Pandemic News Links / Current News Updates

trader32176
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Covid-19: Hospitals forced to suspend routine care amid second surge

11/9/20


https://www.bmj.com/content/371/bmj.m4339


Medical leaders have warned that the health service is already under “extreme pressure” this winter after several large NHS hospitals were forced to suspend routine care because of the high number of patients critically ill with covid-19.

On Friday 6 November, the Queen Elizabeth hospital in Birmingham1 announced that it would be cancelling all planned procedures to cope with a rise in “very sick” patients. This was followed by all hospital trusts in the Greater Manchester area suspending non-urgent surgeries from 9 November. Both areas said they would prioritise the continuation of urgent and emergency care such as cancer treatment.

The news came after the NHS was placed on the highest alert level amid warnings that some hospitals are now seeing more patients with covid-19 than they did at the height of the pandemic in April.2 NHS England’s chief executive, Simon Stevens, said that the NHS currently had the equivalent of 22 hospitals full of patients with covid-19 and that it was “once again facing a serious situation.”

BMA West Midlands regional council chair Stephen Millar said the decision to suspend routine care in Birmingham was “a clear indication of the extreme pressure facing the health service,” and was likely to be replicated at many hospitals across the country this winter. “It’s incredibly concerning that a hospital of this size is having to adopt such drastic measures at this very early stage of winter,” Millar said.

“Despite claims from NHS leaders that lockdown should mean that we do not face mass cancellations, hospitals are clearly already at this tipping point. The government must be forthcoming and deliver urgent resources to ensure that hospitals can cope in the coming months and resume care as quickly as possible.”

As of Sunday 8 November, there were 12 949 people across the UK in hospital with covid-19, 1185 were on a mechanical ventilator.3

According to reports,4 the high volume of patients in intensive care has prompted NHS England to temporarily suspend the 1:1 rule that advises that each nurse in critical care should not look after more than one patient at a time.

Figures shared with The BMJ from the Faculty of Intensive Care Medicine showed that as of 5 November, a quarter (51, 25.7%) of 198 intensive care units which provided data to a national dashboard were working at a nurse-patient staffing ratio of more than 1:1.

Alison Pittard, dean of the faculty and a consultant in intensive care medicine in Leeds, said flexibility in staffing ratios may be required at the present time, but cautioned, “It’s not sustainable on a long term basis, running the risk of adversely affecting staff health and wellbeing and further diluting our workforce.”

Meanwhile, the Royal College of Physicians reported that a poll of its members on 2 November had shown that 92% of 451 doctors who responded expressed concern about the impact of increasing covid-19 admissions on their hospital’s ability to deliver effective care. And a third (30%) said that non-covid-19 patients are coming to them with more severe illnesses than before the pandemic.

RCP president Andrew Goddard warned of “a long and difficult winter ahead.” “We must also do all we can to ensure that services are maintained for our non-covid-19 patients,” he added.
trader32176
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Re: Pandemic News Links / Current News Updates

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Modelling the pandemic—time is of the essence

11/9/20


https://blogs.bmj.com/bmj/2020/11/09/mo ... e-essence/


Is the right kind of modelling guiding time-sensitive policy decisions on covid-19?

Is there scientific consensus about how to deal with the autumn surge in coronavirus cases? One could answer yes and no—and be right on both counts. Yes, there is certainly consensus among the groups that constitute the Scientific Pandemic Influenza Group on Modelling (SPI-M), whose projections underwrite policy decisions issued by the UK government. Yes, there are consensus estimates of fundamental epidemiological constants such as the reproduction ratio, or R number. And there is consensus about the fundamental difference between projections of unmitigated outcomes offered by the SPI-M and the predictions of mitigated outcomes based upon less orthodox approaches like dynamic causal modelling (DCM), which we work on at UCL. [1]

However, this consensus dissolves when it comes to model and data selection used to license various policies. This issue has been foregrounded by the decision to go into a national lockdown in England on the basis of SPI-M projections of unmitigated outcomes. Some commentators are now asking if this is the right kind of quantitative modelling to guide decisions that affect the health, wealth, and wellbeing of so many people? Let us examine the recent English lockdown as an example.

The motivation for going into lockdown was to get the R number below one. At the end of October, the SPI-M consensus estimate of R was between 1.1 and 1.3. With these levels, unmitigated daily fatalities were forecast by the SPI-M to be in the thousands, with escalating death rates into the weeks ahead. This stands in stark contrast to the predictions based on the DCM predictions of mitigated outcomes. These suggested that R was below one when lockdown was announced—and the prevalence of infection had peaked several weeks earlier—predicting fatalities in the hundreds that will now plateau. What sets these two sorts of models apart?

SPI-M estimates of the R-number are based upon curve fitting to recent data, while DCM uses these data to infer the prevalence of infection and its instantaneous change. This means SPI-M estimates are about two weeks behind the curve—and vary depending upon the data used for estimation. However, a very different picture emerges under dynamic causal modelling; namely, that we have just reached peak fatalities, weeks before lockdown could have any effect.

DCM has consistently predicted peak fatalities in early November, albeit with varying amplitudes. In the summer, the peak death rate was predicted to be 150 deaths per day, this came down to around 50 per day a month ago and then increased to 100 or so a day, as more data became available. [2] Crucially, the predicted timing of the peak did not change (around the 8th November). This is important because DCM is trying to predict the timing of fluctuations and their responses to mitigation. This aspect of epidemic forecasting is unavailable to SPI-M models that do not predict mitigating population responses.

One might ask why is timing so important?

Timing is important for many reasons. For example, if the DCM predictions prove correct, it suggests that the national lockdown has been implemented “after the horse has bolted.” In other words, R had already been suppressed by existing national circuit breakers, fire breakers and regional tier systems. [3] This means that we have less time than the SPI-M forecasts would suggest for restructuring and enhancing local contact tracing. Current DCM predictions suggest there will be a window of opportunity in December, when enhanced test, trace, and supported isolation will make a difference. However, this window of opportunity will disappear almost as soon as it emerges (because cases are predicted to rise again, portending a tertiary wave next spring).

There are many other implications of getting the timing right. One prescient example is the role of school closures. On the basis of SPI-M forecasts, closing schools should make a substantive difference by bringing R down. However, if R is already below one, there is no rationale for closing schools. In turn, this means that we can focus on more pressing issues, such as making schools safe places to work and study.

In short, it is all in the timing. If true, one has to ask whether the kind of modelling pursued by SPI-M is apt for guiding time-sensitive policy decisions—and whether we have confused consensus with orthodoxy. We also have to ask whether the DCM currently used is fit for purpose. Its predictions of mitigation and unlocking after the first wave were accurate to within days. [4] If this predictive validity holds for the current wave, we might see a shift in consensus on which modelling to use. If, on the other hand, we see an escalation of fatalities in the next week or two, the orthodox view was right—and we will have to go back to the drawing board. Time will tell—and time is of the essence.
trader32176
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Re: Pandemic News Links / Current News Updates

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Smell and taste changes in general population may indicate COVID-19 spread

11/11/20


https://www.news-medical.net/news/20201 ... pread.aspx


Self-reports of smell and taste changes provide earlier markers of the spread of infection of SARS-CoV-2 than current governmental indicators, according to an international team of researchers. The researchers also observed a decline in self-reports of smell and taste changes as early as five days after lockdown enforcement, with faster declines reported in countries that adopted the most stringent lockdown measures.

" In response to the COVID-19 pandemic, many governments have taken drastic measures to prevent their intensive care units from becoming overwhelmed with patients. Our research suggests that an increase in the incidence of sudden smell and taste change in the general population may indicate that COVID-19 is spreading. This knowledge could help decision-makers take important measures at the local level, either in catching new outbreaks sooner, or in guiding the relaxation of local lockdowns, given the strong impact of lockdown on economic and social activities."

- John Hayes, professor of food science, Penn State

In their study, which published on Oct. 14 in Nature Communications, the researchers used data from the Global Consortium for Chemosensory Research survey, a global, crowd-sourced online study deployed in more than 35 languages. Specifically, the team examined data that were collected from April 7 to May 14, 2020, although study recruitment is still ongoing.

In addition, the team looked at data from the French government -- which beginning on May 7, 2020, has been categorizing various geographical areas of the country as red or green, depending on their COVID-19 prevalence. Compared to green areas, red areas were characterized by higher active circulation of the virus, higher levels of pressure on hospitals and reduced capacity to test new cases.

Finally, to determine whether self-reported smell and taste loss could serve as an early indicator of the number of COVID-19 cases, and therefore hospital stress, the team compared data from France with data from Italy and the United Kingdom, each of which implemented lockdown measures at different times and with different levels of stringency.

"Our primary aim was to test the association between self-reported smell and taste changes and indicators of pressure in hospitals, such as COVID-related hospitalizations, critical care resuscitation unit admissions and mortality rates, for each French administrative region over the last three months," said Veronica Pereda-Loth, lead researcher at the Université Paul Sabatier Toulouse III in France. "Our secondary aim was to examine temporal relationships between the peak of smell and taste changes in the population and the peak of COVID-19 cases and the application of lockdown measures."

Overall, the team found that smell and taste changes were better correlated with the number of COVID-19 admissions to hospitals than France's current governmental indicators, which look at the ratio of ER consultations for suspicion of COVID-19 to general ER consultations. Specifically, the researchers found that the peak onset of changes in smell/taste appeared four days after lockdown measures were implemented. In contrast, the governmental indicator based on ER consultations peaked 11 days after the lockdown.

"Our findings are consistent with emerging data showing that COVID-19-related changes in smell and taste occur in the first few days after infection," said Hayes. "They suggest that self-reports of smell and taste changes are closely associated with hospital overload and are early markers of the spread of infection of SARS-CoV-2. Therefore, potential outbreaks and the short-term efficacy of a lockdown could be monitored by tracking changes in smell and taste in the population."

Data collection for multiple GCCR studies are still ongoing. You can participate by going to https://gcchemosensr.org.
trader32176
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New process helps preserve viral vaccines without refrigeration

11/12/20


https://www.news-medical.net/news/20201 ... ation.aspx


Ever receive a vaccination that seemed to burn a lot while it was injected? The vaccine solution likely contained a lot of salt or sugar -; natural preservatives that help keep it stable, in addition to the cold temperature at which it was kept.

The viruses in vaccines, which train our cells to identify and vanquish viral invaders must be kept cold to keep them from bursting apart. The typical shipping temperature for vaccines ranges from 2 to 8 degrees Celsius (35 to 47 degrees Fahrenheit).

Viruses are kept cold for the same reason we refrigerate food items.

" You wouldn't take a steak and leave it out on your counter for any length of time and then eat it. A steak has the same stability issues – it has proteins, fats, and other molecules that, in order to keep them stable, we need to keep them cold."

- Caryn Heldt, Professor of Chemical Engineering, Director of the Health Research Institute, Michigan Technological University

Like proteins, viruses unfold when it's hot or there's space to move around. Heat provides energy for viruses to shake themselves apart, and not being crowded gives them the room to fall apart. Stable vaccines need cold or crowding.

But what if cold storage isn't available? What if someone accidentally leaves the package on the counter? What if the power goes out?

Heldt, together with Sarah Perry, professor of chemical engineering at the University of Massachusetts Amherst, has developed a way to mimic the body's environment in vaccines using a process called complex coacervation. Rather than relying on refrigeration, Perry and Heldt tap the other method to keep viruses stable -; crowding.

Freezer camp

To keep the viruses in vaccines stable, everyone along the supply chain, from manufacturing facility to shipping company to doctor's office, must maintain the cold temperature. This cooperative effort is known as the cold chain. If a vaccine is kept above that temperature range for even an hour, it may become ruined and unusable.

The World Health Organization estimates that up to 50% of vaccines are wasted every year because the cold chain and ideal temperature for storage cannot be maintained.

The human body is a crowded place. Cells of varying shapes and sizes jockey for position. This includes viruses, who do their nefarious work by hostile takeover. Viruses invade our cells, commandeering them to replicate. Unchecked, virus copies explode out of the cells like darts through a balloon. Then all of those replicas go and do the same to other cells -; and before you know it, you're sick.

Heldt researches vaccine manufacturing techniques and the COVID-19 pandemic has served as a masterclass. But SARS-CoV-2 isn't the only virus in the world -; there is still need for other vaccines and storage methods that don't rely on refrigeration.

"The conditions for a vaccine that make it good to be injected into someone's body are almost the opposite of what makes a virus stable," Heldt said. "There's a really hard trade-off of keeping the virus stable to get good immune response, while having the right components in the vaccine that are safe to inject."

Virus burritos

Heldt and Perry use polypeptides -; synthetic proteins -; that have positive or negative charges. When these charged peptides are put in solution, they stick together and form a separate liquid phase, a process called complex coacervation. The liquid wraps around virus capsids, holding the virus material together like a burrito's tortilla.

"Coacervate materials are something that we actually see all of the time in our daily lives," Perry said. "Many shampoos undergo coacervation. When you put the shampoo onto your wet hair, the water that is present dilutes the shampoo, causing it to phase separate and facilitating the removal of dirt and oil from your hair."

Complex coacervation works for nonenveloped viruses, which have no lipid, or fatty layer, around them. Nonenveloped viruses include polio, rhinovirus (which causes the common cold) and hepatitis A.

Next steps

Heldt and Perry received a $400,000 developmental research grant in March 2020 from the National Institutes of Health (NIH) to continue their research through early 2022, which includes exploring ways to reduce salt concentrations (used in the vaccine to break apart the coacervate phase when it is injected by altering peptide sequences).

Additionally, the chemical engineers are working on ways to apply complex coacervation to enveloped viruses -; like SARS-CoV-2 -; which require a balance of tightness and compartmentalization in the lipid layer in a way nonenveloped viruses do not.

"Looking forward, we want to think more about the specific materials that we use in our coacervates," Perry said. "Crowding alone isn't a universal strategy to improve virus stability. We need to understand how different polymers interact with our viruses and how we can use this to create a toolbox that can be applied to future challenges."

As the taco bar of vaccine storage expands, the research shows that naturally occurring proteins improve our vaccines and make them more widely accessible around the world, refrigerated or not.

"The great thing about these amino acids is that they are the same building blocks as in our bodies," Heldt said. "We're not adding anything to the vaccines that aren't already known to be safe."

Solving the cold storage conundrum promises to improve access to vaccinations against viruses. Bypassing the cold chain with polypeptides and innovative chemical engineering stands to improve health care and reduce medical emergencies around the world.
trader32176
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250,000 cases of child abuse or neglect may have gone unreported in U.S. COVID pandemic

11/12/20


https://www.news-medical.net/news/20201 ... demic.aspx


A recent study published in the journal Child Abuse and Neglect has reported that the number of child maltreatment reports and child welfare interventions decreased significantly in New York City during the initial phase of the coronavirus disease 2019 (COVID-19) pandemic. A reduction in child protective service investigations has also been observed. Overall, the findings suggest that healthcare providers and teachers should be more attentive about detecting possible signs of child abuse during online child interaction sessions.

To curb the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative pathogen for COVID-19, several non-pharmacological control measures, such as mask-wearing, hand washing, social distancing, movement restrictions, and closing of schools/daycare centers and workplaces, have been strictly implemented in many countries across the world. Although these measures have helped manage the pandemic's health-related aspects, they have put a significant burden on the country's economies in general.

Studies conducted during previous pandemic situations have revealed that pandemic-related challenges, such as social isolation, loss of a job, financial hardship, parenting stress, increased alcohol/illicit drug consumption, and emotional distress can significantly increase the risk of family violence, including child abuse. However, because of the pandemic-related restrictions, professionals who are competent for recognizing child abuse cases have limited access to children and their families. This may lead to underreporting of child maltreatment cases.

The current study has been undertaken to evaluate the extent of underreporting of child maltreatment cases by different professionals, such as educators and healthcare providers.

Current study design

The scientists estimated the number of child maltreatment cases monthly received by child protection committees in New York City from January 2015 to May 2020. They also evaluated the number of investigations carried out by child protective services during this period.

Specifically, they analyzed the data collected between January 2015 and February 2020 by seasonal Autoregressive Integrated Moving Average modeling to investigate the deviation between observed. They predicted numbers of child maltreatment cases and childcare investigations for March, April, and May 2020. They separately analyzed the cases reported by authorized reporters (educators, social service providers, law enforcement officers, and medical and mental health personnel) and non-authorized reporters (caregivers, friends, neighbors, and other relatives).

Important observations


The scientists observed that a lower than expected number of child maltreatment cases were reported in March, April, and May 2020 in New York City. Moreover, the reduction in reporting was significant for all subgroups of reporters. A reduction in the number of investigations carried out by child protective services was also noticed in the study.

Specifically, the number of child maltreatment reporting reduced by 29% in March and by 50% in April and May 2020. The scientists believe that the underreporting of child maltreatment cases is likely due to pandemic-related restrictions, such as closure of schools/daycare centers.

Study significance

Because of the COVID-19 pandemic related restrictions, the number of pediatrician-children meets has been reduced significantly in New York City. Similarly, the provision of direct interaction between educators and children has been reduced due to school closures. Although many virtual platforms have been created to facilitate educational and healthcare services, children and caregivers generally feel uncomfortable reporting any incidence of maltreatment online because of a lack of privacy. According to the scientists, these are the major reasons for underreporting, and with the pandemic restrictions continuing, there remains a possibility of missing many cases of child maltreatment nationwide.

Many online portal services that receive reports directly from child maltreatment victims have reported a 31% induction in the numbers of received reports. Similarly, many hospitals have reported a sharp rise in child admission due to severe injuries from family violence. These findings indicate that the reduced number of child abuse reports observed in the study is due to underreporting and not due to an actual reduction in child abuse incidence.

Given the significant impact of financial hardship and psychosocial stress on child maltreatment, the researchers suggest that healthcare providers and educators should be more vigilant about detecting possible child abuse signs during their online visits to children.
trader32176
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Life in the Time of Coronavirus: Full-time RV-ers Working Pandemic-Friendly Jobs Around the Country

11/13/20


https://www.baynews9.com/fl/tampa/coron ... ime-rv-ers


“It's the scenery that you get to live in, it's a million dollar view. And you're not paying a million dollars. You know, it's – it's just fantastic.”

-Andy Morgan, Full-Time RV-er

Six years ago, Andy Morgan and his wife Sarah gave up their corporate jobs, sold their home, and hit the road to live and work in beautiful places.

They are full-time RV-ers that blog and post photographs.

From the west Texas desert to the rocky terrain of coastal Maine, they work seasonally in nature centers and parks and galleries.

“The jobs we've worked since the pandemic have been suited for this,” Morgan said.

“You know, we can, you know, kind of stay in a beautiful place. It's isolated like this, usually around caring people.”

“Like this” is the Big Cypress Preserve in Western Everglades. This is where Andy and Sarah were working when the pandemic took hold of the country.

“The pandemic cut down on traffic, so there's no road noise,” Morgan said. “It was it was one of the best places I could have asked to be when that hit.”

Morgan says he pulls up to million dollar views without million dollar prices.

The couple will stay in the swamps until the Spring then head north back to Maine.

Since March, Virginia Johnson has been talking to people throughout the Tampa Bay area about how they are dealing with Life in The Time of Coronavirus.

They are stories of hope for our community.
curncman
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Re: Pandemic News Links / Current News Updates

Post by curncman »

COVID-19 infections are soaring. Lockdowns could be coming. A list of restrictions in your state.

https://www.usatoday.com/story/news/nat ... 761230001/

U.S. reports record 153,400 new Covid cases as Dr. Fauci urges Americans to be careful: ‘It is not futile’

https://www.cnbc.com/2020/11/13/us-repo ... utile.html
  • The country reported more than 153,400 new cases on Thursday, according to data compiled by Johns Hopkins University.
    That’s the third-straight record one-day spike and has pushed the seven-day average of new U.S. cases to over 131,400, up more than 32% compared with a week ago.
    More than 67,000 people are hospitalized with Covid-19 across the country, more than at any other point during the pandemic.
The United States reported another record one-day spike in Covid-19 cases as the outbreak grows more severe and overwhelms some hospitals.

The country reported more than 153,400 new cases on Thursday, according to data compiled by Johns Hopkins University. That’s the third-straight record one-day spike and has pushed the seven-day average of new U.S. infections to over 131,400, up more than 32% compared with a week ago, according to a CNBC analysis of Hopkins data.

It’s not just cases. More than 67,000 people are hospitalized with Covid-19 across the country, more than at any other point during the pandemic, according to data from the COVID Tracking Project, which is run by journalists at The Atlantic. The number of people dying every day from the disease is climbing, too.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Friday that “a number of factors” is driving the outbreak, including people growing tired of following public health measures. He said that’s a particular issue as the country approaches Thanksgiving in about two weeks, when many Americans are expected to travel to see family and friends, potentially bringing the virus with them.

Fauci urged Americans to wear a mask, practice social distancing, wash hands frequently and to follow other public health measures.

“If we do the things that are simple public health measures, that soaring will level and start to come down,” he said on CBS’ “This Morning.” “You add that to the help of a vaccine, we can turn this around. It is not futile.”

Fauci added that “we need to pull more testing into the community” in order to identify people who don’t have symptoms but are infected and spreading the virus. Testing has increased substantially across the country, but as infections become more prevalent as well, many epidemiologists say even more testing is needed.
curncman
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Even with vaccine, ‘We will be dealing with this forever’: Virus experts Frieden, Osterholm

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Even with vaccine, ‘We will be dealing with this forever’: Virus experts Frieden, Osterholm

https://www.cnbc.com/2020/07/28/even-wi ... perts.html

Even with a vaccine, the country will be fighting the pandemic for at least another year, says former CDC head Thomas Frieden.
Only 7% to 9% of the U.S. population are estimated to have been infected with Covid-19, and herd immunity requires 50% to 70% of the nation to contract the disease.
“We will be dealing with this forever,” says University of Minnesota infectious disease expert Michael Osterholm.

Two of the country’s top infectious disease experts presented a sobering look at the battle still to come against Covid-19. Their message, conveyed during a recent CNBC event, was encapsulated in related views on how much of a difference a coronavirus vaccine can make and what reaching herd immunity in the U.S. population will mean for life across the nation.

“Even with a vaccine, there is no going back to normal anytime soon,” said Thomas Frieden, former director of the Centers for Disease Control and Prevention, speaking at a CNBC Workforce Executive Council virtual event to human resources executives on July 23 about a safe return to the workplace. “Prepare for at least eight to 12 months of this situation,” said Frieden, who now runs the Resolve to Save Lives disease prevention organization.

Michael Osterholm, director of the Center for Infectious Disease Research & Policy at the University of Minnesota, said it is estimated that 7% to 9% of the total U.S. population has been infected with coronavirus, and that means the worst is yet to come. He said the best understanding in the medical field is that transmission will not slow down until 50% to 70% of the population is infected.

“The pain, suffering, death and economic pain we’ve had to date — that’s 7% to 9% of the U.S. population. We’ve got a long way to go,” Osterholm said.

Covid is ‘here to stay’
For businesses and the U.S. economy, that means there will be no “V-shaped” return to workplaces.

“Most businesses in the country will be hard-pressed to operate in a way they want to schedule when we have ‘houses on fire’ in our communities,” said Osterholm. “I understand the pain and economic suffering, but I don’t see any way we get numbers down regionally. We’ve got to stop this virus activity or there will be fear we will see these peaks, but every time it goes down, it plateaus at a higher level and just comes back again. In many communities in this country, I see no way to operate as they once did.”

Cases have started to show some signs of slowing in recent hot spots across the U.S. South and Southwest, including Florida, Texas and Arizona.

In fact, both experts believe Covid-19 is here to stay.

“We will be dealing with this forever,” Osterholm said.

“Covid is here to stay,” added Frieden.

It looks more likely than not that this virus keeps circulating even with a vaccine.
Thomas Frieden
FORMER CDC DIRECTOR AND HEAD OF DISEASE PREVENTION GROUP RESOLVE TO SAVE LIVES
Frieden said one of the biggest issues is that the medical community still lacks good data on the disease, but he added, “Nothing we’ve seen suggests it will just go away.”

That’s why the measures being advocated that may seem like “blunt” tools, from extreme physical distancing in the workplace to remote work as the norm, are the best options we have to stop the virus. Countries that moved quickly to rapid testing and tracing and quarantine were able to get Covid-19 under control more quickly, but the U.S. is too far behind on that more precise tool, “the box-it-in strategy,” Frieden said.

If a vaccine becomes available over the next six to 12 months and we can produce enough of the vaccine for the population, there are still big question marks about its effectiveness, Frieden said. This week the first vaccine to go into a large-scale Phase 3 trial, from Moderna Therapeutics, started toward its goal of enrolling 30,000 individuals. But the scientific community still does not know how long a vaccine will be effective for, and whether immunity within elderly individuals will last. It also is not known about any side effects, as well as the percentage of the population that may refuse to get the vaccine.

“We have great vaccines and still 100,000 deaths a year from measles,” Frieden said, speaking about Africa. “In the U.S. we still have hundreds of thousands of hospitalizations from flu each year with vaccines, and it looks more likely than not that this virus keeps circulating even with a vaccine.”

Osterholm, who has studied the coronavirus class of infectious diseases around the world, including MERS and SARS, said these viruses are “notoriously famous for not granting durable immunity.” He added, “We will be revaccinating on an annual basis.”

Much we don’t know about face masks
One of the blunt tools the U.S. has been using with more frequency is a requirement to wear a face mask, including in workplaces. Research is starting to emerge showing the value of masks in protecting both wearers and those with whom they come into contact, but Osterholm said while wearing a mask is among the best advice we have today, there are problems. First, the masks where data has been strongest are the N95 masks that are used to protect health-care workers, and there is no way we can make those masks available to the general public.

“We have to save those for health-care workers,” Osterholm said, noting that in Minnesota intensive-care units for Covid-19, health-care workers are wearing N95 masks 10 days in a row.”

But he urged everyone to wear a covering.

“Face-cloth covers are not surgical or N95, but wear ‘em, wear ’em,” Osterholm said, even though he added, “We don’t know how well they work.”

The virus expert said distance is the most important protective measure, especially in indoor-air environments, and everything else, including masks, needs to be layered on after that.

Osterholm chided current CDC director Robert Redfield for recently claiming that all we need is masks to drive Covid-19 into the ground in six weeks.

“I thought it was irresponsible,” Osterholm said of Redfield’s claim.

The infectious disease researcher noted that even in regions where citizens can be fined thousands of dollars for not wearing a mask, such as Hong Kong’s public transportation system, we are still seeing problems with Covid-19. We don’t want people to assume masks will make the difference,” Osterholm said.

Another factor, some field work in places like Philadelphia has shown that roughly one-quarter of everyone wearing face-cloth coverings are wearing them under the nose.

Frieden said there is not a lot of data available on the effectiveness of full face shields, but the bottom line is that people need to be wearing some kind of face covering when they are in any indoor environment. There has been a lot of discussion about the need for updated HVAC systems to provide ventilation never considered necessary before Covid-19, but the former CDC director said becoming infected by touching a doorknob or elevator in a building is more probable than contracting the virus due to an AC system, which was the case with SARS.

“One thing we need to do is know there is no one thing we need to do,” Frieden said. “If anyone tells you they know this virus, don’t trust them,” he added.

Living in a ’24/7 Covid world’
Osterholm said anyone who does not know a person who has become infected or died from coronavirus should heed his personal warning about indoor air and large gatherings. He recently warned family members in his hometown of Waukon, Iowa, to not hold a weekend indoor reception for a high school graduate.

“Despite warnings by others, they had it. There was an outbreak that occurred. ... On Wednesday, Grandpa died, and on Friday, Grandma died, both previously healthy. That’s what we are talking about,” the world-renowned epidemiologist said.

As businesses and schools attempt to return workers and students, “clever approaches,” such as four days at the workplace followed by 10 days at home in a form of quarantine, need to be tried, Frieden said. But he warned that the models are only as good as the data we have, and that data is not great today. “It is certainly valid to try and see, and the same goes for schools. I’m not saying we should experiment on kids, but we don’t know the right way to do it,” Frieden said.

Some businesses will continue to rely on remote work when possible and delay returns to physical workplaces. Alphabet announced on Monday it is extending its work-from-home order for any workers who do not need to be in the office until next summer. Businesses need to create a feedback loop to evaluate what is working as they try various ideas such as “de-densifying” the workplace. But the former CDC director warned that as Americans return to work and school, there is no such thing as a “work life” or “school life.”

We are all living “Covid lives” now, he said, and that means workers who demand workforce safety measures but then go to a bar with friends at night are invalidating all the efforts during the day to make the workplace safe.

Individuals will need to understand that going back to work means making significant trade-offs in their personal lives, because it is impossible to know where the explosive spread in a community will start, but we do know how disruptive it will be.

“There is no 100% safe other than everyone staying at home, which is too difficult,” Frieden said. “We will be living in a 24/7 Covid world eventually,” he said.
trader32176
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Re: Pandemic News Links / Current News Updates

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Pandemic restrictions reduced global NO2 concentrations by nearly 20%, shows study

11/18/20


https://www.news-medical.net/news/20201 ... -2025.aspx


Since the COVID-19 pandemic began, space- and ground-based observations have shown that Earth's atmosphere has seen significant reductions in some air pollutants.

However, scientists wanted to know how much of that decline can be attributed to changes in human activity during pandemic-related shutdowns, versus how much would have occurred in a pandemic-free 2020.

Using computer models to generate a COVID-free 2020 for comparison, NASA researchers found that since February, pandemic restrictions have reduced global nitrogen dioxide concentrations by nearly 20%. The results were presented at the 2020 International Conference for High-Performance Computing, Networking, Storage, and Analysis.

Nitrogen dioxide is an air pollutant that is primarily produced by the combustion of fossil fuels used by industry and transportation--both of which were significantly reduced during the height of the pandemic to prevent the novel coronavirus from spreading.

"We all knew the lockdowns were going to have an impact on air quality," said lead author Christoph Keller with Universities Space Research Association (USRA) at NASA's Goddard Space Flight Center in Greenbelt, Maryland. Keller works in Goddard's Global Modeling and Assimilation Office (GMAO), which uses high-tech computer models to help track the chemistry of the ocean and the atmosphere, and forecast future climate scenarios.

He says, "it was also soon clear that it was going to be difficult to quantify how much of that change is related to the lockdown measures, versus general seasonality or variability in pollution."

No two years are exactly alike. Normal variations in weather and atmospheric circulation change the make-up and chemistry of Earth's atmosphere. Comparing 2020 nitrogen dioxide concentrations with data from 2019 or 2018 alone would not account for year-to-year differences.

But, because the NASA model projections account for these natural variations, scientists can use them to parse how much of the 2020 atmospheric composition change was caused by the COVID-19 containment measures.

Even with models, there was no predicting the sudden, drastic shifts in human behavior as the novel coronavirus--and the regulations attempting to control it--spread rapidly. Instead of trying to re-program their model with this unexpected event, Keller and his colleagues accounted for COVID-19 by having the model ignore the pandemic altogether.

The model simulation and machine learning analysis took place at the NASA Center for Climate Simulation. Its "business as usual" scenario showed an alternate reality version of 2020--one that did not experience any unexpected changes in human behavior brought on by the pandemic.

From there it is simple subtraction. The difference between the model simulated values and the measured ground observations represents the change in emissions due to the pandemic response.

The researchers received data from 46 countries--a total of 5,756 observation sites on the ground--relaying hourly atmospheric composition measurements in near-real-time. On a city-level, 50 of the 61 analyzed cities show nitrogen dioxide reductions between 20-50%.

" In some ways I was surprised by how much it dropped. Many countries have already done a very good job in lowering their nitrogen dioxide concentrations over the last decades due to clean air regulations, but what our results clearly show is that there is still asignificant human behavior-driven contribution."

- Christoph Keller, Study Lead Author, Universities Space Research Association (USRA), NASA/Goddard Space Flight Center

Wuhan, China was the first municipality to report an outbreak of COVID-19. It was also the first to show reduced nitrogen dioxide emissions--60% lower than simulated values expected. A 60% decrease in Milan and a 45% decrease in New York followed shortly, as their local restrictions went into effect.

"You could, at times, even see the decrease in nitrogen dioxide before the official policies went into place," said co-author Emma Knowland with USRA at Goddard's GMAO.

"People were probably reducing their transit because the talk of the COVID-19 threat was already happening before we were actually told to shut down." Once restrictions were eased, the decreases in nitrogen dioxide lessened, but remained below expected "business as usual" values.

Keller compared his estimates of the nitrogen dioxide decreases to reported economic numbers, namely, the gross domestic products, of the nations included in the study. According to Keller, they lined up shockingly well.

"We would expect them to be somewhat related because nitrogen dioxide is so closely linked to economic activities, like people who travel and factories running," he said. "It looks like our data captures this very well."
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Re: Pandemic News Links / Current News Updates

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Swiss data shows COVID-19 three times more deadly than the flu

11/19/20


https://www.news-medical.net/news/20201 ... e-flu.aspx


The COVID-19 pandemic has caused a massive health, socio-economic, and financial crisis across the world. Without a preventive or curative solution against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it will continue to impact public health and life globally. Despite this, COVID-19 is often downplayed to be only a seasonal flu by many. This may be because both influenza and COVID-19 have a similar initial presentation, and it is tough to distinguish between the two based on just the clinical presentation.
Is COVID-19 similar to the seasonal influenza?

The virus's characteristics and the disease course in COVID-19 are far more serious than the flu in many aspects. Unlike the flu, SARS-CoV-2 seems to be more contagious and has a reproductive number of 2-2.5. It is contagious even when patients have no symptoms or even before they start showing symptoms.

While the common symptoms of both these infections are cough, fever, or headache, COVID-19 is more deadly in many aspects than the seasonal flu, as is evident from the toll it has taken and the number of lives it has impacted globally. COVID-19 has overwhelmed health care systems in many countries, with ICUs reaching their limits and people with other diseases unable to get treated due to limited resources. Many countries resorted to nation-wide lockdowns to slow down the spread of COVID-19, leading to an unprecedented economic breakdown. Many countries are reeling under a harsher second wave of the pandemic as we speak.

Comparing the clinical outcomes of COVID-19 and seasonal influenza


To date, only a few studies have attempted to compare the clinical outcomes of COVID-19 and influenza, and they found that underlying conditions in patients impact the disease course of both the infections. However, the small sample size of these studies makes it tough to draw tangible conclusions.

Given the significance of the comparison of seasonal influenza and COVID-19 from a public health perspective, a team of researchers from several institutions in Switzerland and Germany set out to investigate the differences in ICU admission and mortality among patients hospitalized with influenza COVID-19 disease in Switzerland. Their study is published on the preprint server medRxiv*.

As per previous estimates, nearly 5,000 patients with seasonal flu infection need hospitalization, and about 1,500 patients die due to seasonal influenza every year in Switzerland. In comparison, COVID-19 has already infected over 285,000 people in Switzerland, with 11,229 hospitalizations and 3,879 deaths as of 19th November 2020.

Differences in ICU admission and mortality among hospitalized COVID-19 and influenza patients

The study cohort included patients over 18 years of age with PCR positive COVID-19 or seasonal influenza infection and admitted to 14 participating Swiss hospitals. Primary and secondary outcomes were in-hospital mortality and ICU admission between seasonal flu and COVID-19 patients. 2,843 COVID-19 patients were included from 14 centers in 2020, while 1,361 influenza patients were recruited in 7 centers between 2018 and 2020.

The results showed that COVID-19 patients were predominantly male and were younger (median age 67 years) compared to influenza patients who were predominantly female and older (median age 74 years). The team found that 12.8% or 363 COVID-19 patients died in the hospital compared to 4.4% or 61 influenza patients who were part of the study.

COVID-19 patients had 3-fold more cumulative risk of mortality than influenza patients

This study compared the clinical outcomes of hospitalized influenza or COVID-19 patients from a Swiss surveillance database. After accounting for competing events and imbalances among patient groups, COVID-19 patients had a 3-fold more cumulative risk of mortality in-hospital compared to influenza patients. This agrees with WHO estimates of fatality rates of COVID-19 (3-4%) and seasonal influenza (0.1%).

COVID-19 patients also had an increased daily mortality risk and an increased duration of stay in hospital. Similarly, COVID-19 patients were at over 2-fold increased risk of being transferred to an ICU compared to influenza patients.

Based on these findings, the authors concluded that even in a well-equipped healthcare system with sufficient resources, COVID-19 was associated with worse outcomes than influenza, as the risk of ICU admission and in-hospital death were ~3-fold higher in COVID-19 patients.

"Even in a national healthcare system with sufficient human and financial resources, community-acquired COVID-19 was associated with worse outcomes compared to community-acquired influenza, as the hazards of in-hospital death and ICU admission were ~3-fold higher.
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