ABSTRACT
The future to geo-political and geo-economic conundrums is by transforming current economies into inclusive and sustainable societies. In this race for global dominance and hegemony, policy makers must be wary of not forgetting institutional practices of conserving and preserving ecosystems and biospheres with pro-active and proper thinking. Governments that are in power must be sensible to realize that economies will eventually grow when more people join the formal and informal sectors, but the challenge is to have a planet that sustains our needs rather than addressing our greed. Legal systems must work harder in the 21st century to embed proper and critical thinking driven by an ecological conscience to preserve, conserve and protect the environment that sustains us. The technology that is being built and fashioned to drive businesses must submit to stringent ecological standards. With the rapid spread of Covid19, scientists are aware that humanity will be afflicted with more such zoonotic diseases primarily brought on by the global warming and climate change. Third world governments in their search for competing and contributing with the global economy forget the impending dangers of a cataclysmic warmer, hotter and unsustainable planet that will deprive burgeoning populations of food and clean water furthering a health scare. Across the globe, we have witnessed government's response to Covid19 especially in the third world and the loss of lives that could have been prevented. This affliction is bound to endure owing to the inadequate policies that fail to create low-carbon economies or submit to Sustainable Development Goals that could mitigate the debilitating effects of a globally warmer planet. In all of this, the future will be fought not over oil but wars are bound to be fought over water and food and lack of immediate or urgent healthcare support. It is observed painfully, that the people most affected or afflicted with the mostly the marginalized, the poor, the disadvantaged. In this paper, I propose how governments of the day must transform their economies to be sustainable and inclusive, ameliorate global warming, promote healthy agricultural practices, constantly set higher moral standards for a low-carbon economy and build on a healthcare system that is robust and flexible to everyone's needs. The globe after observing many discussions at Copenhagen is now becoming familiar with the reality of a resource-efficient economy and natural capital as an invaluable economic asset. © 2023 Scrivener Publishing LLC. All rights reserved.
ABSTRACT
Background. Candida auris is a fungal pathogen associated with multidrug resistance, high mortality, and healthcare transmission. Since its U.S. emergence in 2017, to March 19, 2021, 1708 clinical infections were reported nationwide, of which 235 (13.8%) were reported in New Jersey. The New Jersey Department of Health (NJDOH) maintains C. auris surveillance in healthcare facilities (HCF) such as acute care hospitals, long-term acute care hospitals (LTACHs), and skilled nursing facilities, to monitor clinical infections and patient colonization. We aimed to characterize the epidemiology of C. auris infection and colonization among HCF patients during 2017-2020. Methods. HCFs report C. auris cases identified from clinical specimens and surveillance activities such as admission screenings and point prevalence surveys (PPS) to NJDOH. Cases are classified as either infection or colonization using National Notifiable Diseases Surveillance System case definitions. We analyzed cases reported during 2017-2020 to describe types of cases, facilities reporting cases, and demographics of affected patients. We analyzed PPS results to calculate percent positivity of tests from patients without previously identified infection and compared percent positivity between types of facilities. We examined quarterly trends for all variables before and after the COVID-19 pandemic peak in the second quarter of 2020. Results. During 2017-2020, 614 C. auris cases identified from clinical specimens were reported to NJDOH [243 (39.6%) infection, 371 (60.4%) colonization];of these, 139 (57.2%) and 301 (81.1%) , respectively, were identified at long-term acute care hospitals (LTACHs). PPS percent positivity was higher at LTACHs (mean 7.6%) compared with all other facility types (mean 3.6%) for 13 of 16 quarters during 2017-2020. Case reports increased 2.6-fold from the Q2 2020 peak of the COVID-19 pandemic to Q3 2020.From Q1 to Q4 2020, PPS percent positivity increased from 4.8% to 10.5%. Conclusion. The COVID-19 pandemic may have exacerbated C. auris transmission in HCF and potential causes should be further explored. LTACHs carry a disproportionate burden of patients colonized with C. auris and should be prioritized for surveillance and containment efforts.