Health care systems in Czechia had to adapt to many challenges during COVID-19, one of which was caring for patients with diabetes. WHO supported the use of telemedicine, including continuous glucose monitoring technologies, to allow patients to share personal health data with doctors at a distance, enabling many to stay in control of their diabetes during the pandemic.
Distance care is vital given that diabetic patients who become infected with COVID-19 are at a higher risk of suffering with severe complications from the virus. This is especially true for patients whose condition was not under control prior to catching the virus. Access to treatment and care was made more difficult by disruption to health care services during the pandemic.
“Countries with community transmission of COVID-19 were the most affected by the disruption of health care services,” says Dr Srđan Matić, WHO representative in the Czech Republic. “Introducing telemedicine in the Czech Republic has been a game changer to continue the provision of essential health services while the virus was spreading in the community.”
Sharing health information at a distance allows patients to receive electronic prescriptions for antidiabetic drugs, without needing to visit a doctor’s office. Modern diabetes technologies, like continuous glucose monitoring or smart glucose meters, as well as phone calls, emails and video calls, are also useful. Other methods of data sharing include exporting data from smart devices or creating charts using spreadsheets.
“Telemedicine can be used to check diabetic foot ulcers by examining photographs,” highlights Dr Martin Prázný from the Czech Diabetes Society. “This method, along with the use of clouds to share data from continuous glucose monitoring or smart glucose meters, demonstrates great progress made towards maintaining a high level of diabetes care,” he adds.
While it was possible to maintain the stable condition of many patients without any disruption, some disparities emerged limiting the use of telemedicine for patients who were older or those with lower socioeconomic status or a cognitive impairment. This needs to be taken into account in the management of patients with limited access to health care.
Diabetes and COVID-19
Adequate health care and good communication between medical staff and patients are keys to the successful management of diabetes, reports Dr Prazny, adding that “inadequately controlled diabetes can impair the function of the immune system, thus increasing the body’s susceptibility to COVID-19, and may also be associated with poor outcomes”.
Dr Prazny stresses the importance of prevention, early diagnosis, and appropriate treatment of the disease. He explains that therapy for diabetic patients with COVID-19 is more challenging because of fluctuations in blood sugar levels and the presence of other diabetic complications, especially those affecting the cardiovascular system.
According to the Czech Diabetes Society, diabetes affects 10.2% of the adult population in the country, with 80% of patients being treated with antidiabetics. Unknown cases of diabetes may represent another 1–2% of the total population, with the number increasing over time in men, and decreasing slightly in women.
European governments approved the most ambitious climate change plan to date, agreeing to pour more than €500 billion into everything from electric cars to renewable energy and agriculture.
At a marathon five-day summit in Brussels, heads of government reached a deal on an unprecedented economic rescue plan and seven-year budget for the region worth €1.8 billion (US$2 billion). Almost a third of that is earmarked for climate action, offering the bloc’s 27 nations a chance to develop clean energy resources, stimulate the market for emissions-free cars, invest in budding technologies, and promote energy efficiency.
“There is no doubt this is the world’s greenest stimulus plan,” said Simone Tagliapietra, researcher at Bruegel, a Brussels-based economic think tank. “Member states should now put forward sensible green national recovery plans, prioritizing those policies that have a triple dividend: economic growth, greening, equity.”
The bid to become the world’s first climate-neutral continent puts Europe ahead of other major emitters such as the U.S., China, and India in the fight against global warming. The extensive recovery package was constructed in sync with the EU’s ambitious Green Deal strategy to zero-out greenhouse gas emissions by the middle of the century, a project that will require hundreds of billion of euros of annual investment.
The environmental clean-up is already under way. The European Commission, the EU’s executive arm, is considering raising the bloc’s 2030 emissions-reduction target to as much as 55 per cent from its current 40 per cent, a move that would affect every sector of the economy from energy to agriculture and trade. Under the deal struck early Tuesday morning, the objective will be revised by the end of this year.
Other green provisions of the EU stimulus deal include:
The rescue fund and the 2021-2027 budget must comply with the EU goal of climate neutrality and contribute to the new 2030 emissions target
The European Investment Bank will become the EU’s climate bank; its board will review a capital increase by the end of this year
In order to make farming more sustainable, 40 per cent of the EU’s agriculture budget will be dedicated to climate
The Commission will develop a methodology for monitoring climate spending to detect and prevent greenwashing, and will report annually on green expenditure
The deal didn’t come easy, and talks came close to collapse at several points because of clashing national interests. In a final compromise, the €750 billion (US$858 billion) rescue fund contained fewer grants and more low-interest loans. That impacted the size of some investment programs in areas such as health and climate, triggering criticism from some lawmakers and green activists.
One loss was the Just Transition Fund, a tool to help the most affected regions bear the costs of transitioning toward eliminating emissions. Its value was slashed to €17.5 billion from €40 billion (US$46 billion). The aid can be used to retrain workers or put small and medium-sized companies on a more sustainable track.
“This agreement is at the expense of the climate,” said Michael Bloss, a German member of the Greens group in the European Parliament.
Regular discussions among growing numbers of residents in a South Kivu village are stimulating a local discourse on health and inspired hundreds into united action.
CHANJAVU, Democratic Republic Of The Congo — When faced with an increased incidence of waterborne diseases, a health center in the village of Chanjavu, the Democratic Republic of the Congo, took a novel approach to addressing the issue by promoting a local discourse on health.
“For efforts to be sustainable, we knew that many people had to be involved in the conversation about health, including causes of illnesses” says Alexis Powe Kindi, a clinician who has been supporting the health center established by Bahá’ís in the South Kivu region of the country.
“The management committee of the health center,” he continues, “consulted with the village chief and the Bahá’í Local Spiritual Assembly to identify people who could be trained to promote a discourse on health at the local level.” Thirteen people were trained last year as health educators, each of whom has been creating discussion spaces for large groupings of families to consult together on health-related issues.
Slideshow 7 imagesA health center established in the village of Chanjavu by the Bahá’ís of the Democratic Republic of the Congo. The head nurse (center) is now assisting to train health educators who have been creating discussion spaces for large groupings of families to consult together on health-related issues.
Elizabeth Balibuno, one of the health educators trained by the clinic, describes the effects of these conversations on the well-being of the village. “We all see the changes. The riverbanks are being kept clean, which has improved water quality and led to a reduction in cases of waterborne diseases since June.”
As more people participate in the discussion spaces—while maintaining safety measures put in place by the government—other collective initiatives in the village of Chanjavu are emerging. For example, scores of people recently came together to improve a three-kilometer stretch of road used by an ambulance from a nearby hospital.
Health educators have also been instrumental in raising awareness about the coronavirus, including by facilitating meetings where critical information is shared.
Slideshow 7 imagesPhotograph taken before the current health crisis. Community members in Chanjavu are trained as health educators.
Mr. Powe comments on the growing capacity of the community to consult on health-related matters: “The structure of family groups and health educators is stimulating a local discourse about health among a growing number of inhabitants of the village. The community has found that the most potent tool for improving its overall health includes not only access to certain medicines or technologies, but also the ability to read its own reality and consult as a community in order to enact solutions.”
Leon Karma, chief of the village, reflects on these developments, stating: “These efforts are creating a new consciousness about health. Indeed, we want the number of health educators to increase.”
Slideshow 7 imagesA health educator is seen here teaching community members to make a nutritional flour mix.
Joséphine Tshiova Tshibonga, another health educator trained by the clinic, explains how patterns of community life—such as reflecting, praying, consulting, and acting together—fostered over the decades through educational efforts of the Bahá’ís of the region have enhanced these health-related initiatives.
“When we gather, we look at certain themes such as understanding the causes and symptoms of illness and child nutrition. These gatherings have also become a space where we pray together and reflect about broader societal issues, including the equality of women and men.”
Further commenting on the broader effects of community-building efforts in Chanjavu, Mashiyyat Bulonda Roussa, a member of the Bahá’í Local Spiritual Assembly, states: “I see that unity and collaboration are evident in our community of Chanjavu. We meet and gather together, we work together without religious or tribal prejudice, and we are also in collaboration with the chief of our locality. By being united the community has been able to take charge of its own well-being.”
Books make great last-minute stocking-stuffers. Here are a few suggestions for every type of reader, young, old and everything in between. Hint: You can also use this column for some ideas on how to spend those book store gift certificates that you find in your own stocking this year.
<span>British Prime Minister Boris Johnson has appointed Fiona Bruce, MP for Congleton, as his Special Envoy for Freedom of Religion or Belief.</span>
In her new role, Fiona will bring together efforts across the UK government with faith actors and civil society to promote religious tolerance abroad, read a press release issued by the British Embassy Dubai on Sunday.
Fiona will work alongside the UK Minister responsible for Human Rights, Lord (Tariq) Ahmad of Wimbledon.
In her new role, Fiona will draw on her wealth of experience from the All-Party Parliamentary Group on Freedom of Religion or Belief to look at how the UK Government can protect and promote this fundamental freedom internationally. She will also work with the members of the International Religious Freedom or Belief Alliance to raise awareness of cases of particular concern, advocating for the rights of individuals around the world who are being discriminated against and persecuted for their faith or belief.
Johnson said, “The UK is absolutely committed to protecting the inalienable right to freedom of religion and belief, at home and around the world. As we approach Christmas, the season of peace, people of all faiths and none are still being persecuted for their beliefs. I am delighted to appoint Fiona as my special envoy on this issue, and I know she will be a passionate advocate for tolerance and freedom.”
Foreign Secretary Dominic Raab said, “Fiona has been a standard setter for Freedom of Religion or Belief in Parliament, and I look forward to working with her to make sure everyone, everywhere can have and practise a faith, belief, or no religious belief, in accordance with their conscience.
“Acting as a force for good in the world will see the UK continue to promote and defend Freedom of Religion or Belief for all.”
Speaking on her appointment Fiona said, “I am honoured to be given this opportunity to serve as the Prime Minister’s Special Envoy for Freedom of Religion or Belief.
“I pay tribute to the work of my predecessors, Rehman Chishti MP and Lord Ahmad of Wimbledon, and hope to build on their dedicated work and that of many Parliamentarians and others in this field, to raise further the profile of this fundamental freedom.
“There is much to do, and I shall place myself at the service of some of the most vulnerable individuals across the world.”
This past week a group defining themselves as Secular Democrats of America submitted a 28-page letter to Kamala Harris and Joe Biden calling on them to expunge religion from all sectors of American public life and to “re-educate” Christian Americans that they should keep their “religious dogma” to themselves.
In their document, titled “Restoring Constitutional Secularism and Patriotic Pluralism in the White House,” congressional Democrats Jamie Raskin of Maryland, Jared Huffman of California and Jerry McNerney of California bemoan life under the Trump administration:
“The constant entanglement of religion and government … sweeps far beyond hot-button ‘culture war’ issues … It permeates every aspect of government policy — health care, public and private education, foreign policy, tax policy, environmental policy, military policy, and more …”
They continue:
“[Government] decisions should be guided by science and evidence … We believe that now is the right time to make a case for reviving a Jeffersonian approach to governance that favors reason … and to disentangle government policy from the influence of … religious interests that have become dangerously entrenched at all levels of government.”
The European Union’s chief Brexit negotiator Michel Barnier tweeted Sunday that talks with Britain over a post-Brexit trade deal reached a “crucial moment”, stressing the negotiations were in full swing.
“The EU remains committed to a fair, reciprocal and balanced agreement. We respect the sovereignty of the UK. And we expect the same,” he stressed, arguing both parties “must have the right to set their own laws and control their own waters”.
In this crucial moment for the ???? negotiations, we continue to work hard with @DavidGHFrost and his team.
The EU remains committed to a fair, reciprocal & balanced agreement. We respect the sovereignty of the UK. And we expect the same. (1/2)
— Michel Barnier (@MichelBarnier) December 20, 2020
The head of the European Commission’s Task Force for Brexit stressed the importance of the UK and the bloc being equally able to act “when our interests are at stake”.
The EU and the UK are “widely expected” to wrap up Brexit trade deal talks “one way or another” before Christmas, but a no-deal scenario is still on the table, a number of UK government sources told the Daily Mail.
Downing Street is ostensibly disappointed by Michel Barnier’s ultimatum with regard to the fisheries issue – something that was described as something that would potentially enable Brussels to slap “lightning tariffs” on London should it put curbs on the bloc’s access to UK fishing waters.
EU chief negotiator Michel Barnier (L), wearing a protective face covering to combat the spread of the coronavirus, walks to a conference centre in central London on December 2, 2020 as talks continue on a trade deal between the EU and the UK.
Late last week, Boris Johnson and European Commission President Ursula von der Leyen agreed to extend negotiations on the UK-EU trade deal beyond the initial self-imposed 13 December deadline, which couldn’t be met: additional time had to be earmarked not only for the sides to discuss the arrangements, but for the parliaments of the 27 EU countries and the UK to ratify them.
As the talks proceeded, the British prime minister stressed that London has “done a lot to try and help” resolve the Brexit limbo and it is the EU that should “see sense and come to the table with something themselves”. EU chief Brexit negotiator Michel Barnier, for his part, warned that time is almost up for the bloc and the UK to strike an accord, adding that the possibility of a Brexit deal “is here”.
“It’s the moment of truth. We have very little time remaining, just a few hours to work through these negotiations in a useful fashion if we want this agreement to enter into force on the first of January. There is a chance of getting an agreement but the path to such an agreement is very narrow”, Barnier told the European Parliament.
Trade talks have been stuck for months over wide divergences over fishing quotas, the so-called level playing field — a set of commonly accepted rules designed to prevent businesses in one country from acting unfairly with regard to their rivals in others — as well as governance issues.
If no trade deal is inked before 1 January, the World Trade Organisation’s rules will take effect starting in 2021, including customs tariffs and full border checks for UK goods travelling across the English Channel.
Michel Barnier has warned that Britain must be prepared to respect the EU’s sovereignty if talks on a post-Brexit trade deal are to succeed.
Brussels chief negotiator said the EU remained committed to achieving “a fair, reciprocal and balanced agreement” but said both sides needed to be able to act when their interests were at stake.
His comments came after a UK Government source warned that the negotiations would fail unless there was a “substantial shift” in the EU’s position in the remaining days of the talks.
In this crucial moment for the ???? negotiations, we continue to work hard with @DavidGHFrost and his team.
The EU remains committed to a fair, reciprocal & balanced agreement. We respect the sovereignty of the UK. And we expect the same. (1/2)
The British side has accused the EU of making “unreasonable demands” and of failing to respect UK sovereignty over fishing rights and fair competition rules.
In a statement posted on Twitter, Mr Barnier said the talks with the UK’s chief negotiator Lord Frost were at a “crucial moment”.
“The EU remains committed to a fair, reciprocal and balanced agreement. We respect the sovereignty of the UK. And we expect the same,” he said.
“Both the EU and the UK must have the right to set their own laws and control their own waters. And we should both be able to act when our interests are at stake.”
Talks have been continuing in Brussels over the weekend but UK sources said it was looking increasingly likely the Brexit transition period will end on December 31 without an agreement.
Both ??&?? must have the right to set their own laws & control their own waters. And we should both be able to act when our interests are at stake. (2/2)
A Government source said: “Unfortunately, the EU are still struggling to get the flexibility needed from member states and are continuing to make demands that are incompatible with our independence.
“We cannot accept a deal that doesn’t leave us in control of our own laws or waters.
“We’re continuing to try every possible path to an agreement but without a substantial shift from the Commission we will be leaving on World Trade Organisation (WTO) terms on December 31.”
Health Secretary Matt Hancock said he believed a deal was still possible but said it would require movement on the EU side.
“We want these talks to reach a positive conclusion. I think everybody wants a deal. Unfortunately, the EU have put in some unreasonable demands,” he told Sky News’s Sophy Ridge On Sunday programme.
“I’m sure that a deal can be done but obviously it needs movement on the EU side.”
The European Parliament has said the talks need to be concluded by Sunday evening if it is to ratify any deal before the transition ends.
However, EU leaders could provisionally sign off on any agreement – leaving ratification to 2021 – and the British side expects the talks to continue a few days longer in the week leading up to Christmas.
If there is no deal by December 31, the UK will leave the single market and customs union and begin trading with the EU on WTO terms – with the imposition of tariffs potentially leading to higher prices in the shops.
Britain has insisted that the European Union should shift position to open the way for a breakthrough in post-Brexit trade talks, with health minister Matt Hancock saying the bloc should drop its “unreasonable demands”.
With less than two weeks before Britain leaves the EU’s orbit, both sides are calling on the other to move to secure a deal and safeguard almost a trillion dollars worth of trade from tariffs and quotas.
Talks to reach a trade deal have been largely hamstrung over two issues – the EU’s fishing rights in British waters and creating a so-called level playing field providing fair competition rules.
Hancock again referred to what Britain has described as new demands introduced by the EU earlier this month, saying they were “unreasonable” and should be dropped.
“We want these talks to reach a positive conclusion, of course I want a deal, everybody wants a deal,” Hancock told Sky News.
“Unfortunately, the EU have put in some unreasonable demands … I am sure a deal can be done but obviously it needs movement on the EU side.”
Britain left the EU on January 31 but has been in a transition period since then. That expires at the end of the year.
Prime Minister Boris Johnson has long said he cannot accept any deal that does not respect the country’s sovereignty, a goal that was at the heart of his election last year.
But the EU is equally determined to protect its lucrative single market and wants to prevent London securing what it considers to be the best of both worlds – preferential market access with the advantage of setting its own rules.
There is little time left.
On Saturday, the European Parliament repeated its call for a deal to be reached no later than the end of this weekend, to give it time to properly ratify the agreement.
The EU wants to safeguard the parliament’s right to exercise democratic oversight, but if an agreement arrived later than this weekend the member states could still endorse it on their own to allow for “provisional application”.
The European Union’s Brexit negotiator Michel Barnier said on Sunday that talks were at a “crucial” point and that the negotiations continued.
“In this crucial moment for the negotiations, we continue to work hard with (UK negotiator) David Frost and his team,” Barnier said on Twitter.
“The EU remains committed to a fair, reciprocal and balanced agreement. We respect the sovereignty of the UK. And we expect the same.
“Both the EU and the UK must have the right to set their own laws and control their own waters. And we should both be able to act when our interests are at stake.”
Michel Barnier today warned the UK it must respect the EU’s sovereignty in post-Brexit trade talks as Matt Hancock said the bloc will have to withdraw its ‘unreasonable demands’ for a deal to be agreed.
Mr Barnier tweeted this afternoon that negotiations are at a ‘crucial moment’ and insisted the EU ‘remains committed to a fair, reciprocal and balanced agreement’.
However, he warned: ‘We respect the sovereignty of the UK. And we expect the same.’
The EU’s chief negotiator said both the EU and the UK ‘must have the right to set their own laws and control their own waters’ under the terms of any accord as he stressed ‘we should both be able to act when our interests are at stake’.
His comments came after Mr Hancock fired a broadside at Brussels as he said the EU will have to ‘make the move’ if a deal is to be agreed.
The Health Secretary claimed Brussels’ proposals on the remaining crunch issues of the ‘level playing field’ and fishing ‘do not respect the result of the referendum’ in 2016 and must be scrapped.
However, he insisted he is ‘sure that a deal can be done’ despite time running out before the end of the ‘standstill’ transition period on December 31.
Earlier, Emmanuel Macron was warned Britain will not cave in over fishing as rising optimism of a deal being in sight began to wane.
Mr Macron has dug in over his demands relating to future access to UK waters for French fishermen amid suggestions he believes Britain will come crawling back to the negotiating table in the New Year after the chaos of a no deal split.
But the UK has warned the French President that he will be ‘making a miscalculation of historic proportions’ if he believes Britain will back down.
Michel Barnier today said Brexit trade talks are at a ‘crucial moment’ and ‘we should both be able to act when out interests are at stake’
Emmanuel Macron has been warned the UK will not cave into his demands on post-Brexit fishing rights
There is now less than two weeks before the end of the transition period and a failure to strike and ratify a deal in the coming days will see the two sides forced to trade on basic World Trade Organisation terms from January 1, with tariffs imposed on goods.
European Parliament chiefs had set a deadline of today for an accord to be in place, having warned that if it comes later than that they will not have enough time to properly scrutinise it.
But there remains little sign of a breakthrough being imminent, with Britain and the bloc still unable to agree on the so-called ‘level playing field’ on rules and on fishing rights, with the latter viewed as the biggest stumbling block.
In a statement issued on Twitter this afternoon, Mr Barnier said: ‘The EU remains committed to a fair, reciprocal and balanced agreement. We respect the sovereignty of the UK. And we expect the same.
‘Both the EU and the UK must have the right to set their own laws and control their own waters. And we should both be able to act when our interests are at stake.’
Mr Hancock had earlier told Sky News that the EU will have to rethink its negotiating position if there is to be a deal.
He said: ‘The talks are continuing. I understand that the EU have put in a deadline of having them concluded by Christmas.
‘We want these talks to reach a positive conclusion. Of course I want a deal, I think everybody wants a deal. Unfortunately the EU have put in some unreasonable demands.
‘Obviously I have been mostly concentrating on the pandemic but I have been looking at the detail of some of the requests from the EU. They are unreasonable, they do no respect the result of the referendum.’
Asked specifically which demands the UK considers to be ‘unreasonable’, the Health Secretary said: ‘Well, over the sovereignty of our rules around the so-called level playing field, actually this is rules around how government introduces subsidies, and then over fishing.
‘I am sure that a deal can be done but obviously it needs movement on the EU side. I am an incredibly pragmatic politician and I want to see a deal.
‘But I also think that the EU demands are unreasonable and they are not demands that can be accepted so we do need to see that movement from the EU side and I very much hope that they make the steps that are necessary so we can conclude a deal and then we can all look forward and we have got a huge amount to get through as a continent because there are very significant problems with this virus on the continent as well.’
He added: ‘They need to make the move, they need to remove some of the unreasonable requests, then we can all move forward and concentrate on dealing with the things that are right in front of us and need urgent action.’
Mr Hancock said he believed the two sides should ‘keep talking’ but insisted the UK is ‘ready’ for a no deal split on December 31.
There is growing anger at the position taken by Mr Macron who is adamant European trawlers must retain a high level of access to British waters while the UK insists its own boats must have priority.
The French President is said to be willing to accept a no deal Brexit in the short term rather than back down on the issue because he believes the UK will come back to the negotiating table in the Spring.
But a UK source told the Sunday Times: ‘If he, Macron, thinks that, he’s making a miscalculation of historic proportions.
‘We cannot accept a deal that doesn’t leave us in charge of our own waters.’
A Cabinet minister told the same newspaper: ‘There’s no white smoke. I think we’ll still be talking about this on December 31.’
However, in a sign that a deal could still be done in the coming days another source told the Sunday Telegraph that almost all of the deal was now done and ‘it feels like we are less than two turbots apart’.
MEPs said they needed to see the terms of any agreement by this evening if they are going to be able to ratify it before the end of the Brexit transition period on December 31.
But France’s European affairs minister, Clement Beaune, suggested on Saturday that Sunday was unlikely to prove to be a hard deadline.
‘It would be normal not to say ‘Well it’s Sunday evening so let’s wrap it and sacrifice everything’,’ he was quoted as saying by the Guardian website.
‘It may be hard and sometimes tough to understand, but it’s necessary to take the time and, at any rate, not to sacrifice our interests under the pressure of a calendar.’
Meanwhile in the UK, MPs are on standby to return to Westminster from their Christmas break if an agreement can be struck in the final days of the year.
Both sides have acknowledged that significant differences still have to be overcome if there is to be a breakthrough.
While the fishing industry accounts for only a tiny proportion of the EU and UK economies it carries huge political resonance on both sides of the Channel.
While the UK says that it is entitled as an independent sovereign nation to take control of its waters, countries like France are determined to defend their fishermen who would lose their livelihoods if they could no longer fish in British waters.
