The African Sepsis Alliance supports the John Snow* Memorandum. This Memorandum is a collaborative and inclusive initiative to protect public health in this COVID-19 pandemic and the work of a group of international researchers with expertise spanning public health, epidemiology, medicine, pediatrics, sociology, virology, infectious disease, health systems, psychology, psychiatry, health policy, and mathematical modeling. Said group felt moved to deliver a clear and simple message about how best to manage the COVID-19 pandemic.

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THE JOHN SNOW MEMORANDUM

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected more than 35 million people globally, with more than 1 million deaths recorded by the World Health Organization as of Oct 12, 2020. As a second wave of COVID-19 affects Europe, and with winter approaching, we need clear communication about the risks posed by COVID-19 and effective strategies to combat them. Here, we share our view of the current evidence-based consensus on COVID-19.

SARS-CoV-2 spreads through contact (via larger droplets and aerosols), and longer-range transmission via aerosols, especially in conditions where ventilation is poor. Its high infectivity(1) combined with the susceptibility of unexposed populations to a new virus, creates conditions for rapid community spread. The infection fatality rate of COVID-19 is several-fold higher than that of seasonal influenza(2) and infection can lead to persisting illness, including in young, previously healthy people (ie, long COVID(3)). It is unclear how long protective immunity lasts(4) and, like other seasonal coronaviruses, SARS-CoV-2 is capable of re-infecting people who have already had the disease, but the frequency of re-infection is unknown(5). Transmission of the virus can be mitigated through physical distancing, use of face coverings, hand and respiratory hygiene, and by avoiding crowds and poorly ventilated spaces. Rapid testing, contact tracing, and isolation are also critical to controlling transmission. The World Health Organization has been advocating for these measures since early in the pandemic.

In the initial phase of the pandemic, many countries instituted lockdowns (general population restrictions, including orders to stay at home and work from home) to slow the rapid spread of the virus. This was essential to reduce mortality(6),(7) prevent health-care services from being overwhelmed, and buy time to set up pandemic response systems to suppress transmission following lockdown. Although lockdowns have been disruptive, substantially affecting mental and physical health, and harming the economy, these effects have often been worse in countries that were not able to use the time during and after lockdown to establish effective pandemic control systems. In the absence of adequate provisions to manage the pandemic and its societal impacts, these countries have faced continuing restrictions.

This has understandably led to widespread demoralisation and diminishing trust. The arrival of a second wave and the realisation of the challenges ahead has led to renewed interest in a so-called herd immunity approach, which suggests allowing a large uncontrolled outbreak in the low-risk population while protecting the vulnerable. Proponents suggest this would lead to the development of infection-acquired population immunity in the low-risk population, which will eventually protect the vulnerable. This is a dangerous fallacy unsupported by scientific evidence.

Any pandemic management strategy relying upon immunity from natural infections for COVID-19 is flawed. Uncontrolled transmission in younger people risks significant morbidity(3) and mortality across the whole population. In addition to the human cost, this would impact the workforce as a whole and overwhelm the ability of healthcare systems to provide acute and routine care.

Furthermore, there is no evidence for lasting protective immunity to SARS-CoV-2 following natural infection(4) and the endemic transmission that would be the consequence of waning immunity would present a risk to vulnerable populations for the indefinite future. Such a strategy would not end the COVID-19 pandemic but result in recurrent epidemics, as was the case with numerous infectious diseases before the advent of vaccination. It would also place an unacceptable burden on the economy and healthcare workers, many of whom have died from COVID-19 or experienced trauma as a result of having to practise disaster medicine. Additionally, we still do not understand who might suffer from long COVID(3). Defining who is vulnerable is complex, but even if we consider those at risk of severe illness, the proportion of vulnerable people constitute as much as 30% of the population in some regions(8). Prolonged isolation of large swathes of the population is practically impossible and highly unethical. Empirical evidence from many countries shows that it is not feasible to restrict uncontrolled outbreaks to particular sections of society. Such an approach also risks further exacerbating the socioeconomic inequities and structural discriminations already laid bare by the pandemic. Special efforts to protect the most vulnerable are essential but must go hand-in-hand with multi-pronged population-level strategies.

Once again, we face rapidly accelerating increase in COVID-19 cases across much of Europe, the USA, and many other countries across the world. It is critical to act decisively and urgently. Effective measures that suppress and control transmission need to be implemented widely, and they must be supported by financial and social programmes that encourage community responses and address the inequities that have been amplified by the pandemic. Continuing restrictions will probably be required in the short term, to reduce transmission and fix ineffective pandemic response systems, in order to prevent future lockdowns. The purpose of these restrictions is to effectively suppress SARS-CoV-2 infections to low levels that allow rapid detection of localised outbreaks and rapid response through efficient and comprehensive find, test, trace, isolate, and support systems so life can return to near-normal without the need for generalised restrictions. Protecting our economies is inextricably tied to controlling COVID-19. We must protect our workforce and avoid long-term uncertainty.

Japan, Vietnam, and New Zealand, to name a few countries, have shown that robust public health responses can control transmission, allowing life to return to near-normal, and there are many such success stories. The evidence is very clear: controlling community spread of COVID-19 is the best way to protect our societies and economies until safe and effective vaccines and therapeutics arrive within the coming months.

We cannot afford distractions that undermine an effective response; it is essential that we act urgently based on the evidence.

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*ABOUT JOHN SNOW

John Snow is considered one of the founders of modern epidemiology. He developed the water theory of transmission of cholera. In 1854, he famously persuaded authorities to remove the handle of a water pump to try to curtail transmission of cholera during an outbreak in London. He devoted much of his life to improving public health…

In just one week, on 9 September, the WHO and the GSA will host the “World Sepsis Congress Spotlight: Sepsis, Pandemics, and Antimicrobial Resistance – Global Health Threats of the 21st Century”. This free online congress is a great opportunity to connect to and learn from over 30 high level speakers and leading experts from around the globe.

The African Sepsis Alliance is excited to support the event and invites you to attend. Participation is free of charge and can be done from wherever you have an internet connection. To register and to find out more about the program, speakers, time zones, and much more, please visit wscspotlight.org.

GSA Executive Committee member Prof. Flavia Machado was interviewed by the JAMA Network  on "Coronavirus in Brazil - Report From The Front Lines".

The interview provides a very insightful overview on how Brazil is tackling the pandemic, the efficiency of treatments, and solutions adopted by hospitals to respond to the crisis. Interestingly, Prof. Machado confirmed that in most cases people are dying from refractory septic shock rather than refractory hypoxemia.

Besides, she noted that the usual differences between high (HICs) - and low- and middle-income countries (LMICs), where 85% of sepsis cases occur, are not so visible with COVID-19, in fact, the most affected countries are HICs. 

Prof. Machado is chair of the intensive care session of Anesthesiology, Pain and Intensive Care Department at the Federal University of São Paulo, Brazil, and CEO of the Latin America Sepsis Institute (LASI). 

The rapid global spread of the novel coronavirus SARS-CoV-2 has caused societal, economic, and medical upheaval not seen since the 1918 influenza pandemic. As of April 7th, the World Health Organization has confirmed cases in 203 countries, areas or territories, with over 1.2 million confirmed cases and over 65,000 deaths.  Further, many experts believe these numbers to be a gross underestimate for a variety of reasons, including inadequate testing capacity and suboptimal reporting of cases. Despite extensive modeling by epidemiologists all over the world, it is not possible to accurately predict the course and duration of this pandemic. It is important that we continue to obtain objective data on which we base recommendations. A calm and rational approach from both society and individuals is necessary during these uncertain times.

There remains considerable confusion regarding the differences between seasonal influenza and COVID-19 (the illness caused by SARS-CoV-2). While both viruses are capable of causing severe illness and can spread rapidly, it appears that SARS-CoV-2 is a more deadly pathogen on a case-by-case basis, can be spread during the asymptomatic phase, and is capable of much more rapid spread. The higher burden and mortality may be attributed to the fact that SARS-CoV-2 is a “newly emerged” virus, and consequently, there is very little innate immunity to it among humans, unlike with influenza where both prior infection and annual vaccination can provide protection. Overall, however, the sheer contagiousness of this new virus has led to the high morbidity and mortality seen globally – simply put, healthcare systems have been unable to cope with the number of infected persons seeking care. Indeed, a proportion of the reported deaths are due to overwhelmed medical systems rather than the virulence of COVID-19. This is a crucial factor explaining the “flatten the curve” strategy adopted by many countries. 

Now that more scientific data are available on COVID-19, the African Sepsis Alliance can more definitively state that COVID-19 does indeed cause sepsis. Sepsis is “a life-threatening organ dysfunction caused by a dysregulated host response to infection.” In the case of COVID-19, the effects on the respiratory system are well-known, with most people requiring hospital admission developing pneumonia of varying severity; however, virtually all other organ systems can be affected. This is consistent with a combination of direct viral invasion and sepsis. For example, in a recently published case series of severe COVID-19 cases from the Seattle area in the United States, over 30% had evidence of liver injury and 75% had evidence of a depressed immune response¹; another series from the same region reported acute kidney failure in almost 20% of affected patients requiring ICU care ², and both series reported septic shock severe enough to require drugs to support the heart and circulation in almost 70% of patients. A recent study from China reported that in patients hospitalized with COVID-19, 28% had evidence of significant heart damage (potentially from direct invasion of cardiac muscle by the virus), resulting in heart failure and abnormal heart rhythms – this damage was associated with a five-fold increase in the risk of death³. As there are no proven therapies effective against the virus itself, it is apparent that the best COVID-19 care includes good sepsis care.

Effective and safe treatments for COVID-19 are urgently being sought by scientists across the world. Although it is hoped that the first batches of a COVID-19 vaccine will begin to be tested in humans in April 2020⁴, large-scale distribution of a viable vaccine may still be a year or more away. Treatment trials are underway with antiviral agents such as Lopinavir/ritonavir (LPV/r), Hydroxychloroquine (HCG), Hydroxychloroquine plus azithromycin, Favipiravir (FPV), Remdesivir (RDV), and with immunomodulators such as Tocilizumab, the anti-C5a antibody IFX-1, and Intravenous Immunoglobulin (IVIG). In addition, potential treatment with convalescent serum is being attempted and trialed.

However, despite these efforts, presently there are no specific treatments for COVID-19. As such, the African Sepsis Alliance continues to strongly advocate for strict adherence to the basic protective measures recommended by the WHO – handwashing, maintaining social distancing, avoiding touching one’s face, practicing proper respiratory hygiene, staying at home if feeling unwell, and obtaining prompt medical care if fever, cough, and breathing difficulty develop together. We also recommend close attention and adherence to the restrictions on social gatherings set by local health authorities and government bodies. We encourage you to assess the particular challenges faced by the healthcare systems in your area, and if you are able to materially assist in any way (including something as simple as volunteering to be a blood donor), please do so. We are in this together. Be safe.

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This article was published on April 7th, 2020, with the most recent data from the WHO Situation Report from April 6th, 2020 - we expect both cases and deaths to rise further. The views in this news post are not intended or implied to be a substitute for professional medical advice. Special thanks to Nathan Nielsen, Niranjan ‘Tex’ Kissoon, Konrad Reinhart, Dennis Kredler, Mahawi Aljuaid, and Simon Finfer for helping to put this article together.

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References

¹ (Bhatraju PK, et al. NEJM 2020)
² (Arentz M, et al. JAMA 2020)
³ (Guo T, et al. JAMA 2020)
⁴ https://time.com/5790545/first-COVID-19-vaccine/

Update April 7th: While the article below was factually correct at the time of publication, it has become outdated (as many things that were written or said a month ago) – an updated version is available here.

Original article:

On January 30th, the World Health Organization declared the 2019 Novel Coronavirus (SARS-CoV-2*) a global health emergency, declaring it an “unprecedented outbreak.” Legitimate concerns of a deadly pandemic have increased due to the virus continuing to spread worldwide, with cases reported in 73 countries spanning across Europe, Asia, South America, North America, and the Eastern Mediterranean Region.

As with every major public health crisis, misinformation and fear run rampant. The importance of fact-based information is tantamount. To this end, the African Sepsis Alliance would like to provide the following answer to the question of whether COVID-19 can cause sepsis. The answer is a qualified “YES.”

The presently accepted definition of sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. From information presently available on clinical cases of COVID-19, it appears that a small percentage of COVID-19 infections can result in such organ dysfunction and death.

To date, the most reliable information on the clinical syndrome resulting from COVID-19 comes from recently published data out of Wuhan, China and was published in the Journal of the American Medical Association (JAMA) on February 7, 2020. The most common symptoms attributed to COVID-19 infection requiring hospitalization were fever, fatigue, and a dry cough. A majority of cases also had low white blood cell counts and abnormal blood clotting parameters. Of patients hospitalized with COVID-19, 26% were sick enough to be treated in an intensive care unit (ICU) – of these, approximately 60% developed respiratory failure and 31% developed shock. Prolonged hospital courses were not uncommon. Fortunately, even among patients ill enough to be hospitalized with COVID-19 infection, only 4% died – meaning that even among hospitalized COVID-19 cases, nearly 96% have survived. Broader epidemiological data from both inside and outside China also support a case fatality rate of about 1%.

However, despite the attention being paid to COVID-19, it is important to realize that it is by no means the deadliest infection globally in 2020. It is not even the deadliest virus. Fewer than 3,200 deaths have been attributed in total to COVID-19. In comparison, the influenza virus has been responsible for at least 16,000 deaths in the United States alone so far in the 2019-2020 influenza season, with an in-hospital death rate near 5% – higher than the 4% in-hospital death rate seen with COVID-19 in China. As an additional frame of reference, recent estimates place the annual deaths due to sepsis worldwide in excess of 11 million.

Treatments and vaccines are being sought with urgency but are unlikely to be available within the next year. In the meantime, all individuals, particularly those in areas where the COVID-19 has already struck, should focus on the basic protective measures recommended by the WHO – handwashing, maintaining social distancing, avoiding touching one’s face, practicing proper respiratory hygiene, staying at home if feeling unwell, and obtaining prompt medical care if the triad of fever, cough, and breathing difficulty develop.

In conclusion, while the fears of a COVID-19 pandemic are legitimate, it is the view of the ASA that robust and appropriately funded healthcare systems, having already improved the survival rates for sepsis significantly over the past two decades, will be able to adequately identify and manage patients with emerging infections such as COVID-19. Additionally, while the majority of individuals affected by COVID-19 will not develop life-threatening sepsis, the global threat posed by COVID-19 does underpin the need for all citizens and healthcare workers to ensure they are familiar with the early signs of sepsis and appreciate that sepsis can be caused by a multitude of infections, such as this novel coronavirus, other viral infections, seasonal influenza viruses, or common bacterial infections such as pneumonia, urinary tract, abdominal, or wound infections. Never has the slogan of the World Sepsis Day Movement rung truer than now – Stop Sepsis, Save Lives.

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This article was published on March 4th, 2020, with the most recent data from the WHO Situation Report from March 3rd, 2020. The views in this news post are not intended or implied to be a substitute for professional medical advice. Special thanks to Nathan Nielsen, Luis Gorordo Del Sol, Emmanuel Nsutebu, and Simon Finfer for helping to put this article together.

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*For simplicity, we’ll refer to the virus as COVID-19, even though it’s technically SARS-CoV-2, and the disease it can cause is COVID-19 (by analogy: HIV = virus, AIDS = the disease it can cause).

The Cameroon Sepsis Alliance was launched at the African Federation of Critical Care Nurses Conference held in Douala, Cameroon on the 8th of November 2019.

The conference was attended by over 100 critical care nurses from Africa and physicians from Cameroon. The African Sepsis Alliance provided sponsorship for the event and members of the African Sepsis Alliance Executive Committee attended and provided sepsis training. Local speakers also presented sepsis improvement projects and data from Cameroon.

The African Sepsis Alliance looks forward to hearing about the next steps and is committed to working with this multidisciplinary team to improve sepsis prevention, recognition, and management in Cameroon.

Emmanuel Nsutebu, Chair of the African Sepsis Alliance, was a guest on BBC’s Focus on Africa last Friday.

He was interviewed on the incidence and impact of sepsis in Africa, in light of the Global Burden of Disease Study revealing how the population of low- and middle-income countries, especially in Africa, are particularly at risk to develop or die of sepsis.

You can listen to the segment with Emmanuel below.

Twice as many people are dying from sepsis worldwide than previously estimated, according to a groundbreaking study by an international team of scientists published in The Lancet today. Among them are a disproportionately high number of children in poor areas.

This study, the most comprehensive clinical study on sepsis to date, revealed 48.9 million cases of sepsis in 2017 and 11 million deaths. 1 in 5 deaths globally are associated with sepsis. Sepsis arises when the body’s response to an infection injures its own tissues and organs. It may lead to shock, multi-organ failure, and death – especially if not recognized early and treated promptly. For sepsis survivors, it can create lifelong disabilities and suffering.

It was found that about 85% of sepsis cases occurred in low- or middle-income countries – especially in Sub-Saharan Africa, the South Pacific islands, and South, East, and Southeast Asia. While sepsis incidence is higher among females than males, more than 40% of all cases are occurring in children under 5.

“I’ve worked in rural Uganda, and sepsis is what we saw every single day. Watching a baby die of a disease that could have been prevented with basic public health measures really sticks with you. I want to contribute to solving this tragedy, so I participate in research on sepsis. However, how can we know if we’re making progress if we don’t even know the size of the problem? If you look at any top 10 list of deaths globally, sepsis is not listed because it hasn’t been counted.”

— Lead Author Kristina E. Rudd, M.D., M.P.H., Assistant Professor at Pitt's Department of Critical Care Medicine

For their analysis, Rudd and colleagues leveraged the Global Burden of Disease Study, a comprehensive epidemiological analysis coordinated by the Institute for Health Metrics and Evaluation (IMHE) at the University of Washington School of Medicine. Previous global estimates for sepsis relied upon hospital databases from select middle- and high-income countries, making them severely limited and prone to overlooking the occurrence outside of the hospital, especially in low-income countries.

“We are alarmed to find sepsis deaths are much higher than previously estimated, especially as the condition is both preventable and treatable. We need renewed focus on sepsis prevention among newborns and on tackling antimicrobial resistance, an important driver of the condition.”

— Senior Author Mohsen Naghavi, M.D., Ph.D., M.P.H., Professor of health metrics sciences at IHME at the University of Washington School of Medicine

Although the number of cases are much higher than previously estimated, it is important to note that great international and collaborative work has been done worldwide in the past decades to fight sepsis. These efforts are conveyed in the study which examined annual sepsis incidence and mortality trends from 1990 to 2017. The study found that rates are actually decreasing. In 1990, there were an estimated 60.2 million sepsis cases and 15.7 million deaths, compared to the 48.9 million cases and 11 million deaths in 2017. However, the study highlights we still have a long way to go in the global fight against sepsis and we need to continue to build upon the work being done worldwide.

“This research confirms the urgent need for policymakers, healthcare providers, clinicians, and researchers to work together to implement robust national sepsis strategies, as called for in the 2017 WHO Resolution on Sepsis.”

— Konrad Reinhart, President Global Sepsis Alliance

This research was funded by The Bill & Melinda Gates Foundation, the National Institutes of Health (grants T32HL007287, T32HL007820, R35GM119519), the University of Pittsburgh, the British Columbia Children’s Hospital Foundation, the Wellcome Trust, and the Fleming Fund.

A comprehensive press release, a template for a press release, and a contact person for media inquiries is available on the website of our friends at World Sepsis Day.

The Titanic in Belfast, venue of the Critical Care Reviews Meeting 2020

The most comprehensive clinical study on sepsis will be released in The Lancet this Thursday, January 16th, 2020 at 18:05h Central European Time. This research contains the most far-reaching and up-to-date data on the incidence and mortality of sepsis worldwide. This study has the potential to change health policy and disease management all around the world, in both developing and under-developed countries.

The results of said study will be presented at the Critical Care Reviews Meeting this Thursday, January 16th, 2020, at 16:35h Belfast Time (17:35h Central European Time, please click here to see to the event in your time zone). There will be a livestream* available (embedded below for your viewing convenience), where you’ll be able to follow along. We urge you to tune in and share the link with your colleagues and other interested parties.

As soon as the presentation has concluded, we’ll share the new numbers on the global burden of sepsis, as well as further documentation.

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Livestream

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*Livestreams are tricky, especially when being set up in advance. If the link doesn’t work on the day of the event, we’ll make sure to update it promptly, so stay tuned.

Estimates of the number of sepsis cases in low-income countries are hard to find - it is challenging to identify and confirm the causes of hospital admissions. However, we know that many patients in Africa die of infection. Researchers used routinely collected hospital data from a large teaching hospital in Malawi’s second city (Blantyre) to assess how common sepsis is.

Despite limited diagnostics and information systems, they were able to estimate the rate of cases in the population (which were higher than most estimates from high-income countries), as well as the death rates from sepsis amongst those admitted to hospitals (around one quarter of patients died).

Even with ongoing uncertainty about exact numbers, this work confirms sepsis as a major killer in Africa, and one which demands focused and persistent efforts to improve recognition and treatment. We look forward to seeing the results of other ongoing studies such as the short incidence study of the African Research Collaboration on Sepsis, which will provide more information about the incidence and mortality rates of sepsis in Africa.

Our website now supports your operating systems native dark mode - depending on the settings of your device, this website will be either light or dark, making it more user friendly and easier on the eyes when viewed at night. Please note that you need to use a relatively modern browser for this to work.

How to Enable Dark Mode

Enabling dark mode depends on your device. Here is a quick how-to for the most common operating systems:

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iOS / iPad OS (iPhone / iPad)

1. Make sure you have at least iOS 13.0 installed (you can check in Settings -> General -> Info)

2. Access control center (by swiping down from the top right on Face ID enabled devices or from the bottom up on devices with a home button)

3. Long press on the brightness slider and tap the dark mode icon at the bottom left

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Android (can be different depending on manufacturer)

1. Make sure you have at least Android 10 installed (you can check in Settings -> About Phone -> Software Information)

2. Open the settings app

3. Navigate to Display -> Theme and enable ‘Dark Theme’ (you can also add a tile to the quick settings pull-down menu)

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Mac

1. Make sure you have at least macOS Mojave (10.14) installed (you can check by clicking on the Apple Menu at the top left, and then ‘About this Mac’)

2. Open the settings app and navigate to General

3. Use the buttons at the top to switch between a dark and a light appearance (with macOS Catalina (10.15), you can also set this to automatic, based on sunset at your location)

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Windows

1. Make sure you have at least Windows 10 installed (you can check by clicking on the Start Button -> Settings -> System -> About)

2. Open the settings app and go to Personalization -> Colors

3. Under ‘Choose your default app mode’, choose Dark

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Feedback

We are constantly improving our websites, dark mode is just one of many improvements (although a big one). If you have issues with dark mode, have ideas to improve our websites further, or have other feedback, we’d love to hear from you. If you are interested how we implement dark mode, there is a tutorial on the World Sepsis Day website.

From November 7th to November 9th, the African Federation of Critical Care Nurses will host their 5th annual conference in Douala, Cameroon. The theme of the conference is ‘Bridging the Gap in Recognizing and Managing the Critically-Ill Patients in Africa’, with the sub themes “Critical Care in Africa” and “Focus on Sepsis in Africa”.

The congress features many prestigious speakers on the issue, including:

• Prof. Isabel Coetzee, South Africa

• Dr. Halima Kabara, Nigeria

• Prof. Tih Plus, Director CBCHS, Cameroon

• Prof. Ged Williams, United Arab Emirates

• Dr. Angreas Matthias, RobinAid, Germany

• Prof. Konrad Reinhart, Global Sepsis Alliance, Germany

• Dr. Grace Tadzong Awasum, UCAC, Cameroon

Today is World Sepsis Day* - countless events in all parts of the world are raising awareness for sepsis today.

In addition to joining local WSD Events, here are some last minute tips to get involved online or in your institution:

Sign the World Sepsis Declaration

It’s like a petition against sepsis - the more people sign it, the better.

Follow World Sepsis Day on Social Media

World Sepsis Day is ‘World Sepsis Day’ on Instagram, Twitter, and Facebook - make sure to follow them if you aren’t yet.

Post to Your Social Media

Posting to your personal or company social media account raises awareness and helps to save lives. Templates for posts are below - it’s as simple as copying and pasting. All post are 280 characters or less, meaning they work on Twitter effortlessly. Most work best with a WSD Infographic or a Sepsis Awareness Clip…

• Sepsis is not only a medical #emergency, but also a global health crisis, affecting up to 30 million people a year - September 13th is #WorldSepsisDay. Join us in raising awareness for #sepsis - awareness saves lives! #stopsepsis #savelives

• September 13th is #WorldSepsisDay - I am/We are participating to raise #awareness for #sepsis and #WorldSepsisDay - what are you doing? Start at www.worldsepsisday.org and help #stopsepsis #savelives

• September 13th is #WorldSepsisDay! Sepsis is the final common pathway to death from most infectious diseases worldwide - these are the most common #sources of #sepsis.

• September 13th is #WorldSepsisDay! While everybody can get sepsis, certain people are at an even higher risk. Join us in raising #awareness for #sepsis - awareness saves lives! #stopsepsis #savelives

• September 13th is #WorldSepsisDay! #Sepsis is a medical emergency and must be treated immediately - if you see 2 or more #symptoms, act immediately. #stopsepsis #savelives

• September 13th is #WorldSepsisDay! #Sepsis is the most preventable cause of death worldwide. It can be prevented by #vaccination, #sanitation, and #awareness. Everything depends on #you! Join us and #stopsepsis #savelives

• September 13th is #WorldSepsisDay! #Sepsis does not end at hospital discharge - many #sepsissurvivors face lifelong consequences. Join us to raise awareness! #stopsepsis #savelives

• September 13th is #WorldSepsisDay! Join our global movement now - it is as easy as downloading our free #infographics or #sepsis #awareness clips from www.worldsepsisday.org/toolkits and posting them from your account. Raising awareness starts with #you. #stopsepsis #savelives

• I am participating in the #WorldSepsisDay #Photochallenge to raise awareness for #sepsis, a disease affecting 30 million people annually, but often neglected by #policymakers, the general public, and even #healthcare #professionals - join the global movement to #stopsepsis now!

• September 13th is #WorldSepsisDay - I am participating in the #photochallenge to raise #awareness for #sepsis and #WorldSepsisDay - what are you doing? Start at www.worldsepsisday.org and help #stopsepsis #savelives

Hashtags

The official hashtags for World Sepsis Day are:

• #WorldSepsisDay

• #Sepsis

• #StopSepsis

• #SaveLives

We explicitly discourage using #WorldSepsisDay2019, #WSD19, or #WSD - if we want to ‘trend’, it is imperative we all use the same hashtags.

Infographics, Sepsis Awareness Clips, and More Free Resources

The WSD Toolkit Section has tons of new material - brand-new Sepsis Awareness Clips (covering symptoms, sources, risk groups, and more in about 30 seconds), posters, new wallpapers, and of course our WSD Infographics in six languages, among many other things - all for free and just two clicks away. You can use the material on social media or anywhere else on the internet, or even print it.

WSD Photo Challenge

The WSD Photo Challenge is a quick and easy way to raise awareness for sepsis and show your support for World Sepsis Day - simply print the photo board you like best, write your name on it, take a picture, and upload to Twitter, Instagram, Facebook, LinkedIn, Snapchat, or wherever you like.

Sepsis in 3 Minutes - Video

The video ‘What Is Sepsis? (Sepsis explained in 3 minutes)’ has been viewed over 200,000 times across all 7 languages - it explains many facets of the complex topic that is sepsis in just 3 minutes.

Please send the video to your loved ones - it could save their life:

Press Release

A press release as well as a press release template is available for you to customize and disseminate in multiple languages.

2019 WSD Event Poster

After World Sepsis Day, the 2019 WSD Event Poster will summarize all events that took place around WSD this year - make sure to take some pictures.

On September 14th, there will be a form available here (URL to bookmark: www.worldsepsisday.org/wsdposter) allowing you to upload a short description of your event and the best picture, to be featured on the poster. The poster will be made available for download later this year, and be printed and shipped to you later this year or early next year.

Donate to World Sepsis Day

The GSA, the organization behind WSD, is a small non-profit charity trying to make the world a better place - every cent helps and will be put to good use.

Thank you

Thank you so much for supporting World Sepsis Day - it really means the world to us.

For any questions, please contact them. Due to sheer volume, please allow them a couple of days to respond.

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*at least in our time zone ;).

Sustainable Development Goal No. 3 (SDG-3) of the World Health Organization seeks to ensure that universal healthcare for all becomes a reality, even in underserved populations. Resource-limitation and lack of protocolized care have been identified as major causes of poor outcomes among the critically-ill in low- to middle-income countries.

The implementation of a standardized approach to sepsis recognition and sepsis management in Kenya is therefore key to improving the quality of care offered to our patients, irrespective of the healthcare facility they are managed in.

For this reason, on the 13th September 2019, the African Sepsis Alliance, in conjunction with the Critical Care Society of Kenya will hold the Kenya Sepsis Symposium in Eldoret, Kenya at a meeting that will attract healthcare workers of all cadres, administrators, and policy makers. We plan to roll out a modified sepsis pathway for low-resource settings for implementation in our healthcare facilities as we officially launch the Kenya Sepsis Alliance to champion sepsis activities locally.

Sepsis is a life-threatening condition caused by your body’s toxic response to infection. Globally, there are an estimated 30 million cases of sepsis each year, over 7 million of which end in death. In fact, sepsis is the second biggest cause of death in the world and the leading cause of preventable death. Despite being a major killer, sepsis remains broadly unknown by the general public and health care workers and is under-prioritized by decisionmakers.

To address this lack of awareness and under-prioritization of sepsis, Dr Paul Kawale, a public health social scientist and Knowledge Translation Scientist at the African Institute for Development Policy (AFIDEP), was interviewed by journalist Meclina Chirwa in a live broadcast on Timveni Radio in Malawi. Dr Kawale is project manager on the African Research Collaboration on Sepsis (ARCS). The interview was designed to spark dialogue on sepsis in an effort to bring greater awareness to the issue. In his interview, Dr Kawale informed the public on what sepsis is, its burden on society, and why it is critical to prevent sepsis and save lives. The interactive nature of the interview allowed for the general public to call in, to ask questions, and seek clarifications about sepsis. This engaging interview marked an effective way of bringing awareness to an under-appreciated and complicated health issue like sepsis. Below is an overview of key messages that arose from the interview.

Interview: What is Sepsis?

Dr Kawale explained sepsis as when the microorganisms (bacterium) that fight diseases in our bodies have multiplied and spread throughout the body causing harm. This may lead to other body parts to stop functioning and many times causes death. Sepsis is caused by viruses, bacteria or fungi that can come from unhygienic water and food. Other ways of transmission include contraction from animals or other people, and unsanitary conditions in hospitals as well as in homes.

Interview: Public Queries

After this introductory conversation, the phone line was opened to the audience. People called in from across the country, including from Liwonde in Machinga District, Santhe in Kasungu District, Mvera in Dowa District, Lilongwe City’s Area 24, Mchinji District, Sipwa in Nkhata Bay District, Dedza District and Karonga District. A majority of the callers expressed having little or no knowledge of sepsis and their questions included:

• Has there ever been a sepsis case in Malawi?

• How widespread is sepsis in Malawi?

• Which groups of people are affected by sepsis?

• How can sepsis be prevented?

• What is the connection between AFIDEP and sepsis?

Dr Kawale’s responses to the above questions included noting that everyone is susceptible to sepsis, but vulnerable populations like children and pregnant women are at high risk. Dr Kawale said the best way to prevent sepsis is by preventing infection in the first place. An effective way of controlling infection includes following sanitary practices, for example having good hygiene in hospitals, among health workers and in food handling. Vaccinations can also prevent infection of specific illnesses, like measles. Dr Kawale concluded the interview by reminding the audience that sepsis is killing a lot of people, even in Malawi, but it is preventable. Its massive human and financial costs can be avoided through more research, funding and awareness.

AFIDEP’s Work to Address Sepsis

AFIDEP, together with partners including the Liverpool School of Tropical Medicine, Malawi-Liverpool-Welcome Trust, College of Medicine, the Queen Elizabeth Central Hospital and the African Sepsis Alliance, are looking to tackle sepsis through a consortium called the African Research Collaboration on Sepsis (ARCS). ARCS is being implemented in Malawi, Uganda and Gabon, in order to understand how widespread sepsis is and to identify ways to improve its diagnosis and treatment in our health systems. AFIDEP’s work on ARCS seeks to put sepsis on the national and regional policy agenda. This requires greater awareness on what sepsis is and why it needs to urgently be addressed among populations like the public, health practitioners and decision-makers. The interview demonstrated that although the general public has limited knowledge on sepsis, there is demand to better understand it and how it can be prevented in Malawi. The work that ARCS and AFIDEP are doing is a huge step towards sparking dialogue and generating evidence to address sepsis in Malawi and beyond.

Videos: Sepsis Explained in Three Minutes

The African Research Collaboration on Sepsis (ARCS), African Sepsis Alliance (ASA), and African Institute for Development Policy (AFIDEP) have published a sepsis policy brief. The document highlights the benefits of addressing sepsis in Africa and the key actions required from health policy makers.

Our friends from the Global Sepsis Alliance have released their World Sepsis Day Infographics in French today, as a free download in their toolkit section, next to English, Spanish, and German.

Given many parts of Africa speak French, please feel free to download them and use them wherever you see fit, for example on social media, printed at your events, or everywhere in between.

There are a total of 21 infographics, nine on sepsis itself, ranging from symptoms, sources, prevention, risk groups, to physiology, post-sepsis symptoms, and more. Additionally, there are two on hand-washing, and ten more pointing out the relationship to other World Health Days, such as World Malaria Day, World AIDS Day, World Immunization Week, and more.

The infographics are available as images (.png), as well as optimized for print (.pdf). If you find any translation mistakes or have any other feedback, please let our colleagues from World Sepsis Day know. Please join us in spreading these infographics to bring sepsis awareness to all parts of Africa.

© Crown Copyright 2014, Carl Osmond

The African Research Collaboration on Sepsis (ARCS), African Sepsis Alliance (ASA), and African Institute for Development Policy (AFIDEP) have joined forces to publish a sepsis fact sheet for stakeholders in Africa.

The document highlights what sepsis is,  causes, burden and benefits of addressing sepsis in Africa. Africa has the youngest population in the world. It also has the highest burden of disease of infections. Everybody in Africa deserves to be able to survive sepsis. Please download and share the fact sheet with healthcare workers, stakeholders, and policy makers.

We also recommend this video by our friends from the World Sepsis Day Movement, explaining sepsis in 3 minutes:

The 2nd African Sepsis Symposium was held on the 4th of October 2018 in Mombasa, Kenya. The symposium was organized by the African Sepsis Alliance, the Critical Care Society of Kenya, and the African Federation of Critical Care Nurses.

Presenters included international sepsis experts as well as local experts involved in antibiotic stewardship, improving diagnosis, and infection control. There were over 300 participants - predominantly critical care and senior nurses - from over 10 African countries. Participants received training about prevention, recognition, management, and post-discharge care for children and adults in Africa.

The African Research Collaboration on Sepsis (ARCS) was also advertised and discussed. ARCS is a newly launched collaborative, led by the Liverpool School of Tropical Medicine and funded by the National Institute for Health. It focuses on sepsis research in non-pregnant adults and will involve a short incidence study, development of quality indicators for critical illness and sepsis in Africa, as well as providing opportunities for training in research.

The Centre for International Child Health (part of BC Children’s Hospital) ran a paediatric sepsis collaborative workshop to demonstrate tools used to improve the quality of care in low- and middle-income countries and how data from these tools can be shared to improve the overall burden of sepsis.

MedReach filmed the entire symposium and has made the symposium available to clinicians from low- and middle-income countries free of charge via their online platform.

We would like to thank all our supporters and sponsors who made this event a great success. The symposium poster and program can be downloaded below.

Everybody in Africa deserves to be given a chance to survive sepsis.

Despite a recent resolution by the WHO and increasing worldwide recognition that sepsis poses a major global health threat, our knowledge of what sepsis surveillance, treatment, quality improvement (QI), and reporting practices look like across the world is surprisingly limited and fragmented. As a community of stakeholders from policy makers to healthcare providers, we need to know more about how these programs and practices vary between regions, between patient populations, and between healthcare settings.

The Global Sepsis Alliance is conducting a global survey, which will operate through 2 arms.
The first arm is a targeted survey that will be distributed to the head of every national government health agency in the UN member states. The second arm is a publicly available survey that is targeted to various healthcare providers, health administrators, and government health officials across the world. We aim for participation that includes every UN member state, from diverse types of healthcare providers, and from diverse patient populations.

The survey begins by clarifying respondents’ roles to ask only the questions that are relevant to them. The following 15-20 questions should take about 7-9 minutes to complete. All responses are anonymous, and no data will ever be released in a manner that would allow any specific healthcare institution to be singled out.

Please make the voice of Africa heard and participate in the survey now: