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Decline in green energy spending might offset COVID-era emissions benefits

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The short-term environmental benefits of the COVID-19 crisis, including declines in carbon emissions and local air pollution, have been documented since the early days of the crisis. This silver lining to the global crisis, however, could be far outweighed by the long-term impacts on clean energy innovation, a new Yale-led study finds.

The economic downturn triggered by the pandemic, researchers say, could have a devastating impact on long-term investment in clean energy.

Under a worst-case — but realistic — scenario, they predict an additional 2,500 million metric tons of carbon dioxide — or the equivalent of nearly 3 trillion pounds of coal burned — could be emitted, causing 40 more deaths per month, through 2035.

“This global crisis will certainly defer investments in clean energy,” said Kenneth Gillingham, an associate professor of environmental and energy economics at the Yale School of Forestry & Environmental Studies (F&ES) and lead author of the paper. “Depending on how policymakers respond, the consequences for human health from this deferred investment could far exceed the short-term environmental benefits that we have seen so far.”

Those short-term benefits have been substantial. Consumption for jet fuel and gasoline, for example, declined by 50 and 30 percent, respectively, from early March to June 7, while electricity demand fell by 10 percent. These impacts saved an estimated 200 lives per month since the lockdowns began.

However, there’s also been another, subtler outcome: most investment in clean energy technologies has come to a halt.

“Overall clean energy jobs dropped by almost 600,000 by the end of April, as investments in energy efficiency and renewable generation have plummeted,” said Marten Ovaere, a postdoctoral researcher at F&ES and co-author of the paper. “If that were to continue it could significantly set back the push toward a clean energy future.”

The paper, published in the journal Joule, was coauthored by researchers at MIT Sloan School of Management and Northwestern University.

Drawing on evidence from previous economic shocks, the researchers examine two possible long-term scenarios in the U.S. In the best-case scenario — in which the threat subsides relatively quickly, the worst projections of human fatalities are avoided, and the economy rebounds — they say there should be few long-term implications. Most demands for products and services, they predict, “will be deferred rather than destroyed.” While record declines in emissions would be temporary, investments in new energy solutions would likely reach pre-pandemic levels.

If there is a persistent, long-term recession, however, the impacts on energy innovation would be significant. While energy use related to travel might remain lower, home energy consumption would increase and commercial building use would stay largely unchanged, particularly if office spaces are used in a similar way (even if more American workers decide to work from home). Also, if the public becomes cautious about using public transportation, many commuters will simply decide to drive instead.

The greater impact, however, would be on the energy innovation sector, the study says. Investment in low-carbon technologies would dry up, the transition to cleaner vehicle fleets would be disrupted, and cash-strapped automakers would abandon new vehicle and energy efficiency technologies.

“For example, there has been a huge amount of investment going into electric vehicles,” Gillingham says. “But if companies are just trying to survive, it’s much less likely that they can make large investments towards new technologies for the next generation because they don’t even know if they’re going to make it to the next generation.”

In addition, tighter state and local budgets over the next few years will likely deflate much of the investment in clean-energy options.

Even if green energy investments stall for just a single year, the authors calculate, it would outweigh any emissions reductions that occurred from March to June.

However, while the uncertainty of this crisis poses potentially enormous threats, it also presents an opportunity, Gillingham says. If federal governments produce large stimulus packages to strengthen the economy, even modest investments in clean energy technologies would pay long-term dividends.

“Including a green component in those stimulus packages would be an investment in the future, but it also has short-term benefits,” he says. “We looked back at analyses of the clean energy investments that were part of the American Recovery and Reinvestment Act of 2009 — which promoted new energy infrastructure, smart meters, and other new technologies — and it made a big difference.

“So it really is very much in the hands of policymakers whether green energy is held back or accelerated by this crisis.”

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Hamsters develop protective immunity to COVID-19 and are protected by convalescent sera

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In an animal model for COVID-19 that shares important features of human disease, scientists at the University of Wisconsin-Madison, the University of Tokyo and the Icahn School of Medicine at Mount Sinai show that prior infection with the SARS-CoV-2 virus provides protection against reinfection, and treatment with convalescent serum limits virus replication in their lungs.

Syrian hamsters, commonly found as pets, have served critical roles in understanding human infectious diseases for decades. The new study, led by Yoshihiro Kawaoka and published today (June 22, 2020) in the Proceedings of the National Academy of Sciences, demonstrates they are also a useful small animal model for researchers trying to understand SARS-CoV-2 and in evaluating vaccines, treatments and drugs against the disease it causes.

“Hamsters are good models for human influenza and SARS-CoV,” says Kawaoka, professor of pathobiological sciences at the UW School of Veterinary Medicine and a virology professor at the University of Tokyo. “This is why we decided to study them with COVID-19. We wanted to see if the disease course is similar to humans in these animals from beginning to end.”

A study led by scientists at the University of Hong Kong, published in late March, also showed Syrian hamsters to be a good model for COVID-19-related research. In that study, the hamsters lost weight, became lethargic, and developed other outward signs of illness.

Kawaoka’s group extended this work further, demonstrating that both low and high doses of the virus, from patient samples collected in the U.S. and Japan, replicate well in the airways of juvenile hamsters (1 month old) and adults (7 to 8 months old). The virus can also infect both the upper and lower respiratory tracts.

The research team also showed that SARS-CoV-2 causes severe disease in the lungs of infected animals. This includes lesions and the kind of “ground glass” appearance often found in lung scans in human patients. Scans also revealed a region of gas in the cavity surrounding the hamster’s lungs, indicating severe lung damage. Researchers observed the most severe effects within eight days after infection, and improvement by 10 days.

“Hamsters infected with SARS-CoV-2 share CT imaging characteristics with human COVID-19 disease,” says Samantha Loeber, a veterinarian and radiologist at UW Veterinary Care.

By day 10 following infection, the researchers no longer detected virus in the organs of most of the hamsters, but lung damage persisted for 14 days in a majority of the animals, and for at least 20 days in most of those infected with a high dose.

Overall, the researchers were able to detect virus in all of the respiratory organs of the infected hamsters within six days of infection, and also from samples collected from their brains, though these also contained portions of the olfactory bulb, which is involved in smell and may have been the source of virus in these samples. The initial dose of the virus did not affect how much of the virus researchers ultimately found in the hamster’s organs.

The researchers also looked for but did not detect virus in the kidneys, the small intestine, the colon or in blood.

To determine whether hamsters developed antibodies against SARS-CoV-2 that protected them from reinfection, the researchers administered another round of the virus to a number of the same animals about three weeks following initial infection and were unable to detect virus in their respiratory tracts. They did find virus in the airways of control animals not previously infected.

“The animals all possessed antibodies and did not get sick again, which suggests they developed protective immunity,” says Pete Halfmann, a research professor in Kawaoka’s U.S. lab. “But we still can’t say how long this protection lasts.”

In early April, researchers across the U.S., including at the UW School of Medicine and Public Health and UW Health, initiated a clinical trial to examine whether the antibody-bearing component of blood — the plasma or sera — from recovered COVID-19 patients could be given to sick patients to assist in their recovery. While convalescent plasma has been used in other disease outbreaks, it remains poorly understood as a treatment.

So, Kawaoka’s team extracted convalescent sera from previously sick hamsters and then pooled it together. They infected new hamsters with SARS-CoV-2 and then gave them this antibody-laden sera either one day or two days following infection.

The hamsters that received treatment within a day of infection had much lower amounts of infectious virus in their nasal passages and lungs than those given a mock treatment. Those that received sera on day two showed a less appreciable benefit, though they still had lower levels of virus in their respiratory organs compared to control animals.

A study published just last week in Science showed that transfer of human antibodies to hamsters may also help protect the animals from severe illness from SARS-CoV-2 infection.

“This shows us that convalescent sera, still experimental in human patients, may be part of an effective treatment for COVID-19,” Kawaoka adds.

Finally, the research team also obtained the first images of the internal features of the SARS-CoV-2 virus that aid its ability to replicate, or make copies of itself, in host cells. This, Kawaoka says, warrants further study.

The study was supported by the Japan Research Program on Emerging and Re-emerging Infectious Diseases, the Japan Project Promoting Support for Drug Discovery, the Japan Initiative for Global Research Network on Infectious Diseases, the Japan Agency for Medical Research and Development Program for Infectious Diseases Research and Infrastructure, and the U.S. National Institutes of Allergy and Infectious Diseases.

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Fluorocarbon bonds are no match for light-powered nanocatalyst

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Rice University engineers have created a light-powered catalyst that can break the strong chemical bonds in fluorocarbons, a group of synthetic materials that includes persistent environmental pollutants.

In a study published this month in Nature Catalysis, Rice nanophotonics pioneer Naomi Halas and collaborators at the University of California, Santa Barbara (UCSB) and Princeton University showed that tiny spheres of aluminum dotted with specks of palladium could break carbon-fluorine (C-F) bonds via a catalytic process known as hydrodefluorination in which a fluorine atom is replaced by an atom of hydrogen.

The strength and stability of C-F bonds are behind some of the 20th century’s most recognizable chemical brands, including Teflon, Freon and Scotchgard. But the strength of those bonds can be problematic when fluorocarbons get into the air, soil and water. Chlorofluorocarbons, or CFCs, for example, were banned by international treaty in the 1980s after they were found to be destroying Earth’s protective ozone layer, and other fluorocarbons were on the list of “forever chemicals” targeted by a 2001 treaty.

“The hardest part about remediating any of the fluorine-containing compounds is breaking the C-F bond; it requires a lot of energy,” said Halas, an engineer and chemist whose Laboratory for Nanophotonics (LANP) specializes in creating and studying nanoparticles that interact with light.

Over the past five years, Halas and colleagues have pioneered methods for making “antenna-reactor” catalysts that spur or speed up chemical reactions. While catalysts are widely used in industry, they are typically used in energy-intensive processes that require high temperature, high pressure or both. For example, a mesh of catalytic material is inserted into a high-pressure vessel at a chemical plant, and natural gas or another fossil fuel is burned to heat the gas or liquid that’s flowed through the mesh. LANP’s antenna-reactors dramatically improve energy efficiency by capturing light energy and inserting it directly at the point of the catalytic reaction.

In the Nature Catalysis study, the energy-capturing antenna is an aluminum particle smaller than a living cell, and the reactors are islands of palladium scattered across the aluminum surface. The energy-saving feature of antenna-reactor catalysts is perhaps best illustrated by another of Halas’ previous successes: solar steam. In 2012, her team showed its energy-harvesting particles could instantly vaporize water molecules near their surface, meaning Halas and colleagues could make steam without boiling water. To drive home the point, they showed they could make steam from ice-cold water.

The antenna-reactor catalyst design allows Halas’ team to mix and match metals that are best suited for capturing light and catalyzing reactions in a particular context. The work is part of the green chemistry movement toward cleaner, more efficient chemical processes, and LANP has previously demonstrated catalysts for producing ethylene and syngas and for splitting ammonia to produce hydrogen fuel.

Study lead author Hossein Robatjazi, a Beckman Postdoctoral Fellow at UCSB who earned his Ph.D. from Rice in 2019, conducted the bulk of the research during his graduate studies in Halas’ lab. He said the project also shows the importance of interdisciplinary collaboration.

“I finished the experiments last year, but our experimental results had some interesting features, changes to the reaction kinetics under illumination, that raised an important but interesting question: What role does light play to promote the C-F breaking chemistry?” he said.

The answers came after Robatjazi arrived for his postdoctoral experience at UCSB. He was tasked with developing a microkinetics model, and a combination of insights from the model and from theoretical calculations performed by collaborators at Princeton helped explain the puzzling results.

“With this model, we used the perspective from surface science in traditional catalysis to uniquely link the experimental results to changes to the reaction pathway and reactivity under the light,” he said.

The demonstration experiments on fluoromethane could be just the beginning for the C-F breaking catalyst.

“This general reaction may be useful for remediating many other types of fluorinated molecules,” Halas said.

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Materials provided by Rice University. Note: Content may be edited for style and length.

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Overcoming Phony Politeness

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You may think of maintaining your boundaries as something you need to do to protect yourself, but practicing good boundary management for yourself can actually serve the people around you very well too.

Your boundaries define what you’re willing to allow into your life. You decide the types of people you’ll associate with and to what extent. You decide what types of behaviors you’ll allow and what’s off limits for you.

One guy I know has a clear boundary around whining. He doesn’t tolerate people whining in his presence. He advertises this boundary openly, so the people around him know this. Yes, he maintains this boundary for his own needs, but also consider how it serves others. People in his life will whine less when they’re around him, so they’ll likely spend less time whining overall. The “no whining” rule helps to redirect their energy away from a pointless bad habit.

Many people consider smoking in their presence to be a boundary issue. The more people who establish and maintain this boundary, the less encouragement there is for the horrendously bad habit of smoking. Does being tolerant of smoking actually do smokers as much service as being intolerant of it? Tolerating such a bad habit only invites more of it.

A lot of people are unwilling to maintain in-person relationships with smokers, so smokers will see their social opportunities shrink. Many people will avoid hanging out with smokers, especially for health reasons. Even those who smoke outside and come back inside smelling like ashtrays will incur a negative social hit. Being near someone who smells toxic is repulsive to many people.

It’s hard to imagine a mature, functional adult who doesn’t practice good boundary management to ward off other people’s unwanted behaviors. But a lot of people also resist maintaining good boundaries for the sake of politeness. Consider, however, that excessive politeness may simply encourage the unwanted behavior. If you try to be overly polite instead of firm, you’ll invite and incur more boundary violations.

You don’t get what you want here. You get what you’re willing to tolerate.

When I was in a phase of my life where I did a lot of destructive and illegal stuff, I really didn’t lose friends over it. My friends may have lost some respect for me, but they still hung out with me, shared meals together, and invited me to their all-night poker games just the same. What they didn’t realize is that by being so accepting and tolerant of my illegal activities (like shoplifting and other crazy stunts), they were granting silent approval of my bad habits. They didn’t actually help me in the ways I most needed help.

It would have been better if my friends had maintained stronger ethical boundaries regarding my behavior and cut me off socially while I engaged in those behaviors. I think that would have gotten my attention and helped me straighten out sooner than I did. I respected my friends and the relationships I had with them, and I wouldn’t have wanted to threaten that. It would have been hard for me to deal with being ostracized, but if I had to choose between doing crazy illegal stuff and maintaining my existing friendships, I think I would have chosen to preserve the friendships. I think that type of social pressure would have been healthy for me. Sure it would have been nice if I didn’t need it, but what was the alternative? I had to be straightened out by multiple court appearances instead.

Even if my other option was to continue doing illegal stuff and to lie about it, that would have damaged my friendships too. I’d have to sink even more to continue the bad habits. And I’d know that if my friends discovered the truth, I’d be in for more social problems. I think that threat to my social life would have also had a beneficial effect. Of course this depends on how much leverage there is in those relationships.

Some friends did try to talk some sense into me, but they were so gentle and polite about it, and there were no real social consequences for noncompliance on my part, so it really had no effect. I just replied with sarcasm or joked around with them in response.

While I agree that it’s nice to allow people social freedoms, I think this approach has its limits and ought to be balanced with some firm encouragement to develop better self-control. At some point when a person is engaging in destructive behavior, it may be wise to escalate to a stronger social consequence.

This is how many human tribes resolved differences before we developed more complex state-based societies. Negative behaviors were often socially punished. And dispute resolution was based on preserving and restoring healthy community relationships, not primarily on achieving justice.

In yesterday’s post about Trump supporters, I did my best to make it clear that people who support this loser will incur a social consequence from me. I’m just one person doing this, but if more people joined in, perhaps we could really shift something here and help people abandon this foolish and destructive behavior pattern.

While some people feel it’s best to keep communication channels open and try to be polite, I think that’s too weak of a position, especially with respect to the disease of Trumpism. and it will just enable and encourage more idiotic behavior. “Let’s be polite and civil about this” is the same attitude that enables racism to continue. At some point when a problem has festered long enough, it’s time to establish some firmer consequences. When the consequences become strong enough, it really does change people’s behaviors.

Don’t you feel that certain negative behaviors are much riskier today than they were 10-20 years ago? Why? Because the social consequences of some of those behaviors are even higher today than they used to be.

To raise our collective social standards, we must be firmer with boundary management as individuals.

Consider that being firm and resolute in your boundary management may be a lot more beneficial for others than being so polite and gentle. When you’re leaning towards gentleness, consider why you’re doing that. Is it really the best course of action for the other person in the long run? Or are you really just trying to avoid a conflict that you’d rather not deal with?

Politeness and gentleness are good values when your boundaries aren’t being violated. If you want to preserve the status quo, go ahead and favor politeness in your interactions. I for one think the status quo in the USA right now is pretty fucking far from okay, as do many people I know. I like that we’ve opened a gateway where honesty and firmness are becoming more important than politeness and gentleness. Yes, there’s a lot of anger coming out too – the result of too much phony politeness for too long. I find the emotional honesty coming out of people these days to be refreshing.

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Health24.com | Looking for ways to protect against pandemic PTSD

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  • One of the results of the coronavirus pandemic may be a mental health pandemic
  • We should expect mental health problems like depression, anxiety, substance abuse and an increase in suicide
  • To cope with this psychological aftermath, doctors need better training in how to treat addiction, depression, PTSD and grief

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As many places start to look forward to life after the first wave of the coronavirus, another type of illness could be about to follow in its wake.

“We’re going to have many more mental health issues as time goes on,” said Dr Rima Styra, a psychiatrist at Toronto’s University Health Network and associate professor of psychiatry at the University of Toronto. “And people will refer to it as a mental health pandemic.”

US crisis centres already report being flooded with calls. The Well Being Trust, a foundation that focuses on mental health issues, predicts the pandemic could cause 75 000 “deaths of despair” from suicide or addiction.

Not everyone will have a problem, experts say. And there are ways for everyone to support people at risk.

Post-traumatic stress 

But the past offers a warning. After the 2003 epidemic of SARS, or severe acute respiratory syndrome, studies in Hong Kong found 40% of the survivors had post-traumatic stress symptoms.

Styra was co-author of a study of 129 people quarantined in Toronto because of SARS. About 30% showed symptoms of post-traumatic stress disorder and depression. More time in quarantine was associated with more symptoms.

Yuval Neria, director of the PTSD programme at the New York State Psychiatric Institute, said we’re in uncharted territory in terms of predicting the current pandemic’s effects.

“I don’t think the mental health consequences will be limited to PTSD only,” said Neria, who also is a professor in the department of psychiatry and epidemiology at Columbia University Medical Center in New York City. “In fact, I think we should expect other mental health problems, such as depression, anxiety, substance abuse and potentially increase in suicide. They are already there and kind of showing themselves.”

Workers “who continue to serve us while we self-isolate at home” could be at particular risk. But, he said, “there is so much to learn here. It’s a big unknown, and we badly need good research.”

For example, he said, “Being isolated for a long time, without social support, is very unique to this pandemic on a global scale.” As is the wave of grief that will follow tens of thousands of deaths.

Ambiguous threat

Neria, a combat veteran whose own experiences with war trauma guided his decision to research the topic, has studied how PTSD follows wars, natural disasters and events such as 9/11. The pandemic is like and unlike those.

“Disasters are usually limited to space and time. And there is an onset of a disaster – which may take some time – but there is an end,” he said. “But I think viruses have their own way to inflict adversities on us. The threat is ambiguous. [It] is everywhere and nowhere. It’s ongoing. It may take a long time.”

Anxiety alone doesn’t lead to PTSD. It is sparked by a trauma – a direct threat to life, such as an assault, exposure to war, or being treated in an intensive care unit. Symptoms may include flashbacks, nightmares and becoming hypervigilant or emotionally numb.

Neria said the crisis highlights the need to upgrade the entire mental health system. In particular, he said, doctors need better training in how to treat addiction, depression, PTSD and grief.

And while not everyone who experiences trauma gets PTSD, Neria said those at risk now are people who have high chances of being exposed to the virus, “especially frontline health care workers, first responders and Covid patients coming out of ventilators and ICUs.”

Dr Laura Hawryluck, lead author of the Toronto SARS study, understands the stresses too well. Like Styra, she treated patients during the SARS outbreak. Then as now, patients had to be isolated.

A mental health crisis

“And the thought of somebody who is desperately ill not having the support of people they love and not having those people around until perhaps the last moments of their lives is very hard emotionally on the health care team.”

Covid-19 has brought more death in less time. Healthcare workers also must worry about protective gear and other vital supplies running out.
On top of that, Styra said, they worry about exposing loved ones to the virus as they continue to deal with aspects of everyday life made harder by the pandemic, from getting groceries to finding child care.

She said anyone with symptoms of a mental health crisis – high levels of anxiety, feeling tearful, having trouble sleeping – should seek help. (The Department of Veterans Affairs offers PTSD-related advice at ptsd.va.gov, as does the National Alliance on Mental Illness at nami.org.) Family members should keep an eye on loved ones as well, Styra said, and encourage them to seek aid if they need it.

Hawryluck encourages health care workers to try to maintain self-awareness and a support network. She also encourages them to seek help if they feel they are not able to cope.

“There’s been a lot more support for healthcare workers and frontline workers and being called heroes and stuff like this” compared with SARS, said Hawryluck, an associate professor of critical care medicine at University Health Network/University of Toronto.

“We aren’t used to this overwhelming support, and it means more than we can ever express.”

Image credit: iStock

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Coronavirus: Brazil becomes second country to pass 50,000 deaths

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Growing political unrest adds to Brazil’s woes, days after confirming over a million Covid-19 cases.

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Coronavirus: Children ‘developing post-traumatic stress’ from pandemic

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A report from the Childhood Trust warns of a mental health crisis among disadvantaged children.

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‘Do it at home’ coronavirus saliva test trialled

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More than 14,000 key workers in the UK will try out the ‘no swab’ test that can spot new infections.

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Health24.com | OPINION | Healthcare worker Covid-19 infections: hoping for the best but prepared for the worst

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  • As the coronavirus pandemic gains momentum in South Africa, healthcare workers will be increasingly exposed to Covid-19 
  • In many countries, however, healthcare staff infection rates dropped significantly as the pandemic progressed
  • Like in the rest of the world, comprehensive safety measures are being implemented locally to protect healthcare workers and patients

On 3 June, the International Council of Nurses (ICN) implored governments to compile data on healthcare worker (HCW) Covid-19 infections and deaths.

As yet there is no global registry to track the pandemic’s impact on HCWs, although it has infected an estimated 230 000 and led to the deaths of 600 nurses. Analysis by the ICN suggests that on average, 7% of all Covid-19 cases worldwide occur among HCWs. Notable exceptions include some high-income countries (USA, Spain and Ireland) where HCWs account for 15–30% of all infections. 

Staff infection rates decline

There is a clear need to collect standardised epidemiological data on HCW infections to identify risk factors for Covid-19 infections and deaths, with few published studies to date. A single hospital study of 9 000 HCWs in Wuhan identified a 1% staff infection rate, mainly affecting female nurses under 45 years of age with mild disease. The risk of infection was highest in Covid-19 low-risk areas of the hospital, suggesting a lack of awareness among these HCW.

Staff infection rates declined rapidly as the outbreak progressed, possibly owing to enhanced HCW training, preparedness and compliance with infection prevention measures. In a study from two Dutch hospitals early in the pandemic, less than 1% of 9 705 HCWs became infected. The infected staff worked in 52 different hospital departments, suggesting infection acquisition in the community rather than as part of a hospital outbreak.

South African  HCWs have not been spared, with 511 HCW infections accounting for 7% of cases nationally by 6 May 2020.(4) As the outbreak gathers pace, our HCWs will be increasingly exposed to Covid-19 in the workplace, on public transport and in communities.

Many will fall ill, although a large proportion will remain asymptomatic, and at risk of unknowingly transmitting infection to others (rates of asymptomatic disease range from 10-80%). In common with the country’s population, many HCWs are at risk for severe Covid-19 disease due to underlying conditions such as hypertension, diabetes, HIV or obesity. 

As Covid-19 infections accelerate, HCW absences due to illness and death will exacerbate pre-existing staff shortages. Even among HCWs who remain healthy, Covid-19 will contribute to chronic fatigue, psychological distress, and potential burnout.

Community-acquired infections

These negative direct and indirect effects of Covid-19 are already being experienced in many Cape Town hospitals, with staff fearing for their own safety and that of their patients, colleagues and family members. Numbers of HCW infections and deaths have risen in tandem with increasing community infection rates, prompting labour unions to demand an investigation of HCW safety in public hospitals. 

In the Cape Metro’s largest facility (Tygerberg Hospital), approximately 6% of staff were diagnosed with Covid-19 infection between 1 April and 31 May (296/4 672 staff members). It is not possible to  establish definitively whether these infections were acquired in the community, on public transport or in the workplace.

Similar to the Dutch Covid-19 HCW infection study, HCW infections at Tygerberg Hospital have occurred in over 50 different areas and wards, suggesting that a substantial proportion may be community-acquired rather than healthcare-associated. Indeed, three-quarters of staff diagnosed with Covid-19 infection work in non-clinical areas and Covid low-risk wards (where contact with Covid-infected patients would be absent or minimal), strengthening the likelihood that these infections were not acquired through clinical or patient contact. 

It is unclear why the Western Cape and South African HCW Covid-19 infection rates are much higher than that reported from the Wuhan and Dutch hospitals. However, local HCW infection rates are in keeping with the global estimates suggested by ICN and could reflect high Covid-19 exposure in the community, as well as a need to further strengthen infection prevention practices in communities and healthcare settings. 

Multiple safety measures

Given the delayed Covid-19 introduction to South Africa and the flattening of the outbreak curve achieved by the national lockdown, our healthcare facilities, fortunately, had more time to prepare than many countries.

At Tygerberg Hospital, a co-ordinated infection prevention and occupational health plan was enacted to mitigate the risk of Covid-19 infection transmission to staff and patients. Multiple measures were implemented to support staff and patient safety including: 

  • A Covid-19 risk assessment per department with identification of high-risk staff who required medical shielding by re-deployment to low-risk areas
  • Covid-19 prevention training for all categories of staff as well as daily Covid-19 educational and support messages for staff 
  • Daily Covid-19 symptom screening of all staff, patients and paediatric inpatient’s caregivers visitor restrictions
  • A universal masking policy for staff and patients and provision of hand sanitiser at all entrances and clinical areas
  • Enhanced surface and equipment cleaning and disinfection, and evaluation of symptomatic staff with priority SARS-CoV-2 testing
  • A secure supply chain for personal protective equipment (PPE) including prudent use and onsite ultraviolet decontamination of N95 respirators
  • Building of showers for staff to use after shifts and installation of extraction fans and air-handling units in ICU areas 

Notwithstanding these many active measures to enhance staff and patient safety during the Covid-19 pandemic, there remain several challenges at Tygerberg Hospital and other healthcare facilities in our country. These include ageing hospital structures with minimal provision for patient isolation, inadequate bed spacing, lack of dedicated space for donning and removal of PPE and low staff to patient ratios, particularly for nurses and cleaners.

Despite the many challenges and the fraught working conditions, South Africa’s HCWs consistently demonstrate their optimism, tenacity and willingness to adapt to and overcome obstacles. It is this resilience that gives HCWs, including those at Tygerberg Hospital, faith to hope for the best while at the same time preparing for the worst that Covid-19 may bring. 

*Angela Dramowski is a Professor in Department of Paediatrics and Child Health at Stellenbosch University (SU). Members of the Infection Prevention and Control, Infectious Diseases and Occupational Health teams at Tygerberg Hospital and SU contributed to this article.

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Angela Dramowski*

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Health24.com | Good news for menopausal women who take hops

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Women who take hop-based supplements to relieve symptoms of menopause needn’t fear that they will interact with other drugs, a new study suggests.

Hops are the flowers of hop plants and they give beer its bitter taste. They also contain phytoestrogens and act like female sex hormones. Some women who can’t use hormone replacement therapy find that hop supplements alleviate change-of-life complaints such as night sweats and hot flushes.

However, there’s been concern about drug interactions. “There are reports from other lab studies that compounds from hops may inhibit or deactivate certain drug-metabolising enzymes,” said study researcher Richard van Breemen, director of Oregon State University’s Linus Pauling Institute.

“There is additional concern because we know the compounds in hops have a long half-life in humans, possibly more than 20 hours after taking them,” he said in a university news release. This means these supplements remain in the bloodstream when other drugs are taken.

No relevant interactions

To see if hops interacted with other drugs, researchers worked with 16 female participants at menopausal age. They were given a cocktail of four drugs, including caffeine, alprazolam (Xanax), dextromethorphan (an over-the-counter cough medicine) and tolbutamide, used to treat type 2 diabetes.

“We did each drug trial twice. Once to see how these women metabolised the drugs normally,” van Breemen said. “Then we repeated the trial with hops after the participants took a hops extract twice daily for two weeks. Thankfully, no enzyme inhibition was detected.”

Using US Food and Drug Administration guidelines, the researchers found the hop supplement “caused no clinically relevant pharmacokinetic interactions”, said study co-author Luying Chen, a PhD student in van Breemen’s lab.

“So we can say that hop dietary supplements are not expected to produce any harmful drug interactions, at least with respect to the enzymes probed during this investigation,” Chen said in the release. “More research is needed, but these findings are good news for women who take hops for relief of menopause symptoms.”

The report was recently published in the Journal of Agricultural and Food Chemistry.

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