes, and local officials.

†Numbers will be updated on Sunday, Tuesday, and Thursday by 7:00 pm.






MMWR: Suspected SARS-CoV-2 Reinfections Among Residents Of A Skilled Nursing Facility - Kentucky, Jul.- Nov. 2020



#15,833

Almost exactly a year ago, in Osaka Japan: `Recovered' Patient Tests Positive For COVID-19, we saw the first inkling that infection and recovery from COVID-19 might not produce robust and long lasting immunity. 

The patient, a tour bus guide in Osaka - who was hospitalized with COVID-19 in late January, 2020 and released from the hospital on Feb. 6th after testing negative - tested positive again 3 weeks later.

Of course, reinfection wasn't the only possible explanation. It is possible that the tests used to clear her for discharge simply weren't sensitive enough to pick up a lingering, low grade, infection. In that case, this could have been a relapse, not a reinfection.

But over the past 12 months we've seen a small number of other cases where reinfection has been established, often among COVID patients who reportedly had a mild first bout of the virus.  A few examples include:




With the exception of the Nevada case (mentioned above), reinfection was generally reported to be mild or even asymptomatic.  While reinfections are only rarely documented - laboratory confirmation can be quite difficult - and so many probably go unreported.  

Meanwhile, last summer and fall we saw a number of studies and cautionary statements from public health agencies, on the uncertainty of prolonged post-infection SARS-CoV-2 immunity. 
 
EID Journal: Antibody Profiles According to Mild or Severe SARS-CoV-2 Infection
 
CDC Clarifies: Recovered COVID-19 Cases Are Not Necessarily Immune To Reinfection

Kings College: Longitudinal Evaluation & Decline of Antibody Responses in SARS-CoV-2 infection

More recently, with the rise of new variants we are seeing increasing - albeit often anecdotal - evidence of increased rates of reinfection in hard hit places like South Africa and Brazil (see Brazil MOH Confirms Reinfection With COVID Variant P.1 In Amazonas and  The Lancet: Resurgence of COVID-19 in Manaus, Brazil, Despite High Seroprevalence).
How big of an obstacle this may be in achieving herd immunity and ending this pandemic is unknown, as is how much more (or less) protective a vaccine may be over natural infection.  

There is also likely a wide range of post-infection immune responses across the population - due to age, immune competence, individual genetics, medications and comorbidities - with some people acquiring far more robust and longer-lasting immunity than others. 

Adding to our limited data on reinfection, yesterday the CDC's MMWR published a report on suspected repeat infections among five elderly residents of a SNF in Kentucky. Unlike with many previous reports, all five experienced more severe illness the second time around. 

I've only reproduced the summary, and some excerpts from a much longer report. So follow the link to read it in its entirety. 

Suspected Recurrent SARS-CoV-2 Infections Among Residents of a Skilled Nursing Facility During a Second COVID-19 Outbreak — Kentucky, July–November 2020
Weekly / February 26, 2021 / 70(8);273–277
Alyson M. Cavanaugh, DPT, PhD1,2; Douglas Thoroughman, PhD1,3; Holly Miranda1,4; Kevin Spicer, MD, PhD1,5  
What is already known about this topic?
Case reports of reinfection with SARS-CoV-2 exist; however, data are limited as to the frequency and outcomes of reinfection.
What is added by this report?
Five residents of a skilled nursing facility received positive SARS-CoV-2 nucleic acid test results in two separate COVID-19 outbreaks separated by 3 months. Residents received at least four negative test results between the two outbreaks, suggesting the possibility of reinfection. Severity of disease in the five residents during the second outbreak was worse than that during the first outbreak and included one death.
What are the implications for public health practice?
Skilled nursing facilities should use strategies to reduce the risk for SARS-CoV-2 transmission among all residents, including among those who have previously had a COVID-19 diagnosis. Vaccination of residents and health care personnel in this setting is particularly important to protect residents. 

          

Reinfection with SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is believed to be rare (1). Some level of immunity after SARS-CoV-2 infection is expected; however, the evidence regarding duration and level of protection is still emerging (2).
The Kentucky Department for Public Health (KDPH) and a local health department conducted an investigation at a skilled nursing facility (SNF) that experienced a second COVID-19 outbreak in October 2020, 3 months after a first outbreak in July. Five residents received positive SARS-CoV-2 reverse transcription–polymerase chain reaction (RT-PCR) test results during both outbreaks. During the first outbreak, three of the five patients were asymptomatic and two had mild symptoms that resolved before the second outbreak.
Disease severity in the five residents during the second outbreak was worse than that during the first outbreak and included one death. Because test samples were not retained, phylogenetic strain comparison was not possible. However, interim period symptom resolution in the two symptomatic patients, at least four consecutive negative RT-PCR tests for all five patients before receiving a positive test result during the second outbreak, and the 3-month interval between the first and the second outbreaks, suggest the possibility that reinfection occurred.
Maintaining physical distance, wearing face coverings or masks, and frequent hand hygiene are critical mitigation strategies necessary to prevent transmission of SARS-CoV-2 to SNF residents, a particularly vulnerable population at risk for poor COVID-19–associated outcomes.* Testing, containment strategies (isolation and quarantine), and vaccination of residents and health care personnel (HCP) are also essential components to protecting vulnerable residents. The findings of this study highlight the importance of maintaining public health mitigation and protection strategies that reduce transmission risk, even among persons with a history of COVID-19 infection.

         (SNIP)

Five SNF residents received positive SARS-CoV-2 test results during two separate facility outbreaks that occurred in July and October 2020, suggesting possible reinfection. Affected persons experienced more severe illness during their second SARS-CoV-2 infection. Reinfection risk to the general population is suspected to be low, but SNF residents might have higher risk for new exposures, given the congregate nature of these settings and ongoing interactions with HCP and other residents.
In addition, the level and duration of postinfection immunity in persons with an aging immune system is unknown, but the potential health consequences of reinfection among SNF populations remain serious. Therefore, steps to protect this population from the ongoing potential of SARS-CoV-2 exposures should be implemented.
Based on the observations of this study, testing and cohorting practices in SNFs should not assume that residents infected >90 days earlier are immune to COVID-19. Public health interventions to limit transmission are vital for all persons in SNFs, including those who have previously been infected with SARS-CoV-2; these include physical distancing, use of masks (including by SNF residents, if tolerated), and frequent hand hygiene using hand sanitizer with 60%–95% alcohol or washing with soap and water for at least 20 seconds. Vaccination in these settings, as recommended by the Advisory Committee on Immunization Practices, is particularly important to optimally protect these vulnerable persons (10).

          (Continue . . . )

While those who are infected with, and recover from, SARS-CoV-2 likely carry some degree of acquired immunity, how long that will last, and how effective it will be against a growing array of variants, is unknown.  

Today's study is a reminder that even if you've had and recovered from COVID, the usual precautions of social distancing, wearing face covers in public, and getting vaccinated when it is offered still apply. 



Thursday, February 25, 2021

Finland STM & TFL Statement: COVID Infections/Hospitalizations Rising Significantly


 Finland - WHO Dashboard

#15,832

After peaking in early-to-mid December, COVID cases in Finland dropped nearly 50% in early January, only to begin a steady rise over the past 6 weeks. 

In the week ending February 15th, Finland reported its largest weekly (n=3278) case total since the pandemic began. A jump of nearly 20% over the previous week. 

Finland remains one of the least affected European nations, but the recent trends are concerning, and today the Prime Minister Sanna Marin held a press conference announcing a 3-week lockdown - starting March 8th - that would close restaurants and require older students to return to remote learning. 

Although the Finnish government websites have not updated their information, details are available in this Reuters report: Finland to tighten COVID-19 restrictions from March 8The Prime Minister also indicated she is prepared to declare a state of emergency if necessary. 

While many countries are looking at their falling COVID numbers and are exploring ways to reduce COVID restrictions in the weeks and months ahead, the spread of a more transmissible B.1.1.7 variant - which is also linked to increased severity - may derail those plans. 

Today the TFL (Finnish Institute for Health and Welfare) and Finland's STM (Social and Health Ministry) released the following joint statement on the recent rise in cases. 

STM and THL inform
The number of coronavirus infections has risen significantly, with the need for hospitalization increasing

Social and health Ministry
2/25/2021 9.47 RELEASE

A total of more than 3,400 new coronavirus infections were detected in week 7, ie between 15 and 21 February 2021, which is clearly more than in the previous week. The incidence of cases across the country was 62 infections per 100,000 population, compared to 46 infections per 100,000 population in the previous week.

Working-age infections are most prevalent, especially among young adults. Of all cases, about 80 percent were found in those under 50 years of age and about 45 percent in those under 30 years of age. Those over 60 years of age accounted for about 9 percent of the cases diagnosed, and those over 70 years of age accounted for about 3 percent.

More than 11,000 people were quarantined in week 7. This is 2,700 more people than the previous week.

This information is reflected in the weekly monitoring report of the Department of Health and Welfare. Coronavirus monitoring (THL)

The situation remains the worst in the HUS area - extensive clusters of infection in many areas

The coronavirus epidemic situation has deteriorated in recent weeks, especially in the Helsinki and Uusimaa hospital districts. The incidence of the disease has also increased in nine other areas in the last two weeks. Incidence, on the other hand, decreased or remained the same in 11 hospital districts.

New cases have been reported both inside and outside known infection chains.

Mass exposures have been reported in several hospital districts, triggering chains of infection. The incidence of coronavirus cases has increased, for example, in Satakunta's South Savo and South Karelia hospital districts and in Ă…land in week 7 compared to the previous week.

Some of the new chains of infection could possibly have been prevented by careful adherence to the recommendations and restrictions. Late application for the test has in some cases led to the emergence of extensive chains of infection.

During ski holidays, tourism can increase the likelihood of the disease spreading to areas where the disease situation is calmer.

Nationwide, the workload of hospital care has been increasing over the past week. The need for intensive care has also increased over the last couple of weeks, but the capacity of intensive care nationwide has not been threatened.

According to the data of 24 February 2021, there are 193 people in hospital nationwide. Of the patients, 86 are in specialist nursing wards, 72 in primary care wards and 35 in intensive care units. A week ago, there were a total of 132 coronary patients in hospital.

The number of deaths related to the coronavirus is slowly declining. At week 7, 14 were reported, and at weeks 5-6, 21 and 17, respectively.

Transformation viruses require effective control measures

To date, 690 cases of modified coronavirus have been reported in Finland. Of these, 660 are British virus variants.

The epidemic situation calls for very effective control of the spread of the virus in the coming weeks and months. Rapid and wide-ranging containment measures are also effective against the transformation virus.

Corona epidemic: regional situation, recommendations and constraints (THL)

The coronavirus is effectively transmitted, especially in prolonged close contact. Everyone can slow down the spread of the coronavirus by their own actions. It is also important to reduce close contacts in good health, and even in the case of mild symptoms suitable for coronavirus disease, a test should be applied immediately.

Coronavirus - Infection and Protection (THL)
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