As coronavirus continues to spread across the world, the total number of cases in India has reached 80. More than 100 countries have now reported cases, and on 11 March, the WHO declared COVID--19 as a pandemic. 90% cases are being reported from four countries: cases in China are now decreasing, but there are major outbreaks in Italy, Iran and South Korea. In other countries, including Europe, the numbers are growing exponentially.
This is a new contagious virus and much remains to be understood. Unlike influenza, there is no known pre-immunity, no vaccine, no specific treatment and everyone is presumed to be susceptible. There will be a mild respiratory illness for the vast majority (estimated 80% of confirmed cases) but it has a higher rate of quite severe complications for vulnerable people (elderly and people with comorbidities), than other viruses such as flu.
Protecting patients and healthcare workers is essential, so our medical teams are also preparing for potential cases of COVID-19 in our projects. In places where there is a higher chance of cases, this means ensuring infection control measures are in place, setting up screening at triage, isolation areas, and health education.
Caption:MSF donated 3.5 tonnes of personal protective equipment to health workers at the Wuhan Jinyintan Hospital in Hubei province. Wuhan Jinyintan Hospital is one of the designated hospitals providing treatment to COVID-19 patients, especially those in severe and critical conditions. Copyright: MSF
It is clear that healthcare workers need support and patients need care. Given the size of this pandemic, MSF’s ability to respond on the scale required will be limited. In Italy, which is now the second-most affected country (after China), this week MSF has begun supporting four hospitals in the epicentre of the outbreak with infection control, as well as patient care. In Hong Kong, our health education and mental health support continues for vulnerable groups. In Iran, MSF has submitted a proposal to the authorities to help provide care for patients with COVID-19. Whether we will be able to make similar offers to other countries will depend on the nature of the outbreak but also on our capacity to deploy. In this video, field coordinator in Hong Kong Karin Huster shares more about MSF's response to the outbreak.
Study on stigma faced by people living with HIV:
As we mentioned in our last newsletter, we published our qualitative study on stigma and discrimination faced by people living with HIV (PLHA) in accessing healthcare facilities last month. The study is significant since, to our knowledge, this would be the first such study from the region to document discrimination faced by PLHA in accessing health facilities, despite legal protection under law. Our team wished to understand the issues faced by PLHA in the region before we initiated our advanced HIV treatment center in Patna, Bihar.
The study revealed several findings among PLHA including high levels of stigma, largely due to HIV status, and routine discrimination in both private and government treatment centres. You can access the study here. You can also read more about our Patna project here and read patient stories from our project here.
Last month we had Vineetha Bambasala return from her mission in South Sudan. Vineetha was in South Sudan for 14 months as learning and development manager where she was tasked with implementing a new strategy focusing on the learning needs of the staff in the country. Vineetha’s biggest challenge was to ensure people’s expectations were met in areas with limited access to resources and low infrastructure for education.
During our conversation with Vineetha, she shared her favorite part about her mission, “My greatest achievement was to be able to provide access to books for you staff. Most of our staff pursue higher education in neighboring countries using their own funds or through the MSF sponsored study grant program. In the first couple of months, we were able to bring on board Book-Aid, a UK based NGO that decided to donate close to a thousand books on a range of topics by the end of 2020 !” Do get in touch if you wish to speak to her!
Last week, we also had Animesh Sinha, return from his mission in Belarus after four long years. Animesh went as the clinical trial coordinator for TB Practical, an MSF supported clinical trial that aims to evaluate short treatment regimens containing bedaquiline and pretomanid in combination with existing anti-TB drugs for the treatment of multi drug-resistant TB. Belarus has the highest proportion of drug resistant TB cases in the world (in absolute numbers, India has the highest number of cases). If the trial results in a more effective new regimen, MSF plans to advocate it for DR-TB patients everywhere, through the adoption of the newly identified treatment regimen into national protocols and global policy and guidelines.
MSF is already running a global campaign calling on Johnson & Johnson (J&J) to lower the price of its anti-tuberculosis medicine bedaquiline to no more than US$1 per day for people everywhere who need it, in order to allow scale-up of DR-TB treatment.
Belarus is a perfect example of how, even in a country with a well-functioning health system, the treatment of drug-resistant tuberculosis– which does not respond to traditional antibiotics – poses a major challenge for the healthcare system, physicians and patients. You can know more about TB Practecal here. MSF also provides psychological support for patients to improve adherence to treatment. You can read more about our project in Belarus project here. Do get in touch if you wish to speak with Animesh!