MOH Malaysia lists six criteria for lifting MCO and help develop a ‘soft landing’ exit strategy

The Ministry of Health Malaysia (MOH) has listed six criteria to lift the MCO and help achieve a ‘soft landing’ for the nation amidst the Covid-19 crisis:

1. Strict border control: “If we open our borders then people will start coming in and there’s a big possibility they may have the virus.”
2. Single-digit number of cases: Only when cases start to fall in the single-digit can the government seriously consider lifting the MCO
3. Having a good health system and improving testing standards: Look carefully at e.g. (a) testing capability of labs (b) if we have enough wards and intensive care units. Raise the detection standards from say 48 hours to 24 hours or less.
4. Capability to look after high-risk groups — the handicapped, elderly, and those with co-morbidity illnesses, including patients receiving hospital treatment like chemotherapy
5. (5) Adherence to new social norms: “Putrajaya needs to study this and instil in Malaysians’ minds that following social distancing, washing hands frequently and avoiding crowding around each other is the way to go moving forward.”
6. (6) Community cooperation in infected areas: Identify infected areas and get their communities to work with MOH and the relevant authorities to make sure the virus doesn’t spread again.

Read here (The Malay Mail, April 21, 2020)

Has the pandemic accelerated the growth of technology?

The global health crisis has opened the door for a bigger role of technology, assisting efforts in fighting COVID-19 and helping citizens adapt to a new way of life. As opportunities unfold, technology – being a double-edged sword – is also acting as a conduit for those wanting to take advantage of the crisis. Moving forward, cautious steps are vital as technological emergency measures could also expose citizens to vulnerabilities that violate human rights and privacy.

Read here (ISIS Malaysia, April 21, 2020)

Undaunted by COVID-19 and border controls, Malaysian mums in Singapore send around 3,000kg of breast milk to babies back home

‘Just as the women exhausted all possible channels and nearly lost hope in late March, a Malaysia-based forwarder agreed to help them, first with 20 boxes of frozen breast milk from Singapore to Johor at a small fee of S$10 on Mar 29, and then another 20 boxes to states farther away two days later. The maximum weight for each box is 20kg... The mums were elated, and at the same time anxious about when their turn would come. Luck was on their side when one of them approached Johor’s Stulang assemblyman Andrew Chen Kah Eng for help... Never in history has a large quantity of frozen breast milk been brought over the Causeway in such a manner, the Democratic Action Party politician claimed. Usually, mothers just bring their own breast milk across the border as part of their personal luggage.’

Read here (Channel News Asia, April 21, 2020)

The role of banks in a pandemic

Piyush Gupta, Group CEO, DBS Bank: ‘The scale of the pandemic is such that it cannot be left to governments to find resolution on their own. And the truth is that private sector corporations are some of the biggest actors on the world stage, and have an ability to carry influence across borders. There is also no real conflict between shareholder and stakeholder interests. The issue is one of timeframes. While there may be some trade-offs between maximising shareholder returns and providing societal benefits in the short term, addressing broader issues in society is completely consistent with shareholder interests in the long term.’

Read here (LinkedIn, April 21, 2020)

Covid-19 has a grandma, grandpa and great grandpa. Where are they?

‘In an unusual move last weekend, China’s envoy to Moscow, Zhang Hanhui highlighted that the whole story about Covid-19 is only unfolding and there are surprises in store for the world community.  It is inconceivable that Ambassador Zhang spoke without the knowledge of Beijing. Significantly, the Chinese envoy chose the Russian state news agency Tass for making some startling disclosures.’ The Tass story is entitled “Ambassador says coronavirus imported to China, points to genetic sequence as proof”.

Read here (Indian Punchline, April 21, 2020)

County of Santa Clara identifies three additional early COVID-19 deaths -- much earlier than the one on March 9, 2020, originally thought to be the first in the US

‘The County of Santa Clara Medical Examiner-Coroner has identified three individuals who died with COVID-19 in Santa Clara County before the COVID-19 associated death on March 9, 2020, originally thought to be the first death associated with COVID-19 in the county.

‘The Medical Examiner-Coroner performed autopsies on two individuals who died at home on February 6, 2020 and February 17, 2020. Samples from the two individuals were sent to the Centers for Disease Control and Prevention.  Today, the Medical Examiner-Coroner received confirmation from the CDC that tissue samples from both cases are positive for SARS-CoV-2 (the virus that causes COVID-19).’

Read here (Santa Clara County Public Health, April 21, 2020)

Coronavirus is accelerating eight challenging mega trends

‘...be in no doubt, as the long days at home seem to pass ever so slowly: in its effect on societies, politics and the distribution of power in the world, COVID-19 is on track to be the Great Accelerator.’

1. Eurozone existential crisis: ‘To put it crudely, Italians will not work as productively as Germans, and Germans will not agree to pay off the debts of Italians.’ 
2. Trans-Pacific tensions: ‘...the process of “deglobalisation” - more of what we consume being made closer to home, even if it is more expensive - will accelerate.
3. Greater rise of the Asian tigers: ‘[Asia] was already going to account for 90 per cent of new middle-class people in the next decade. Perhaps we can revise that up to 95 per cent now.’
4. Oil price volatility: ‘Countries dependent on oil production already faced forecasts that petroleum demand would peak and fall before 2030.’ We have in recent days seen negative oil prices.
5. Politics of inequality: ‘It will push to the forefront of politics fundamental issues about the taxation of wealth, the case for basic incomes provided by governments, and the responsibility of companies for their employees.’
6. Debts: ‘Political parties will campaign for debt forgiveness and write-offs, and for the cancelling by central banks of money borrowed by governments, with inflationary consequences.’
7. Data: ‘Once we are all carrying around an app on our phones to show where we have been and who we have met, pressure will grow to use that information for other purposes.’
8. Crisis as the mother of innovation: ‘More optimistically, they have one positive companion - the massive incentive this crisis provides for innovation’

Read here (The Age, April 21, 2020)

Everything we know about coronavirus immunity and antibodies — and plenty we still don’t

‘But as the tests roll out, some experts are trying to inject a bit of restraint into the excitement that the results of these tests could, for example, clear people to get back to work. Some antibody tests have not been validated, they warn. Even those that have been can still provide false results. And an accurate positive test may be hard to interpret: the virus is so new that researchers cannot say for sure what sort of results will signal immunity or how long that armor will last.

‘They caution that policymakers may be making sweeping economic and social decisions — plans to reopen businesses or schools, for example — based on limited data, assumptions, and what’s known about other viruses. President Trump last week unveiled a three-phased approach to reopen the country; he said some states that have seen declining case counts could start easing social distancing requirements immediately. And some authorities have raised the idea of granting “immunity passports” to people who recover from the virus to allow them to return to daily life without restrictions.’

Read here (STAT News, April 20, 2020)

When Americans go back to work, things won't be the same... and what can be done

‘Modern manufacturing plants are very capital-intensive enterprises with a lower population density. And a typical factory is used to putting a premium on controlled work processes that are safety-driven. Many could open now.’

‘For the record, Caulkins thinks restaurants should stay open, too. But, with more creativity and flexibility from governments, he sees a pathway for millions of additional workers to soon join cooks and cashiers back at work with even greater safety than we have today. Even furniture and electronics stores are potential candidates.’

Read here (Futurity, April 20, 2020)

Learning how to dance - Part 1: A dancing masterclass, or what we can learn from countries around the world. Tomas Pueyo

‘A month ago we sounded the alarm with “Coronavirus: Why You Must Act Now”. After that, we asked countries to buy us time with “Coronavirus: The Hammer and the Dance” and looked in detail at the US situation with “Coronavirus: Out of Many, One. Together”, these articles have been viewed by over 60 million people and translated into over 40 languages.

‘This article will explain when, and how, we will dance. Specifically, we will discover:

• What can we learn from the experiences of countries around the world?
• What measures will we need to implement during the dance, so we can get back to a new normal? At what cost?
• How can we make them a reality?’

Read here (Medium, April 20, 2020)

Distance learning isn’t working: Instead of trying to move classes online, schools should support parents in educating their children

‘And is this how families want to be spending the next months? Sitting inside staring at a computer screen for six hours a day? Most adults have a hard time in online meetings for that long for one day; it’s completely unreasonable to expect it of a child for months on end. And it’s leading to behavior issues, too...

‘Schools can still play a constructive role, even if they aren’t holding online classes for kids stuck in their homes. Instead of spending time on online lessons and hours of videochats, schools need to provide a crash course in education for parents, provide loose individual lesson plans and suggestions, and operate as a help line...’

Read here (The Atlantic, April 20, 2020)

China ever vigilant with ‘stronger, more rigorous’ testing

‘China’s health authority called for a stronger and more rigorous testing regime to ensure that the new coronavirus does not escape detection, whether in travellers arriving from abroad or from other parts of the country. All localities must improve their testing capabilities, including those at border crossings, and report any epidemic information in a timely manner, the National Health Commission cited its director Ma Xiaowei as saying. Ma made the comments on Saturday, but they were released by the ministry on Monday.

‘China, where the new virus emerged late last year, reported 12 new confirmed cases on April 19, the lowest since March 13. Despite the downtrend, officials remain concerned about the re-emergence of local transmissions in parts of the country, including Beijing, where a central district has been re-classified as high-risk following three recent local infections.’

Read here (Reuters, April 20, 2020)

The relation between media consumption and misinformation at the outset of the SARS-CoV-2 pandemic in the US

‘A US national probability-based survey during the early days of the SARS-CoV-2 spread in the US showed that, above and beyond respondents’ political party, mainstream broadcast media use (e.g., NBC News) correlated with accurate information about the disease’s lethality, and mainstream print media use (e.g., the New York Times) correlated with accurate beliefs about protection from infection. In addition, conservative media use (e.g., Fox News) correlated with conspiracy theories including believing that some in the CDC were exaggerating the seriousness of the virus to undermine the presidency of Donald Trump. Five recommendations are made to improve public understanding of SARS-CoV-2.’

Read here (Harvard Kennedy School Misinforrmation Review, April 20, 2020)

Download 24-page PDF here

Could the power of the sun slow the coronavirus?

‘Dr. Merow said that although the lethal effects of ultraviolet light on viruses are well-known, he and his colleague were surprised to find a seasonal drop evident on a global scale... Dr. Merow said he and his colleague had mined existing studies on how environmental and ecological factors correlate with virus infection rates and used them in ecological modeling of the global repercussions. Global data on temperatures, humidity, the penetration through the atmosphere of sunlight’s ultraviolet rays, population ages and densities, and Covid-19 infection counts were combined into a computer model that mapped out the seasonal trends, he said. Dr. Merow noted that the study’s range of uncertainty was considerable, such that, depending on the location within the United States, the chance of seeing no viral slowdown in the summer ranged from 20 percent to 40 percent.’

Read here (New York Times, April 20, 2020)

David Nabarro underscores and defends WHO's role in the pandemic

With nation states across the world struggling to contain the coronavirus pandemic, there is an urgent need for an internationally coordinated response. That is where the UN agency the World Health Organisation should have a vital role to play, but right now the WHO is at the centre of a political storm. Donald Trump has withdrawn US funding, accusing the agency of being China-centric. Stephen Sackur speaks to WHO special envoy for Covid-19 David Nabarro. Is his organisation failing its greatest test?

View here (BBC, Youtube, April 20, 2020)

Coronavirus’s ability to mutate has been vastly underestimated, and mutations affect deadliness of strains, Chinese study finds

• The most aggressive strains of Sars-CoV-2 could generate 270 times as much viral load as the least potent type
• New York may have a deadlier strain imported from Europe, compared to less deadly viruses elsewhere in the United States

“Drug and vaccine development, while urgent, need to take the impact of these accumulating mutations … into account to avoid potential pitfalls.”.

Read here (South China Morning Post, April 20, 2020)

‘There is a reason the rest of India cannot be Kerala’

This is not a Covid-19 story, however, it gives the social backdrop to the state’s successful response to the virus... ‘Modern India has been trying to be more like Mumbai. It is raising congested cities out of villages, shrinking homes, building amoeba-shaped golf courses for a few and calling it progress. Instead, maybe India should try to be a Kerala? Modern Kerala, which is misunderstood as a communist region, is in reality a post-capitalist state. A lot of things have gone into the making of its character. Mere policy cannot transform the rest of India into Kerala.’

Read here (Live Mint, April 19, 2020)

Covid-19, ‘silent hypoxia’ and a simple way to identify patients sooner (even do it at home with a ‘pulse oximeter’)

‘We are just beginning to recognise that Covid pneumonia initially causes a form of oxygen deprivation we call “silent hypoxia” — “silent” because of its insidious, hard-to-detect nature...

‘There is a way we could identify more patients who have Covid pneumonia sooner and treat them more effectively — and it would not require waiting for a coronavirus test at a hospital or doctor’s office. It requires detecting silent hypoxia early through a common medical device that can be purchased without a prescription at most pharmacies: a pulse oximeter...

‘Pulse oximetry is no more complicated than using a thermometer. These small devices turn on with one button and are placed on a fingertip. In a few seconds, two numbers are displayed: oxygen saturation and pulse rate. Pulse oximeters are extremely reliable in detecting oxygenation problems and elevated heart rates.’

Read here (New York Times, April 20, 2020)

The hammer and the dance -- What the next 18 months can look like, if leaders buy us time

This second article by Tomas Pueyo, a follow-up to his ‘Coronavirus: Why you must act now’, is summarised as follows: ’Strong coronavirus measures today should only last a few weeks, there shouldn’t be a big peak of infections afterwards, and it can all be done for a reasonable cost to society, saving millions of lives along the way. If we don’t take these measures, tens of millions will be infected, many will die, along with anybody else that requires intensive care, because the healthcare system will have collapsed.’

In this article he deals with: (1) What’s the current situation? (2) What options do we have? (3) What’s the one thing that matters now: Time (4) What does a good coronavirus strategy look like? (4) How should we think about the economic and social impacts?

Read here (Medium, updated March 19, 2020)

Malaysia’s youth on the unemployed frontline: Five additional measures to effect reform

Story by Bridget Welsh & Calvin Cheng

‘These [existing] measures [to address the problems of youth unemployment] however are not enough. There is an urgent need to engage in meaningful reform to address underlying issues to ameliorate the negative impact of Covid-19. In keeping with our aim to offer constructive suggestions to address Covid-19, we offer five additional concrete ideas for consideration.

• First, the government can strengthen private-public sector partnerships through incentives to hire, retain and train young employees.
• Second, the government should consider ramping up training for younger Malaysians, not just those in the Klang Valley, but those in the states hardest hit by youth unemployment.
• Third, a rethink is needed on how to aid those young workers stuck in the low-paying jobs, with possible structured tax incentives for companies that offer training and advancement for employees to hire young workers who show promise.
• Fourth, while there have been important reforms in encouraging student debt repayment, including incentives for repayment, Covid-19 may provide an opportunity to consider broader measures of student debt relief based on need and debt restructuring.  
• Fifth, we need to appreciate that the social safety net in Malaysia is inadequate. The relief measures are tiny, compared to the scale of the economic downturn coming ahead, and the reality of being experienced now by those facing insecurity. 

Read here (Malaysiakini, April 18, 2020)

The Achilles heel of Malaysia’s Covid-19 battle

‘There is a major “Achilles Heel” in our Covid control programme that has yet not been addressed comprehensively – the six million or so migrant workers in our country, two-thirds of who are undocumented, and the majority of whom live in crowded unsanitary conditions.

‘The PSM has been advocating since March 19 that the government reaches out to this community and win their trust as our main weapons for containing Covid-19 – case identification, contact tracing, isolation of cases and contacts – will be resisted by the migrant community because they will be afraid that, after the two weeks of quarantine in a government facility, they might be charged for immigration violations, flogged, jailed and/or deported.’

Read here (Malaysiakini, April 18, 2020)

How did Britain get its coronavirus response so wrong? Three factors

Lack of long-term planning and ignoring experts: ‘When the investigations into the UK’s response to Covid-19 come to be written, there is widespread recognition among experts that this lack of long-term strategic planning will be at the centre of it. So too should be the need to ensure that the views of experts are fed into government more efficiently and widely.

Going on its own: ‘Britain was still doing quite well in containing the disease by testing, tracing contact and setting up quarantine for those suspected of being infected with Covid-19 at this time [February]. “Then, in March, the government decided to abandon this approach and shift from containing the disease to delaying its progress,” says Wingfield. “I would really like to know why the decision to give up testing and contact tracing was taken.”

Absence of social memory of epidemics: ‘One conclusion that experts are already drawing is that it was those countries close to China, with memories of Sars, or cultural ties to their neighbour, which were much faster to act in response to Covid-19. Perhaps most notable in its success was Taiwan...’

Read here (The Guardian, April 18, 2020)

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)