H5N1

Nessun Dorma...alla Corona - Daniel Emmet

A friend sent this item this afternoon: Nessun Dorma...alla Corona - Daniel Emmet. Amid all the bleak news, it's remarkably cheering.

COVID-19: Germany should not ease lockdown over Christmas, says top doctor

Via DW.com: Coronavirus: Germany should not ease lockdown over Christmas, says top doctor.

Uwe Janssens, president of the German Interdisciplinary Association of Critical Care and Emergency Medicine, told DW on Friday that easing lockdown restrictions would put a huge strain on the health care system. 

"We currently have infection rates above 20,000 per day," Janssens explained. "And although we have a lot of intensive care beds in Germany, there is a great strain on the intensive care units at the moment."  

This week, Germany announced an extension of lockdown measures until December 20. But restrictions are expected to loosen over Christmas, allowing more family members to meet. 

"We understand that people will meet together, but we really think it is not a good idea to allow 10 people to come together," Janssens said, citing the number that Chancellor Angela Merkel mentioned in her announcement of the way forward on Wednesday.

Families at risk
The chancellor urged people to voluntarily self-isolate before seeing relatives at Christmas, especially if visiting vulnerable people, and asked employers to show flexibility at that time of year.

But Janssens still believes that family gatherings could be a catalyst for infections.

"We fear there will be new and rising infections in these families," he said. "We know that will happen. We know it from Thanksgiving Day in Canada (October 12), where families came together. And as a result, infection rates rose up again."

Many opponents of the relaxed restrictions say that Germany's intensive care units will be overwhelmed, which Janssens expects.

"We will have a heavy load afterward, two weeks later on intensive care units," he explained. "The pandemic is not over here."

A doctor reminds that #Covid-19 "is still here" while America focuses on election outcome

Via The Washington Post, Tom Dean, a 75-year-old semi-retired doctor, describes the situation: A doctor reminds that coronavirus/covid-19 "is still here" while America focuses on election outcome. Excerpt:

Election Day is over, and guess what? The virus is still here. It didn’t just go away like the president said. We’re not rounding any corners. Nobody I know in South Dakota stopped talking about it because the voting is done. How could we? It’s right in our faces. It’s spreading. It keeps getting worse. 

Look, I’m as tired of hearing about covid as the president seems to be. I’m so sick of this virus, but what else should I be focused on, exactly? I’m one of three doctors in this county. We have to do a little bit of everything in a rural community, and this virus follows me wherever I go. We test people at our clinic, and probably about half are positive. We give them supplemental oxygen in our local hospital until they get critical, and then we have to transfer them to the ICU in Sioux Falls. I’m also a medical adviser for our nursing home, and it just had a big outbreak. Now they have eight or 10 empty beds. 

Jerauld County is an out-of-the-way place. We don’t have a whole lot, but we’re proud of what we have, so it pains me that we’re becoming famous now for our statistics. One in every 20 people has gotten sick in about the last month. Our death rate is the highest in the country, but it’s more than that. These aren’t anonymous cases. These are my patients, my friends, my family. I know every single one.  

We got lucky early in this pandemic, and I think that made us complacent. It was China, Seattle, New York. There was some hope in rural America that this might stay more of a big-city problem. We have about 2,000 people here spread out over 500 square miles of cows and wheat, so social distancing came naturally to us. The governor decided to kind of pretend it away and keep everything going as usual. You didn’t see too many people wearing masks. The school opened back up. They started playing football. I bet we went three months at the clinic without seeing a single positive test. 

How do you go from nothing to the worst outbreak in the country? I don’t know. I don’t have a good answer. We started to see a few little pockets of it, but the virus seemed fairly contained. There was a small outbreak at a cafe, and that led to seven or eight cases in our farming community, but then it seemed to go away. There were a few cases up north at the beef jerky plant. A couple of our students came down with it. Then a few teachers. I went into the clinic one day this fall, and the phones were ringing off the hook. Coughs. Fevers. Chills. 

We tested people as they pulled up in their cars. We have rapid tests, so you hope and pray for those 15 minutes. I was worried about how fast this could spread through town. We have one grocery store, one bank, one pharmacy — it’s all the same Petri dish. I was worried about what would happen if covid got into the nursing home, where both of my parents lived. I told myself: Maybe it’s the flu or something seasonal that’s going around.  

Positive. Positive. Positive. Positive. We had 11 new cases within about five hours.

Half of Indians may have had COVID-19 by February, government panel estimates

Via Reuters: Half of Indians may have had coronavirus by February, government panel estimates.

MUMBAI (Reuters) - At least half of India’s 1.3 billion people are likely to have been infected with the new coronavirus by next February, helping slow the spread of the disease, a member of a federal government committee tasked with providing projections said on Monday. 

India has so far reported 7.55 million cases of the coronavirus and is second only to the United States in terms of total infections. 

But COVID-19 infections are decreasing in India after a peak in mid-September, with 61,390 new cases reported on average each day, according to a Reuters tally.  

“Our mathematical model estimates that around 30% of the population is currently infected and it could go up to 50% by February,” Manindra Agrawal, a professor at the Indian Institute for Technology in Kanpur and a committee member, told Reuters. 

The committee’s estimate for the current spread of the virus is much higher than the federal government’s serological surveys, which showed that only around 14 per cent of the population had been infected, as of September.  

But Agrawal said serological surveys might not be able to get sampling absolutely correct because of the sheer size of the population that they were surveying.  

Instead, the committee of virologists, scientists and other experts, whose report was made public on Sunday, has relied on a mathematical model. 

“We have evolved a new model which explicitly takes into account unreported cases, so we can divide infected people into two categories – reported cases and infections that do not get reported,” Agrawal said.  

The committee warned that their projections would not hold up if precautions were not followed, and cases could spike by up to 2.6 million infections in a single month if measures such as social distancing and wearing masks were ignored. 

Experts have warned that infections could rise in India as the holiday season nears, with celebrations for the Hindu festivals of Durga Puja and Diwali due this month and in mid-November, respectively.

India's COVID-19 infections cross 7 million ahead of festivals

Via Reuters: India's coronavirus infections cross 7 million ahead of festivals.

MUMBAI (Reuters) - India’s coronavirus caseload topped 7 million on Sunday when the health ministry reported 74,383 new infections in the previous 24 hours, with a rise in infections in southern states offsetting a drop in western regions.

Deaths from COVID-19 rose by 918 in the last 24 hours to 108,334, the ministry said. 

India added a million cases in just 13 days, according to a Reuters tally of government data, and it has the second-highest number of infections, behind the United States which is approaching the 8 million mark.  

The southern state of Kerala, which won praise for its early handling of the coronavirus pandemic, on Saturday reported 11,755 new cases, the highest in the country. 

Neighbouring Karnataka and its capital Bengaluru, where many software companies are based, has also been struggling to contain the spread of virus. 

Prime Minister Narendra Modi’s government, faced with a collapsing economy after imposing a tough lockdown to try to stem the spread of the virus in late March, is pushing ahead with a full opening of the country just before the festival season. 

But India’s festival season, which climaxes in October and November with the popular Hindu celebrations of Dussehra and Diwali, poses additional challenges, as officials try to dampen the usual large public celebrations and cross-country travel. 

Typically the festival season brings a big increase in consumer spending, and the more sombre atmosphere this year will further dampen an economy that contracted by almost a quarter in the three months to June - the worst figure on record. 

A few states such as Maharashtra and Gujarat in the west have put restrictions on gathering during the nine-day Navratri festival due to begin on Oct. 17.  

“Festival season is approaching. A little carelessness of people during festivals can worsen the situation,” India’s health minister Harsh Vardhan told his social media followers in a broadcast on Sunday. 

“There is no need to congregate in large numbers to prove your faith or your religion. If we do this we may be heading for a big trouble,” Vardhan said.

Women are excluded from global COVID-19 coverage, experts say

This baffles me, because I rely so heavily on women who are health experts. Via The Washington Post: Women are excluded from global coronavirus coverage, experts say. Excerpt:

On a Canadian Broadcasting Corporation program earlier this month, a debate between two physicians over coronavirus-related restrictions turned into a brief clash over the role of gender in mainstream discourse. “

You’re just shouting; you’re not actually speaking,” infectious-disease expert Neil Rau told his female colleague, interrupting.  

“Do not be sexist,” family doctor and medical anthropologist Nili Kaplan-Myrth responded, not missing a beat. “I’m speaking in an assertive voice.”  

“NEVER tell a woman (professional or otherwise) that she cannot speak with authority,” she wrote later on Twitter. “NEVER tell us we aren’t educated enough, experts enough, or good enough. We have every bit as much authority to speak.”  

The exchange underscored a broader concern over the lack of female voices in media coverage of and policy debates on the coronavirus pandemic. 

In coverage of the coronavirus, female scientists and doctors are cited far less frequently than their male counterparts, according to multiple multicountry studies. And when women are vocal, as with other policy debates and key areas of coverage, they often face online harassment and second-guessing of their expertise, several female scientists told The Washington Post. 

The consequences are far-reaching. The marginalization of female experience and expertise colors the information available to policymakers forming coronavirus responses — which means interests and issues important to women may get underprioritized. This dynamic has, according to a recent study commissioned by the Bill and Melinda Gates Foundation, perpetuated a “war framing” around the virus, reinforcing the gendered stereotype that men are more reliable in emergencies and as decision-makers.  

Marginalized voices 

Since reports of the novel coronavirus began circulating in January, the world has been inundated with news and perspectives. Male scientists and physicians have played an outsize role in global efforts to make sense of the virus. 

“The pandemic exacerbated the lack of women’s voices,” said Muge Cevik, who works on infectious diseases and medical virology at the University of St. Andrews in Scotland. “It just reinforced the prevailing gender norm in which men continue to be allocated to leadership roles, speaking to media.” 

Last month’s Gates Foundation report, written by audience researcher Luba Kassova, analyzed coronavirus coverage published in mainstream publications online in the United Kingdom, the United States, Kenya, South Africa, Nigeria and India. The study focused on articles identified by Google’s news search engine as highly ranked between March 1 and April 15. It found that women are “worryingly marginalized.” On average, every female voice in a coronavirus story was “drowned out” by at least three male interviewees, the study concluded. 

“Women were four times less likely to feature as experts and commentators” in stories on the coronavirus, the study found. When cited, “women are more likely to be used as sources sharing subjective views than experts sharing authoritative expertise,” according to the report. Women constituted 19 percent of experts quoted overall and were less likely to feature as protagonists in coronavirus stories.  

The trend has been documented elsewhere. A report published last month by the French Ministry of Culture and the ministry responsible for gender equality found that during the country’s coronavirus lockdown this spring, “newspapers devote[d] a predominant place to male personalities in their content.” More than 83 percent of the people pictured on the front page of major newspapers during this period were men, who also wrote a majority of opinion pieces. 

A recent University of Zurich study calculated that women made up two of the 30 scientists most frequently cited by the Swiss media in coronavirus coverage during the first half of the year. 

The experiences of female scientists and medical experts echo across sectors. Statistically, few women are part of national-level decision-making processes on the coronavirus, although 69 percent of health professionals around the globe are women. For working mothers and women from minority and marginalized communities, many disparities are growing even deeper amid school and economic disruptions.  

“There are lots of women who are working really hard [on coronaviruses-related research] and they don’t make it into the media or policy advisories,” said Emma Hodcroft, one of the two female scientists among the group most widely cited in Switzerland, who studies and tracks viruses at the University of Basel.

China's successful control of COVID-19

Via The Lancet Infectious Diseases: China's successful control of COVID-19.

On Sept 22, 2020, US President Donald Trump gave a combative address to the UN General Assembly referring to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as the “China virus”. He demanded that China was held accountable for “unleash[ing] this plague onto the world”. Chinese premier Xi Jingping, who addressed the General Assembly after Trump, urged nations affected by COVID-19 to “follow the guidance of science...and launch a joint international response to beat this pandemic”. He added that “any attempt of politicising the issue or stigmatisation must be rejected”. 9 days later, Trump tested positive for SARS-CoV-2.  

According to a July survey by the Pew Research Center, two-thirds of Americans believe that China has done a bad job dealing with the COVID-19 pandemic. It is clearly not an opinion shared by WHO. In a press conference in September, Mike Ryan, executive director of the WHO Health Emergencies Programme, offered “deepest congratulations...to the front-line health workers in China and the population who worked together tirelessly to bring the disease to this very low level”. 

As of Oct 4, 2020, China had confirmed 90 604 cases of COVID-19 and 4739 deaths, while the USA had registered 7 382 194 cases and 209 382 deaths. The UK has a population 20 times smaller than China, yet it has seen five times as many cases of COVID-19 and almost ten times as many deaths. All of which raises the question: how has China managed to wrest control of its pandemic? 

Despite being the first place to be hit by COVID-19, China was well-placed to tackle the disease. It has a centralised epidemic response system. Most Chinese adults remember SARS-CoV and the high mortality rate that was associated with it. 

“The society was very alert as to what can happen in a coronavirus outbreak”, said Xi Chen (Yale School of Public Health, New Haven, Connecticut, USA). “Other countries do not have such fresh memories of a pandemic”. Ageing parents tend to live with their children, or alone but nearby. Only 3% of China's elderly population live in care homes, whereas in several western countries, such facilities have been major sources of infection. 

“The speed of China's response was the crucial factor”, explains Gregory Poland, director of the Vaccine Research Group at the Mayo Clinic (Rochester, Minnesota, USA). “They moved very quickly to stop transmission. Other countries, even though they had much longer to prepare for the arrival of the virus, delayed their response and that meant they lost control”. 

The first reported cases of the disease that came to be known as COVID-19 occurred in Wuhan, Hubei province, in late December 2019. China released the genomic sequence of the virus on Jan 10, 2020, and began enacting a raft of rigorous countermeasures later in the same month. 

Wuhan was placed under a strict lockdown that lasted 76 days. Public transport was suspended. Soon afterwards, similar measures were implemented in every city in Hubei province. Across the country, 14 000 health checkpoints were established at public transport hubs. School re-openings after the winter vacation were delayed and population movements were severely curtailed. Dozens of cities implemented family outdoor restrictions, which typically meant that only one member of each household was permitted to leave the home every couple of days to collect necessary supplies. 

Within weeks, China had managed to test 9 million people for SARS-CoV-2 in Wuhan. It set up an effective national system of contact tracing. By contrast, the UK's capacity for contact tracing was overwhelmed soon after the pandemic struck the country. 

As the world's largest manufacturer of personal protective equipment, it was relatively straightforward for China to ramp up production of clinical gowns and surgical masks. Moreover, the Chinese readily adopted mask wearing. “Compliance was very high”, said Chen. “Compare that with the USA, where even in June and July, when the virus was surging, people were still refusing to wear masks. Even in late September, President Trump still treated Joe Biden's mask-wearing as a weakness to be ridiculed”. 

Drones equipped with echoing loudspeakers rebuked Chinese citizens who were not following the rules. The state-run Xinhua news agency has released footage taken from the drones. “Yes Auntie, this drone is talking to you”, one device proclaimed to a surprised woman in Inner Mongolia. “You shouldn't walk around without wearing a mask. You'd better go home and don't forget to wash your hands”. In the UK, 150 000 people were permitted to attend a horse racing meet in mid-March, 10 days before the country went into lockdown. In August, 460 000 Americans congregated in Sturgis, South Dakota, for a motorcycle rally.

On Febr 5, 2020, Wuhan opened three so-called Fangcang hospitals. Another 13 would appear over the next few weeks. The hospitals were established within public venues such as stadiums and exhibition centres and were used to isolate patients with mild-to-moderate symptoms of COVID-19. Patients who started to show symptoms of severe disease were quickly transferred to conventional hospitals. The network of Fangcang hospitals, which held 13 000 beds, meant that patients with COVID-19 did not have to isolate at home, which reduced the risk of family members becoming infected. By Mar 10, 2020, the Fangcang hospitals were no longer needed. From around the same time, the focus of China's countermeasures shifted from controlling local transmission to preventing the virus from taking hold as a result of imported cases. Those who entered the country were tested and quarantined.

A modelling study co-authored by Chen calculated that the public health actions undertaken by China between Jan 29 and Feb 29 may have prevented 1·4 million infections and 56 000 deaths. Still, it does not necessarily follow that China's response to the pandemic is generalisable. “As each country has its own health system and epidemic curve, measures implemented in one country may not be easily replicated by another”, points out Imperial College London's Han Fu. “Other factors such as coordination between government sectors and civil compliance with regulations may also affect the effectiveness of the response”. Much also depends on each nation's conception of civil liberties.

“In China, you have a combination of a population that takes respiratory infections seriously and is willing to adopt non-pharmaceutical interventions, with a government that can put bigger constraints on individual freedoms than would be considered acceptable in most Western countries”, adds Poland. “Commitment to the greater good is engrained in the culture; there is not the hyper-individualism that characterises parts of the USA, and has driven most of the resistance to the countermeasures against the coronavirus.”

Poland noted that the Chinese accept the notion that disease control is a matter of science. “China does not have the kind of raucous anti-vaccine, anti-science movement that is trying to derail the fight against COVID-19 in the USA”, he said.

In August, Wuhan hosted an enormous pool party. There were objections from some foreign media outlets. The state-owned Global Times was unapologetic. It suggested that the event stood as “a reminder to countries grappling with the virus that strict preventive measures have a payback”. The newspaper quoted a local resident who back in April had feared he might be bankrupted by the pandemic. “There weren't even many local people, not to mention tourists. But now my business is blooming with the city having fully recovered”, he said.

COVID-19: Israel tightens second lockdown amid acrimony

Via BBC News: Coronavirus: Israel tightens second lockdown amid acrimony. Excerpt:

Israel has tightened restrictions on its population in the fight against coronavirus, one week after a second lockdown came into effect. 

From Friday afternoon, businesses not officially considered essential were ordered closed, and travel restricted to 1km (0.6 miles) from people's homes. 

Other planned rules which would affect protesters and synagogue-goers have not yet been approved amid acrimony. 

Covid-19 cases in Israel have continued to rise despite the latest lockdown. 

A new record of more than 8,000 infections for a single day was recorded on Thursday in Israel, which has one of the highest rates of infections per capita in the world.

Some 1,405 people have died with the disease, with the total number of confirmed cases reaching 215,273 out of a population of 9.2 million.

Prime Minister Benjamin Netanyahu said on Thursday the stricter measures were a necessity. 

"Wake up. Enough is enough. We are in a different reality. Something needs to be done and it must be done now." 

Under the latest restrictions, almost all businesses have been told to close for at least the next two weeks, with a possibility the lockdown might be extended depending on the situation. Restaurants are only being permitted to serve home-deliveries. 

People are also restricted to staying within a reduced radius from their homes, apart from in emergencies and for specific exemptions. 

The government's most controversial planned measure - limits on public gatherings - has not yet been approved after a parliamentary committee that must amend the law to allow it could not reach agreement. 

 Opponents see the move as an attempt to stop weekly protests against Mr Netanyahu, which have drawn thousands of demonstrators to assemble outside his residence in Jerusalem. 

Restrictions on gatherings would also drastically affect the number of people allowed to attend prayer services in synagogues - two days ahead of Yom Kippur, the holiest day in the Jewish calendar, which traditionally sees synagogues full to capacity across the country. 

Such a move is particularly opposed by sections of the ultra-Orthodox community, whose support Mr Netanyahu relies upon in his national unity government.

Rugged individualism and collective (in)action during the COVID-19 pandemic

Via the National Bureau of Economic Research: Rugged Individualism and Collective (In)action During the COVID-19 Pandemic. The abstract:

Rugged individualism—the combination of individualism and anti-statism—is a prominent feature of American culture with deep roots in the country’s history of frontier settlement. Today, rugged individualism is more prevalent in counties with greater total frontier experience (TFE) during the era of westward expansion. While individualism may be conducive to innovation, it can also undermine collective action, with potentially adverse social consequences. 

We show that America’s frontier culture hampered the response to the COVID-19 pandemic. Across U.S. counties, greater TFE is associated with less social distancing and mask use as well as weaker local government effort to control the virus. 

We argue that frontier culture lies at the root of several more proximate explanations for the weak collective response to public health risks, including a lack of civic duty, partisanship, and distrust in science.

Hutterite colonies, health authorities could have acted sooner to prevent COVID-19: Epidemiologist

Via CBC News: Hutterite colonies, health authorities could have acted sooner to prevent COVID-19: epidemiologist. Excerpt:

Manitoba could have acted quicker to prevent COVID-19 from spreading in Hutterite colonies, especially given the "intense threat" the virus has demonstrated to Hutterites west of the province, an epidemiologist says.  

The latest numbers show nearly 600 confirmed cases on Saskatchewan Hutterite colonies, which account for one-third of the provincial total and an infection rate of roughly 10 per cent of the Hutterite population there. 

"Had there been more willingness, openness, to identify the first few cases, and then had there been a very quick, almost instantaneous response to that case … the case number could have been fewer than we ended up having," said Saskatchewan-based epidemiologist Nazeem Muhajarine, who studies community health.  

If Manitoba wants to avoid something similar, aggressive testing needs to happen from the outset, local doctors familiar with communities need to be used and culturally-sensitive relationships need to be built before the crisis, he said.  

Manitoba's chief public health officer Dr. Brent Roussin said on Monday that one-third of all active cases in the province are connected to tight-knit communities, which includes Hutterite colonies. 

Lessons learned out west 

While health officials in Saskatchewan have been able to track the cases,  their ability was sometimes hampered by cultural differences, including language barriers, as not all Hutterites speak English. 

"People were giving information sheets in English. That might not actually have gone over very well," he said. 

The province also had time to build better relationships before the pandemic hit the colonies, he said. 

"It helps a great deal if you are building on a cultural understanding and a relationship between non-Hutterites and Hutterite communities," he said.  

"A pandemic situation is not a good time to be building that relationship."