Flu activity rose sharply last week, with 36 states now reporting widespread circulation and other markers such as clinic visits for flu and positive respiratory specimens also showing steep increases, the US Centers for Disease Control and Prevention (CDC) said today in its latest update.The new report underscores a warning that came from the CDC 2 days ago about steadily climbing flu dominated by H3N2, a subtype known for its heavy impact, especially on seniors and young children. Between that and known gaps in H3N2 protection in seasonal flu vaccines, the CDC also reminded providers that antiviral drugs are an important second line of defense in treating flu.Closer look at rising US flu markersIn its report today, the CDC said since its last report, the number of states reporting widespread flu activity—encompassing a broad swath of the country—jumped from 23 to 36, and the proportion of respiratory samples testing positive for flu at clinical labs rose from 14% to 22.4%.Nationally, the percentage of clinic visits for flu—which climbed from 3.5% to 5%—has been at or above the national baseline for 5 weeks so far this season, the CDC said, adding that in recent seasons, flu has been at those levels for an average of 13 weeks.In its chart comparing clinic visits this year to the past five seasons, the pattern seems to be closely following the moderate-to-severe 2014-2015 season, which was also dominated by H3N2.High flulike illness activity, another marker of clinic visits for flu, was reported in 21 states, with regional activity reported by 13 states and Puerto Rico.Flu hospitalizations are rising steadily, and last week were at an overall rate of 8.7 hospitalizations per 100,000 population. The levels were much higher in seniors, at 35.8 per 100,000 population.Three more pediatric flu deaths were reported, raising the total to 12 this season. One was from an unsubtyped influenza A virus, while the other two were linked to influenza B.Overall deaths from pneumonia and flu, an indicator that typically lags other flu markers, are below the seasonal baseline.In tests last week at public health laboratories, 89% of positive flu specimens were influenza A and 11% were influenza B. Of the subtyped A viruses, 88.1% were H3N2. Analysis of a subset of H3N2 viruses shows extensive genetic diversity with many clades and subclades circulating, most of them similar to a cell-propagated reference virus that is a component of Northern Hemisphere flu vaccines.Flu in Canada and EuropeCanada, which has also been experiencing early flu activity, reported a notable increase in flu outbreaks and hospitalizations in the most recent update from the Public Health Agency of Canada (PHAC), covering the week ending Dec 16.Though H3N2 is the dominant strain, Canada is seeing a substantially greater number of influenza B illnesses for this time of year compared to past seasons. Levels of hospitalizations and deaths are highest in seniors, and since early November, surveillance has reported above-average hospitalizations for flu among children.In Europe, where flu activity began more slowly, disease levels are on the rise in western, northern, and southern Europe, according to a joint report covering the week ending Dec 24 from the European Center for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) regional office for Europe. Both influenza A and influenza B viruses are circulating, with mixed patterns detected across the region, including higher proportions of influenza B than influenza A and more 2009 H1N1 than H3N2. An analysis of a small number of H3N2 viruses suggests that the circulating viruses belong to the vaccine virus clade.At sentinel healthcare sites, the percentage of respiratory specimens that tested positive for flu rose from 28% to 32% compared to the previous week.See also:Dec 29 CDC FluView updateDec 29 CDC situation updateDec 27 CIDRAP News story “Jump in H3N2 flu prompts CDC warning, antiviral reminder”Dec 22 PHAC updateDec 29 Flu News Europe report
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Employment tribunals are failing to hit basic targets and judges are departing without being replaced, users have revealed. Minutes of the National User Group Meeting on employment tribunals report that tribunals are falling short of targets for completing and disposing of claims.Employment tribunals aim to complete 75% of claims within 26 weeks of receipt. However, according to the minutes, the current level of claims completed in that time stands at 67%. In terms of disposing of a claim, tribunals aspire to dispose of single claims within 26 weeks. However, the current timeframe is 29 weeks.Furthermore, judges are retiring at a rate of around five or six per year but are not being replaced – the meeting heard.User group president Judge Brian Doyle said that despite losing salaried judicial resources there ’were currently no recruitment exercises planned’. The position was similar regarding fee-paid judges and non-legal members.The minutes come from the user group’s June 2017 meeting – the latest for which minutes are available. The most recent meeting was held on 16 October. The group, made up of judges and professionals, is a forum for customers to discuss the service.A spokesperson for HMCTS told the Gazette: ’Maintaining access to justice is vital and continues to be at the heart of our reforms. Most employment tribunal claims are made within 26 weeks and the rate improved on the last quarter. We continue to look to improve timeliness in these cases.’Meanwhile, the government has again refused to reveal details of when and how people who paid the now outlawed tribunal fees will be reimbursed.A spokesperson said: ’Following the Supreme Court’s judgment we said we would put in place arrangements to refund those who have paid employment tribunal fees. We will set out further details in due course.’
“Sometimes, it’s kind of Orwellian. You think we’re living in a place where, ‘Is this really happening?’ But that comparison was pretty stark when you put our president up against those leaders when he’s with them or talking to him and how he reacts compared to the way Adam Silver reacted. I was proud of him. It was great.”Asked about Trump’s comments, Popovich added: “All I did was make a comparison between Adam Silver’s show of principle and courage in a tough situation, as opposed to how our president reacts when in the company of authoritarian figures, whether it’s Saudi Arabia, North Korea, Russia or Turkey, whatever it is.”It comes off as really feckless, impotent, cowardly by comparison.” San Antonio Spurs head coach Gregg Popovich said Sunday he prefers NBA commissioner Adam Silver’s leadership to that of President Donald Trump.Popovich was responding to criticism from Trump, who blasted the Spurs coach and Golden State Warriors counterpart Steve Kerr last week for their responses to questions about the NBA-China controversy. Houston Rockets general manager Daryl Morey issued an apology for a now-deleted tweet, that read “Fight for freedom, stand with Hong Kong” amid the ongoing protests in the region.While Popovich and Kerr unwilling to discuss the matter, Silver drew praise for his response after saying the league was “apologetic” but added that “we are not apologising for Daryl exercising his freedom of expression”.final frames from today’s action pic.twitter.com/Fvt2x3HedB— San Antonio Spurs (@spurs) October 13, 2019Popovich – who has been critical of Trump in the past – told reporters prior to the Spurs’ 123-114 preseason loss to the New Orleans Pelicans on Sunday: “[Silver] stood by our nation and its principles. That’s pretty huge in these days.