The impact of climate change on maternal and child health

It can be argued that there are three colliding pandemics that are currently affecting the planet and its people: COVID-19, global inequities and climate change. Regrettably, these are all the result of human action or inaction and are preventable. The United Nations Conference of the Parties (COP26), held in November 2021 in Glasgow, addressed some of these issues.1 Prince Charles called this meeting the 'last chance saloon to save the planet.' The main objective of COP26 was to reduce global heating and limit global warming to the target maximum temperature of 1.5-degree Celsius above pre-industrial levels. According to the National Aeronautics and Space Administration (NASA), since the late 19th century, the earth surface temperature rose by 1.18 degrees Celsius, caused by increased carbon dioxide and other emissions into the atmosphere, with the years 2016 and 2020 being tied as the warmest years on record.2 However, many, including a group of scientists called 'Scientist Rebellion' were not convinced that COP26 would make any difference to the warming of the planet.3 President of COP26, Alok Sharma admitted that the objective of the conference was not reached but remained cautiously optimistic: "We can now say with credibility that we have kept 1.5 degrees alive. But its pulse is weak and it will only survive if we keep our promises and translate commitments into rapid action".

Vaccinate: protecting pregnant patients from COVID-19

It is now clear that there are increased risks of maternal and fetal morbidity and mortality when COVID-19 is contracted during pregnancy. Preventing severe COVID-19 in this population must be a priority.

College of obstetricians and gynaecologists of South Africa - recommendations for COVID-19 vaccination in pregnancy

Pregnant and lactating women were excluded from initial COVID-19 vaccine trials;thus data to guide vaccine decision-making are lacking. In the largest US study comparing pregnant and non-pregnant women, pregnant women were significantly more likely to require intensive care and mechanical ventilation than non-pregnant women of the same age.1 Black women experienced a disproportionally higher number of deaths. Preliminary data from the South African Obstetric Survey Systems suggests that majority of COVID-positive pregnant women west diagnosed in the third trimester of pragnancy.1 One in six pregnant women admitted to hospital required admission to the intensive care unit, while one in six teen women died.

Decreased severity of disease during the first global omicron variant covid-19 outbreak in a large hospital in tshwane, south africa.

INTRODUCTION: The coronavirus disease 2019 (COVID-19) first reported in Wuhan, China in December 2019 is a global pandemic that is threatening the health and wellbeing of people worldwide. To date there have been more than 274 million reported cases and 5.3 million deaths. The Omicron variant first documented in the City of Tshwane, Gauteng Province, South Africa on 9 November 2021 led to exponential increases in cases and a sharp rise in hospital admissions. The clinical profile of patients admitted at a large hospital in Tshwane is compared with previous waves. METHODS: 466 hospital COVID-19 admissions since 14 November 2021 were compared to 3962 admissions since 4 May 2020, prior to the Omicron outbreak. Ninety-eight patient records at peak bed occupancy during the outbreak were reviewed for primary indication for admission, clinical severity, oxygen supplementation level, vaccination and prior COVID-19 infection. Provincial and city-wide daily cases and reported deaths, hospital admissions and excess deaths data were sourced from the National Institute for Communicable Diseases, the National Department of Health and the South African Medical Research Council. RESULTS: For the Omicron and previous waves, deaths and ICU admissions were 4.5% vs 21.3% (p<0.00001), and 1% vs 4.3% (p<0.00001) respectively; length of stay was 4.0 days vs 8.8 days; and mean age was 39 years vs 49,8 years. Admissions in the Omicron wave peaked and declined rapidly with peak bed occupancy at 51% of the highest previous peak during the Delta wave. Sixty two (63%) patients in COVID-19 wards had incidental COVID-19 following a positive SARS-CoV-2 PCR test . Only one third (36) had COVID-19 pneumonia, of which 72% had mild to moderate disease. The remaining 28% required high care or ICU admission. Fewer than half (45%) of patients in COVID-19 wards required oxygen supplementation compared to 99.5% in the first wave. The death rate in the face of an exponential increase in cases during the Omicron wave at the city and provincial levels shows a decoupling of cases and deaths compared to previous waves, corroborating the clinical findings of decreased severity of disease seen in patients admitted to the Steve Biko Academic Hospital. CONCLUSION: There was decreased severity of COVID-19 disease in the Omicron-driven fourth wave in the City of Tshwane, its first global epicentre.

Obstetrics and Gynaecology Forum - the effect of the first wave of COVID-19 on use of maternal and reproductive health services and maternal deaths in South Africa

Aim: To monitor the impact of the rst wave of the Covid-19 pandemic on use of maternal and reproductive health services, and maternal mortality. Compared with the second quarter of 2019, but in many provinces there were discrepancies between DHIS and PPIP data so national still birth data is not presented in this report.