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Monday February 6th, 2023

Vietnam smashes Coronavirus to save elderly patients, deploys ECMO machines against SARS-Cov-2

ECONOMYNEXT – Taking the battle against Coronavirus to a new level, doctors in Vietnam have deployed heart-lung machine technology to oxygenate the blood of elderly Covid-19 patients who cannot be saved with mechanical ventilators.

Extra-Corporeal Membrane Oxygenation (ECMO) involves taking blood out of the patient, oxygenating and pumping it back in, also maintaining blood pressure, taking over the functions of both the heart and lungs.

Heart-lung machines are usually used during heart transplants.

Patient No 19, known as Madam LTH, the 64-year old aunt of Patient 17, the first Second Wave infection who visited Italy and London, was taken off the ECMO machine, after her condition improved, Vietnam’s Tuoitre newspaper reported on April 04.

Vietnam had 16 Wave I patients in January and February 2020, all of whom recovered, including a 72 year old father of a Chinese resident, who had a history of complications.

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Madam LTH was transferred to the Intensive Care Unit of the Central Tropical Diseases Hospital in Ha Noi on March 15.

Elderly Covid-19 patients in particular develop a form of pneumonia quickly. Their lungs fill with fluid, making it difficult to breathe on their own, needing ventilator support in intensive care units.

Patients on ventilators also need constant care and their survival depends of the skills of ICU nurses who suck fluid out the lungs as well doctors who keep blood pressure, saturation (oxygen level), pulse, kidney function and other vitals stabilized.

After her condition worsened, on March 19, she was hooked up to the ECMO machine.

A bigger team is needed to run an ECMO machine. Vietnam’s Ministry of Health had set up a 30-member team to monitor the condition of Patient 19, Tuổi Trẻ Online said.

They were monitoring her condition adjusting drugs and life support, every hour.

She had now made much progress and has been taken off the ECMO machine, the newspaper said.

Three serious cases, including two Britishers and a 50-year old Vietnamese lady who were on ventilators are also making progress.

Two had been taken off the ventilator. Two out of three had tested negative for SARS-Cov-2 (the virus that causes Covid-19), twice.

Madam LTH, who is off the ECMO machine had also tested negative three times, the newspaper said.

The Central Tropical Disease Hospital now has only one patient on Ventilator, an 88 year old who contracted the disease while warded at the neurology unit of Bach Mai hospital.

Vietnam has so far confirmed 239 patients, 90 had recovered and no one had died, the country’s Health Ministry said.

Vietnam has quarantined foreign arrivals, diligently chased after contacts of every confirmed patients to stop wider community transmission of the diseases.

Vietnam had quarantined over 38,000 in centres and a total of 75,000 had been either home quarantined or surgically locked down and 75,000 tests done.

Vietnam, Sri Lanka and Korea among few countries that have used contact tracing strategies and quarantine to check the spread of Covid-19.

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Researchers from Vietnam have also shown how to close gaps currently practised contact tracing and quarantine strategies, in an article to be published in the news issue of the International Journal of Tuberculosis and Lung Disease (IJTLD), released online under a fast-tracking process.

The authors from the Woolcock Institute of Medical Research, Hanoi, Viet Nam; Sydney School of Medicine, Faculty of Medicine and Health, The University of Sydney, Australia, supported by others in Laos say at least three generations of contacts have to be traced and two tested to successfully kill community transmission.

T A Nguyen, Q N Cuong, A L T Kim, T N Huong, H N Nguyen, G J Fox, G B Marks, say once a patient had been identified (F0), the next generation should be tested and another two generations traced.

“First, three generations of contact (F) with COVID-19 cases should be traced to offer timely testing if the previous contact generation is found positive,” they wrote.

“This algorithm starts with the first generation (F1) who are close contacts of the index case (F0).

“All F1 contacts should be tested for SARS-CoV-2 regardless of symptom presentation.

“F1 individuals who are asymptomatic or have two negative tests 24 hours apart should be quarantined for 14 days.”

“F2 contacts should self-isolate at home and be monitored by public health units. If F1 tests positive, we recommend that F3 contacts should also be identified.

“When the previous F becomes positive, the next one will be informed to follow the contact management procedure.”

Quarantine persons should also be tested twice before being released, the researchers say.

“Inappropriate quarantine discharge could occur among patients who have an initial negative test for SARS-CoV-2 and may subsequently test positive,” they said.

(Colombo/Apr05/2020)

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Sri Lanka to address SME tax problems at first opportunity: State Minister

ECONOMYNEXT – Problems faced by Sri Lanka’s small and medium enterprises from recent tax changes will be addressed at the first opportunity, State Minister for Finance Ranjith Siyambalapitiya said.

Business chambers had raised questions about hikes in Value Added Tax, Corporate Income Tax and the Social Security Contribution Levy (SSCL) that’s been imposed.

It should be explored on how to amend the Inland Revenue Act, Siyamabalapitiya said, adding that the future months should be considered as a period where the country is being stabilized.

Both the VAT and SSCL are effectively paid by customers, but the SSCL is a cascading tax that makes running businesses difficult.

In Sri Lanka SMEs make up a large part of the economy, accounting for 80 per cent of all businesses according to according to the island’s National Human Resources and Employment Policy.

(Colombo/ Feb 05/2023)

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Sri Lanka revenues Rs158.7bn in Jan 2023 up 51-pct

ECONOMYNEXT – Sri Lanka’s government revenues were 158.7 billion rupees in January 2023 but expenditure and debt service remained high, Cabinet spokesman Minister Bandula Gunawardana said.

In January 2022 total revenues were Rs104.5 billion according to central bank data.

Sri Lanka’s tax revenues have risen sharply amid an inflationary blow off which had boosted nominal GDP while President Ranil Wickremesinghe has also raised taxes.

Departing from a previous strategy advocated by the IMF expanding the state and not cutting expenses, called revenue based fiscal consolidation, he is attempting to do classical fiscal consolidation with spending restraint.

President Ranil Wickremesinghe has presented a note to cabinet requesting state expenditure to be controlled, Gunawardana told reporters.

State Salaries cost 87.4 billion rupees.

Pensions and income supplements (Samurdhi program) were29.5 billion rupees.

Other expenses were 10.8 billion rupees.

Capital spending was   21 billion rupees.

Debt service was 377.6 billion rupees for January which has to be done with borrowings from Treasury bills, bonds and a central bank provisional advance of 100 billion rupees, Gunawardana said.

Interest costs were not separately given. (Colombo/Feb05/2023)

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Sri Lanka’s Ceylon Tea prices down for second week

ECONOMYNEXT – Sri Lanka’s Ceylon Tea prices fell for the second week at an auction on January 31, with teas from all elevations seeing a decline, data showed.

“In retrospect, the decline in prices would be a price correction owing to the overall product quality and less interest from some key importers due to the arrival of cargo at destinations ahead of schedule,” Forbes and Walker tea brokers said.

The weekly sale average fell from 1475.79 rupees to 1465.40 rupees from a week ago, according to data from Ceylon Tea Brokers.

The tea prices are down for two weeks in a row.

High Growns

The High Grown sale average was down by 20.90 rupees to 1380.23 rupees, Ceylon Tea Brokers said.

High grown BOP and BOPF was down about 100 rupees.

“Ex-Estate offerings which totalled 0.75 M/Kg saw a slight decline in quality over the previous week” Forbes and Walker said.

OP/OPA’s in general were steady to marginally down.

Low Growns

In Low Grown Teas, FBOP 1 was down by 100 rupees and FBOP was down by 50 rupees while PEK was up by 150 rupees.

The Low Growns sale average was down by 8.55 rupees to 1547.93 rupees.

A few select Best BOP1s along with Below Best varieties maintained.

OP1                     Select Best OP1’s were steady, whilst improved/clean Below Best varieties maintained.   Others and poorer sorts were easier.

PEKOE                 Well- made PEK/PEK1s in general were steady, whilst others and poorer sorts were down.

Leafy and Semi Leafy catalogues met with fair demand,” Forbes and Walker brokers said.

“However, the Small Leaf and Premium catalogues continued to decline.

“Shippers to Iran were very selective, whilst shippers to Türkiye and Russia were fairly active.”

This week  2.2 million Kilograms of Low Growns were sold.

Medium Growns

Medium Grown BOP and BOPF fell by around 100 rupees

The Medium Growns sale average was down by 33.40 rupees to 1199.4 rupees.

“Medium CTC teas in the higher price bracket witnessed a similar trend, whilst teas at the lower end were somewhat maintained subject to quality,” Forbes and Walker brokers said.

“Improved activity from the local trade and perhaps South Africa helped to stabilize prices to some extent.”

OP/OPA grades were steady while PEKOE/PEKOE1 were firm, while some gained 50-100 rupees at times.

Well-made FBOP/FBOPF1’s were down by 50-100 rupees per kg and more at times.

(Colombo/Feb 5/2023)

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