COVID-19

Not good at all

Good editorial here from The Lancet:

COVID-19: we will not be returning to the old normal

The Lancet Microbe

Recently there has been a gradual shift in the COVID-19 discourse based on an acknowledgement that clearer communication is needed to manage public expectations. Although not directly factored into this shift of tone, the so-called fatalism effect can teach us something. This concept essentially warns that if a problem is characterised as nearly insurmountable then many people will just give up. These people surmise that the cost of the intervention is not worth it, given they perceive that the cost yields little benefit. Conversely, it is also important to guard against overly optimistic assessments, such as those from certain governments relating to a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. Many governments have confidently asserted, without due consideration of the consequences, that a vaccine will abruptly end the pandemic.

Given the potential for misunderstanding at this point, let us be clear: an approved vaccine will be beneficial and its uptake should be strongly encouraged, but it can only be a part of the solution. The reason a vaccine cannot be the complete solution is illustrated with the three vaccine scenarios recently put forth by Zain Chagla, Isaac Bogoch, and Sumon Chakrabarti: a vaccine that prevents nearly all person-to-person spread (presumably also halting illness; scenario 1), one that prevents some spread and reduces severe illness and death (scenario 2), and one that does not prevent spread but reduces severe illness and death (scenario 3). At this stage of clinical assessment it is difficult to be certain whether the real vaccines will fit into scenario 2 or 3. They are unlikely to fit into scenario 1, although even this scenario would not be an instantaneous solution given the mind-boggling logistics of delivering a vaccine to over 7 billion people.

All the vaccine scenarios will require that the mitigation measures employed worldwide continue for a few years at least. Of course, the scenario 1 vaccine would, in time, allow us to reach a point where other measures to prevent transmission of SARS-CoV-2 become unnecessary. Ideally, in a show of global solidarity, the measures would be retained until the world had largely brought COVID-19 under control. However, it would be naive to assume that individual nations would not lift restrictions as soon as possible. The other scenarios are more tricky propositions and illustrate that political optimism can be genuinely dangerous. If we use the scenario 3 vaccine as our example, this might eliminate severe and potentially deadly disease in those able to receive the vaccine, but the virus would still be able to spread through the population unhindered. So those unable to receive the vaccine, a group which overlaps with many groups current measures are protecting, would be unprotected.
For months many governments have proclaimed that a vaccine is the complete solution, without any mention that not all potential vaccines will fill this role.

Nonetheless, some quarters will push to roll out a vaccine, irrespective of its properties, and abandon other measures. It is not unreasonable for the public to expect this drive, given the failure to manage expectations to date. In this setting most people would experience little disease but those who currently are at greatest risk would find themselves completely exposed. This would be an inversion of the underlying principles guiding current interventions. Some might see this characterisation as absurd, but we have seen the world over how easily physical distancing seems to have been abandoned when people are led to believe, deliberately or otherwise, that new measures replace rather than complement earlier interventions.

Often it is difficult to offer solutions, but it is straightforward in this case: interventions that have been in use since early in the pandemic, most crucially physical distancing and hand hygiene, must continue indefinitely. The benefits of these simple measures will have far-reaching implications as shown in a news story in this issue by Paul Adepoju, which describes how work to control neglected tropical diseases has benefitted from the drive for improved hygiene in response to the pandemic. It might be that the vaccines that ultimately become available are more like those described under scenario 2: slowing transmission in addition to limiting illness and death. This scenario will be more welcome than scenario 3 but will not change the need to maintain earlier interventions in place.

It is time to forcefully impress on people that basic measures to limit the transmission of SARS-CoV-2 are here to stay.

This is the new normal.

Bulletin #203:

724 new cases and day positivity up to 19.37%.

La Romana 344 new cases. PP 73 new cases.

Medical College attributes coronavirus outbreak to incorrect decision to modify the state of emergency

https://listindiario.com/la-republica/2 … emergencia

The reappearance of coronavirus cases in the country is due to an incorrect action by the Government to modify the state of emergency, sending a subliminal message to the population that the situation of the pandemic had improved.........


Health and public safety authorities ask to maintain social distancing

https://listindiario.com/la-republica/2 … nto-social

Government is beginning to panic!

Puerto Plata province is now the hot spot in the country. 80 new cases today and current positivity just under 21%.

Take care.

Yikes.

President Abinader requests 45 days of state of emergency[b][/b]

https://noticiassin.com/presidente-abin … mergencia/

President Luis Abinader requested 45 days of a state of emergency to continue with the measures in place to control the coronavirus.

Abinader explains in the letter sent to the president of the Chamber of Deputies, Alfredo Pacheco, “although the contagion of the disease has been contained thanks to the measures adopted during the state of emergency, it is still necessary to maintain some of these to ensure a orderly economic and social reopening ”.

The request made by President Abinader would take effect on October 18.

The president emphasized that social distancing is one of the most effective measures to prevent the spread of the pandemic, according to the World Health Organization (WHO) and the Pan American Health Organization (PAHO), which is why it is necessary continue to implement the curfew and other such measures.

Yup its still necessary!

Given the attitude of the public here...

few workable options are available....
a firm hand is needed - unfortunately

I agree 100%

***

That post doesn't belong in this thread. If you wish to post it in one of the generic covid threads please fact check it first.   And any references that are racist in nature need removal.

Only now are we beginning to understand the long term lasting effects of covid19 on all age groups.

'Long covid' is something we are beginning to hear much more abaout as research begins to catch up on how this virus affects humans.

'Long Covid': Why are some people not recovering?

https://www.bbc.com/news/health-54296223

For most people, Covid-19 is a brief and mild disease but some are left struggling with symptoms including lasting fatigue, persistent pain and breathlessness for months.

The condition known as "long Covid" is having a debilitating effect on people's lives, and stories of being left exhausted after even a short walk are now common.

So far, the focus has been on saving lives during the pandemic, but there is now a growing recognition that people are facing long-term consequences of a Covid infection.

Yet even basic questions - such as why people get long Covid or whether everyone will fully recover - are riddled with uncertainty..............

All the more reason to test more, track, trace and isolate the infected for the benefit of all society as was recommended by the WHO scientist as one of the essential parallel measures other than just using full lockdown.

It will have long term repercussions!

It was too expensive anyhow for DR and indeed most nations.

[i]Covid: Remdesivir 'has little or no effect' on survival, says WHO

https://www.bbc.com/news/world-54566730[/i]

This will be a long haul finding a cure or treatment for covid19 and even a vaccine would not have much effect on reducing spread for a few years. We must adapt our lives to live alongside this virus. I have with rural low density living now.

And the herd immunity idea is both unrealistic and immoral.

Coronavirus: WHO head calls herd immunity approach 'immoral'

https://www.bbc.com/news/world-54518286

My personal view is that we are safer here living in DR than in developed countries where society is struggling with the basics of covid19 living such as masks and avoiding crowds and nightime revelry.

The objective is to prevent a large number of individuals from getting ill and overwhelming the health care system at one time (i.e. that infection curve that people seem to forget about). Four percent of people may be dying but that number, and the amount of suffering, will increase if health care is not available for those testing positive and having symptoms. Imagine getting ill with this and not having a health care system to rely on because too many people are jamming up the health care system.

Hi Rocky,

We are informed people.  Unfortunately, we hear lots of propaganda and the governments, the ones we depend upon are doing little to combat the propaganda.  If you feel ill today in the DR, do you know what you should do or who should you call?  In fact, is there anyone anywhere that feels comfortable answering that question?  Are you confident that you have the right information?  We all know about the preventatives but even that is coming into question.  Unfortunately, if this is the most serious situation the world has faced in a very long time, then we are very poorly prepared.  Not only as people and individuals but the governments are letting us down terribly.

Here is a link to one news story: https://apple.news/APclN1plfRRK__UrjYshmGQ

It certainly makes you wonder.  I have heard countless cases, real cases, where what you hear in this article really makes sense.

In the end, you have to follow your gut instinct and we cannot control the rest of the world.

Everything in moderation has always been my motto.  I'm not changing now...

The extent of ignorance never ceases the amaze me!   Wow.

This virus is real. I have lost 7 friends. I have employees, young employee with permanent physical damage.

To suggest this is no big deal is just plain ignorant.

I am sorry for your loss Planner, perhaps your views have been obscured by your own reality.  Perhaps a step back is in order.  I too have lost family members from COVID and also from cancer, alzheimers, diabetes, car accidents....

No one is saying its NO big deal.  Perhaps a bigger deal to some than others.  No one on this planet has a real answer to this problem.  So, we have to look at past experience and similar situations to find answers that help us.  We will each find answers that help us cope with the problem and they will not all be the same.  We are in a different time with technology playing a much larger role in what we do every day.

We have all heard what seems to be working best is social distancing, wearing a mask, not to be in groups, no unnecessary travel, cleanliness and disinfection etc. Same guidelines they give for the flu season every year for those of you that are familiar with the flu.

My comments are geared towards people in panic mode, and my message is look at the positive, we all know how much negativity is around us and frankly, COVID isn't any worse than many other problems we are faced with.  Your probability of getting cancer and dying is higher than getting COVID and dying but I am not letting the chance of getting cancer control my life and neither should anyone else. 

Get on with your life.  This virus will burn out and mutate to the level that has very little significance.  Yes, it will take some time.  Less time if we just get on with our lives in a "safe" mode.

Only my opinion.  I hope that you give my opinion the same rights and respect that you give your own.

No one has s in panic mode.

No one says wear mask in flu season.

This discussion will not continue.

Planner I have always found your posts to be informative and factual. I always looked forward to your opinion. I am seeing something different now and I for one do not like where it is going.

"This discussion will not continue."

Are you saying that free speech will no longer be tolerated.

I believe it simply means that she will not participate. I share the view that this/these times are of concern and we must take care of ourselves and not live in fear or panic.  I am fearful for my wife in Moca but know she will be watched carefully by her daughter. IIn Alberta where I am working, people are carrying on  - some wear the mask, some do not but what is occurring is there is social distancing between non-family/customers in stores and in malls. Although I do not feel restricted here and I freely move about,  I do agree that residing in the DR is preferable than here except for the fact that locals still congregate and do not social distance as much as they should. And yes, it is even worse in cities and major centers of population. Losing friends, relatives and employees is never nice and until the WORLD learns to cope and live with this as we do with so many other diseases, no matter what the survival or death rate is, we all should practice safety measures while encouraging our friends and neighbours todo so to. It is easy to say these things when there is such a high discrepancy between how the average person in the DR must live/survive day to day while here there is social assistance and still employment to meet the much higher minimum living needs. Wishing you to be safe....as I slow freeze with winter setting in (my first since 2009/2010)....

I am glad you cleared that up Planner.  I was really worried about you...

I believe it simply means that she will not participate.

I agree, that would be a better view. Sorry Planner, I should have known better.

I was born and raised in Alberta so I know what you will be facing in the months ahead.

I believe very few people indeed are now in so called panic mode as regards the virus.

We should understand by now that this virus is very contagious and is affecting the whole world and many of us have adapted how we live and manage our lives. People adapt in many ways. Some refuse to adapt and fuel the pandemic.

For sure pandemic fatigue has set in. But to ignore it and treat it like a flu or cancer just exacerbates the problem. Go look at the USA and Europe now. It is looking like this winter will be chaotic in those parts of the world with covd19 and flu.

DR is sticking to it's approach and the curfew has been extended for another 25 days. The curfew effect coupled with good compliance with mask wearing in cities and towns and social distancing in businesses has been effective and positivity in DN has dropped to under 10%. Overall it is at 12.45% nationally,  but places such as Puerto Plata hover near 20% with lots of daily cases. I hear mask wearing is more lax in those parts. You reap what you sow.

Long covid

Good presentation of the long term effects of covid19 which affects between 10% and perhaps 35% of those infected with mild covid19 as well as those with more serious infection.

https://news.sky.com/story/long-covid-t … s-12104961

Interesting article, thanks for sharing

A "good" article? There are none since they all reiterate how little the best experts know, and how controversial all actions are.

Science is by its very nature constantly evolving.  The more they know the better they can respond.

I am not permitting these  posts.    JUST STOP. There are thousands of places  you all can go and  have these conversations.  They are not happening here.

DO not start with Free Speech either. This is a privately owned and run  site.  We are NOT causing panic and we are NOT allowing the  dissemination of unproven and  un scientific theories!  Period.

We will stick to  scientifically proven  facts!  Anyone not liking it can have my job!

Long covid is a reality and as more research takes place more gets known about the long term effects of covid19 and the people it affects.

https://en.wikipedia.org/wiki/Long_Covidhttps://www.mayoclinic.org/diseases-con … t-20490351

The article in question is factually based and is written for the Murdoch owned right wing UK news media SKY News. Politics doesn't enter into this. Medicine does.

Very little focus has been paid to this reality so far in the USA.

covid19 cannot be brushed aside as another flu and the long term effects of this virus will be felt for many years to come both heathwise and economically.

When a country has 65k new cases daily with no plan of action, then the future will be dire for many. 10% of 8 million is one hell of a lot of people who could suffer long covid with massive long term health costs, not to mention those not recorded or yet to get infected.

Simple advice. Take covid19 seriously and take all measures necessary to avoid catching it as you continue your chosen lifestyle.

This is ridiculous. I joined this forum to get inside information from Expats in the DR.
The tone of this conversation is way off base and very disturbing. People should take themselves a little less seriously.

I come here to read about people's experiences and information that may help myself or provide info for others. Some good and some bad with the help but does not effect me personally.

For a volunteer you seem to be taking things very personally and more involved than it seems. It has to be more beneficial to you because otherwise you would have left a long time ago.

It has been my volunteer job to moderate this forum for well over   10 years. Its not often I lose my cool and I lost it yesterday.  I do this because I like to help others.  I do not do it to be personally attacked or to have my motives questioned!   

I apologize for reacting instead of responding. That is on me!

For clarity - anything not widely accepted as scientific, not published by a  widely accepted  source will not be allowed.

Science is constantly evolving as are peoples thoughts.

We will not engage in these kinds of discussions again.  Take it somewhere else if that is what you want to do!

We will stick to the  discussion as it applies to the Dominican Republic.

Hello everyone,

Please note that some posts have removed from this topic.

Thanks,

Diksha
Team Expat.com

MOH have given an updated Bulletin on covid19 in resort areas:

https://es-la.facebook.com/SaludPublica … mp;theater

19.6% and 19.8% positivity in Puerto Plata and Sosua/Cabarete respectively. 16.4% in Samana and 14.4% in La Altagracia.

Nationally today, it is greater Santo Domingo having most (324) of the 425 new cases at 12.86% day positivity.

Authorities do not contemplate relaxing measures during Christmas festivities

https://www.arecoa.com/destinos/2020/10 … navidenas/

Despite the fact that the COVID-19 positivity rate has decreased in the last 4 weeks, the health authorities do not contemplate relaxing the restrictive measures during the Christmas festivities, health advisor Eddy Pérez Then reported last Wednesday .

Nor have the authorities considered the total opening and even less to release the regulations, because experience in other countries has said that this implies increasing cases and deaths from the virus.

Pérez Then assured that epidemiology cannot ignore the culture of the Dominican Republic that is preparing for the Christmas and New Year festivities.

"The cultural patterns of the towns cannot be ignored, for that reason we are already under review to determine how it would be done so that Dominicans can have a quiet Christmas," he added.

In his opinion, the celebration of the Christmas and New Year festivities constitute a challenge that the authority has already scheduled.

However, in no way are they going to make confinement, curfew and hand washing measures more flexible and avoid the crowding of groups.

The measures cannot be liberalized, because the virus is in the country, it does not matter if the number of cases or deaths falls, the two specialists assured.

On his side, the Director of Communications of the Ministry of Public Health, Ulises Jiménez , assured that the authorities have not lowered their guard when supervising that the population does not violate the norms to avoid the spread of the viral disease that keeps the DR under a state of emergency and curfew.

2,860 Covid cases in a week mark gradual increase in infections

https://listindiario.com/la-republica/2 … -contagios

A total of 2,860 cases of coronavirus were reported by the epidemiological bulletins of the Ministry of Public Health during the past week, which presented a gradual increase in the daily number of infected for five days.

Starting with report number 215, corresponding to Monday, October 19, the number of those infected by COVID-19 was 306. The following day this figure rose by more than one hundred cases, reaching 425.

For the report 217 Public Health had announced 475 new positives; on Thursday 22 Public Health published that these rose to 511; Last Friday the largest jumped was registered, when the cases were 634.

However, the streak ended in bulletin 220 yesterday where it was specified that the number of reported cases was 509, the third highest amount in that period.

Regarding deaths for the week, the total was 20 deaths from coronavirus, with the daily number ranging from a single death to six, with Wednesday and Friday being the deadliest days for patients with the virus.

Hospitalization
During the last seven days the level of hospitalization has tended to decline, with a decrease in the number of beds in medical centers dedicated exclusively to people affected by the virus. Although the figure fluctuated in the referred period, compared to report 215, which had 20 percent occupancy (683 of 3,348), 220 had less, with 19 percent (644 of 3,348).

Conversely, cases taken to the Intensive Care Units (ICU) have increased, reaching 35 percent occupancy during the last report.

In 220, the number of people transferred to the ICU was 178; in 219 and 218 they presented 172; for 217 the figure was 158; in 216, 157, and in 215, 154 were registered.


Sadly we are going the wrong way.

The problem is the towns and cities. Campo is normal.

Not good news and this all comes at a time when we are beginning to see a spike in cases and hospital entries in DR especially amongst the younger generation.

Moscoso Puello COVID-19 area at its maximum capacity

COVID-19 area director shows concern about the number of young patients affected by the virus

https://www.diariolibre.com/actualidad/ … PH22258250

Europe is locking down with curfews to control the second wave which could be worse than the first wave whilst the USA gets worse and worse daily.

Antibodies fall rapidly after COVID infection, dashing hopes of herd immunity - study[/b]

https://news.sky.com/story/coronavirus- … y-12115510

Hopes that the population will become immune to COVID-19 have been dashed by new research showing antibodies fall rapidly after recovering from the disease.

So-called herd immunity has been proposed by some scientists as a better alternative to lockdowns in tackling the coronavirus pandemic.

It would require around 50-60% of the population to have protection against the virus so it could no longer transmit efficiently.

The number of people with antibodies fell since lockdown measures eased

However, a major UK study has found that rather than building immunity over time, the number of people with antibodies has fallen by 26% since lockdown was eased over the summer.

Researchers from Imperial College London screened 365,000 people over three rounds of testing between June and September.

Results of the REACT-2 study showed that 6% of people had antibodies to the virus around the time lockdown was eased in late June and early July.

But by the start of the second wave last month, this dropped to just 4.4%.

Professor Helen Ward, one of the researchers, said the new results strongly suggest that herd immunity is unachievable.

"When you think 95 people out of 100 are still likely to be susceptible, we are a long, long way from anything resembling population level protection against onward transmission," she said.

"It's not something you can use as a strategy for infection control [for COVID-19] in the population."

The new research suggests herd immunity cannot be achieved
The finding is another blow to scientists behind the controversial Great Barrington Declaration, who had suggested that vulnerable people could be shielded at home while the virus spreads through the young and healthy to build up herd immunity.

The proposal has been strongly criticised by many other scientists.

The researchers found younger people, those from black, Asian and minority ethnic (BAME) communities and health workers had higher antibody levels, possibly because they were in regular contact with infected individuals.

The fall in antibodies suggest people will be regularly re-infected, just as they are with related coronaviruses that cause the common cold.

Professor Wendy Barclay, an infectious diseases specialist and one of the researchers, said antibodies peak three to four weeks after symptoms and then drop away, as they do for related viruses.

She said: "Seasonal coronaviruses that circulate every winter and cause common colds can re-infect people after six to 12 months.

"We suspect that the way the body reacts to infection with this new coronavirus is similar to that."

There have so far only been a handful of documented cases of re-infection.

Dr Alexander Edwards, associate professor in biomedical technology at the University of Reading, said: "What is not clear is how quickly antibody levels would rise again if a person encounters the virus a second time.

"It is possible they will still rapidly respond, and either have a milder illness, or remain protected through immune memory.

"So even if the rapid antibody test is no longer positive, the person may still be protected from re-infection."

The study, which is yet to be peer reviewed, only measured antibodies.

It is possible that another arm of the immune system called T-cells, may remain active, but there is currently no available test for them.

Scientists are cautious about using the results to predict the protection provided by a vaccine.

They say immunisations may lead to a more robust antibody response.

Health Minister Lord Bethell said the study "is a critical piece of research, helping us to understand the nature of COVID-19 antibodies over time, and improve our understanding about the virus itself".

He added: "We rely on this kind of important research to inform our continued response to the disease, so we can continue to take the right action at the right time.

"It is also important that everyone knows what this means for them - this study will help in our fight against the virus, but testing positive for antibodies does not mean you are immune to COVID-19."[/i]

Good news on the Oxford/Zeneca vaccine which shows positive results in people of all ages including the older. It is one of the vacccines that DR will have access to.

(Government makes an agreement with the University of Oxford for the purchase of vaccines https://n.com.do/2020/08/27/gobierno-ha … e-vacunas/)

Oxford Covid vaccine works in all ages, trials suggest

Vaccine being trialled by Oxford University and AstraZeneca offers hope for all age groups

https://www.theguardian.com/world/2020/ … ls-suggest

I wonder if DR can make vaccination compulsory?

Thank you for the up dates. We want to back in LT  in February praying that the Oxford study is a silver bullet. Be safe

My personal view is that Las Terrenas living in covid19 times is a safer bet.

Open air venues and living.