Greetings from cool sunny Seattle (we are vacationing) where 75% of the people are vaccinated, we have a mask mandate for all indoor areas and Covid is still a problem but our home in Mississippi  (2800 miles away) is #1 in Covid Cases in the USA and we get to fly home Friday, wearing N95 masks.  

I had a long conversation with an ICU nurse of 35 years experience last week, she is close to burnout and holding on just because she can choose to retire in April.  Overwhelming patients, denying Covid, unvaccinated and in a small rural 80 bed hospital.  Needless to say, our conversation was frank, unpublishable and scary about where our compassion has gone. Maybe it was the wine or because we are family but it was a tough talk..   I am glad I am retired, have decided to be numb about my son's unvaxed family and just plod onward.  Not certain I could find the emotional strength to care for patients of any kind any more.  A gun carrying, covid denying patient is not uncommon in an urgent care practice in Mississippi.

Please answer this email which will go to everyone about how you are doing, how bad is it there?  Any ideas of how to work through burn out and still give competent care?.  

Praying for all of you on the front or back lines.  

Yours in Rotary Fellowship and Service  John

John Dugaw MD. FAAFP  International Secretary IRFHP

Indian Rocks Beach Florida here

Its a mess in Pinellas County - no masks for the students and under reporting and waiting 5 days for health dept confirmation of cases in schools is just letting it run rampant here

Our local hospitals are beyond max capacity and they all closed and went on divert within the same hour - this has never happened - even the small non hospital based ERs went on bypass

Meanwhile the community is still acting like nothing is happening

We (my husband and myself) are back to lock down and wearing masks when out and only leave for bare necessitates

I am struggling with my club where there are multiple non vaxers and non mask wearers - I do not know how they can be called Rotarians anymore - anyone see the latest episode mailed out - I havent had the pleasure to read it yet but the cover is masks 

Thank you for listening, reaching out and caring

I am grateful I am semi retired and left the ER 4 years ago - my old colleagues are stretched thin, tired and wore out 

Be safe 

Ricki C Pollack Frayman MD

In Howard county, MD, where I live is > 70 % vaccinated, with over 60 being 92% vaccinated. No mask mandates. But j and I wear masks outside our home.

as district Governor I have trouble with unvaccinated Rotarians who clearly read and listen to nothing.

And my heart goes out to my fellow health care providers who are under enormous stress. 

I am also concerned about pressure from our zine directors to attend the zine assembly in Naples, Florida where the delta variant is rampant. As of now no signs of change.

I have booked j and myself for a booster shot. We are due to get it first week in October. Any idea if getting it 2 weeks earlier is harmful?

Regards,

Geetha

In little Denmark life is close to normal again. Nearly 70% are full vaccinated, and it’s mostly the old and chronically ill, while we have an issue with the young generation. There’s constantly about 1.300 new infected daily, in-patient numbers are constantly low with 131 today, 20 in ICU and 6 with need for a respirator (Denmark has nearly 6 mil. people). There are no restrictions regarding masks or distance, not even in public transport, because our government has listened to the young generation, which arguments for, that the restrictions are doing more harm than an infection (I’m not sure, though, whether they have understood, that long-time symptoms could be disastrous, too). But it’s a matter of social peace, Denmark is a liberal country, and they want to have It that way.

With that in general, there are some local communities who are more affected, and have the possibility to lock down certain things like schools, museums, sports arenas etc.. These communes have a high proportion of people with migratory background, with language issues and different cultural habits (bigger family living together, more physical contact) and lower educational level, meaning that there can be a lack in information both regarding to background and offer for test and vaccination.

In relation to the load in our health care system, everything is quite fine. The biggest influence just now comes from a strike of the nurses, who want to get a lift of their basis wages – which is a long-term thing, following a discussion about equal wages. In the 70’s, government had preferred the male-dominated jobs, resulting in traditionally female-dominated having lower income, although education and burden (both physical and psychological) can be higher. It seems to have come to a showdown (triggered by Covid) and meaning that we still can’t do elective surgery…

Best regards

Stephan Kantak

Dear friends,

I am a nurse in my beloved Peru, and of the 32 million inhabitants, approximately 28% have been covered to date.

We have advanced by age groups, being currently in the second dose of 38 years, however, if we make a cut, we can mention that from 80 years of age the coverage is 81%, from 70 to 79, the coverage is 79 %. , from 60 to 69 years, the coverage is 76%, from 50 to 59, the coverage is 63%, from 40 to 49 years, the coverage is only 43%, and from 36 to 39 years, the coverage is 11%

In those over 42 years of age, the vaccine has been pfizer, and in health personnel and those under 42 years of age, the vaccine is Sinopharm; through campaigns called "Vacunatón"

The importance of vaccination has been raised and motivated with more force because there have been campaigns against vaccination and unfavorable and even malicious opinions, on the part of public and political figures.

Our territory, with a very varied geography, has many areas that are difficult to access, but here we go, the circuits to deliver the vaccines have already begun, we hope that better alternatives will be available because the cold chain is at risk.

In hospitals, the second wave (feb-may2021) was very harrowing, far exceeding the capacity to care, both in the hospital and in the ICU. We are now in the rising phase of the third wave, which for the moment is gradual.

Regarding Nursing, in an investigation that we developed, we related the perception of the organizational climate and the job satisfaction of the nurses of the covid 19 services of a public hospital, the cut was made at the peaks of the second wave; The results were an unfavorable perception of the organizational climate, a perception of job dissatisfaction and a significant direct relationship in 3 of the 4 dimensions of job satisfaction perceived by the nurse (in terms of working conditions, the importance of the task, personal and / or social recognition, and economic benefits). This pandemic is more than 1 year old, 'and nurses continue to care for covid19 patients without the necessary resources, with poor infrastructure, low staffing, inadequate training and lack of institutional representation, and little leadership and support from those responsible.

Eliana Medina Neyra

Rotary Club Lima Nueva Era,  Peru.

Meanwhile, on Polio in Afghanistan:

Greetings.  

The polio eradication work continues in Afghanistan.The polio partnership, in remaining politically neutral, has had several meetings with the Taliban over the last year  to discuss vaccinations in areas they have controlled for some time.  Even as recently as yesterday, the Taliban health lead, .not yet a health minister, visited the polio emergency operations center in Kabul to discuss the program moving forward and to discuss immunizations planned for later this month.

The most immediate problem is that some funders have held back payments for several months including having held payments to the former government.  The NGOs who work in the country cannot keep working without resources.  I was on a call this morning with top leadership of the Global Polio Eradication Initiative reviewing options to ensure the workers are paid.  This challenge is not limited to polio and impacts many humanitarian programs. 

We also discussed the danger of refugees spreading polio beyond the borders and measures needed to forestall that from occurring.  I know from minutes of a meeting held in Karachi late last week that this is a major concern in Sindh. Fortunately, the polio surveillance system has not shown the wild polio virus to be present in Afghanistan for about six months. 

So to your question on how  Rotary plans to respond:

We remain committed to polio eradication in Afghanistan.

We will maintain our stance of being politically neutral. 

We will continue to fund grants in the country through providing funds to WHO and UNICEF. 

We will work to ensure that polio workers are provided good security and are paid for their work. 

Upon request, we will fund activities ensuring that environmental sampling and other activities relating to polio surveillance remain a priority.

We will advocate for a focus on ensuring that refugees are fully vaccinated.

We remain in close contact with our Rotary chair in the country who keeps us updated on the evolving situation. He has been a keen observer of the situation there and thus we were anticipating the evolution that has occurred. 

One additional issue is that many in the country now feel abandoned.  While they might direct this towards their former government, it is much easier to instead blame outsiders. We are aware of this dynamic, understand it and  anticipate it will be a challenge moving forward. 

Nothing is ever easy but we are focused on continuing to work with the Afghani people to protect their children against the polio virus.

Best regards,

Michael K. McGovern

Rotary International PolioPlus Committee Chair 

https://rotary-site.org/health-professionals

https://rotariandoctors.org