Medical Oxygen Desperately Needed in Poorer Countries
At the onset of the global pandemic, wealthy countries were concerned with their lack of preparedness for a surge in patients entering hospitals with an infectious disease. The industrialized nations bought up the world's supply of masks, gowns and ventilators, leaving poorer countries in dangerously short supply, as EcoWatch reported at the time.
Now that the coronavirus is spreading rapidly through Africa, South Asia and Latin America, the shortage of medical equipment in developing countries is causing a desperate scramble for a simple life saving treatment: oxygen.
Many severe COVID patients struggle with hypoxia — radically low blood-oxygen levels — as the primary danger. Only pure oxygen in large quantities buys the time they need to recover, as was the case with Prime Minister Boris Johnson of the UK who credited the "liters and liters of oxygen" he received for saving his life. Oxygen is also used for the treatment of respiratory diseases such as pneumonia, the single largest cause of death in children worldwide, according to The Associated Press.
As EcoWatch previously noted, the entire continent of Africa, for example, has fewer than 2,000 working ventilators in public hospitals across 41 African countries, the World Health Organization says, compared with more than 170,000 in the U.S.
In Congo, only 2 percent of health care facilities have oxygen; in Tanzania, it's 8 percent, and in Bangladesh, 7 percent, according to limited surveys for USAID, as The Associated Press reported.
The rising demand for oxygen is bringing out a stark global truth: even the right to breathe depends on money, according to The Associated Press. In much of the world, oxygen is expensive and hard to get, but in Europe and North America, hospitals treat oxygen as a fundamental need, like water and electricity. It is delivered in liquid form by tanker truck and piped directly to the beds of coronavirus patients. Running short of a resource that can be pulled from the air is unfathomable.
By contrast, in Guinea, a secondhand pickup truck carries cylinders over shoddy roads from the country's one source of medical-grade oxygen, a factory from the 1950s. Outside the capital, doctors say there is no oxygen to be found at all, which leaves people literally gasping for air, according to The Associated Press.
In Peru, where the healthcare system is woefully underfunded, oxygen on the black market has a 1,000 percent markup, making it entirely unaffordable for families that desperately need it to save their loved ones, according to The Washington Post.
And yet, there's no way to know if the oxygen is legitimate. Peru is rampant with counterfeit medical equipment and treatments for the coronavirus. A scarcity of parts and maintenance means several hospitals' oxygen plants have been out of service for years. Health Minister Víctor Zamora says Peru now faces a daily shortfall of 180 tons of oxygen. He has unveiled a $28 million package to import oxygen and build new plants, and is calling on the country's Congress to criminalize hoarding and speculation on medical supplies.
"Until that happens, we don't have a way to intervene," said Zamora to The Washington Post. "The only tool we have right now is our purchasing power. Only when we buy more and become more effective in distributing this essential medicine are we going to reduce this practice."
The World Health Organization has ramped up its efforts to supply oxygen to the neediest countries, hoping to raise $250 million to increase oxygen delivery. The World Bank and the African Union are contributing to the effort, and some medical charities are seeking donations for the cause, according to The New York Times.
"Oxygen is one of the most important interventions, (but) it's in very short supply," said Dr. Tom Frieden, former director of the Centers for Disease Control and Prevention in the U.S. and current CEO of Resolve to Save Lives, as The Associated Press reported.
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By Joni Sweet
If you get a call from a number you don't recognize, don't hit decline — it might be a contact tracer calling to let you know that someone you've been near has tested positive for the coronavirus.
Interviews With Contact Tracers<p>Contact tracing is a public health strategy that involves identifying everyone who may have been in contact with a person who has the coronavirus. Contact tracers collect information and provide guidance to help contain the transmission of disease.</p><p>It's been used during outbreaks of sexually transmitted infections (STIs), Ebola, measles, and now the coronavirus that causes COVID-19.</p><p>It starts when the local department of health gets a report of a confirmed case of the coronavirus in its community and gives that person a call. The contact tracer usually provides information on how to isolate and when to get treatment, then tries to figure out who else the person may have exposed.</p><p>"We ask who they've been in contact with in the 48 hours prior to symptom onset, or 2 days before the date of their positive test if they don't have symptoms," said <a href="https://case.edu/medicine/healthintegration/people/heidi-gullett" target="_blank">Dr. Heidi Gullett</a>, associate director of the Center for Community Health Integration at the Case Western Reserve University School of Medicine and medical director of the Cuyahoga County Board of Health in Ohio.</p>
“You’ve Been Exposed”<p>After the case interview, contact tracers will get to work calling the folks who may have been exposed to the coronavirus by the person who tested positive.</p><p>"We give them recommendations about quarantining or isolating, getting tested, and what to do if they become sick. If they're not already sick, we still want them to self-quarantine so that they don't spread the disease to anyone else if they were to become sick," said Labus.</p><p>Generally, the contact tracer won't ask for additional contacts unless they happen to call someone who is sick or has a confirmed case of the virus. They will help ensure the contact has the resources they need to isolate themselves, if necessary. The contact tracer may continue to stay in touch with that person over the next 14 days.</p><p>"We follow the percentage of people that were contacts, then converted into being actual cases of the virus. It's an important marker to help us understand what kind of transmission happens in our community and how to control the virus," said Gullett.</p>
Why You Should Participate (and What Happens If You Don’t)<p>A <a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30457-6/fulltext" target="_blank">Lancet study</a> from June 16, which looked at data from more than 40,000 people, found that COVID-19 transmission could be reduced by 64 percent through isolating those who have the coronavirus, quarantining their household, and contacting the people they may have exposed.</p><p>The combination strategy was significantly more effective than mass random testing or just isolating the sick person and members of their household.</p><p>However, contact tracing is only as effective as people's willingness to participate, and a small number of people who've contracted the coronavirus or were potentially exposed are reluctant to talk.</p><p>"Contact tracers have all been hung up on, cussed at, yelled at," said Gullet.</p><p>The hesitation to talk to contact tracers often stems from concerns over privacy — a serious issue in healthcare.</p>
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By James Shulmeister
Climate Explained is a collaboration between The Conversation, Stuff and the New Zealand Science Media Centre to answer your questions about climate change.
If you have a question you'd like an expert to answer, please send it to firstname.lastname@example.org
What was the climate and sea level like at times in Earth’s history when carbon dioxide in the atmosphere was at 400ppm?<p>The last time global carbon dioxide levels were consistently at or above 400 parts per million (ppm) was around <a href="https://www.nature.com/articles/nature14145" target="_blank">four million years ago</a> during a geological period known as the <a href="http://www.geologypage.com/2014/05/pliocene-epoch.html" target="_blank">Pliocene Era</a> (between 5.3 million and 2.6 million years ago). The world was about 3℃ warmer and sea levels were higher than today.</p><p>We know how much carbon dioxide the atmosphere contained in the past by studying ice cores from Greenland and Antarctica. As compacted snow gradually changes to ice, it traps air in bubbles that contain <a href="https://www.cambridge.org/core/journals/annals-of-glaciology/article/enclosure-of-air-during-metamorphosis-of-dry-firn-to-ice/09D9C60A8DA412D16645E6E6ABC1892F" target="_blank">samples of the atmosphere at the time</a>. We can sample ice cores to reconstruct past concentrations of carbon dioxide, but this record only takes us back about a million years.</p><p>Beyond a million years, we don't have any direct measurements of the composition of ancient atmospheres, but we can use several methods to estimate past levels of carbon dioxide. One method uses the relationship between plant pores, known as stomata, that regulate gas exchange in and out of the plant. The density of these stomata is <a href="https://journals.sagepub.com/doi/abs/10.1177/095968369200200109" target="_blank">related to atmospheric carbon dioxide</a>, and fossil plants are a good indicator of concentrations in the past.</p><p>Another technique is to examine sediment cores from the ocean floor. The sediments build up year after year as the bodies and shells of dead plankton and other organisms rain down on the seafloor. We can use isotopes (chemically identical atoms that differ only in atomic weight) of boron taken from the shells of the dead plankton to reconstruct changes in the acidity of seawater. From this we can work out the level of carbon dioxide in the ocean.</p><p>The data from four-million-year-old sediments suggest that <a href="https://agupubs.onlinelibrary.wiley.com/doi/full/10.1029/2010PA002055" target="_blank">carbon dioxide was at 400ppm back then</a>.</p>
Sea Levels and Changes in Antarctica<p>During colder periods in Earth's history, ice caps and glaciers grow and sea levels drop. In the recent geological past, during the most recent ice age about 20,000 years ago, sea levels were at least <a href="https://science.sciencemag.org/content/292/5517/679.abstract" target="_blank">120 meters lower</a> than they are today.</p><p><span></span>Sea-level changes are calculated from changes in isotopes of oxygen in the shells of marine organisms. For the Pliocene Era, <a href="https://agupubs.onlinelibrary.wiley.com/doi/full/10.1029/2004PA001071" target="_blank">research</a> shows the sea-level change between cooler and warmer periods was around 30-40 meters and sea level was higher than today. Also during the Pliocene, we know the West Antarctic Ice Sheet was <a href="https://www.nature.com/articles/nature07867" target="_blank">significantly smaller</a> and global average temperatures were about 3℃ warmer than today. Summer temperatures in high northern latitudes were up to 14℃ warmer.</p><p>This may seem like a lot but modern observations show strong <a href="https://journals.ametsoc.org/jcli/article/23/14/3888/32547" target="_blank">polar amplification</a> of warming: a 1℃ increase at the equator may raise temperatures at the poles by 6-7℃. It is one of the reasons why Arctic sea ice is disappearing.</p>
Impacts in New Zealand and Australia<p>In the Australian region, there was no Great Barrier Reef, but there may have been <a href="https://link.springer.com/content/pdf/10.1007/BF02537376.pdf" target="_blank">smaller reefs along the northeast coast of Australia</a>. For New Zealand, the partial melting of the West Antarctic Ice Sheet is probably the most critical point.</p><p>One of the key features of New Zealand's current climate is that Antarctica is cut off from global circulation during the winter because of the big <a href="https://www.tandfonline.com/doi/abs/10.3402/tellusa.v54i5.12161" target="_blank">temperature contrast</a> between Antarctica and the Southern Ocean. When it comes back into circulation in springtime, New Zealand gets strong storms. Stormier winters and significantly warmer summers were likely in the mid-Pliocene because of a weaker polar vortex and a warmer Antarctica.</p><p>It will take more than a few years or decades of carbon dioxide concentrations at 400ppm to trigger a significant shrinking of the West Antarctic Ice Sheet. But recent studies show that <a href="http://nora.nerc.ac.uk/id/eprint/521027/" target="_blank">West Antarctica is already melting</a>.</p><p>Sea-level rise from a partial melting of West Antarctica could easily exceed a meter or more by 2100. In fact, if the whole of the West Antarctic melted it could <a href="http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.695.7239&rep=rep1&type=pdf" target="_blank">raise sea levels by about 3.5 meters</a>. Even smaller increases raise the risk of <a href="https://www.pce.parliament.nz/publications/preparing-new-zealand-for-rising-seas-certainty-and-uncertainty" target="_blank">flooding in low-lying cities</a> including Auckland, Christchurch and Wellington.</p>
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