H5N1

‘We ran out of space’: Bodies pile up as NY struggles to bury its dead

Via The New York Times, a reminder that whatever the century, some things never change: ‘We Ran Out of Space’: Bodies Pile Up as N.Y. Struggles to Bury Its Dead. Excerpt:

The 40-foot trailer has been there for weeks, parked outside the Leo F. Kearns Funeral Home in Queens. Its refrigerator hums in an alley next to a check-cashing establishment. Thirty-six bodies, one atop the other, are stacked on shelves inside.  

The funeral director, Patrick Kearns, has barely slept since the day he took charge of them. As he lies awake in the middle of the night, he knows there will be more. 

“It weighs on you, having so many cases in your care,” he said. “The death rate is just so high, there’s no way we can bury or cremate them fast enough.” 

With more than 18,000 announced fatalities and a total death toll that is almost certainly higher, the coronavirus crisis is the worst mass casualty event to hit New York since the Spanish flu pandemic a century ago.  

At the height of the outbreak in April, a New Yorker was dying almost every two minutes — more than 800 per day, or four times the city’s normal death rate. And though the daily toll has recently slowed, hundreds of bodies are still emerging each day from private homes and hospitals.  

While hospitals bore the initial brunt of the crisis as sick people flooded emergency rooms, the sheer volume of human remains has pushed the system for caring for the dead to its limits, too: Hospital morgues, funeral homes, cemeteries and crematories are all overflowing and backed up.  

The scale of the problem was brought into sharp relief on Wednesday afternoon, when the police found dozens of decomposing bodies stashed inside two trucks outside a funeral home on Utica Avenue in Brooklyn. The owner, Andrew T. Cleckley, said he had nowhere else to put them, adding simply: “I ran out of space.” 

What happened in Brooklyn appears to be an extreme case, and state health officials said on Thursday they would investigate the matter. But in the last two months, funeral home directors have begun to store bodies in viewing rooms and chapels, turning up their air-conditioning systems to avoid decomposition. Some are transporting bodies to other cities and states to be cremated.  

Some hospitals ran out of body bags — the city has since distributed 20,000 — and others have used forklifts to transfer piles of corpses into makeshift mobile morgues. So many people have been dying at home that the medical examiner's office has turned to teams of soldiers working around the clock to pick them up.

Danes and Czechs say easing lockdowns has produced no COVID-19 surge

Via The Guardian: Danes and Czechs say easing lockdowns has produced no Covid-19 surge. Excerpt:

Denmark and the Czech Republic have said partially easing their lockdowns has not led to a surge in new coronavirus infections, as the WHO continued to urge extreme caution and Germany relaxed some restrictions but extended others. 

As EU governments grappled with the complex and conflicting imperatives of easing the lockdowns crippling their economies while avoiding a disastrous second wave of infections, meanwhile, South Korea reported no new cases for the first time. 

Of the 44 European countries to have imposed restrictions to curb the spread of the virus, 21 had started easing some of them and a further 11 were planning to do so soon, said Hans Kluge, regional director of the World Health Organization in Europe.  

Kluge warned that all governments must remain extremely circumspect. “As I have said before, this virus is unforgiving,” he said. “We must remain vigilant, persevere and be patient – and ready to ramp up measures again as and when needed.”  

There was, though, encouraging news from the Czech Republic and Denmark, where phased exits from strict lockdowns implemented early in the pandemic are under way. In Denmark, daycare facilities and schools began reopening two weeks ago, followed by hairdressers and other small businesses on 20 April. 

“There are no signs at all that the partial reopening has caused a bigger spread of infection,” said Christian Wejse, a scientist at the department of infectious diseases at Aarhus University. “At least there is no indication that we are heading into another wave. That has been the concern, but I can’t see that at all.” 

The Czech health minister, Adam Vojtěch, said the country’s number of new cases had been below 100 for the past eight consecutive days and also reported that a staggered reopening of shops and services had not so far led to a surge in infections.

North Atlantic hurricane season prediction: 20 named storms

Via Pennsylvania State University's Earth System Science Center: North Atlantic Hurricane Season Prediction. Excerpt:

ESSC scientists Dr. Michael E. Mann and Daniel J. Brouillette and alumnus Dr. Michael Kozar have released their seasonal prediction for the 2020 North Atlantic hurricane season, which officially starts on 1 June and runs through 30 November. 

The prediction is for 19.8 +/- 4.4 total named tropical cyclones, which corresponds to a range between 15 and 24 storms, with a best estimate of 20 named storms. This prediction was made using the statistical model of Kozar et al. (2012, see PDF here). This statistical model builds upon the past work of Sabbatelli and Mann (2007, see PDF here) by considering a larger number of climate predictors and including corrections for the historical undercount of events (see footnotes). 

The assumptions behind this forecast are (a) the persistence of current North Atlantic Main Development Region (MDR) sea surface temperature (SST) anomalies (+1.1 °C in early to mid-April 2020 from NOAA’s Coral Reef Watch) throughout the 2020 hurricane season, (b) the development of mild El Niño-Southern Oscillation (ENSO)-negative conditions by boreal late summer and early fall 2020 (ENSO forecasts here; we used mid-April 2020), and (c) climatological mean conditions for the North Atlantic Oscillation in boreal fall/winter 2020-2021.  

If no La Niña develops, then the prediction will be slightly lower: 18.3 +/- 4.3 storms (range of 14-23 storms, with a best guess of 19). 

Using an alternative model that uses "relative" MDR SST (MDR SST with the average tropical mean SST subtracted) in place of MDR SST yields a considerably lower prediction (13.6 +/- 3.7 total named storms). This alternative model also includes mild ENSO-negative conditions.

Swedish epidemiologist Anders Tegnell the target of praise, criticism over handling of COVID-19 pandemic

Via The Globe and Mail: Swedish epidemiologist Anders Tegnell the target of praise, criticism over handling of COVID-19 pandemic. Excerpt:

The COVID-19 pandemic has cast a spotlight on public health officials around the world. But few are facing the intense scrutiny that’s been aimed at Sweden’s State Epidemiologist Anders Tegnell. 

Dr. Tegnell has attracted international attention for his hands off approach to the pandemic and his resolute defence of the Swedish model. There’s no lockdown in the country and most schools, pubs, restaurants and stores remain open. The few measures that have been introduced – social distancing in eateries, no gatherings of more than 50 people and a request that everyone work from home – are largely voluntarily and there are no fines or police checks to ensure compliance. 

The strategy has made Dr. Tegnell a target of praise and ridicule. Critics accuse him of gambling with people’s lives and pursuing a dangerous “herd immunity” strategy that has resulted in a soaring mortality rate. Others see him as a hero who has pursued a sensible policy and spared Sweden from economic catastrophe. The 64-year old bureaucrat has become such a polarizing figure that while 2,000 Swedish scientists have signed a petition denouncing his strategy, more than 100,000 people have joined Anders Tegnell fan clubs. He’s even had his face plastered on T-shirts and inked on tattoos across Stockholm.  

“It’s all absurd I must say,” Dr. Tegnell said in a recent interview, using the matter-of-fact tone that has become a hallmark of his daily news conferences. “The media attention is something completely different, that’s for sure. I have not been called by Canadian newspapers very often over the years in spite of working with a lot more dangerous things than this.”    

The blunt-talking physician who favours brightly-coloured pullovers has spent nearly 30 years in public health, working mainly on vaccine programs and pandemic preparedness before becoming state epidemiologist in 2013. He’s also worked with the World Health Organization in Asia and Africa where he spent time in Zaire during the Ebola outbreak in 1995.  

Dr. Tegnell insisted that his go-slow approach to the coronavirus pandemic is working. His objective has always been to pursue measures that were sustainable and that would keep hospitals from becoming overwhelmed. It didn’t hurt that the Swedes have an inherent trust in government agencies and a willingness to take direction. “There is a big part of trust in the population that this is the right thing to do,” he said. 

He pointed out that although the number of new cases has been growing, and is now above 20,000, one third of the country’s intensive care beds remain empty. “There is quite a lot of excess capacity at this stage,” he said. “Our health care service is still functioning.” If anything, he’s feeling vindicated as he watches officials in other countries, including Canada, grapple with how to ease restrictive lockdowns. “To me it looks like a lot of the exit strategies that are being discussed look very much like what Sweden is already doing,” he said.  

Dr. Tegnell got a boost this week from Michael Ryan, the WHO’s executive director, who praised the Swedish method of voluntary compliance and said the country was an example for a way out of lockdowns. “I think there may be lessons to be learned from our colleagues in Sweden,” Dr. Ryan told a news conference. 

The strategy has not been entirely successful and there have been some serious failings which Dr. Tegnell acknowledged. Sweden’s death toll has topped 2,500 or roughly 22 for every 100,000 inhabitants. That’s higher than neighbouring Norway, Finland and Denmark which have imposed strict lockdowns. Norway and Finland have less than four deaths per 100,000, while in Denmark it is 7.3, according to Johns Hopkins University.

Bolsonaro faces calls to change tack on COVID-19 as Rio heads for ‘great hardship’

Now that TypePad is back up, blogging resumes with a story in The Guardian: Bolsonaro faces calls to change tack on Covid-19 as Rio heads for ‘great hardship’. Excerpt:

Rio de Janeiro is entering a period of “great hardship” in which thousands of lives could be lost, its top health official has warned, as Brazil’s president faced growing calls to change tack on coronavirus. 

Jair Bolsonaro has sabotaged efforts to impose effective social distancing measures by flouting his own health ministry’s recommendations, sacking his health minister and attacking Covid-19 “hysteria”. 

Asked about the rising death toll this week, the far-right populist sparked outrage by declaring: “So what?”  

But on Thursday Edmar Santos, the health secretary of Rio, Brazil’s third most populous state, said an intensification of containment measures – perhaps including some form of China-style lockdown – was the only way to avoid a dramatic surge in fatalities and social turmoil. 

“We are going to live through moments of great national hardship, the likes of which we’ve never experienced before,” Santos told the television network Globo.  

“We aren’t a country that has lived through major wars like countries in Europe. But we’ve all lost loved ones at some point. We’re going to experience big emotional problems, social problems in the coming days and, unfortunately, we’re going to see a big rise in the number of deaths.” 

According to official figures Covid-19 has so far claimed 5,466 lives in Brazil – 794 of them in Rio and 2,247 in neighbouring São Paulo. 

Santos said that if current trends continued about 1,800 people would die in Rio during May – although the number would “undoubtedly be higher” if authorities failed to slow the rate of transmission. 

But the secretary – who was himself diagnosed with Covid-19 earlier this month – admitted underreporting meant official figures did not capture the scale of the crisis. He believed Rio – which has a population of 17 million - actually had about 140,000 cases – more than 15 times the official number of under 9,000. 

A study published in the O Globo newspaper suggested the national figures were being similarly underestimated, with more than 1.2m likely infections, compared with the official figure of under 74,000. That would mean Brazil had more cases than the United States, so far the country worst hit by the pandemic, which has about 1 million. 

“The truth is this: if we don’t flatten the curve we will face chaos in May [and] a second round of chaos in June,” Santos warned, pointing to Italy, which suffered nearly 1,000 deaths on its most deadly day, in late March.

Second wave of locusts causing havoc in East Africa

Via The Globe and Mail, Geoffrey York writes: Second wave of locusts causing havoc in East Africa. Excerpt:

As a second generation of desert locusts expands into massive swarms in East Africa, there are growing fears that the next wave could jeopardize a crucial harvest in June and July in a region already suffering from widespread hunger and the COVID-19 pandemic.  

The first generation of locusts invaded East Africa at the end of 2019, causing devastation across several countries in January and February. They bred, and a second generation has now hatched and begun aggressively spreading, while a third wave is expected in June and July.  

Each generation of locusts can produce swarms up to 20 times bigger than the previous one. This means the current second generation will contain trillions, potentially destroying up to 5 million square kilometres of farmland. 

A single locust can travel 150 kilometres in a day, eating its own weight in maize and other crops. A small swarm of 40 to 80 million can cover a square kilometre, consuming as much food as 35,000 people in a day. 

Larger swarms of billions of locusts have already covered hundreds of square kilometres in Kenya, consuming as much food as 90 million people. 

“The current situation in East Africa remains extremely alarming as more swarms form and mature in northern and central Kenya and southern Ethiopia,” the United Nations Food and Agriculture Organization (FAO) warned in its latest assessment this week. 

The locusts have also inflicted damage in Somalia, Uganda and South Sudan. In some East African countries, it has been the worst locust outbreak in 70 years. Because swarms like these have not been seen in decades, some governments lack the experience and expertise to tackle the crisis fully.  

The FAO appealed in January for US$70-million to fight the locusts, then later increased it to US$153-million. It expects to increase the appeal again to a new target of more than US$200-million.  

Heavy rains and flooding in late March have boosted the breeding and hatching of the second generation of locusts, the FAO says. 

“The risk is that they will form new locusts in June and July, which would coincide with the harvest season, which would pose a real risk to food production in the region,” Dominique Burgeon, the FAO director of emergencies, said in a briefing on Wednesday for the U.S.-based Center for Strategic and International Studies (CSIS).

Ed Yong: The COVID-19 pandemic doesn’t have to be this confusing

I've been hearing about Ed Yong's great article in The Atlantic: The Pandemic Doesn’t Have to Be This Confusing. Now I've finally read it. It's better than great; it's wise. Here are the last three paragraphs:

The coronavirus not only co-opts our cells, but exploits our cognitive biases. Humans construct stories to wrangle meaning from uncertainty and purpose from chaos. We crave simple narratives, but the pandemic offers none. The facile dichotomy between saving either lives or the economy belies the broad agreement between epidemiologists and economists that the U.S. shouldn’t reopen prematurely. The lionization of health-care workers and grocery-store employees ignores the risks they are being asked to shoulder and the protective equipment they aren’t being given. The rise of small anti-lockdown protests overlooks the fact that most Republicans and Democrats agree that social distancing should continue “for as long as is needed to curb the spread of coronavirus.” 

And the desire to name an antagonist, be it the Chinese Communist Party or Donald Trump, disregards the many aspects of 21st-century life that made the pandemic possible: humanity’s relentless expansion into wild spaces; soaring levels of air travel; chronic underfunding of public health; a just-in-time economy that runs on fragile supply chains; health-care systems that yoke medical care to employment; social networks that rapidly spread misinformation; the devaluation of expertise; the marginalization of the elderly; and centuries of structural racism that impoverished the health of minorities and indigenous groups. It may be easier to believe that the coronavirus was deliberately unleashed than to accept the harsher truth that we built a world that was prone to it, but not ready for it. 

In the classic hero’s journey—the archetypal plot structure of myths and movies—the protagonist reluctantly departs from normal life, enters the unknown, endures successive trials, and eventually returns home, having been transformed. If such a character exists in the coronavirus story, it is not an individual, but the entire modern world. The end of its journey and the nature of its final transformation will arise from our collective imagination and action. And they, like so much else about this moment, are still uncertain.

At least 89 COVID-19 vaccines are being developed. It may not matter.

In The New York Times, Seth Berkley writes: At Least 89 Coronavirus Vaccines Are Being Developed. It May Not Matter. Excerpt:

If an effective and safe coronavirus vaccine were available today, would it be enough to stop this pandemic? That would depend on whether everyone who needs it can get it. But if what took place during the 2009 H1N1 pandemic happens again, then the answer is no.  

As swine flu swept across the globe, the vaccines that were developed ended up mostly in wealthy countries, while the rest of the world went without them. That’s what goes wrong when manufacturing agreements or domestic export policies in countries producing vaccines place restrictions on their international availability. 

Fortunately, the H1N1 pandemic turned out not to be much more severe than a normal flu season — as many as 285,000 may have died worldwide — though it struck people younger than 65 particularly hard. But if the same thing happens with a coronavirus vaccine as happened with the swine flu vaccine, the current pandemic, which has already killed at least 212,000 people worldwide, will continue to spread and kill across the globe.  

The first priority for any country, of course, is to protect its own citizens. But countries must think globally when the world faces an infectious disease. An outbreak anywhere is a risk everywhere. World leaders need to act now to ensure that everyone who needs the vaccine when it becomes available gets it.

The potential for outbreaks to spread uncontrollably is particularly high in low-income countries where inadequate public health systems are unable to effectively track and respond to new diseases or to treat people who are infected. These countries are also limited in their ability to pay for vaccines, which is why the organization I run, Gavi, the Vaccine Alliance, provides subsidies to countries to purchase them. 

Even so, substantially more financial help will be required if large numbers of vulnerable people are to be vaccinated. Otherwise, reservoirs of the virus will remain and continue to spread. With cases of coronavirus infection now confirmed in more than five dozen lower-income countries, that is a big concern. 

At least 89 coronavirus vaccines are in development, according to the World Health Organization, and possibly double that number. So when the first gets regulatory approval for widespread use, how do we ensure equal access? Initially, the challenge will be how to distribute the limited number of doses that are available.  

The danger is that richer nations will buy up the supply for their own use or prevent exports of vaccines developed within their borders as countries scramble to protect their citizens or stockpile for future outbreaks. Another concern is that manufacturers might restrict sales to the highest bidder. 

In the long term this may point to the need to expand the vaccine manufacturing base to a wider range of countries and regions. Because it is likely that the first vaccines will be produced in wealthy countries, we will fall short of producing a global supply if we rely only on their manufacturing capabilities. What we will need is a technology transfer to manufacturers around the world if we have any hope of having adequate quantities and global access.

For now, the Coalition for Epidemic Preparedness Innovations is trying to expedite the development of vaccines against emerging infectious diseases. The coalition has kick-started the development of at least nine coronavirus vaccines but needs to raise $2 billion to help up to three of these candidates make it through the regulatory and quality requirements and to complete efficacy trials. The world would then need to ensure funds to guarantee manufacturing capacity for global production to make billions of doses available within the next 18 to 24 months.

In addition to this, the coalition is working to create a mechanism to ensure equal access to these vaccines. It is unclear precisely how this would be achieved and whether, for dozens of other vaccines under development through other efforts, others making vaccines will follow suit once a mechanism is developed. It is also unclear how poorer countries will pay for them. But in global health crises where emergency vaccines are a global public good that keeps us all safe, the answer has to be largely through public funding.

COVID-19 on Wednesday night: 3,219,437 cases, 228,030 deaths

A screenshot from Covidly.com taken at 7:25 p.m. Wednesday night: 3,219,437 Cases, 228,030 Deaths.

It's hard to understand how an advanced country that is suffering over 1,000 cases and 100 fatalities an hour can think seriously about "reopening."

Decline in remittances from COVID-19 pandemic could be hard-felt in Haiti

Via The Haitian Times: Decline in remittances from pandemic could be hard-felt in Haiti. Excerpt:

Members of the Haitian diaspora are among the millions of people throughout the world facing job loss, late payments and other financial burdens, as the economy contracts in response to the novel coronavirus pandemic. 

But few countries rely on remittances from diaspora members as heavily as Haiti. In 2019, remittances represented more than 36% of Haiti’s GDP. The economic slowdown in the developed world could have a serious impact on Haitians who rely on this money to pay for necessities like food.  

According to figures provided by Inter-American Dialogue, an international affairs think tank, remittances to Haiti totaled more than $3.3 billion in 2019, a growth of 4.5% from the previous year. The year-over-year increase prevented Haiti’s economy from further declining, as the country experienced negative economic growth last year, wrote Manuel Orozco, a senior fellow at Inter-American Dialogue, in a March 18 paper, “Migration Remittances and the Impact of the Pandemic,” which examined remittances to Latin America and the Caribbean.  

A decline in remittances could exacerbate an alarming food crisis in Haiti. Free trade policies imposed by industrialized nations since the 1980s have made the country more reliant on imported food, eroding its once-robust agricultural sector and leading to increased unemployment. The crisis has also been exacerbated by natural disasters and the political unrest that ground the country to a halt in 2019.   

Charles Edouard-Denis of Petionville owns a seafood export company called HOPE Haiti. Many of the fishermen he employs are no longer working, after Haitian law required his company to stop fishing for lobsters beginning April 1.   

These employees cannot count on a social safety net, like many workers in the United States.  

“If they were getting some remittances, they’re going to be more dependent on those as time goes by, until we are allowed to start back up again and start producing and exporting,” Edouard-Denis said.

He expressed hope that business will resume by July. Until then, he is helping his employees by paying their full salaries for April and agreeing to pay half of their salaries for both May and June.   

The $1 million worth of seafood HOPE Haiti exports each year by Edouard Denis’s estimate represents a small chunk of Haiti’s export base, one source of foreign exchange and income. Clothing, textiles and cosmetics account for nearly 90% of the roughly $1 billion in goods Haiti exports. Along with remittances, this key source of income has also been threatened by coronavirus.