Covid-19, Belt and Road Initiative and the Health Silk Road: Implications for Southeast Asia

• Similar to the Belt and Road Initiative, the Health Silk Road is not precisely defined, covering a wide scope of activities, including bilateral and multilateral health policy meetings and networks, capacity building and talent training, mechanisms to control and prevent cross-border infectious diseases, health aid, traditional medicine, and healthcare industry.
• The Health Silk Road is tied to the domestic program of Health China 2030 and builds on existing practices of China’s health diplomacy.
• COVID-19 highlights the need for public health infrastructure for many countries, especially developing countries. The Health Silk Road provides the policy frame for China to strengthen and reform its foreign medical aid system, increase its influence in regional and global health governance, direct BRI investment to basic public health investment, and enlarge China’s role in the supplies of medical products and services.
• Southeast Asia will be an important region where China promotes the HSR. Concrete health cooperation projects will be negotiated bilaterally. Multilaterally (ASEAN) and at the sub-regional level (Mekong region and East ASEAN area), China will engage for the purposes of policy consensus and coordination. Economically, different Southeast Asian countries will have different kinds of investment and trade relationship with China, depending on their level of economic development.

Download PDF here (Friedrich Ebert Stiftung, Oct 2020)

The pandemic's digital shadow

‘The coronavirus pandemic is accelerating a dramatic decline in global internet freedom. For the 10th consecutive year, users have experienced an overall deterioration in their rights, and the phenomenon is contributing to a broader crisis for democracy worldwide. Three notable trends punctuated an especially dismal year for internet freedom... First, political leaders used the pandemic as a pretext to limit access to information... Second, authorities cited COVID-19 to justify expanded surveillance powers and the deployment of new technologies that were once seen as too intrusive... The third trend has been the transformation of a slow-motion “splintering” of the internet into an all-out race toward “cyber sovereignty,” with each government imposing its own internet regulations in a manner that restricts the flow of information across national borders...

‘Global internet freedom has declined for the 10th consecutive year: 26 countries’ scores worsened during this year’s coverage period, while 22 countries registered net gains. The largest declines occurred in Myanmar and Kyrgyzstan, followed by India, Ecuador, and Nigeria. A record number of countries featured deliberate disruptions to internet service. On the positive side, Sudan and Ukraine experienced the largest improvements, followed by Zimbabwe. A raft of court rulings shored up human rights online in countries ranked Free, Partly Free, and Not Free alike. The United States ranked seventh overall, while Iceland was once again the top performer. For the sixth consecutive year, China was found to have the worst conditions for internet freedom.

‘Freedom on the Net assesses internet freedom in 65 countries around the globe, accounting for 87 percent of the world’s internet users. This report, the 10th in its series, covers developments between June 2019 and May 2020. More than 70 analysts contributed to this year’s report, using a standard methodology to determine each country’s internet freedom score on a 100-point scale, based on 21 indicators pertaining to obstacles to access, limits on content, and violations of user rights. Freedom on the Net also identifies global trends related to the impact of information and communication technologies on democracy. The data underpinning this year’s trends, in-depth reports on each of the countries surveyed, and the full methodology can be found here.’

Read here (Freedom House, October 2020)

How three prior pandemics triggered massive societal shifts

‘None of this is to argue that the still-ongoing COVID-19 pandemic will have similarly earth-shattering outcomes. The mortality rate of COVID-19 is nothing like that of the plagues discussed above, and therefore the consequences may not be as seismic. But there are some indications that they could be... 

‘Will the bumbling efforts of the open societies of the West to come to grips with the virus shattering already-wavering faith in liberal democracy, creating a space for other ideologies to evolve and metastasize? In a similar fashion, COVID-19 may be accelerating an already ongoing geopolitical shift in the balance of power between the U.S. and China... Finally, COVID-19 seems to be accelerating the unraveling of long-established patterns and practices of work, with repercussions that could affect the future of office towers, big cities and mass transit, to name just a few. The implications of this and related economic developments may prove as profoundly transformative as those triggered by the Black Death in 1347.’

Read here (The Conversation, Oct 1, 2020)

Why we need to keep using the patient made term “Long Covid”

“Long Covid” was first used by Elisa Perego as a Twitter hashtag in May to describe her own experience of a multiphasic, cyclical condition that differed in time course and symptomatology from the bi-phasic pathway discussed in early scientific papers, which focused on hospitalized patients. Just three months later, following intense advocacy by patients across the world, this patient made term has been taken up by powerful actors, including the World Health Organization. Politicians have used it too: Matt Hancock, UK health secretary, recently explained to a parliamentary committee that “the impact of long covid can be really debilitating for a long period of time.”...

‘As patients and professionals, we see “Long Covid” as better able to navigate the socio-political, as well as clinical and public health challenges, posed by the pandemic in the coming months, for a number of reasons: (1) Long Covid acknowledges that cause and disease course are as yet unknown (2) Long Covid makes clear that “mild” covid-19 is not necessarily mild (3) Long Covid avoids “chronic,” “post” and “syndrome” (4)Long Covid draws attention to morbidity (5) Long Covid centres disabled people.

Read here (BMJ Opinion, Oct 1, 2020) 

Study finds ‘single largest driver’ of Coronavirus misinformation: Donald Trump

‘Of the flood of misinformation, conspiracy theories and falsehoods seeding the internet on the coronavirus, one common thread stands out: President Trump. That is the conclusion of researchers at Cornell University who analyzed 38 million articles about the pandemic in English-language media around the world. Mentions of Mr. Trump made up nearly 38 percent of the overall “misinformation conversation,” making the president the largest driver of the “infodemic” — falsehoods involving the pandemic.’

Read here (New York Times, Sept 30, 2020)

In a pandemic we learn again what Sartre meant by being free

‘The pandemic also teaches us about freedom in ways that go beyond Sartre’s discussion of the individual. Politically, using Isaiah Berlin’s distinction, we talk of the ‘negative liberty’ to go about our business without restraint, and the ‘positive liberty’ to do the things that give us the possibility to flourish and maximise our potential. For example, a society where there is no compulsory schooling gives parents the negative liberty to educate their children as they wish. But, generally speaking, this doesn’t give the child the positive liberty to have a decent education.

‘Over recent decades in the West, negative liberty has been in the ascendancy and positive liberty has been tarred with the brush of the nanny state. What we should have learned in 2020 is that without health services, effective regulation and sometimes strict rules, our negative freedom is useless and even sometimes destructive. Without state ‘interference’, many more lives would have been lost, jobs destroyed and businesses ruined. We now have an opportunity to reset the balance between negative and positive liberty...’

Read here (Psyche, Sept 30, 2020)

Germans embrace fresh air to ward off coronavirus

‘Ventilating rooms has been added to the German government’s formula for tackling coronavirus, in refreshing news for the country’s air hygiene experts who have been calling for it to become official for months. The custom is something of a national obsession, with many Germans habitually opening windows twice a day, even in winter. Often the requirement is included as a legally binding clause in rental agreements, mainly to protect against mould and bad smells. But while some people may dismiss the method as primitive, “it may be one of the cheapest and most effective ways” of containing the spread of the virus, Angela Merkel insisted on Tuesday.’

Read here (The Guardian, Sept 30, 2020) 

In a pandemic we learn again what Sartre meant by being free

‘One of the most powerful effects of the COVID-19 pandemic, after its terrible toll on human life, has been on our liberty. Around the world, people’s movements have been severely curtailed, tracked and monitored. This has had an impact on our abilities to earn a living, study and even be with loved ones at the end of their lives. Freedom, it seems, is one of this virus’s biggest casualties.

‘But an article by Jean-Paul Sartre for The Atlantic in 1944 makes me question whether this is a straightforward tale of loss. The French philosopher summed up his thesis in the line: ‘Never were we freer than under the German occupation.’ Sartre’s core insight was that it is only when we are physically stopped from acting that we fully realise the true extent and nature of our freedom. If he is right, then the pandemic is an opportunity to relearn what it means to be free.

‘Of course, our situation is not nearly as extreme as it was for the French under occupation, who, as Sartre said, ‘had lost all our rights, beginning with the right to talk’. Still, like most of us, I have at times found myself unable to do almost everything I had taken for granted. During the strictest lockdown period, nights out at theatres, concert halls and cinemas were cancelled. I couldn’t go for a walk in the countryside, relax in a bar or restaurant, sit on a park bench, visit anyone, even leave my home more than once a day.’

Read here (Aeon, Sept 30, 2020)

Tamil Nadu and Andhra Pradesh study: (1) 8% of the detected Covid-19 cases accounted for 60% of the transmission (2) Transmission among individuals of approximately the same age was highest among children under 15 years old and adults 65 years and older

‘A study published in Science analyzed surveillance and contact tracing data from two South Indian states, Tamil Nadu and Andhra Pradesh, collected through August 1. This is one of the few studies that captures the epidemiology of COVID-19 in low- or middle-income countries on a large scale. Together, these states account for approximately 10% (127.8 million) of India’s national population, and they contain the most robust healthcare workforces and public health infrastructure in the country. The study provides a detailed look at the timeline and growth of the COVID-19 epidemics in these states, including incidence and mortality.

‘The researchers found that the majority of cases (71%) did not result in secondary transmission to any of their contacts identified through contact tracing efforts. Based on data collected from more than 600,000 cases and contacts, the researchers estimate that 8% of the detected COVID-19 cases accounted for 60% of the transmission, providing further evidence that super-spreading events play a major role in the COVID-19 pandemic. The researchers also identified that transmission among individuals of approximately the same age was highest among children under 15 years old and adults 65 years and older. While the researchers were not able to determine the degree of transmission from children to adults, the study results support that pediatric cases do play a role in the ongoing pandemic. Overall, the case fatality ratio was 2.06%, and generally increased with age; however, unlike the US, mortality tended to plateau rather than increase in individuals 75 years and older. The reasons for this trend are uncertain. Additionally, the median hospital admission time before death was 6 days.’

Read here (John Hopkins Newsletter, Science, Sept 30, 2020)

The US excess mortality rate from COVID-19 is substantially worse than Europe’s

‘The US has 4% of the world’s population but 21% of the global COVID-19-attributed infections and deaths. This column shows that when comparing excess mortality rates, a more robust way of reporting on pandemic deaths, Europe’s cumulative excess mortality rate from March to July is 28% lower than the US rate, contradicting the Trump administration’s claim that Europe’s rate is 33% higher. The US Northeast – the region most comparable with individual European countries – has experienced substantially worse excess mortality than Europe’s worst-affected countries. Had the US kept its excess mortality rate down to the level in Europe, around 57,800 American lives would have been saved.’

Read here (Vox EU, Sept 29, 2020)

The world after Coronavirus: A Pardee Center video series

The COVID-19 pandemic is a global crisis of unprecedented scale, with aftershocks that will be felt in virtually every aspect of life for years or decades to come. The Frederick S. Pardee Center for the Study of the Longer-Range Future at the Pardee School of Global Studies is pleased to present “The World After Coronavirus,” a video series featuring more than 100 interviews with leading experts and practitioners from Boston University and across the world, exploring the challenges and opportunities we will face in our post-coronavirus future.

The series is hosted by Prof. Adil Najam, the Inaugural Dean of the Pardee School of Global Studies and former Director of the Pardee Center. Each episode is around five minutes long, and is an edited version of a slightly longer conversation between Dean Najam and our featured guest.

The entire series is curated on the Pardee Center’s YouTube channel.

• Ban Ki-moon on The Future of the United Nations
• Leon E. Panetta on The Future of Public Service
• Richard N. Haass on The Future of ‘The World’
• Lawrence Lessig on The Future of Expertise
• Fred Swaniker on The Future of Education in Africa
• Nicol Turner Lee on The Future of Technology and Work
• Paul Webster Hare on The Future of Diplomacy
• Michelle A. Williams on The Future of Public Health
• Kara Lavender Law on The Future of the Oceans
• Ricardo Meléndez-Ortiz on The Future of the WTO
• Alanna Shaikh on The Future of Global Health
• Barry Hughes on The Future of Disruptions
• Mariette DiChristina on The Future of Science Journalism
• James J. Collins on The Future of Synthetic Biology
• Sharon Goldberg on The Future of Cybersecurity
• Jeffrey D. Sachs on The Future of Global Sustainable Development
• Guy Kawasaki on The Future of Digital Marketing
• Ian Bremmer on The Future of Geopolitics
• Umar Saif on The Future of E-Commerce in the Developing World
• Janine Ferretti on The Future of Environmental Performance
• Judith Butler on The Future of Gender and Identity
• Richard Florida on The Future of Cities
• Martin Rees on The Future of the Future
• Julia Kim on The Future of Happiness
• Jeremy Corbyn on The Future of Politics (and Part 2)
• Ian Goldin on The Future of Globalization
• Judith Butler on The Future of Hope
• Robin Murphy on The Future of Robots
• Thomas Lovejoy on The Future of Nature
• Sandrine Dixson-Declѐve on The Future of the Green Economy
• Mary Evelyn Tucker on The Future of Religion and Ecology
• Mark C. Storella on The Future of Health Diplomacy
• Paul R. Ehrlich on The Future of Population and Extinction
• Adela Pineda on The Future of Literature
• Peter Gleick on The Future of Water
• Ricardo Hausmann on The Future of Tax Policy in Developing Countries
• Ramachandra Guha on The Future of Globalism
• Ann Marie Lipinski on The Future of Journalism
• Peter Frankopan on The Future of the Silk Roads
• Ha-Joon Chang on The Future of Developing Economies
• Alice Ruhweza on The Future of the Food System in Africa
• Elizabeth Economy on The Future of U.S.-China Relations
• Ibram X. Kendi on The Future of Racism
• Peter Maurer on The Future of Humanitarianism
• Jessica Stern on The Future of Extremism
• Angus Deaton on The Future of Despair
• Danielle Citron on The Future of Cyber Civil Rights
• Zeid Ra’ad Al Hussein on The Future of Human Rights
• Elizabeth M. Mrema on The Future of Biodiversity
• Dani Rodrik on The Future of Global Trade
• Nahid Bhadelia on The Future of Infectious Disease
• Vali Nasr on The Future of the Middle East
• Graham T. Allison on The Future of Thucydides
• Rachel Kyte on The Future of Renewable Energy
• David Miliband on The Future of Refugees
• Vala Afshar on The Future of Digital Business
• Kevin P. Gallagher on The Future of Economic Multilateralism
• Karen H. Antman on The Future of Medicine
• Adm. James G. Stavridis on The Future of the Military
• Thomas Piketty on The Future of Inequality
• Jomo Kwame Sundaram on The Future of Food Security
• Kevin Outterson on The Future of Health Law
• Bill McKibben on The Future of Environmentalism
• Laurie Garrett on The Future of Pandemics
• Malik Dahlan on The Future of Muslim Societies
• Sandro Galea on The Future of Mental Health
• Michael Barber on The Future of Government
• Peter Singer on The Future of Meat
• Phil Baty on The Future of Global Higher Education
• Sunita Narain on The Future of Global Cooperation
• Adil Haider on The Future of Emergency Medicine
• Michael Woldemariam on The Future of Africa
• Lucy Hutyra on The Future of CO2
• David Chard on The Future of Education
• Sakiko Fukuda-Parr on The Future of the SDGs
• Francis Fukuyama on The Future of Democracy
• Mark Blyth on The Future of Growth
• Claudia Juech on The Future of Data Governance
• Tom Tugendhat on The Future of the Nation State
• Rachel Nolan on The Future of Immigration
• Achim Steiner on The Future of International Development
• Michael Kugelman on The Future of South Asia
• Enrico Letta on The Future of the E.U.
• Marcia McNutt on The Future of Science
• Jorge Heine on The Future of Latin America
• Harvey Young on The Future of the Fine Arts
• Kishore Mahbubani on The Future of Asia
• Yolanda Kakabadse on The Future of Sustainable Development
• Atif Mian on The Future of Debt
• Parag Khanna on The Future of Supply Chains
• Noam Chomsky on The Future of Neoliberalism (and Part 2)
• Neta Crawford on The Future of War
• Perry Mehrling on The Future of Money
• Larry Susskind on The Future of Problem Solving in Crises
• Ellen Ruppel Shell on The Future of Work
• Kishore Mahbubani on The Future of World Order & Global Governance
• Saleemul Huq on The Future of Global Climate Policy
• Andrew J. Bacevich on The Future of National Security
• Muhammad Hamid Zaman on The Future of Humanitarian Relief
• Vivien Schmidt on The Future of Europe
• Jon Hutton on The Future of Conservation

Read here (Pardee School of Global Studies, Sept 29, 2020) 

Pandemic to keep Asia's growth at lowest since 1967, warns World Bank

‘The coronavirus pandemic is expected to lead to the slowest growth in more than 50 years in East Asia and the Pacific as well as China, while up to 38 million people are set to be pushed back into poverty, the World Bank said in an economic update on Monday. The bank said the region this year is projected to grow by only 0.9%, the lowest rate since 1967.

‘Growth in China was expected to come in at 2% this year, boosted by government spending, strong exports and a low rate of new coronavirus infections since March, but held back by slow domestic consumption. The rest of the East Asia and Pacific region was projected to see a 3.5% contraction, the World Bank said.’

Read here (Reuters, Sept 29, 2020)

On the futility of contact tracing (in badly-affected countries like the US)

‘Is contact tracing now futile for the COVID-19 epidemic in most of the world? Probably yes. The infection is already too widespread for disease eradication to be feasible in most places. It might be useful in slowing the spread of the epidemic in areas where hospital resources are at risk of congestion. This benefit will come, however, at considerable costs to the privacy rights and civil liberties of traced individuals, often with no public health benefit because of testing errors. Some may argue that these costs are worth paying temporarily if contact tracing really can help slow the spread of the epidemic. But contact tracing creates incentives to avoid testing and may make the epidemic worse. Studies involving contact tracing can provide useful information to help us better understand transmission dynamics—one fascinating study involving contact tracing has clarified the very limited role that children play in disease spread. Apart from this ancillary benefit, contact tracing does not deserve the central place it has received in the tool kit public health authorities use to control COVID-19.’

Read here (Inference, Sept 28, 2020)

Coronavirus deaths pass one million worldwide

‘More than HIV. More than dysentery. More than malaria, influenza, cholera and measles — combined. In the 10 months since a mysterious pneumonia began striking residents of Wuhan, China, Covid-19 has killed more than one million people worldwide as of Monday — an agonizing toll compiled from official counts, yet one that far understates how many have really died. It may already have overtaken tuberculosis and hepatitis as the world’s deadliest infectious disease, and unlike all the other contenders, it is still growing fast.’

Read here (New York Times, Sept 28, 2020)

Knowing Covid-19 was at their door, family of 8 planned strategy to fight it

‘When Aman Gwjwn, 17, developed a persistent cough and cold in July while on holiday at her grandmother's home in Bangalore, her family of eight went to war, preparing themselves for Covid-19 to sweep through their home. Everyone from a 14-year-old eighth-grade student to a near-octogenarian would go on to be infected. But the Chinese-Indian family slowly won their battle against the disease over the next 1½ months, armed with discipline, composure and logistical planning.

"Our approach was: We'll all surely get it, but we'll all survive it as a family. We just made sure everyone didn't fall sick together, so that some people were healthy enough to take care of the others," said Ms Jennifer Liang, 48, Aman's mother and a social worker in Assam who flew to Bangalore immediately. The Liangs formed what they called "a war council" of decision makers, which included Jennifer's husband Sunil Kaul, a doctor and public health activist in Assam. As Aman isolated herself in her uncle's house nearby, the family set up a WhatsApp group called Covid Planning.’

Read here (Straits Times, Sept 26, 2020) 

Offline: Covid-19 is not a pandemic -- It is a syndemic: Richard Horton

‘The most important consequence of seeing COVID-19 as a syndemic is to underline its social origins. The vulnerability of older citizens; Black, Asian, and minority ethnic communities; and key workers who are commonly poorly paid with fewer welfare protections points to a truth so far barely acknowledged—namely, that no matter how effective a treatment or protective a vaccine, the pursuit of a purely biomedical solution to COVID-19 will fail. Unless governments devise policies and programmes to reverse profound disparities, our societies will never be truly COVID-19 secure. 

‘As Singer and colleagues wrote in 2017, “A syndemic approach provides a very different orientation to clinical medicine and public health by showing how an integrated approach to understanding and treating diseases can be far more successful than simply controlling epidemic disease or treating individual patients.” I would add one further advantage. Our societies need hope. The economic crisis that is advancing towards us will not be solved by a drug or a vaccine. Nothing less than national revival is needed. Approaching COVID-19 as a syndemic will invite a larger vision, one encompassing education, employment, housing, food, and environment. Viewing COVID-19 only as a pandemic excludes such a broader but necessary prospectus.’

Read here (The Lancet, Sept 26, 2020)

Countries should meet these five criteria before easing lockdowns, study says. Many aren't even close

‘Countries should not ease coronavirus lockdown restrictions until they meet five criteria -- and many nations are not even close, according to a new analysis published in The Lancet medical journal. The research, published Thursday, said that the prerequisites for easing Covid-19 measures are: knowledge of infection status, community engagement, adequate public health capacity, adequate health system capacity and border controls.

‘The authors looked at nine high-income countries and territories that have started to relax restrictions -- Hong Kong, Japan, New Zealand, Singapore, South Korea, Germany, Norway, Spain and the UK. They found that many governments had failed to meet the criteria necessary to avoid new waves of infection, as seen in Spain, Germany and the UK.’

Read here (CNN, Sept 25, 2020)

Rapid, cheap home tests: Companies attempt to make coronavirus tests widely available

‘Nearly two months after federal regulators unveiled rules for at-home coronavirus tests, no company has federal approval to sell these fast and cheap tests even though the technology is ready.

‘Molecular PCR tests processed at medical labs remain the standard of accurate testing, but they are more expensive and results can take days to process. Antigen tests are less expensive, plentiful and deliver results in minutes. Three companies gained Food and Drug Administration authorization to sell antigen testing instruments to labs or clinics. A fourth company, Abbott Laboratories, won approval to market a $5 rapid, credit card-sized test administered by a health care professional.

‘But no company has been cleared to sell tests directly to consumers for widespread screening – a step some believe is necessary to slow the spread of COVID-19, as more than 200,000 Americans have died and people worry about safely returning to work, school, travel or sporting events. “The way to get this under control is if people find out as early as possible they are infected and then quarantine from others,” said Dr. Yukari Manabe, a Johns Hopkins University professor of medicine.’

Read here (USA Today, Sept 25, 2020)

Dogs used to detect coronavirus in pilot project at Helsinki airport

‘Dogs trained to detect the novel coronavirus began sniffing passenger samples at Finland’s Helsinki-Vantaa airport this week, authorities said, in a pilot project running alongside more usual testing at the airport. The dogs’ efficiency has not been proven in comparative scientific studies so passengers who volunteer to be tested and are suspected as carrying the virus are instructed to also take a swab to confirm the result.’

Read here (Reuters, Sept 24, 2020)

Dozens of COVID-19 vaccines are in development. Here are the ones to follow

‘Though it’s too soon to say which candidates will ultimately be successful, here’s a look at the prospects that have reached phase three and beyond—including a quick primer on how they work and where they stand.’

Read here (National Geographic, Sept 24, 2020)

Covid-19 may have a hidden impact on the heart, including that of healthy athletes

‘Last month, several college conferences, the Big Ten and the Pac 12 among them, postponed their sports seasons, including football, citing the risks posed to athletes by the coronavirus. A major factor in those decisions, according to some physicians, was the uncertain implications of a July paper in JAMA Cardiology. In this study of 100 people who had Covid-19, M.R.I.’s showed at least some signs of myocarditis in 60 of them, meaning they had inflammation in the heart muscle, which can weaken the organ and, on rare occasions, lead to sudden cardiac arrest. Another study, published this month in the same journal, looked at 26 Ohio State athletes who experienced Covid-19 with mild or no symptoms and detected evidence of possible myocarditis in five of them and lesser abnormalities in nine more. The condition poses a heightened risk to those whose physical activity puts stress on the heart: Even before the pandemic, myocarditis was a leading cause of death in young, otherwise healthy athletes.’

Read here (New York Times, Sept 23, 2020)

UK mulling vaccine trials that deliberately expose volunteers to Covid-19

‘The British government is exploring the possibility of clinical trials in which volunteers are deliberately exposed to coronavirus to test the effectiveness of vaccine candidates, the UK Department for Business, Energy, and Industrial Strategy (BEIS) revealed Wednesday in a statement... In so-called "challenge trials," researchers give study subjects an experimental vaccine and then intentionally expose them to coronavirus to see if the vaccine works. Such trials were used in early research with smallpox, yellow fever and malaria.’

Read here (CNN, Sept 23, 2020)

Philippines’ President Duterte extends coronavirus state of calamity for another year

‘Philippine President Rodrigo Duterte says he has extended a state of calamity in the entire Philippines by a year to allow the government to draw emergency funds faster to fight the Covid-19 pandemic and harness the police and military to maintain law and order. Duterte first placed the country under a state of calamity in March when the number of confirmed infections was approaching 200 with about a dozen deaths. The country now has more than 290,000 confirmed cases, the highest in Southeast Asia, with nearly 5,000 deaths.

‘State of calamity allows officials to draw emergency funds quickly anywhere in the country, and to control the prices of basic commodities like rice and cooking oil. President Duterte also signalled that the country remains at the mercy of a vaccine, which is unlikely to be developed and distributed until the second quarter of 2021.’

Read here (South China Morning Post, Sept 22, 2020)

Indonesia: Can Jakarta get its raging Covid-19 outbreak under control?

‘Seven months after Indonesia reported its first cases, the country is struggling with mounting infections. It reported 4,071 new cases on Tuesday, bringing its total to 252,923, with 9,837 fatalities – the highest death toll in Southeast Asia.

‘While other countries have managed to slow the spread of infections with partial lockdowns – only to see a resurgence in cases when they reopened – Indonesia has not yet passed the peak of the first wave, according to Mahesa Paranadipa Maikel, the chairperson of the Indonesia Health Law Society, an industry body of medical workers and legal experts.’

Read here (South China Morning Post, Sept 22, 2020)

Can European countries avoid a second lockdown?

"Catastrophic," "disastrous," and "devastating" — the words European leaders are using to describe the consequences of a second lockdown are more than clear. In order to curb the spread of COVID-19 in the spring of this year, public life across Europe was brought almost completely to a halt. In the summer, many places relaxed those restrictions. For weeks now, however, infection rates have been rising in almost every European country. According to the World Health Organization, Europe is registering between 40,000 and 50,000 new coronavirus cases each day. That increase is down to more than just more widespread testing. The numbers from September "should serve as a wake-up call for all of us," said the WHO's regional director for Europe, Hans Kluge. The weekly infection numbers have even exceeded those reported in the first phases of the peak in March, the WHO says.’

Read here (DW, Sept 21, 2020)

Experts warn coronavirus may cause 'wave' of neurological conditions including Parkinson's disease

‘COVID-19 can cause worrying neurological symptoms like a loss of smell and taste, but Australian scientists are warning the damage the virus causes to the brain may also lead to more serious conditions such as Parkinson's disease.

‘It has happened before... Five years after the Spanish flu pandemic in the early 1900s, there was up to a three-fold increase in the incidence of Parkinson's disease. Kevin Barnham from the Florey Institute of Neuroscience and Mental Health said he believed a similar "silent wave" of neurological illness would follow this pandemic. "Parkinson's disease is a complex illness, but one of the causes is inflammation, and the virus helps to drive that inflammation," he said.’

Read here (ABC News, Sept 23, 2020)

Bill Gates: The pandemic has erased years of progress

‘The US had a lot of assets going into this. We weren’t ground zero, so the US had more time to get ready. The US has more PCR [polymerase chain reaction] machines than all other countries per capita. We are very blessed with an expensive medical infrastructure. And we have groups like the CDC [Centers for Disease Control and Prevention] and BARDA [the Biomedical Advanced Research and Development Authority]. So the US had done more to get ready than other countries had in advance...

‘Certainly humility is called for because the damage—whether it’s economic, educational, mental health—is so large. Other than a world war, this is the worst thing that’s happened in over a century. And so we should all say, “Wow, we didn’t understand about masks; we didn’t understand about asymptomatics.” Even the medical profession. We haven’t taken understanding these different respiratory diseases quite as seriously as we should. So everyone has lessons here.’

Read here (The Atlantic, Sept 21, 2020)

The core lesson of the Covid-19 heart debate

‘Autopsies have found traces of the coronavirus’s genetic material in the heart, and actual viral particles within the heart’s muscle cells. Experiments have found that SARS-CoV-2 can destroy lab-grown versions of those cells. Several studies have now shown that roughly 10 to 30 percent of hospitalized COVID-19 patients had high levels of troponin—a protein released into the blood when the heart’s muscle cells are damaged. Such patients are more likely to die than others with no signs of heart injury.

‘This is worrying for people with severe symptoms, but more recently, a few studies suggested that COVID-19 can cause heart inflammation, or myocarditis, even in people who showed mild symptoms, or had recovered. These results were controversial but concerning. Myocarditis is frequently caused by viruses, and resolves on its own in many cases. But it can progress to more severe heart problems, and is one of the leading causes of sudden death in young adults. These studies contributed to decisions by two college football conferences—the Big Ten and the Pac-12—to cancel their fall season. (The Big Ten has since reversed its call, and the Pac-12 is considering doing the same)’

Read here (The Atlantic, Sept 21, 2020)

A Covid-19 vaccine for children may not arrive before Fall 2021

‘The pandemic has many parents asking two burning questions. First, when can I get a vaccine? And second, when can my kids get it? It may come as a surprise that the answers are not the same. Adults may be able to get a vaccine by next summer. But their kids will have to wait longer. Perhaps a lot longer.

‘Thanks to the U.S. government’s Operation Warp Speed and other programs, a number of Covid-19 vaccines for adults are already in advanced clinical trials. But no trials have yet begun in the United States to determine whether these vaccines are safe and effective for children.’

Read here (New York Times, Sept 21, 2020)

When will the Covid-19 pandemic end?

Normalcy by spring, and herd immunity by fall? This McKinsey & Co article assesses the prospects for an end to the pandemic in 2021.

‘More than eight months and 900,000 deaths into the COVID-19 pandemic,1 people around the world are longing for an end. In our view, there are two important definitions of “end,” each with a separate timeline:

• An epidemiological end point when herd immunity is achieved.
• A transition to a form of normalcy. 

‘Both the epidemiological and normalcy ends to the COVID-19 pandemic are important. The transition to the next normal will mark an important social and economic milestone, and herd immunity will be a more definitive end to the pandemic. In the United States, while the transition to normal might be accomplished sooner, the epidemiological end point looks most likely to be reached in the second half of 2021. Other advanced economies are probably on similar timetables.’

Read here (McKinsey & Co, Sept 21, 2020)

‘The whole world is coming together’: How the race for a COVID vaccine is revolutionizing Big Pharma

‘There are few people on earth who better understand the power of vaccines—or who know more about the challenge of developing, vetting, and distributing them around the world—than [Seth] Berkley. The physician and epidemiologist presides over GAVI, the Vaccine Alliance, which over the past 20 years has immunized nearly 800 million children against a host of deadly pathogens, saving millions of lives. 

‘Before becoming GAVI’s CEO in 2011, Berkley founded and led the International AIDS Vaccine Initiative—which itself was a long lesson in both perseverance and keeping one’s expectations in check. There is, after all, no vaccine yet for HIV, the virus that causes AIDS, despite nearly four decades of global endeavor. Nor is there one for SARS or MERS, those two other deadly coronaviruses that have emerged in recent years—nor for Lyme disease, West Nile virus, Zika, or the common cold.

‘Yet in one striking way, the swarm of initiatives to develop vaccines against COVID is unique, says Berkley. That is in the readiness of pharmaceutical companies to stand together in one very important common cause: ensuring that when vaccines are ready, they are available to the whole world at the same time.’

Read here (Fortune, Sept 21, 2020)

As more local lockdowns begin, the hard truth is there’s no return to ‘normal’ [comment on Britain]

‘As well as the risk Covid poses to individuals, our actions affect others including vulnerable and elderly people. Think of it as a chain of infections – if you are a part of this and it gets passed on, others may become ill and die because of your role in that chain. A wedding in Maine resulted in more than 170 people contracting the virus, and seven people dying. None of those who died attended the wedding...

‘Nine months after South Korea and Senegal started building diagnostic capacity, it is comically depressing that the UK government, one of the richest in the world, does not have a functional testing system that returns results within 24 hours. In addition, given that we know the virus spreads easily through households, those who test positive should have the offer to isolate in external facilities (such as hotels). The “14-day isolation” measures for people entering the UK are also a box-ticking exercise where given the lack of screening or monitoring, a constant stream of infections keep coming into the country. It’s like trying to empty a bucket under a tap.’

Read here (The Guardian, Sept 21, 2020) 

Covid-19: UK could face 50,000 cases a day by October without action - Vallance

‘The UK could see 50,000 new coronavirus cases a day by mid-October without further action, the government's chief scientific adviser has warned. Sir Patrick Vallance said that "would be expected to lead to about 200 deaths per day" a month after that. It comes as the PM prepares to chair a Cobra emergency committee meeting on Tuesday morning, then make a statement in the House of Commons.’

Read here (BBC, Sept 21, 2020)

Ministry: Malaysia will join Covax initiative to ensure Covid -19 vaccine acquired quickly at affordable price

‘The Ministry of Science, Technology and Innovation (Mosti) today clarified that Malaysia will be signing up for the global Covid-19 vaccine development platform Covax. The ministry in a statement today said that the government is currently discussing the terms of joining the Global Alliance for Vaccine and Immunisation (Gavi), which is managing the Covax initiative.

‘Yesterday, the Malaysian Medical Association (MMA) today urged the government to explain why Malaysia has yet to join the Covax Vaccination Plan co-led by the World Health Organisation (WHO). MMA president Dr N. Ganabaskaran said the association believes even if Malaysia has its own bilateral negotiations for a vaccine, signing up for the Covax Vaccine Plan can be an added option that will guarantee access to vaccines for Covid-19.’

Read here (Malay Mail, Sept 19, 2020)

How people coped in lockdown: Jules Evans

‘What conclusions can we draw from this? Here are some personal suggestions and reflections:

1. Difficult times bring out the best (and sometimes the worst) in people. As Stoic philosopher Epictetus said: ‘Difficulties reveal people’s characters’. Most of us are finding the pandemic incredibly hard, we’re tired, anxious and sometimes feel defeated. But there’s cause for hope too — the emergency is bringing out the best in people, and helping us rediscover what really matters.
2. Doctors and health authorities should be careful not to pathologize the normal and appropriate suffering people feel in hard times, or to immediately prescribe pills for emotional suffering. Anti-depressants can be helpful in the short-term, but they also have side effects and can lead to long-term dependency. Declaring a mental health ‘epidemic’ and saying mental health services are the only solution can create bottlenecks for services that either don’t exist or have long waiting lists.
3. Instead, as well as supporting mental health services, we should also emphasize people’s strengths, assets and natural coping skills, including community approaches like getting to know your neighbours or joining local mutual aid groups. This empowers people rather than making them feel weaker and more dependent on medical experts.
4. For two decades, as part of the ‘politics of well-being’, policy makers have tried to improve people’s happiness in schools, companies and society. There is some evidence this is counter-productive, especially in difficult times. It can make people ashamed of feeling anxiety, anger or grief, even if these emotions are appropriate. Instead of focusing narrowly on happiness, we can help people develop psychological flexibility, and discover what gives them a sense of meaning and purpose, especially in adversity. This could make people more resilient and less prone to ‘the happiness trap’ (ie avoiding activities that make them feel anxious in the short-term).
5. Mental health and flourishing involve all aspects of society, from the economy to the arts to travel and green spaces. Building a flourishing organisation or society means taking a joined-up approach. That joined-up approach needs to come from the top — from the head of state, or the CEO of an organisation, or the head of a school or university.
6. An example of that joined-up approach to flourishing is social prescribing — perhaps 25% of people who go to see their GP (local doctor) don’t have anything physically wrong with them. Instead, they’re mainly suffering from loneliness and disconnection. Under a new NHS programme, the GP can refer them to a ‘link worker’, who then connects them to local community groups (sports, arts, faith and philosophy, and so on). Rather than asking ‘what’s wrong with you’ they can ask ‘what matters to you? What do you value?’
7. The challenge is that we are discovering the importance of these community approaches to flourishing just as the pandemic destroys community infrastructure — shutting down theatres, churches, youth groups, sports facilities and pubs. Yes, online courses have boomed, but we can’t go entirely digital, nor should governments only support big national arts projects. We all need to support local organisations that foster well-being, especially local companies.
8. In an age of emergency, you are only as strong as your community. The fantasy of the invulnerable Stoic individual is just that - a fantasy. We need each other, now more than ever, so the best thing you can do to support your long-term mental health is to invest in your community and in community relationships.

Read here (Jules Evans, Philosophy for Life, Sept 18, 2020)

Coronavirus: Constantly surprising virus found to be heat tolerant, self-healing and very resilient in lab tests

‘Hungarian team finds virus particle withstands being probed by a nano needle 100 times, possibly making it the most physically elastic virus known. French scientists find it can replicate in animal cells after being exposed to temperatures of 60 degrees Celsius for an hour.’

Read here (South China Morning Post, Sept 18, 2020)

Covid-19 vaccine leaders make trial plans public in transparency push

‘Makers of the leading coronavirus vaccine candidates disclosed detailed information about their pivotal late-stage clinical trials and how they plan to gauge their shots' safety and effectiveness. The moves by first Moderna Inc, and then later from Pfizer Inc and its partner BioNTech SE, follow increasing worry that the effort to develop a Covid-19 vaccine is becoming politicised, and that an inoculation could be rushed to market before it is proven safe and effective. AstraZeneca said in an e-mail it would share its plans as well, though it hadn't as of Thursday (Sept 17) evening in the US.’

Read here (Straits Times, Sept 18, 2020)

How people coped in lockdown

‘The first wave of COVID caused huge suffering, and has led to warnings of an ‘epidemic’ or ‘tsunami’ of mental health problems. But there is another, more hopeful story to tell, about how people coped and even thrived during the adversity of 2020. It’s important to remember this as we head into the winter and a likely second wave.

‘The Collective Psychology Project has been researching how people coped, for a report for the Wellcome Trust called Collective Resilience. We were interested in how people discovered the ‘active ingredients’ of mental health, not just through therapy and pills, but also through self-care and mutual aid activities — from poetry to philosophy, from baking to cycling, from online learning to joining a neighbourhood support group.

‘What we discovered tallied with a lot of evidence, such as from the What Works Centre for Well-Being, about how people cope and flourish through non-medical activities like exercise, gardening, the arts, faith, philosophy & spirituality.’

Read here (Medium, Sept 18, 2020) 

Fighting the Covid infodemic

‘Countering the COVID-19 infodemic requires not only facts, but also the coordinated and strategic advocacy for which those fighting HIV are renowned. In the face of misinformation, silence kills. All segments of society must act now to dispel myths and amplify the voice of science. Our lives, and especially those of the poorest and most marginalized, depend on it.’

One of the co-authors is Adeeba Kamarulzaman, Dean of the Faculty of Medicine and Professor of Medicine and Infectious Diseases at the University of Malaya. She is also President of the International AIDS Society.

Read here (Project Syndicate, Sept 18, 2020) 

Covid-19 and health equity — Time to think big

To achieve health equity, we need to reach beyond the health care system — and think big. New social policies on a few key fronts could advance both health equity and the Covid-19 response.

• First, we propose establishing a universal food income.
• Second, we recommend reforming unemployment insurance.
• Finally, we need policies supporting investment in community development.

Read here (New England Journal of Medicine,  Sept 17, 2020)

Rich nations have cornered half of future COVID-19 vaccine supply: Oxfam

‘A group of wealthy nations representing 13 per cent of the global population have already bought up more than half of the promised doses of future COVID-19 vaccines, according to a report by Oxfam on Wednesday (Sep 16).

‘The non-governmental organisation analysed deals struck by pharmaceuticals and vaccine producers for the five leading vaccine candidates currently in late-stage trials, based on data collected by the analytics company Airfinity.’

Read here (Channel News Asia, Sept 17, 2020)

For Covid-19, as with everything else, Americans on the right and left live in different universes when it comes to trusting the media

‘More in Common — a group that tries to “counter polarization” and “build bridges across dividing lines” — has a new report out this morning called “The New Normal,” which looks at “the impacts of COVID-19 on trust, social cohesion, democracy and expectations for an uncertain future.” It looks at seven countries (U.S., U.K., France, Germany, Italy, Poland, and the Netherlands) and is based on surveys of about 14,000 people.’

This story focuses on ‘how people in [the] seven countries view the motives of the news media in covering the pandemic. Only in the United States is that a profoundly partisan question.’

Read here (Nieman Lab, Sept 17, 2020)

Is herd immunity an option for India as it becomes second country after US to cross 5 million Covid-19 cases?

‘As coronavirus cases continue to spiral in India, only the second country after the US to cross the 5 million milestone, questions have been raised over whether herd immunity is an option for India now. Some epidemiologists believe it is already taking place in small areas where high infection levels have been followed by a weakening of the Covid-19 virus. Others believe that it is too soon to predict or holds little promise.

‘Dr Rajni Kant from the Indian Council of Medical Research: "Herd immunity right now is not a (government) strategy for coronavirus control. The current strategy is wearing a mask, following social distancing and good hygiene with regular washing of hands." Still, there are silver linings in India's Covid-19 fight. The country's mortality rate at 1.64 per cent is the lowest in the world and recovery is among the highest with a recovery rate of 78-79 per cent.’

Read here (Straits Times, Sept 17, 2020)

With effective prevention of outbreaks, nations do not need to choose between public health and economy: WHO chief

‘The head of the World Health Organisation (WHO) has debunked arguments that countries have to choose between public health and the economy when they look at whether to ease restrictions following a lockdown. "That is a false choice," said WHO director-general Tedros Adhanom Ghebreyesus. Instead, the WHO urges countries to focus on four essential priorities:

• Prevent Covid-19 amplifying events. All around the world, explosive outbreaks have been linked to gatherings, in places like stadiums, nightclubs and places of worship.
• Protect the vulnerable to save lives and reduce the burden on the health systems in terms of severely and critically ill patients.
• Educate and empower communities to protect themselves and others. Physical distancing, hand hygiene, respiratory etiquette and masks can help to curb transmission and save lives, not when done in isolation, but by practising all the measures together.
• Persist with the public health basics. Find, isolate, test and care for people who have been infected, and trace and quarantine their contacts.

Read here (Straits Times, Sept 17, 2020)

CDC Director: Masks are ‘the most important, powerful public health tool we have’

‘The director of the Centers for Disease Control and Prevention again urged Americans during a Wednesday Senate hearing to wear face masks, in contrast to President Donald Trump’s lax attitude. “These face masks are the most important, powerful public health tool we have. ... If we did it for six, eight, 10, 12 weeks, we would bring this pandemic under control,” Robert Redfield said. “We have clear scientific evidence they work.” 

‘He added that it was unlikely that a vaccine would be available to the general public until mid-late 2021. This comes as the federal government rolls out a COVID-19 vaccine plan, aiming to make the vaccine free to all Americans. Trump publicly slapped down Redfield later, saying he was wrong about a vaccine timeline and the effectiveness of masks.’

Read here (Huffington Post, Sept 16, 2020)

Who gets a Covid vaccine first? Access plans are taking shape

‘The WHO’s guidance at this point lists only which groups of people should have priority access to vaccines. The NASEM (US National Academies of Sciences, Engineering, and Medicine) guidance goes a step further by ranking priority groups in order of who should get a vaccine first (see ‘A tiered approach’).

‘After health-care workers, medically vulnerable groups should be among the first to receive a vaccine, according to the NASEM draft plan. These include older people living in crowded settings, and individuals with multiple existing conditions, such as serious heart disease or diabetes, that put them at risk for more-serious COVID-19 infection.

‘The plan prioritizes workers in essential industries, such as public transit, because their jobs place them in contact with many people. Similarly, people who live in certain crowded settings — homeless shelters and prisons, for example — are called out as deserving early access.’

Read here (Nature, Sept 16, 2020)

Fast coronavirus tests: What they can and can't do

‘Rapid antigen tests are designed to tell in a few minutes whether someone is infectious. Will they be game changers? At present, antigen tests are administered by trained professionals, but some companies are developing versions that are simple enough to be used at home — similar to pregnancy tests.

“Making the tests faster, cheaper, easier is definitely the goal — and I think the antigen test is the way to get there,” says Martin Burke, a chemist at the University of Illinois at Urbana-Champaign, who is co-developing rapid tests, including antigen-based assays. “This is by no means the perfect solution, it’s just the fastest thing we could get going now,” he says.

Read here (Nature, Sept 16, 2020) 

Vitamin D may help in Covid-19 fight, studies show

‘Multiple studies suggest that having adequate amounts of vitamin D may play a role in helping people stave off or combat the coronavirus, although the jury is still out on whether the results are conclusive or why this is so.

‘At least one overseas study has associated vitamin D deficiency with a higher risk of Covid-19. Published in medical journal JAMA Network Open on Sept 3, the study observed 489 patients from the University of Chicago Medicine health system, about a third of whom had vitamin D deficiency. Patients with vitamin D deficiency and who were not given treatment for it were 1.77 times more likely to test positive for Covid-19 than those who were not. The study also noted that other research had found that Covid-19 was less prevalent in groups that had lower rates of vitamin D deficiency.’

Read here (Straits Times, Sept 16, 2020)

Impact of Covid-19 on women and children

‘The impacts of crises are never gender-neutral and COVID-19 is no exception. The pandemic has resulted in increased rates of violence against women and has exacerbated challenges in accessing justice. Women are losing their livelihoods faster than men.

‘Millions of women are assuming disproportionate responsibility for caregiving. Many women have found themselves unable to access contraception and other sexual and reproductive health services. UN experts predict that as many as 13 million more child marriages could take place over the next 10 years because of COVID-19 shutdowns of schools and family planning services combined with increasing economic challenges.’

Read here (IPS News, Sept 16, 2020)

The Covid silver linings playbook

• The first is that we are living through one of the most exciting and promising periods of medical invention and innovation in history. 
• Second, deeper cross-border private-sector collaboration, often outside the purview of governments, is fueling this process of scientific leapfrogging.
• Third, the economic disruptions resulting from the pandemic have fueled multiple private-sector efforts to collect and analyze a broader range of high-frequency data in domains extending far beyond medicine. 
• Fourth, the COVID-19 shock has raised our collective awareness and sensitivity to low-probability, high-impact “tail risks.”
• Fifth silver lining... The pandemic has led country after country to run a series of “natural experiments,” which have shed light on a host of issues that go well beyond health and economics.
• Finally, the crisis has required many companies to hold candid conversations about work-life balance, and to devise innovative solutions to accommodate employees’ needs.

Read here (Project Syndicate, Sept 15, 2020) 

Only 15 per cent in 13 advanced economies in Europe, North America and Asia approve of US handling of the coronavirus: Pew Research Centre survey

‘The median percentage of people polled in 13 countries who said the US has done a good job dealing with the coronavirus was only 15 per cent, the study says... China received a median approval rating of 37 per cent, while nearly two out of three people believed the WHO, from which the US withdrew this year over allegations of a bias toward China, had done a good job. The study “clearly indicates that around the globe no one is buying the Trump administration’s ardent efforts to pin blame on the pandemic upon China and the WHO,” said Allen Carlson, an associate professor in Cornell University’s government department.’

Read here (South China Morning Post, Sept 15, 2020)

How coronavirus pandemic has fuelled the rise of QAnon conspiracy theories in Europe

‘QAnon, the US-based conspiracy about a Satan-worshipping, paedophile cabal secretly running the world, is taking root in Europe feeding on fears stirred up by the coronavirus outbreak, analysts say. Anti-vaxxers, white supremacists and government sceptics in Europe are starting to buy into the ill-defined but pro-Donald Trump conspiracy that emerged across the Atlantic in 2017.

‘Dozens of European QAnon offshoots have sprung up online, while protesters have brandished Q-themed messages at demonstrations in Berlin, London and Paris denouncing face masks and other measures to curb the pandemic. “While the conspiracy’s growth in the US has been an outward and visible process, what has gone less noticed is QAnon’s extensive root growth and spread in Europe,” fake news monitor NewsGuard warned in a report in July. It identified the Covid-19 crisis as a “catalyst”.’

Read here (South China Morning Post, Sept 15, 2020) 

NIH ‘very concerned’ about serious side effect in coronavirus vaccine trial​

‘A great deal of uncertainty remains about what happened to the unnamed patient, to the frustration of those avidly following the progress of vaccine testing. AstraZeneca, which is running the global trial of the vaccine it produced with Oxford University, said the trial volunteer recovered from a severe inflammation of the spinal cord and is no longer hospitalized.

‘AstraZeneca has not confirmed that the patient was afflicted with transverse myelitis, but Nath and another neurologist said they understood this to be the case. Transverse myelitis produces a set of symptoms involving inflammation along the spinal cord that can cause pain, muscle weakness and paralysis. Britain’s regulatory body, the Medicines and Healthcare Products Regulatory Agency, reviewed the case and has allowed the trial to resume in the United Kingdom.’

Read here (Scientific American, Sept 15, 2020)

Lancet COVID-19 Commission Statement on the occasion of the 75th session of the UN General Assembly

Executive summary: ‘The Lancet COVID-19 Commission was launched on July 9, 2020, to assist governments, civil society, and UN institutions in responding effectively to the COVID-19 pandemic. The Commission aims to offer practical solutions to the four main global challenges posed by the pandemic: suppressing the pandemic by means of pharmaceutical and non-pharmaceutical interventions; overcoming humanitarian emergencies, including poverty, hunger, and mental distress, caused by the pandemic; restructuring public and private finances in the wake of the pandemic; and rebuilding the world economy in an inclusive, resilient, and sustainable way that is aligned with the Sustainable Development Goals (SDGs) and the Paris Climate Agreement. Many creative solutions are already being implemented, and a key aim of the Commission is to accelerate their adoption worldwide.’

Download full statement here (Sept 14, 2020)

India considers emergency authorisation of vaccine as COVID-19 cases surge

‘India said on Sunday (Sep 13) it was considering granting an emergency authorisation for a COVID-19 vaccine, particularly for the elderly and people in high-risk workplaces, as the country's number of reported infections passed 4.75 million. India, which has consistently reported over 1,000 COVID-19 deaths daily this month, has now recorded 78,586 fatalities from the disease. It lags only the United States globally in overall number of infections, but it has been adding more daily cases than the United States since mid-August. "India is considering emergency authorisation of a COVID-19 vaccination," said Health Minister Harsh Vardhan. "If there is a consensus we may go ahead with it, especially in the case of senior citizens and people working in high-risk settings."

Read here (Channel News Asia, Sept 14, 2020)

To beat the coronavirus, build a better fence: Tomas Pueyo

‘No country has been able to control the virus without a fence. Fences are not enough to stop the virus on their own, but they’re a necessary part of the solution. European countries and U.S. states had hoped otherwise. They were deluded. They opened their arms to their neighbours too soon and got infected in the hug.

‘They need to realise that not every country or state is effectively fighting the virus. Why should their citizens sacrifice so much for so long, with lockdowns and business closures, only to waste their efforts when their neighbours visit?

‘And as long as states fail to control their borders, the coronavirus will come back.’

Read here (New York Times, Sept 14, 2020) 

A world in disorder

On September 14th 2020, the GPMB released its second report titled, A World in Disorder. In this report, the GPMB provides a harsh assessment of the global COVID-19 response, warning that the world cannot afford to be unprepared again when the next pandemic hits. The Board called for five urgent actions to be taken to bring order out of the catastrophe and chaos currently facing the world: responsible leadership; engaged citizenship; strong and agile systems for health security; sustained investment; and robust global governance of preparedness.

The Global Preparedness Monitoring Board (GPMB) is an independent monitoring and accountability body to ensure preparedness for global health crises. Comprised of political leaders, agency principals and world-class experts, the Board provides an independent and comprehensive appraisal for policy makers and the world about progress towards increased preparedness and response capacity for disease outbreaks and other emergencies with health consequences. In short, the work of the GPMB will be to chart a roadmap for a safer world.

Download here (Global Preparedness Monitoring Board, Sept 14, 2020)

The cyber side of vaccine nationalism

‘In the COVID-19 pandemic, vaccine nationalism has become an important and controversial phenomenon. Rather than cooperate through global mechanisms to develop, manufacture, and distribute a vaccine against the coronavirus, countries with the means to do so have prioritized national access to a vaccine. Despite warnings about its adverse consequences for global health and international cooperation, vaccine nationalism is not abating. The political momentum of vaccine nationalism can be found in not only the pharmaceutical realm but also cyberspace.

‘A New York Times story from September 5 detailed how the race to develop a coronavirus vaccine has produced a proliferation of cyber espionage targeting vaccine research and development. According to the article, the pandemic triggered a shift “for the world’s intelligence agencies, pitting them against each other in a new grand game of spy versus spy” such that “every major spy service around the globe is trying to find out what everyone else is up to.”

Read here (Council on Foreign Relations, Sept 14, 2020)

How the ageing immune system makes older people vulnerable to Covid-19

‘Covid-19 patients who are 80 or older are hundreds of times more likely to die than those under 40. That’s partly because they are more likely to have underlying conditions — like diabetes and lung disease — that seem to make the body more vulnerable to Covid-19.

‘But some scientists suggest another likely, if underappreciated, driver of this increased risk: the ageing immune system. The changes that ripple through our network of immune cells as the decades pass are complex, resulting in an overreaction here, a delayed response there and, overall, a strangely altered landscape of immunity.’

Read here (Today Online, Sept 13, 2020) 

Face masks could be giving people Covid-19 immunity, researchers suggest

‘Face masks may be inadvertently giving people Covid-19 immunity and making them get less sick from the virus, academics have suggested in one of the most respected medical journals in the world.  The commentary, published in the New England Journal of Medicine, advances the unproven but promising theory that universal face mask wearing might be helping to reduce the severity of the virus and ensuring that a greater proportion of new infections are asymptomatic. 

‘If this hypothesis is borne out, the academics argue, then universal mask-wearing could become a form of variolation (inoculation) that would generate immunity and “thereby slow the spread of the virus in the United States and elsewhere” as the world awaits a vaccine. It comes as increasing evidence suggests that the amount of virus someone is exposed to at the start of infection - the “infectious dose” - may determine the severity of their illness. Indeed, a large study published in the Lancet last month found that “viral load at diagnosis” was an “independent predictor of mortality” in hospital patients.’

Read here (The Telegraph, Sept 12, 2020) 

Battered travel industry will take years to recover even after coronavirus vaccines are rolled out, says Booking.com

“We believe that a vaccine and/or proven treatment is critical for people to feel safe to travel again, and even then, it will be years – not quarters – before travel returns to 2019 pre-pandemic levels,” said Angel Llull Mancas, vice president and managing director, Asia-Pacific, at the online travel service provider. If and when a successful vaccine programme is rolled out globally, the travel industry’s recovery will also be dependent on the world economy and consumers’ willingness to spend money on leisure amid a downturn that has decimated corporate revenues and triggered salary cuts and even redundancies for many workers.

Read here (South China Morning Post, Sept 11, 2020)

Covid-19 symptoms usually last months, large-scale Dutch survey suggests

‘A survey in the Netherlands has suggested that most people who showed signs of having Covid-19 still had multiple symptoms nearly three months later. Only 0.7 per cent of respondents said they were completely symptom-free 79 days after first showing signs of infection, according to research published on Thursday in the European Respiratory Society’s Open Research journal. The survey is the first to show only a partial recovery among a large sample of people, according to the researchers. It involved more than 2,100 mostly non-hospitalised people confirmed or suspected to have had Covid-19 in the Netherlands and Flanders, the northern Dutch-speaking part of Belgium.’

Read here (South China Morning Post, Sept 11, 2020)

With RMCO extended to Dec 31, here’s a (gentle) reminder of what you can and cannot do

‘Bearing in mind the strict standard operating procedures (SOP) enforced by the National Security Council (NSC), here are some of the things we can and cannot do until New Year’s Eve, or when the government announces otherwise.’ 

Read here (Malay Mail, Sept 11, 2020) 

Facts v feelings: How to stop our emotions misleading us -- Tim Harford

‘The pandemic has shown how a lack of solid statistics can be dangerous. But even with the firmest of evidence, we often end up ignoring the facts we don’t like...’ This is also shown in evidence from two other areas: (1) Coffee and breast cysts and (2) Climate change. They should inform our reaction to Covid-19 and other matters...

‘When it comes to interpreting the world around us, we need to realise that our feelings can trump our expertise. This explains why we buy things we don’t need, fall for the wrong kind of romantic partner, or vote for politicians who betray our trust. In particular, it explains why we so often buy into statistical claims that even a moment’s thought would tell us cannot be true. Sometimes, we want to be fooled. Psychologist Ziva Kunda found this effect in the lab, when she showed experimental subjects an article laying out the evidence that coffee or other sources of caffeine could increase the risk to women of developing breast cysts. Most people found the article pretty convincing. Women who drank a lot of coffee did not...

‘Scientific evidence is scientific evidence. Our beliefs around climate change shouldn’t skew left and right. But they do. This gap became wider the more education people had. Among those with no college education, 45% of Democrats and 23% of Republicans worried “a great deal” about climate change. Yet among those with a college education, the figures were 50% of Democrats and 8% of Republicans. A similar pattern holds if you measure scientific literacy: more scientifically literate Republicans and Democrats are further apart than those who know very little about science.’

Read here (The Guardian, Sept 10, 2020)

Singapore researchers develop ‘smart mask’ that can monitor signs associated with Covid-19

‘Local scientists have developed an integrated monitoring system that can be easily attached to any face mask in order to monitor the wearer for health indicators associated with Covid-19. Sensors pick up skin temperature, blood oxygen saturation, blood pressure and heart rate - all of which are parameters associated with coronaviruses. Professor Loh Xian Jun, who is one of the scientists behind the invention, told The Straits Times on Thursday (Sept 10) that the inspiration for the system came around the circuit breaker period.’

Read here (Straits Times, Sept 10, 2020)

America is trapped in a pandemic spiral

‘The country is now trapped in an intuition nightmare: Like the spiraling ants [army ants that sometimes walked in circles until they died of hunger and dehydration because they followed pheromone trails of others], Americans are walled in by their own unhelpful instincts, which lead them round and round in self-destructive circles. “The grand challenge now is, how can we adjust our thinking to match the problem before us?” says Lori Peek, a sociologist at the University of Colorado at Boulder who studies disasters. Here, then, are nine errors of intuition that still hamstring the U.S. pandemic response, and a glimpse at the future if they continue unchecked. The time to break free is now. Our pandemic summer is nearly over. Now come fall, the season of preparation, and winter, the season of survival.’

The nine errors:

1. A serial monogamy of solutions
2. False dichotomies
3. The comfort of theatricality
4. Personal blame over systemic fixes
5. The normality trap
6. Magical thinking
7. The complacency of inexperience
8. A reactive rut
9. The habituation of horror

On point 9: ‘The US might stop treating the pandemic as the emergency that it is. Daily tragedy might become ambient noise. The desire for normality might render the unthinkable normal. Like poverty and racism, school shootings and police brutality, mass incarceration and sexual harassment, widespread extinctions and changing climate, COVID-19 might become yet another unacceptable thing that America comes to accept.’

Read here (The Atlantic, Sept 9, 2020)

Covid-19 vaccine makers issue rare safety pledge as fears of political pressures swirl

‘A coalition of nine pharmaceutical chief executives issued a joint pledge Tuesday that they will not rush the development of a COVID-19 vaccination for political purposes and will not seek approvals until the vaccines have gone through Phase 3 clinical trials.

‘The unusual joint move from nine industry leaders comes after the U.S. Centers for Disease Control and Prevention notified states to be ready to distribute a vaccine to certain groups just two days before the presidential election, stoking concerns that the Trump administration may be putting political pressure on companies and health officials to fast-track vaccine approvals ahead of the November vote.’

Read here (ABC News, Sept 8, 2020) 

AstraZeneca Covid-19 vaccine study put on hold due to suspected adverse reaction in participant in the UK

‘A large, Phase 3 study testing a Covid-19 vaccine being developed by AstraZeneca and the University of Oxford at dozens of sites across the U.S. has been put on hold due to a suspected serious adverse reaction in a participant in the United Kingdom. A spokesperson for AstraZeneca, a frontrunner in the race for a Covid-19 vaccine, said in a statement that the company’s “standard review process triggered a pause to vaccination to allow review of safety data.” 

Read here (STAT News, Sept 8, 2020)

Hundreds of thousands have been given Covid-19 vaccines without a single infection, Chinese drug firm says

‘Hundreds of thousands of Chinese have been given two experimental Covid-19 vaccines under an emergency scheme without a single case of infection, a top official with a state-owned vaccine developer has said. Zhou Song, secretary for the commission for discipline inspection with China National Biotec Group, also said the company’s two candidate vaccines were likely to protect people for up to three years. Zhou told China National Radio on Monday that the firm’s vaccines were the most widely used in the emergency scheme, adding: “Hundreds of thousands have taken the shot and no one has shown any obvious adverse effects or got infected.”

Read here (South China Morning Post, Sept 8, 2020)

Skills lost due to COVID-19 school closures will hit output for generations: OECD

‘Disruption to schooling stemming from the COVID-19 epidemic will cause a skill loss that could result in a 1.5 per cent drop in global economic output for the rest of this century, the Organisation for Economic Cooperation and Development estimated.

‘For the United States, that will represent an economic loss of US$15.3 trillion, the OECD said in a report published on Tuesday (Sep 8), with the bill rising higher still if disruption to education extends into the next academic year.’ 

Read here (Channel News Asia, Sept 8, 2020)

The coronavirus is mutating — does it matter?

‘Different SARS-CoV-2 strains haven’t yet had a major impact on the course of the pandemic, but they might in future...

‘It’s even possible that the D614G change could make the virus an easier target for vaccines, Montefiori’s team found in a study posted to bioRxiv in July 13. Mice, monkeys and humans that received one of a number of experimental RNA vaccines, including one being developed by drug maker Pfizer in New York City, produced antibodies that proved more potent at blocking G viruses than D viruses.

‘With G viruses now ubiquitous, the finding is “good news”, says Montefiori. But as a scientist who has watched HIV mutate to elude many vaccines developed against it, he remains wary of the potential of SARS-CoV-2 to evade humanity’s responses. Luban agrees: “We need to keep our eyes open for additional changes.”

Read here (Nature, Sept 8, 2020)

Demographic perspectives on the mortality of Covid-19 and other epidemics

‘With a hypothetical 1 million COVID-19 deaths [in the US], it is possible to portray the epidemic as unimaginably large—the biggest killer in American history—or small, reducing our remaining life [expectancy] by less than 1 part in 1,000. However, when the loss of life is put into comparative perspective, we see that the scale of an epidemic with 1 million deaths would be as large as that of the recent opioid and HIV crises but much smaller than that of the Spanish flu. The 1918 epidemic killed more people relative to population size, and it also caused a much greater loss of remaining life expectancy because those who died were so young.

‘As a society, we are and we should be making major and costly efforts to reduce mortality. The anticipated economic costs appear appropriate, or perhaps low, when compared to the statistical value of lives that may be saved.

‘The death toll of COVID-19 is a terrible thing, both for those who lose their lives and for their family, friends, colleagues, and all whom their lives touched. Those are real individuals, not the abstract statistics presented here. But the population perspective helps us to place this tragedy in a broader context. As we put our efforts into reducing the impact of the epidemic, it is important to know that we as a society have been through such mortality crises before.’

Read here (PNAS, Sept 8, 2020)

World’s struggle with coronavirus will affect growth and employment for a long time

‘The next few months will tell us a lot about the shape of the coming global recovery. Despite ebullient stock markets, uncertainty about COVID-19 remains pervasive. Regardless of the pandemic’s course, therefore, the world’s struggle with the virus so far is likely to affect growth, employment, and politics for a very long time.’

Read here (Channel News Asia, Sept 7, 2020)

CRISPR, the gene-editing technology, carries much promise – and peril – amid pandemic

‘As the battle against Covid-19 intensifies, one scientist calls CRISPR ‘our power pellet to help us fight this horrible virus’. The genome-editing tool could indeed bring an end to disease and drastically improve our lives, but with it comes the spectre of bioengineered abomination...

‘It might turn out that CRISPR and its spin-off techno­logies arrive too late to have any effective and lasting impact on the current pandemic. There could be a backlash against CRISPR’s darker potential that undermines the hope for the life-changing good it undoubtedly holds. Fear and scepticism could outmuscle reason and diligent inquiry as the CRISPR saga plays out against a backdrop of polar­isation and bias.

“In the old days, people came to herbs to find new medicine,” says Qi. “In the past century, people turned to chemistry. While human lifespans become longer, the quality of human life still needs to be improved. There are many age-related diseases which simply cannot be addressed using herbs or chemical drugs. The solution is likely in molecules – and CRISPR is probably one of them. One ultimate hope is that CRISPR can help to address ageing, and help people with age-related diseases.”

Read here (South China Morning Post, Sept 5, 2020)  

Coronavirus crisis shatters India's big dreams

‘Not so long ago, India’s future looked entirely different. It boasted a sizzling economy that was lifting millions out of poverty, building modern megacities and amassing serious geopolitical firepower. It aimed to give its people a middle-class lifestyle, update its woefully vintage military and become a regional political and economic superpower that could someday rival China, Asia’s biggest success story. But the economic devastation in Surat and across the country is imperiling many of India’s aspirations. The Indian economy has shrunk faster than any other major nation’s. As many as 200 million people could slip back into poverty, according to some estimates. Many of its normally vibrant streets are empty, with people too frightened of the outbreak to venture far.

‘Much of this damage was caused by the coronavirus lockdown imposed by India’s prime minister, Narendra Modi, which experts now say was at turns both too tight and too porous, both hurting the economy and spreading the virus. India now has the fastest growing coronavirus crisis, with more than 80,000 new infections reported each day.’

Read here (New York Times, Sept 5, 2020)

Everything you need to know about the coronavirus: A very informative summary as at September 2020

‘As we head into fall, questions loom large about everything from reopening schools to the start of flu season. We’ve put together a guide to everything you need to know about this pandemic—be it how to keep your children entertained or how this outbreak is affecting the economy. We’ll be updating it regularly to help you keep track of all aspects of this rapidly evolving situation.’

Read here (Wired, Sept 4, 2020)

Iceland has very good news about coronavirus immunity

‘A study on the pandemic in Iceland published in the New England Journal of Medicine offers some evidence to dispel such fears. The researchers have looked at serum samples from 30,576 individuals, using six different types of antibody testing (since different techniques often produce conflicting results).

‘The paper’s central findings are that, out of 1,797 tested people who’d recovered from Covid, 91.1% produced detectable levels of antibodies. Moreover, these levels hadn’t declined four months after the diagnosis. The immune response was higher among older individuals — who are at greater risk of developing a more dangerous form of the coronavirus — and among those who presented the worst symptoms.’

Read here (Bloomberg, Sept 3, 2020)

WHO suffers setback on its plan for global vaccine access facility

‘The World Health Organization appears to have suffered a setback in its major global initiative for a Covid-19 vaccine procurement facility, as the United States and other major industrialized nations remain reluctant to sign up to the scheme in combating the worsening pandemic which has so far claimed more than 842,000 lives.

‘Despite repeated warnings in August by the WHO director-general, Dr Tedros Adhanom Ghebreyesus, that “no one is safe until everyone is safe; no one country has access to research and development, manufacturing and all the supply chain for essential medicines and materials,” the major pharmaceutical producing countries are increasingly pursuing “nationalist” initiatives instead of multilateral schemes, according to media reports.’

Read here (Third World Network, Sept 3, 2020)

How to decide who should get a Covid-19 vaccine first

‘If and when a safe and effective COVID-19 vaccine is available, what is the fairest way to distribute it? In a policy report published on Thursday in Science, 19 public health experts laid out an ethical framework called the Fair Priority Model. It is geared toward three principles: benefiting people and limiting harm, prioritizing countries already disadvantaged by poverty or low life expectancy, and avoiding discrimination.

‘The report is critical of previously suggested vaccine allocation plans, including two proposed by the World Health Organization: one of them would distribute vaccines to each country according to its population size, and the other would prioritize health care workers and adults who are above age 65 or have underlying health conditions.’

Read here (Scientific American, Sept 3, 2020)

Steroids can be lifesaving for Covid-19 patients, scientists report: New data in hand, the WHO recommended that doctors give the drugs to critically ill patients worldwide

‘International clinical trials published on Wednesday confirm the hope that cheap, widely available steroid drugs can help seriously ill patients survive Covid-19, the illness caused by the coronavirus. Based on the new evidence, the World Health Organization issued new treatment guidance, strongly recommending steroids to treat severely and critically ill patients, but not to those with mild disease...

‘JAMA published that paper and three related studies, along with an editorial describing the research as an “important step forward in the treatment of patients with Covid-19.” Corticosteroids should now be the first-line treatment for critically ill patients, the authors said. The only other drug shown to be effective in seriously ill patients, and only modestly at that, is remdesivir. Steroids like dexamethasone, hydrocortisone and methylprednisolone are often used by doctors to tamp down the body’s immune system, alleviating inflammation, swelling and pain. Many Covid-19 patients die not of the virus, but of the body’s overreaction to the infection.’

Read here (New York Times, Sept 2, 2020)

WHO ‘living guidance' on corticosteroids for Covid-19:

Download here (WHO)

CDC tells states how to prepare for Covid-19 vaccine by early November

‘The Centers for Disease Control and Prevention has notified public health officials in all 50 states and five large cities to prepare to distribute a coronavirus vaccine to health care workers and other high-risk groups as soon as late October or early November.

‘The new C.D.C. guidance is the latest sign of an accelerating race for a vaccine to ease a pandemic that has killed more than 184,000 Americans. The documents were sent out on the same day that President Trump told the nation in his speech to the Republican National Convention that a vaccine might arrive before the end of the year.’

Read here (New York Times, Sept 2, 2020)

In Latin America, religious misinformation on Covid-19 spreads with the help of the Christian press

‘Latin American Christian communities aren’t the only religious groups to fall victim to misleading claims or outright misinformation about the pandemic. In June, Spanish cardinal Antonio Cañizares Llovera declared attempts to find a vaccine the “work of the devil” that would involve “aborted fetuses” in a filmed Mass shared around the world. Church leaders in Australia raised similar concerns recently, apparently unaware that the practice of using cell lines grown from a fetus in 1972 has been commonplace in vaccine development for decades.

‘In India, Hindu religious and political leaders have promoted cow urine as a cure for Covid-19, inspired by the sacred status of cows in Hinduism, and declared the coronavirus would leave India once a controversial temple was completed. Claims that a polio vaccine contained pork products or toxic ingredients, often circulated by Muslim clerics, have damaged the fight against the disease in Muslim-majority Pakistan.’

Read here (Nieman Lab, Sept 2, 2020)