5:41 PM 4/30/2020 - Michael Novakhov - SharedNewsLinks: Role of fecal excretion in spread of SARS-CoV-2 'cannot be ignored'

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Michael Novakhov - SharedNewsLinks℠ | InBrief | 
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Michael Novakhov - SharedNewsLinks 
Role of fecal excretion in spread of SARS-CoV-2 'cannot be ignored'
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Michael Novakhov - SharedNewsLinks 
Role of fecal excretion in spread of SARS-CoV-2 'cannot be ignored'

Michael_Novakhov shared this story .

NEW YORK (Reuters Health) - The novel coronavirus (SARS-CoV-2) stays significantly longer in stool than in the lungs and serum, suggesting that the management of stool samples is important for controlling the virus, clinicians in China report.
Dr. Tingbo Liang and colleagues of First Affiliated Hospital in Hangzhou estimated the viral load from 3497 respiratory, stool, serum and urine samples from 96 patients with SARS-CoV-2 infection.
Infection was confirmed in all patients via sputum and saliva samples, they report in a fast-track report in The BMJ. In addition, viral RNA was detected in the stool of 55 (59%) patients, in the serum of 39 (41%) patients, and the urine of only one patient.
The average lifespan of the virus was 22 days (range 17-31 days) in stool compared to 18 days (range 13-29 days) in respiratory tissue and 16 days (range 11-21 days) in serum, the researchers report.
Based on this finding, they say the role of fecal excretion in the spread of SARS-CoV-2 cannot be ignored; however, the importance of high detection in stool samples in the prevention and control of the SARS-CoV-2 epidemic requires comprehensive and careful evaluation.
They also found that the virus persists for a longer period and peaks later in respiratory tissue in people with severe disease. The average duration of virus in respiratory samples of patients with severe disease was 21 days (range 14-30 days) compared with 14 days (range 10-21 days) in those with mild disease.
In those with mild disease, the viral loads peaked in respiratory samples in the second week after disease onset, whereas viral load continued to be high during the third week in those with severe disease.
These findings suggest that reducing viral loads through clinical means and strengthening management during each stage of severe disease should help to prevent the spread of the virus, the authors write.
They also observed that the virus lasts longer in men than women and in patients over age 60 years, which may partly explain the high rate of severe illness in older patients.
By way of limitations, they note that this was a single center cohort study, and the sample size was inadequate to compare the effects of antiviral therapy in different subgroups, which could lead to an unbalanced distribution of confounders when evaluating viral shedding and viral load. Secondly, viral load is influenced by many factors. The quality of collected samples directly affects the viral load, so the study of viral load only partly reflects the amount of virus in the body.
Dr. Liang did not respond to a request for comment by press time.
SOURCE: bit.ly/2KI5OvI The BMJ, online April 23, 2020.
Is It Coronavirus? What We Know About Common and Atypical COVID-19 Symptoms NBC Connecticut

Michael_Novakhov shared this story .

San Diego musician Drew Andrews was cooking soup on March 22, when out of the blue, he lost his sense of taste and smell. Actress Rita Wilson described losing her sense of taste and smell before developing other symptoms more commonly associated with the new respiratory disease. Utah Jazz star Rudy Gobert tweeted he had suffered the same sudden, unexplained loss of these senses and wondered whether others had experienced the same. All three also tested positive for COVID-19.
While anosmia, the loss of smell, and ageusia, the diminished sense of taste, are not atypical symptoms for viral infections of the throat and nose, like the common cold, anecdotal evidence from around the world found patients experiencing these without having any other respiratory symptoms. In some cases, those symptoms later developed. Citing mounting reports from several countries, experts concluded a loss of smell or taste may be an early sign of infection and serve as a useful screening tool.
On Monday, the U.S. Centers for Disease Control and Prevention expanded its guidelines for identifying COVID-19 to include loss of taste and smell. The CDC also added chills, repeated shaking with chills, muscle pain, headache and sore throat. A previous list of symptoms was limited to fever, coughing and shortness of breath or difficulty breathing.
The evolving list reflects some of the conditions doctors have encountered while treating patients with COVID-19. But many more have appeared with some regularity. Patients and doctors alike are parsing signs of illness to figure out who needs what tests or care and how worried they should be.

Coronavirus Pandemic Coverage

Here's what we do and don't know about coronavirus symptoms:

Classic Symptoms: The Basics

As previously noted, the CDC has identified nine key symptoms associated with the new coronavirus:
  • fever
  • coughing
  • shortness of breath or difficulty breathing
  • chills
  • repeated shaking with chills
  • muscle pain
  • headache
  • sore throat
  • new loss of taste or smell
The World Health Organization includes tiredness, diarrhea, nausea and a runny nose in its list of common and "other" symptoms.
For most people, the coronavirus causes mild or moderate symptoms that clear up in two to three weeks. For some, especially older adults and people with other medical problems such as high blood pressure, obesity, diabetes or heart conditions, it can cause more severe illness and death.
The CDC advises that people seek immediate medical attention if they have trouble breathing, persistent pain or pressure in the chest, new confusion or inability to arouse or bluish lips or face.

Red Flags: Telltale Signs of COVID-19

As the number of confirmed cases surge past 3.1 million globally and deaths surpass 216,000, health experts are still trying to understand how the disease impacts the human body. Dozens of studies and reports have documented smaller subsets of people who've experienced everything from rashes to seizures to pink eye.
Accumulating evidence points to a possible link to COVID-19, but experts maintain that more peer reviewed studies are needed to come to a conclusion about these less familiar symptoms.
RASHES AND HIVES: In a report published in March in the Journal of the European Academy of Dermatology and Venereology, Italian researchers studied 88 COVID-19 patients at Lecco Hospital in the country's Lombardy region, and found 20.4% had skin issues ranging from a red rash on their torsos to hives or chickenpox-like blisters. Similar reports have surfaced in France, Spain, Thailand and in the U.S., prompting the American Academy of Dermatology to open a registry for health professionals to log skin complaints thought to be related to COVID-19.
According to the AAD, many viral illnesses are accompanied by skin rashes caused by the body's immune system fighting off the infection.
COVID TOES: Dermatologists and podiatrists are also investigating another possible symptom known as "COVID toes." The pseudo-frostbite condition is characterized by purple or red lesions on toes and sometimes even the bottoms of feet and fingers. Feet can occasionally become itchy, painful or may show no other symptoms besides discoloration, according to Dr. Amy Paller, a dermatologist for Northwestern Medicine, who has seen dozens of cases of "COVID Toes."
In the first week that the AAD symptoms registry was launched, more than half of the 90 to 100 reports addressed patients with purple lesions on feet or hands. For some but not all patients, it was the only symptom, according to Dr. Esther Freeman, a dermatologist at Massachusetts General Hospital in Boston, who is running the registry in collaboration with the AAD. Freeman told TODAY that experts have some ideas on what could be causing the lesions, but the research is just beginning.
The sores have also been reported in patients in Spain, Italy, France and Thailand, according the AAD.
CONJUNCTIVITIS: Also known as pink eye, conjunctivitis may occur in 1% to 3% of infected people, the American Academy of Ophthalmology warned members last month, advising eye doctors to be on the lookout for patients who complained of pink eye and who also had fever and respiratory symptoms such as cough and shortness of breath. Virus particles have been found in eye secretion of COVID-19 positive patients, but the group acknowledges the risk of transmission is low.
And it's not just atypical symptoms that have baffled the medical community. Doctors on the front lines are also discovering new complications of COVID-19. Growing evidence suggests the respiratory disease's reach stretches beyond the lungs to wreak havoc on the blood and nervous systems.
Doctors have observed hospitalized patients with coronavirus developing unusual blood clots, NBC News reported. A study from the Netherlands published this month looked at data on 184 patients in intensive care with COVID-19. Nearly a third were found to have clots, which is "remarkably high" for ICU patients, the study authors wrote.
Some physicians are reporting increases of patients in their 30s and 40s with COVID-19-related strokes that result when clots block blood vessels leading to the brain, according to The Washington Post.
A recent study of 214 hospitalized patients in Wuhan, China, where the pandemic started, found more than a third had neurologic manifestations of the disease, including impaired balance or coordination, loss of consciousness and seizures.
[The disease] can attack almost anything in the body with devastating consequences, says cardiologist Harlan Krumholz of Yale University and Yale-New Haven Hospital. Its ferocity is breathtaking and humbling.

2:37
How to Get a COVID-19 Test
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How to Get a COVID-19 Test
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As coronavirus spreads across the globe, many in the United States are wondering how they can get tested. Here is the process.

What Are the Coronavirus Symptoms in Kids?

To date, children have been among the least affected group by the coronavirus. Data from more than 75,000 cases in China showed they comprised 2.4% of all cases and mostly suffered only mild symptoms.
Isolated reports show infants, babies, toddlers and older children experience similar symptoms of COVID-19 as adults. Dr. Patricia Whitley-Williams, chief of pediatric infectious disease at Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey, told TODAY that the medical community still relies on cough, respiratory distress breathing fast, having difficulty catching your breath fever" as screening tools for possible infections in children.
But doctors have observed that children with coronavirus do report a unique symptom: stomach distress.
Theyll develop gastrointestinal symptoms, especially diarrhea and vomiting, which may not be seen in adults, Whitley-Williams explained.

0:55
New Study Shows Challenges in Detecting COVID-19 in Children
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Researchers in China released a new study that shows many children infected with coronavirus do not show the same symptoms as adults, making early detection more challenging.

Is There a Link Between Kawasaki Disease and COVID-19 in Kids?

More recently, doctors in the United Kingdom reported a rare inflammatory condition in children that is possibly linked to the new coronavirus, The Associated Press reported. Britains Paediatric Intensive Care Society issued an alert to doctors noting that in the past three weeks, there has been an increase in the number of children with inflammatory problems requiring intensive care. The group said there was growing concern that either a COVID-19 related syndrome was emerging in children or that a different, unidentified disease might be responsible.
The cases were also reported to have features of toxic shock syndrome or Kawasaki disease, a rare blood vessel disorder. Only some of the children tested positive for COVID-19, so scientists are unsure if these rare symptoms are caused by the new coronavirus or by something else. Health officials estimate there have been about 20 such cases in Britain and NHS England said it is urgently investigating the reports.
Spains Association of Pediatrics recently made a similar warning as did the Italian Paediatricians' Society. Some possible cases have also been reported in France and Belgium.
In the U.S., three children who range in age from 6 months to 8 years with the coronavirus have undergone treatment for similar cases, according to Columbia University Medical Center in New York, Reuters reported. All three had fever and inflammation of the heart and the gut.
The three cases in New York follows a similar report at Stanford University involving a 6-month-old girl in California who was admitted to the hospital with Kawasaki disease and then diagnosed with COVID-19.
Dr. Roshni Mathew, a pediatric infectious disease specialist at Stanford's Lucile Packard Children's Hospital who wrote up the case in the journal Hospital Pediatrics, said the cause of Kawasaki disease is not known, but several pathogens have been suggested as a possible trigger, including some human coronaviruses.
Well need more information published in the peer-reviewed literature to better understand this association. However, Kawasaki disease is a relatively rare condition, so seeing these cases makes us concerned that Kawasaki disease could be a rare complication of COVID-19, said Dr. Sonja Rasmussen, a University of Florida pediatrics professor who co-authored a recent JAMA Pediatrics article about COVID-19 and children. We need to remain vigilant when we see children with findings that arent typical for COVID-19.
The chair of the WHO's European Technical Advisory Group said Thursday it was urgently conducting a surveillance study in the United Kingdom to establish what is going on."
As more and more people contract COVID-19, doctors are gaining further knowledge of the disease. While it may seem like a new symptom pops up every other day, raising awareness of what to look out for can help to slow the spread of this disease.

Social Distancing To Fight Coronavirus: A Strategy That Is Working and Must Continue

Michael_Novakhov shared this story from Center for American ProgressCenter for American Progress.

For the last several days, President Donald Trump has become increasingly vocal in his opposition to the social distancing policies that state and local governments have put in place to slow the spread of the COVID-19 pandemic, citing concerns about their business impact. This position is utterly reckless and contradicts the universal consensus of public health and infectious diseases experts. It also ignores the reality that allowing further spread of COVID-19 will result in more damaging and longer-term economic impact than continuing with social distancing. State and local governments must continue to lead in this crisis; measures that may seem overly disruptive remain essential to protect peoples health.
The United States is still in the early stages of this pandemic. For this reason, it may seem to some as though social distancing rules are unnecessary, overly onerous, or not working. In fact, evidence from other countries shows that social distancing interventions can slow the spread of COVID-19. Beyond the international evidence of social distancings effectiveness, there is promising data from states that were early adopters of key social distancing policies, including bans on large gatherings and closing bars and restaurants. Together, these case studies should reassure state and local governments that they are continuing on the correct path.

Social distancing and the spread of COVID-19

Mass testing allows officials to utilize up-to-date and localized data on the disease spread, including identifying asymptomatic individuals who can then isolate themselves before they further spread the virus. In the absence of widespread testing, however, the centerpiece of the public health response to COVID-19 is social distancing. The goal of social distancing is also to prevent contagious people from coming into close contact with healthy people in order to flatten the curveslowing down the spread of the viruswhich in turn helps to avoid a spike in cases that overwhelms the health care system. To lessen the chances of catching COVID-19, experts recommend that people stay at least six feet away from each other. Social distancing policies include telework and business and school closures.
Social distancing works, but it takes time to generate results. Even before social distancing completely eliminates transmission of the virus, it can still slow the transmission of the virus, ensuring that health care systems have adequate time to ramp up capacity to respond to the pandemic. For this reason, when evaluating social distancing results, it is critical to remember that the United States is still comparatively in the early stages of this pandemic. Chinas first cases appeared in early December; the first case in the United States was identified in mid-January. The total number of reported cases in the United States has exceeded 62,000, with more than 800 people dying from the disease. Due to the lack of testing, we know that many more people have contracted COVID-19, and the virus will continue to spread to some degree in coming weeks.
New cases will continue to be diagnosed during periods of social distancing efforts for two reasons. First, even successful, aggressive stay-at-home orders do not stop all transmission. Individuals will still need to leave their homes for necessities such as food, and workers with essential jobs will continue to go to work. Both of these present opportunities for new transmissions, and relatively more lax social distancing practices will be less effective than stay-at-home orders. Second, the public health benefit of social distancing will not be felt until communities had these policies in place for the entire incubation periods worth of time. Many individuals who contracted COVID-19 in the weeks before the start of social distancing will not be diagnosed until they begin to show symptoms, which can take up to 14 days.
Reducing asymptomatic transmission is the primary goal of social distancing. However, asymptomatic transmission is the more difficult form of transmission to monitor without widespread testing, which is currently unavailable in the United States. With these caveats, we will likely begin to see some clearer flattening of the curve in some areas in early April. Many states and localities began aggressively responding to the pandemic in the latter half of March, and the first statewide stay-at-home order, in California, was issued on March 19. With studies suggesting that patients are no longer contagious around 10 days after they start showing symptoms, this creates a 12 to 24 day delay between when social distancing begins and curve flattening is likely to show itself in the data.
The first coronavirus case in the United States was confirmed on January 21, 2020, in Washington state. The patient had traveled to Wuhan, China. By March 18, there was a confirmed case in all 50 states and the District of Columbia. States have implemented different social distancing requirements with varying levels of enforceability. By the afternoon of March 14, 14 states, the District of Columbia, and at least seven major cities or counties had implemented bans on gatherings, with an additional 19 states recommending the cancellation of large events. In the following days and weeks, other states, cities, and counties strengthened and implemented additional measures.

Evidence from other nations

South Korea and Italy are two of the nations with some of the greatest numbers of cases. These countries show how two completely different approaches to addressing the pandemic in its early stages can dramatically change the spread of the disease. Of course, many of the policies implemented by other countries may not be appropriate for adoption in the United States, but these case studies still illustrate the importance of social distancing.
South Korea
South Korea has had one of the earliest and most robust responses to the coronavirus pandemic. The impact of these policies is clearwith a case fatality rate of just more than 1 percent, the nation has one of the lowest fatality rates globally. Just one week after confirming its first case, South Korean government officials urged companies to mass produce testing kits. With enough supplies to do so, the government has proven its commitment to test often and quickly. The government opened 600 testing centers designed to test as many people as possible, as quickly as possible and minimize contact to prevent further infection. Some of these testing designs were innovative, including 50 drive-through centers and a chamber resembling a transparent phone booth.
South Korea has taken a unique approach to surveilling its citizens to contain the spread of the coronavirus, aided by a loosening of privacy laws during a 2015 outbreak of MERS that allows the government to access peoples personal data. The government monitors bank card, cell phone location, and CCTV data to identify people who may have come into contact with known cases and ensure they get tested. It also implemented an extensive emergency alert system that texts residents with reports of activity of nearby citizens who tested positive. These tactics have helped the government locate coronavirus clusters, investigate the path of infection, quickly isolate those involved, and warn the public about trouble spots to avoid.
Widespread testing, coupled with access to data on patients and paths of infection, has allowed social distancing measures to be used even more effectively than in other affected countries. For example, the government introduced an app that sets off an alarm if quarantined people leave their home. Live, app-based information about infected people nearby allows residents to avoid hotspots of infection. Furthermore, Gyeonggi Province, which includes Seoul, required public-use businesses to take precautions to mitigate risk of infection, including disinfecting and ventilating their premises; maintaining maximum distance between customers; and keeping a list of all visitors and their contact information.
Less than a week after a series of new infections in late February that peaked on February 29, the number of new cases in South Korea were halved. Within four days, it halved againand again the next day. While these measures would not be an appropriate course of action in the United States, they have been effective at flattening the curve in South Korea.
Italy
Italy is one of the nations that COVID-19 has hit the hardest. As of March 24, Italy had nearly 70,000 positive casessecond only to China. This large number of cases is especially concerning given Italys relatively old population. The first cases in Italy were confirmed on January 31, resulting in the nation closing its air traffic to and from China. After this, it was nearly a month until Italian officials took further action to slow the spread of the disease, imposing travel restrictions in the northern region of Lombardy as well as closing schools in major cities nationwide on February 23.
In March, the Italian government imposed several additional measures meant to slow the spread of COVID-19. It ordered all schools and universities closed and sporting events to be held behind closed doors. A few days later, the government announced a forced quarantine for the Lombardy region, and then expanded the quarantine to the entire nation the next day. The Italian government ordered all shops, bars, and restaurants closed on March 11 and ordered all nonessential businesses closed on March 22.
As with the United States, however, different regions and provinces acted at different paces in Italy. Codogno, a small town outside of Milan where the first case of the coronavirus was confirmed in the nation in mid-February, demonstrates the effectiveness of swift and early social distancing, according to The Wall Street Journal. Local authorities told residents not to leave their homes except for emergencies and sealed the town off from the rest of Italy. While Codogno residents stayed home, life in the nearby city of Bergamo carried on as usual until the entire region of Lombardywhich includes Bergamo and Codognowas placed under lockdown on March 8. In the week following, during which Codogno residents had been social distancing for roughly a month compared to just days for Bergamo residents, the number of overall cases had increased by nearly 76 percent in Bergamo compared to 21 percent in Lodi, the province that took early action and includes Codogno.
Unfortunately, the national social distancing measures were largely implemented too late to avoid significant spread of COVID-19 and resulting deaths. Italy has a death rate of more than 7 percent, over double the global average, and its total death toll of over 6,800 people is more than twice that of China, despite Chinas population being around 20 times larger. It does appear that these measures are starting to take effect, however. Both deaths and new cases slowed recently, according to Italys Civil Protection Department.

Emerging evidence from early acting states and localities

Because the spread of COVID-19 in the United States is more recent than in Asia and Europe, evidence of the impact of social distancing also lags behind other nations. However, because some state and local officials adopted social distancing policies in mid-Marchwell before the federal government actedthere are early signs that the virus is potentially flattening or spreading more slowly in Kentucky, the San Francisco Bay Area, and in Washington state.
Kentucky vs. Tennessee
Throughout the crisis, Tennessees response has lagged behind that of Kentucky, from both a policy and communication standpoint. Kentucky Gov. Andy Beshear (D) recommended against large gatherings on March 11, while Tennessee Gov. Bill Lee (R) did not issue similar guidance until March 13. Gov. Beshear recommended school closures on March 12, while Gov. Lee did not issue a similar guidance until March 16, the following Monday. Gov. Beshear issued an executive order restricting restaurants and bars to carryout, delivery, and drive-through sales on March 16. Gov. Lee, on the other hand, did not issue a similar executive order until March 22, nearly a week later. Gov. Beshear issued an executive order on March 22 requiring all nonessential businesses to close. Gov. Lee has yet to issue a similar order, and neither state has issued a stay-at-home order.
The consistent difference in approach from the states has resulted in measurable difference in transmissions. While both states found similar numbers of positive COVID-19 cases at first, Kentuckys aggressive actions have slowed the transmission of the virus in the state early in the outbreak. This early slowing will likely prove critical to ensuring a positive response. Data from the COVID Tracking Project show that Kentuckys positive cases have increased much more slowly than Tennessees, even when accounting for differences in testing capacity and population.
This divergence in transmission rates between Kentucky and Tennessee highlights how imperative early actioneven by a few daysis in slowing the spread of COVID-19.
San Franciscos Bay Area
Santa Clara was the first Bay Area county to issue a ban on large gatherings on March 9, which was followed by similar actions in other counties and ultimately the state of California. On March 13, bars with maximum occupancy of at least 100 people were ordered to close and restaurants were ordered to limit capacity in San Francisco. Many of the schools in the area closed on March 16. On the same day, seven counties in the Bay Area issued stay-at-home orders that directed all residents to stay home and only leave for essential trips and called for all nonessential businesses to close. On March 19, California Gov. Gavin Newsom (D) issued a similar order directing all California residents to stay at home.
While the full impact of social distancing measures will likely be seen in the next few weeks, some preliminary data sources suggest that social distancing may be correlated with a reduction in coronavirus cases. For example, Kinsaa health technology company that produces smart thermometershas aggregated data to track the prevalence of flu-like symptoms. By comparing the percent of the population that is ill with symptoms that could be related to flu or the coronavirus, it is evident that Santa Clara County, which took some of the earliest, most robust social distancing actions, experienced a sharp reduction in flu-like cases. However, cases continued to rise in the absence of comprehensive actions in Miami-Dade County, Florida.
The Bay Area implemented the most robust of the social distancing measuresa stay-at-home orderdays before the rest of the state. While it is still early, recent data show that cases in the Bay Area are now growing more slowly than those in the rest of the state. As county and city leadership in the Bay Area was several steps ahead of the rest of the state for early measures, that swift action may be flattening the curve ahead of the rest of the state.
Washington state
Washington state was the initial epicenter of COVID-19 in the United States due to early spread from international travel. As of March 24, Washington state had the third-highest levels of COVID-19 cases, behind New York and New Jersey. Throughout the crisis, both the Washington state government and several local governments have taken actions to help reduce the spread of this pandemic.
Gov. Jay Inslee (D) issued an executive order prohibiting gatherings of more than 250 people in the counties experiencing high COVID-19 outbreaks on March 11. King County, Washington, issued a supplemental order the same day prohibiting smaller events unless steps were taken to reduce spread of the virus, such as discouraging vulnerable populations from attending and ensuring that close contact between attendees would be limited. Gov. Inslee issued an executive order limiting bars and restaurants to delivery and takeout on March 16, and he issued a stay-at-home order on March 24.
While the impact of the more aggressive actions such as restaurant closures and the stay-at-home order will likely not be observed for some time, there is some evidence that early actions by Gov. Inslee and county executives may have helped to slow the spread of COVID-19. As Washington has increased its testing, its growth of positive cases has not accelerated compared with earlier trends, which is potentially good news. The virus continues to spread, but the state is no longer experiencing as severe growth as it was in the early stages of this outbreak. But even this slight flattening can contribute to lower mortality rates. Even with this potentially encouraging news, Washington statelike other statesstill faces a shortage of critical medical equipment and supplies.

Conclusion

While the Trump administration wasted precious weeks to slow the spread of COVID-19 throughout the United States, states and localities made the difficultyet criticaldecision to implement social distancing measures. Now, President Trump is creating a shortsighted, false choice between protecting the nations economy and the nations public health. We are just now starting to see how these early interventions can disrupt the spread of the virus. Over the upcoming weeks, evidence will continue to build that these steps are, in fact, helping to flatten the curve. Halting social distancing efforts now would not only allow further spread of COVID-19, but it would also cause even greater long-term economic damage than continuing with social distancing in the short term, as more cases and deaths occur, fear grows, and hospitals become more overwhelmed. State and local governments must keep these lifesaving temporary policies in place.
Maura Calsyn is the managing director of Health Policy at the Center for American Progress. Emily Gee is the health economist of Health Policy at the Center. Thomas Waldrop is a policy analyst for Health Policy at the Center. Nicole Rapfogel is a research assistant for Health Policy at the Center. The authors would like to thank Jerry Parshall, Jordan Link, Haneul Lee, Laura Edwards, Anna Lipscomb, and Jeremy Venook for their research assistance.
To find the latest CAP resources on the coronavirus, visit our coronavirus resource page.
Scientists need to figure out which measures best control Covid-19

Michael_Novakhov shared this story from STAT.

Banning gatherings, having people stay at home, closing schools, and other measures to reduce the spread of Covid-19 are working so well that an influential model of the pandemics course now projects that the number of U.S deaths from the new coronavirus by early August will be 60,415 rather than the minimum of 100,000 that it forecast last month.
The new, lower estimate is prompting officials to be cautiously optimistic about controlling the outbreak, possibly by early summer. But it comes with a mystery: Which social distancing has reduced transmission the most?
Figuring that out will be crucial as policymakers look for ways to lock in the progress against Covid-19 while eventually re-opening schools and the economy, an imperative that has become even greater in light of the more than 17 million people who have lost their jobs due to the epidemic.
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The earlier projection of Covid-19 deaths 100,000 from modelers at the Institute for Health Metrics and Evaluation at the University of Washington assumed there would be broad adoption of social distancing, which is also how China broke the back of the epidemic that began in Wuhan. But the effect of that social distancing has been greater than the IHME team expected.
This should be entirely obvious, epidemiologist Trevor Bedford of UW and the Fred Hutchinson Cancer Research Center tweeted on Wednesday night. But we now have strong evidence that social distancing results in decreased Covid-19 transmission rates.
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In epidemiologists terms, the number of cases caused by each infected person, called the effective reproduction number (Re), has fallen precipitously. If peoples contacts drop by a certain amount, then so does the the reproduction number, said epidemiologist Gerardo Chowell of Georgia State University. The new IHME projection, he said, looks reasonable. As additional data become available, the model can provide a better view of the trajectory of the epidemic in the near future.
In the U.S., Re has fallen most clearly in Seattles King County. There, researchers at the Institute for Disease Modeling calculated, it fell from 2.7 (and possibly as high as 3.5) in late February, when community transmission was accelerating, to roughly 1.4 or even lower on March 18. The county would have had roughly triple the number of cases in late March without social distancing, they found.
In 11 European countries, modelers at Imperial College London estimated in late March, Re has fallen from 3.87 to 1.43, averting 59,000 deaths, and possibly 120,000, just through the end of March.
The new Re in Europe as well as King County, and probably elsewhere, is encouragingly close to 1, the level at which the outbreak will burn itself out.
Like other countries, the U.S. has taken an everything-but-the-kitchen-sink approach to social distancing: close schools and ban many international arrivals and close restaurants and ban church services (and other events that bring people together, even funerals) and order those who can to work from home. As a result, officials cant tell which measures have been the most effective.
It is also difficult to decouple the effect of those government policies from any voluntary measures people took to protect themselves, health economist Rahi Abouk of William Paterson University and computational social scientist Babak Heydari of Northeastern University argue in a paper posted to a social science site on Thursday.
The reason it is so important to determine which interventions lower peoples contact rate the most, Heydari said, is that policies in many states are still evolving. In those that have laxer policies but may be about to experience a surge in cases, he said, that understanding can help them update their policies. [And] it is likely that some states, or the country as a whole, will experience subsequent outbreak waves, after they phase out some of the [current] policies. These results can inform reinstating social distancing measures.
For instance, projections released this week by researchers at Columbia University identify U.S. counties at risk of seeing their health care systems overwhelmed by Covid-19 cases. The researchers ran models in which they assumed that peoples contacts dropped by 20%, 30%, or 40%. The latter could avert as many as 185,000 deaths in the Northeast and 33,000 deaths in the Midwest. But the model is agnostic on what mix of business closings, work-at-home policies, and other measures achieve any given level of social distancing.
So is the IHME model. That makes it difficult for policymakers to tell whether relaxing one form of social distancing while tightening others might bring the same benefits, at perhaps a lower economic cost, or to know which forms of social distancing can be eased first in an effort to tiptoe toward normalcy, Chowell said.
Results from preliminary studies are starting to provide some answers.
In research posted to the preprint site medRxiv this week, Chowell and his colleagues show that the pandemic may be readily controllable through a combination of testing, treatment if necessary, and self-isolation after testing positive of symptomatic individuals together with social protection such as face-mask use and hand-washing.
When the basic reproduction number is as high as 2.4, which King County and some areas in the U.S. are likely well below, 65% effective social distancing (that is, people have only 35% of their previous number of close contacts) brings Re below 1, the magic this is ending number. But social distancing thats only 20% effective (people have 80% of their usual close contacts) also brings Re below 1 if 75% of infected and symptomatic people are identified and isolated within 12 hours of symptom onset.
Sustained universal mask-wearing and frequent hand-washing have the potential to dramatically reduce the transmission rate of the virus after the first wave, Chowell said. They have the potential to help us safely return to work and school, though hes in favor of remote learning and telework as much as possible.
Europe Flooded With Cocaine Despite Coronavirus Trade Disruptions

Michael_Novakhov shared this story from CoronaVirus News Review In Brief.

The illegal drugs industry has been disrupted by the virus, with international supply chains busted and millions of customers on lockdown. But drug ...
A Pork Panic Won't Save Our Bacon

Michael_Novakhov shared this story from CoronaVirus News Review In Brief.

The order also pressures meat-processing plants to remain open to ensure a continued supply of protein to ... recent weeks after they became Covid-19 hotbeds, including the Smithfield Foods pork plant in Sioux Falls, South Dakota ...
Invisible Enemy: Imperial Fascism 2020, Not Covid-19

Michael_Novakhov shared this story from CoronaVirus News Review In Brief.

For even if Covid-19 is not perceived as a U.S. bioweapon, Washington is undeniably its pimp. ... but could also be useful for nefarious purposes like biowarfare or bioterrorism and are referred to by scientists as dual-use research.
Leading Swedish Epidemiologist Slams British Scientist Whose Paper Triggered Worldwide Lockdowns: Normally Quite Arrogant

Michael_Novakhov shared this story from The Daily Wire.


BSS_200303_Marketing Breakout.mp4
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A Swedish professor who was the State Epidemiologist for Sweden between 1995 to 2005, then served as the first Chief Scientist of the European Centre for Disease Prevention and Control (ECDC), blasted Professor Neil Ferguson, the British epidemiologist from the Imperial College London, who wrote a paper that convinced many countries, including the United States, Germany, France, and those in the United Kingdom, to impose lockdowns to deal with the coronavirus, saying Ferguson was normally quite arrogant, according to Unherd.Professor Johan Giesecke was interviewed by the Swedish broadsheet Svenska Dagbladet. Referring to Fergusons interview on UnHerd, he stated,  I know [Ferguson] a little and he is normally quite arrogant, but I have never seen him as tense and nervous as during that interview. Giesecke added, Ferguson modified quite a few of the straightforward statements [from his report], but still seems to think that the lethality is somewhere at just under one percent, while I think it is actually much lower, perhaps as low as 0.1%.
Giesecke had given an interview to Unherd in mid-April in which he was asked about the Imperial College report, which had suggested 510,000 people would die in the U.K. without a lockdown and 250,000 if mitigating steps were taken.  He answered:
I think its not very good, and the thing that they miss a little is that any models for infectious diseases theyre very popular, many people do them theyre good for teaching, they seldom tell you the truth because I make a small parenthesis which model could have assumed that the outbreak would start in northern Italy, in Europe, Difficult to model that one.  And any such model it looks complicated, there are strange mathematical formulae, and integral signs and stuff, but it rests on the assumptions. And the assumptions in that article will be heavily criticized for I wont go through that, it would take the rest of your day if I went through them all. The paper was never published scientifically; its not peer-reviewed, which a scientific paper should be; its just an internal departmental report from Imperial. And its fascinating; I dont think any other scientific endeavor has made such an impression on the world as that rather debatable paper.
Asked whether European countries instituting a lockdown to deal with the coronavirus was a misguided policy and whether it was doing more harm than good, he answered that he was worried about politicians assuming dictatorial powers: Yes. I think so, on the whole. What Im saying is that people who will die a few months later are dying now and thats taking months from their lives so thats maybe not nice. But comparing that to the effects of the lockdown what am I most afraid of? Its the dictatorial trends in eastern Europe; Orban is now dictator of Hungary forever; theres no finishing that. I think the same is popping up in other countries; it may pop up in other more established countries as well. I think the ramifications can be huge from this.

 

Giesecke said Sweden had not been on our toes to protect the elderly, acknowledging, There are many things we could have done better a couple of months ago.
He was asked, What was it about this pandemic that was so different that has led to this global shutdown? He answered, New disease, lot of people dying, you dont know really what will happen, and this fear of contagion is almost genetic in people. And showing political strength, decisiveness, force. Very important for politicians.
As far as Fergusons projection that Sweden will see an increase in deaths from the coronavirus, Giesecke has countered, No, on the contrary, I think the number will go down although it may tick up slightly when we get an outbreak in West Götaland or Skåne [provinces of Sweden that have so far been less badly affected].
In Great Britain, the initial government policy on March 12 was to pursue a herd immunity strategy against the coronavirus, but on March 16, Ferguson gave a 20-page paper to UK Prime Minister Boris Johnson that predicted 510,000 people would die by that strategy. One week later, the British government changed course, instituting a suppression strategy.
Business Insider noted, In 2009, one of Fergusons models predicted 65,000 people could die from the Swine Flu outbreak in the UK the final figure was below 500. Business Insider also noted, Michael Thrusfield, a professor of veterinary epidemiology at Edinburgh University, told the paper he had déjà vu after reading the Imperial paper, saying Ferguson was responsible for excessive animal culling during the 2001 Foot and Mouth outbreak. Ferguson warned the government that 150,000 people could die. Six million animals were slaughtered as a precaution, costing the country billions in farming revenue. In the end, 200 people died.
Some people ripped Ferguson for reportedly overestimating the potential death toll in the 2005 Bird Flu outbreak. Ferguson allegedly estimated 200 million could die, but the actual total was reportedly less than 1,000.
The Daily Wire, headed by bestselling author and popular podcast host Ben Shapiro, is a leading provider of conservative news, cutting through the mainstream medias rhetoric to provide readers the most important, relevant, and engaging stories of the day. Get inside access to The Daily Wire by becoming a member.
Anyone can now get a coronavirus test at home for $119

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Quest's test is helpful if you know for sure that you had COVID-19 and you want to check your immune system's response to the novel coronavirus.
Antibody testing hints at coronavirus' hellish toll on FDNY/EMS, NYPD

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Nearly 20 percent of FDNY/EMS members and over 10 percent of NYPD cops screened for coronavirus antibodies tested positive, Gov. Andrew ...
Coronavirus Antibodies Present in 16 Percent of First Responders Tested Across New York

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The tests were administered to 1,000 members of the New York City Fire Department (FDNY), including emergency medical technicians, and 1,000 ...
Coronavirus: Navy wants investigation into USS Theodore Roosevelt outbreak

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Key Points
  • The Navys top civilian is calling for another investigation into the events surrounding the coronavirus outbreak on the USS Theodore Roosevelt aircraft carrier.
  • Last week, the Navys top officials recommended that Brett Crozier, the captain relieved of duty after sounding the alarm of a growing coronavirus outbreak aboard the vessel, should be reinstated. 

Captain Brett Crozier addresses the crew for the first time as commanding officer of the aircraft carrier USS Theodore Roosevelt during a change of command ceremony on the ships flight deck in San Diego, California, U.S. November 1, 2019.
U.S. Navy | Mass Communication Specialist 3rd Class Sean Lynch | Reuters
WASHINGTON  The Navys top civilian is calling for another investigation into events surrounding the coronavirus outbreak on an aircraft carrier, which led to the dismissal of its captain, who had pleaded for help, and the resignation of the former acting Secretary of the Navy.
Upon reviewing the findings of the investigation into the USS Theodore Roosevelt and Capt. Brett Crozier, the newly tapped acting secretary of the Navy said he had unanswered questions and would, therefore, need a deeper review.
This investigation will build on the good work of the initial inquiry to provide a more fulsome understanding of the sequence of events, actions, and decisions of the chain of command surrounding the COVID-19 outbreak aboard USS Theodore Roosevelt, acting Secretary of the Navy James McPherson in a statement.
The latest twist comes on the heels of the Navys recommendation made last week that Crozier, who sounded the alarm of a growing coronavirus outbreak aboard the carrier, should be reinstated to his command.
At the time, the decision to reinstate Croziers command of the USS Theodore Roosevelt sat with Secretary of Defense Mark Esper. The Pentagon boss, who was briefed on the recommendations following the Navy investigation, requested more time to review the findings.
The secondary investigation is the latest development in a messy string of events that resulted in the resignation of acting Secretary of the Navy Thomas Modly.
Crozier was relieved of duty by Modly after the captains letter pleading for help to mitigate the spread of the virus aboard the aircraft carrier was leaked to the media. Modly then took a 35-hour trip, which cost taxpayers $243,000, to address the crew of the Roosevelt.
In the address, delivered via the ships loudspeaker, Modly doubled down on his decision to relieve Crozier and called the former vessels captain naive and stupid. Hours later Modly issued an apology to the Navy.
Acting Secretary of the Navy Thomas Modly speaks at a Pentagon press briefing, Washington, D.C., April 2, 2020.
Lisa Ferdinando | Department of Defense
I also want to apologize directly to Captain Crozier, his family, and the entire crew of the Theodore Roosevelt for any pain my remarks may have caused, he said in a statement April 6.
A day later, Modly handed in his resignation to Esper, who then announced that he had tapped James McPherson, undersecretary of the Army, to be the new acting Navy secretary.

Sailors do not need to die

In a four-page letter, first reported by the San Francisco Chronicle in late March, Crozier described a worsening coronavirus outbreak aboard the warship, a temporary home to more than 4,000 crew members. At the time, more than 100 people on the ship were infected.
We are not at war. Sailors do not need to die. If we do not act now, we are failing to properly take care of our most trusted asset our Sailors, Crozier wrote. The spread of the disease is ongoing and accelerating.
Captain Brett Crozier, commanding officer of the U.S. Navy aircraft carrier USS Theodore Roosevelt, addresses the crew during an all-hands call on the ships flight deck in the eastern Pacific Ocean December 19, 2019.
Mass Communication Specialist 3rd Class Nicholas Huynh | US Navy
The coronavirus exposure aboard the Roosevelt, which is docked in Guam, followed a recently completed port call to Da Nang, Vietnam.
Fifteen days after leaving Vietnam, three sailors from the Roosevelt tested positive for the virus. The infections were the first reports of the coronavirus on a U.S. Navy vessel at sea.
As of Wednesday, all crewmembers of the Roosevelt have been tested for the coronavirus. With the majority of the crew now healthy, efforts are underway to test and re-man the ship. One sailor remains in the hospital for Covid-19 symptoms and one sailor assigned to the vessel died.
Crozier, who contracted the virus, was in the distinguished visitors quarter at a Navy base in Guam, according to a report, where he awaited confirmation that he no longer had the virus.

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Navy Identifies USS Theodore Roosevelt Sailor Who Died of COVID-19

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PEARL HARBOR (NNS) -- Aviation Ordnanceman Chief Petty Officer Charles Robert Thacker Jr., 41, of Fort Smith, Arkansas, assigned to USS Theodore Roosevelt (CVN 71), died from COVID-19 April 13 at U.S. Naval Hospital Guam.
Thacker tested positive for COVID-19 March 30, was removed from the ship and placed in isolation on Naval Base Guam. On April 9 (local date), Thacker was found unresponsive during a daily medical check and transferred to Naval Base Guam via ambulance where he was placed in the Intensive Care Unit (ICU).
"Our thoughts and prayers are with the family during this difficult time," said Capt. Carlos Sardiello, Theodore Roosevelt's commanding officer. "Our number one priority continues to be the health and well-being of all members of the Theodore Roosevelt Strike Group and we remain steadfast in our resolve against the spread of this virus."
Thackers spouse, an active duty member stationed in San Diego, was flown via Navy Air Logistics Office (NALO) flight to Guam, arriving April 11 (local date). At the time of his passing, Thackers spouse was by his side.
Crew members who tested positive for COVID-19 remain in isolation at controlled locations on Naval Base Guam, where they receive daily medical supportive care. All medical care is being provided by medical personnel from USS Theodore Roosevelt, U.S. Naval Hospital Guam, and elements of the U.S. Marine Corps 3rd Medical Battalion.
To support Sailors, USS Theodore Roosevelt has a civilian resiliency counselor, a chaplain team and medical psychologist assisting as needed. The crew is also being supported by Joint Region Marianas and Naval Base Guam chaplains.
USS Theodore Roosevelt arrived in Guam March 27 for a scheduled port visit for resupply and crew rest.
Coronavirus outbreak has added a new dimension to 'undeclared World War III', Opinions & Blogs News

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The COVID-19 outbreak has demonstrated the potential of a virus as a weapon of mass destruction. It has added a new dimension to alter the global strategic balance and triggered another chain of events for global strategic dominance, besides unprecedented human sufferings.
During the First and Second World Wars era, the use of military forces and declaration of war was considered as basic essentiality to call it a World War. War is defined to be a state in which a nation prosecutes its right by force. Similarly as per Collins English Dictionary; World War is a war that involves countries all over the world. During earlier World Wars, the strategic aim was the capture of key territories or surrender of political leadership/will of adversaries. In the current era, the strategic aim revolves around the economic collapse of the adversary.
Were We already in World War III prior to COVID-19? 
Considering the destructive capability of major world powers, a declared World War between combat forces may not occur as it will be devastating for all. The Force for application potential will be measured in terms of Comprehensive National Power (CNP) of the world powers. It includes economy, military strength (including nuclear capability), strategic posturing, foreign policy/diplomacy, governance, Human Development Index (HDI), technological capability, knowledge information, geography, natural resources, national will and leadership. Out of all the components of CNP, economic power is the over-riding component dictating the rest. The dimensions of war have grown globally from erstwhile conventional wars under nuclear hangover (barring nuclear strike on Japan) to the aggressive trade war, military posturing, arms race (including Chemical, biological, radiological and nuclear arsenal), with political bouts interspersed with few offensive actions involving conventional forces.
The application of economic power had resulted in an intense trade war between the two largest economies - the US and China. In Indo-Pacific, the conventional and nuclear-armed combat forces of the US and China are continuing strategic posturing, deterrence and messaging to all stakeholders. China used combat forces to occupy and develop features in the South China Sea. The recent US-Iran confrontation after the killing of Major General Qasem Soleimani saw active use of conventional force and brought both countries close to war. If all cases of use of conventional forces are linked, then two opposing alliances covering worldwide conflicts appear on the scene, the first one being US-Israel-Saudi Arabia-South Korea-Japan and the other one being China-Russia-North Korea-Iran-Syria, with other countries seem to be doing the strategic balancing.
The space warfare has taken a dangerous turn with each side taking preparatory actions to destroy each others space assets. The use of elements like misinformation campaign, election meddling, cyberwar, hacking of economic and crucial military network, perception management, is already in progress.
Diplomatic pressures, economic and technological threats, nuclear blackmailing, proxy wars by nations amount to use of force/CNP to achieve strategic objectives.
The number of casualties suffered in ongoing conflicts surpasses the total casualties and refugees of both the earlier world wars put together. The global strategic situation has graduated to conflicts, the capture of  South China Sea, innumerable deaths and economic destruction; hence calling it cold war will be an understatement. The global situation even before COVID-19 had every element of a World War, except that the dimension, instruments and modalities have changed, and the war has not been formally declared; hence it may not be wrong to call it an undeclared World War III.
COVID-19 impact
The outbreak of COVID-19 has put humanity to one of the biggest risks of this century. It exposed the vulnerability of strongest nations, triggered by a possible biological weapon (accidentally or otherwise). While the global powers were busy strengthening other elements of CNP, it exposed the consequences of any possible biological weapon to the world adding a new dimension in ongoing undeclared World War III. Wuhan being the initial epicentre, the trends in early 2020 suggested a sheer drop in CNP of China with a combined effect of US-China trade war, failing BRI and COVID-19.
The last week of March 2020 onwards saw the epicentres of COVID-19 shifting westwards with the US, Europe and UK emerging to be worst affected. China, having declared victory over the pandemic, was quick to put back its manufacturing sector in place, trying to boost a COVID-19 economy by creating a Health Silk Road and re-activating most needed supply chain of medical equipment and medicines, as an attempt to earn maximum profit out of the pandemic, besides attempting to repair its global image.
Contours of undeclared World War IIIpost-COVID-19 pandemic 
COVID-19 has exposed some vulnerabilities of US and created huge trust deficit for China globally; hence the idea of everyone accepting one/two countries as superpowers or global leader may be outdated in future. The new paradigm will be unlike earlier World Wars, all countries will not be at war, because all of them may not agree to common narratives of key players. And hence, some countries would be at hot war, some in military posturing stage, and some using other dimensions and instruments of war, simultaneously. A new global order will emerge post-COVID-19 which need not be the US or China-centric. Next few decades will see the pivot shifting towards the East, which has fastest-growing economies. It can, therefore, be argued that the battleground for Undeclared World War III could be Indo-Pacific, and the world has already entered in the preparatory phase of it, without recognising/declaring it to be so.
(Disclaimer: The opinions expressed above are the personal views of the author and do not reflect the views of ZMCL)
11:30 PM 4/28/2020 - The same pattern of the connection of Covid-19 Epicenters with the historical events related to the WW2 emerges in Italy (see the earlier post); Tehran, Iran; Wuhan, China; Alsace, France; and association of La Rochelle, France with New Rochelle, New York.

Michael_Novakhov shared this story from Tweets And News - From Michael Novakhov.

https://tweetsandnews.blogspot.com/2020/04/1130-pm-4282020-same-pattern-of.html
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The same pattern of the connection of Covid-19 Epicenters with the historical events related to the WW2 emerges in Italy (see the earlier post); Tehran, Iran; Wuhan, China; Alsace, France; and association of La Rochelle, France with New Rochelle, New York. 
The impression is, that the New Abwehr, in its commemoration of the 75th anniversary of WW2 gets engaged in the symbolic undoing of the events of WW2 and the symbolic punishment with the Covid-19 of these places and locations. 
See also other previous related posts on this subject. 
And all this, while Germany shines in her preparedness and the "undone" superiority. Is this not the PATTERN? 

Michael Novakhov

11:30 PM 4/28/2020


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  1. New Abwehr blamed the Battle of Wuhan as the factor in defeat in WW2 and punished Wuhan with Covid-19 -
    https://images.app.goo.gl/KHHEbKche8n3fvA58 
  2. The Epicenter is clearly Tehran, the route: air travel frrom Germany. Qom is secondary location.
    New Abwehr blamed Persian Corridor for losses in WW2 and punished Iran with Covid-19
    https://images.app.goo.gl/yHM6USuYqmoCsE659 
  3. Tweets And News - From Michael Novakhov: 'Are We Pigs?': Gazprom Pipeline Workers Protest C... https://tweetsandnews.blogspot.com/2020/04/are-we-pigs-gazprom-pipeline-workers.html?spref=tw 



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Tweets And News - From Michael Novakhov: 'Are We Pigs?': Gazprom Pipeline Workers Protest Conditions Amid Coronavirus Outbreak (Apr 28, 2020 12:04) Gas workers in Russia's Far East staged a mass rally to demand better working condition...
Tue, 28 Apr 2020 16:31:59 -0400
Why COVID-19 Damages Some Communities More Than Others

Michael_Novakhov shared this story from [Untitled].

COVID-19 is devastating particular communities globally. Here in the United States, where New York City is the epicenter of the pandemic, preliminary data released by the city shows that Latinx and black populations are dying at disproportionate rates. For example, the Latinx population is 29 percent of New Yorks population, but it has accounted for 34 percent of COVID-19 deaths, and the citys black population is 22 percent, but has accounted for 28 percent of deaths. Moreover, it has been widely reported that Latinx and blacks may be dying at disproportionate COVID-19 rates because they may be more likely to have underlying conditions or comorbidities compared to other groups.
Insufficient attention is paid to how racial and social determinants can negatively impact health and contribute to an increased rate of underlying conditions, which make certain populations more at risk of dying. For example, research studies have shown that poverty, racism, inadequate housing, environmental toxins and lack of access to such things as health insurance, quality medical care, good education, economic opportunities and nutritious food can influence health and well-being at the individual and population levels. These factors have harmful influences on the neurodevelopmental and biological consequences beginning early in life that accumulate and produce disease.
The neighborhoods most affected by COVID-19 tend to be poorer. According to the New York City Comptrollers Office, 75% of all frontline workers are people of color, who work in public transit; grocery, convenience and drug stores; trucking, warehouse and postal services; and healthcare, as well as childcare, homeless shelters and family services. Nearly 60% of these workers are also renters and, on average, spend 1.5 hours commuting on public transport to and from their jobs daily.
In my research at the intersection of urban planning and health equity, I explore how neighborhood environments and access to resources can affect health. The physical characteristics and quality of neighborhood servicesschools, transportation, food, employment opportunitiescan result in better economic outcomes and well-being. The fact that underlying conditions can increase the risk of death from COVID-19 is not simply attributable to individual behaviors, but represents a failure in our society to develop and implement policy interventions that address the social determinants of health and reduce inequities.
Public health studies show that interventions targeted at addressing these social inequities can improve overall population health. Such interventions include improving access to quality education and early childhood development programs; investing in the physical environment to enable activities such as walking and bicycling, with open space and recreational centers; safe, affordable housing; improving community-based health facilities; and promoting nutrition and increased awareness of healthy diets. Additional help is provided by income enhancements and opportunities like the Supplemental Nutrition Program for Women, Infants and Children, the Earned Income Tax Credit and Supplemental Security Income.
The disparate outcomes for black and Latinx populations during the COVID-19 crisis highlight how we need to invest in such policies and programs to address the pressing needs of the most vulnerable members of society. That includes providing adequate medical testing, along with  financial and material support to frontline healthcare professionals. Extending unemployment insurance, paid sick leave, financial support for small business owners and access to universal health insurance is essential now.
Why are white supremacists protesting to 'reopen' the US economy?

Michael_Novakhov shared this story from CoronaVirus News Review In Brief.

These protests riskspreading the virus and have disrupted traffic, potentially ... spreading the coronavirus, either unintentionally at rallies or in intentional efforts: ... One thing police could do which they often do when facing criminal ...
Tweets And News - From Michael Novakhov: 'Are We Pigs?': Gazprom Pipeline Workers Protest Conditions Amid Coronavirus Outbreak (Apr 28, 2020 12:04) Gas workers in Russia's Far East staged a mass rally to demand better working condition...

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https://tweetsandnews.blogspot.com/2020/04/are-we-pigs-gazprom-pipeline-workers.htm ________________________________________________________ 'Are We Pigs?': Gazprom Pipeline Workers Protest Conditions Amid Coronavirus Outbreak (Apr 28, 2020 12:04) Gas workers in Russia's Far East staged a mass rally to demand better working condition... CoronaVirus News Saved Stories 250 | Page

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Coronavirus antibody testing suggests infections are widely under-reported | Fox News

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Mounting evidence suggests that the coronavirus might be more widespread throughout the country than previously thought -- in some cases more than 80 times original estimates -- as states expand capacity for antibody testing and find surprising results.
On Monday, New York Gov. Andrew Cuomo, who has emphasized the importance of antibody testing and contact tracing in order to determine who can safely return to work, said that early results suggested 14.9 percent of residents had contracted COVID-19 at some point.
When broken down by region, Cuomo said in New York City -- the state's hotbed for COVID-19 infections -- the rate was about 24.7 percent.
IF YOU THINK YOU HAD CORONAVIRUS, NEW ANTIBODY TEST AVAILABLE WITHOUT TRIP TO DOCTOR'S OFFICE
He earlier said preliminary results suggested a statewide infection rate of 13.9 percent, which would mean roughly 2.7 million residents contracted the illness at some point, which is about 10 times more than what's been confirmed by COVID-19 testing. As of Tuesday, the number of coronavirus cases reported worldwide had reached just over 3 million.
The state had expanded antibody testing to 7,500 people, nearly double the total number tested five days earlier. As of Tuesday, 844,994 persons had been tested for COVID-19 statewide, resulting in 295,106 positive cases. New York, a state with over 8.9 million people, also has the highest number of coronavirus-related fatalities in the U.S., with at least 22,668.
But the state has largely reserved COVID-19 testing for symptomatic people, or those considered to be at-risk who had known exposure, before it began prioritizing antibody testing for health care and frontline workers, presenting a potential gap in the number reported versus the number of infections contracted.
NEARLY 3 MILLION NEW YORKERS HAVE HAD CORONAVIRUS, ANTIBODY STUDY SUGGESTS
An antibody test seeks to detect IgM and IgG antibodies against SARS-CoV-2, the virus that causes COVID-19, in serum, plasma or venipuncture whole blood from individuals who are suspected to have had it. IgG and IgM are antibodies that the bodys immune system produces in response to a virus, and are detectable as soon as several days after the initial infection. While officials have championed the test as a way to determine who is immune to the virus, others, including Dr. Anthony Fauci, have urged caution as its not yet clear what immunity means for this virus.
Still, the antibody results highlighted by Cuomo are the latest preliminary findings that suggest the true number of coronavirus cases is far greater than those reported by health department officials and the Centers for Disease Control and Prevention (CDC). Two other studies involving Santa Clara County in California and another in LA County have suggested the same.
In Santa Clara County, Stanford University-led researchers found the number of cases may actually be up to 85 times higher than what health officials have tallied, while LA County results suggested the number of infected persons there may be between 28 to 55 times higher than currently confirmed COVID-19 cases.
We havent known the true extent of COVID-19 infections in our community because we have only tested people with symptoms, and the availability of tests has been limited, said Neeraj Sood, lead investigator of the LA County study and professor of public policy at the USC Price School for Public Policy. The estimates also suggest that we might have to recalibrate disease prediction models and rethink public health strategies.
CLICK HERE FOR COMPLETE CORONAVIRUS COVERAGE 
In addition to the risk that silent carriers," or asymptomatic patients, can pose to others, the new data may also help researchers better estimate the virus true fatality rate.
Many estimates of fatality rate use a ratio of deaths to lagged cases (because of duration from case confirmation to death), with an infections-to-cases ratio in the 1-5 fold range as an estimate of under-ascertainment, wrote the Stanford University researchers. Our study suggests that adjustments for under-ascertainment may need to be much higher.
Fox News' Greg Norman contributed to this report. 
Coronavirus antibody testing suggests infections are widely under-reported

Michael_Novakhov shared this story from CoronaVirus News Review In Brief.

On Monday, New York Gov. Andrew Cuomo, who has emphasized the importance of antibody testing and contact tracing in order to determine who can ...
Forget the United States and China. Global Leadership During the Coronavirus Pandemic Comes From Germany.

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Forget Washington and Beijing. These Days Global Leadership Comes From Berlin.


People love to hate Germanybut the country is doing far more than most nations to help its European neighbors fight the coronavirus.

At the beginning of April, the university hospital in the central German city of Jena dispatched two doctors, two medical assistants, and assorted medical supplies to Naples, Italy. A couple of days before, the Bundeswehr, Germanys military, had airlifted French and Italian patients to German hospitals. Thats just a tiny part of Germanys coronavirus assistance to allies.
Germanys initial response to the coronavirus outbreak was not exactly covered in glory. At the beginning of the year, Italy, the first European country badly hit by the coronavirus, logged an appeal for medical supplies with the European Unions emergency hub. But the German government reacted the way every other EU government did: It sent nothing. Then, in early March, the German government imposed an export ban on vital medical supplies including face masks, medical gloves, and protective gowns. By March 14, Italy had still not received any medical aid from its EU allies.
Two days later, Germanys Ministry for Economic Affairs and Energy announced that the delivery of 400,000 face masks to Italy had been approved by the government. With that, Germany changed the tenor of the Europeans response to Italy: Soon medical supplies were arriving from around the continent. When theres a crisis, the worlds collective instinct is often to pick on the Germans. This time, we owe them a thank youand a request for more global leadership.
Even as Germany took initiative to help Italy, Beijing had dispatched supplies and a few medics there, as it subsequently would to other countries such as Serbia. Though most of the supplies had been purchased by Italy, Beijingassisted by Italys foreign minister, Luigi Di Maiomade a big deal of the Chinese support. Soon Russia sent 100 military medics and medical supplies to Italy.When theres a crisis, the worlds collective instinct is often to pick on the Germans. This time, we owe them a thank you.
Any governments first responsibility is to look after its own population. The German government imposed a ban on medical supply exports just as Italy was succumbing to the coronavirus in early March, while other countries closed their borders with Italy. But the damage to the EUand stature gained by China and Russiawas immense.
new survey by SWG, an Italian pollster, reveals a shocking shift in Italian attitudes toward other countries: 52 percent of Italians surveyed now consider China a friendly country, a massive 42 percentage point leap compared with last year. Likewise, 32 percent consider Russia a friendly country, up from 15 percent, while only 17 percent consider the United States a friendly country, down from 29 percent a year ago. Even more shockingly, 45 percent of Italians surveyed now consider Germany a hostile country, 38 percent consider France an enemy, and 17 percent see the U.K. that way.
Had Germany immediately responded to Italys appeal for medical supplies, chances are it could have reversed some of the resentment with which many Italians view it. That resentment has been simmering since the 2012 eurozone crisis, when many Italians felt Germany acted heartlessly (though it finally agreed to a bailout of Italy and Spain). Germany wouldnt even have had to send enormous amounts of medical supplies: China and Russia didnt.
But Berlins change of heart is better late than never. Now Germany is not just sending supplies; the much-maligned Bundeswehr has airlifted 22 Italian and two French intensive-care coronavirus patients to Germany, transporting them on the militarys flying intensive care unitan Airbus A310 medevac planeand other aircraft. It has also donated its space on NATOs Strategic Airlift International Solution initiativewhich features enormous cargo aircraftto coronavirus deliveries. And despite having a slightly higher COVID-19 caseload than Britain, it has donated and delivered 60 of its own ventilators to the U.K.

And thats just the beginning. To date, according to the German foreign ministry, Germany has treated 229 foreign intensive-care coronavirus patients (44 from Italy, 55 from the Netherlands, and 130 from France) and offered to foot the bill for all of them. Berlin has donated and delivered 7.5 tons of medical supplies (including ventilators) to Italy and 25 ventilators to France. The government-run Robert Koch Institute, the countrys disease control and prevention agency, has sent coronavirus test kits to developing countries. Doctors employed by the Fresenius Helios hospital chain in Germany have traveled to Spain for coronavirus duty, bringing 50 ventilators with them. And when the coronavirus first hit China, the Germans sent Beijing more than 14 tons of medical equipment.
On top of that, the German Ministry for Economic Cooperation and Development has reallocated 1.15 billion euros ($1.25 billion) to help developing countries fight the coronavirus, for example in strengthening their health care systems and securing otherwise perilous jobs in supply chains and tourism. The German government is also working with other governments to ensure sufficient global production of medical supplies for coronavirus patients. Berlin is also now permitting exports of medical supplies to EU countries. In recent weeks, German firms have, for example, exported 8 million medical gloves to Austria, according to the German foreign ministry.Many governments have clearly realized that helping other countries coronavirus victims is a good thing and indeed a geopolitical imperative.
Since a virus doesnt stop at any border, the response to it has to be a signal of global solidarity, said Agnieszka Brugger, a deputy leader of the Green Party in the Bundestag, the German parliament. Every government that has the capacity to do so should help those most in need, and there have been German acts of solidarity with our European neighbors that should be applauded. My home state of Baden-Württemberg, for example, provided hospital beds for corona[virus] patients from neighboring Alsace [in France], and the Bundeswehr is helping with transport capacity. These signals are exactly what we need now.
Germany is, of course, not the only helper. Romania and Norway have, for example, sent doctors to Italy. Albania, with only 2.8 million people, has sent the Italians a 30-strong medical team, and France and Austria have sent medical supplies. U.S. soldiers based in Germany are making face masks for German soldiers, and the U.S. government has put all U.S. military personnel in Italy (some 30,000 service members) at Italys disposal for coronavirus duty. Indeed, European airspace today is dotted with coronavirus aid flights between friendly countries.
Many governments have clearly realized that helping other countries coronavirus victims is a good thing and indeed a geopolitical imperative. The most phenomenal coronavirus aid effort has been put in by Taiwan, which has donated millions of face masks to countries around the world, including 6.9 million to EU member states, dwarfing Chinas aid. But, thanks to concerted Chinese pressure, Taiwan is an international outcast and is not even recognized by the World Health Organization.
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But unlike the Chinese and Russians with their modest aid, the Germans havent been very good at publicizing their efforts. (That might be why nearly 50 percent of Italians surveyed consider them enemies.) That needs to change, argued Roderich Kiesewetter, a Christian Democratic Union member in the Bundestag. Otherwise there will be a skewed picture of the situation, particularly regarding the aid from Russia and China, he said. Kiesewetter also proposed that the EU develop self-sufficiency in advanced medical technology and protective equipment. Considering that the German medical technology industry already employs some 200,000 people, far more than any other European country, thats an area where Germany could likewise play a leading role. When the next global health crisis appears, the Europeans could then make sure the world is not dependent on Chinese supplies.
The German government isnt compassionate in every way: It has been reluctant to agree to so-called coronabonds, where all eurozone countries would share debt accumulated by the countries worst hit by the coronavirus crisis. Given the severe economic threats to the EU, the German government has to stop blocking effective solidarity measures such as common bonds to deal with this crisis, Brugger told Foreign Policy. Preventing an economic collapse in European countries is not just the right thing to do but also in Germanys own economic interest. On April 23, EU leaders finally agreed on a 540 billion euro ($585 billion) coronavirus rescue package.Germany is indisputably aiding other countries coronavirus victims, and its mostly doing so at taxpayers expense. 
Still, Germany is indisputably aiding other countries coronavirus victims, and its mostly doing so at taxpayers expense. The German effort is also taking place in a global leadership vacuum. During a global crisis, the United States would typically take charge. It did so during the 2014 Ebola pandemic, sending soldiers and medics to the most affected countries in Africa and marshaling a global response that curtailed the outbreak. This time there is no such U.S. leadership.
The absence of such leadership during this pandemic has created a Darwinian situation where countries compete against one another for medical supplies, components for medical supplies, and components for coronavirus vaccine and drug research. Researchers are even competing to purchase the genetically modified mice best suited for coronavirus vaccine development.
If the world is to manage the next crisis less chaotically than this one, there has to be more coordination of resources, and that requires a leading country doing its part and nudging and encouraging others. But Germanys coronavirus aid offers a model for such leadership in the future.
Thats especially important because when the next disaster hits, countries certainly wont turn to China for leadershipand given Washingtons bungling of this crisis, perhaps not even to the United States either. The EU can be a formidable actor but requires consensus among its member states, which doesnt come quickly or easily.
The next time a dictator like Syrias Bashar al-Assad decides to kill his own people, it would be unwise to count on Germany to lead a global military effort to stop him. But if theres another a pandemic or a climate-triggered disaster, theres potential in Berlin.
For once, the world should thank the Germansand ask them for more global leadership.
Forget Washington and Beijing. These Days Global Leadership Comes From Berlin.

Michael_Novakhov shared this story from CoronaVirus News Review In Brief.

That's just a tiny part of Germany's coronavirus assistance to allies. ... U.S. soldiers based in Germany are making face masks for German soldiers, and ...
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Michael_Novakhov shared this story from Tweets And News - From Michael Novakhov.

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Michael_Novakhov shared this story from Donald Trump.

Weeks after Jared Kushner was appointed to the coronavirus task force, the presidents son-in-law is nowhere to be seen.

Donald Trump tries to calm mounting alarm over food shortages

Michael_Novakhov shared this story from News | Mail Online.

President Donald Trump on Tuesday tried to calm mounting fears of a food crisis by telling Americans 'there is no shortage of meat.'
The country's largest meat companies - including Smithfield Foods Inc , Cargill Inc , JBS USA and Tyson Foods Inc - have halted operations at about 20 slaughterhouses and processing plants in North America since April after workers became ill with the coronavirus, sparking fears of a meat shortage.
The president took to twitter to try and calm concerns, retweeting a post from The Counter, a nonprofit that examines the nation's food supply.
'First, there is no shortage of meat destined for the grocery store shelf. It might take stores longer than usual to restock certain products, due to supply chain disruptions. But we have many millions of pounds of meat in cold storage across the nation,' it read.
President Donald Trump tried to calm mounting fears of a food crisis by telling Americans 'there is no shortage of meat.'
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President Donald Trump tried to calm mounting fears of a food crisis by telling Americans 'there is no shortage of meat.'
President Trump retweeted a message about the country's meat supply
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President Trump retweeted a message about the country's meat supply
The pork industry has been hit especially hard by the coronavirus as meat processing plants have closed throughout the country
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The pork industry has been hit especially hard by the coronavirus as meat processing plants have closed throughout the country
The USDA reported last week there is 921 million pounds of chicken in storage and 467 million pounds of boneless beef, including hamburger, roasts and steaks.
The demand for meat has gone up under stay-at-home orders with more Americans cooking instead of eating out.
But before much of that meat could be sold at grocery stores it would need to be recut and repackaged, as restaurants buy in greater bulk than an individual at a market.
Even if there is no shortage of meat, prices are expect to rise and selection is expected to decrease as companies warn that grocery shelves may take longer to fill.
The Agriculture said last week beef prices are expect to rise 1% to 2% this year, poultry as much as 1.5% and pork between by from 2% and 3%.
More than 5,000 meat and food processing workers have been infected by the coronavirus and 13 have died, the United Food and Commercial Workers International Union said last week.
Meanwhile, live stock farmers are facing difficult choices. With meat processing plants unable to take animals, the farmers are considering having piglets aborted and euthanizing animals as they run out of space to house them.
The pork industry typically slaughters around 510,000 pigs daily for bacon, hams and sausage.
But, because of the coronavirus, plants that handle one-fifth of the daily total, or 105,000 pigs a day, have closed - leading to a backup on farms and raising the prospect of having to euthanize them and then render or bury the carcasses, The Wall Street Journal reported.

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The pork industry has been hit especially hard. Three of the largest process plants in the United States have gone offline indefinitely: Smithfield Foods in Sioux Falls, South Dakota, JBS pork processing in Worthington, Minnesota and Tyson Fresh Foods in Waterloo, Iowa.
Unlike cattle, which can be housed outside in fields, hogs are fattened up inside temperature-controlled buildings. If they stay too long, they get big and injure themselves. Mature animals have to be moved out before the sows who were impregnated before the pandemic give birth.
'We have nowhere to go with the pigs,' Iowa farmer Al Van Beek told Reuters. 'What are we going to do?'
The president's reassurance also comes as the chairman of Tyson Foods warned Sunday that 'the food supply chain' is breaking after coronavirus outbreaks forced the closure of their plants.
John Tyson said 'millions of pounds of meat' will fail to reach stores and there will be a 'limited supply of our products available in grocery stores' until they are able to reopen facilities currently closed.
Tyson Foods announced last week that it was shuttering two pork processing plants, including its largest in the United States, to contain the spread of the coronavirus.
'We have a responsibility to feed our country. It is as essential as healthcare. This is a challenge that should not be ignored. Our plants must remain operational so that we can supply food to our families in America,' John Tyson said.
'This is a delicate balance because Tyson Foods places team member safety as our top priority.'
Tyson Foods, the largest U.S. meat supplier, said it will indefinitely suspend operations at its largest pork plant in Waterloo, Iowa, pictured, after operating at reduced capacity
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Tyson Foods, the largest U.S. meat supplier, said it will indefinitely suspend operations at its largest pork plant in Waterloo, Iowa, pictured, after operating at reduced capacity
ATyson Foods Inc unit said on Thursday it will temporarily halt production at a beef facility in Pasco, Washington, pictured, adding to the meat processing plant the company has had to shutter as it tests workers for COVID-19
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ATyson Foods Inc unit said on Thursday it will temporarily halt production at a beef facility in Pasco, Washington, pictured, adding to the meat processing plant the company has had to shutter as it tests workers for COVID-19
Tyson also closed a pork processing facility in Logansport, Indiana, pictured, while its more than 2,200 workers at the plant undergo testing for COVID-19
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Tyson also closed a pork processing facility in Logansport, Indiana, pictured, while its more than 2,200 workers at the plant undergo testing for COVID-19
Tyson Foods to indefinitely suspend pork plant in Iowa
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Tyson Foods, the largest U.S. meat supplier, said it will indefinitely suspend operations at its largest pork plant in Waterloo, Iowa, after operating at reduced capacity.
Tyson also closed a pork processing facility in Logansport, Indiana, while its more than 2,200 workers at the plant undergo testing for COVID-19.
John Tyson, pictured, has warned that 'the food supply chain' is breaking
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John Tyson, pictured, has warned that 'the food supply chain' is breaking
The company also temporarily closed a beef processing plant in Pasco, Washington.
The closures are limiting the amount of meat the United States can produce during the outbreak and adding stress on farmers who are losing markets for their pigs.
Lockdowns that aim to stop the spread of the coronavirus have also prevented farmers around the globe from delivering food products to consumers.
Millions of laborers cannot get to fields for harvesting and planting, and there are too few truckers to keep goods moving.
Tyson's statement, in the form of an advert in a number of newspapers on Sunday, came after workers at plants argued they were not being protected by their employer.
Employers have struggled to contain the virus in meatpacking plants, where workers toil side by side on production lines and often share crowded locker rooms, cafeterias and rides to work.
One Tyson worker at the plant in Waterloo told CNN he called HR amid concerns coronavirus was at the facility.
Ernest Latiker said: 'I was scared for me and my family. They told me I was safe and they told me that everything was ok.
'They told me I have a better chance of catching the coronavirus going out to Walmart than at Tyson, if you come to work you're safe.
'I wanted to believe to them and I needed the money at the same time so I went to work.'
Tyson Foods worker Ernest Latiker, pictured, said he called HR amid coronavirus concerns
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Tyson Foods worker Ernest Latiker, pictured, said he called HR amid coronavirus concerns
Tyson's statement in the form of an advert in a number of newspapers on Sunday came after workers at plants argued they were not being protected by their employer
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Tyson's statement in the form of an advert in a number of newspapers on Sunday came after workers at plants argued they were not being protected by their employer

Spread of coronavirus closes meat plants

Some of the facilities that have shut or reduced production as coronavirus spreads:
JBS USA said it would indefinitely close a pork plant in Worthington, Minnesota, that processes 20,000 hogs a day.
JBS closed a beef plant in Greeley, Colorado, until April 24.
Smithfield Foods indefinitely shut a Sioux Falls, South Dakota, plant that produces about 4% to 5% of U.S. pork.
Smithfield also shuttered two plants in Wisconsin and Missouri that process bacon and ham.
Tyson Foods Inc closed a hog slaughterhouse in Columbus Junction, Iowa. It has since reopened
National Beef Packing Co suspended cattle slaughtering at an Iowa Premium beef plant in Tama, Iowa
 National Beef said it suspended operations at a Dodge City, Kansas, beef plant for cleaning and to install stainless steel partitions
Aurora Packing Company temporarily closed a beef plant in Aurora, Illinois
JBS shut a beef plant in Souderton, Pennsylvania. It reopened on April 20
Cargill closed a plant in Hazleton, Pennsylvania, that produces meat for U.S. grocery stores
The health department in Ogle County, Illinois, on April 17 ordered a Rochelle Foods plant owned by Hormel Foods Corp to close for two weeks
Hormel-owned Alma Foods suspended production at a Kansas plant until May 4
Sanderson Farms Inc reduced chicken production to 1 million birds a week from 1.3 million at a plant in Moultrie, Georgia.
'Consumers will see an impact at the grocery store as production slows,' Tyson Fresh Meats Group President Steve Stouffer had said last week.
'It means the loss of a vital market outlet for farmers and further contributes to the disruption of the nation's pork supply.'
After the closure of the Logansport facility, slaughterhouses that account for 19 per cent of pork production in the United States will be shut.
And coronavirus-related staffing shortages at chicken processing plants will lead farms in Maryland and Delaware to destroy nearly two million chickens.
The Baltimore Sun reported Friday that the plants are unable to keep pace with the number of birds that are ready for harvest. They had been placed into poultry houses as chicks several weeks ago.
The chickens will not be processed for meat.
The trade group the Delmarva Poultry Industry said that every poultry plant on the Delmarva Peninsula has struggled with a reduced worker attendance. The reasons include workers being sick with the coronavirus and people following guidance to stay home if sick.
The Delmarva Peninsula includes parts of Delaware, Maryland and Virginia.
The trade group said that one unidentified company has become the first to do what's called 'depopulation.' The trade group said the company was unable to find other options, such as allowing another company to take the chickens.
Delmarva Poultry Industry Inc said the chickens will killed 'using approved, humane methods'.
The former Chief Veterinary Officer for the U.S. Department of Agriculture, John Clifford, said at the time of avian flu 'the fastest way and probably the most humane way to take care of this' was to 'shut off ventilation systems.'
The trade group said that the extermination methods have been approved by the American Veterinary Medical Association for handling cases of infectious avian disease.      
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Michael Novakhov - SharedNewsLinks℠ | InBrief | 

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