What history can teach us about building a fairer society after coronavirus

‘In recent weeks, some people have optimistically predicted that the Covid-19 outbreak will force governments to build fairer economic systems. But the peasants’ story reminds us that change isn’t automatic, and Spain’s history shows that the bad guys can take advantage of a crisis, too. Look at the Hungarian prime minister, Viktor Orbán, seizing the right to rule by decree while citing Covid-19 as his excuse.

‘There are great strategic challenges ahead. Lockdown gives workers and renters power – the government has to pay people not to work, and landlords are struggling to evict tenants or get new ones – but it will not last. While previous pandemics cut the labour force, this crisis will increase unemployment, perhaps to levels unknown for centuries, and bosses will exploit workers’ desperation so that they can keep wages low and conditions poor.’

Read here (The Guardian, April 18, 2020)

Stanford study finds presence of Covid-19 may be 50 to 85 times higher than official figures

‘The study [not peer reviewed yet] has been interpreted by some to mean we are closer to herd immunity – the concept that if enough people in a population have developed antibodies to a disease that population becomes immune – than expected. This would allow some to more quickly get back to work, a strategy currently being deployed in Sweden. But researchers behind the study said not to jump to conclusions or make policy choices until more research has been done.

‘The study confirms the widely-held belief that far more people than originally thought have been infected with the coronavirus, said Arthur Reingold, an epidemiology professor at UC Berkeley who was not involved in the study, but it doesn’t mean the shelter-in-place order will be lifted any time soon.’

Read here (The Guardian, April 17, 2020)

Trump fans protests against Democrat governors

‘Groups rallied in at least six states this week, and protests are planned in four more in coming days. On Friday, President Trump encouraged protesters in Michigan, Minnesota and Virginia who this week violated stay-at-home orders and social distancing guidelines to march against Democratic governors.

‘LIBERATE MICHIGAN!’ Trump tweeted. ‘LIBERATE MINNESOTA,’ he continued. ‘LIBERATE VIRGINIA, and save your great 2nd Amendment. It is under siege!’

Read here (Washington Post, April 17, 2020)

Public health principles for a phased reopening during COVID-19: Guidance for US governors

‘This document provides an assessment of the risk of SARS-CoV-2 transmission in a variety of organisations and settings that have been closed. We outline steps to reduce potential transmission during the reopening of these organisations and settings, building on the proposed phased approach from the National Coronavirus Response: A Road Map to Reopening. Reopening businesses and other sectors represents one of many steps that will need to be taken to revitalise communities recovering from the pandemic, restore economic activity, and mitigate the unintended public health impact of the distancing measures that were necessary to confront the epidemic of COVID-19. A discussion of larger community-wide considerations for holistically enhancing recovery can be found in the Appendix.’

Download here (John Hopkins Center for Health and Security, April 17, 2020)

How Covid-19 immunity compares to other diseases

If you get Covid-19 and recover does that mean you are immune to the virus? If you become immune, how long does that immunity last? We are still looking for answers to many of these questions. In the meantime, Dr. Seema Yasmin takes a look at the human body's immunity to some other viral infections such as chickenpox, HIV and the common cold.

View here (Wired, 9-minute video, April 17, 2020)

Transmission of Covid-19 to health care personnel during exposures to a hospitalised patient

What is already known about this topic? ‘Health care personnel (HCP) are at heightened risk of acquiring COVID-19 infection, but limited information exists about transmission in health care settings.’

What is added by this report? ‘Among 121 HCP exposed to a patient with unrecognised COVID-19, 43 became symptomatic and were tested for SARS-CoV-2, of whom three had positive test results; all three had unprotected patient contact. Exposures while performing physical examinations or during nebuliser treatments were more common among HCP with COVID-19.’

What are the implications for public health practice? ‘Unprotected, prolonged patient contact, as well as certain exposures, including some aerosol-generating procedures, were associated with SARS-CoV-2 infection in HCP. Early recognition and isolation of patients with possible infection and recommended PPE use can help minimise unprotected, high-risk HCP exposures and protect the health care workforce.’

Read here (US CDC, April 17, 2020)

Coronavirus outbreak may have started as early as September 2019

‘Based on the data Forster and his colleagues have collected, the coronavirus outbreak appears to have started between September 13 and December 7. “This assumes a constant mutation rate, which is admittedly unlikely to be the case, and the time estimate could therefore be wrong,” he told Newsweek. “But it is the best assumption we can make at the moment, pending analysis of further patient samples stored in hospitals during 2019”.’

Read here (Newsweek, April 17, 2020)

Related

• Cambridge researchers identify 3 variants of Covid-19, say their methods could be used to help identify undocumented infection sources. Read here
• First case of Covid-19, presumably Type A, occurred ‘no earlier than September 13, 2019 and no later than December 7, 2019’. View here

Characteristics of health care personnel with Covid-19: A US CDC profile from Feb 12 to Apr 9, 2020

What is added by this report? ‘Of 9,282 US Covid-19 cases reported among HCP, median age was 42 years, and 73% were female, reflecting these distributions among the HCP workforce. HCP patients reported contact with COVID-19 patients in health care, household, and community settings. Most HCP patients were not hospitalised; however, severe outcomes, including death, were reported among all age groups.

What are the implications for public health practice? ‘It is critical to ensure the health and safety of HCP, both at work and in the community. Improving surveillance through routine reporting of occupation and industry not only benefits HCP, but all workers during the COVID-19 pandemic.’

Read here (US CDC, April 17, 2020)

Our front-liners deserve better

Suddenly, as we need them most, we see cracks in a system that ought to take care of them more than ever... Letter to The Star describes the ‘bitter truth for medical staff claiming allowance’.

Read here (The Star, April 17, 2020)

The Malaysian Health Coalition (MHC), representing 44 member societies and 16 individuals, calls for four measures to effect a rationalised opening-up

They are (please look at letter for full text}:

1. Decision-making on a phased restart that includes MOH, other relevant ministries or agencies and relevant medical health experts.
2. An exit strategy for the post-MCO period based on the advice of medical health and public health experts with guidelines according to the colour-coded zoning system: green, yellow and red.
3. Large-scale disinfection and sanitisation efforts that follow evidence-based procedures.
4. Work with religious authorities to adapt upcoming religious and cultural traditions to prevent mass gatherings that would further spread Covid-19.

Read here (The Star, April 17, 2020)

Musim Sengsara or The Season of Suffering

Heritage activist Khoo Salma has written an inspirational song dedicated to frontline health workers against Covid-19 in Malaysia. Sung by Ayie, it is entitled ‘The Season of Suffering’ or ‘Musim Sengsara’

View here (Youtube, April 17, 2020)

Expanding the military’s role?

The MAF has been deployed since 21 March to help patrol and enforce the MCO in response to COVID-19. At the time of writing, the MCO has been extended twice and is now set to end on 28 April 2020. During this prolonged period, some thought should be given to the possibility of the MAF’s expanded role in the crisis.

Read here (ISIS Malaysia, April 17, 2020)

Digital trade: A boon during the MCO and beyond

Throughout the Covid-19 MCO, digital trade has been a boon in not only connecting businesses to consumers, but also serving as a lifeline for MSMEs and informal workers. Given that digital trade is beneficial in maintaining employment and livelihood in crucial times of emergency, on top of its benefits during “ordinary” times, the government needs to rethink – or better yet, strike while the iron is hot – on how to further encourage digital trade among MSME entrepreneurs in the country.

Read here (ISIS Malaysia, April 17, 2020)

Malaysia already has a contact tracing app (Gerak Malaysia) and it’s downloadable now

‘The Malaysian Communications and Multimedia Commission is testing a beta app called Gerak Malaysia that can do just that and it uses location tracking...

‘At hospitals, the QR code can be used to determine your risk level and it will allow frontliners to assign you to the right queue. For example, if you’ve been to an area that was visited by a confirmed Covid-19 case, you will be flagged as a high-risk...

‘The QR code can also assist the police and armed forces at the roadblocks as they can determine whether you’re travelling within the permitted radius. This feature can potentially replace the approval letters that are required to be presented to the police. As a result, this feature can help speed up the checks and reduce congestion...’

Read here (The Malay Mail, April 17, 2020)

Swedish epidemiologist Johan Giesecke‘s forthright views on Covid-19

In this 34-minute interview, Professor Johan Giesecke, one of the world’s most senior epidemiologists, advisor to the Swedish Government, lays out with typically Swedish bluntness why he thinks:

1. UK policy on lockdown and other European countries are not evidence-based 
2. The correct policy is to protect the old and the frail only 
3. This will eventually lead to herd immunity as a “by-product” 
4. The initial UK response, before the “180 degree U-turn”, was better 
5. The Imperial College paper was “not very good” and he has never seen an unpublished paper have so much policy impact 
6. The paper was very much too pessimistic 
7. Any such models are a dubious basis for public policy anyway 
8. The flattening of the curve is due to the most vulnerable dying first as much as the lockdown 
9. The results will eventually be similar for all countries 
10. Covid-19 is a “mild disease” and similar to the flu, and it was the novelty of the disease that scared people. 
11. The actual fatality rate of Covid-19 is the region of 0.1% 
12. At least 50% of the population of both the UK and Sweden will be shown to have already had the disease when mass antibody testing becomes available

View here (LockdownTV, Youtube, April 17, 2020)

Manifesto for post-neoliberal development: Five policy strategies for the Netherlands after the Covid-19 crisis

‘The Manifesto calls the Dutch Government to implement five key policy strategies for moving forward during and after the Covid-19 crisis:

• A move away from “development” focused on aggregate GDP growth;
• An economic framework focused on redistribution;
• Transformation towards regenerative agriculture;
• Reduction of consumption and travel; and
• Debt cancellation.

‘This Manifesto brings to the forefront some fundamental concerns of degrowth scholars and activists, and shows that these concerns are close to the hearts and minds of many academics who may not (yet) see themselves as part of the degrowth community. Particularly relevant is the link between economic development, the loss of biodiversity and important ecosystem functions, and the opportunity for diseases like COVID-19 to spread among humans. The Manifesto proposes policies that, as research tells us, are critical for a more sustainable, equal and diverse society - one that can better prevent and deal with shocks, including climate change related ones, and pandemics to come.’

Read here (Ontgroei, April 16, 2020)

Related:

Use crisis to make post corona society fairer and sustainable, say scientists. Read here

Covid-19 & China: A View from Asia -- George Yeo

‘In China, national interest comes before human rights. In the liberal west, there is continuous tension between the two which is the source of western creativity from the time of Greece and Rome. It is interesting to compare the national reaction to two whistleblowers - China’s Dr Li Wenliang who first sounded the alarm in Wuhan and Captain Brett Crozier who publicised the deteriorating situation onboard USS Theodore Roosevelt. Both men came down with the virus.

‘In Dr Li’s case, he has been officially vindicated after his death and the dossier is closed by central edict. In Captain Crozier’s case, the debate will never cease whatever the White House might say. China and the US are built on different foundations, each having the weakness of its strength. Global cooperation requires each to accept the other for what it is.’

Read here (Brunswick Group, April 16, 2020)

Consider 10-year contract extension for public medical officers: MMA

‘The government is urged to consider the contract extension of up to 10 years for the Health Ministry’s medical officers to facilitate absorption as permanent staff... The Malaysian Medical Association (MMA) is asking for the extension “to allow for specialisation and gazettement before absorption as permanent staff for successful specialists to provide the much-needed services to the country.”

Read here (Malaysiakini, April 16, 2020)

Is China winning? Economist special on China & Covid-19

‘China’s rulers combine vast ambitions with a caution born from the huge task they have in governing a country of 1.4bn people. They do not need to create a new rules-based international order from scratch. They might prefer to keep pushing on the wobbly pillars of the order built by America after the second world war, so that a rising China is not constrained.

‘That is not a comforting prospect. The best way to deal with the pandemic and its economic consequences is globally. So, too, problems like organised crime and climate change. The 1920s showed what happens when great powers turn selfish and rush to take advantage of the troubles of others. The covid-19 outbreak has so far sparked as much jostling for advantage as far-sighted magnanimity. Mr Trump bears a lot of blame for that. For China to reinforce such bleak visions of superpower behaviour would be not a triumph but a tragedy.’

Read here (The Economist, April 16, 2020)

The number of new cases of Covid-19 in US has plateaued: Is this a good sign?

‘But there is another way to interpret the decline in new cases: The growth in the number of new tests completed per day has also plateaued. Since April 1, the country has tested roughly 145,000 people every day with no steady upward trajectory. The growth in the number of new cases per day, and the growth in the number of new tests per day, are very tightly correlated.

‘This tight correlation suggests that if the United States were testing more people, we would probably still be seeing an increase in the number of COVID-19 cases. And combined with the high test-positivity rate, it suggests that the reservoir of unknown, uncounted cases of COVID-19 across the country is still very large.

‘Each of those uncounted cases is a small tragedy and a microcosm of all the ways the U.S. testing infrastructure is still failing...’

Read here (The Atlantic, April 16, 2020)

Finding effective treatments for COVID-19: Scientific integrity and public confidence in a time of crisis

‘Everyone wants new treatments and vaccines to address the devastation of coronavirus disease 2019 (COVID-19). But, currently, under intense pressure and based on hope and limited data from poorly conducted clinical trials and observational data, many clinicians are embarking on ill-advised and uncontrolled human experimentation with unproven treatments.’

This paper calls for three important considerations:

1. ‘First, the regulatory and research communities owe it to patients, families, and clinicians to quickly learn what treatments are effective... 
2. ‘Second, it is important to optimise treatments that already exist, including supportive critical care. As learned from the Ebola outbreak, mortality can be reduced through identifying best practices...
3. ‘Third, and most important, it is critical to protect the integrity of and resulting public trust in the scientific and regulatory agencies and their advice and decisions. That trust will be needed once vaccines against COVID-19 become available and in future public health emergencies.’

Read here (JamaNetwork, April 16, 2020)

Dutch study suggests 3% of population may have coronavirus antibodies

“This study shows that about 3% of Dutch people have developed antibodies against the coronavirus,” Van Dissel said. “You can calculate from that, it’s several hundred thousand people” in a country of 17 million. The blood donation service Sanquin announced it would begin testing on 10,000 samples weekly on March 19, but later said it would only disclose results to the RIVM.’

The confirmed cases in Netherlands as of April 18 (Wikipedia) was 32,655 with 3,684 deaths

Read here (Reuters, April 16, 2020)

WHO's new strategy update outlines six factors for countries as they consider lifting restrictions

1. First, that transmission is controlled; 
2. Second, that health system capacities are in place to detect, test, isolate and treat every case and trace every contact;  
3. Third, that outbreak risks are minimised in special settings like health facilities and nursing homes; 
4. Fourth, that preventive measures are in place in workplaces, schools and other **places where it’s essential for people to go; 
5. Fifth, that importation risks can be managed; and 
6. Sixth, that communities are fully educated, engaged and empowered to adjust to the “new norm”

Read here (WHO, April 16, 2020)

Dow futures rally 700 points after Gilead drug reported shows effectiveness. There are reservations about the report and clinical trials funded by Gilead

Dow futures rally. Read here (CNBC, April 16, 2020)

‘Gilead’s severe Covid-19 study includes 2,400 participants from 152 different clinical trial sites all over the world. Its moderate Covid-19 study includes 1,600 patients in 169 different centers, also all over the world.

‘The trial is investigating five- and 10-day treatment courses of remdesivir. The primary goal is a statistical comparison of patient improvement between the two treatment arms. Improvement is measured using a seven-point numerical scale that encompasses death (at worst) and discharge from hospital (best outcome), with various degrees of supplemental oxygen and intubation in between.

‘The lack of a control arm in the study could make interpreting the results more challenging.’

Read here (STAT News, April 16, 2020)

China's post-lockdown monitoring rides on existing hi-tech finance and social media platforms

‘The Chinese government has enlisted the help of the country's two internet giants — Alibaba (BABA) and Tencent (TCEHY) — to host the health code systems on their popular smartphone apps. Alibaba's mobile payment app Alipay and Tencent's messaging app Wechat are both ubiquitous in China, each used by hundreds of millions of people. Placing the health codes on these platforms means easy access for many...

‘Within a week of its launch, the Alipay health codes were rolled out in more than 100 cities across the country, the state-run Xinhua news agency reported. By late February, more than 200 cities had adopted these QR codes, according to Alipay... Tencent's health code system had also expanded to more than 300 cities as of last month, according to the state-run Science and Technology Daily."

Read here (CNN, April 16, 2020)

Twelve lessons from countries that have ameliorated the effects of Covid-19

Taiwan, Iceland, South Korea and Germany, according to this CNN article, have succeeded so far in ameliorating the effects of Covid-19. There are 12 lessons to be learned from them:

Lesson #1: Be prepared
Lesson #2: Be quick
Lesson #3: Test, trace and quarantine
Lesson #4: Use data and tech
Lesson #5: Be aggressive
Lesson #6: Get the private sector involved 
Lesson #7: Act preventatively
Lesson #8: Use tech, but respect privacy
Lesson #9: You can drive-through test
Lesson #10: Learn from the past
Lesson #11: Test more as restrictions ease
Lesson #12: Build capacity at hospitals

Read here (CNN, April 16, 2020)

For the record -- Beyond containment: Health systems responses to COVID-19 in the OECD

‘Health systems are facing the most serious global pandemic crisis in a century. Containing and mitigating the spread and infection rate of the coronavirus SARS-CoV-2 is the first priority of public health authorities to distribute the number of infections over time and, if possible, reduce the incidence of the disease it causes (COVID-19). However, beyond containment, additional measures - operational, financial, and R&D - are needed to provide effective patient care and reduce the pressure on health systems to manageable levels. The main focus of this brief is on the policies aimed at providing effective care and managing the pressure on health systems.

‘Four key measures health systems are putting in place in response to the epidemic are considered: 1) ensuring access of the vulnerable to diagnostics and treatment; 2) strengthening and optimising health system capacity to respond to the rapid increase in caseloads; 3) how to leverage digital solutions and data to improve surveillance and care; and 4) how to improve R&D for accelerated development of diagnostics, treatments and vaccines.’

https://oecd.dam-broadcast.com/pm_7379_119_119689-ud5comtf84.pdf

Download here (OECD, April 16, 2020)

Ensuring safe environment for primary healthcare settings — Dr Amar-Singh HSS, Dr Lee Chee Wan, Dr Paranthaman and Dr Timothy William

‘This guideline is written to offer ideas to general practitioners (GP) and those working in out-patient clinic settings (OPD) on what precautionary measures to take to curb the spread of Covid-19 disease and protect themselves when the relevant government authorities ease our lockdown.

‘It may also be useful for other clinic settings like speciality clinics, antenatal clinics, dental clinics, etc. We are sharing it to the general public as it may be useful for patients and the community to think though some of these issues.’

Read here (The Malay Mail, April 15, 2020)

Circumventing catastrophes: ‘We will never know unless we try: again and again, and ever harder’

In the last paragraph of his 100-page book, ‘Does the richness of the few benefit us all?’, the highly distinguished sociologist, Zygmunt Bauman (1925-2017) wrote:

‘It seems that one needs catastrophes to happen in order to recognise and admit (retrospectively alas, only retrospectively...) their coming. A chilling thought if ever there was one. Can we ever refute it? We will never know unless we try: again and again, and ever harder.’

The following is a synopsis of the book published in 2013: ‘It is commonly assumed that the best way to help the poor out of their misery is to allow the rich to get richer, that if the rich pay less taxes then all the rest of us will be better off, and that in the final analysis the richness of the few benefits us all. And yet these commonly held beliefs are flatly contradicted by our daily experience, an abundance of research findings and, indeed, logic. Such bizarre discrepancy between hard facts and popular opinions makes one pause and ask: why are these opinions so widespread and resistant to accumulated and fast-growing evidence to the contrary?

‘This short book is by one of the world’s leading social thinkers is an attempt to answer this question. Bauman lists and scrutinises the tacit assumptions and unreflected-upon convictions upon which such opinions are grounded, finding them one by one to be false, deceitful and misleading.’

Purchase here (Amazon, undated)

Watch a video on making surgical masks as safe as N95 masks: Towards Surgical Mask Brace 2.0, a scalable, open source design by ex-Apple engineers

Why adapt surgical masks?

• ‘Safety: Surgical masks have a government standard that regulates their filtration efficiency. They are regulated to meet ASTM standard F2100 which guarantees filtering 95% or more of COVID-19 sized particles.
• ‘Accessible: Surgical masks are faster to manufacture and more readily available. Currently, of the 200 million masks China makes a day, only 600,000 are N95 standard masks. That means surgical masks can be made more than 300x faster than N95’s.’

Watch here (fixthemask.com, undated)

Down To Earth magazine's e-edition focuses on Covid-19

‘We believe our post-COVID-19 world is going to be different. But it is in our hands to make sure it is better. Given the urgency and the fact that we need to inform you about these developments as they happen, we decided to bring out the two April issues of our Down To Earth fortnightly English magazine in digital format only, as printing and distribution is a challenge in these days of lockdown. Our fortnightly Print editions will of course be back, once the lockdown is lifted.

‘DTEI am giving below a link to our latest issue of Down To Earth (DTE) magazine where you can read an in depth cover story on COVID-19, as well as all our normal coverage.’

Read here (DTEI, April 15, 2020)

The teenager in us re-emerges during the COVID-19 outbreak

‘Dr Frances Jensen, chair of the neurology department at the University of Pennsylvania’s Perelman School of Medicine and author of The Teenage Brain, says most of the behaviours we associate with teenagers—like video-game marathons and junk food feasts—relate to impulsivity and a desire for immediate gratification. Adults are displaying these same behaviours during the COVID-19 pandemic, but for different neurological reasons, Jensen says...

“Stress can increase impulsivity, and people are under a lot of stress” right now, Jensen says. “It’s a balance between the executive function parts of your brain and the ‘I want it, I want it, I want it!’ parts of your brain,” which are mainly housed in the limbic system. When you’re under stress, and “your barriers are down,” the limbic system may win out more than normal, giving rise to stereotypically teenage behaviours, she says.

Read here (Time, April 15, 2020)

Rotten: The highly unpalatable side of our food supply chains

Subscribers of Netflix can watch the two-season ‘Rotton’, a ‘docuseries [that] travels deep into the heart of the food supply chain to reveal unsavoury truths and expose hidden forces that shape what we eat.’ The reception to this series on Wikipedia: ‘Reaction to the series has been relatively positive, with a rating of 80% on Rotten Tomatoes. It is praised for its high-quality cinematography and compelling, human-centred narratives but criticised for focusing on particular issues rather than providing explanation for wider industry problems, or giving the viewer answers as to which brands and products are unaffected by the issues the series presents.’

Read here (Netflix)

Covid-19 and human rights: We are all in this together

Human rights are key in shaping the pandemic response, both for the public health emergency and the broader impact on people’s lives and livelihoods. Human rights put people centre-stage. Responses that are shaped by and respect human rights result in better outcomes in beating the pandemic, ensuring healthcare for everyone and preserving human dignity. But they also focus our attention
on who is suffering most, why, and what can be done about it. They prepare the ground now for emerging from this crisis with more equitable and sustainable societies, development and peace.

Download here (WHO, April 2020)

Media freedom and fake news during the time of Covid-19

The likening of the fight against Covid-19 to a war should neither be a rationale for war-time measures, nor a free hand to muzzle the media and impinge on individual free speech. With new normals being expected, these normals must include a free media coupled with better protected free speech rights.

Read here (ISIS Malaysia, April 15, 2020)

MySejahtera app to help Malaysians manage Covid-19 outbreaks

‘MySejahtera is an application developed by the Government of Malaysia to assist in managing the COVID-19 outbreaks in the country. It allows users to perform health self-assessment on themselves and their family members. The users can also monitor their health progress throughout the COVID-19 outbreak. Also, MySejahtera enables the Ministry of Health (MOH) to monitor users’ health condition and take immediate actions in providing the treatments required.’

• For IOS, click through here 
• For Android, here
• For Huawei, here

Eleven people died in Manaus, in the state of Amazonas, Brazil, during a study conducted with high doses of the drug chloroquine

‘Eighty-one patients participated in the research, 41 of whom received a high dose of chloroquine. After three days of treatment, those who received the highest dose of chloroquine began to have heart arrhythmias. On the sixth day of treatment, 11 of them died, leading the group of researchers to abandon the investigation.

‘The patients in the study were also given the antibiotic azithromycin, a drug that presents the same cardiac risk. The data is still preliminary, not conclusive, which means that more studies are needed on the relationship between the drug, the disease and the deaths.’

Read here (TeleSureTV, April 15, 2020)

Reflexivity in the age of pandemia: Adaptive policy making and the Covid-19 crisis

The authors argue that ’the current tendency of using the war metaphor is not the way to respond. Such a metaphor is useful to mobilise and rally people around a short-term external threat. But it is also the root cause for the chaos we are experiencing now – the lack of government preparedness despite having experienced similar events such as the ‘Spanish’ Flu, SARS or the Zika virus epidemic throughout the last century. The war metaphor masks the fact that the threat of pandemic is a long game requiring a more complex response at the local, national and global levels of society.

’We require far-reaching changes to the way we design and organise our cities and supply chains, and a rethinking of the way we interact and transact as a global society. Arundhati Roy wrote recently that, “Historically, pandemics have forced humans to break with the past and imagine their world anew.” In this paper, we argue that such a response would require reshaping policy making around the concept of reflexivity and made operational through an adaptive policy making approach.’

Read further and download here (Think City, April 2020)

‘Kerala model is nothing but focus on education and welfare’

This opinion piece covers (1) what Kerala did right in fighting coronavirus? (2) Kerala model: Left, right and centre (3) Kerala sticks to WHO guidelines & executes them efficiently (4) No time for political one-upmanship

Read here (The Quint, April 15, 2020)

Boris Johnson recovery shows need for rehabilitation after coronavirus

‘One answer is having more rehabilitation teams – comprising doctors, nurses, physiotherapists, occupational therapists, psychologists, social workers, pharmacists and dieticians – treat patients in their own homes. This can be done via telehealth and online platforms, which allows services to be delivered in a way that minimises risk to health professionals and doesn’t further deplete personal protection equipment.

‘Rehabilitation reduces bed block as patients are discharged more quickly. It also takes pressure off GPs and reduces re-presentations to emergency departments for issues that can be dealt with at home.’

Read here (The Sydney Morning Herald, April 15, 2020)

Could the next normal emerge from Asia?

This McKinsey & Co report talks about Asia’s resilience to disruption and focuses on four areas that will shape the next normal: (a) Rethinking social contracts (b) Defining the future of work and consumption (c) Mobilising resources at speed and scale (d) From globalisation to regionalisation. It concludes that the future global story starts in Asia.

Read here (McKinsey & Co, April 2020)

Google provides info on community mobility in response to Covid-19

‘As global communities respond to COVID-19, we’ve heard from public health officials that the same type of aggregated, anonymised insights we use in products such as Google Maps could be helpful as they make critical decisions to combat COVID-19.

‘These Community Mobility Reports aim to provide insights into what has changed in response to policies aimed at combating COVID-19. The reports chart movement trends over time by geography, across different categories of places such as retail and recreation, groceries and pharmacies, parks, transit stations, workplaces, and residential.’

Read here (Google, constantly updated)

China’s initial coronavirus outbreak in Wuhan spread twice as fast as we thought, new study suggests

‘Each carrier was infecting 5.7 people on average, according to US researchers, who say previous estimate had used incomplete data Latest data based on cases whose origin could be traced more clearly, in provinces that had test kits and ample health care capacity.’

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

Covid-19 is an opportunity for gender equality within the workplace and at home

‘Crisis can be an opportunity for gendered change: WW1 was a watershed moment for women’s emancipation with large swathes being added to the workforce, and the creation of women’s institutes, which latterly led to women’s suffrage. We hope that covid-19 can be another such movement for greater gender-equality in the workplace. To do so we need to stop apologising for personal lives, and let’s see more children on conference calls.’

Read here (BMJ Opinion, April 15, 2020)

Medical researchers have been studying everything we know about Covid-19. What have they learned – and is it enough to halt the pandemic?

‘Due to the unprecedented and ongoing nature of the coronavirus outbreak, this article is being regularly updated to ensure that it reflects the current situation as best as possible. Any significant corrections made to this or previous versions of the article will continue to be footnoted in line with Guardian editorial policy.’

Read here (The Guardian, April 15, 2020)

‘On cronies, cranks and the coronavirus’: Opinion piece by Paul Krugman

‘So where’s this [push to open up the economy quickly] coming from? I’ve seen some people portray it as a conflict between epidemiologists and economists, but that’s all wrong. No, this push to reopen is coming not from economists but from cranks and cronies. That is, it’s coming on one side from people who may describe themselves as economists but whom the professionals consider cranks...’

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

Vietnam winning new war against invisible enemy

‘While much more resource constrained, some key features of Vietnam’s response are similar to other much lauded East Asian responses, with its infection rates significantly lower than even Taiwan’s. For many other developing countries struggling to cope with the Covid-19 pandemic, key aspects of its response are very relevant.’

Read here (IPS News, April 14, 2020)

Up to 70% of those infected may show no symptoms, making coronavirus tough to tackle

‘Asymptomatic persons with the coronavirus disease are more common than was previously thought - some research says potentially as many as 55 per cent to 70 per cent of infections - and they can go on to infect others without anyone ever finding out. It is one of three reasons that make Covid-19 such a challenging disease to tackle, National Centre for Infectious Diseases executive director Leo Yee Sin told The Straits Times yesterday.’

The other two reasons: (1) high virus secretion at its onset (2) as Sars-CoV-2 is a novel pathogen, the whole of Singapore is susceptible to it.

Read here (Strait Times, April 14, 2020)

Intermittent social distancing may be needed through 2022 to manage Covid-19

‘On-and-off periods of social distancing will likely be needed into 2022 to ensure that hospitals have enough capacity for future Covid-19 patients in need of critical care, according to a new modeling study from researchers at Harvard TH Chan School of Public Health.

‘The research, published April 14, 2020 in the journal Science, predicted several scenarios for how the coronavirus might spread over the next five years, taking into account factors such as whether or not the virus will exhibit seasonality, whether people who are infected go on to develop short-term or long-term immunity, and whether people would get any cross-protective immunity from having been infected with other types of coronaviruses that cause common colds.’

Read here (Harvard School of Public Health, April 14, 2020)

First UN solidarity flight departs Addis Ababa carrying vital COVID-19 medical supplies to all African nations

‘The first United Nations “Solidarity Flight” is scheduled to leave Addis Ababa, Ethiopia, today [April 14] - from there, the aircraft will transport the vital medical cargo to all countries in Africa, where supplies are desperately needed to contain the spread of COVID-19. WHO cargo is being  transported by the United Nations World Food Programme (WFP), and includes face shields, gloves, goggles, gowns, masks, medical aprons and thermometers, as well as ventilators.’

Read here (WHO, April 14, 2020)

From ‘gold standard’ to a coronavirus ‘explosion’: Singapore battles new outbreak

‘There were warning signs before the new outbreak. On Feb. 10, after a Bangladeshi labourer became the first to be infected with the virus, lawyer Dipa Swaminathan, founder of It’s Raining Raincoats, an initiative that works with migrants, wrote a Facebook post warning that ‘the spread among them could be rapid, given the cramped conditions in which they live, work and are transported.’

‘Health officials said the man had visited Mustafa Center, a giant shopping complex in Singapore’s Little India district that is popular with foreign workers.

‘But as recently as two weeks ago, shoppers were going in and out of the building without temperature checks, and few employees were seen wearing masks. On Tuesday, the government said 86 infections had been linked to Mustafa Center.’

Read here (Los Angeles Times, April 14, 2020)

Will religion lead Covid reform? Joachim Ng

‘This original belief that God and nature are dual modes of one whole reality did not get lost but was preserved in many scriptures. An integral part of this belief is compassion for animals. Folks in Wuhan may be surprised to learn that China’s major indigenous religion, Confucianism, has strong reservations about meat-eating.

‘The Works of Mencius contain these verses: “Beasts devour one another, and people hate them for doing so” (Book 1, Pt1, Ch4, v.5). “So is the superior person affected towards animals, that, having seen them alive, he cannot bear to see them die; having heard their dying cries, he cannot bear to eat their flesh” (Ch7, v.8).

‘If religions continue their spiritual distancing from one another and from the original faith in nature, they will lose their relevance to society. This is the moment of truth: Will religion lead Covid reform?’

Read here (theSun Daily, April 14, 2020)

Coronavirus doubters follow climate denial playbook

‘For the climate community, observing US national political leaders’ responses to the coronavirus pandemic has been like watching the climate crisis unfold on fast-forward. Many – particularly on the political right – have progressed through the same five stages of science denial in the face of both threats.’

Read here (Yale Climate Change Connection, April 14, 2020)

The plague writers who predicted today

‘In uncertain – indeed, weird – times like these, as we increase our social isolation to ‘flatten the curve’, literature provides escape, relief, comfort and companionship. Less comfortingly, though, the appeal of pandemic fiction has also increased. Many pandemic titles read like guide books to today’s situation. And many such novels give a realistic chronological progression, from first signs through to the worst times, and the return of ‘normality’. They show us we’ve been through this before. We’ve survived.’

Read here (BBC, April 14, 2020)

‘Short-sighted.’ Health experts decry Trump’s freeze on US funding for WHO as world fights pandemic

‘Health scholars have long pointed out that the funding of WHO is not commensurate with the global role it is supposed to play. The agency’s overall spending is less than the budget of some major hospitals in the United States. Less than one-fifth of its budget comes from “assessed contributions,” essentially membership fees paid by the 194 countries that make up WHO. The rest of the organisation’s funding comes from donations, with the United States as the biggest donor. “As each outbreak shows, countries’ expectations for the WHO are not aligned with the limitations on funding, political, and legal authorities those same countries set on the organisation,” Phelan says.

‘In an interview in December 2019, Tedros told Science that WHO’s reliance on just a few donors left the organisation vulnerable. “If one of them refuses to continue funding,” he said, “WHO could get into a serious shock”.’

Read here (Science, April 14, 2020)

Singapore announces enhanced “circuit breaker”: Masks now mandatory in public places

‘Everyone must wear a mask when outside of their homes. This applies on public transport, taxis, private hire cars, walking to or at markets, and also for essential workers at all workplace premises, whether they are frontline staff (such as food handlers, cashiers and bus drivers) or performing back office functions (such as data entry personnel and payroll executives). Individuals may remove their mask while engaging in strenuous exercise outdoors (e.g. running/ jogging), but they must put it back on after completing exercise. Mask-wearing is not recommended for young children below the age of two for child safety reasons. Medical experts have also advised that some groups may have difficulties wearing a mask, including children with special needs and young children aged two and above, and we will exercise flexibility in enforcement for these groups.’

Read here (Ministry of Health, Singapore, April 14, 2020)

Coronavirus saliva test gets FDA emergency use approval, Rutgers University says

• The Food and Drug Administration granted emergency use authorisation for a coronavirus test relying on saliva samples developed by a Rutgers University-backed entity, Rutgers said Monday.
• The test could increase, by tens of thousands of tests per day, the number of screenings for Covid-19, Rutgers said.
• The test was developed by Rutgers’ RUCDR Infinite Biologics and its collaborators, Spectrum Solutions and Accurate Diagnostic Labs.

Read here (CNBC, April 13, 2020)

It is the math, stupid

‘Every nation is eagerly awaiting to lift its lockdown as soon as there are fewer cases. But when 15 cases become 460,000 in 6 weeks, how is it ok to lift a lockdown when we are down to, say, “only 100 new cases” in a given day? Once again, our human mind is incapable of thinking in exponentials. We will not have learned from history — a history that occurred just two months ago.

‘The real pandemic will start the day we start lifting the lockdown.’

Read here (Center for Inquiry, April 13, 2020)

Use crisis to make post corona society fairer and sustainable, say scientists

‘In a manifesto published in Trouw, a group of 170 sociologists and environmental scientists from eight Dutch universities said that the disruption of economic certainties caused by the pandemic offers a chance for radical reforms. These could include the introduction of a universal basic income and debt cancellation for poor countries, the scientists state.’

Read here (Dutch News, April 13, 2020)

Of haircuts, MITI website crashes and living with Covid-19

‘I really, really wish our backdoor ministers postpone their ambitions to exert the power in their hands to do things and instead seek the counsel of experienced and knowledgeable civil servants in their ministries before opening their mouths and coming up with ridiculous suggestions. It would not only save money but human lives in the current dire environment.’

Read here (Focus Malaysia, April 13, 2020)

Misinformation: China… and now Russia

‘[T]he State Department recently accused Russia of using thousands of social media accounts to spread coronavirus misinformation — including a conspiracy theory that the United States engineered the deadly pandemic.

‘The Kremlin’s audience for open disinformation is surprisingly large. The YouTube videos of RT, Russia’s global television network, average one million views per day, “the highest among news outlets,” according to a U.S. intelligence report. Since the founding of the Russian network in 2005, its videos have received more than four billion views, analysts recently concluded.’

Read here (New York Times, April 13, 2020)

Sound advice from a USM medical microbiologist

Besides giving three important points on Covid-19, she said: ‘We know that besides our fallibility from threats like infectious disease, nothing else is certain. But uncertainty is a familiar friend in science and the quest for truth. And as the great physicist Richard Feynman said, “What is not surrounded by uncertainty cannot be the truth.” Pain is inevitable, suffering is optional. There is inevitably pain in uncertainty, and it is unsettling. But instead of suffering, we can choose to view uncertainty with hope. For as long as we acknowledge that we do not know for certain, we can try and find out. That is the scientific truth.’

Read here (The Star, April 12, 2020)

Clinical trials on repurposing two vaccines, BCG and polio: Both statements start with "There is no evidence..."

On polio: ’There is no evidence that oral poliovirus vaccine (OPV) protects people against infection with COVID-19 virus. A clinical trial addressing this question is planned in the USA, and WHO will evaluate the evidence when it is available. In the absence of evidence, WHO does not recommend OPV vaccination for the prevention of COVID-19.’

Download here (Polio Eradication Initiative, March 2020)

On BCG: ‘There is no evidence that the Bacille Calmette-Guérin vaccine (BCG) protects people against infection with COVID-19 virus. Two clinical trials addressing this question are underway, and WHO will evaluate the evidence when it is available. In the absence of evidence, WHO does not recommend BCG vaccination for the prevention of COVID-19. WHO continues to recommend neonatal BCG vaccination in countries or settings with a high incidence of tuberculosis.’

Read here (WHO, April 12, 2020)

African nations demand answers from China over mistreatment of their citizens in Guangzhou

Chairman of African Union Commission calls for ‘immediate remedial measures’ after Africans are racially targeted following investigation into Covid-19 infections in city’s Yuexiu district. ‘I regret and highly condemn this act of ill treatment and racial discrimination,’ Ghana’s Foreign Affairs Minister Shirley Ayorkor Botchwey says.

Read here (South China Morning Post, April 12, 2020)

Malaysia's response to Covid-19 ranked fourth strictest in South East Asia

‘Malaysia's Covid-19 response is the fourth strictest among South-East Asian countries as of Friday, according to the University of Oxford’s Blavatnik School of Government. Malaysia is ranked fourth in Asean after Laos, Vietnam and the Philippines.

‘A higher position in the Stringency Index, however, does not necessarily mean that a country's response is “better” than others lower on the index, according to the Blavatnik School of Government.

‘The score is based on measurements of seven response indicators. They include policies such as school and workplace closures, travel bans, public event cancellations, public transport closures, public information campaigns and movement restrictions. Other six measures gauged by the tracker include fiscal or monetary measures, investment in vaccines, Covid-19 testing framework and contact tracing measures.’

Read here (The Star, April 12, 2020)

How the virus transformed the way Americans spend their money

‘In a matter of weeks, pillars of American industry essentially ground to a halt. Airplanes, restaurants and arenas were suddenly empty. In many states, businesses deemed nonessential — including luxury goods retailers and golf courses — were ordered closed.’

[NOTE: These figures, while they don't apply to many developing countries as a whole, give us a glimpse of how the more urbanised, consumerist parts of our economies may be affected. Also the patterns of spending give us an idea of what we may expect in large sections of the economy dependent on travel and tourism, including “medical tourism”, international students, retailing in malls, etc. They also tell us why we should now focus on basic needs.]

Read here (New York Times, April 11, 2020)

Behind Trump’s failure on the Covid-19 virus

‘An examination reveals the president was warned about the potential for a pandemic but that internal divisions, lack of planning and his faith in his own instincts led to a halting response…

‘During the last week in March, Kellyanne Conway, a senior White House adviser involved in task force meetings, gave voice to concerns other aides had. She warned Mr. Trump that his wished-for date of Easter to reopen the country likely couldn’t be accomplished. Among other things, she told him, he would end up being blamed by critics for every subsequent death caused by the virus.

‘Within days, he watched images on television of a calamitous situation at Elmhurst Hospital Center, miles from his childhood home in Queens, NY. where 13 people had died from the coronavirus in 24 hours.’

NOTE: On April 13, when NY Governor Cuomo said the ‘worst is over’, the total cases in New York was 195,031 with 10,056 deaths (NYT report of April 13)

Read here (New York Times, April 11, 2020)

Jane Goodall says ‘disrespect for animals’ caused pandemic

‘It is our disregard for nature and our disrespect of the animals we should share the planet with that has caused this pandemic, that was predicted long ago.

‘It’s also the animals who are hunted for food, sold in markets in Africa or in the meat market for wild animals in Asia, especially China, and our intensive farms where we cruelly crowd together billions of animals around the world. These are the conditions that create an opportunity for the viruses to jump from animals across the species barrier to humans.’

Read here (The Malay Mail, April 11, 2020)

Coronavirus found in air samples up to 4 metres from patients: China study

’A new study examining air samples from hospital wards with COVID-19 patients has found the virus can travel up to 4m – twice the distance current guidelines say people should leave between themselves in public. The preliminary results of the investigation by Chinese researchers were published on Friday in Emerging Infectious Diseases, a journal of the US Centers for Disease Control and Prevention (CDC).‘

Read here (Channel News Asia, April 11, 2020)

The second wave: How did the fight go wrong? (Singapore)

‘The government was blindsided by the spread among our foreign workers... But it needs to be pointed out that the new cases outside this group is worrying in itself. Of the record 287 new cases reported two days ago on 9 April (surpassed again yesterday), 202 were linked to foreign worker dormitories. But a large number (85 cases) were not, including 48 unlinked to existing cases. We are now fighting the virus now on not one but two raging fronts.’

COMMENT: The second front could have been opened up due to an underestimation of how effectively the virus could spread within the community especially by asymptomatic carriers

Read here (Tan Tarn How, April 11, 2020)

Verena Friederike Hasel: NZ's Covid-19 coronavirus response ‘extraordinary’

‘At first glance, corona seems to be an example of a wicked problem: a question that causes a dilemma because there are legitimate but conflicting interests at work. It is either people's health or the economy that will suffer. But the response of the New Zealand Government shows there need not be a contradiction. The more seriously you take the virus itself, the more quickly you can tackle the economic recovery.’

Read here (NZ Herald, April 11, 2020)

First case of Covid-19, presumably Type A, occurred ‘no earlier than September 13, 2019 and no later than December 7, 2019’

‘Peter Forster, a geneticist at the University of Cambridge, has identified three distinct strains of COVID-19. Forster and his team traced the origins of the epidemic by analysing 160 genomes from human patients and found that the strain in #Wuhan mutated from an earlier version.’

View here (CGTN, Youtube, April 11, 2020)

Top physicians pen letter to PM calling for gradual relaxation of MCO

‘The president of the Malaysian Medical Association and 12 predecessors have penned an open letter to Prime Minister Muhyiddin Yassin calling for a gradual relaxation of the movement control order (MCO) measures currently being implemented to combat the spread of Covid-19.’

Read here (Malaysiakini, April 10, 2020)

John Hopkins produces a 15-page ‘national plan to enable comprehensive COVID-19 case finding and contact tracing in the US’

It says ‘to manage COVID-19 epidemics going forward, communities in the United States need:

1. Ready access to rapid diagnostic tests for all symptomatic cases or those with a reasonable suspicion of COVID-19 exposure;
2. Widespread serological testing to understand underlying rates of infection and identify those who have developed immunity and could potentially return to work or school without fear of becoming infected; and
3. The ability to trace all contacts of reported cases.’

Download here (John Hopkins Center for Health and Security, April 10, 2020)

UK government urged to investigate coronavirus deaths of BAME doctors with ‘disproportionate severity of infection’: They often feel 'bullied and harassed'

‘Among the factors he speculated could be contributing was whether BAME [black, Asian and minority ethnic] doctors felt less able to complain about inadequate personal protective equipment (PPE) – a recurring complaint among healthcare workers during the crisis – thereby putting themselves in danger.

“BAME doctors often feel bullied and harassed at higher levels compared to their white counterparts,” he said. “They are twice as likely not to raise concerns because of fears of recrimination”.’

Read here (The Guardian, April 10, 2020)

Health insecurity and its impact on refugees in Malaysia

Refugees and asylum seekers in Malaysia have always struggled with a lack of identification and healthcare. How have these issues impacted the Government’s response to Covid-19? What are some of the challenges that will still need to be addressed beyond the MCO?

Read here (ISIS Malaysia, April 10, 2020)

Report of special survey on effects of COVID-19 on economy & individual - Round 1

‘This report provides a summary of findings Special Survey “Effect of Covid-19 on the Economy and Individual” - Round 1, was conducted online by the Department of Statistics, Malaysia for the period 23rd - 31 March 2020. This survey consists of 3 modules and 21 questions. A total of 168,182 respondents aged 15 years and above has participated in this survey. The analysis presented are based on respondent’s feedback that includes qualitative personal opinion on economics, employment and spending pattern.’

Read here (Department of Statistics Malaysia, DOSM, April 10?, 2020)

Why blood from coronavirus survivors could be a lifeline for the sick

A growing number of hospitals are investigating antibody testing and blood plasma therapy as a way to combat the new coronavirus in sick patients. WSJ’s Daniela Hernandez explains in a video.

View video here (Wall Street Journal, April 10, 2020)

Iceland study confirms a great fear: 50% asymptomatic

‘Among the Nordic nation's findings: about half of its citizenry at any given time who have coronavirus but don't know it, will be asymptomatic – a large percentage many experts studying the virus have suspected, but have had little firm data to corroborate. The US Centers for Disease Control has previously estimated that about 25% of people infected with coronavirus may be asymptomatic.’

Read here (USA Today, April 10, 2020)

Cruising ban now extended for months! What you need to know

COMMENT: This will affect all industries related to tourism and hospitality. The hotel and travel industries in general may learn a bit from the 7 requirements to address before the cruising ban will be lifted. 

‘On 9 April 2020, the USA CDC (Center for Disease Control) issued an updated “no-sail cruise ban” for cruise lines and ships operating in and out of USA ports and waters. This strong ruling suggests cruising will be prohibited in and out of the USA until at least 18 July 2020, and probably longer. The lift of the cruise ban is also subject to the CDC agreeing cruise lines proposal on how to address at least 7 major areas and issues, which could significantly change the facilities and way that cruising operates. In this video, I explore the ban including (1) how long the order looks to ban cruising, (2) why they are taking such a strong stance and (3) the 7 things that cruising have to address and convince them on before the cruising ban will be lifted.’

View here (Tips for Travellers, Youtube, April 10, 2020)

Hong Kong’s edge over Singapore shows early social distancing works

‘The diverging outcomes in Hong Kong and Singapore -- which are still handling the virus far better than many other advanced economies -- show how early and strict social distancing measures may be more beneficial to the economy over the long term. In Europe and the US, politicians are now mulling lifting lockdowns to revive their economies, even as health experts caution against relaxing too soon.’

Read here (Bloomberg, April 10, 2020)

I’ve read the plans to reopen the economy. They’re scary. There is no plan to return to normal

‘Over the past few days, I’ve been reading the major plans for what comes after social distancing. You can read them, too. There’s one from the right-leaning American Enterprise Institute, the left-leaning Center for American Progress, Harvard University’s Safra Center for Ethics, and Nobel Prize-winning economist Paul Romer.

‘I thought, perhaps naively, that reading them would be a comfort — at least then I’d be able to imagine the path back to normal. But it wasn’t. In different ways, all these plans say the same thing: Even if you can imagine the herculean political, social, and economic changes necessary to manage our way through this crisis effectively, there is no normal for the foreseeable future. Until there’s a vaccine, the US either needs economically ruinous levels of social distancing, a digital surveillance state of shocking size and scope, or a mass testing apparatus of even more shocking size and intrusiveness.’

Read here (Vox, April 10, 2020)

Prepare for the ultimate gaslighting

A massive campaign to return to normality is on the way, however, this writer implores his fellow citizens to listen: ‘From one citizen to another, I beg of you: Take a deep breath, ignore the deafening noise, and think deeply about what you want to put back into your life. This is our chance to define a new version of normal, a rare and truly sacred (yes, sacred) opportunity to get rid of the bullshit and to only bring back what works for us, what makes our lives richer, what makes our kids happier, what makes us truly proud...

‘We are a good people. And as a good people, we want to define — on our own terms — what this country looks like in five, 10, 50 years. This is our chance to do that, the biggest one we have ever gotten. And the best one we’ll ever get.’

Read here (Medium, April 10, 2020)

Drugmaker Gilead Sciences funds study on "compassionate use of Remdesivir for patients with severe Covid-19" showing positive results

‘In this cohort of patients hospitalised for severe Covid-19 who were treated with compassionate-use remdesivir, clinical improvement was observed in 36 of 53 patients (68%). Measurement of efficacy will require ongoing randomised, placebo-controlled trials of remdesivir therapy. (Funded by Gilead Sciences.)’

In this short conclusion in its introduction, the paper published by the New England Journal of Medicine, mentions specifically who funded it.

Read here (New England Journal of Medicine, April 10, 2020)

Stanford University epidemiologist John Ioannidis calls out media for panicking the public over COVID-19, reasons that ‘flattening the curve’ may make things worse for overall health system

‘Flattening the curve to avoid overwhelming the health system is conceptually sound—in theory,’ he wrote in a paper in March. ‘A visual that has become viral in media and social media shows how flattening the curve reduces the volume of the epidemic that is above the threshold of what the health system can handle at any moment. Yet if the health system does become overwhelmed, the majority of the extra deaths may not be due to coronavirus but to other common diseases and conditions such as heart attacks, strokes, trauma, bleeding, and the like that are not adequately treated,’ he continued. ‘If the level of the epidemic does overwhelm the health system and extreme measures have only modest effectiveness, then flattening the curve may make things worse… Instead of being overwhelmed during a short, acute phase, the health system will remain overwhelmed for a more protracted period. That’s another reason we need data about the exact level of the epidemic activity.’

Read here (Straight, April 10, 2020)

Leaders in Africa, South Asia, and Latin America need to look carefully at alternative policies

‘Some possibilities include:

• A universal mask-wearing requirement when workers leave their homes (as masks and homemade face coverings are comparatively cheap, and such a policy is likely feasible for almost all countries to implement); 
• Targeted social isolation of the elderly and other at-risk groups, while permitting productive individuals with lower-risk profiles to continue working; 
• Improving access to clean water, hand-washing, and sanitation, and other policies to decrease the viral load; and 
• Widespread social influence and information campaigns to encourage behaviours that slow the spread of disease but do not undermine economic livelihoods. This could include restrictions on the size of religious and social gatherings or programs to encourage community and religious leaders to endorse safer behaviours and communicate them clearly.’

Read here (Foreign Policy, April 10, 2020)

For the record: MMA's open letter to the Rt Honourable Prime Minister of Malaysia

This letter, signed by the president of the Malaysian Medical Association (MMA), and 12 past ones, says ‘a stepwise relaxation of movement control will be the way forward. For instance, businesses may be allowed to operate with strict guidelines on how many people can be on the premises. Public transport may have to operate with limited loads, with frequent disinfection. Solitary public exercise will have to be permitted, to allow for mental and physical health issues. In all cases, strict hand hygiene and physical distancing must be observed, with masks if necessary. Interstate travel may need to be restricted, but will have to be prioritised for economic needs rather than personal.’

Read here (MMA, April 9, 2020)

Does coronavirus survive even longer in your fridge or freezer?

• Viruses similar to the novel coronavirus have demonstrated an ability to live for extended periods of time in cooler temperatures.
• Past studies have shown that these viruses can live up to a month in temperatures similar to that of a household refrigerator.
• The virus is also believed to be capable of surviving after being frozen, which means it could also persist in the environment of a household freezer.

Read here (BGR, April 10, 2020)

How rituals and focus can turn isolation into a time for growth

‘Joan and I banished the feeling that we had fallen into limbo by reconstructing our daily activities. By celebrating shared experiences and intensifying attention to mundane tasks, we filled those moments with passion and awareness. Exercise, cooking, eating, reading, work and even watching the news became more deliberate components of our daily ritual, giving us happy moments to look forward to, creating a mood of anticipation rather than paralysis. In a time of randomness and uncertainty, it made us feel proactive instead of reactive.’

Read here (Wall Street Journal, April 9, 2020)

Ray Dalio discusses depression economics and what to expect

Ray Dalio, "Global Macro Investor", philanthropist and founder of the world's largest hedge fund, understands deeply the inner workings of the world economy. In this 52-minute interview with Corey Hajim and Chris Anderson of TED, he mentions the following:

1. The world is going through a massive stress test, akin to the 1930s, when there would be widespread economic collapse, money printing and subsequent restructuring. Wealth will be redistributed but the levers of power will decide how it would be (within nations and internationally). This will cause a lot of friction, even wars.
2. Even today, there is demonisation of "others" even if they are being helpful. For example, while China is helping many countries, anyone holding such views can be ostracised in the US.
3. It is an opportunity to reform capitalism to create more equal opportunities, greater harmony, more innovation and more productivity via universal education.
4. Companies that win will be those that provide basic needs and those that are adaptive and creative. Algorithmic thinking, especially in investment, will give way to more human interventions and creative input.
5. For the individual investor, he calls for humility and diversification, and not to try to time the market. Cash, he stresses, is not good investment.

View here (TED, April 9, 2020)

Cambridge researchers identify 3 variants of Covid-19, say their methods could be used to help identify undocumented infection sources

‘Researchers from Cambridge, UK, and Germany have reconstructed the early “evolutionary paths” of COVID-19 in humans – as infection spread from Wuhan out to Europe and North America – using genetic network techniques... ‘Study charts the “incipient supernova” of COVID-19 through genetic mutations as it spread from China and Asia to Australia, Europe and North America. Researchers say their methods could be used to help identify undocumented infection sources... The research revealed three distinct “variants” of COVID-19, consisting of clusters of closely related lineages, which they label “A”, “B” and “C”.’

Read here (Cambridge Research News, April 9, 2020)

WHO initiates a SOLIDARITY trial for vaccine

‘Recognising the critical importance to world health of the rapid availability and deployment of effective vaccines against COVID-19, this large, international, multi-site, individually randomised controlled clinical trial will enable the concurrent evaluation of the benefits and risks of each promising candidate vaccine within 3-6 months of it being made available for the trial.

‘Its goal is to “coordinate evaluation of the many preventive candidate SARS CoV-2 vaccines under development, to evaluate promptly, efficiently and reliably their safety and efficacy, enabling assessment of whether any are appropriate for deployment to influence the course of the pandemic”.’ 

Read here (WHO, April 9, 2020)

How ‘bureaucratic inertia and disinterest’, an ‘alphabet soup of overlapping authority’, ignoring early warnings and muddled decision-making delayed coronavirus testing in the US

‘...Over January and February, agencies within the Department of Health and Human Services not only failed to make early use of the hundreds of labs across the United States, they enforced regulatory roadblocks that prevented non-government labs from assisting, according to documents obtained by CNN, and interviews with 14 scientists and physicians at individual laboratories and national laboratory associations.

‘When the CDC stumbled out of the blocks in early February, releasing a flawed test that took it weeks to correct, labs across the country had been effectively sidelined. Many public health labs were waiting for the revised CDC tests, while commercial and clinical labs were barred from conducting their own tests unless they went through a complex, slow process of applying for their own "emergency use authorisation" from the US Food and Drug Administration.

‘As a result, the government squandered a critical month during which aggressive and widespread testing might greatly have reduced the speed and scale of the pandemic.’

Read here (CNN, April 9, 2020)

Coronavirus replicates in throat making it easy to transmit, German scientists say

‘Pathogen that causes Covid-19 does not have to travel to the lungs to replicate, researchers say. High viral load in the throat at the onset of symptoms suggests people with Covid-19 are infectious very early on, they say.’

Read here (South China Morning Post, April 9, 2020)

Does COVID-19 prove women are best suited to lead in a crisis?

‘According to American professors Jacqueline and Milton Mayfield, “effective leader talk” requires “direction-giving”, “meaning-making” and “empathetic language” – capabilities that become existentially critical in a time of national distress and crisis, all of which both Johnson and Trump are lacking.’

Read here (Byline Times, April 9, 2020)

Trump is creating a ‘dangerous situation’ by promoting an unproven coronavirus treatment, according to an expert on misinformation

‘President Donald Trump’s promotion of an unproven coronavirus treatment is creating a “dangerous situation,” according to misinformation expert Lisa Fazio. Trump has repeatedly talked up the potential benefits of anti-malaria drug chloroquine and the more widely used hydroxychloroquine despite a lack of clinical evidence showing that either are effective against COVID-19. His enthusiasm has helped fuel a surge in demand that’s led to a shortage, making it hard for people who rely on the drugs to treat non-coronavirus conditions to fill their prescriptions. Trump’s endorsement is particularly worrisome given the amount of misinformation already surrounding the coronavirus, Fazio told Business Insider.’

Read here (Business Insider, April 9, 2020)

Covid-19 and healthcare's guerrilla warfare

‘Since the Peninsular War in the early 1800s we have recognised guerrillas – the Viet Cong, the Tamil Tigers, and recently, the Taliban – frustrate and humiliate larger forces by discretely invading territories, co-opting locals and being seemingly resistant to traditional warfare offensives. Equally, our public health institutes, gleaming hospital buildings, expensive diagnostic machines, a legion of administrators and medical personnel have been humbled (and humiliated) by this virus. Our fragmented healthcare industry is now united by a microscopic organism, as competing systems share laboratory testing and treatment protocols while hospital leadership cross battle lines to share guarded patient census and drug availability information.’

This is a most personal and touching account by a doctor on the frontline in the US. Dr Avinesh S Bhar, now in Georgia, grew up in Kuala Lumpur.

Read here (SLIIP, April 9, 2020)

Kerala’s Covid-19 approach: Less disruptive, less costly and more effective than most others

‘Some key features of Kerala’s response, undertaken by a government with very limited fiscal resources, are instructive:

1. All-of-government approach: involving a range of relevant state government ministries and agencies to design measures to improve consistency, coordination and communication, and to avoid confusion.
2. Whole-of-society approach: wide community consultations, including experts, to find the most locally appropriate modes of limiting infections, along with means to monitor and enforce them.
3. Social mobilisation: communities were provided essential epidemiological information to understand the threat and related issues, ensure compliance with prescribed precautionary measures, and avoid panic.
4. No one left behind: adequate supply of essential commodities, particularly food and medicines, has been ensured, especially to protect the most vulnerable sections of society.’

Read here (IPS News, April 9, 2020)

‘Dignity not destitution: An ‘economic rescue plan for all’ to tackle the Coronavirus crisis and rebuild a more equal world’. A paper by Oxfam

Oxfam calls for US$2.5 trillion plan to tackle the pandemic and prevent global economic collapse in a paper:

‘New analysis shows the economic crisis caused by coronavirus could push over half a billion people into poverty unless urgent and dramatic action is taken... We can only beat this virus through coming together as one. Developing countries must act to protect their people, and demand action from rich nations to support them. Rich country governments must massively upscale their help – led by the G20. This paper lays out an Economic Rescue Plan For All that meets the scale of the crisis, mobilising at least $2.5 trillion dollars to tackle the pandemic and prevent global economic collapse. It prioritises helping people directly: giving cash grants to all who need them. An immediate suspension of the debt payments of poor countries, combined with a one-off economic stimulus by the IMF and an increase in aid and taxes, can pay for this.’

Download here (Oxfam, April 9, 2020)

Many Malaysians say not financially prepared for an extended MCO — Survey released by the Department of Statistics Malaysia (DOSM)

‘Generally, more than half of survey respondents (52.6%) said they were most affected when it came to financial savings, whereas 6.2% said they were least affected. Two-thirds or 71.4% of self-employed respondents said they have sufficient savings for less than one month.’

Read here (The Edge, April 9, 2020)

A toxic ‘infodemic’: The viral spread of COVID-19 conspiracy theories

‘Like other businesses impacted by the crisis, social media companies’ daily operations have also been upended by social distancing protocols. With content reviewers working from home, platforms are relying far more heavily on artificial intelligence technologies to flag and remove problematic content, which has already resulted in a wave of erroneous enforcement actions.

‘Another part of the problem seems to be a lack of high-level coordination, said Wardle, as certain virus-related posts have been banned on some platforms but permitted on others. “It’s a whack-a-mole approach,” she said, “and it’s nowhere near enough”.’

Read here (Huffington Post, April 8, 2020)

First-wave COVID-19 transmissibility and severity in China outside Hubei after control measures, and second-wave scenario planning: a modelling impact assessment

‘We estimated the instantaneous reproduction number (Rt) of COVID-19 in Beijing, Shanghai, Shenzhen, Wenzhou, and the ten Chinese provinces that had the highest number of confirmed COVID-19 cases; and the confirmed case-fatality risk (cCFR) in Beijing, Shanghai, Shenzhen, and Wenzhou, and all 31 Chinese provinces. We used a susceptible–infectious–recovered model to show the potential effects of relaxing containment measures after the first wave of infection, in anticipation of a possible second wave.

‘In all selected cities and provinces, the Rt decreased substantially since Jan 23, when control measures were implemented, and have since remained below 1. The cCFR outside Hubei was 0·98% (95% CI 0·82–1·16), which was almost five times lower than that in Hubei (5·91%, 5·73–6·09). Relaxing the interventions (resulting in Rt >1) when the epidemic size was still small would increase the cumulative case count exponentially as a function of relaxation duration, even if aggressive interventions could subsequently push disease prevalence back to the baseline level.’

Read here (The Lancet, April 8, 2020)

“If you insist on every single contractual right... that will suck the life out of the economy”

Singapore passed a new bill that gives temporary relief to businesses and individuals if they are unable to fulfill their contractual obligations due to the coronavirus outbreak such as paying rent. “If you insist on your minutest every single contractual right at this point, that will suck the life out of the economy. You have got to protect everyone,” Singapore’s minister for home affairs, K Shanmugam said.

Read here (CNBC, April 8, 2020)

Dr Amar Singh on life after Covid-19 and other personal beliefs

In this 20-minute interview, Dr Amar Singh talks about his background and experience, who his co-author Dr Lim Swee Im is and life after Covid-19, detailing three exit strategies. He also delves into what the government should do and the type of leadership needed. On a more personal level, he discusses (a) why people should not chase the usual success markers: money, power and fame (b) why belief matters, and (c) ‘life is short, live “death days”…

Amar is a columnist with Malay Mail Online on Covid-19. He is a retired paediatrician, public health practitioner, columnist and avid birdwatcher. This video is part of a series ‘Do More: Take control of your life’ created by former staffer of The Edge, Khoo Hsu Chuang.

View here (Do more, YouTube, April 8, 2020). Listen to podcast here

Wuhan opens up

‘The months-long lockdown in the city of Wuhan in China's Hubei province - where the coronavirus pandemic started - has been lifted. Anyone who has a “green” code on a widely used smartphone health app is now allowed to leave, for the first time since 23 January. Train, road and rail connections have now been re-established. It comes after China reported no deaths on Tuesday, the first time since it began publishing figures.’

Read here (BBC, April 8, 2020)

Study finds link between low Vitamin D levels in people and higher mortality and higher occurrence of Covid-19; suggests supplementation

Vitamin D has already been shown to protect against acute respiratory infections. This study aimed to assess the association between the mean levels of Vitamin D in people in various countries and (1) the mortality rate of Covid–19 and (2) the number of cases of the disease.

It finds a positive correlation and says: ‘Vitamin D levels are severely low in the ageing population especially in Spain, Italy and Switzerland. This is also the most vulnerable group of population for Covid-19’. It concludes: ‘We advise Vitamin D supplementation to protect against SARS-CoV2 infection’.

Read here (Research Square, April 8, 2020)

Amartya Sen: Overcoming a pandemic may look like fighting a war, but the real need is far from that

‘Tackling a social calamity is not like fighting a war which works best when a leader can use top-down power to order everyone to do what the leader wants — with no need for consultation. In contrast, what is needed for dealing with a social calamity is participatory governance and alert public discussion.’

Read here (Indian Express, April 8, 2020)

Six points from Dr Amar Singh's article: ‘To understand our epidemic stop looking at daily Covid-19 numbers’

(1) Only 20% of the 11,500 daily test capacity we have are used to look for community spread. “The remainder are used to re-test confirmed cases with a view to determine discharge ability, treatment response and possibly repeated tests for suspected cases that are negative the first time (polymerase chain reaction (PCR) tests depends on quality of the sample and have only 60-70 per cent positivity for nasal swabs or sputum).”

(2) The number tested positive (daily or cumulative) is dependent on the number of tests we conduct. Some modelling studies estimate the actual number in any country to be 10 times that.

(3) If we used death rate and assumed 1 death per 100, we would have 6,200 cases (as at April 6) but this figure is distorted by other factors. E.g. we could have missed out counting Covid-19 among other pneumonia cases. Pneumonia accounts for 11.8% of deaths in Malaysia or 390 per week.

(4) There are two lag times that affect the figures: (a) First, “it takes about 7-14 days before an infected person presents clinically. It takes another 7-14 days before illness severity and dying (ventilation and ICU care).” (b) Second, there is a backlog of testing. “Some say it takes 5-7 days to get results. Even health care staff that have potentially been exposed may have to wait for 4-5 days to get their status known.”

(5) We have community spread: “From MoH Influenza-Like Illness (ILI) & Severe Acute Respiratory Infection (SARI) surveillance that is conducted at selected sites, about 1.2 per cent of these patients have been Covid-19 positive in the past week. This indicates community spread, as these persons have no contact with known cases. We do not know how many patients with pneumonia and severe respiratory illnesses (influenza-like illness) we have missed in the past 4-6 weeks.”

Point 5 justifies a lockdown because, given community spread, gatherings of people could become “transmission amplification events”.

(6) We need to do more to protect our front-line workers. “Many staff have had to rely on homemade (not all reliable) or donated PPE. We are still struggling with the distribution of national PPE supplies. Even as far back as March 20, MoH reported that 15 HCPs had been infected by Covid-19 as part of their work.”

Read here (Malay Mail, April 7, 2020)

Hydroxychloroquine or else! Trump threatens India

‘India, the world’s main supplier of generic drugs, said on Tuesday it will allow limited exports of the anti-malaria drug hydroxychloroquine that US President Donald Trump has touted as a potential weapon in the fight against the coronavirus.

‘The Indian government had put a hold on exports of hydroxychloroquine as well as on the pain reliever, paracetamol, saying stocks were depleting because of the hit to global supply chains after the coronavirus emerged in China late last year.

‘But Trump spoke to Prime Minister Narendra Modi over the weekend seeking supplies and on Monday said India may face retaliation if it didn’t withdraw the ban on exports.’

Read here (Reuters, April 7, 2020)

Austria and Denmark are first to announce easing of coronavirus lockdowns

Austria and Denmark are first to announce easing of coronavirus lockdowns

Austrian Chancellor Sebastian Kurz credited his country’s early response [to the virus]; it imposed a national lockdown on March 16, earlier than some of its neighbours. “We reacted faster and more restrictively in Austria than in other countries and were therefore able to prevent the worst from happening so far...” Austria has seen three consecutive days in which the number of coronavirus recoveries have exceeded the number of new cases.

Denmark also imposed its lockdown relatively early, on March 11, and invested in widespread testing. Announcing the plan for lifting restrictions, Danish Prime Minister Mette Frederiksen said, “It’s like walking on a line. If we stand still along the way, we can fall. If we go too fast, things can go wrong. Therefore, we must take one cautious step at a time. And we do not yet know when we have firm ground under our feet.”

Read here (Washington Post, April 7, 2020)

How are people being infected with COVID-19? A lot we still do not know

‘The new coronavirus has upended all of our usual calculus about seemingly ordinary activities. Is running past someone on the street safe? How about shopping in a grocery store with a 6-foot (2 meters) distance? And what about packages and takeout? And which of these activities poses the biggest risk?

Three types of transmission are discussed: Respiratory, aerosol and contact. ‘Unfortunately, there's a lot we still don't know about the way the virus that causes COVID-19 spreads.’

Read here (Live Science, April 7, 2020)

Media consumption in the age of Covid-19

‘Due to the frenzy of pandemic-induced quarantines, media consumption has seen a massive increase. But what exactly are people doing, and how are they staying informed? GLOBAL WEB INDEX surveyed almost 4,000 internet users between the ages of 16-64 across the US and the UK to find out how the COVID-19 outbreak has changed their media consumption.’

Read here (Visual Capitalist, April 7, 2020)

Towards a market structure that serves the greater good

‘This crisis lays bare the myth of the invincibility of the market. Market has broken down in a big way and the state is asked to step in to solve this crisis – from bail out of companies, to paying wages of workers, to cutting interest rates, soft and loans to small business guaranteed by the state etc.

‘Markets will continue to exist and play a part in the economy. But it must be subordinated to society, to be regulated by the state to serve a greater good. For market to function well as a public good, it must not only be free but also fair. Both attributes are equally important, like the two wings of birds. The new economy must prioritise people’s as well as nature’s wellbeing over profit making for a few.’

Read here (IPS News, April 6, 2020)

Will Covid-19 remake the world?

‘Covid-19 may well not alter – much less reverse – tendencies evident before the crisis. Neoliberalism will continue its slow death. Populist autocrats will become even more authoritarian. Hyper-globalization will remain on the defensive as nation-states reclaim policy space. China and the US will continue on their collision course. And the battle within nation-states among oligarchs, authoritarian populists, and liberal internationalists will intensify, while the left struggles to devise a program that appeals to a majority of voters.’

Read here (Project Syndicate, April 6, 2020)

Key food prices on the up: Hopefully they are short-term spikes

‘Rice and wheat -- crops that account for about a third of the world’s calories -- have been making rapid climbs in spot and futures markets. For countries that rely on imports, this is creating an added financial burden just as the pandemic shatters their economies and erodes their purchasing power. In Nigeria, for example, the cost of rice in retail markets soared by more than 30% in the last four days of March alone...

‘To be clear, it’s likely the supply disruptions could prove temporary. And that will probably mean that wheat and rice will stabilise. In the last several years, food costs have been relatively benign thanks to plentiful supplies. Global rice and wheat reserves are both projected at all-time highs, according to the US Department of Agriculture.’

Read here (Bloomberg, April 6, 2020)

Why smart people believe coronavirus myths

From students to politicians, many smart people have fallen for dangerous lies spread about the new coronavirus. Why? And how can you protect yourself from misinformation? The following are some points from this story:

(1) ‘Truthy fakes’ within the information overload: “Purveyors of fake news can make their message feel ‘truthy’ through a few simple tricks, which discourages us from applying our critical thinking skills – such as checking the veracity of its source. As the authors of one paper put it: ‘When thoughts flow smoothly, people nod along’... ‘The simple presence of an image alongside a statement increases our trust in its accuracy – even if it is only tangentially related to the claim.’
(2) Repetition of a statement – whether the same text, or over multiple messages – can increase the “truthiness” by increasing feelings of familiarity, which we mistake for factual accuracy. So, the more often we see something in our news feed, the more likely we are to think that it’s true – even if we were originally sceptical.
 (3) ‘Cognitive miserliness’ (some of us possess substantial mental reserves, but don’t ‘spend’ them) renders us susceptible to many cognitive biases, and it also seems to change the way we consume information (and misinformation).

Matthew Stanley, Duke University in Durham, North Carolina: ‘...around 13% of US citizens believed this theory [that Covid-19 was a hoax], which could potentially discourage hygiene and social distancing... “We need more communications and strategy work to target those folks who are not as willing to be reflective and deliberative.”

Read here (BBC, April 6, 2020)

Hurrah to The Atlantic for focus on must-read stories about Covid-19

The Atlantic had a very good March. In an email to his staff, editor-in-chief Jeffrey Goldberg announced:

‘We have never, in the 163-year history of this magazine, had an audience like we had in March: 87 million unique visitors to our site, and more than 168 million pageviews. The number of unique visitors is astonishing — more than double the previous one-month record. But the most notable statistic, the one with possibly the greatest salience for The Atlantic’s future, is this: Your work has brought in more than 36,000 new subscribers over the past four weeks, even as we have lifted paywall restrictions on our coronavirus coverage.’

Those traffic numbers are very impressive. To put them in context, 87 million uniques is not far off what The New York Times (118 million in January, per Comscore), Fox News (104 million), The Washington Post (92 million), or the Daily Mail (89 million) might get in a normal, non-COVID-19 month. (The Atlantic’s media kit cites 33.7 million uniques as of a year ago, March 2019.)

Read here (Nieman Lab, April 6, 2020)

Free book on coronavirus for primary schoolchildren

Axel Scheffler has illustrated a digital book for primary school age children, free for anyone to read on screen or print out, about the coronavirus and the measures taken to control it. Published by Nosy Crow, and written by staff within the company, the book has had expert input: Professor Graham Medley of the London School of Hygiene & Tropical Medicine acted as a consultant, and the company also had advice from two head teachers and a child psychologist.

Download here (Nosy Crow, April 6, 2020)

Covering a pandemic: Ian Bremmer explores the media's handling of the coronavirus pandemic

‘In this week’s episode, Ian Bremmer explores the media's handling of the coronavirus pandemic, and President Trump’s treatment of journalists. With guest Ben Smith, media columnist at The New York Times and former head of Buzzfeed News, the show looks at global coverage of COVID-19, including misinformation campaigns and social media’s role in society today. Later in the program, meet Danny Rogers of The Global Disinformation Index. His group is working hard to find harmful or misleading information online and alert major publishers and tech platforms.’

View here: (GZeroMedia, Youtube, April 6, 2020)