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A large multi-year study based on 2016-2019 data found that children facing relational and social risks are more likely to have mental, emotional, or behavioral health problems, but the negative impact of these problems on child resilience, self-regulation and school engagement can be offset by protective factors such as strong caretaker-child connection and family resilience.
The study, led by researchers at Johns Hopkins Bloomberg School of Public Health, also found that children who were facing relational risks only, such as substance abuse among family members, were more likely to have mental, emotional, or behavioral concerns than those who were only facing social risks, such as economic hardship.
The findings are published as the U.S. and other countries face a crisis in children’s mental health exacerbated by the pandemic. The study appears online in the January 2022 issue of Child and Adolescent Psychiatric Clinics of North America.
The study found that, overall, 21.8 percent of U.S. children ages 3 to 17 have one or more of the common mental, emotional, and behavioral health conditions assessed. The prevalence of mental health problems across U.S. children ranged from about 15 to 60 percent, increasing with the type (social, relational, or both) and number of these risks that children had been exposed to.
The analysis, based on survey responses covering nearly 132,000 children ages 3 to 17, examined the complex interplay between common mental health problems among children, social and relational health risks, and protective factors.
“If we treat children with mental, emotional, and behavioral problems without individually and collectively addressing social and relational health risks, or even assessing them, which is often the case, we are missing some of the biggest factors driving the mental and emotional suffering of our children,” says study leader Christina Bethell, PhD, MPH, MBA, professor in the Department of Population, Family and Reproductive Health and director of the Child and Adolescent Health Measurement Initiative at the Bloomberg School.

A technique that uses ultrasound images to determine the depth and shape of the hip socket can accurately predict which infants with hip dysplasia will develop normal hip structure and which remain dysplastic, according to a study in Radiology. Researchers said statistical shape modeling improves on existing techniques and could spare many infants from unnecessary treatment.
Developmental dysplasia of the hip occurs when the baby’s hip socket is too shallow to cover the head of the thigh bone. In severe cases, the thigh bone can become dislocated from the hip entirely. According to the International Hip Dysplasia Institute, 1 in 10 infants are born with hip instability, meaning the hips can be wiggled in the socket because of loose ligaments. After birth, most will tighten up naturally. One in 100 infants will need treatment for hip dysplasia.
There is no consensus on how and when to treat stable hip dysplasia (Graf type 2, as determined by the Graf classification system). It is estimated that about 80% of stable Graf 2 hips will develop to normal without treatment. But since there is currently no way to differentiate those that will develop to normal in the future compared to those that will not, a large percentage of stable cases are likely to be overtreated, according to study senior author Ralph J. B. Sakkers, M.D., Ph.D., from the Department of Orthopedic Surgery at the University Medical Center Utrecht in Utrecht, the Netherlands. Overtreatment has significant drawbacks.
“The most important negative consequences of overtreatment are the financial and logistical burdens for parents and society,” Dr. Sakkers said. “Medical consequences of overtreatment are relatively rare, but the risk is not zero. If there is a rare medical consequence this would probably be avascular necrosis of the hip due to non-proper use of the treatment device.”
Avascular necrosis is a disease that results from the temporary or permanent loss of blood supply to the bone.
The Graf classification system is commonly used to evaluate hip dysplasia, but it has limitations. Patients are classified into groups based on acetabular angle appearance on ultrasound images. This angle is derived from the depth and shape of the socket of the hip bone where the head of the femur fits. The Graf system is reported to have a high variability and low agreement in all reported hip dysplasia metrics, and the ultrasound image quality and anatomic appearance of the hip can be affected by probe positioning.

New laboratory research from Oregon Health & Science University reveals more than one path toward robust immunity from COVID-19.
A new study finds that two forms of immunity — breakthrough infections following vaccination or natural infection followed by vaccination — provide roughly equal levels of enhanced immune protection.
The new study published online today in the journal Science Immunology.
“It makes no difference whether you get infected-and-then-vaccinated, or if you get vaccinated-and-then-a-breakthrough infection,” said co-senior author Fikadu Tafesse, Ph.D., assistant professor of molecular microbiology and immunology in the OHSU School of Medicine. “In either case, you will get a really, really robust immune response — amazingly high.”
The research follows an OHSU study published in December that described extremely high levels of immune response following breakthrough infections — so-called “super immunity.” That study was the first to use multiple live SARS-CoV-2 variants to measure cross-neutralization of blood serum from breakthrough cases.
The new study found that it doesn’t matter whether someone gets a breakthrough infection or gets vaccinated after a natural infection. In both cases, the immune response measured in blood serum revealed antibodies that were equally more abundant and more potent — at least 10 times more potent — than immunity generated by vaccination alone.

In the journal Science, researchers from Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) and Charité — Universitätsmedizin Berlin present new findings on the immune response against the coronavirus SARS-CoV-2. Their study is based on investigations of antibodies elicited by infection with the Beta variant of the virus. The researchers conclude that the Beta variant can confer broad immunity to multiple viral strains, which could be beneficial for protection against the currently prevalent Delta and Omicron variants, as well as against future viral variants. In their view, this aspect should be taken into account in the development of vaccination strategies.
“The Beta variant of the coronavirus shows marked differences from the wild type, the original strain of the virus. Until the emergence of the now dominating Omicron variant, it was the viral form that had evolved furthest from the wild type, against which the existing vaccines have been developed,” says Dr. Momsen Reincke, a researcher at DZNE and the Department of Neurology with Experimental Neurology on Campus Charité Mitte as well as one of the first authors of the current publication in Science. “We were interested in learning more about the exact antibody response to this variant — to see what conclusions can be drawn from this about the immune response to other variants. Since the coronavirus is likely to continue mutating, we were interested in whether the antibodies we found acted only against the Beta variant or had broader potential.”
Antibody Diversity
Antibodies are proteins that the body uses to defend itself against pathogens. The human immune system can produce an almost inexhaustible variety of them by making use of various mechanisms: in particular, by repeatedly recombining the blueprints for the components of an antibody that are stored in the genome. “The immune response to coronavirus also produces a spectrum of antibodies that bind to different areas of the pathogen,” Reincke says. From an immune defense perspective, binding to the so-called spike protein is particularly effective. “In a nutshell, this is the hook that the virus uses to attach itself to body cells so that it can then slip in. Some antibodies bind to this protein and thereby render the hook useless. These are the neutralizing antibodies. In our study, these were exactly the antibodies we looked at.”
Replication in the Laboratory
The findings of the Berlin scientists are based on an analysis of antibodies that they isolated from the blood of 40 individuals. All patients had been infected with the Beta variant of SARS-CoV-2. Of the approximately 300 antibodies initially surveyed, 81 bound particularly strongly to the spike protein of the coronavirus. Reincke and his colleagues unraveled the genetic blueprints of the antibodies. This enabled them to understand which genes play a role in the assembly of these antibodies and to artificially produce these immune proteins for further studies. In doing so, they benefited from a project funded by the Helmholtz Association: the “BaoBab Innovation Lab.” Within the framework of BaoBab, they develop and refine technologies for the characterization and production of antibodies.

A new study published this week in mBio, an open access journal of the American Society for Microbiology, has opened the door to a new approach to attacking herpesviruses. The study demonstrated that targeting 2 metal ion-dependent enzymes of human herpesviruses with 2 compounds, AK-157 and AK-166, can inhibit the replication of the virus. The finding provides new opportunities to developing agents against herpesviruses.
“A lot of people know the herpes simplex viruses, but there is actually a family of 9 different herpesviruses including cytomegalovirus (CMV) which causes a lot of problems for immunocompromised people, folks getting transplants and chemotherapy patients for example. We need better therapeutic agents that can be used in these very vulnerable populations,” said co-author of the study Dennis Wright, Ph.D., professor of medicinal chemistry in the School of Pharmacy at the University of Connecticut. “Right now, the therapeutic agents that are out there aren’t terribly effective in terms of being able to treat all the viruses, and many of them have a significant dose-limiting toxicities and associated side effects.”
Ideally, said Wright, there would be 1 drug that would inhibit the reactivation of all 9 of the herpesviruses. Co-study author Sandra K. Weller, Ph.D., a distinguished professor of molecular biology and biophysics in the School of Medicine at the University of Connecticut, identified targets that would allow just that. She identified herpesvirus enzymes that require 2 magnesiums for the herpesvirus to replicate. “The majority of drug discovery efforts against herpesviruses has focused on nucleoside analogs that target viral DNA polymerases. We are pursuing a strategy based on targeting two-metal-ion-dependent viral enzymes,” said Weller.
In test tube studies, the researchers tested the ability of a panel of compounds to inhibit specific 2 metal ion-dependent enzymes as well as herpesvirus replication. The panel of compounds tested included HIV integrase inhibitors, the anti-influenza agent baloxavir, 3 natural products previously shown to exhibit anti-herpes simplex virus (HSV) activity, and two 8-hydroxyquinolones, AK-157 and AK-166.
While HIV integrase inhibitors have been reported to inhibit replication of herpesviruses, the researchers found the integrase inhibitors exhibited weak overall anti-HSV-1 activity. However, the researchers found that 8-hydroxyquinolones displayed strong antiviral activity against both HSV-1 and CMV and could inhibit 1 or more of the 2 metal ion dependent enzymes. This opens up the possibility of potentially developing dual targeting agents against herpesviruses.
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Many experts now predict that COVID-19, which so far has killed more than 5.5 million people worldwide, will remain endemic as new, infectious variants of SARS-CoV-2 emerge. These new variants could pose a greater risk of reinfection — infecting people who have already had COVID19 — than previous ones. The rapid identification of reinfection cases and surges could improve public health responses and reveal variants that escape the protection offered by vaccination.
A study published this week in mBio, by collaborators from the Broad Institute, MIT, Harvard Medical School, and the company SpaceX,suggests a way to keep track of those cases. In the work, a multi-institutional group of researchers have identified immunological blood biomarkers that correspond to reinfection and re-exposure to the virus.
“In the setting of waning natural and vaccine immunity, reinfections have emerged across the globe, even amongst previously infected and vaccinated individuals,” noted the immunologists, virologists, biologists, and others who worked on the study.
Previous studies have reported that rhesus macaques have a clinical response to SARS-CoV-2 infection similar to that of humans. For the new study, the researchers studied a group of rhesus macaques that had previously been infected with the virus. They exposed the primates to a different variant of the virus — at varying doses — and collected blood samples before and after both the original infection and the rechallenge.
Notably, analyses of the blood samples revealed distinct biomarkers of reinfection. Those included increased levels of immunoglobulin antibodies that bind to the Spike protein, nucleocapsid protein, or other parts of the virus particle. Animals exposed to higher doses of the virus showed higher SARS-CoV-2 immunoglobulin responses.
The authors reported that those immunological features differentiated primary infection from re-exposure and reinfection in the macaques. The researchers then analyzed blood samples from a small group of humans who were participating in a community-based surveillance cohort at SpaceX and had been reinfected with the coronavirus. The study on humans confirmed the findings from the one on macaques.
Simple, inexpensive, and widely accessible surveillance tools are needed to identify new hotspots of infection, the authors noted. The new work, they added, shows how simple titers might be used as readily available markers of reinfection. “Our ability to monitor and control both infection and reinfection hinges on the development of simple, immunologically sound screening strategies,” they wrote.
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The gene of the brain-derived neurotrophic factor (BDNF) is associated with several processes related to memory and brain plasticity. Now, a paper reveals that it is easier to alter the cognitive activity through transcranial magnetic stimulation (TMS) in people with the genetic variant Val/Val for the BDNF gene.
The article, published in the journal Scientific Reports, is led by the researcher Kilian Abellaneda, member of the Barcelona Brain Stimulation Lab (BBSLab), coordinated by David Bartrés-Faz, professor at the Faculty of Medicine and Health Sciences and researcher at the Institute of Neurosciences of the Universitat de Barcelona (UBNeuro), and member of the August Pi i Sunyer Biomedical Research Institute (IDIBAPS). The study counts on the participation of teams from the Hospital Clínic de Barcelona, Guttmann Institute, the Harvard School of Medicine (United States) and the universities of Siena, Trento and La Sapienza (Italy), among other institutions.
TMS is a non-invasive technique that helps to a better understanding of the brain activity and it has multiple applications in the study of cognitive processes and neuropsychological rehabilitation. As part of the study, using techniques of functional neuroimaging, the team could confirm that under the effects of neurostimulation, the Val/Val allele variant carriers showed a greater brain activity in processes in which memory is used — specifically in the brain regions contralateral to stimulation — , a feature that would be related to functional compensation brain processes.
“We believe the obtained data in this study provides relevant information on the neurobiological mechanisms related to the neuroplasticity processes that explain the individual differences regarding the effects of stimulation at a cognitive level. Therefore, the new results could be of great interest in order to design future interventions that prioritize the highest level of customization,” notes Kilian Abellaneda, member of the Department of Medicine of the UB and IDIBAPS.
This study is part of a European collaboration in the Pharmacog project, within the field of neurodegenerative diseases. One of the objectives of this project is to develop experimental platforms to modify, in a controlled way, cognitive functions in humans and the underlying brain processes, in order to use them later to study the effect of future drugs in the early stages of their development.
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SharecloseShare pageCopy linkAbout sharingImage source, Getty ImagesThe government is planning on banning a cosmetic surgery called hymenoplasty across the UK. It attempts to recreate a woman’s hymen, which in some cultures is linked to virginity, and has been described as a form of honour-based abuse. The procedure will be criminalised, as will virginity testing.Minister for Care and Mental Health Gillian Keegan said the government was “committed to safeguarding vulnerable women and girls in this country”. Hymenoplasty is available in clinics and can cost up to £3,000. The procedure recreates a thin membrane known as the hymen which partially covers the entrance to the vagina. It is often done as a way to “repair” a hymen.But the World Health Organization (WHO) says “the appearance of a hymen is not a reliable indication of intercourse”.Minister backs virginity test and hymenoplasty banControversial ‘virginity tests’ sold by UK clinicsA women’s hymen can tear for all sorts of reasons and not just through sexual intercourse, for instance through playing sports or using tampons. The practice of hymenoplasty is linked to conservative cultures which place a high value on virginity, with the expectation a virgin should bleed after sex on her wedding night. The WHO says virginity testing is practised in at least 20 countries. It involves an intrusive vaginal examination to check if the hymen is intact.This video can not be playedTo play this video you need to enable JavaScript in your browser.Aleena, whose name we have changed, said she was raped and then, as a teenager, faced years of pressure from her family to get the procedure. “It wasn’t something I felt like I had a choice over,” she said. “It was always put on me as if this was the only option and this is something you can do to fit back in.”I felt very, very alone. I felt guilty if I didn’t do it, I felt it was a very big weight on my shoulders. I didn’t feel like I had a choice.”Aleena said she refused to have the surgery but the pressure continued. In order to escape the situation she married someone who did not care that her hymen was not intact.She said she is proud she had the courage to not go through with the procedure.”I knew that I made the right choice and I knew everything that my parents were saying was only for pressure and their honour,” she said. Help and supportIf you’re affected by any of the issues in this article you can find details of organisations who can help via BBC Action Line.The government promised at the end of last year to “introduce legislation to ban hymenoplasty at the earliest opportunity”. It has now included amendments in the health and care bill which would criminalise “aiding or abetting” a person carrying out hymenoplasty and could result in up to five years in prison. It would also be a criminal offence to take a girl or women overseas to have the procedure. Last year when the bill was in the House of Commons, the government amended it to ban virginity testing after calling the practise “indefensible”. Campaigners say virginity testing and hymenoplasty are closely linked. This video can not be playedTo play this video you need to enable JavaScript in your browser.Diana Nammi, executive director at Iranian & Kurdish Women’s Rights Organisation, has campaigned for a ban and said: “Every woman and girl who faces this invasive surgery, it is under duress – direct or indirect – to present as a ‘virgin’ and in many cases, it is carried out to enable a forced marriage, organised by her family.”Hymenoplasty causes trauma and in around half of cases, it fails to make the women or girl bleed the next time she has intercourse, leaving her highly vulnerable to ‘honour’ based abuse or even ‘honour’ killing.”Halaleh Taheri is the founder of the Middle Eastern Women and Society Organisation charity. She said it will take time and education to stop the practice from happening and has been working with parents. One of the women she has worked with is Golaleh Simili, who is Kurdish. Growing up in Iran she was brought up to believe in the purity of virginity and had to present a virginity certificate before her own wedding. She said she felt “humiliated”. She moved to the UK in 2017 but when she found out her daughter was not a virgin, she says she was very nervous and worried and they discussed the surgery. But after working with MEWso, she said she realised she should not impose the same injustice on her daughter.Cycle of abuseIndira Varma works for a helpline run by charity Karma Nirvana. She said it can take months for woman and girls who call the helpline to admit to having hymen repair surgery. She says the procedure is often described as is being “cut”, “fixed’ or “sewn up”.While the majority of procedures are thought to be done in clinics, there is anecdotal evidence of some getting the procedure done at home.She said: “Victims described community elders coming into the home or doctors would make home visits to patients and they would charge an obscene amount of money for it. This is usually to avoid having to take the victim out to minimalize [the risk of] the victim asking for help or running away.”She said it was “an underground but thriving industry” but one that “deepened the cycle of abuse for victims”.But Dr Bhar, a cosmetic surgeon who runs a privative clinic in Harley Street London, disagrees with the ban. He says he has never done a virginity test and does not agree with them, but does perform hymenoplasty. On average, he says it can cost between £3,000-£4,000 and takes up to 45 minutes.By banning the procedure he worries women and girls could be put at further risk, instead he says it should be regulated. He said: “When you ban something like a medical procedure you drive patients underground. They will start to go to back alley doctors, or fly in doctors who fly from other countries to perform these procedures.”I think the bigger issue here is if you don’t know these procedures are being done you can’t then monitor the complications and follow ups.”Many of the women who come to him are pressured by family or society but are not being forced into it, he said. “It’s just that they want to be accepted by their society and in order to be accepted by their own individual societies this is one of the pillars and tenets they have to follow though they do so,” he added. He says he has refused patients where he has felt they were being pressured by family members.Ms Keegan said the government would continue to work with local communities and organisations “to tackle the taboos and damaging preconceptions associated with virginity and a women’s worth”.

The Health Department could not confirm reports of an outbreak of the bacterial disease, which is spread by rats, linked to McCarren Park, but said it was working with the Parks Department to keep rats out.Alarm has grown among some New York City dog owners in recent days as reports have circulated about the risks to canine health posed by the city’s legions of rats.In the Williamsburg section of Brooklyn, a corner of McCarren Park that is used as a dog run was temporarily shut for maintenance after rumors of an outbreak of leptospirosis, a bacterial disease spread by rat urine, lit up social media. The bacteria can fester in puddles and damp spots, and animals can become gravely ill if they contract the disease. It can also sicken humans.Lincoln Restler, a councilman who represents the area, tweeted last week that his office had received reports that several dogs who had visited the park later died of the disease. The city Health Department said it could not confirm the reports, but said that it was working with the Parks Department to inspect for rat activity in the park. Local veterinarians are supposed to report positive cases of leptospirosis to the Health Department.“I’m hopeful that the actions taken by the parks and health department will address the conditions we have at McCarren,” Mr. Restler said in an interview.The accounts led to grave concern from dog owners, and reminders from local veterinarians about the importance of vaccinating dogs that spend a lot of time in parks.What is leptospirosis?The disease is caused by bacteria found in the urine of infected rodents and both humans and animals are susceptible to it.The bacteria thrives in warm, wet environments, and can survive in soil, water and food. It can enter the body through open wounds or mucous membranes, or by drinking infected water.The bacteria usually surges in the late summer and fall, said Dr. Gabrielle Fadl, a veterinarian at Bond Vet, a local chain. The initial symptoms are fairly nonspecific, including vomiting, fever and lethargy, making it tricky to diagnose an infection quickly.Symptoms usually begin a week or two after exposure, and can be treated with antibiotics. If left untreated, leptospirosis can cause severe liver and kidney damage, and can be life-threatening.How prevalent is the disease in New York City?Reported cases of leptospirosis among people increased fairly dramatically last year, a spike that is believed to be linked to the spike in the rat population. At the same time, reported cases of canine leptospirosis actually dropped.The city reported 15 cases among people last year, in contrast to an average of three cases a year for the previous 15 years. Health officials said that most cases “had a clear history or risk factor which exposed them to an environment with a severe rat infestation.” At least one of the people who was infected died. Human-to-human transmission is rare, and none of the cases was linked to a dog’s infection.Among dogs, there were also 15 cases reported last year, down from a high of 29 in 2018. But health officials warned that the drop may be because providers failed to report cases as required. Between 2006 and 2020, a total of 269 cases — anywhere from eight to 29 cases per year — were reported to the Health Department from all five boroughs.The federal Centers for Disease Control and Prevention notes on its website that the disease has been diagnosed among pets more frequently nationwide in the past few years.Dr. Fadl, who works at the Cobble Hill location of Bond Vet, said that the practice had not seen any cases there or at its Williamsburg location recently. Katy Hansen, director of marketing and communications for Animal Care Centers of N.Y.C., said the three shelters run by the organization, which together take in about 6,000 dogs a year, have not recorded an outbreak of leptospirosis either.How do I protect my dog (and myself)?Crucially, there is a vaccine. The initial dose is followed by a booster three to four weeks later, and then administered annually. Dr. Fadl generally recommends it, especially given the uptick in the rat population in New York City.“If you have a private backyard, if your pet is in the parks, if your pet likes to sniff around garbage, drink from standing puddles, get a lepto vaccine,” she said.“It can save them, it can save you,” she added. “Especially if you have very young people or elderly people that are interacting with this pet, it’s really important to talk to your vet about getting a vaccine.”Staying away from puddles and pools that could contain rat urine is key. So is keeping your dog away from actual rats, as well as other small rodents, like squirrels, that can spread the disease.Dr. Fadl also recommended making sure your dog avoids communal water bowls, and instead use a travel bowl or bottle to provide fresh, uncontaminated water to drink.Humza Rizvi with his dog Ollie at McCarren Park. Mr. Rizvi has been more cautious about visiting the park since hearing reports of a rise in cases of leptospirosis.Amir Hamja for The New York TimesHow are city agencies and dog owners responding?The McCarren Park Dog Run is a “makeshift area” and not an official dog run, according to the Parks Department, but it is heavily used by local dog owners. The department said it had received only two 311 complaints regarding rodents in the park in the past year.But the Parks Department switched out the trash receptacles in the area to rat-resistant metal cans on Friday, had an exterminator conduct an inspection, and began on Monday to refresh the area and replace the wood chips that line the ground.The area was practically deserted on a cold day last week. Dog owners in the area said they were staying away from the park after hearing stories circulating that a dog named Oreo had died from leptospirosis.Humza Rizvi, 26, of Williamsburg, said fears about the disease’s spread, and the park’s general lack of cleanliness, had kept him from taking his golden retriever Ollie there.“It’s a dog park, so it’s going to be dirty,” he said. But, he added, “sitting water and things that can apparently spread the disease are always there.”Billy Lucas, 32, of Williamsburg expressed similar concerns. He said he had returned to the park with Wally, his German shepherd mix, after noticing that a sign warning of an “outbreak” had been taken down. (He noted that the sign he saw did not appear to have been posted by the city.)“I assumed everything was fine,” he said. “Then a concerned dog owner came up to me and told me that a few puppies have passed away from lepto recently, so we all got out of there.”Michael Malone has started bringing his dog Rio to play at the field at McCarren Park instead of in the dog run.Amir Hamja for The New York TimesMichael Malone, 28, of Williamsburg, said he double checked to make sure his four-month-old Australian Shepherd Rio’s vaccinations were up-to-date and that he had received the leptospirosis shot.“They encouraged us to get it because of the rats in the area,” he said. “They told us it’s not really common outside of the city, but in the city it’s a good idea to just get it.”

SharecloseShare pageCopy linkAbout sharingImage source, EPAA Covid outbreak has hit a crucial Australian relief ship which was bound for tsunami-stricken Tonga. Some 23 cases of Covid were recorded among the crew of the HMAS Adelaide, which left Australia on Friday.It comes as Tonga is desperately trying to prevent Covid from reaching its shores as more humanitarian aid begins arriving in the Pacific nation.Australia defence minister Peter Dutton has vowed not to put the Tongan population “at risk”.The Australian Department of Defence said the HMAS Adelaide would continue making its way to Tonga as planned, and is due to arrive on Wednesday. It said in a statement that it would ensure its supplies were delivered in a “Covid-safe manner”. Tonga currently has only had one confirmed Covid case, which was recorded in October 2021.Authorities have stressed the need for aid to be delivered in a contactless way to avoid bringing in the virus.How to get aid safely into Covid-free TongaAustralia had earlier despatched military transport planes carrying relief supplies, however the HMAS Adelaide vessel is carrying a larger shipment of much-needed aid, including engineering equipment, water and shelter. More than 600 crew are onboard the HMAS Adelaide, which has on board medical facilities including a 40-bed hospital and a critical care ward onboard, said the Department of Defence. This is the second aid shipment from Australia that has been hit with Covid – a C-17 plane had to turn around mid-flight last week after a crew member was diagnosed with the virus.Tonga is reeling from the aftermath of a devastating underwater volcanic eruption that hit the South Pacific island nation several weeks ago. The eruption triggered a tsunami that Nasa estimated was hundreds of times more powerful that the WWII atomic bombs, wreaking widespread devastation and leaving three dead. Officials say four-fifths of the population have been affected by the tsunami and volcanic ashfall, which continues to pose a public health risk to Tonga’s 105,000- strong population. The disasters, and ensuing rescue efforts, have threatened Tonga’s ability to remain Covid-free, with just one case of infection reported last October. Authorities are determined to keep it that away, as the remoteness of some of its island communities, many with limited healthcare resources, makes them particularly vulnerable to an outbreak.This video can not be playedTo play this video you need to enable JavaScript in your browser.