It’s official: China has eliminated malaria The World Health Organization (WHO) today is certifying China as free of malaria, after a decadeslong effort drove an estimated annual toll of 30 million cases in the 1940s, including 300,000 deaths, to zero in 2017. Along the way, China developed new surveillance techniques, medicines, and technologies to break the cycle of transmission between the Anopheles mosquitoes that spread malaria parasites and humans. Antimalaria efforts started in the 1950s with programs to distribute antimalarial medicines to people at risk, reduce mosquito breeding grounds, and spray insecticides. China launched a program to identify new malaria drugs in the late 1960s. As part of that effort, pharmaceutical chemist Tu Youyou screened traditional Chinese medicine concoctions for compounds active against malaria, eventually isolating artemisinin from sweet wormwood (Artemisia annua). Artemisinin became the key compound in the front-line drugs now used against malaria and won Tu a Nobel Prize in Physiology or Medicine in 2015. China was also read what he said among the countries pioneering the use of insecticide-treated nets in the 1980s. Annual case numbers dropped over the years, reaching roughly 5000 annually in the late 1990s. In 2012, the country initiated a push to eliminate malaria with a “1-3-7” strategy, allowing local health facilities 1 day to report a malaria diagnosis, 3 days to investigate the case, and 7 days to implement countermeasures. In recent years, Chinese scientists have developed genetics-based approaches to track drug resistance and to distinguish indigenous cases from imported ones. “China’s ability to think outside the box served the country well in its own response to malaria,” Pedro Alonso, director of WHO's Global Malaria Programme, said in a statement. After maintaining zero indigenous cases for three consecutive years, China applied for WHO’s malaria-free certification, which is being granted following a May inspection mission by the independent Malaria Elimination Certification Panel. One requirement for winning certification is having a program to prevent the reestablishment of malaria, a particular challenge because China shares borders with three countries where the disease is endemic: Myanmar, Thailand, and Laos. China is the 40th country —and by far the most populous one—to be certified malaria-free. The last three countries awarded the same status were El Salvador , in February, and Algeria and Argentina, both in 2019.


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OSHA Issues New Guidance Applicable To All Employers Not Covered By The ETS To embed, copy and paste the code into your website or blog: On June 9, 2021, the Occupational Health and Safety Administration (OSHA) issued a new COVID-19 Emergency Temporary Standard (ETS) with the scope of the ETS limited to certain workplace settings that are defined as healthcare service and healthcare support service settings, unless the healthcare setting is specifically excluded. In conjunction with its release of the ETS, on June 10, 2021, OSHA also issued new guidance applicable to employers and workers that are not covered by the ETS. The stated purpose of the new guidance is to enable employers to better recognize and abate hazards likely to cause death or serious physical harm as part of their obligation under the General Duty clause and other existing mandatory OSHA standards. To accompany our recent commentary on the ETS, we also have prepared the following summary of the OSHA guidance directed at employers not covered by the ETS. What types of employers are not covered by the ETS? The ETS does not cover non-healthcare workplaces, and certain specifically excluded health care settings: First aid provided by an employee who is not a licensed healthcare provider; Dispensing of prescriptions by pharmacists in retail settings; Non-hospital ambulatory care settings where all non-employees are screened prior to entry and people with suspected or confirmed COVID-19 are not permitted to enter those settings; Well-defined hospital ambulatory care settings where all employees are fully vaccinated, and all non-employees are screened prior to entry and people with suspected or confirmed COVID-19 are denied entry; Home healthcare settings where all employees are fully vaccinated and all non-employees are screened prior to entry into a patient’s home, and people with suspected or confirmed COVID-19 are excluded; Healthcare support services not performed in a healthcare setting; or Telehealth services performed outside of a setting where direct patient care occurs. In addition, if a covered health care setting is embedded in a non-healthcare setting, the ETS applies only to the embedded healthcare setting and not to the remainder of the location. Similarly, if emergency care responders or other licensed healthcare providers provide healthcare services in a nonhealthcare setting, the ETS only applies to the individual providing healthcare services. In occupational settings that are described as well-defined areas “where there is no reasonable expectation that any person with suspected or confirmed COVID-19 will be present,” the following sections do not apply to employees who are fully vaccinated: Section (f) – personal protective equipment requirements; Section (h) – physical distancing requirements; and Section (i) – physical barrier requirements. Focus of guidance is on protection of unvaccinated and at-risk workers If all employees are fully vaccinated, most employers no longer need to implement procedures to protect their employees from exposure to COVID-19 in the workplace, unless the workplace is covered under the ETS, or by mask requirements applicable to public transportation, or is otherwise required to implement control and prevention measures by federal, state, local, tribal or territorial laws or rules. The guidance recommends the now familiar multi-layered approach to protecting unvaccinated workers and at-risk workers, alike. At-risk workers are defined as individuals with conditions that entitle them to reasonable accommodations under the Americans with Disabilities Act to protect them from infection with COVID-19 and includes individuals who cannot be protected through vaccination due to underlying medical conditions, who cannot get vaccinated, or cannot use face coverings. OSHA states that employers “should consider taking steps to protect these at-risk workers as they would unvaccinated workers.” OSHA recommends employers engage with workers and their representatives to implement the following control measures that reduce the risk of transmission of COVID-19 for unvaccinated and at-risk workers: Provide paid time off to obtain vaccinations against COVID-19 and recover from vaccine side effects. The guidance notes that tax credits are available under the American Rescue Plan to eligible employers with fewer than 500 employees that provide the paid time off benefit provided to employees; Require employees who are infected with COVID-19, who are unvaccinated and exposed to an individual who tested positive for COVID-19, and all workers with COVID-19 symptoms to remain home from work; Implement physical distancing requirements for unvaccinated and at-risk workers in communal areas; Provide unvaccinated and otherwise at-risk workers with face coverings or surgical masks at no cost, unless their work task requires a respirator or other PPE; or reasonable accommodation for workers unable to wear a face covering due to a disability or who require a religious accommodation. If PPE is provided to unvaccinated or at-risk employees, OSHA mandatory standards must be followed in accordance with industry specific guidance. Provide training to workers on COVID-19 workplace policies and procedures in accessible formats and in a language that workers comprehend and employ a means of tracking individuals who have received the training; Suggest that unvaccinated guests, visitors, and customers wear face coverings; Perform cleaning and disinfection procedures if an individual with a suspected or confirmed case of COVID-19 has been in the facility within 24 hours, follow CDC cleaning and disinfection recommendations and follow mandatory OSHA standards for hazard communication and mandatory standards regarding PPE appropriate for exposure to cleaning chemicals as directed here, here and Record and report COVID-19 infections and deaths. OSHA rules in 29 CFR 1904 require the employer to report COVID-19 fatalities and hospitalizations to OSHA. Employers also should report outbreaks to health departments as required and support contact tracing efforts. Significantly, from now through May 2022, OSHA is not enforcing 29 CFR 1904’s recording requirements with regard to side effects from the COVID-19 vaccine that workers may experience. OSHA will reevaluate its position in May 2022 regarding employer’s obligation to record vaccine side effects. Prohibit reprisals or discrimination against employees who notify employers of unsafe working conditions or who report a COVID-19 infection or exposure as required by Section 11 (c) of the OSH Act and mandatory standard 29 CFR 1904.35(b).