Mission Issues

Thinking and re-thinking missionary issues

COVID-19 (Global) – 2021/09/20

When you compare my seven-day forecast for Brazil from last week to the actual numbers of this week, you will notice that the actual number this week is much higher than predicted last week. The reason is that there was a huge backlog of almost 150,000 cases in Rio de Janeiro which was only reported on Saturday. The backlog has now been spread over the actual time when the cases were reported, but on average there are almost 4,000 more cases per day than reported last week. This has happened on several occasions in different countries (Sweden, India, the UK and South Africa, to name a few). You can read the Reuters report on this here:
https://www.reuters.com/…/brazil-reports-over-150000…/

Apart from Brazil which obviously shows an increase in its infection rate this week, Russia also started moving upwards slightly this week, together with Turkey which has been moving upwards for the past several weeks. The USA and the UK (the two countries, apart from Botswana, with the highest number of new cases per million of the population) are both still showing a decrease in their infection rates and the top ten countries as a whole are also still moving downwards.

An article I found quite interesting regards the possibility of combination vaccines. This does not mean combining different brands of COVID vaccine, but rather combining COVID vaccines with vaccines for influenza and other viruses, such as the respiratory syncytial virus (RSV). I enjoy reading about advancements being made in science, and if you enjoy this as well, then you might also find this article interesting:
https://www.medpagetoday.com/opinion/second-opinions/94571?xid=nl_mpt_DHE_2021-09-20&eun=g1759597d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%20Top%20Cat%20HeC%20%202021-09-20&utm_term=NL_Daily_DHE_dual-gmail-definition

For now, things are still moving in the right direction, although large countries with relatively low vaccination rates such as Russia (28.3% fully vaccinated) and Brazil (38.1%) could push up the global number of infections in the future.

Monday, September 20, 2021 Posted by | COVID-19 | Leave a comment

COVID-19 (South Africa) – 2021/09/17

Last week I expressed the hope that the mortality rate in the Free State will start moving downwards. And indeed, this happened over this past week, dropping from 0.27% to 0.19%. But then six of the other provinces and South Africa as a whole had an increase in their death rates. However, with the infection rates continuing their downward trends all over the country, we can foresee that the death rates will move downwards again soon. Mpumalanga has now joined Gauteng and Limpopo with a number of infections per million below 50. I am fairly sure that by next week North-West will also fall into this category. Limpopo is now standing at 11 infections per million per day. Below 10 is a good indicator that things are fairly under control. Northern Cape is still the one province with over 250 infections per million per day, this 158 days after the third wave started in the province.

The case fatality rate is still moving upwards and is now at 2.99% for the entire time of the pandemic. However, for the past week this ratio rose to 4.78% (up from 3.01% last week) which simply means that for every 100 people who tested positive for COVID, almost five people died (almost two more than a week ago). On the other hand, the positivity rate of tests is now 9.96%, down from 13.8% last week. This is good news.

Although the number of vaccinations over this past week exceeded those of last week, we are still 320,000 short of 16 million vaccinations in total. The total number of people who are now fully vaccinated went over 7.7 million this week.
Looking at the number of people in hospitals and ICU in South Africa, we see that the number of people in hospitals went down to 9,384 (last week the number was 11,027) while those in ICU decreased to 1,413 (compared to 1,692 last week). Of those hospitalised, 843 are currently on ventilation (967 last week).

South Africa’s number of COVID-related mortalities is still greatly underreported. The number of excess deaths is updated weekly by the SAMRC and the actual number of people who had died because of COVID may be as much as three times higher than the 85,800 officially reported.

Now that the country is on Level 2 with the promise that the situation will be evaluated again within another week, my guess is that we can prepare ourselves to move to Level 1 by next Sunday. What is more difficult to predict is when the fourth wave will hit the country, but I cannot foresee that we will be spared this wave.

Friday, September 17, 2021 Posted by | COVID-19 | Leave a comment

COVID-19: (Smaller countries) – 2021/09/16

The overall picture among the smaller countries is much the same as last week. Ukraine and Canada are the two countries with the greatest upwards movement. Ukraine moved back to more than 50 cases per million per day (74) and Canada, which had 99 cases per million last week, moved up to 113. Four of the countries are reporting less than 10 mortalities per day, while Argentina is the only country among this group with more than 100 deaths per day being reported (144).

I didn’t have the time over the past few days to do any other reading on the pandemic, but I was able to look at a few interesting articles today. The first one concerns so-called long COVID, also known as Post COVID-19 syndrome. I’ve mentioned this quite often over the past few weeks, as this changes the picture to a large extent. Many of those who survive COVID-19, struggle for a long time with symptoms linked to the COVID infection. In up to 13% of patients, symptoms persisted for 1-2 months, in 4.5% of the cases symptoms lasted for longer than two months and in 2.6% of cases, they lasted for longer than three months. The symptoms included fatigue, headache, difficulty in breathing and anxiety or depression. People need to take note of this. An article that appeared yesterday, covers this topic in depth. Please take time to read it here:
https://www.medpagetoday.com/infectiousdisease/covid19/94524?xid=nl_mpt_DHE_2021-09-16&eun=g1759597d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%20Top%20Cat%20HeC%20%202021-09-16&utm_term=NL_Daily_DHE_dual-gmail-definition

Last week I mentioned the double-edged sword of diabetes. Diabetes increased the risk of severe COVID or even death, but at the same time COVID also often starts or worsens diabetes, even in people who have had no sign of diabetes before getting COVID-19. In a short excerpt from a planned webinar hosted by the Foundation for Professional Development, it is said that mortality amongst the diabetic population is three times more than that of the general population. Unfortunately, I won’t be able to attend the webinar, but anyone may attend (free of charge) and you will know whether this is something which you need to listen to. The keynote speaker will be Professor Paul Rheeder, a trained specialist physician with a PhD in Clinical Epidemiology at the Steve Biko Academic Hospital. If you are interested in the topic, you can register here:
https://foundation.eventsair.com/…/regist…/Site/Register

I’ve moved past the Ivermectin debate, but I did notice this morning that a recent article once again proved that Ivermectin “isn’t a helpful treatment for COVID-19” after two groups with COVID-19 were monitored in hospital, 65 of whom were given Ivermectin plus standard care and 67 received only standard care. The outcome was that there was no difference between the two groups. You can read a summary of the trial outcome here:
https://www.medpagetoday.com/meetingcoverage/ers/94408

Lastly, after England recently lifted most of their COVID restrictions, it was clear that the infection rate was climbing at a steep rate “with cases, hospitalisations and deaths all higher than a year ago despite the success of the vaccination programme” and government scientific advisors have now warned Boris Johnson that fresh restrictions might have to be implemented soon, saying that “you have to go earlier than you think you want to, you have to go harder than you think you want to”. Whether this will be done, remains an open question. The Guardian published a lengthy article on the current situation in England, which you can read here:
https://www.theguardian.com/…/bring-in-measures-soon-or…

Thursday, September 16, 2021 Posted by | COVID-19 | Leave a comment

COVID-19 (Medium-sized countries) – 2021/09/15

Two weeks ago we saw the infection rate in the UK dropping from 0.52% to 0.5%. Last week it rose again to 0.55% and this week it dropped once again to 0.45%. The UK still has a high number of new infections per million per day (477) but hopefully, the downward trend will continue. If this happens, the death rate should also start moving downwards again. Turkey still had an increase in the infection rate over this past week, but all the other countries moved downwards, including South Africa which dropped from 0.26% to 0.18%. South Africa now has 84 cases per million per day and should cross the 50 mark by next week.

I think we can safely say that the positivity ratio (the number of tests that have a positive result) will drop below 10% within the next few days, one important indicator used to determine when a country moves out of a wave. On Friday I’ll have a closer look at the different provinces, but for now, things are looking positive.

Wednesday, September 15, 2021 Posted by | COVID-19 | Leave a comment

COVID-19: (Large countries) – 2021/09/14

From today until Thursday I’m involved in a full-day webinar, which means that I have to write my update during our coffee breaks.

Compared to last week, the USA’s infection rate is starting to move upwards again, which confirms what I’ve so often said, that it remains extremely difficult to predict what will happen. Daily 434 new cases per million of the population is being reported (only exceeded by the UK with 500 per million per day). However, in the USA the CFR is still less than 1% (0.94%), while the CFR in Brazil is 3.1%, in Russia 4.3%, in Mexico 5.5% and in Indonesia 7.3% which means that, in Indonesia, for every 100 people who contract COVID-19, between 7 and 8 people will die. Among the larger countries, the one with the lowest CFR is Japan (0.7%). The infection, as well as the death rate, increased considerably from the time that the Olympic games started in Tokyo on 23 July, but with more than 51% of the population fully vaccinated and 63% having received at least one dose, the number of infections and the number of mortalities are much lower than one would have expected.

Tuesday, September 14, 2021 Posted by | COVID-19 | Leave a comment

COVID-19 (Global) – 2021/09/13

The trend which started last week continued this week. Globally the infection rate is dropping and in the top ten countries the same is happening, although the UK, as I expected last week, became the fifth country to have a total of more than seven million positive cases. In fact, the UK has now passed Russia and is presently in the fourth position overall. But having said that, the UK, reporting more than 35,000 new cases per day, still have only 139 mortalities per day, a case fatality rate of 0.4%. The increase in cases in the UK can be ascribed to the higher transmissibility of the delta variant as well as the recent drop in COVID restrictions. The relatively low mortality rate is the result of a well-run vaccination programme.

Other news is that Denmark has now dropped virtually all their COVID restrictions, except for border controls. Over 71% of the adult population is fully vaccinated and the number of new cases per day has dropped to 84 per million. (I’ll include an article, but I notice that, in the article, the reporter refers to a number per 100,000 which should actually be 1,000,000). What I appreciate in the decision that Denmark made, was that they are prepared to reinstate lockdown regulations should it be necessary in the light of possible new variants. The news report can be read here:
https://fortune.com/…/denmark-to-scrap-all-coronavirus…/

Only five countries are on Denmark’s “green” list (Poland, Romania, Slovakia, Czech Republic, and Hungary) which means that people from those countries (on condition of having a valid proof of vaccination) may enter Denmark without being tested or isolated upon entry. More on these restrictions can be read here:
https://en.coronasmitte.dk/…/legal-requirements-upon…

Of the top ten countries, it was only Turkey which still had an increase in its infection rate. How long this downward trend will last is not clear, although there seems to be consensus that a next wave is inevitable. After someone asked a question about the waves, why it happens and how it can be predicted, I came across this article in Medrxiv where it is discussed. It attempts to provide a working definition of epidemic waves. If this topic interests you, you can have a look at the full article:
https://www.medrxiv.org/…/2021.02.21.21252147v2.full-text

A last remark (positive): Not a single country reported a new peak in their number of infections nor in their number of mortalities this past week. It is almost as if we can give a sigh of relief. I’m not sure for how long, but for now it feels good, although, as I’m writing this, we mourn the death of an extremely efficient teacher at one of the schools in the town where I live, who died on Saturday after several weeks in ICU. And another friend and colleague of mine is slowly recovering in a rehabilitation centre after he was diagnosed with COVID-19 at the beginning of July and also spent several weeks in ICU.

And then, just on a lighter note, someone shared this copy from a 1918 newspaper where advice was given at that time on how to avoid getting the flu. It might have been written today.

Monday, September 13, 2021 Posted by | COVID-19 | Leave a comment

COVID-19 (South Africa) – 2021/09/10

It is good to see how things are improving in South Africa. Last week all nine provinces had a decrease in their infection rates and only four still had an increase in their death rates. As of this week, it is only the Free State where the death rate increased (from 0.22% to 0.27%), but I am fairly confident that by next week this will also have turned around. The daily cases per million of the population is still high. If you look at the table below, you will see that all the blue cells are above 50. As a first option, we would want all of them to be pink (below 50), but ideally, they should all be white (below 10) which would then indicate that the pandemic is under control, although I don’t see this happening soon. The last time that the country as a whole had less than 10 new cases per million per day, was on 12 May 2020.

For the past two weeks, the case fatality rate (CFR) in the country has been moving upwards again, after it started to drop from its all-time high of 3.44% on 30 April. It is now 2.97% which means that, out of every 100 people who are tested positive for COVID-19, three will die. However, this is the figure over the entire period from when the first cases were reported in South Africa. For the past week only, the CFR was 3.01%.

The positivity rate of tests is now 13.8%, down from 16.84% last week. This is an indication of the percentage of tests done that have a positive outcome. This should be below 10% or even better, below 5%. Since 30 April this year, this percentage was constantly over 5% with the highest on 11 July at 29.48%.

More than 7 million people in South Africa are now fully vaccinated, either with the single-dose J&J vaccine or the double dose Pfizer vaccine. Last week the country had just passed the 13.1 million mark and as of today, 14.4 million doses have been administered.

Looking at the number of people in hospitals and ICU in South Africa, we see that the number of people in hospitals went down to 11,027 (last week the number was 12,320) while those in ICU decreased to 1,692 (compared to 1,821 last week). Of those hospitalised, 967 are currently on ventilation (1,029 last week).

Yesterday there was a vaccination rally at the University of Stellenbosch. I smiled as I read some of the messages on their neatly printed boards which fits in well with the academic atmosphere of a university. The messages all started with (hashtag)Fact, followed by messages such as:

  • The vaccines don’t cause COVID-19 and don’t contain a complete form of the virus
  • The COVID-19 vaccines does not modify your DNA
  • COVID-19 vaccines offer one of our best chances for a life without lockdowns, social isolation, and other interruptions
  • Already vaccinated? Become a vaccine champion

Kudos to the staff and students of the University of Stellenbosch for taking part in this rally. I’ll share a photo from the rally below.

A friend of mine asked me last week whether the vaccine is safe for pregnant women. I assured her that it is safe, but this was confirmed by even more research by Jaleesa Baulkman which was published this past week in a medical journal. The title is, “More Reassuring Data on COVID-19 Vaccines and Pregnancy.” If this is something which you may be wondering about, you can read the full article here:
https://www.webmd.com/…/more-reassuring-data-covid…

What can we hope for during this coming week? Firstly it would be good to see the Free State’s death rate start moving downwards. They have now been in their third wave for a total of 149 days (just two days short of Northern Cape) with more mortalities reported than in the first two waves combined. There is a possibility that both Mpumalanga and North-West may move out of their third waves, although chances are higher that it will only happen in two week’s time. Unfortunately, the vaccination programme is still not running at optimum speed. My hope is that the total number of vaccinations administered will be close to 16 million by next week.

Friday, September 10, 2021 Posted by | COVID-19 | Leave a comment

COVID-19: (Smaller countries) – 2021/09/09

Last week I remarked that there is a significant increase in COVID cases among younger people as opposed to the earlier days of the pandemic when it seemed that the virus mostly affected older people. Yesterday I read the latest update from Dr Emily Smith an epidemiologist in the USA who reported that 250,000 children in the USA tested positive for COVID-19 last week, which equates to approximately 15% of all cases. Since the beginning of July paediatric hospitalisations rose by 600%. Although the death rate among younger people is not as high as among the elderly, the effects of long COVID (Post COVID-19 syndrome) among younger people still needs to be determined. You can read this article here:
https://emilysmith.substack.com/…/250000-children…

Among the smaller countries, six have a higher infection rate than a week ago, although in all of these countries the increase is relatively small, although Ukraine had 450 more cases per day than a week ago and Canada also reported 370 more cases per day. The rise in the death rates in four of the countries is also relatively small. Argentina is the only country with more than 100 mortalities per day (137), followed by Spain with 96 mortalities on average. Poland now has less than 10 new cases per day per million of the population (9.7) which seems to be the number which a country should aim at to say that the pandemic is under control. By the way, the only other countries on my list where this is the case are all situated in southern Africa (Zimbabwe, Mozambique, Zambia, Angola, Malawi and Lesotho), but whether these numbers are accurate still remains to be seen, especially as neighbouring Botswana has one of the highest numbers of infections per million in the world (319), with only the USA and the UK exceeding this number.

Thursday, September 9, 2021 Posted by | COVID-19 | Leave a comment

COVID-19 (Medium-sized countries) – 2021/09/08

I still regularly see posts of people claiming that we are overreacting about COVID, that they don’t believe the WHO nor the CDC and that COVID is nothing worse than a common cold. If one had not lost a friend or a relative over the past 18 months due to COVID, then I assume that one could say that COVID is nothing more than a cold, but all of us who had lost friends, colleagues or relatives to this pandemic would know that COVID is totally different from anything we have experienced up to now.

This morning friends of ours came to visit. The last time we saw them was at the end of May and shortly afterwards the couple were positively diagnosed with COVID-19. The man struggled more than his wife to recover but fortunately, both survived. A while ago I posted an update on long or chronic COVID, also known as Post Covid-19 syndrome (PCS). One of the symptoms is “brain fog”. My friend is a writer and he told me shortly after I wrote it that this describes exactly how he feels – his brain feels “foggy”. But this morning, as we enjoyed coffee and snacks, he told me that another effect that COVID had had on his life, was that he had developed diabetes. They both take good care of their health and he had never had problems with diabetes before and then, as his doctor monitored his health after recovering from COVID, he discovered that his blood sugar is out of control. I was not aware that COVID could cause diabetes and started searching for academic articles discussing Post Covid-19 syndrome (PCS) and diabetes and found that an increasing number of people are reporting the development of diabetes after they had had COVID-19. If this topic interests you, have a look at the published research done by A V Raveendran:
https://reader.elsevier.com/…/sd/pii/S1871402121002551…

Last week we saw the infection rate in the UK dropping slightly from 0.52% to 0.5%. This week the infection rate moved upwards again to 0.55%. This is attributed to the delta variant which is less sensitive than other common variants to antibodies in the blood of people who have previously been infected or vaccinated. This situation may likely worsen as schools open up soon. The high prevalence of infection is causing 40 to 50 hospitalisations per day of those under 18 and there is a strong plea made to the Department of Education in England to offer vaccines to all those older than 12 years of age and to reinstate face coverings for both students and staff in secondary schools. You can read the open letter here:
https://blogs.bmj.com/…/englands-schools-must-be-made…/

In South Africa, the infection rate has dropped once again and the average number of mortalities per day is almost 100 less than a week ago, although it is still much higher than in the UK, Italy, France and Germany. The case fatality rate in South Africa is still moving upwards and is now just under 3% (2.97%) which means that for every 100 people positively diagnosed with COVID-19, three people will die. In the UK this number is moving downwards and currently, it is standing at 1.89%, while in France it is 1.68%, and in Turkey it is 0.9%, although it is moving upwards again. Obviously, the lower this rate, the better.

Wednesday, September 8, 2021 Posted by | COVID-19 | Leave a comment

COVID-19: (Large countries) – 2021/09/07

Last week I started the post by mentioning that it is extremely difficult to predict what is going to happen in the future. While I want to start today’s update with the positive news that all the large countries (with a population of more than 100 million) have a lower infection rate than last week, I am wondering what will happen next week. Four of the countries still have more than 100 new cases per million per day (the USA is the highest at 395) and Brazil just missed the mark with 99 case per million per day. The USA and Japan still have a growth in their death rates with the USA averaging 1,452 mortalities per day. Three of these countries are also recording a growing case fatality rate: Brazil (2.79%), Russia (2.67%) and Indonesia (3.3%) which is not good.

A new variant of interest has been identified, known by the Greek symbol “mu”. It started in Colombia and it has since spread to around four dozen countries and has also been detected in 49 of the states in the USA, Nebraska being the only one where it has not been detected yet. Although it is not yet classified as a variant of concern, the variant is spreading at a higher speed than the original virus. Many articles are focussing on this variant, but if you want a summary of it, you can read it here:
https://www.nydailynews.com/…/ny-mu-variant-covid-19-us…

This morning someone brought to my attention a post from a Christian political party in South Africa claiming that 9,636 people had already died from the vaccines and almost 2 million “adverse events” had been reported after vaccination. As I’ve mentioned often before, not a single death has thus far been recorded as a direct result of a COVID vaccine. The death toll which this political party reports is obviously not the truth, which I find quite distressing as they openly declare that they stand for the truth. And regarding the “adverse events”, these are, according to the website (VigiAccess) from where they obtained the data, not confirmed in any manner, as clearly stated in a disclaimer message on the website: “Note also that this reporting (so-called spontaneous reporting) refers only to suspected causal relationships between a drug and an adverse event, without this relationship being proven.” What this boils down to is that, if I have a sore arm or a mild headache or feel tired after getting the vaccine, I can report it and it will be counted as an “adverse event”. If 100,000 people report a sore arm, then those 100,000 will be counted, regardless of whether it was confirmed by a doctor. Nonetheless, out of 5.5 billion vaccinations administered, 0.036% led to some form of discomfort or “adverse effect” which was reported on the website, however mild it might have been.

Perhaps the hashtags that the political party uses on their post, says it all: (hashtag)Ivermectin and (hashtag)NoVaccineDompas, and for those not familiar with the term “Dompas” – this refers to a special ID which all “non-white” people had to carry with them at all times during the early apartheid years in South Africa. In this context, it refers to the vaccination certificate given to people who had received their COVID vaccinations.

I try to refrain from arguing about the vaccines on social media (I try, although I’m not always successful in doing this). A report which I saw this morning issued by the Groote Schuur Hospital in Cape Town stated that on 6 September 2021 the hospital had 156 COVID-19 patients (of which three were vaccinated), 66 in high care or ICU (zero vaccinated) and 32 on ventilators (zero vaccinated). Why is it that this seems to me to be a no-brainer?

Tuesday, September 7, 2021 Posted by | COVID-19 | Leave a comment