The impacts of COVID-19 on structural inequities faced by people living with HIV who inject drugs: A qualitative study in St. Petersburg, Russia.

BACKGROUND: People who inject drugs (PWID) living with HIV may be disproportionately impacted by pandemic restrictions. This study qualitatively explored the impacts of the SARS-CoV-2 pandemic on PWID with HIV in St. Petersburg, Russia. METHODS: In March and April 2021, we conducted remote, semi-structured interviews with PWID with HIV, health care providers, and harm reductionists. RESULTS: We interviewed 25 PWID with HIV (aged 28-56 years, 46% female) and 11 providers. The pandemic exacerbated economic and psychological challenges experienced by PWID with HIV. Simultaneously, barriers to HIV care access, ART prescription refill and dispensing and police violence, which hindered the health and safety of PWID with HIV, were themselves hindered from normal operations by the pandemic, significantly reducing these burdens. CONCLUSION: Pandemic responses should account for the unique vulnerabilities of PWID with HIV to avoid worsening the structural violence they already experience. Wherever the pandemic decreased structural barriers, such as institutional, administrative, and bureaucratic challenges and state violence enacted by police and other elements of the criminal justice system, such changes should be protected.

Genomic epidemiology of SARS-CoV-2 in Russia reveals recurring cross-border transmission throughout 2020.

In 2020, SARS-CoV-2 has spread rapidly across the globe, with most nations failing to prevent or substantially delay its introduction. While many countries have imposed some limitations on trans-border passenger traffic, the effect of these measures on the global spread of COVID-19 strains remains unclear. Here, we report an analysis of 3206 whole-genome sequences of SARS-CoV-2 samples from 78 regions of Russia covering the period before the spread of variants of concern (between March and November 2020). We describe recurring imports of multiple COVID-19 strains into Russia throughout this period, giving rise to 457 uniquely Russian transmission lineages, as well as repeated cross-border transmissions of local circulating variants out of Russia. While the phylogenetically inferred rate of cross-border transmissions was somewhat reduced during the period of the most stringent border closure, it still remained high, with multiple inferred imports that each led to detectable spread within the country. These results indicate that partial border closure has had little effect on trans-border transmission of variants, which helps explain the rapid global spread of newly arising SARS-CoV-2 variants throughout the pandemic.

[The analysis of application of telemedicine technologies in the Russian Federation in 2019-2022].

Over the past five years, development of telemedicine was accompanied by many changes. Despite the need for remote medical care, development of telemedicine technologies was not uniformly intensive, both in different countries and in regions of a single state (such as Russia). The purpose of the study is to evaluate dynamics of volume of medical care and number of types of services using telemedicine technologies in regions of the Russian Federation. The retrospective analysis was applied to data retrieved from the Form of the Federal Statistical Observation № 30 of 2019-2021, from documentation of territorial programs of state guarantees of free medical care of population and tariff agreements in regions of the Russian Federation in 2021-2022 and from the Federal Telemedicine System in 2021. The study established that total number of telemedicine consultations increased in 2021 by 23% as compared with 2020. The percentage of consultations financed by the Compulsory Health Insurance Fund also increased from 6.95% in 2020 to 11.72% in 2021. The number of patients being on remote monitoring increased in 2021 up to 44% as compared to 2020. In addition, percentage of patients receiving medical care through remote monitoring and financed by the Compulsory Medical Insurance Fund increased from 6.55% in 2021 to 19.96% as compared with 2020. In the territorial programs of state guarantees for seven regions of the Russian Federation the number of types of telemedicine services fixed in tariff agreements increased in 2022 as compared to 2021. However, it decreased in ten regions. The most common medical care profiles for which telemedicine consultations in the "physician-physician" format were provided by Federal medical organizations in 2021 were: oncology (55 regions of Russia requested consultations on this profile), pediatrics (45 regions), and intensive-care medicine (39 regions). The telemedicine solutions are in high demand, as it is demonstrated by increasing both of volume of remote medical care and of percentage of consultations financed by the Compulsory Medical Insurance Fund. The COVID-19 pandemic had rather strong impact on development of telemedicine. The alignment of market for telemedicine services in public health sector began in 2021 and it is confirmed by decreasing of total number of consultation types in tariff agreements in 2022. In terms of remote interaction in "physician-physician" format, situation continues to be stable. In the nearest future one should expect more gradual development of telemedicine in Russia with appearance of individual initiatives in terms of pilot projects and experimental law modes.

COVID-19: seroprevalence and adherence to preventive measures in Arkhangelsk, Northwest Russia.

BACKGROUND: The published estimates of SARS-CoV-2 seroprevalence in Russia are few. The study aimed to assess the SARS-CoV-2 seroprevalence in Arkhangelsk (Northwest Russia), in a year after the start of the pandemic, to evaluate the population adherence to non-pharmaceutical interventions (NPIs), and to investigate characteristics associated with COVID-19 seropositive status. METHODS: We conducted a SARS-CoV-2 seroprevalence study between 24 February and 30 June 2021 involving 1332 adults aged 40-74 years. Logistic regression models were fit to identify factors associated with seropositive status and with adherence to NPIs. RESULTS: Less than half (48.9%) of study participants adhered all recommended NPIs. Male sex (odds ratio [OR] 1.7, 95% confidence intervals [CI] 1.3; 2.3), regular employment (OR 1.8, 95% CI 1.3; 2.5) and low confidence in the efficiency of the NPIs (OR 1.9, 95% CI 1.5; 2.5) were associated with low adherence to internationally recommended NPIs. The SARS-CoV-2 seroprevalence rate was 65.1% (95% CI: 62.5; 67.6) and increased to 73.0% (95% CI: 67.1; 85.7) after adjustment for test performance. Regular employment (OR 2.0, 95% CI 1.5; 2.8) and current smoking (OR 0.4, 95% CI 0.2; 0.5) were associated with being seropositive due to the infection. CONCLUSIONS: Two third of the study population were seropositive in a year after the onset of the pandemic in Arkhangelsk. Individuals with infection-acquired immunity were more likely to have regular work and less likely to be smokers. The adherence to NPIs was not found associated with getting the virus during the first year of the pandemic.

Predictive algorithm for the regional spread of coronavirus infection across the Russian Federation.

BACKGROUND: Outbreaks of infectious diseases are a complex phenomenon with many interacting factors. Regional health authorities need prognostic modeling of the epidemic process. METHODS: For these purposes, various mathematical algorithms can be used, which are a useful tool for studying the infections spread dynamics. Epidemiological models act as evaluation and prognosis models. The authors outlined the experience of developing a short-term predictive algorithm for the spread of the COVID-19 in the region of the Russian Federation based on the SIR model: Susceptible (vulnerable), Infected (infected), Recovered (recovered). The article describes in detail the methodology of a short-term predictive algorithm, including an assessment of the possibility of building a predictive model and the mathematical aspects of creating such forecast algorithms. RESULTS: Findings show that the predicted results (the mean square of the relative error of the number of infected and those who had recovered) were in agreement with the real-life situation: σ(I) = 0.0129 and σ(R) = 0.0058, respectively. CONCLUSIONS: The present study shows that despite a large number of sophisticated modifications, each of which finds its scope, it is advisable to use a simple SIR model to quickly predict the spread of coronavirus infection. Its lower accuracy is fully compensated by the adaptive calibration of parameters based on monitoring the current situation with updating indicators in real-time.

[The hospital substitution form of home medical care of population of Tte Russian Federation: the analysis of functioning].

The important direction of the National Project "Health Care" are improvement of primary health care system, including introduction of hospital-replacing technologies.The purpose of the study is to evaluate functioning of hospital-substituting form of home medical care (home hospitals) to population of the Russian Federation in 2006-2020.The normative legal documents regulating activities of stationary-substituting form of home medical care (home hospitals) for adults and children, reporting forms of sectoral statistical observation № 14ds for 2006-2018 were analyzed. In 2019-2020, unified data on functioning of day hospitals and home hospitals and composition of patients treated there of medical organizations providing medical care on out-patient basis was filled in form № 14ds. The in-depth analysis permitted to extract information about activities of home hospitals for adults and children and to study their functioning in dynamics for 15 years. The content analysis, statistical and analytical methods were applied.The examination of data for 2006-2020 established increasing of number of treated adult patients in home hospitals up to 27.9% and children up to 15.0%.The distribution of the number of treated adults and children in hospitals at home per 1000 of the corresponding population by subjects indicates their significant fluctuation.For 15 years, it has been established that in the structure of treated adult patients, the proportion of people with diseases of the circulatory system has decreased from 62.2 to 31.5%, the musculoskeletal system and connective tissue - from 11.7 to 7.4%; in children - with respiratory diseases from 81.9 to 63.4%, some infectious and parasitic diseases - from 7.7 to 3.0%, diseases of the digestive system - from 3.6 to 3.2%.In the country for 2019-2020 in hospitals at home, the number of treated adults significantly increased by 1.8 times, children - by 2.3 times, the composition of those treated has changed, which is associated with the treatment of patients with a new coronavirus infection COVID-19 in them under conditions re-profiling of the majority of medical organizations into infectious diseases hospitals.

The Search of Association of HLA Class I and Class II Alleles with COVID-19 Mortality in the Russian Cohort.

HLA genes play a pivotal role in the immune response via presenting the pathogen peptides on the cell surface in a host organism. Here, we studied the association of HLA allele variants of class I (loci A, B, C) and class II (loci DRB1, DQB1, DPB1) genes with the outcome of COVID-19 infection. We performed high-resolution sequencing of class HLA I and class II genes based on the sample population of 157 patients who died from COVID-19 and 76 patients who survived despite severe symptoms. The results were further compared with HLA genotype frequencies in the control population represented by 475 people from the Russian population. Although the obtained data revealed no significant differences between the samples at a locus level, they allowed one to uncover a set of notable alleles potentially contributing to the COVID-19 outcome. Our results did not only confirm the previously discovered fatal role of age or association of DRB1*01:01:01G and DRB1*01:02:01G alleles with severe symptoms and survival, but also allowed us to single out the DQB1*05:03:01G allele and B*14:02:01G~C*08:02:01G haplotype, which were associated with survival. Our findings showed that not only separate allele, but also their haplotype, could serve as potential markers of COVID-19 outcome and be used during triage for hospital admission.

Myopic axial elongation in school children and the COVID-19 lockdown in Russia: The Ural Children Myopia Study.

BACKGROUND: To explore an influence of the COVID-19-related lockdown on ocular axial elongation in school children in Russia. METHODS: The participants of the school-based Ufa Children Myopia Study in Ufa/Russia underwent, at baseline in 2019/2020 before the COVID-19 outbreak and after a COVID-19-related lockdown, a detailed interview and ophthalmological examination including laser interferometric biometry for axial length measurement. RESULTS: The study included 461 children (age:10.7±2.1 years;range:6.8-16.9 years). The mean follow-up was 1.41±0.33 years. Mean axial length at baseline was 23.96±0.95mm and 23.94±0.95mm in the right and left eyes, respectively. During the study period, annual axial elongation (right/left eyes) was 0.19±0.17mm/0.19±0.22mm. Before the COVID-19 lockdown, the age-dependent coefficient for axial length (ADCAL) for the right/left eyes was 0.21mm (95%CI:0.17,0.25)/0.20mm (95%CI:0.16,0.24). In children younger than 9.6 years (n = 157), annual axial elongation (right eyes) during the study period was larger than the ADCAL before the COVID-19 outbreak (0.29 mm (95%:0.00,0.66) versus 0.21 mm (95%CI:0.02,0.41)). In the groups aged 9.6 to 11.4 years (n = 148) and aged >11.4 years (n = 156), annual axial elongation during the study period was comparable to the ADCAL before the COVID-19 outbreak (0.18mm (95%CI:-0.07,0.46) versus 0.22mm (95%CI:-0.05,0.48), and (0.09mm (95%CI:-0.15,0.34) versus 0.14mm (95%CI:0.00,0.28), respectively). In children aged ≤9 years at study end, axial length at study end was 0.20 mm larger than axial length at baseline in the participants aged ≤9 years at baseline. Larger axial elongation during the study period was associated (multivariable analysis) with younger age (beta:-0.62;P<0.001), female sex (beta:0.21;P<0.001), longer study period (beta:0.22;P<0.001), and longer axial length at baseline (beta:0.28;P<0.001), and marginally, with less time spent outdoors (beta:-0.07;P = 0.06). CONCLUSIONS: The COVID-19-related lockdown in the Russian city of Ufa was associated with a relatively minor increase in axial elongation, detected only in children aged <9.6 years.

Dynamics of Regional Mortality Rates From Cardiac Causes in Russia 2019-2020.

Aim      To analyze the dynamics of standardized mortality ratios (SMR) (2019-2020) for the cardiological causes indicated as the primary (original) cause of death, in regions of the Russian Federation, based on the RF State Statistics Service Brief Nomenclature of Causes of Death (RFSSS BNCD). Reports have indicated substantial changes in the indexes and structure of mortality since the beginning of the COVID-19 pandemic in many countries.Material and methods  RFSSS data on numbers of deaths were analyzed according to BNCD and mid-year population in single year of age groups in 2019 and 2020. SMRs were determined for 23 cardiological causes of death listed in the BNSD in a separate line; the average regional SMR value and the standard deviation were provided; and SMRs were compared both among 4 groups (with a previously described method) and by 23 RFSSS BNCD causes using the Wilcoxon test.Results In 2020 vs. 2019, the mean regional SMR for cardiological causes increased by 12.07±9.86 % (from 301.02±77.67 to 336.15±84.5 %; р<0.0001). Decreases in SMR were found in 9 of 82 regions; however, only in two of them (the Republic of Ingushetia and the Sakhalin Region), SMR was decreased for all 4 groups of causes. In both 2019 and 2020 (60.9±13.8 and 62.5±12.8 %, respectively), the highest proportion of deaths was related with the 1st group of causes (chronic ischemic heart disease, IHD), with an increase in SMR of 18.66±33.28 % (р<0.0001). Increases in SMR were found in 75 regions while in the other regions, decreases in SMRs were observed. For the 2nd group of causes (myocardial infarction, other acute forms of IHD, sudden cardiac death), the mean regional SMR increased in 2020 by 3.2±18.1 % (р=0.3). Increased SMRs were noted in 54 regions. The proportion of the 2nd group in cardiological mortality was 17.3±9.7 % in 2019 and 16.1±9.6 % in 2020. The mean regional SNR for the 3rd group of causes (heart defects, myocardial diseases, etc.) increased in 2020 by 11.6±23.1 % (р=0.006). The mean regional proportion of causes for this group did not significantly changed compared to 2019 (17.5±8.2 and 17.1±7.3 %, respectively); however, the contribution of this group was greater than the contribution of the 2nd group. Increases in SMR were observed in 65 regions, while the contribution of causes related with arterial hypertension did not significantly change. Significant mid-regional differences in SMR values, dynamics of SMRs for different causes, and increases in the coefficient of variation were noted for almost all causes of death. Significant differences between 2019 and 2020 were found for 3 of 23 causes: other forms of chronic IHD (decreased SMRs in 15 regions and increased SMRs in the others), atherosclerotic heart disease (decreased SMRs in 38 regions), and alcoholic cardiomyopathy (decreased SMRs in 28 regions).Conclusion      During the COVID-19 pandemic, the SMR for cardiological causes was increased. Considerable regional differences in values and dynamics of SMR for individual causes call for attention to the unification of the criteria for clinical diagnosis.

[THE RUSSIAN HEALTHCARE IMAGE DURING THIRD WAVE OF COVID-19 IN THE INFO FIELD].

The article contains the results of primary research of the information field of medical tourism in Russia, conducted in the period before the COVID-19 pandemic in the Yandex search engine and the Medialogia media database from January 01, 2019 to December 31, 2019. The analysis of the results of the study with measurements of the beginning of the year and the end is carried out. The results of the study are one of the parts of the panel study of the image of medical tourism in Russia and can be used in the future by interested structures in order to adjust it.

Study of the Deep Processes of COVID-19 in Russia: Finding Ways to Identify Preventive Measures.

The novel coronavirus disease 2019 (COVID-19) pandemic has had a huge impact on all areas of human life. Since the risk of biological threats will persist in the future, it is very important to ensure mobilization readiness for a prompt response to the possible emergence of epidemics of infectious diseases. Therefore, from both a theoretical and practical standpoint, it is currently necessary to conduct a thorough examination of the COVID-19 epidemic. The goal of this research is to investigate the underlying processes that led to the COVID-19 pandemic in Russia and to identify ways to improve preventive measures and ensure mobilization readiness for a quick response to potential COVID-19-like pandemics. This research will analyze the daily dynamics of the number of infection cases and the number of new lethal cases of COVID-19. We analyzed the daily number of new cases of COVID-19 infection N(d), the daily number of new lethal cases L(d), their percentage ratio L(d)/N(d) 100% in Russia for 2 years of the pandemic (from the beginning of the pandemic to 23 March 2022), the rate of increase and decrease of these indicators (dN(d)/dd and dL(d)/dd), as well as their spectra created on the basis of wavelet analysis. Wavelet analysis of the deep structure of the N(d) and L(d) wavelet spectra made it possible to identify the presence of internal cycles, the study of which makes it possible to predict the presence of days with the maximum number of infections and new deaths in a pandemic similar to COVID-19 and outline ways and methods for improving preventive measures and measures to ensure mobilization readiness for a rapid response to the potential emergence of pandemics similar to COVID-19.

Stress and Anxiety among Healthcare Workers Associated with COVID-19 Pandemic in Russia.

BACKGROUND: Mental health of medical workers treating patients with COVID-19 is an issue of increasing concern worldwide. The available data on stress and anxiety symptoms among healthcare workers during the COVID-19 are relatively limited and have not been evaluated in Russia yet. SUBJECTS AND METHODS: The cross-sectional anonymous survey included 1,090 healthcare workers. Stress and anxiety symptoms were assessed using Stress and Anxiety to Viral Epidemics - 9 (SAVE-9) and Generalized Anxiety Disorder - 7 (GAD-7) scales. Logistic regression, Kaiser-Meyer-Olkin two component factor model, Cronbach's alpha and ROC-analysis were performed to determine the influence of different variables, internal structure and consistency, sensitivity and specificity of SAVE-9 compared with GAD-7. RESULTS: The median scores on the GAD-7 and SAVE-9 were 5 and 14, respectively. 535 (49.1%) respondents had moderate and 239 (21.9%) had severe anxiety according to SAVE-9. 134 participants (12.3%) had severe anxiety, 144 (13.2%) had moderate according to GAD-7. The component model revealed two-factor structure of SAVE-9: "anxiety and somatic concern" and "social stress". Female gender (OR - 0.98, p=0.04) and younger age (OR - 0.65, p=0.04) were associated with higher level of anxiety according to regression model. The total score of SAVE-9 with a high degree of confidence predicted the GAD-7 value in comparative ROC analysis. CONCLUSIONS: Healthcare workers in Russia reported high rates of stress and anxiety. The Russian version of the SAVE-9 displayed a good ratio of sensitivity to specificity compared with GAD-7 and can be recommended as a screening instrument for detection of stress and anxiety in healthcare workers.

Forecasting Trends in the Tuberculosis Epidemic Situation in the Region of the Russian Federation by Dynamic Simulation Model.

The spread of a new coronavirus infection in the last two years together with HIV infection preserves and even increases the potential for the spread of tuberculosis in the world. Sverdlovsk oblast (SO) of Russian Federation is the region with high levels of HIV and tuberculosis (TB). The search for new methods of forecasting of the future epidemic situation for tuberculosis has become particularly relevant. The aim was to develop an effective method for predicting the epidemic situation of tuberculosis using an artificial intelligence (AI) method in the format of a dynamic simulation model based on AI technologies. Statistical data was loaded from the state statistical reporting on TB patients for the period 2007-2017. The parameters were controlled through a system of inequalities. The proposed SDM made it possible to identify and reliably calculate trends of TB epidemiological indicators. Comparison of the predicted values made in 2017 with the actual values of 2018-2021 revealed a reliable coincidence of the trend of movement of TB epidemiological indicators in the region, the maximum deviation was no more than 14.82%. The forecast results obtained with SDM are quite suitable for practical use. Especially, in operational resource planning of measures to counteract the spread of tuberculosis at the regional level.

COVID-19 and excess mortality in Russia: Regional estimates of life expectancy losses in 2020 and excess deaths in 2021.

Accurately counting the human cost of the COVID-19 at both the national and regional level is a policy priority. The Russian Federation currently reports one of the higher COVID-19 mortality rates in the world; but estimates of mortality differ significantly. Using a statistical method accounting for changes in the population age structure, we present the first national and regional estimates of excess mortality for 2021; calculations of excess mortality by age, gender, and urban/rural status for 2020; and mean remaining years of life expectancy lost at the regional level. We estimate that there were 351,158 excess deaths in 2020 and 678,022 in 2021 in the Russian Federation; and, in 2020, around 2.0 years of life expectancy lost. While the Russian Federation exhibits very high levels of excess mortality compared to other countries, there is a wide degree of regional variation: in 2021, excess deaths expressed as a percentage of expected deaths at the regional level range from 27% to 52%. Life expectancy loss is generally greater for males; while excess mortality is greater in urban areas. For Russia as whole, an average person who died due to the pandemic in 2020 would have otherwise lived for a further 14 more years (and as high as 18 years in some regions), disproving the widely held view that excess mortality during the pandemic period was concentrated among those with few years of life remaining-especially for females. At a regional level, less densely populated, more remote regions, rural regions appear to have fared better regarding excess mortality and life expectancy loss-however, a part of this differential could be owing to measurement issues. The calculations demonstrate more clearly the true degree of the human cost of the pandemic in the Russian Federation.

[THE RUSSIAN HEALTHCARE IMAGE IN THE INFO FIELD DURING THE THIRD WAVE OF COVID-19].

The article contains the results of repeated studies of the Russian healthcare information field conducted during the third wave of COVID-19 in the Medialogia media database, as well as in the Yandex search engine from May 20, 2021 to September 01, 2021. There was carried out a comparative analysis of the results of the study with previous measurements conducted from December 01, 2019 to February 15, 2021. The results of the study are just a part of the image panel study of the Russian healthcare and they can further be used by concerned structures in order to adjust it.

[SECTORS INVOLVED IN PUBLIC HEALTH IN THE RUSSIAN FEDERATION DURING COVID-19 PANDEMIC].

The article develops a research agenda for cross-sectoral collaboration on the issues of public health. The aspects of this collaboration are not scientifically founded during the COVID-19 pandemic. The aim of the research is to study the inventory of the sectors involved in public health in the Russian Federation during the COVID-19 pandemic and to put in perspective their importance. An anonymous survey of 49 experts - health service managers was made. The respondents were asked to identify the inventory of the sectors involved in public health and to voice their opinion on their importance during the COVID-19 pandemic. The results of the survey were compared to the results obtained before the pandemic. The results of the study suggest that 23 sectors should always be involved in public health both during the COVID-19 pandemic and without it. The sectors are of relatively equal importance. However, the sectors of the inventory are ranked differently in the order of importance during the pandemic and without it. A statistically significant difference in the analysed characteristic feature is noted. The article develops a research agenda for further studies and provide implications for health-service managers.

The changing epidemiology of lumpy skin disease in Russia since the first introduction from 2015 to 2020.

Lumpy skin disease (LSD) is an economically important transboundary disease affecting cattle, causing large economic losses such as decreased production and trade restrictions. LSD has been a historically neglected disease since it previously caused disease limited to the African continent. Currently, the epidemiology of LSD virus is based on how the disease is transmitted in tropical and sub-tropical climates. The understanding of its epidemiology in hemiboreal climates is not well understood and needs urgent attention to expand the current knowledge. In this study, the epidemiological findings on LSD in Russia over a 6-year period are summarized and discussed. A total of 471 outbreaks were identified spanning over a 9000 km range. The outbreaks of LSD occur primarily in small holder farms (backyard) compared to commercial farms between mid-May through mid-November including weather conditions with snow and freezing temperatures that preclude vector activity. Mortality and morbidity varied across the 6 years ranging from 1.19% to 61.8% and 0% to 50%, respectively, with a tendency to decline from 2015 to 2020. The geographic pattern of spread was assessed by means of directionality, indicating a northward movement from 2015 to 2016, with a consequent East turn in 2017 through Siberia to the Far East by 2020. All cases occurred along the border with Kazakhstan. Mathematical modelling showed that the disease tended to form statistically verified annual spatiotemporal clusters in 2016-2018, whereas in 2019 and 2020 such segregation was not evident. The trend of spread was mainly either from south to north or from south to a north-east direction.

Molecular characterization of a novel recombinant lumpy skin disease virus isolated during an outbreak in Tyumen, Russia, in 2019.

Lumpy skin disease virus causes a debilitating pox disease of domesticated cattle and water buffalos. In the last decade, LSDV has spread from Africa into the Middle East, Europe and most recently Asia. As of 2017, atypical outbreaks caused by novel LSDV strains were reported in Russia, followed by China and Vietnam between 2018 and 2020. In this work, we describe another unique recombinant LSDV strain recovered from Tyumen, Russia in 2019. Typing of the virus using currently available qPCR protocols produced inconclusive results and subsequently the complete genome of the isolate was determined. The consensus genome contained statistically significant signals of possible recombination events between parental strains KSGPO-240/Kenya/1958 and the live attenuated vaccine LW/1958. The novel strain carries 25 unique breakpoints different from the known recombinant strains. Additionally, the findings reiterate the importance of complete genome sequencing when analysing outbreak samples caused in particular by mosaic LSDV, in contrast to only performing specified qPCRs.

The human toll and humanitarian crisis of the Russia-Ukraine war: the first 162 days.

BACKGROUND: We examined the human toll and subsequent humanitarian crisis resulting from the Russian invasion of Ukraine, which began on 24 February 2022. METHOD: We extracted and analysed data resulting from Russian military attacks on Ukrainians between 24 February and 4 August 2022. The data tracked direct deaths and injuries, damage to healthcare infrastructure and the impact on health, the destruction of residences, infrastructure, communication systems, and utility services - all of which disrupted the lives of Ukrainians. RESULTS: As of 4 August 2022, 5552 civilians were killed outright and 8513 injured in Ukraine as a result of Russian attacks. Local officials estimate as many as 24 328 people were also killed in mass atrocities, with Mariupol being the largest (n=22 000) such example. Aside from wide swaths of homes, schools, roads, and bridges destroyed, hospitals and health facilities from 21 cities across Ukraine came under attack. The disruption to water, gas, electricity, and internet services also extended to affect supplies of medications and other supplies owing to destroyed facilities or production that ceased due to the war. The data also show that Ukraine saw an increase in cases of HIV/AIDS, tuberculosis, and Coronavirus (COVID-19). CONCLUSIONS: The 2022 Russia-Ukraine War not only resulted in deaths and injuries but also impacted the lives and safety of Ukrainians through destruction of healthcare facilities and disrupted delivery of healthcare and supplies. The war is an ongoing humanitarian crisis given the continuing destruction of infrastructure and services that directly impact the well-being of human lives. The devastation, trauma and human cost of war will impact generations of Ukrainians to come.