‘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)
Thursday 9 April 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)
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:
- 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.
- 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.
- Social mobilisation: communities were provided essential epidemiological information to understand the threat and related issues, ensure compliance with prescribed precautionary measures, and avoid panic.
- 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.’
‘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)
‘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)
Read here (The Edge, April 9, 2020)
Wednesday 8 April 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)
‘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)
‘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)
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
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)
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)
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)
Read here (Indian Express, April 8, 2020)
Tuesday 7 April 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)
(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)
‘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)
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)
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)
Read here (Visual Capitalist, April 7, 2020)
Monday 6 April 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)
‘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)
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)
‘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)
(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)
‘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)
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)
View here: (GZeroMedia, Youtube, April 6, 2020)
Lockdown can’t last forever. Here’s how to lift it
‘Trying to see our way through the pandemic with this “suppress and lift” approach is much like driving a car on a long and tortuous road. One needs to hit the brakes and release them, again and again, to keep moving forward without crashing, all with an eye toward safely reaching one’s final destination.’
Opinion by Gabriel Leung, infectious disease epidemiologist and dean of medicine at the University of Hong Kong.
Read here (New York Times, April 6, 2020)
Opinion by Gabriel Leung, infectious disease epidemiologist and dean of medicine at the University of Hong Kong.
Read here (New York Times, April 6, 2020)
WHO issues guidelines on the use of masks in community, homecare and healthcare settings
‘This document provides advice on the use of masks in communities, during home care, and in health care settings in areas that have reported cases of COVID-19. It is intended for individuals in the community, public health and infection prevention and control (IPC) professionals, health care managers, health care workers (HCWs), and community health workers. This updated version includes a section on Advice to decision makers on the use of masks for healthy people in community settings.’
Read here (WHO, April 6, 2020)
Read here (WHO, April 6, 2020)
Sunday 5 April 2020
Decentralisation is helping Germany beat Covid-19
‘German public health services are provided not by one central authority but by approximately 400 public health offices, run by municipality and rural district administrations.
‘Such an environment allows for a variety of laboratories – some attached to universities or hospitals, others privately run, medium-sized businesses – which act largely autonomously of central control.’
Read here (The Guardian, April 5, 2020)
‘Such an environment allows for a variety of laboratories – some attached to universities or hospitals, others privately run, medium-sized businesses – which act largely autonomously of central control.’
Read here (The Guardian, April 5, 2020)
Paul Krugman: ‘We really are talking about a depression level event’
‘Nobel Prize-winning economist Paul Krugman tells Lawrence O’Donnell that Trump and his allies in Congress are “balking” at the things that need to be done to support parts of the economy that need the most help, like small businesses, hospitals and local governments: “We are at risk of turning this into even worse than it has to be… the administration is refusing to acknowledge the depth of the problem and is trying to pursue an ideological agenda that is getting in the way of dealing with this”.’
View here (MSNBC, Youtube, April 15, 2020)
View here (MSNBC, Youtube, April 15, 2020)
‘SARS-CoV-2 RNA found in air pollution particles in Italy’
’A study conducted in Italy (not yet peer reviewed) detected the presence of SARS-CoV-2 RNA in air pollution particles. The particulate matter that contributes to air pollution can be inhaled, potentially providing an additional mechanism for SARS-CoV-2 infection. This study did not evaluate the viability of the virus detected in the air pollution, nor did it assess the potential for this route of exposure to result in infection.‘
Read here (Medrxiv, April 15, 2020)
Read here (Medrxiv, April 15, 2020)
Saturday 4 April 2020
18 lessons of urban quarantine urbanism
This is a most succinct and informed piece of communication on our present predicament and what we could/should do.
‘To what world will we reemerge after the distress and devastation of the COVID-19 pandemic? Calling for a geopolitics based on a deliberate plan for the coordination of the planet, design theorist and The Terraforming Program Director Benjamin H. Bratton looks at the underlying causes of the current crisis and identifies important lessons to be learned from it.’
Read here (Strelkamag, April 4, 2020)
‘To what world will we reemerge after the distress and devastation of the COVID-19 pandemic? Calling for a geopolitics based on a deliberate plan for the coordination of the planet, design theorist and The Terraforming Program Director Benjamin H. Bratton looks at the underlying causes of the current crisis and identifies important lessons to be learned from it.’
Read here (Strelkamag, April 4, 2020)
Making the invisible visible: Faces of poverty in Malaysia revealed under the MCO
This article, by Bridget Welsh and Calvin Cheng, is written in the context of the current movement control order (MCO) as a result of the Covid-19 outbreak. It concludes:
‘Moving ahead, a serious rethink of how to address vulnerabilities and the poor is needed, beyond cash transfers of assistance and other immediate relief measures. The poor as a whole need to be recognised and disaggregated, with more attention to how to treat those facing the most serious hardships. A key step is to start getting the numbers right and to stop leaving out the many different groups being affected.
‘Practically, a task force can be set up to look at different sets of policies that are more holistic in addressing needs and causes along the various dimensions, with greater collaboration with NGOs, academics and international organisations, notably United Nations High Commissioner for Refugees (UNHCR). This will allow for better targeting of available limited resources, offer opportunities to find new resources and importantly, allow for the framing of sound policies that will not just ameliorate problems caused by Covid-19, but also work to address the underlying social conditions that will inevitably worsen as the economy contracts.
‘A crucial part of the way forward is to make the reality of poverty more visible.’
Read here (Malaysiakini, April 4, 2020)
‘Moving ahead, a serious rethink of how to address vulnerabilities and the poor is needed, beyond cash transfers of assistance and other immediate relief measures. The poor as a whole need to be recognised and disaggregated, with more attention to how to treat those facing the most serious hardships. A key step is to start getting the numbers right and to stop leaving out the many different groups being affected.
‘Practically, a task force can be set up to look at different sets of policies that are more holistic in addressing needs and causes along the various dimensions, with greater collaboration with NGOs, academics and international organisations, notably United Nations High Commissioner for Refugees (UNHCR). This will allow for better targeting of available limited resources, offer opportunities to find new resources and importantly, allow for the framing of sound policies that will not just ameliorate problems caused by Covid-19, but also work to address the underlying social conditions that will inevitably worsen as the economy contracts.
‘A crucial part of the way forward is to make the reality of poverty more visible.’
Read here (Malaysiakini, April 4, 2020)
Arundhati Roy: ‘The pandemic is a portal’
The novelist starts by telling how the coronavirus has changed our lives and how it has overwhelmed us so suddenly. However, she says: ‘The tragedy is the wreckage of a train that has been careening down the track for years.’ She goes on to examine how leadership has failed and how the disease threatens India, especially the disadvantaged. She also talks about what the country, and the world, should do next.
‘Whatever it is, coronavirus has made the mighty kneel and brought the world to a halt like nothing else could. Our minds are still racing back and forth, longing for a return to “normality”, trying to stitch our future to our past and refusing to acknowledge the rupture. But the rupture exists. And in the midst of this terrible despair, it offers us a chance to rethink the doomsday machine we have built for ourselves. Nothing could be worse than a return to normality.
‘Historically, pandemics have forced humans to break with the past and imagine their world anew. This one is no different. It is a portal, a gateway between one world and the next.
‘We can choose to walk through it, dragging the carcasses of our prejudice and hatred, our avarice, our data banks and dead ideas, our dead rivers and smoky skies behind us. Or we can walk through lightly, with little luggage, ready to imagine another world. And ready to fight for it.’
Read here (Financial Times, April 4, 2020)
‘Whatever it is, coronavirus has made the mighty kneel and brought the world to a halt like nothing else could. Our minds are still racing back and forth, longing for a return to “normality”, trying to stitch our future to our past and refusing to acknowledge the rupture. But the rupture exists. And in the midst of this terrible despair, it offers us a chance to rethink the doomsday machine we have built for ourselves. Nothing could be worse than a return to normality.
‘Historically, pandemics have forced humans to break with the past and imagine their world anew. This one is no different. It is a portal, a gateway between one world and the next.
‘We can choose to walk through it, dragging the carcasses of our prejudice and hatred, our avarice, our data banks and dead ideas, our dead rivers and smoky skies behind us. Or we can walk through lightly, with little luggage, ready to imagine another world. And ready to fight for it.’
Read here (Financial Times, April 4, 2020)
Friday 3 April 2020
Covid-19: To mask or not to mask? — Amar Singh
‘The wearing of mask is an issue that is currently being hotly debated in many parts of the world. Some are calling it the “great mask debate”. I had planned earlier this week to write a full article on this but I think it would serve us better to read some of the very valuable commentaries that have already been done. What I hope to do is to summarise the key points to help us come to a better understanding on whether the general public should wear masks.’
Read here (The Malay Mail, April 3, 2020)
Read here (The Malay Mail, April 3, 2020)
Shockwave: Adam Tooze on the pandemic’s consequences for the world economy
This lengthy essay begins by painting the economic background of this crisis, covering the weaknesses of the globalised system and its over-dependence on government stimulus post-2008. There were detractors though. ‘True conservatives, as distinct from those merely wedded to the religion of the stock market, welcomed the prospect of a shakeout. It was time for a purge, time to slim down the businesses that had gorged on too much cheap funding, time for a return to discipline." However, as we know, it was not to be.
When Covid-19 hit, the three main economic blocs responded, strapped to the underpinnings of their own socio-economic systems. Many East Asian countries, notably China, South Korea, Hong Kong, Taiwan and Singapore, employed ‘the hammer and the dance’ by hitting the virus hard and fast. Europe ended up in an uncoordinated and dispiriting stalemate. ‘From the point of view of the wider world, what matters is that Europe does not unleash a sovereign debt crisis.’ In the US, ‘more than the flame-out of Trump, is the gulf between the competence of the American government machine in managing global finance and the Punch and Judy show of its politics. That tension has been more and more glaring since at least the 1990s, but the virus has exposed it as never before.’
‘If you swiftly declare an emergency and are prepared to interrupt business as usual, both the medical and economic costs of confronting the virus appear more reasonable, and the conventional priorities of modern politics remain basically in place... As the Europeans and Americans have discovered, once you lose control all the options are bad: shut down the economy for an unforeseeable duration, or hundreds of thousands die.’
Tooze concludes that ‘for those of us in Europe and America these questions [about opening up] are premature. The worst is just beginning.’
Read here (London Review of Books, April 3, 2020)
When Covid-19 hit, the three main economic blocs responded, strapped to the underpinnings of their own socio-economic systems. Many East Asian countries, notably China, South Korea, Hong Kong, Taiwan and Singapore, employed ‘the hammer and the dance’ by hitting the virus hard and fast. Europe ended up in an uncoordinated and dispiriting stalemate. ‘From the point of view of the wider world, what matters is that Europe does not unleash a sovereign debt crisis.’ In the US, ‘more than the flame-out of Trump, is the gulf between the competence of the American government machine in managing global finance and the Punch and Judy show of its politics. That tension has been more and more glaring since at least the 1990s, but the virus has exposed it as never before.’
‘If you swiftly declare an emergency and are prepared to interrupt business as usual, both the medical and economic costs of confronting the virus appear more reasonable, and the conventional priorities of modern politics remain basically in place... As the Europeans and Americans have discovered, once you lose control all the options are bad: shut down the economy for an unforeseeable duration, or hundreds of thousands die.’
Tooze concludes that ‘for those of us in Europe and America these questions [about opening up] are premature. The worst is just beginning.’
Read here (London Review of Books, April 3, 2020)
Beijing approves TCM drugs for Covid-19
‘China has added three patented items of traditional Chinese medicines (TCM) to the treatments for COVID-19. The drugs, specifically Jinhua Qinggan granules, Lianhua Qingwen capsules, and Xuebijing injections have undergone clinical trials with the National Medical Products Administration and now list treating COVID-19 as one of their uses.
"That means these three drugs have passed strict reviews by the administration, and can be commonly and widely used in China. Their effects are exact and backed with ample evidence. So people may have a new choice if there's a similar epidemic in the future," said Zhang Boli, president of Tianjin Hospital of TCM.’
Read here (CGTN, April 4, 2020)
Bringing in the experts: Blame deflection and the COVID-19 crisis
“The contemporary visibility and political emphasis on ‘the experts’ is therefore a double-edged sword. On the one hand, it is completely rational to heed the advice of those who have dedicated their professional lives to understanding and protecting public health; on the other hand, it is also a depoliticisation strategy in the sense that politicians who have dedicated their professional lives to not going MAD (i.e. falling foul of ‘multiple accountabilities disorder’) will understand the benefit of allowing ‘the experts’ to become the public face of the crisis.”
Read here (LSE, April 3, 2020)
Read here (LSE, April 3, 2020)
Coronavirus: Out of many, one -- What the US federal government and the states should do to fight the coronavirus
‘It makes political and economic sense for the US to suppress the coronavirus. For that, states and the federal government each have their own roles that they need to adjust.
‘The US is now the country with most coronavirus cases in the world. It is likely to keep that title in the history books. Two key reasons are government decentralisation and concerns about the economic impact of aggressive social distancing measures. Here’s what we’re going to cover today, with a lot of data, charts and sources: (a) What’s the situation in the US and its states (b) Why the coronavirus should be a bipartisan issue (c) The economics of controlling the virus (d) Which decisions should be left to the federal government or to states
Read here (Medium, April 2, 2020)
Read here for a list of people who have endorsed or shared his article
‘The US is now the country with most coronavirus cases in the world. It is likely to keep that title in the history books. Two key reasons are government decentralisation and concerns about the economic impact of aggressive social distancing measures. Here’s what we’re going to cover today, with a lot of data, charts and sources: (a) What’s the situation in the US and its states (b) Why the coronavirus should be a bipartisan issue (c) The economics of controlling the virus (d) Which decisions should be left to the federal government or to states
Read here (Medium, April 2, 2020)
Read here for a list of people who have endorsed or shared his article
Thursday 2 April 2020
Nations with mandatory TB vaccines show fewer coronavirus deaths
‘The preliminary study posted on medRxiv, a site for unpublished medical research, finds a correlation between countries that require citizens to get the bacillus Calmette-Guerin (BCG) vaccine and those showing fewer number of confirmed cases and deaths from Covid-19. Though only a correlation, clinicians in at least six countries are running trials that involve giving frontline health workers and elderly people the BCG vaccine to see whether it can indeed provide some level of protection against the new coronavirus.’
Read here (Bloomberg, April 2, 2020)
Read here (Bloomberg, April 2, 2020)
Privacy: Thrown to the wind in the pandemic?
‘These are strange times. Germany, perhaps the most privacy conscious nation on earth, is considering a mobile phone app that would trace the contacts of anyone infected with Covid-19.
‘So are we becoming more relaxed about privacy because of the pandemic, or are we in danger of allowing governments and corporations to trample over our rights using the excuse of the emergency?...
‘Earlier this week the British Prime Minister shared a picture of an online Cabinet meeting, complete with the Zoom meeting ID and the usernames of ministers. And millions of us are sharing views of our kitchens over this and other video-conferencing apps, without apparently being too concerned about poor privacy controls.
‘Meanwhile, the National Health Service in England has sent out a document that appears to mark a shift in its policy on patient data, giving staff more latitude to share information relating to the coronavirus. In particular, it mentions the use of data to understand trends in the spread and impact of the virus and “the management of patients with or at risk of Covid-19 including: locating, contacting, screening, flagging and monitoring such patients”.’
Read here (BBC, April 2, 2020)
‘So are we becoming more relaxed about privacy because of the pandemic, or are we in danger of allowing governments and corporations to trample over our rights using the excuse of the emergency?...
‘Earlier this week the British Prime Minister shared a picture of an online Cabinet meeting, complete with the Zoom meeting ID and the usernames of ministers. And millions of us are sharing views of our kitchens over this and other video-conferencing apps, without apparently being too concerned about poor privacy controls.
‘Meanwhile, the National Health Service in England has sent out a document that appears to mark a shift in its policy on patient data, giving staff more latitude to share information relating to the coronavirus. In particular, it mentions the use of data to understand trends in the spread and impact of the virus and “the management of patients with or at risk of Covid-19 including: locating, contacting, screening, flagging and monitoring such patients”.’
Read here (BBC, April 2, 2020)
China rolls out the Health Silk Road
‘In a graphic demonstration of soft power, so far China has offered Covid-19-related equipment and medical help to no fewer than 89 nations – and counting...
‘That covers Africa (especially South Africa, Namibia and Kenya, with Alibaba in fact announcing it will send help to all African nations); Latin America (Brazil, Argentina, Venezuela, Peru); the arc from East Asia to Southwest Asia; and Europe...
‘Key recipients in Europe include Italy, France, Spain, Belgium, the Netherlands, Serbia and Poland. But Italy, most of all, is a very special case. Most are donations. Some are trade – like millions of masks sold to France (and the US)...
‘This Chinese soft power offensive is carefully calibrated to offset the current paralysis of global supply chains. China is now working overtime to supply many parts of the world with medicine and related healthcare items – always with the Belt and Road framework in mind, as if doubling down on Globalization 2.0.’
Read here (Asia Times, April 2, 2020)
The four rules of pandemic economics: A playbook that should govern America’s short-term reaction to the health crisis.
Rule 1: “Save the economy or save lives” is a false choice. ‘The infamous trade-off between people and GDP? It doesn’t exist—or, at least, it didn’t in 1918. The reason, Verner told me, is that pandemics are “so, so disruptive that anything that you can do to mitigate that destructive impact of the pandemic itself is going to be useful.” Without a healthy population, there can be no healthy economy.’
Rule 2: Pay people a living wage to stop working. ‘Once the government has put the economy into an artificial coma, it must keep the patient alive. The US economic-relief package does so in a few ways. Washington will send to most households one-time payments of $1,200 per adult—plus $500 per child—and expand unemployment benefits, bumping up weekly payments for eligible workers, including independent contractors and the self-employed, by $600 for the next few months. The new law also delays tax filing, suspends wage garnishing among those who have defaulted on their student loans, and establishes a four-month eviction moratorium among landlords with mortgages from federal entities, such as Fannie Mae and Freddie Mac. This is a huge and kaleidoscopic response. But it still might not be enough.’
Rule 3: Build companies a time machine. ‘“We have to build companies a time machine,” Justin Wolfers, an economist at the University of Michigan, told me. He isn’t talking about the H G Wells contraption. He’s referring to anything—including grants, cheap loans, and debt relief—that would allow companies to shift their expenses to the future.’
Rule 4: The business of America is now science. ‘Our lack of knowledge about the virus is our greatest weakness in combatting it. Not knowing who has the virus, or who is most susceptible, contributes to higher infection rates. Not knowing who has recovered from, and built immunity to, the virus delays our ability to treat individuals, or release select individuals from isolation. The possibility that the virus is anywhere means that we have to shut down economic activity everywhere. The road back to normalcy is through more clear and public information.’
Read here (The Atlantic, April 2, 2020)
The impact of the coronavirus on global higher education: Exclusive QS survey data
‘When asked for their thoughts on the higher education sector’s approach to crisis management and the coronavirus, many respondents emphasised the importance of: (1) Online learning (2) International coordination and collaboration (3) Proactive, preventative measures (4) Strong university leadership (5) Flexibility for assessment deadlines and exams (6) Stricter sanitation initiatives (7) Clear communication from university leadership and administrators.’
Download here (QS, April 2, 2020)
Download here (QS, April 2, 2020)
Corona, East and West: Has Western-centrism mitigated against our well-being in the UK?
“That there is something special and distinct about Europe/the West, the ‘miracle’ view of Europe/West (Bhambra 2007; Sayyid 1997) are inextricably intertwined with othering views of the non-West. Such perceptions and views have contributed to narrow understanding of not just the West, but also the West’s understanding of ‘the Rest’. We need an examination of the extent to which such views and assumptions about the ‘West’ and ‘the Rest’ have come to shape the UK government’s reactions to the risks posed by the coronavirus.”
Read here (Discover Society, April 2, 2020)
Read here (Discover Society, April 2, 2020)
Wednesday 1 April 2020
Three lessons from this pandemic by Dr Lim Mah Hui & Dr Michael Heng
‘There are three lessons to draw from this crisis.
‘First, the pandemic exposes the flaws of neoliberalism which deifies the free market and vilifies the state... Under this scenario, risks are socialised while profits are privatised. It weakens the capacity and readiness of society to respond to unanticipated nation-wide crisis.
‘Second, had the rich western countries cast off their ideological blinkers and used the opportunities after the GFC to invest in infrastructure, research and development, public goods, reduction of huge inequalities and other form of capital development, the whole world would have been in better conditions to deal with the unfolding situation.
‘Third, the crisis underscores the interdependence resulting from systematic integration over the past several decades. It is a cliché now to say that pathogen respects no border. It took only a few weeks for the virus to travel worldwide. A global solidarity is needed to tackle problem of this nature which unfortunately is not being displayed...
‘The world has to act in a concerted action. We are all in the same boat; a leak in one part will sink the boat no matter where the source.’
Read here (IPS News, April 1, 2020)
‘First, the pandemic exposes the flaws of neoliberalism which deifies the free market and vilifies the state... Under this scenario, risks are socialised while profits are privatised. It weakens the capacity and readiness of society to respond to unanticipated nation-wide crisis.
‘Second, had the rich western countries cast off their ideological blinkers and used the opportunities after the GFC to invest in infrastructure, research and development, public goods, reduction of huge inequalities and other form of capital development, the whole world would have been in better conditions to deal with the unfolding situation.
‘Third, the crisis underscores the interdependence resulting from systematic integration over the past several decades. It is a cliché now to say that pathogen respects no border. It took only a few weeks for the virus to travel worldwide. A global solidarity is needed to tackle problem of this nature which unfortunately is not being displayed...
‘The world has to act in a concerted action. We are all in the same boat; a leak in one part will sink the boat no matter where the source.’
Read here (IPS News, April 1, 2020)
Timeless lessons from Albert Camus’ “The Plague” (published 1947)
‘There is no more important book to understand our times than Albert Camus's The Plague, a novel about a virus that spreads uncontrollably from animals to humans and ends up destroying half the population of a representative modern town. Camus speaks to us now not because he was a magical seer, but because he correctly sized up human nature. As he wrote: “Everyone has inside it himself this plague, because no one in the world, no one, can ever be immune”.’
View here (The School of Life, YouTube, April 1, 2020)
View here (The School of Life, YouTube, April 1, 2020)
Covid-19 in Malaysia: Fours ways to address the problem of transmission
We have reached a plateau, but we must do more to reduce the transmission rate, says Jeyakumar Devaraj:
1. Masks for all those venturing out of their homes
2. More effective quarantining of contacts
3. Earlier testing of symptomatic cases
4. Winning the trust of the migrant worker population
Read here (Aliran, April 1, 2020)
1. Masks for all those venturing out of their homes
2. More effective quarantining of contacts
3. Earlier testing of symptomatic cases
4. Winning the trust of the migrant worker population
Read here (Aliran, April 1, 2020)
Questions on the government stimulus package
‘The way the government has crafted the package raises a host of questions. Does it help those in greatest need? Is it the most effective way to help the needy and keep the economy intact? Is the principle of sharing pain, i.e. the well to do should do their part to sacrifice a bit of their income for the needy, adhered to? Are some groups getting more at the expense of others?’
Read here (FreeMalaysiaToday, April 1, 2020)
Read here (FreeMalaysiaToday, April 1, 2020)
MIT revives project to build makeshift ventilators at US$400-500 using existing hospital supplies: An idea developing countries can consider too
‘Researchers at the Massachusetts Institute of Technology have revived a project from several years ago to develop a makeshift ventilator using “ambu” resuscitation bags, widely available at hospitals around the world. The team intends to share its design instructions free of charge, which will allow others to construct their own unit, using US$400-500 in supplies. The units are not currently FDA-approved, but the team hopes to obtain approval in the future."
This is the reasoning behind the project:
‘We are one of several teams who recognised the challenges faced by Italian physicians, and are working to find a solution to the anticipated global lack of ventilators. In the US alone, the COVID-19 pandemic may cause ventilator shortages on the order of 300,000-700,000 units (CDC Pandemic Response Plans). These could present on a national scale within weeks, and are already being felt in certain areas. An increase in conventional ventilator production is very likely to fall short and with significant associated cost (paywall warning).
‘Almost every bed in a hospital has a manual resuscitator (Ambu-Bag) nearby, available in the event of a rapid response or code where healthcare workers maintain oxygenation by squeezing the bag. Automating this appears to be the simplest strategy that satisfies the need for low-cost mechanical ventilation, with the ability to be rapidly manufactured in large quantities. However, doing this safely is not trivial.
‘Use of a bag-valve mask (BVM) in emergency situations is not a new concept. A portable ventilator utilizing an ambu-bag was introduced in 2010 by a student team in the MIT class 2.75 Medical Device Design (original paper here and news story here), but did not move past the prototype stage. Around the same time, a team from Stanford developed a lower-cost ventilator for emergency stockpiles and the developing world. It looks similar to a modern ICU ventilator (Onebreath), but “production for US hospitals would start [in] about 11 months”, making it “a second wave solution” (MIT Tech Review Article).
‘Last year, the AMBU®️ Bag concept was re-visited by two student teams, one from Rice university (here & here), and another Boston-based team who won MIT Sloan’s Healthcare prize (MIT News: Umbilizer).’
Read here (MIT, April 1, 2020)
This is the reasoning behind the project:
‘We are one of several teams who recognised the challenges faced by Italian physicians, and are working to find a solution to the anticipated global lack of ventilators. In the US alone, the COVID-19 pandemic may cause ventilator shortages on the order of 300,000-700,000 units (CDC Pandemic Response Plans). These could present on a national scale within weeks, and are already being felt in certain areas. An increase in conventional ventilator production is very likely to fall short and with significant associated cost (paywall warning).
‘Almost every bed in a hospital has a manual resuscitator (Ambu-Bag) nearby, available in the event of a rapid response or code where healthcare workers maintain oxygenation by squeezing the bag. Automating this appears to be the simplest strategy that satisfies the need for low-cost mechanical ventilation, with the ability to be rapidly manufactured in large quantities. However, doing this safely is not trivial.
‘Use of a bag-valve mask (BVM) in emergency situations is not a new concept. A portable ventilator utilizing an ambu-bag was introduced in 2010 by a student team in the MIT class 2.75 Medical Device Design (original paper here and news story here), but did not move past the prototype stage. Around the same time, a team from Stanford developed a lower-cost ventilator for emergency stockpiles and the developing world. It looks similar to a modern ICU ventilator (Onebreath), but “production for US hospitals would start [in] about 11 months”, making it “a second wave solution” (MIT Tech Review Article).
‘Last year, the AMBU®️ Bag concept was re-visited by two student teams, one from Rice university (here & here), and another Boston-based team who won MIT Sloan’s Healthcare prize (MIT News: Umbilizer).’
Read here (MIT, April 1, 2020)
Mathematical modelling, "herd immunity" and the resultant failure of "test, test, test" in Britain
‘According to Richard Horton, editor-in-chief of the Lancet medical journal, the dominant voices in the Scientific Advisory Group for Emergencies (Sage), the scientific expert group advising the government, were mathematical modellers and behavioural scientists, including [David] Halpern...
‘Testing, isolation and quarantine – basic public health interventions – were barely on the agenda. Warnings from Chinese scientists of the severity of Covid-19 had not been understood.
‘“We thought we could have a controlled epidemic. We thought we could manage that epidemic over the course of March and April, push the curve to the right, build up herd immunity and that way we could protect people,” said Horton. “The reason why that strategy was wrong is it didn’t recognise that 20% of people infected would end up with severe critical illness. The evidence was there at the end of January.”
‘Anthony Costello, a UK paediatrician and former director of the WHO, also fiercely criticised the decision to stop tests. “For me and the WHO people I have spoken to, this is absolutely the wrong policy,” he said. “The basic public health approach is playing second fiddle to mathematical modelling.”
Read here (The Guardian, April 1, 2020)
‘Testing, isolation and quarantine – basic public health interventions – were barely on the agenda. Warnings from Chinese scientists of the severity of Covid-19 had not been understood.
‘“We thought we could have a controlled epidemic. We thought we could manage that epidemic over the course of March and April, push the curve to the right, build up herd immunity and that way we could protect people,” said Horton. “The reason why that strategy was wrong is it didn’t recognise that 20% of people infected would end up with severe critical illness. The evidence was there at the end of January.”
‘Anthony Costello, a UK paediatrician and former director of the WHO, also fiercely criticised the decision to stop tests. “For me and the WHO people I have spoken to, this is absolutely the wrong policy,” he said. “The basic public health approach is playing second fiddle to mathematical modelling.”
Read here (The Guardian, April 1, 2020)
Case for wearing face masks (3): WHO considering changing guidelines
‘Speaking at a Chatham House briefing on Wednesday, Prof David Heymann, an infectious disease expert who led the global response to the SARS outbreak, said that new evidence from Hong Kong had prompted a reconsideration of the role of face masks. “The WHO is debating that tomorrow to understand if there is evidence that would call for a change in what WHO is recommending,” he said.
‘The data from Hong Kong was shared confidentially with the WHO, but is likely to be published soon, Heymann said. He added that, in reassessing its policy, the WHO would take into account health workers’ need for masks in all countries.’
Read here (The Guardian, April 1, 2020)
‘The data from Hong Kong was shared confidentially with the WHO, but is likely to be published soon, Heymann said. He added that, in reassessing its policy, the WHO would take into account health workers’ need for masks in all countries.’
Read here (The Guardian, April 1, 2020)
Face masks: Asia may have been right about coronavirus and face masks, and the rest of the world is coming around
‘Writing last month, Adrien Burch, an expert in microbiology at the University of California, Berkeley, noted that “despite hearing that face masks ‘don't work,’ you probably haven't seen any strong evidence to support that claim. That's because it doesn't exist…
‘In fact, there is evidence of the exact opposite: that masks help prevent viral infections like the current pandemic.
‘Burch pointed to a Cochrane Review -- a systemic analysis of published studies on a given topic -- which found strong evidence during the 2003 SARS epidemic in support of wearing masks. One study of community transmission in Beijing found that "consistently wearing a mask in public was associated with a 70% reduction in the risk of catching SARS.”’
Read here (CNN, April 1, 2020)
‘In fact, there is evidence of the exact opposite: that masks help prevent viral infections like the current pandemic.
‘Burch pointed to a Cochrane Review -- a systemic analysis of published studies on a given topic -- which found strong evidence during the 2003 SARS epidemic in support of wearing masks. One study of community transmission in Beijing found that "consistently wearing a mask in public was associated with a 70% reduction in the risk of catching SARS.”’
Read here (CNN, April 1, 2020)
Tuesday 31 March 2020
Case for wearing face masks (2): Microdroplets pose coronavirus risk
‘An NHK experiment found that microdroplets emitted while sneezing and coughing and during conversations stay in the air for longer than normal droplets, potentially posing a uniquely dangerous risk for coronavirus infection.’
View here (NHK, March 31, 2020)
Monday 30 March 2020
Exit strategies for Covid-19 a.k.a can life return to normal? — Dr Amar-Singh HSS and Dr Lim Swee Im
‘We are living in a new reality, what I call the “post-coronavirus reality” and we have to learn how we need to change, how we can adapt and survive this reality. We would like to share with you some preliminary ideas and thoughts on exit strategies from a “lockdown”.
They discuss three exit strategies (1) Give up and give in (2) Segregate old people and children/adults with chronic conditions and (3) A more realistic exit strategy which ‘will require us to cooperate and to work together in a way like we have never done so before. Not as individuals but as a responsible family, a nation of sisters and brothers.’
It will require the following: (1) Continue to maintain strict physical (social) distancing as a long term lifestyle (2) Cleaning hands and surfaces must be normative (3) Using masks must become common place (4) Develop rapid response coronavirus teams ('precision quarantine') (5) Availability of mass testing capability (6) Using technology wisely to track contacts (7) All travellers into the country should be screened (8) Waiting for vaccines to arrive and provide immunity to the population
Read here (The Malay Mail, March 30, 2020)
They discuss three exit strategies (1) Give up and give in (2) Segregate old people and children/adults with chronic conditions and (3) A more realistic exit strategy which ‘will require us to cooperate and to work together in a way like we have never done so before. Not as individuals but as a responsible family, a nation of sisters and brothers.’
It will require the following: (1) Continue to maintain strict physical (social) distancing as a long term lifestyle (2) Cleaning hands and surfaces must be normative (3) Using masks must become common place (4) Develop rapid response coronavirus teams ('precision quarantine') (5) Availability of mass testing capability (6) Using technology wisely to track contacts (7) All travellers into the country should be screened (8) Waiting for vaccines to arrive and provide immunity to the population
Read here (The Malay Mail, March 30, 2020)
New research suggests industrial livestock, not wet markets, might be origin of Covid-19
‘There is a growing body of evidence that points to a different origin story for Covid-19. We now know that none of the animals tested at the Wuhan seafood market tested positive and about a third of the initial set of reported cases in people in Wuhan from early December 2019 had no connection to the seafood market, including the first reported case. And we also now know, thanks to the leak of an official Chinese report to the South China Morning Post that the actual first known case of Covid-19 in Hubei was detected in mid-November, weeks before the cluster of cases connected to the Wuhan seafood market were reported.’
Two studies quoted in this article point to industrial farming of animals as the more probable cause, in particular that of pigs.
Read here (Grain, March 30, 2020)
Related article: Viral times - The politics of emerging global animal diseases (Grain, Jan 20, 2020). Read here
Two studies quoted in this article point to industrial farming of animals as the more probable cause, in particular that of pigs.
Read here (Grain, March 30, 2020)
Related article: Viral times - The politics of emerging global animal diseases (Grain, Jan 20, 2020). Read here
For the record: Two game-changing studies from Imperial College that affected Europe-wide policies
The Imperial College COVID-19 Response Team in London produced two studies that influenced policy in Europe in a big way. In particular, it helped push Britain to switch its strategy from one based on ‘herd immunity’ to that of "suppression".
(1) March 16: ‘Suppression the only viable strategy’
The first study, published March 16, 2020, concluded that ‘epidemic suppression is the only viable strategy at the current time. The social and economic effects of the measures which are needed to achieve this policy goal will be profound. Many countries have adopted such measures already, but even those countries at an earlier stage of their epidemic (such as the UK) will need to do so imminently.’
Read here (Imperial College, March 16, 2020)
(2) March 30: ‘59,000 lives saved in 11 European countries via non-pharmacologial interventions, between 7 to 43 million individuals infected -- as of March 31’
The second study, published March 30, 2020, said that ‘with current interventions remaining in place to at least the end of March, we estimate that interventions across all 11 countries will have averted 59,000 deaths up to 31 March [95% credible interval 21,000-120,000]. Many more deaths will be averted through ensuring that interventions remain in place until transmission drops to low levels.
‘We estimate that, across all 11 countries between 7 and 43 million individuals have been infected with SARS-CoV-2 up to 28th March, representing between 1.88% and 11.43% of the population. The proportion of the population infected to date – the attack rate - is estimated to be highest in Spain followed by Italy and lowest in Germany and Norway, reflecting the relative stages of the epidemics.’
Read here (Imperial College, March 30, 2020)
(1) March 16: ‘Suppression the only viable strategy’
The first study, published March 16, 2020, concluded that ‘epidemic suppression is the only viable strategy at the current time. The social and economic effects of the measures which are needed to achieve this policy goal will be profound. Many countries have adopted such measures already, but even those countries at an earlier stage of their epidemic (such as the UK) will need to do so imminently.’
Read here (Imperial College, March 16, 2020)
(2) March 30: ‘59,000 lives saved in 11 European countries via non-pharmacologial interventions, between 7 to 43 million individuals infected -- as of March 31’
The second study, published March 30, 2020, said that ‘with current interventions remaining in place to at least the end of March, we estimate that interventions across all 11 countries will have averted 59,000 deaths up to 31 March [95% credible interval 21,000-120,000]. Many more deaths will be averted through ensuring that interventions remain in place until transmission drops to low levels.
‘We estimate that, across all 11 countries between 7 and 43 million individuals have been infected with SARS-CoV-2 up to 28th March, representing between 1.88% and 11.43% of the population. The proportion of the population infected to date – the attack rate - is estimated to be highest in Spain followed by Italy and lowest in Germany and Norway, reflecting the relative stages of the epidemics.’
Read here (Imperial College, March 30, 2020)
Work from home tips for staying sane and productive during stressful times of Covid-19 lockdowns
‘Whether you’re new to working from home or you’ve worked remotely for years, COVID-19 is presenting challenges for all workers right now. It’s stressful enough to process the big changes happening to our economy and society, but there’s probably a lot happening within your own home too.
‘While all these changes add stress to your day, it can be tough to concentrate. Here are a few tips we’ve learned over the years to stay productive and focused during difficult times.’
Read here (Upwork, March 20, 2020)
‘While all these changes add stress to your day, it can be tough to concentrate. Here are a few tips we’ve learned over the years to stay productive and focused during difficult times.’
Read here (Upwork, March 20, 2020)
White House airlifts medical supplies from China amid Covid-19 crisis: 22 planeloads scheduled
‘A commercial aircraft carrying 80 tons of gloves, masks, gowns and other medical supplies from Shanghai touched down in New York on Sunday, the first of 22 scheduled flights that White House officials say will funnel much-needed goods to the United States by early April as it battles the world’s largest coronavirus outbreak.
‘The plane delivered 130,000 N95 masks, 1.8 million face masks and gowns, 10 million gloves and thousands of thermometers for distribution to New York, New Jersey and Connecticut, said Lizzie Litzow, a spokeswoman for the Federal Emergency Management Agency. Ms. Litzow said that flights would be arriving in Chicago on Monday and in Ohio on Tuesday, and that supplies would be sent from there to other states using private-sector distribution networks.
‘While the goods that arrived in New York on Sunday will be welcomed by hospitals and health care workers — some of whom have resorted to rationing protective gear or using homemade supplies — they represent just a tiny portion of what American hospitals need. The Department of Health and Human Services has estimated that the United States will require 3.5 billion masks if the pandemic lasts a year.’
Read here (New York Times, March 30, 2020)
‘The plane delivered 130,000 N95 masks, 1.8 million face masks and gowns, 10 million gloves and thousands of thermometers for distribution to New York, New Jersey and Connecticut, said Lizzie Litzow, a spokeswoman for the Federal Emergency Management Agency. Ms. Litzow said that flights would be arriving in Chicago on Monday and in Ohio on Tuesday, and that supplies would be sent from there to other states using private-sector distribution networks.
‘While the goods that arrived in New York on Sunday will be welcomed by hospitals and health care workers — some of whom have resorted to rationing protective gear or using homemade supplies — they represent just a tiny portion of what American hospitals need. The Department of Health and Human Services has estimated that the United States will require 3.5 billion masks if the pandemic lasts a year.’
Read here (New York Times, March 30, 2020)
Coronavirus lockdown measures may have saved 59,000 lives in Europe already, says new study by Imperial College
‘At least 59,000 lives have already been saved in 11 European countries due to the social distancing measures introduced to stem the spread of Covid-19, new modelling suggests.
‘According to the analysis, 370 deaths have already been averted in the UK - where a nationwide lockdown came into effect just one week ago - while Italian interventions have saved 38,000 lives to date.
‘But the study also shows that the continent remains a long way from developing “herd immunity”, whereby the vast majority of people have caught, recovered and become immune to the coronavirus.
‘The modelling, published yesterday by Imperial College, London, analyses the impact of lockdown in 11 European countries, including the UK.’
Read here (Telegraph, March 30, 2020)
The mechanics of mobile contact tracing: Information collected can be quite extensive
‘A mobile phone App can make contact tracing and notification instantaneous upon case confirmation. By keeping a temporary record of proximity events between individuals, it can immediately alert recent close contacts of diagnosed cases and prompt them to self-isolate.
‘Apps with similar aims have been deployed in China. Public health policy was implemented using an App which was not compulsory but was required to move between quarters and into public spaces and public transport. The App allows a central database to collect data on user movement and coronavirus diagnosis and displays a green, amber or red code to relax or enforce restrictions on movement. The database is reported to be analysed by an artificial intelligence algorithm that issues the colour codes. The App is a plug-in for the WeChat and Alipay Apps and has been generally adopted...’
Read here (Science, March 30, 2020)
‘Apps with similar aims have been deployed in China. Public health policy was implemented using an App which was not compulsory but was required to move between quarters and into public spaces and public transport. The App allows a central database to collect data on user movement and coronavirus diagnosis and displays a green, amber or red code to relax or enforce restrictions on movement. The database is reported to be analysed by an artificial intelligence algorithm that issues the colour codes. The App is a plug-in for the WeChat and Alipay Apps and has been generally adopted...’
Read here (Science, March 30, 2020)
‘Consider this: COVID-19’ with Jomo Kwame Sundaram
On March 30, 2020, Sharaad Kuttan and Melisa Idris interviewed Dr Jomo Kwame Sundaram on Covid-19 and its fallout. In their Astro Awani show, ‘Consider this’, they covered the three topics:
China to reveal a key virus data point: People with no symptoms
‘China’s government indicated it will start releasing data on how many people are infected with coronavirus but don’t have symptoms, seemingly responding to a growing chorus of domestic and international criticism of China’s data on the outbreak.’
Read here (Bloomberg, March 30, 2020)
Read here (Bloomberg, March 30, 2020)
Coronavirus: Don’t politicise medical supply problems, China says
‘China has urged countries not to “politicise” concerns about the quality of medical supplies after some countries in Europe reported defective products sourced from China. Chinese foreign ministry spokeswoman Hua Chunying said on Monday, March 30, that an objective approach was needed to solve the problems.’
Countries affected include Slovakia, the Netherlands, Spain and the Philippines.
Read here (South China Morning Post, March 30, 2020)
Countries affected include Slovakia, the Netherlands, Spain and the Philippines.
Read here (South China Morning Post, March 30, 2020)
Sunday 29 March 2020
RM250bil stimulus: Priorities in response to a three-faceted crisis
Commentary by Jeyakumar Devaraj
“The first aspect and the precipitating cause of this crisis is the Covid-19 pandemic that is sweeping the world. The pandemic is causing a massive overload on the medical services even in the richest countries in the world...
“The first aspect and the precipitating cause of this crisis is the Covid-19 pandemic that is sweeping the world. The pandemic is causing a massive overload on the medical services even in the richest countries in the world...
“The second aspect of the crisis is that many Malaysians in the B40 and M40 groups, especially daily rated workers and small business people have already run out of their meagre savings after 10 days of the Movement Control Order (MCO) and are already having difficulty in providing food for their families...
“The third aspect of the problem is that our small and medium-sized enterprises (SMEs) which employ about 65percent of our workforce are seriously under threat. The lockdown means that the vast majority of these SMEs have had no income since March 18.
“Given this bleak scenario, several measures have to be implemented quickly to address each aspect of the crisis. The capacity of our health care system to respond to the Covid 19 epidemic has to be bolstered, measures to ensure that the poorer 50% of our population have access to food and other basic necessities have to be rolled out and another set of measures to ensure that as many as possible of our SMEs are kept viable so that they can provide employment to the rakyat when we are able to restart the economy.”
Read here (Malaysiakini, March 29, 2020)
Locked down and locked up: Domestic violence during the pandemic
As the implementation of movement restriction measures disrupts our daily lives, governments are compelled to respond to the high demand for support as domestic violence cases soar in a short period of time. With such measures predicted to last for weeks and even months to come, the urgency to address this issue is unprecedented.
Read here (ISIS Malaysia, March 29, 2020)
Read here (ISIS Malaysia, March 29, 2020)
Preparing for a new normal
Governments around the world have had to scramble to find ways to manage an unprecedented crisis with varying levels of success. While Malaysia has done well compared to its peers, do we have the institutional capacity to manage present and future crises to come?
Read here (ISIS Malaysia, March 29, 2020)
Read here (ISIS Malaysia, March 29, 2020)
Approved: System to decontaminate N95 masks and allow reuse -- as many as 20 times
‘A system to decontaminate N95 masks to allow healthcare workers to safely reuse them -- as many as 20 times -- has been approved by the US FDA. It uses hydrogen peroxide vapour to “destroy bacteria, viruses and other contaminants, including... SARS-CoV-2,” and it can process up to 80,000 masks per day.’
Note: This is interesting. If the principle of decontamination and re-use is acceptable, what other ways can we use to recycle personal protection equipment (PPEs) especially in poor countries?
Read here (Politico, March 29, 2020)
Note: This is interesting. If the principle of decontamination and re-use is acceptable, what other ways can we use to recycle personal protection equipment (PPEs) especially in poor countries?
Read here (Politico, March 29, 2020)
A road map to reopening: US-focused but we can learn a thing or two
‘This report provides a road map for navigating through the current COVID-19 pandemic in the United States. It outlines specific directions for adapting our public-health approach away from sweeping mitigation strategies as we limit the epidemic spread of COVID-19, such that we can transition to new tools and approaches to prevent further spread of the disease.
‘The authors outline the steps that can be taken as epidemic transmission is brought under control in different regions. They also suggest measurable milestones for identifying when we can make these transitions and start reopening America for businesses and families.
‘In each phase, the authors outline the steps that the federal government, working with the states and public-health and health care partners, should take to inform the response. This will take time, but planning for each phase should begin now so the infrastructure is in place when it is time to transition.’
Read here (AEI, March 29, 2020)
‘The authors outline the steps that can be taken as epidemic transmission is brought under control in different regions. They also suggest measurable milestones for identifying when we can make these transitions and start reopening America for businesses and families.
‘In each phase, the authors outline the steps that the federal government, working with the states and public-health and health care partners, should take to inform the response. This will take time, but planning for each phase should begin now so the infrastructure is in place when it is time to transition.’
Read here (AEI, March 29, 2020)
Covid-19 package: The woes of a small business owner
‘There is a saying, “Give a man a fish and you can feed him for a day. Teach a man to fish and you feed him for a lifetime”. So help small businesses stay afloat.
‘Revenues are down. Margins, if any are non existent. Wages, rentals and raw material are the three main costs of business. Government assistance is needed to subsidise one part of the expense to keep Malaysians employed.
‘We have been told that we are fighting a war with an invisible enemy. We issue a one-off “Coronavirus War Bond” to fund this fight to keep jobs. It will break the budget deficit ceilings. What alternative do we have?’
Read here (FocusMalaysia, March 29, 2020)
‘Revenues are down. Margins, if any are non existent. Wages, rentals and raw material are the three main costs of business. Government assistance is needed to subsidise one part of the expense to keep Malaysians employed.
‘We have been told that we are fighting a war with an invisible enemy. We issue a one-off “Coronavirus War Bond” to fund this fight to keep jobs. It will break the budget deficit ceilings. What alternative do we have?’
Read here (FocusMalaysia, March 29, 2020)
Saturday 28 March 2020
In Singapore, quarantine comes with sea view, room service
“The government said last week it’s placing residents returning from the US and the UK in hotels to prevent them from potentially spreading the virus to their families, a measure that’s tighter than one that earlier allowed them to serve the period at home.”
Read here (Bloomberg, March 28, 2020)
Read here (Bloomberg, March 28, 2020)
Offline: COVID-19 and the NHS—“a national scandal” - Commentary in The Lancet
“When this is all over, the NHS England board should resign in their entirety.” So wrote one National Health Service (NHS) health worker last weekend. The scale of anger and frustration is unprecedented, and coronavirus disease 2019 (COVID-19) is the cause. The UK Government's Contain–Delay–Mitigate–Research strategy failed. It failed, in part, because ministers didn't follow WHO’s advice to “test, test, test” every suspected case. They didn't isolate and quarantine. They didn't contact trace. These basic principles of public health and infectious disease control were ignored, for reasons that remain opaque. The UK now has a new plan—Suppress–Shield–Treat–Palliate. But this plan, agreed far too late in the course of the outbreak, has left the NHS wholly unprepared for the surge of severely and critically ill patients that will soon come...
Read here (The Lancet, March 28, 2020)
Read here (The Lancet, March 28, 2020)
Checking the pandemic of Covid-19 misinformation and disinformation
“Advice on how to prevent, treat and cure COVID-19 has been shared in every corner of the globe. It often comes from ‘doctors’ or ‘health experts’ and sometimes includes reasonable suggestions alongside nonsensical and harmful claims. It has fooled many smart, well-meaning people who have shared it with the best of intentions. There is currently no ‘cure’ for COVID-19.”
This AFP site allows us to check the misinformation that has spread regarding Covid-19.
Read here (AFP, continually updated, started March 28, 2020)
This AFP site allows us to check the misinformation that has spread regarding Covid-19.
Read here (AFP, continually updated, started March 28, 2020)
Friday 27 March 2020
Not all or nothing: Anti-virus lockdowns could lift slowly
“While we may yearn for a clear timeline for when life will return to normal, scientists say that isn’t exactly the right question. Routines won’t resume exactly as they were for several months, or longer – but that doesn’t mean we’ll all be stuck in total lockdowns until then.”
Read here (Associated Press, March 27, 2020)
Read here (Associated Press, March 27, 2020)
'It’s a razor’s edge we’re walking': Inside the race to develop a coronavirus vaccine...
'Like every other scientist, Heeney spends part of his days worrying about funding. All these vaccine projects hurtling towards trials may yet be drawn to a screeching halt by a lack of money. Trials are expensive; so is the outlay on manufacturing and marketing vaccines. “If you’re going to make enough doses for the whole world, you’re going to need billions and billions of dollars,” Heeney said. Earlier this week, the Wellcome Trust put an exact number on it: a further $3bn, across the industry, to fund and produce enough vaccines to beat the pandemic.
'Most of this money will go towards trials and production, the costs of which are now frequently borne by drug companies. After the 80s, when a series of mergers left the pharma industry in the hands of a few behemoth companies, vaccines fell thoroughly under the sway of market forces, subject to the kind of logic that prompted Goldman Sachs, in a 2018 report, to wonder: “Is curing patients a sustainable business model?” (It isn’t, the analysts concluded.)
'Diseases that are borne out of poverty, and that require cheap vaccines, such as cholera, are largely ignored, says Peter Jay Hotez, the dean of the National School of Tropical Medicine at the Baylor College of Medicine in Houston. So are diseases that are uncommon, or diseases that have come and gone. Taxpayers fund most vaccine research, but the pharma titans that can make them at scale are reluctant to commit to a vaccine if the likelihood of profit is meagre. “We have a broken ecosystem for making vaccines,” Hotez told me.'
Read here (The Guardian, March 27, 2020)
Read here (The Guardian, March 27, 2020)
Coronavirus has not suspended politics – it has revealed the nature of power
‘In recent years, it has sometimes appeared that global politics is simply a choice between rival forms of technocracy. In China, it is a government of engineers backed up by a one-party state. In the west, it is the rule of economists and central bankers, operating within the constraints of a democratic system. This creates the impression that the real choices are technical judgments about how to run vast, complex economic and social systems.
‘But in the last few weeks another reality has pushed through. The ultimate judgments are about how to use coercive power. These aren’t simply technical questions. Some arbitrariness is unavoidable. And the contest in the exercise of that power between democratic adaptability and autocratic ruthlessness will shape all of our futures. We are a long way from the frightening and violent world that Hobbes sought to escape nearly 400 years ago. But our political world is still one Hobbes would recognise.’
Read here (The Guardian, March 27, 2020)
‘But in the last few weeks another reality has pushed through. The ultimate judgments are about how to use coercive power. These aren’t simply technical questions. Some arbitrariness is unavoidable. And the contest in the exercise of that power between democratic adaptability and autocratic ruthlessness will shape all of our futures. We are a long way from the frightening and violent world that Hobbes sought to escape nearly 400 years ago. But our political world is still one Hobbes would recognise.’
Read here (The Guardian, March 27, 2020)
Covid-19 exposes the fragility of our belief-systems
‘You could say COVID-19 has exposed the extent to which we are in a ‘meaning crisis’ (to use John Vervaeke’s phrase). But I’m a little wary of this term as a historical concept. When did this ‘meaning crisis’ begin? For who? Maybe young Americans are in something of a meaning crisis now, as they turn away from Christianity, but British people went through that loss of faith in the late 19th century, and I’m sure it’s different for every culture around the world.
‘I’d suggest humans are always in a meaning crisis, we always have been. We have a tiny mind-map, equivalent to a photo of a street, and we’re out there in a great megapolis trying to use this photo as if it was Google Maps. We look around bewildered, look at our photo, and think ‘this looks a bit familiar’.
‘There is so much we don’t know, and we can learn to be OK with that. As a rule of thumb, we can be suspicious of any expert who seems over-certain, who rarely pauses for breath or questions their assumptions. When was the last time they admitted they were wrong? When was the last time they said ‘I’m not very sure about this, this isn’t my field of expertise’?’
Read here (Medium, Jules Evans, Mar 27, 2020)
Questions about leadership and open-mindedness: A response to why Covid-19 deniers stick to their beliefs
‘Q: What kind of leadership is needed right now, given our belief systems and what is at stake?
‘A: We all need to be more intellectually humble. We all need to recognise that how certain we feel is irrelevant to how certain we should be. We need to recognise that there are scientists and medical experts out there who have the knowledge and expertise we need to make smart decisions, and they are willing and able to share that information with us.
‘We need our leaders especially right now to understand the role they have in all of this. Words aren’t just words. Words are the basis of beliefs, and beliefs drive our behaviour. People who don’t believe the pandemic is real or that it will spread put themselves and everyone else at risk by not doing what needs to be done to stop it…
‘Q: Can people be taught to be more open-minded?
‘A: It’s possible. Beliefs are not stable, finished things because we are constantly taking in new data and updating. It may seem disheartening that people shut down once they become certain. But I see hope in the fact that people are fundamentally social and that they seek to engage with one another.
‘People are sensitive to the beliefs of those around them. When those beliefs change, people may reconsider their positions. That’s why talking about what is happening is important, and informed people who know the most should be talking the loudest.’
Read here (Futurity, March 27, 2020)
‘A: We all need to be more intellectually humble. We all need to recognise that how certain we feel is irrelevant to how certain we should be. We need to recognise that there are scientists and medical experts out there who have the knowledge and expertise we need to make smart decisions, and they are willing and able to share that information with us.
‘We need our leaders especially right now to understand the role they have in all of this. Words aren’t just words. Words are the basis of beliefs, and beliefs drive our behaviour. People who don’t believe the pandemic is real or that it will spread put themselves and everyone else at risk by not doing what needs to be done to stop it…
‘Q: Can people be taught to be more open-minded?
‘A: It’s possible. Beliefs are not stable, finished things because we are constantly taking in new data and updating. It may seem disheartening that people shut down once they become certain. But I see hope in the fact that people are fundamentally social and that they seek to engage with one another.
‘People are sensitive to the beliefs of those around them. When those beliefs change, people may reconsider their positions. That’s why talking about what is happening is important, and informed people who know the most should be talking the loudest.’
Read here (Futurity, March 27, 2020)
Trump’s response to the pandemic has been haunted by the science denialism of his ultraconservative religious allies
‘Donald Trump rose to power with the determined assistance of a movement that denies science, bashes government and prioritised loyalty over professional expertise. In the current crisis, we are all reaping what that movement has sown...
‘It is fair to point out that the failings of the Trump administration in the current pandemic are at least as attributable to its economic ideology as they are to its religious inclinations. When the so-called private sector is supposed to have the answer to every problem, it’s hard to deal effectively with the very public problem of a pandemic and its economic consequences. But if you examine the political roots of the life-threatening belief in the privatisation of everything, you’ll see that Christian nationalism played a major role in creating and promoting the economic foundations of America’s incompetent response to the pandemic.’
Read here (New York Times, March 27, 2020)
‘It is fair to point out that the failings of the Trump administration in the current pandemic are at least as attributable to its economic ideology as they are to its religious inclinations. When the so-called private sector is supposed to have the answer to every problem, it’s hard to deal effectively with the very public problem of a pandemic and its economic consequences. But if you examine the political roots of the life-threatening belief in the privatisation of everything, you’ll see that Christian nationalism played a major role in creating and promoting the economic foundations of America’s incompetent response to the pandemic.’
Read here (New York Times, March 27, 2020)
Mild cases as infectious as severe ones? There are strong correlations in Lombardy and Guangzhou. If proven true, this would underscore the need for tweaking social-distancing policies for the longer term...
‘If you have a high viral load, you are more likely to infect other people, because you may be shedding more virus particles. However, in the case of covid-19, it doesn’t necessarily follow that a higher viral load will lead to more severe symptoms.
‘For instance, health workers investigating the covid-19 outbreak in the Lombardy region of Italy looked at more than 5,000 infected people and found no difference in viral load between those with symptoms and those without. They reached this conclusion after tracing people who had been in contact with someone known to be infected with the coronavirus and testing them to see if they were also infected.
‘Similarly, when doctors at the Guangzhou Eighth People’s Hospital in China took repeated throat swabs from 94 covid-19 patients, starting on the day they became ill and finishing when they cleared the virus, they found no obvious difference in viral load between milder cases and those who developed more severe symptoms...
‘It is early days, but if the infectious dose doesn’t correlate with the severity of disease symptoms, this would mark covid-19 out as different from influenza, MERS and SARS...’
Read here (New Scientist, March 27, 2020)
Thursday 26 March 2020
Genomic study points to natural origin of COVID-19, says NIH Director’s blog. Two scenarios suggested
‘In the first scenario, as the new coronavirus evolved in its natural hosts, possibly bats or pangolins, its spike proteins mutated to bind to molecules similar in structure to the human ACE2 protein, thereby enabling it to infect human cells. This scenario seems to fit other recent outbreaks of coronavirus-caused disease in humans, such as SARS, which arose from cat-like civets; and Middle East respiratory syndrome (MERS), which arose from camels.
‘The second scenario is that the new coronavirus crossed from animals into humans before it became capable of causing human disease. Then, as a result of gradual evolutionary changes over years or perhaps decades, the virus eventually gained the ability to spread from human-to-human and cause serious, often life-threatening disease.
‘Either way, this study leaves little room to refute a natural origin for COVID-19. And that’s a good thing because it helps us keep focused on what really matters: observing good hygiene, practicing social distancing, and supporting the efforts of all the dedicated health-care professionals and researchers who are working so hard to address this major public health challenge.’
Read here (NIH Director’s Blog, March 26, 2020)
Read here too on ‘The proximal origin of SARS-CoV-2’ (Nature Medicine, March 17, 2020)
‘The second scenario is that the new coronavirus crossed from animals into humans before it became capable of causing human disease. Then, as a result of gradual evolutionary changes over years or perhaps decades, the virus eventually gained the ability to spread from human-to-human and cause serious, often life-threatening disease.
‘Either way, this study leaves little room to refute a natural origin for COVID-19. And that’s a good thing because it helps us keep focused on what really matters: observing good hygiene, practicing social distancing, and supporting the efforts of all the dedicated health-care professionals and researchers who are working so hard to address this major public health challenge.’
Read here (NIH Director’s Blog, March 26, 2020)
Read here too on ‘The proximal origin of SARS-CoV-2’ (Nature Medicine, March 17, 2020)
Modes of contact and risk of transmission in COVID-19 among close contacts
A new preprint on medRxiv examines the modes of contact and the level of transmission among close contacts of persons infected with COVID-19. The study follows just under 5,000 close contacts in Guangzhou, China. Of the close contacts identified, 2.6% of cases developed symptoms during their quarantine, the majority of which were mild or moderate cases (89.9%) and a small portion of which were asymptomatic (6.2%). They authors found that contacts within the same household were at the highest risk of contracting COVID-19.
Read here (Medrxiv, March 26, 2020)
Note: As the Covid-19 situation worsens in the US, Europe and other countries, our students and other citizens are coming home in large numbers. They are being told to self-quarantine. Many are doing it at home, in which case they may infect others if they are carrying the virus. Some are sending their folks to AirBNBs.
Read here (Medrxiv, March 26, 2020)
Note: As the Covid-19 situation worsens in the US, Europe and other countries, our students and other citizens are coming home in large numbers. They are being told to self-quarantine. Many are doing it at home, in which case they may infect others if they are carrying the virus. Some are sending their folks to AirBNBs.
Healthcare front liners demand action
“If this virus is not stringently contained now, the repercussions to the health of the American population, as well as the impact on the country’s economic, educational and welfare systems, will be incalculable,” notes Megan E. Brunson, RN, president of the American Association of Critical‐Care Nurses.
Critical care front liners in the US plead for (1) greater public cooperation (2) suspension of non-essential activities -- stop mass travel and close hotels and hospitality venues (3) suspension of non-essential health care (4) at least three weeks stay-in-place.
“Our guidance to the public, US Federal Government and state and local governments comes after substantial input from the U.S. Centers for Disease Control and Prevention (CDC) and careful examination of best practices from other health officials from around the world.”
Read here
Wednesday 25 March 2020
Nurses. Nurses. Nurses
“Among the nine countries with the highest number of Covid-19 cases, the country that has the highest nurse rate also has the lowest death rate from the disease. Germany has 13.2 nurses per 1,000 (echoing a trend for high nurse numbers throughout Northern Europe) far above the other heavily Covid-19 affected countries.
“This may be just another armchair epidemiologist observation of course. But higher numbers of nurses may reflect one of two beneficial factors (or both): first, that nurses, the backbone of hospital (and especially ICU) care, are essential to patient management and, ultimately, survival.
“The second is that the sort of hospital or country that knows the value of nurses also is a hospital or country that understands how to deliver effective health care and has likely made countless other unmeasured adjustments to improve quality.”
Read here (CNN, March 25, 2020)
The analogy between Covid-19 and climate change is eerily precise
“We went through the stages of climate change denial in the matter of a week,” said Gordon Pennycook, a psychologist at the University of Regina in Saskatchewan, Canada, who studies how misinformation spreads. Naomi Oreskes, a historian of science who has studied the origins of climate disinformation, spelled out the pattern in an email: “First, one denies the problem, then one denies its severity, and then one says it is too difficult or expensive to fix, and/or that the proposed solution threatens our freedom.”
Read here (Wired, March 25, 2020)
Read here (Wired, March 25, 2020)
How the pandemic will end
‘The US may end up with the worst COVID-19 outbreak in the industrialised world. This is how it’s going to play out...
‘Three months ago, no one knew that SARS-CoV-2 existed. Now the virus has spread to almost every country, infecting at least 446,000 people whom we know about, and many more whom we do not. It has crashed economies and broken health-care systems, filled hospitals and emptied public spaces. It has separated people from their workplaces and their friends. It has disrupted modern society on a scale that most living people have never witnessed. Soon, most everyone in the United States will know someone who has been infected. Like World War II or the 9/11 attacks, this pandemic has already imprinted itself upon the nation’s psyche.’
Read here (The Atlantic, March 25, 2020)
Social distancing in China now: A vlog by The China Traveller, a UK citizen who lived through the lockdown in Beijing
‘Life is very gradually returning to normal in China, but there are still loads of social distancing measures in place. Some measures are hi-tech whereas others are quite the opposite. I want to show everyone how social distancing works in the capital, Beijing, at a time when people are starting to return to their normal lives. If you're in another country and you're still unsure of what social distancing should entail, this video might help you understand how others around the world are doing it.’
View here (The China Traveller, Youtube, March 25, 2020)
View here (The China Traveller, Youtube, March 25, 2020)
How will the Covid-19 pandemic end?
This long article discusses the near-term effects, end-game and aftermath of the Covid-19 crisis in the US. It concludes that the lessons that America draws from this experience are hard to predict but there could be two extreme scenarios, with many variations in between. As the most powerful socio-economic and political entity in the world, whichever path it takes, it will affect the entire world.
NEGATIVE ENGAGEMENT: ‘One could easily conceive of a world in which most of the nation believes that America defeated COVID-19. Despite his many lapses, Trump’s approval rating has surged. Imagine that he succeeds in diverting blame for the crisis to China, casting it as the villain and America as the resilient hero. During the second term of his presidency, the U.S. turns further inward and pulls out of NATO and other international alliances, builds actual and figurative walls, and disinvests in other nations. As Gen C grows up, foreign plagues replace communists and terrorists as the new generational threat.’
POSITIVE ENGAGEMENT: ‘One could also envisage a future in which America learns a different lesson. A communal spirit, ironically born through social distancing, causes people to turn outward, to neighbours both foreign and domestic. The election of November 2020 becomes a repudiation of “America first” politics. The nation pivots, as it did after World War II, from isolationism to international cooperation. Buoyed by steady investments and an influx of the brightest minds, the health-care workforce surges. Gen C kids write school essays about growing up to be epidemiologists. Public health becomes the centerpiece of foreign policy. The US leads a new global partnership focused on solving challenges like pandemics and climate change.’
Read here (The Atlantic, March 25, 2020)
Potential Covid-19 game changer in the UK: Fingerprick tests
‘Widespread availability of a fingerprick test that produces results in 10 to 15 minutes would be a game-changer. NHS doctors and nurses with symptoms would know immediately whether they have had Covid-19, enabling them to get back to work sooner.
‘NHS workers or anyone else would be able to know if they have had the virus and are therefore immune, which means they could resume their normal lives, no longer having to work from home or keep their distance from other people. It is widely thought that having had Covid-19 makes people immune to the disease. There have been cases of apparent reinfection, though they are rare.
‘The test detects the presence of IGM, an antibody that arises very early on in the infection, and IGG, which is increased in the body’s response to the virus. The results of some of the tests on order can be read by anyone, but others would need to be interpreted by healthcare professionals.
‘The UK is not the only country ordering the antibody tests. “Tests are being ordered across Europe and elsewhere and purchased in south-east Asia. This is widespread practice. We are not alone in doing this,” said Peacock [Prof Sharon Peacock, the director of the national infection service at PHE].’
Read here (The Guardian, March 25, 2020)
‘NHS workers or anyone else would be able to know if they have had the virus and are therefore immune, which means they could resume their normal lives, no longer having to work from home or keep their distance from other people. It is widely thought that having had Covid-19 makes people immune to the disease. There have been cases of apparent reinfection, though they are rare.
‘The test detects the presence of IGM, an antibody that arises very early on in the infection, and IGG, which is increased in the body’s response to the virus. The results of some of the tests on order can be read by anyone, but others would need to be interpreted by healthcare professionals.
‘The UK is not the only country ordering the antibody tests. “Tests are being ordered across Europe and elsewhere and purchased in south-east Asia. This is widespread practice. We are not alone in doing this,” said Peacock [Prof Sharon Peacock, the director of the national infection service at PHE].’
Read here (The Guardian, March 25, 2020)
Tuesday 24 March 2020
Case for wearing face masks (4): History -- showing how Wu Lien-Teh from Penang, in the face of racism and widespread doubt, soldiered on to make the face mask an icon of modern healthcare
‘In the fall of 1910, a plague broke out across Manchuria—what we know now as Northern China—which was broken up in politically complex jurisdictions shared between China and Russia...
‘The Chinese Imperial Court brought in a doctor named Lien-teh Wu to head its efforts. He was born in Penang and studied medicine at Cambridge. Wu was young, and he spoke lousy Mandarin. In a plague that quickly attracted international attention and doctors from around the world, he was “completely unimportant,” according to Lynteris. But after conducting an autopsy on one of the victims, Wu determined that the plague was not spread by fleas, as many suspected, but through the air.
‘Expanding upon the surgery masks he’d seen in the West, Wu developed a hardier mask from gauze and cotton, which wrapped securely around one’s face and added several layers of cloth to filter inhalations. His invention was a breakthrough, but some doctors still doubted its efficacy.
‘“There’s a famous incident. He’s confronted by a famous old hand in the region, a French doctor [Gérald Mesny] . . . and Wu explains to the French doctor his theory that plague is pneumonic and airborne,” Lynteris says. “And the French guy humiliates him . . . and in very racist terms says, ‘What can we expect from a Chinaman?’ And to prove this point, [Mesny] goes and attends the sick in a plague hospital without wearing Wu’s mask, and he dies in two days with plague.”
‘Other doctors in the region quickly developed their own masks. “Some are . . . completely strange things,” Lynteris says. “Hoods with glasses, like diving masks.”
‘But Wu’s mask won out because in empirical testing, it protected users from bacteria. According to Lynteris, it was also a great design. It could be constructed by hand out of materials that were cheap and in ready supply. Between January and February of 1911, mask production ramped up to unknown numbers. Medical staff wore them, soldiers wore them, and some everyday people wore them, too. Not only did that help thwart the spread of the plague; the masks became a symbol of modern medical science looking an epidemic right in the eye.’
Read here (Fast Company, March 24, 2020)
‘The Chinese Imperial Court brought in a doctor named Lien-teh Wu to head its efforts. He was born in Penang and studied medicine at Cambridge. Wu was young, and he spoke lousy Mandarin. In a plague that quickly attracted international attention and doctors from around the world, he was “completely unimportant,” according to Lynteris. But after conducting an autopsy on one of the victims, Wu determined that the plague was not spread by fleas, as many suspected, but through the air.
‘Expanding upon the surgery masks he’d seen in the West, Wu developed a hardier mask from gauze and cotton, which wrapped securely around one’s face and added several layers of cloth to filter inhalations. His invention was a breakthrough, but some doctors still doubted its efficacy.
‘“There’s a famous incident. He’s confronted by a famous old hand in the region, a French doctor [Gérald Mesny] . . . and Wu explains to the French doctor his theory that plague is pneumonic and airborne,” Lynteris says. “And the French guy humiliates him . . . and in very racist terms says, ‘What can we expect from a Chinaman?’ And to prove this point, [Mesny] goes and attends the sick in a plague hospital without wearing Wu’s mask, and he dies in two days with plague.”
‘Other doctors in the region quickly developed their own masks. “Some are . . . completely strange things,” Lynteris says. “Hoods with glasses, like diving masks.”
‘But Wu’s mask won out because in empirical testing, it protected users from bacteria. According to Lynteris, it was also a great design. It could be constructed by hand out of materials that were cheap and in ready supply. Between January and February of 1911, mask production ramped up to unknown numbers. Medical staff wore them, soldiers wore them, and some everyday people wore them, too. Not only did that help thwart the spread of the plague; the masks became a symbol of modern medical science looking an epidemic right in the eye.’
Read here (Fast Company, March 24, 2020)
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