Children hospitalized with COVID-19 in U.S. hits record number

By Gabriella Borter

(Reuters) -The number of children hospitalized with COVID-19 in the United States hit a record high of just over 1,900 on Saturday, as hospitals across the South were stretched to capacity fighting outbreaks caused by the highly transmissible Delta variant.

The Delta variant, which is rapidly spreading among mostly the unvaccinated portion of the U.S. population, has caused hospitalizations to spike in recent weeks, driving up the number of confirmed and suspected pediatric COVID-19 hospitalizations to 1,902 on Saturday, according to data from the U.S. Department of Health and Human Services.

Reuters includes confirmed and suspected COVID-19 cases for hospitalization, case and death data.

Children currently make up about 2.4% of the nation’s COVID-19 hospitalizations. Kids under 12 are not eligible to receive the vaccine, leaving them more vulnerable to infection from the new, highly transmissible variant.

“This is not last year’s COVID. This one is worse and our children are the ones that are going to be affected by it the most,” Sally Goza, former president of the American Academy of Pediatrics, told CNN on Saturday.

The numbers of newly hospitalized COVID-19 patients aged 18-29, 30-39 and 40-49 also hit record highs this week, according to data from the U.S. Centers of Disease Control and Prevention (CDC).

The spike in new cases has ramped up tension between conservative state leaders and local districts over whether school children should be required to wear masks as they head back to the classroom this month.

School districts in Florida, Texas and Arizona have mandated that masks be worn in schools, defying orders from their Republican state governors that ban districts from imposing such rules. The administration of Florida Governor Ron DeSantis has threatened to withhold funding from districts that impose mask requirements, and Texas Governor Greg Abbott is appealing to the state Supreme Court to overturn Dallas County’s mask mandate, the Dallas Morning News reported on Friday.

A fifth of the nation’s COVID-19 hospitalizations are in Florida, where the number of hospitalized COVID-19 patients hit a record 16,100 on Saturday, according to a Reuters tally. More than 90% of the state’s intensive care beds are filled, according to data from the Department of Health and Human Services.

INCREASED HOSPITALIZATIONS

The nation’s largest teachers union, the National Education Association, came out in support of mandatory vaccination for its members this week. NEA President Becky Pringle said on Saturday that schools should employ every mitigation strategy, from vaccines to masks, to ensure that students can come back to their classrooms safely this school year.

“Our students under 12 can’t get vaccinated. It’s our responsibility to keep them safe. Keeping them safe means that everyone who can be vaccinated should be vaccinated,” Pringle told CNN.

The U.S. now has an average of about 129,000 new COVID-19 cases per day, a rate that has doubled in a little over two weeks, according to a Reuters tally. The number of hospitalized COVID-19 patients is at a six-month high, and an average of 600 people are dying each day of COVID-19, double the death rate seen in late July.

Arkansas, Florida, Louisiana, Mississippi, and Oregon have reported record numbers of COVID-19 hospitalizations this month, according to a Reuters tally, pushing healthcare systems to operate beyond their capacity.

“Our hospitals are working to maximize their available staff and beds, including the use of conference rooms and cafeterias,” Florida Hospital Association President Mary Mayhew said in a statement on Friday.

In Oregon, Governor Kate Brown said on Friday that she was sending 500 National Guard members to assist overwhelmed hospitals, with 1,500 members in total available to help.

In Jackson, Mississippi, federal medical workers are assisting understaffed local teams at a 20-bed triage center in the parking garage of the University of Mississippi Medical Center (UMMC) to accommodate the overflow of COVID-19 patients.

Fifteen children and 99 adults were hospitalized with COVID-19 at UMMC as of Saturday morning, the hospital said. More than 77% of those patients were unvaccinated.

(Reporting by Gabriella Borter and Lisa Shumaker; editing by Diane Craft and Aurora Ellis)

Death rate soars as Canada’s British Columbia suffers “extreme heat”

(Reuters) – The Canadian province of British Columbia suffered nearly double the average deaths as temperatures hit a record high of 46.6°C (115.88°F) during the past four days of “extreme heat,” officials said on Tuesday.

At least 233 people died in the West coast province between Friday and Monday, about 100 more than the average for a four-day period, and the number was expected to rise as more reports were filed, officials said.

“Since the onset of the heat wave late last week, the BC Coroners Service has experienced a significant increase in deaths reported where it is suspected that extreme heat has been contributory,” BC Coroners Service said on Monday.

Coroners are now gathering information to determine the cause and manner of deaths and whether heat played a role, the statement said.

Environmental heat exposure can lead to severe or fatal results, particularly in older people, infants and young children and those with chronic illnesses, Chief Coroner Lisa Lapointe said in a statement.

British Columbia closed schools and universities on Monday as temperatures soared.

Lytton, a town in central British Columbia roughly 200km (124 miles) north of Vancouver, reported a temperature of 46.6°C (115.88°F) on Sunday.

Canada is widely known for its brutal winter and snows, and prior to the weekend the historical high in Canada was 45°C, set in Saskatchewan in 1937, according to Environment and Climate Change Canada.

The heatwave in the Pacific Northwest, which is more accustomed to long bouts of rain than sun, resulted from a high pressure system that wasn’t moving, said Greg Flato, a senior research scientist with Environment and Climate Change Canada based in Victoria.

(Reporting by Juby Babu and Kanishka Singh in Bengaluru; Editing by Simon Cameron-Moore)

Italy’s old pay high price for regional vaccine lottery

By Crispian Balmer and Angelo Amante

ROME (Reuters) – Agostino Airaudo, 86, died of the coronavirus on March 21. Ninety minutes earlier he had received an SMS telling him that, after weeks of waiting, he had got an appointment for a vaccine.

Ten days later, his 82-year-old wife Michela also died of the disease.

Unlike many other European countries, Italy did not give automatic precedence to its army of pensioners when it launched its inoculation campaign in December, even though they were bearing the brunt of the disease.

The failure to provide swifter protection has cost thousands of lives, experts say, and stoked anger about a fragmented health system under which regions take most of the decisions and the central government has struggled to impose a clear strategy.

“People could have been saved,” said Giorgio Airaudo, the son of Agostino and Michela, and the head of Italy’s powerful FIOM metalworkers’ union in the northern region of Piedmont.

“As soon as the vaccines arrived, there was no justification for not giving priority to fragile people and the elderly…,” he told Reuters by telephone.

“But this did not happen. The government made suggestions and each region did as they pleased.”

More than 110,000 people have died of COVID-19 in Italy, the world’s seventh highest tally. Their average age was 81, and 86% of them were 70 or over, data from the ISS national health institute shows.

Many countries, including Britain and the United States, vaccinated old people first, recognizing their great vulnerability.

Italy’s government also said the over 80’s should get priority, but a haphazard rollout has allowed professionals including lawyers, magistrates and university professors to move to the head of the queue in many places.

As the death rate has fallen in much of Europe thanks to the early impact of the vaccines, Italy’s has stayed stubbornly high, and its average daily toll of 431 during the past week was the highest on the continent, according to Reuters data.

Acknowledging the problem, Prime Minister Mario Draghi – the epitome of measured calm during his eight-year stint as head of the European Central Bank – on Thursday made an impassioned plea to fellow Italians to wait their turn.

“With what conscience does someone jump the line knowing that they are leaving a person who is over 75 or fragile exposed to the real risk of dying?” Draghi told reporters.

“Stop vaccinating people under 60,” he said, raising his voice.

‘DEATH, PAIN AND GRIEF’

At the start of this year, Italy’s 20 regions focused almost exclusively on protecting health workers, even those in their 20s with no contact with patients. Most places did not begin mass vaccinations for over 80’s until mid-February.

By that stage, France and Germany had already given a first dose to 20% of their over 80s.

Italy has since caught up with the EU average, with data from the European Centre for Disease Prevention and Control showing it had given at least one shot to 62% of its over 80’s. But just 13.4% of people in their 70’s have had a first dose, the lowest rate in Europe after Bulgaria.

Regional governors say they followed government guidelines and blame delays on slower-than-expected vaccine deliveries.

They also say they were blindsided in January when the national drug regulator advised that the AstraZeneca/Oxford shot should only be used for the under 55’s.

They had planned to give this shot to older residents and had to change strategy. Now guidance has swung round again with a recommendation that it should be used only for over-60s after concern emerged that it may cause rare blood clots in young adults.

Matteo Villa, a researcher with the ISPI think-tank, says other EU nations facing the same issues were more agile. His analysis suggests Italy could have saved 11,900 lives had it focused more on the elderly.

“Central government did not control the situation and then, amazingly, many of the regions did not prepare carefully for the rollout,” Villa told Reuters.

He said some regions competed with each other to see who could administer the most shots, and found it easier to corral health workers than the elderly.

“This isn’t a race …This is a situation where there is death, pain and grief,” said the union boss Airaudo.

His parents lived in Piedmont, which is centered on Turin. They both had serious ailments and had registered with their doctor for the vaccine. An algorithm adopted by the region decides who gets a vaccine, and when.

Piedmont health officials did not respond to questions over why they had not received timely shots.

‘AN INCREDIBLE MESS’

Adding to the confusion, each region uses its own booking system.

Franco Perco, 81, lives in the central Marche region, a COVID-19 hotspot. He is still waiting for a vaccine appointment despite numerous phone calls to helplines and efforts to book online.

“I feel very scared. There is no clarity,” said Perco, the former head of one of Italy’s major national parks. “I am going out as little as possible.”

Under the constitution, Italian regions have broad autonomy over healthcare decision-making, even during a pandemic.

In Tuscany, Abruzzo and Sicily, magistrates and lawyers were given priority status. In the southern region of Molise, journalists were allowed early vaccinations. Lax supervision in Sicily meant one priest was able to get his congregation vaccinated regardless of age.

“It created an incredible mess. It has served as a lesson for us to be more careful,” said Angelo Aliquò, the health agency director general in the Sicilian city of Ragusa.

Health undersecretary Andrea Costa, who took office in February, told Reuters that mistakes had been made in not clearly identifying priority groups.

“There will be time in the future to analyze what happened, but now we need to achieve as soon as possible immunization which will allow a return to normal life,” he said.

Angered by the sudden death of both his parents, Airaudo hopes there will be a reckoning.

“I always thought that decentralization was about being close to the people. Instead, today we have confusion, difference, injustice and delays,” he said.

NYC deaths from non-COVID causes rise over 5,000 above normal rate: CDC

Reuters) – The number of deaths in New York City from causes other than COVID-19 rose by more than 5,000 people above the seasonal norm during the first two months of the pandemic, the Centers for Disease Control and Prevention (CDC) said on Monday.

The deaths could be due to several factors, the CDC said, including delays in seeking or getting life-saving care for fear of exposure to the coronavirus.

Tracking excess mortality is vital in understanding the contribution to the death rate of both COVID-19 and poor availability of care for people with non-COVID conditions, noted researchers, who reported their findings in the CDC’s Morbidity and Mortality Weekly Report (MMWR).

The CDC used data from the New York City Department of Health and Mental Hygiene, which has an electronic reporting system with a near complete count of all deaths in the city.

Between March 11 and May 2, 32,107 deaths were reported to the department. Of these, 24,172 were found to be in excess of the seasonal norm. This included 13,831 (57%) laboratory-confirmed COVID-19–associated deaths and 5,048 (21%) probable COVID-19–associated deaths.

That means 5,293, or 22% of the excess deaths, were not identified as being associated with COVID-19.

These deaths could be directly or indirectly attributed to the pandemic and counting only the confirmed or probable COVID-19–associated deaths likely underestimates deaths attributable to the pandemic, the researchers said.

(Reporting by Vishwadha Chander in Bengaluru; Editing by Arun Koyyur)

Speed of coronavirus deaths shock doctors as New York toll hits new high

By Nick Brown and Gabriella Borter

NEW YORK (Reuters) – New York state, epicenter of America’s coronavirus crisis, set another single-day record of COVID-19 deaths on Wednesday, as veteran doctors and nurses voiced astonishment at the speed with which patients were deteriorating and dying.

The number of known coronavirus infections in New York state alone approached 150,000 on Wednesday, even as authorities warned that the official death tally may understate the true number because it omits those who have perished at home.

“Every number is a face, ” said New York Governor Andrew Cuomo, who ordered flags flown at half-staff across New York in memory of the victims.

“This virus attacked the vulnerable and attacked the weak, and it’s our job as a society to protect the vulnerable.”

Doctors and nurses say elderly patients and those with underlying health conditions are not the only ones who appear relatively well one moment and at death’s door the next. It happens to the young and healthy, too.

Patients “look fine, feel fine, then you turn around and they’re unresponsive,” said Diana Torres, a nurse at Mount Sinai Hospital in New York City, the center of the nation’s worst outbreak. “I’m paranoid, scared to walk out of their room.”

Nearly 430,000 cases of COVID-19, the highly infectious lung disease caused by the coronavirus, were confirmed in the United States as of Wednesday afternoon, including more than 14,700 deaths. For the second straight day the virus killed at least 1,900 in a 24-hour period.

Cuomo said 779 people had died in the past day in his state. New Jersey reported 275 had died there. Both totals exceeded one-day records from just a day earlier.

Despite the grim figures, Cuomo said overall trends still appeared positive. Cuomo cited a drop in new hospitalizations and other data as evidence that New York’s social-distancing restrictions were “bending the curve,” helping to gain some control over the infection rate.

New York is one of 42 states where governors have issued “stay-at-home” orders and closed all non-essential workplaces.

While public health experts say such measures are vital for controlling the contagion, the restrictions have strangled the U.S. economy, leading to widespread layoffs, upheavals on Wall Street and projections of a severe recession.

Cuomo said the loss of life would likely continue at current levels or increase in days ahead as critically ill patients die after prolonged bouts hooked up to ventilators.

SCALING BACK TOLL

U.S. deaths due to coronavirus topped 14,700 on Wednesday, the second highest reported number in the world behind Italy, according to a Reuters tally.

New York state accounts for over a third of the U.S. total.

Officials have warned Americans to expect alarming numbers of coronavirus deaths this week, even as an influential university model on Wednesday scaled back its projected U.S. pandemic death toll by 26% to 60,000.

“We are in the midst of a week of heartache,” Vice President Mike Pence said during a White House briefing on Wednesday, but added, “we are beginning to see glimmers of hope.”

Dr. Craig Smith, surgeon-in-chief at Presbyterian Hospital’s Columbia University Medical Center in Manhattan, heralded encouraging numbers that suggested a turning tide in Wednesday’s edition of his daily newsletter to staff.

There were more discharges of patients than admissions for two days running, he said, adding: “Hosanna!”

But that comes as cold comfort to some healthcare workers on the front lines, who told Reuters they have treated patients while experiencing symptoms of the novel coronavirus themselves without being able to get tested.

In Michigan, one of the few hospital systems conducting widespread diagnostic screenings of staff, found more than 700 workers were infected – over a quarter of those tested.

The continued test kit shortages – even for the workers most at risk – is “scandalous” and a serious threat to the patients they treat, said Dr. Art Caplan, a professor of bioethics at the NYU Grossman School of Medicine.

‘BIG BANG’

At the White House on Wednesday, U.S. President Donald Trump said he would like to reopen the U.S. economy with a “big bang” but not before the death toll is on the downslope.

Trump did not offer a time frame, but his chief economic adviser, Larry Kudlow, said on Tuesday a resumption of commerce was possible in four to eight weeks.

Louisiana is “beginning to see the flattening of the curve” with the number of new coronavirus cases reported in the past 24 hours – 746 – lower than recent days, Governor John Bel Edwards said. Louisiana had been one of the nation’s hot spots.

California, like New York, had one of its highest single-day death tolls with 68 people dying of COVID-19 in the past 24 hours, Governor Gavin Newsom said. The state may not see its infection curve flattening until the end of May, requiring weeks more of social distancing, officials say.

New York City officials said a recent surge in people dying at home suggests the most populous U.S. city may be undercounting the loss of life.

“I think that’s a very real possibility,” Cuomo told his daily news briefing.

So far New York City’s announced death toll has reflected only laboratory-confirmed COVID-19 diagnoses, mostly at hospitals. At least 200 people are believed to be dying at home in the city every day during the pandemic, authorities said.

Pence warned that Philadelphia and Pittsburgh were cities of “particular concern” as a possible future flash points in the epidemic.

(Reporting by Peter Szekely, Nick Brown, Jonathan Allen, Doina Chiacu, Susan Heavey, Maria Caspani, Brad Brooks, Susan Cornwell, Nathan Layne, Lisa Lambert, Stephanie Kelly, and Gabriella Borter; Additional reporting by Dan Whitcomb; Writing by Will Dunham and Bill Tarrant; Editing by Bill Berkrot, Cynthia Osterman and Michael Perry)

Why is New Orleans’ coronavirus death rate nearly three times New York’s? Obesity is a factor

By Brad Brooks

(Reuters) – The coronavirus has been a far deadlier threat in New Orleans than the rest of the United States, with a per-capita death rate almost three times that of New York City. Doctors, public health officials and available data say the Big Easy’s high levels of obesity and related ailments may be part of the problem.

“We’re just sicker,” said Rebekah Gee, who until January was the health secretary for Louisiana and now heads Louisiana State University’s healthcare services division. “We already had tremendous healthcare disparities before this pandemic – one can only imagine they are being amplified now.”

Along with New York and Seattle, New Orleans has emerged as one of the early U.S. hot spots for the coronavirus, making it a national test case for how to control and treat the disease it causes. Chief among the concerns raised by doctors working in the Louisiana city is the death rate, which is close to three times that of New York and over four times that of Seattle, based on publicly reported data.

New Orleans residents suffer from obesity, diabetes and hypertension at rates higher than the national average, conditions that doctors and public health officials say can make patients more vulnerable to COVID-19, the highly contagious respiratory disease caused by the coronavirus.

Some 97% of those killed by COVID-19 in Louisiana had a pre-existing condition, according to the state health department. Diabetes was seen in 40% of the deaths, obesity in 25%, chronic kidney disease in 23% and cardiac problems in 21%.

Orleans Parish, which encompasses the city, reported 115 deaths as of Wednesday, giving it 29.5 coronavirus deaths per 100,000 people. That rate for New York City was at 10.8 on Wednesday.

New Orleans could be a harbinger for the potential toll the pandemic could take in other parts of the South and Midwest that also have high rates of obesity, diabetes, and hypertension.

A host of other factors could contribute to New Orleans’ high death rate from COVID-19, ranging from access to healthcare and hospital quality, to the prevalence of other conditions, including lung disease, health officials say.

But they also note that it is clear that obesity-related conditions are playing a role in the deaths. That could be a warning sign for the United States at large, where chronic obesity is more common than in other developed countries, they said.

Hospitals are reporting cases across the generations -mothers and daughters, fathers and sons – being intubated and cared for in the same intensive care units, said Tracey Moffatt, the chief nursing officer at Ochsner Health, the largest healthcare provider in Louisiana. The prevalence of obesity, diabetes, hypertension and heart disease in New Orleans and Louisiana plays into that, she said.

Those family members often suffered from the same medical conditions before becoming sick, leaving them similarly vulnerable to the coronavirus despite their age gaps.

“We had a case where a mom was already in the ICU and the daughter, who was obese, came in,” she said. “The daughter asked staff to wheel her by her mom’s room so she could say goodbye before she herself was intubated. We knew the mother was going to pass away.”

Both patients suffered from obesity.

‘MORE VULNERABLE’

The Centers for Disease Control and Prevention this week released for the first time a report showing that 78% of COVID-19 patients in ICUs in the United States had an underlying health condition, including diabetes, cardiovascular disease and chronic lung disease.

The CDC report was based on a sample of under 6% of reported coronavirus infections, but doctors in Louisiana said it was consistent with what they are seeing, and it is in line with what other countries like Italy and China have faced.

Those percentages, said Dr. Joseph Kanter, an emergency department doctor and the top public health official in New Orleans, are likely similar in cities across the United States.

“What we worry about here is that we have more people in our communities with those conditions,” he said. “We’re more vulnerable than other communities, and the number of deaths we’ve seen illustrates that.”

The New Orleans metropolitan statistical area ranks among the worst in the United States for the percentage of residents with diabetes, high blood pressure and obesity, a Reuters analysis of CDC data shows. An estimated 39% have high blood pressure, 36% are obese and about 15% have diabetes.

Nationally, the median is 32% with high blood pressure, 31% obese and 11% with diabetes.

“The burden of disease in Louisiana and the Deep South is higher than in the rest of the country,” said Gee. “Invariably that means that the South is going to be hard hit by this.”

(This story corrects headline, paragraphs 1 and 3 to reflect actual death toll of Orleans Parish of 115 deaths; Inserts new paragraph 6 with breakdown of figures.)

(Reporting by Brad Brooks in Austin, Texas, additional reporting by Ryan McNeill in London; Editing by Scott Malone, Rosalba O’Brien and Dan Grebler)

Myanmar trains midwives to tackle maternal death rate

Midwives attend pacients in Central Women's Hospital in Yangon, Myanmar March 17, 2017. REUTERS/Pyay Kyaw Aung

By Aye Win Myint

YANGON (Reuters) – Myanmar is training up hundreds of midwives in an effort to reduce the number of women who die in childbirth, one of many social policy reforms launched by the country as it emerges from decades of military rule.

Statistics show childbirth and pregnancy-related complications are the leading causes of death among women in Myanmar, mainly due to delays in reaching emergency care.

According to the most recent census, 282 women die per 100,000 births in the country, equivalent to about eight deaths every day, double the regional average and far above the mortality ratio of 20 deaths per 100,000 in neighboring Thailand or six per 100,000 in Singapore.

Nay Hnin Lwin, 19, is among 200 midwifery students currently studying at the Central Midwifery School in Yangon.

She said her parents, who live in a rural area, still do not recognize the importance of midwives, relying instead on traditional birth attendants.

“If there is an emergency situation, they cannot save lives. Mothers are losing their lives because of them. I’m proud to be a midwife to save them from these situations,” she told Reuters Television.

At the end of the two-year course, Nay Hnin Lwin and other trainee midwives will be deployed to remote clinics with poor infrastructure and bare-bones medical facilities.

“The role of midwives is very important because two thirds of our country is in rural areas. They are not only working on healthcare, but also documenting and compiling data for the country,” said Dashi Hkwan Nu, head teacher at the Central Midwifery School.

Myanmar’s healthcare — particularly in far-flung areas — is plagued by ramshackle services, with hospitals lacking basic equipment because the military junta diverted funds away from services benefiting the general population to the army.

The government of Myanmar’s first de-facto civilian leader in about half a century, Aung San Suu Kyi, has launched a series of social reforms such as national health and education plans, and the introduction of a bus transport system in Yangon.

A year after sweeping to power, however, Suu Kyi acknowledged earlier this week public frustration with the slow pace of reforms and development.

The midwives’ training program is being supported by the United Nations Population Fund (UNFPA), which says Myanmar must tackle maternal mortality in order to raise living standards.

“Maternal mortality needs to come down if Myanmar wants to graduate from the least developed into a middle-income country,” said Hla Hla Aye, assistant representative to the Fund.

(Reporting by Aye Win Myint; Writing by Antoni Slodkowski; Editing by Helen Popper)