Month: January 2023

Posted on

Disease Outbreak News: Yellow fever – African Region (AFRO) (3 January 2023)

Outbreak at a glance

This is an update on the yellow fever situation in the WHO African Region since the last disease outbreak news was published on 2 September 2022.

From 1 January 2021 to 7 December 2022, a total of 203 confirmed and 252 probable cases with 40 deaths (Case Fatality Ratio 9%) were reported to WHO from 13 countries in the WHO African Region.

Risk factors for further yellow fever spread and amplification include low population immunity, population movements, viral transmission dynamics, and climate and environmental factors that have contributed to the spread of Aedes mosquitoes. Recent Reactive Vaccination Campaigns increase population immunity and may have contributed to reducing the risk of yellow fever spread in targeted countries, resulting in a gradual downward trend in reported confirmed cases in 2022. However, the countries remain at high risk.

Description of the outbreak

In 2022, 12 countries in the WHO African Region have reported confirmed cases of yellow fever (Cameroon, the Central African Republic, Chad, Côte d’Ivoire, the Democratic Republic of the Congo, Ghana, Kenya, Niger, Nigeria, the Republic of the Congo, Sierra Leone and Uganda). Eight of these countries are experiencing a continuation of transmission from 2021 (Cameroon, the Central African Republic, Chad, Côte d’Ivoire, the Democratic Republic of the Congo, Ghana, Nigeria, and the Republic of the Congo) and four countries are newly reporting confirmed cases (Kenya, Niger, Sierra Leone and Uganda). One country, Gabon, reported an isolated confirmed case in 2021, but no further cases were registered in 2022.

Since 2021, a total of 203 confirmed and 252 probable cases with 40 deaths and a CFR of 9% have been reported. Of these, 23 deaths have been reported among confirmed cases (CFR among confirmed cases 11%) (Table 1). The high overall CFR among confirmed cases in 2021 (17 deaths, 11%) continued in 2022 (six deaths, 12%).

The male-to-female ratio among confirmed cases is not significantly different in 2021 and 2022 (1.3 and 1.6 respectively). The most affected age group amongst confirmed cases in 2021 was 10 years and below; meanwhile, the most affected group in 2022 is 20 to 30 years old. Overall, about 71% of confirmed cases are aged 30 years and below, and children aged 10 years and below are disproportionately affected.

According to the WHO/UNICEF Estimates of National Immunization Coverage (WUENIC), in 2021 routine immunization coverage against yellow fever in the African Region for childhood vaccinations was 48%, much lower than the 80% threshold required to confer population immunity against yellow fever, indicating the presence of an underlying susceptible population at risk of yellow fever and the risk of continued transmission. Country-specific estimates of vaccination coverage for 2021 are 54% in Cameroon, 41% in the Central African Republic, 45% in Chad, 67% in the Republic of the Congo, 65% in Côte d’Ivoire, 56% in the Democratic Republic of the Congo, 64% in Gabon, 94% in Ghana, 7% in Kenya, 80% in Niger (subnational introduction limited to four counties in 2021), 63% in Nigeria and 85% in Sierra Leone. Uganda has recently rolled-out yellow fever into the Routine Immunization programme.

Increasing population immunity through past and ongoing Preventive Mass Vaccination Campaigns (PMVC) supported through the EYE Strategy, and Reactive Vaccination Campaigns (RVC) have increased population immunity rapidly in implementing countries which has contributed to reducing the risk of spread of yellow fever in targeted countries. This may contribute to the gradual downward trend in reported confirmed cases in 2022, but should be noted that there is also variation in virus transmission dynamics that are difficult to predict.

Epidemiology of Yellow fever

Yellow fever is an epidemic-prone, vaccine-preventable disease caused by an arbovirus transmitted to humans by the bites of infected Aedes and Haemagogus mosquitoes. The incubation period ranges from 3 to 6 days. Many people do not experience symptoms, but when they occur, the most common are fever, muscle pain with prominent back pain, headache, loss of appetite, and nausea or vomiting. In most cases, symptoms disappear after 3 to 4 days. A small percentage of cases progress to a toxic phase with systemic infection affecting the liver and kidneys. These individuals can have more severe symptoms of high-grade fever, abdominal pain with vomiting, jaundice and dark urine caused by acute liver and kidney failure. Bleeding can occur from the mouth, nose, eyes, or stomach. Death can occur within 7 – 10 days in about half of cases with severe symptoms.

Yellow fever is prevented by an effective vaccine, which is safe and affordable. A single dose of yellow fever vaccine is sufficient to grant sustained immunity and life-long protection against yellow fever disease. A booster dose of the vaccine is not needed. The vaccine provides effective immunity within 10 days for 80-100% of people vaccinated, and within 30 days for more than 99% of people vaccinated.

Public health response

Surveillance and Laboratory.

WHO provides support to national health authorities in conducting field investigations and determining the epidemiological classification of yellow fever cases. A total of 51 personnel from at least 10 countries have been trained to investigate confirmed or probable cases of yellow fever. Furthermore, case investigation reports were reviewed, and feedback was provided to field teams to assess disease exposure and risk of disease spread.

An innovative programme to facilitate the international shipment of yellow fever samples to regional reference laboratories, as well as laboratory testing and capacity building, has been initiated with support from the EYE Strategy. WHO is engaged in ongoing activities to support countries in the laboratory diagnosis of yellow fever, including periodic accreditation visits and capacity development.

Reactive vaccination

Since the beginning of the current outbreak (2021 to 7 December 2022), a total of 4 385 320 persons have been vaccinated in five countries: Cameroon, the Central African Republic, Chad, Ghana and Kenya, as part of the ICG-supported response. Nine ICG requests for vaccination campaigns were approved for Cameroon (one request), the Central African Republic (two requests), Chad (two requests), Ghana (two requests), Kenya (one request), and Niger (one request).

Reactive campaign conducted in Kembe Satema in the Central African Republic from 2 to 19 November 2022 had 101.7% coverage. Based on preliminary results, the campaign in Bambari, the Central African Republic, which ended on 23 November 2022, had 87.7% coverage.

Final results are pending from an ICG-supported RVC in Niger, which is anticipated to protect approximately 1.1 million people.

Preventive mass campaign vaccination

Most priority countries have conducted a PMVC against yellow fever or are in process. Gabon, Kenya, and Niger have not planned PMVCs, however, they are included in the EYE Strategy as priority countries. Approximately 50 million people are expected to be protected by PMVCs conducted in 2022.

Chad: The country has prepared an application for a PMVC to be submited in January 2023. Weekly risk analysis sessions supported by the EYE Strategy have been conducted since 18 October 2022 to inform the planning of priority areas for the PMVC.

The Republic of the Congo: PMVC for yellow fever and measles integrated vaccination was organized from 5 to 14 August 2022 in 11 out of 12 departments with a coverage of 93% for yellow fever (preliminary report). The final report of the campaign and the mandatory Post Campaign Coverage Survey (PCCS) are pending.

The Democratic Republic of the Congo: Eight provinces have organized preventive campaigns in 2021 including Bas-Uele, Equateur, Haut-Uele, Mongala, Nord-Ubangi, Sud-Ubangi, Tshopo and Tshuapa. Three provinces have been scheduled to conduct preventive campaigns from the end of November 2022 through January 2023, and include Maniema, Sankuru and Sud Kivu.

Nigeria: The country has entered its final phases of PMVCs. In 2022 alone, campaigns have been conducted in Adamawa, Borno (special approach), Enugu, Gombe, Kano and Ogun States. Bayelsa State is planned for early 2023. The country is anticipated to complete nation-wide PMVCs by 2024.

Uganda: The country introduced yellow fever vaccination into routine immunization in late October 2022. In addition, 10 of 13 million vaccine doses have been received for PMVC, the rest were expected at the end of November 2022 but have not yet been received. PMVC has been planned for late January 2023.

Prevention of International Spread and Points of Entry (PoE)

All 13 countries that reported confirmed cases have implemented requirements for proof of vaccination against yellow fever as a condition for entry. Ten countries require proof of vaccination against yellow fever for any traveller, regardless of the origin of their voyage; whereas three countries (Chad, Kenya, and Nigeria) require proof of vaccination against yellow fever for travellers arriving from countries with areas at risk for yellow fever transmission as determined by the WHO Secretariat.

WHO risk assessment

Between 26 August 2022 and 29 November 2022, there have been 22 additional confirmed cases of yellow fever reported from ten countries. However, based on retrospective classification of the cases, there were only seven new confirmed cases and one death. Countries including Burkina Faso, Senegal and Togo have reported probable cases that were subsequently discarded, indicating that there is enhanced surveillance put in place. However, there is still persistent yellow fever virus circulation, as several of the recent confirmations have been from locations with little or no underlying immunity (e.g., near urban areas in Cameroon and Uganda; areas with no history of yellow fever vaccination such as Isiolo county, Kenya) hard-to-reach and under-served populations, including children that have been disproportionately impacted.

Based on the current situation of yellow fever in the WHO African region, the risk at the regional level was re-assessed as moderate on 12 December 2022 (high in November 2021 and June 2022) due to:

1. The decrease in the number of reported cases and the increasing population immunity, since there are ongoing and recent preventive vaccination campaigns, as well as reactive campaigns that have been organized in the affected countries, with more than four million people vaccinated in five countries (Ghana, Cameroon, Chad, the Central African Republic and Kenya), and an estimated 50 million people immunized during the PMVCs in 2021-2022 (Nigeria, the Democratic Republic of the Congo, the Republic of the Congo) supported by the EYE Strategy.

2. There is ongoing yellow fever virus circulation in some high-risk areas, the most recent cases, and outbreaks are reported in areas impacted by underlying risk factors, including gaps in routine immunization, missed special populations (e.g., nomadic or pastoralists and other mobile populations), security and access challenges.

3. Most confirmed cases were reported in the last quarter of 2021, however several of the recent confirmations have been from urban areas and/or locations with little or no underlying immunity (e.g., near urban areas in Cameroon and Uganda; areas with no history of yellow fever vaccination);

4. Case classifications, and response operations remain a challenge;

5. Delays in detection and investigation; delays in the implementation of previously planned PMVC, competing outbreaks and pandemics of COVID-19 and Mpox that are attracting more attention in yellow fever-affected countries, and security constraints in affected areas (the Central African Republic, far North of Cameroon, Eastern – the Democratic Republic of the Congo, and Northern Nigeria), population movement, all present risks that could lead to new yellow fever transmission.

The overall global risk remains low, as no cases related to this current outbreak have been reported at this stage outside of the African region. However, there are favorable ecosystems for yellow fever outside the African region, especially in the neigbouring countries in the WHO Eastern Mediterranean Region. There might be challenges in surveillance and immunization capacities due to the potential onward transmission through viremic travellers and due to the presence of the competent vector, if not detected in a timely way.

The impact on public health will persist until the ongoing outbreaks are controlled, vaccination coverage is high and immunity gaps in the population are closed. The importation of cases to countries with suboptimal coverage and persisting population immunity gaps poses a high risk and may jeopardize the tremendous efforts invested to achieve elimination.

WHO advice

Transmission can be amplified in circumstances where the Aedes mosquitos (day feeder) are present in urban settings and densely populated areas causing rapid spread of the disease.

Surveillance: WHO recommends close monitoring of the situation with active cross-border coordination and information sharing, due to the possibility of cases in neighboring countries. Enhanced surveillance with investigation and laboratory testing of suspect cases is recommended.

Vaccination: Vaccination is the primary means for the prevention and control of yellow fever. Yellow fever vaccines approved by WHO are safe, highly effective, and provide life-long protection against infection.

The countries reporting yellow fever cases and outbreaks are all high-priority countries for the EYE Strategy. The EYE Strategy recommends that all high-risk countries introduce yellow fever vaccination into their routine immunization (RI) schedule for those aged 9 months (Ethiopia, South Sudan have yet to introduce it into RI). Review of the risk analysis and scope of immunization activities to protect the population could help avert the risk of future outbreaks (e.g. Kenya).

To protect populations in high-risk areas in the longer term, it is important to continue the roll-out of Preventive Mass Vaccination Campaigns (PMVCs) and bolster Routine Immunization (RI), as well as take steps to strengthen the application of International Health Regulations (IHR 2005) and bolster surveillance for rapid detection aligned to EYE objectives.

WHO recommends vaccination for all international travellers, aged 9 months and older, going to areas determined by the WHO Secretariat as at risk for yellow fever transmission and for additional areas the recommendation for vaccination of international travellers is subject to the assessment of the likelihood of exposure of each individual traveller.

Yellow fever vaccination is safe, highly effective and a single dose provides life-long protection. Yellow fever vaccination is not recommended for infants younger than 9 months, except during epidemics when the risk of yellow fever virus transmission may be very high. The risks and benefits of vaccination in this age group should be carefully considered before vaccination. The vaccine should be used with caution during pregnancy or breastfeeding. However, pregnant or breastfeeding women may be vaccinated during epidemics or if travel to a country or area with a risk of transmission is unavoidable.

According to the provisions of the International Health Regulations (IHR), any country may decide to implement the requirement for proof of vaccination against yellow fever for arriving travellers. For international travel purposes, the proof of vaccination against yellow fever is only valid if recorded in the International Certificate of Vaccination or Prophylaxis. The International Certificate of Vaccination or Prophylaxis becomes valid 10 days after vaccination against yellow fever and extends for the life of the person vaccinated with a WHO-approved vaccine. A booster dose of the yellow fever vaccine cannot be required of international travellers as a condition of entry.

Vector control: In urban centres, targeted vector control measures are also helpful to interrupt transmission. As a general precaution, WHO recommends avoidance of mosquito bites, including the use of repellents and insecticide-treated mosquito nets. The highest risk for transmission of yellow fever virus is during the day and early evening.

Risk communication: WHO encourages its Member States to take all actions necessary to keep travellers well informed of risks and preventive measures including vaccination. Travellers should be made aware of yellow fever symptoms and signs and instructed to rapidly seek medical advice if presenting signs and symptoms suggestive of yellow fever infection. Infected returning travellers may pose a risk for the establishment of local cycles of yellow fever transmission in areas where a competent vector is present.

International travel and trade: WHO advises against the application of any travel or trade restrictions to the Region.

The updated areas at-risk for yellow fever transmission and the related recommendations for vaccination of international travellers were updated by WHO on 1 July 2020; the map of revised areas at risk and yellow fever vaccination recommendations is available on the WHO International Travel and Health website.

Source: World Health Organization

Posted on

War in Ukraine Bolstered EU Solidarity-Will it Last?

Zohra stuffs packages of sliced bread, fresh fruit and canned vegetables into her shopping cart — free handouts she once never thought she would need.

Other Parisians patiently wait their turn for the Salvation Army’s weekly food distributions in the French capital: two women from Africa, a middle-aged man from the French Antilles, a young woman who looks like a student. Most are reluctant to talk. In a room nearby, volunteers prepare food packages for the charity’s swelling clientele.

“The prices for everything are rising — rent, electricity, gas telephone,” Zohra said, declining to give her last name. She lost her job at a medical clinic a few months ago. “People can’t live like this.”

Such sentiments are growing across the European Union that greets 2023 with an energy crisis and a war at the bloc’s doorstep for the first time in decades. If Russia’s invasion of Ukraine has sparked sometimes stunning displays of EU unity and power, analysts say, some question how long that will last as winter bites and the price for supporting Kyiv and European values mounts.

“It’s been transformative in so many ways — and in areas in which it’s difficult for the European Union to act quickly,” said Ian Lesser, vice president of the German Marshall Fund and head of the policy institute’s Brussels office, of the Ukraine conflict. “In some of these areas, it acted very quickly — which surprised many people.”

This past year, the EU slapped eight rounds of sanctions against Moscow, earmarked billions of dollars of military and humanitarian aid for Ukraine and took in millions of Ukrainian refugees. The war in Ukraine led Europe to end its dependency on cheap Russian energy, pushing the bloc to seek new suppliers and power sources — and to stock up on its all-important gas reserves before the cold sets in.

Still, the conflict in Ukraine has delivered a blow to Europe’s economy and energy security, at least in the short term. It also slowed, as some countries revive coal mines, Brussels’ emissions-cutting goals. The International Monetary Fund and other experts believe the bloc will fall into recession this year. Despite government efforts to cushion the blow, prices and poverty are rising.

“What really shook us is we’re seeing a lot of young people — students who are having a hard time making it to the end of the month,” said Salvation Army spokesperson Samuel Coppens. “Also, single parents and older people with tiny pensions who can’t even afford heat. For them, food is a top priority.”

A recent IFOP poll found that more than half of the French surveyed feared their income wouldn’t cover their monthly expenses. One quarter believed they would need help from charities like the Salvation Army.

“I can go shopping with 50 euros ($53) and my shopping cart is still pretty empty,” said Valerie, a health care worker from Cameroon, who signed up for the Salvation Army’s food distributions a few weeks ago.

“From the start I didn’t like this war,” she added of the Ukraine conflict. “I thought there would be consequences here. Now, I see it is hitting the poorest.”

Even as Europeans send generators to power-crippled Ukraine after Russian strikes on its energy facilities, some are bracing for possible blackouts at home. Germans are squirreling away candles, Finns who own electric cars are asked not to heat them before climbing inside.

In France, normally an electricity exporter, half the country’s nuclear fleet is offline for repairs. Authorities have urged citizens and businesses to lower their thermostats, hoping energy savings will avert possible blackouts.

“My village raised funds for Ukrainians,” said Valerie, a tourist from southern France. “But if there are electricity cuts, it will be very difficult for French and Europeans. It will really impact our daily lives and our morale.”

“At the moment, solidarity is pretty strong” among European citizens, said John Springford, deputy director for the Center for European Reform think-tank. “But if the Ukraine war turns into a complete stalemate, things might get more difficult.”

French energy expert Thierry Bros is more pessimistic, describing a Russian energy war to defeat Ukraine and unravel European unity.

“The fact we are getting less energy, the fact we are getting less rich, that the economy is turning into a recession, could lead to Ukraine fatigue,” Bros added. “European citizens will look out for themselves first.”

Divisions are already showing in other areas.

Hungarian Prime Minister Viktor Orban, with once-close ties to Russia, has suggested EU sanctions against Moscow should be scrapped, and temporarily blocked $19 billion in EU financial aid for Ukraine. The legislation ultimately passed last month.

Poland and Germany have sparred over the placement of a German Patriot missile air defense system, in what some reports suggest underscores larger differences.

EU divisions also exist over Russia’s threat and Europe’s future relationship with Moscow, analysts say. French President Emmanuel Macron’s recent suggestion that the West should consider “security guarantees” for Russia drew sharp pushback from Poland and the Baltic states.

“There is a clear understanding the fight against Russia’s invasion is a fight for their own liberty,” said Sebastien Maillard, head of the Jacques Delors Institute in Paris, describing mindsets in European countries located near Russia. “It’s very obvious for Poland, the Baltic states and the Balkans. It’s not that obvious for the western part of Europe.”

Lesser, of the German Marshall Fund, believes Europe will face another test. To date, U.S. financial and military support for Ukraine has dwarfed the EU’s.

“When it comes to reconstruction in Ukraine, including things that could be done now to support Ukrainian society even before the war ends — I think there’s going to be a much stronger push from the American side for Europe to do more, and spend more,” Lesser said. “Because it can.”

Source: Voice of America

Posted on

Trust Issues Becoming the Norm

For decades, if not longer, intelligence agencies worldwide have worried about disinformation, whether from adversaries or their own efforts to influence others.

It was persistent, and at times pitched, though it was not often on the minds of everyday people.

In 2022, however, that seems to have changed.

“In this age of misinformation — of ‘fake news,’ conspiracy theories, Twitter trolls and deepfakes — gaslighting has emerged as a word for our time,” the Merriam-Webster English language dictionary announced in November, naming it the official word of the year.

Online searches of the word, which means “the act or practice of grossly misleading someone especially for one’s own advantage,” jumped by 1740% throughout the year, the dictionary said, noting consistent interest in the word and modern efforts at deception.

In the United States, such concerns consistently dominated the public discourse, starting with President Joe Biden’s appeal to defend democracy on the first anniversary of the January 6, 2021, attack on the U.S. Capitol.

“Are we going to be a nation that lives not by the light of the truth but in the shadow of lies?” he asked.

“We cannot allow ourselves to be that kind of nation,” Biden said. “The way forward is to recognize the truth and to live by it.”

The U.S. president’s comments came just weeks after U.S. Homeland Security officials warned of ongoing — and more volatile — efforts by foreign intelligence services and terrorist organizations to seed the country with disinformation.

And those concerns grew as Russia prepared for its invasion of Ukraine.

Russia – Ukraine

“We’re seeing Russian state media spouting off now about alleged activities in eastern Ukraine,” U.S. Defense Secretary Lloyd Austin told reporters in late January, as 100,000 Russian troops took up positions along Ukraine’s border.

“This is straight out of the Russian playbook,” Austin said of the Russian disinformation efforts. “And they’re not fooling us.”

By mid-February, senior U.S. Homeland Security officials were warning that Moscow had fine-tuned its disinformation operations, “trying to lay the blame for the Ukraine crisis and the potential escalation in that conflict at the feet of the U.S.”

Russian disinformation efforts took another turn in the days following the invasion, according to U.S. defense officials, with the Kremlin publicizing false reports about the widespread surrender of Ukrainian troops to erode Ukrainian morale and resistance.

Russian-government affiliated news outlets also sought to use the war in Ukraine to boost Moscow’s standing in Africa, amplifying accounts in late February and early March of Africans and other people of color being subjected to racism as they sought to evacuate.

Other Russian disinformation campaigns focused on claims the U.S. was running biological weapons labs in Ukraine and on efforts to undermine Western support for Ukraine by targeting countries perceived as weak links.

Countercampaigns

Russia’s disinformation efforts and influence campaigns, however, did not go unanswered.

Even before the first Russian troops crossed the border into Ukraine in February, U.S. intelligence officials made a decision to fight disinformation with evidence and facts, taking the unprecedented step to declassify assessments to share with allies and even the public.

“The work that we’ve done, and it’s not without risk as an intelligence community to declassify information, has been very effective,” CIA Director William Burns told lawmakers in early March.

“We hopefully can provide some credible voice of what is actually happening,” added U.S. Director of National Intelligence Avril Haines. “That’s both for the domestic population, but that’s also for the international audience.”

Other Western countries and allies of Ukraine followed with pushback of their own.

In early March, the European Union banned broadcasts and websites affiliated with Russian state-funded media outlets.

Ukraine also ran its own counter-disinformation efforts, targeting audiences in Russia and Belarus, hoping to sow doubts and erode support for Moscow’s invasion.

“I’m not realistic about changing their minds,” Heorhii Tykhy, with Ukraine’s Foreign Ministry, said during a virtual forum in March, though he added that overall, Kyiv was “winning this information war and winning it massively.”

U.S. domestic fears

At the same, the U.S. intelligence agencies and their Western allies were focused on Russia’s disinformation efforts surrounding Ukraine, U.S. Homeland Security efforts were focused on disinformation at home.

In June, the Department of Homeland Security (DHS) reissued a National Terrorism Advisory System (NTAS) Bulletin, citing the pervasive disinformation environment, much of it originating in the U.S., as a key concern.

“It’s really the convergence of that myth and disinformation with the current events that creates those conditions that we’re concerned about in terms of mobilization to violence,” a senior DHS official said at the time.

Some of those fears had already manifested a month earlier when 18-year-old Payton Gendron, who consumed online conspiracy theories, shot and killed 10 Black people at a grocery store in Buffalo, New York.

Other acts of violence across the U.S., such as the shooting at a gay nightclub in Colorado in November, an attack against the husband of U.S. House Speaker Nancy Pelosi and a rash of threats against religious institutions, also had links of various sorts to the online disinformation environment.

“One of the things we’ve seen with violent extremist ideologies is that they often commingle or cross over,” a second senior DHS official said this past November. “It just contributes to an environment where individuals … might grab on to those narratives in a way that motivates and animates their violent or potentially violent activity.”

U.S. elections

Some of the most targeted disinformation efforts, though, centered on the U.S. midterm elections in November.

“We are concerned malicious cyber actors could seek to spread or amplify false or exaggerated claims of compromise to election infrastructure,” a senior FBI official said in early October.

Other senior U.S. officials warned that adversaries like Russia, China and Iran would seize upon false narratives, originating in the U.S., questioning the integrity of the electoral process, and seek to amplify them.

Researchers also found evidence that Russia and China, in particular, had resurrected dormant social media accounts as part of intensified disinformation campaigns to spread doubts about the U.S. election.

And as the election neared, top U.S. officials called the threat of foreign influence operations and disinformation sparking violence a “significant concern.”

In the end, fears of potential violence never materialized into actual incidents, though U.S. officials did find themselves pushing back against domestic and largely partisan efforts to take scattered malfunctions and cast them as evidence of a larger conspiracy.

A report by the cybersecurity firm Mandiant concluded that in the end, efforts by Russia, China and Iran, some targeted specific contests but were mostly “limited to moderate in scale.”

A number of experts warn the threat of election disinformation is here to stay.

Future disinformation threats

“Narratives like the Big Lie have become systemic,” Graham Brookie, senior director of the Digital Forensic Research Lab at the Atlantic Council, said about former President Donald Trump’s disproven claims that the 2020 U.S. presidential election was stolen from him.

“[There is] not a huge amount of audience growth on that narrative, but for the audiences and communities that are engaged in and believe in that narrative, their engagement has gone up and become more hardened,” Brookie told VOA.

Some U.S. lawmakers are likewise warning the threats are not dissipating.

“After each election cycle, social media platforms like Meta often alter or roll back certain misinformation policies, because they are temporary and specific to the election season,” Democratic Representative Adam Schiff, chair of the House Intelligence Committee, and Democratic Senator Sheldon Whitehouse wrote in a letter to the social media giant December 14.

“Doing so in this current environment, in which election disinformation continuously erodes trust in the integrity of the voting process, would be a tragic mistake,” they added. “Meta must commit to strong election misinformation policies year-round, as we are still witnessing falsehoods about voting and the prior elections spreading on your platform.”

Other lawmakers are looking at social media apps from China and Russia, calling for some, such as TikTok, to be banned in the U.S.

“TikTok is digital fentanyl that’s addicting Americans, collecting troves of their data, and censoring their news,” Republican Representative Mike Gallagher said in a statement regarding a bill designed to block such apps.

“This isn’t about creative videos,” Republican Senator Marco Rubio, vice chair of the Senate Intelligence Committee said in a statement regarding TikTok.

“This is about an app that is collecting data on tens of millions of American children and adults every day. We know it’s used to manipulate feeds and influence elections,” he said. “We know it answers to the People’s Republic of China.”

Source: Voice of America

Posted on

UN chief ‘deeply saddened’ at deaths from South Africa gas tanker explosion

The UN Secretary-General António Guterres on Monday expressed his deep sadness over the reported death of at least 34 people in South Africa, due to a fuel tanker explosion in a suburb of the capital, Johannesburg, on Christmas Eve.

The blast in Boksburg severely damaged the roof of the emergency department at the Tambo Memorial hospital there, killing and injuring dozens while also reportedly destroying houses and cars.

Initial reports estimated around 27 deaths, but that figure had risen to 34 by the past weekend, according to regional health authorities. A memorial service for the dead was held last Friday.

News reports said the victims included nearly a dozen health workers, and almost two dozen members of the public, and due to serious injuries caused by burns, the death toll could rise still further. Children were reportedly among those who perished.

Condolences

“The Secretary-General expresses his condolences to the families of those who lost their lives from the explosion and to the people and the Government of South Africa”, said the statement issued by the office of the UN Spokesperson.

“The Secretary-General wishes a full and fast recovery for those injured and the quick reconstruction of the damaged health infrastructure.”

According to news reports, the gas tanker struck the underside of a low bridge, before exploding.

Many of the victims were admitted to the hospital’s casualty unit, before having to be evacuated, ahead of the roof collapsing.

Source: United Nations

Posted on

Indirect effects of COVID-19 on child and adolescent mental health: an overview of systematic reviews

Leila Harrison, Bianca Carducci, Jonathan D Klein, Ahmed Bhutta

Correspondence to Dr Zulfiqar Ahmed Bhutta; zulfiqar.bhutta@aku.edu

Abstract

Introduction To control the spread of COVID-19, mitigation strategies have been implemented globally, which may have unintended harmful effects on child and adolescent mental health. This study aims to synthesise the indirect mental health impacts on children and adolescents globally due to COVID-19 mitigation strategies.

Methods We included relevant reviews from MEDLINE, Embase, PsycINFO, LILACS, CINAHL, The Cochrane Library and Web of Science until January 2022 that examined the impact of COVID-19-related lockdown and stay-at-home measures on the mental health of children and adolescents. Data extraction and quality assessments were completed independently and in duplicate by BC and LH. A Measurement Tool to Assess Systematic Reviews-2 was used to assess the methodological quality.

Results Eighteen systematic reviews, comprising 366 primary studies, found a pooled prevalence of 32% for depression (95% CI: 27 to 38, n=161 673) and 32% for anxiety (95% CI: 27 to 37, n=143 928) in children and adolescents globally following COVID-19 mitigation measures. Subgroup analyses also uncovered important differences for both depression and anxiety by World Health Organization regions with few studies from Africa and relative high burden of anxiety and depression in the Eastern Mediterranean region.

Conclusions Our findings reveal a high prevalence of depression and anxiety in children and adolescents during the COVID-19 pandemic, globally, compared with prepandemic estimates. These findings highlight the urgency for governments and policymakers to strengthen mental health systems in the COVID-19 recovery, especially in low-and middle-income countries where compounding psychological stress, access and affordability of care and discrepant reporting of mental health in this population remains a challenge. We also provide insight into how to alter mitigation strategies to reduce the unintended negative consequences for the health and well-being of children and adolescents in future pandemics.

Source: British Medical Journal