Oahu this month became one of many communities across the world testing wastewater for the new coronavirus.
Scientists are finding that the amount of the virus detected in a communitys sewage could predict the rise and fall of infections, raising hopes for a cheap and reliable early warning tool. The virus that causes COVID-19 can be detected in a persons fecal matter within three days of infection, much earlier than the 14 days it can take to develop symptoms.
Sewage provides a statistical sample of the population, said Rick Bennett, a microbiologist with a specialty in infectious diseases on the Big Island. To get the same data with nasal swabs, you would need just an army of public health workers.
Employees with the Honolulu Department of Environmental Services, who already regularly test wastewater, are taking nine samples a week, one from every public wastewater treatment plant on Oahu.
The samples are then sent to BioBot Analytics, a laboratory partnering with Massachusetts Institute of Technology, Harvard University and Brigham and Womens Hospital. Before the pandemic, BioBot tested sewage to determine the levels of opioid use in a community.
As we attempt to go back to normal it will be a very slow process largely because we will have to overcome peoples fear. Rick Bennett, microbiologist
Wastewater from 170 facilities in the country are being sent to the COVID-19 testing program.
In an optimal world, they said we would have the results in three to four days, said Josh Stanbro, Honolulus chief resilience officer and executive director of the Office of Climate Change, Sustainability and Resiliency. But with so many other cities signing up, were seeing it more like nine days, maybe even more.
Even if results take longer than a week, officials say wastewater testing provides more robust information about outbreaks since asymptomatic carriers, who are unlikely to receive a nasal swab test, are included.
The first samples were taken and frozen on May 1, before the deal with BioBot was even finalized. Stanbro wanted to have a snapshot of Oahus viral load during the strictest shelter-in-place order.
The first stage of reopening was on April 30 so we needed the data of what the virus levels were before opening so we have a baseline to compare as we open back up, he said.
The results will be compared week-by-week and used in conjunction with results from nasal swabbing and antibody tests to paint a clearer picture of the viruss spread on Oahu.
The Sand Island Wastewater Treatment Plant is one of nine facilities sending samples to Massachusetts.
Cory Lum/Civil Beat
We were looking at this as more tools in the toolbox, said Department of Environmental Services deputy director Ross Tanimoto.
As we attempt to go back to normal, it will be a very slow process largely because we will have to overcome peoples fear, Bennett said. If we can point to several weeks of sewage data and say Hey theres no detectible virus that would be pretty good.
Funding for the $25,000 two-month pilot program came from a federal emergency aid package, and officials will decide whether to continue testing once they get a few weeks of results back.
Stanbro said the city is looking into opportunities with a local laboratory to speed up results and help the economy.
We think it would be better, given the economic situation, to be creating lab jobs here rather than elsewhere, he said.
There are no plans to collect more than nine samples a week or release the wastewater results by sub-region.
But Bennett hopes that as wastewater testing improves, officials will test sewage from every pipe entering the treatment plant to hone in on specific communities.
For example if a small community, like Wahiawa, had a high amount, the public health officials could focus their nasal swabbing there and see why theres more contagion going on there, he said.
While most of Oahu is served by sewers, a similar program on other islands like Maui and the Big Island would be constrained by the higher proportion of cesspools and septic tanks.
Stanbro said officials on Kauai are considering it but so far no other counties have announced specific plans.
In 2011, sewage testing in Honolulu identified a salmonella outbreak. Similar testing around the world has zeroed in on outbreaks of antibiotic-resistant bacteria, measles and polio.
But the tool isnt only for emergencies. Japan regularly tests wastewater for all kinds of diseases, said Bennett.
Its been especially successful for norovirus, also known as cruise ship disease, in that country and its something that this island could implement for the health of people here, he said.
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(CNN) As the world slowly eases its way out of the Covid-19 lockdown, we're on the verge of a new era in air travel.
We could soon encounter armies of robotic cleaners patrolling airport concourses, disinfecting check-in counters and ticket kiosks. We might see passengers wafting through security and baggage checkpoints without touching anything.
And we might be boarding aircraft where hand gestures and eye movements open overhead stowage bins and navigate our inflight entertainment screens.
Everything could become touch-free. Out go the tailored uniforms, in come astronaut-style anti-Covid-19 flight attendant suits.
Most of these concepts are trials but could soon morph into realities that become as ubiquitous as the biometric gates and body scanners to which we've already become accustomed at airport terminals.
From the cloud to the clouds
As we shift from the virtual world of Zoom meetings and Houseparty chats back into the skies, what will the touchpoints along that journey look like -- and when might things get going?
"I'm making an assumption, and I think many of our clients are making an assumption, that at some point in 2021, this will be largely behind us," Alex Dichter, senior partner at McKinsey & Company, tells CNN Travel.
Dichter points to stringent measures implemented in China requiring validation that travelers are Covid 19-free, using a system whereby passengers travel with a QR code that is either green, yellow or red. Green means they've been tested and are free of the virus, and authorities know exactly where passengers have been.
"You need to scan in and scan out of every location, your temperature is checked multiple times, you're signing forms. It's hard to imagine those kinds of processes implemented in the West."
But data and tracking are key to our return to the skies.
Dichter suspects some countries are going to focus on these. Therefore protocols need to be established so that if a passenger tests Covid 19-positive after being on a flight, the airline can contact every other passenger that was on the plane.
"Airlines will take this opportunity to accelerate self-service. That's a trend that's been in place for some time, but airlines were probably slower at scaling these technologies out than many customers would like," he says.
Until these new technologies fully materialize, passengers returning to the air may have to make do with what's already out there.
Therefore, Dichter says, "there may be a bit more focus on premium products, providing people with the ability to be alone" -- already a long-time aspiration of the weary business traveler.
Longer term, the financial shock airlines are facing combined with customers' sensitivity to price may bring us back to a world where airlines are taking things away and becoming leaner to reduce prices.
"If we look at the state of the industry in 2022, 2023 and 2024, the big question about what air travel looks like is going to have more to do with the economic fallout than it does to do with the virus," says Dichter.
Passport, boarding pass, mask
Qatar Airways has introduced PPE suits for its crew.
Courtesy Qatar Airways
In the new era of flight, we can expect personal protective equipment (PPE) to be integral to the passenger experience as airlines are beginning to demand -- rather than request -- their use.
European airlines Lufthansa, Air France and KLM have made mask-wearing compulsory for passengers and crew. In the United States, Delta, United, American Airlines and JetBlue have introduced similar measures. Air Canada has mandated their use since April 20.
In Asia, Singapore Airlines, Air Asia and Cathay Pacific have also made masks mandatory.
Qatar Airways, in the Middle East, is one of several airlines to introduce PPE suits for its cabin crew in light of the coronavirus pandemic.
"At least for the whole of 2020, passengers are going to be wearing masks," says Federico Heitz, CEO of Kaelis, a manufacturer of airline on-board supplies that is providing more than 20 airlines with PPE for crew and passengers.
Heitz tells CNN Travel there's high demand for its Self-Protective Pocket Pouch (SP.3), a package that includes a mask, gloves, hand sanitizer, alcohol wipes and an info leaflet with tips on how to prevent the virus spreading. The pouch can be customized to align with the airline's branding.
"These are going to be like the new amenity kits for quite a long time I expect," says Heitz.
"What's going to happen five years from now depends on whether they find a vaccine and on how the virus evolves. For now, we definitely need protection." But who bears the cost?
"This is public health. My view is that it should be provided to all for free," says Heitz. "Wearing a mask is not only about protecting yourself; it's about how to protect the other passengers."
A clean bill of health
While airport terminals remain mostly desolate, initiatives are underway to verify passenger health preflight and assure that airports are scrupulously clean.
Various technologies are in trial phases now.
That includes a contactless voice-activated kiosk for monitoring passengers' temperature, heart and respiratory rates before check-in. It's being developed in partnership between Etihad Airways and Australian company Elenium Automation, and it's undergoing tests at Abu Dhabi Airport.
Etihad's Joerg Oppermann says the technology is an early warning indicator that will help identify symptoms that can be assessed by medical experts to help prevent further contagion.
The system automatically suspends the self-service check-in or bag-drop process if a passenger's vital signs indicate potential symptoms of illness.
"We believe it will not only help in the current Covid-19 outbreak but also into the future with assessing a passenger's suitability to travel and thus minimizing disruptions," says Oppermann.
In it, passengers and airport staff undergo a temperature check before entering an enclosed channel for a 40-second sanitizing procedure, using "photocatalyst" and "nano needles" technologies.
In another initiative at HKIA, invisible antimicrobial coatings that destroy germs, bacteria and viruses are being applied to high-touch surfaces in the terminal such as kiosks, counters and trolleys.
Hong Kong's airport is also testing autonomous Intelligent Sterilization Robots equipped with ultraviolet light sterilizers that roam the airport, disinfecting passenger facilities.
Terminal velocity
"Experimentation at a number of airports with UV lights, cleaning robots and other technologies is part of an attempt to minimize the distancing that's needed if you want to maintain throughput of passengers at airports," says Cristiano Ceccato, director of Zaha Hadid Architects, designers of the recently opened Daxing Beijing Airport.
"Otherwise," he tells CNN Travel, "you're going to need a bigger airport to space people further apart."
For the very long-term future, Ceccato ponders a possible scenario where passengers have some kind of chip injected in their arms that continuously monitors their health, "Star Trek" style. It would start beeping if it detects they've been infected with something.
"We're not there yet. And then, of course, there are ethical questions about people's privacy and the invasion of civil liberties. We used to joke that the airport today is basically an airport mixed with a shopping mall. Now the airport could be mixed with a hospital."
Nearer term, Ceccato anticipates that airports could have some form of high-tech arch that passengers walk through that scans for metals, liquids and gels, and also checks the passenger's health.
"That stuff is on the way, but we don't know exactly when it will happen. A lot of ideas for these kinds of technologies are tied to the profiling of people," he says.
Another motivation behind the adoption of security and health tech at airports is to accelerate the flow of passengers through the terminal checkpoints by reducing human-to-human contact, or contact between passengers and conveyor belts and trays at security.
"Eventually at airports, you won't have to grapple with getting your laptop and washbag out of your hand luggage, and you won't have to deal with the security guy fumbling through your stuff," says Ceccato.
While architects figure out how to adapt the airports to accommodate all the extra new health screening and sanitation technologies, Ceccato says that on the upside, "it might be reassuring for passengers to know, having passed all these preflight checks, that their health is in good shape."
Up in the air
The main focal point for air travel is the aircraft interior, and this is where traditionally there has been prolonged interaction between the passenger and the cabin surfaces -- seating, inflight entertainment systems, toilets and other furnishings.
"There's probably a future for a stowage bin that will be gesture-based, where passengers don't have to touch the handle, just wave their hand to raise or lower the door," says Devin Liddell, principal futurist of Teague, the Seattle-based design consultants that created the Dreamliner cabin and the interior of every Boeing airliner since the 1940s.
The other area where Liddell believes airlines will be focusing to reinstate passenger confidence will be the application of antimicrobial surfaces.
"That will be a big one," says Liddell. "I think airlines actually just heralding the cleanliness of their aircraft and the processes that they use to clean the aircraft will be something that we see both near term and far term, as well as the touting of advanced systems that strip viruses out of the air."
As touching things becomes poor etiquette in the cabin, designers of inflight entertainment systems will need to come up with new approaches.
"Eventually, we'll see eye movement tracking-based user interfaces when it comes to the inflight entertainment system, so not having to touch the IFE system at all," says Liddell.
Longer-term opportunities to improve the on-board experience are with rethinking the layout of the passenger cabin.
"Airlines will need to be smarter in the post Covid-19 world with zoning the cabin, and various airlines have tinkered with child-free zones and so forth," says Liddell.
But one of the biggest challenges in the cabin will be inflight catering. In the early days of the virus, carriers stopped serving food to minimize crew having to walk up and down the aisles. Liddell sees opportunities for robotics and automation inside the cabin to take on many of the catering tasks.
"The galley cart in particular is such a strange piece of tech in the sense that it blocks the aisle, and makes part of the aircraft inaccessible during meal service."
"There's an opportunity for aisle-based robots that would bring food to you, maybe when you want it, versus when the airline decides it's going to give it to you," he says.
The people have spoken
Ultimately, whether passengers will feel confident enough to take to the skies depends on consumer confidence and the sense amongst passengers of whether airlines are adequately addressing their concerns regarding Covid-19 and its bearing on air travel.
To gauge this, the Airline Passenger Experience Association and the International Flight Services Association commissioned data consultants Fethr, the aviation wing of Black Swan Data, to assess passenger sentiment.
Using data analysis and predictive analytics, Fethr analyzed more than 900 million naturally occurring conversations on Twitter, news, blogs and reviews related to Covid-19 and air travel.
"Over a third of the conversations at the moment related to safety and sanitation on board the aircraft are very negatively charged," Will Cooper, insights director at Fethr, tells CNN Travel.
"Passengers are expressing their concerns and frustration around not knowing whether it's safe to travel or how they protect themselves and are unclear about what airlines are doing."
Perhaps one of the longest journeys facing airlines today is restoring passenger confidence.
Paul Sillers is an aviation journalist specializing in passenger experience and future air travel tech. Follow him at @paulsillers
A potentially game-changing spit test for coronavirus is set to be trialled by the government on 5,000 police and army staff amid growing concern about the accuracy of invasive nasal swabs.
The two-minute test requires someone to spit in a tube, and is thought to be as accurate, if not more so, than the throat and nose swab that detects if someone has Covid-19.
Prof Paul Elliott, the Imperial College London scientist who is leading a major government programme on home testing, told the Guardian saliva tests would be trialled on 5,000 key workers in the next fortnight.
He said he was very, very interested in the potential of the tests because they are much easier to use. A swab must penetrate deep into the mucous membrane behind the nose and in the mouth, often triggering the gag reflex.
Elliott said that clinical experiences suggested that as many as 30% of nasal swab tests result in a false negative, where people are wrongly told they do not have the virus.
The government trial will initially examine saliva antibody tests which detect if someone has previously had Covid-19 before being expanded to antigen tests showing current infections if it proves successful.
The Guardian has also learned that the government is in advanced discussions with one of the biggest saliva test companies in the US about getting approval for its product to be used in the UK.
The California-based firm, Curative, which is run by an award-winning UK scientist, has told officials it can provide 100,000 tests a week immediately, with the potential for capacity to be massively expanded if it gets the go-ahead. The company is providing tests for the US air force and said it had carried out more than 300,000 tests in five states including Texas and California.
Early studies in the US, including one by Yale University, have found the saliva test to be as or more accurate than the nasal swab test.
Philip Beales, a professor at the University College London Institute of Child Health, who has been helping to coordinate the efforts of UK testing firms, described saliva tests as a game-changer and said they could really could get us out of this epidemiological nightmare.
Beales said his team had found that saliva samples were superior to nasopharyngeal swabs for detecting Covid-19 because they remove almost all possibility of operator failure.
The government has refused to publish its research into the false negative rate of the nasopharyngeal test, despite tens of thousands people a day carrying out the difficult procedure.
A number of the governments regional drive-through testing facilities, which are run by private contractors, require people to carry out the swab on themselves with the aid of a nine-page, 20-step instruction manual.
Matt Hancock, the health secretary, told the Commons this week that the efficacy of self-administered tests was not significantly different from tests administered by specially trained NHS staff.
His claim has been met with scepticism by some in the scientific community, while health bosses in Greater Manchester have asked to see the research. Weve no idea how many [tests there are], are they statistically significant? Id love to see those data, said Beales, director of the Centre for Translational Genomics.
The fallibility of the nasal swabs has led some GPs to advise patients to disregard negative results if they still have symptoms.
Dr Richard Vautrey, the chair of the British Medical Associations general practitioners committee, said he had seen patients with coronavirus symptoms but repeated negative tests.
No test is perfect, particularly when tests are self-administered and this is a particularly difficult test to do [so] there will be some false negatives, he said. Going on the symptoms is as good a guide as any as to what condition a patient has.
Martin Hibberd, professor of emerging infectious disease at the London School of Hygiene and Tropical Medicine, said false negatives could be devastating if a patient was returned to a care home and passed the disease on.
Dr Philippa Whitford, the SNPs health spokeswoman and a former breast surgeon, called for the government to publish its research. A false-negative rate of a quarter or up to 30% is massive. Theres a danger that key staff are being told to go through the drive-through system [and self-testing] and so you could be sending positive staff who are virus carriers back into hospitals and care homes.
Combining a test that is designed to detect current infection with a test that detects infection at some point in the past is just really confusing and muddies the water, Hanage told us.
Read: Why the coronavirus is so confusing
The CDC stopped publishing anything resembling a complete database of daily test results on February 29. When it resumed publishing test data last week, a page of its website explaining its new COVID Data Tracker said that only viral tests were included in its figures. These data represent only viral tests. Antibody tests are not currently captured in these data, the page said as recently as May 18.
Yesterday, that language was changed. All reference to disaggregating the two different types of tests disappeared. These data are compiled from a number of sources, the new version read. The text strongly implied that both types of tests were included in the count, but did not explicitly say so.
The CDCs data have also become more favorable over the past several days. On Monday, a page on the agencys website reported that 10.2 million viral tests had been conducted nationwide since the pandemic began, with 15 percent of themor about 1.5 millioncoming back positive. But yesterday, after the CDC changed its terms, it said on the same page that 10.8 million tests of any type had been conducted nationwide. Yet its positive rate had dropped by a percent. On the same day it expanded its terms, the CDC added 630,205 new tests, but it added only 52,429 positive results.
This is what concerns Jha. Because antibody tests are meant to be used on the general population, not just symptomatic people, they will, in most cases, have a lower percent-positive rate than viral tests. So blending viral and antibody tests will drive down your positive rate in a very dramatic way, he said.
The absence of clear national guidelines has led to widespread confusion about how testing data should be reported. Pennsylvania reports negative viral and antibody tests in the same metric, a state spokesperson confirmed to us on Wednesday. The state has one of the countrys worst outbreaks, with more than 67,000 positive cases. But it has also slowly improved its testing performance, testing about 8,000 people in a day. Yet right now it is impossible to know how to interpret any of its accumulated results.
Read: Should you get an antibody test?
Texas, where the rate of new COVID-19 infections has stubbornly refused to fall, is one of the most worrying states (along with Georgia). The Texas Observer first reported last week that the state was lumping its viral and antibody results together. On Tuesday, Governor Greg Abbott denied that the state was blending the results, but the Dallas Observer reports that it is still doing so.
While the number of tests per day has increased in Texas, climbing to more than 20,000, the combined results mean that the testing data are essentially uninterpretable. It is impossible to know the true percentage of positive viral tests in Texas. It is impossible to know how many of the 718,000 negative results were not meant to diagnose a sick person. The state did not return a request for comment, nor has it produced data describing its antibody or viral results separately. (Some states, following guidelines from the Council of State and Territorial Epidemiologists, report antibody-test positives as probable COVID-19 cases without including them in their confirmed totals.)
Georgia is in a similar situation. It has also seen its COVID-19 infections plateau amid a surge in testing. Like Texas, it reported more than 20,000 new results on Wednesday, the majority of them negative. But because, according to The Macon Telegraph, it is also blending its viral and antibody results together, its true percent-positive rate is impossible to know. (The governors office did not return a request for comment.)
Stats show Ohio's median age of death is 80, and 92% of deaths are patients over 60. No child has died during outbreak
The parallel is causing some to question why Gov. Mike DeWine opted to end the mandated closure of thousands of businesses, but case numbers alone are not the primary data on which to focus.
New cases offer a snapshot of a day, and with testing becoming more common and available, rising case numbers are expected.
Fears of rampant caseloads is why Ohio opted its "Flatten the Curve" mantra. The plan was not to eradicate the virus. Rather, the lockdown was meant to spread out cases over a longer period of time in order to preserve our medical system and supplies.
Ohioans succeeded in flattening the curve, and its become time, DeWine has said, to reopen businesses in a safe and steady fashion.
Still, some see the new cases as reason for concern. However, other data show Ohio has seen critical numbers, like deaths and hospital stays, dropping for several weeks.
Deaths in Ohio started in March and peaked in late April when 327 deaths were reported in a 7-day span, according to the Ohio Department of Health. Death reporting, however, lags in time due to reporting constraints and gathering techniques, so the peak was likely closer to mid April.
Regardless, deaths in the past three weeks have slowly but steadily lessened from 288 deaths April 30-May 5 to 258 on May 6-12 and 237 from May 13-19.
Ohios total deaths are now at 1,836.
And while cases continue to stay steady, hospitalizations have trended downward by almost 8 percent in the past 21 days, going from 1,064 on May 6 to 981 on May 17.
Intensive Care Units have seen an 11 percent drop in that same time frame, going from 408 patients to 364.
Ventilator use saw a 10 percent drop, from 278 patients to 250.
It is true that COVID-19 continues to kill. But the virus is especially deadly to one group: those over 60 years of age. They account for 92 percent of all Ohio deaths.
The median age for death is 80, and nearly 70 percent of all deaths are nursing home patients, i.e. those who are not only older but also suffering from other medical issues.
Those under 60 years of age have fared much better. For example, only five people under age 30 have died, less than 1 percent of all deaths. Children have been spared the most, as Ohio has not had anyone under age 19 die from the virus.
Demographically, men (53%) die more often than women.
In addition, black residents, while impacted most by hospitalizations (31% of all hospital COVID-19 patients and 27% of all cases), account for 17% of deaths. Blacks comprise about 14 percent of Ohios population.
UPDATE (4:34 p.m. PT) An inmate at the Oregon State Penitentiary who tested positive for COVID-19 died Wednesday evening, according to the Department ofCorrections.
Its the first COVID-19 related death connected to the states prisonsystem.
The unidentified inmate was between 50 and 60 years old and one of three with the disease who have been hospitalized, DOC said in a statement. Next of kin have been notified. Two other inmates remainhospitalized.
The Oregon State Police will investigate the death and the state medical examiner will determine thecause.
Inmates are at greater risk for contracting the disease because its difficult to create enough social distance in prisons, jails and detention centers to slow the spread of COVID-19. Some of the largest outbreaks in the country have been in correctionalinstitutions.
As of Thursday, Oregon DOC said there were 148 inmates who have tested positive for the disease, as well as38 employees. The agency houses more than 14,000 inmates across 14institutions.
Last month, Gov. Kate Brown said she wouldnt release inmates in large groups over risks surrounding the disease. Rather, she said, she would evaluate early releases on acase-by-casebasis.
The death comes as the DOC and Brown are being sued for their response to the pandemic inside the states prisons. Inmates in several institutions allege not enough has been done to slow thedisease.
Among other things, the suit asks a judge to mandate a social distance of 6 feet or more between inmates in all of the DOCs facilities. If that cant be accomplished, the lawsuits ask that a three-judge panel review cases and reduce the number of prisoners inOregon prisons so itispossible.
The Oregon Justice Resource Center, which is suing the DOC and Brown, said the death underscores the risks COVID-19 poses to staff andinmates.
There is an urgent and clear need for a comprehensive program of prevention, testing, and care to be implemented throughout Oregons prisons, OJRCs Juan Chavez said in a statement. Governor Brown must no longer ignore the reality that prisons are not built to withstand a global pandemic and act on the knowledge she has of the riskofharm that exists for all those who work and live in theprisons.
DOC has set up medical isolation units for patients with COVID-19 at the Coffee Creek Correctional Institution and the Snake River Correctional Institution, where theres 24/7nursingcare.
This week, DOC started antibody testing, but have not yet receivedresults.
Antibody testing will help us quantify the breadth and scope of COVID at our institutions with positive tests, DOC said in a statement. For example, we will offering antibody testing to all(inmates) at Shutter Creek. This will allow us to identify those now presumptivelyimmune.
"Unless we open up our economy, we have millions facing starvation."
That was the straightforward assessment of Pakistani Prime Minister Imran Khan on the impact of COVID-19 during a virtual meeting of the Forum's COVID Action Platform on 20 May.
Khan explained: "In Pakistan, we have 25 million workers who are either [on] daily wages or get paid weekly or are self-employed. When we locked down, like the whole of the world, to stop the spread of the virus, all these people became unemployed. When we're talking about 25 million workers, you're talking about 25 million families and it has affected almost 120-150 million people...unless the men and women work, they cannot feed their families."
Launched in March, the Forum's platform aims to convene leaders from governments and the business community for collective action to protect peoples livelihoods, facilitate business continuity and mobilize support for a global response to COVID-19. To date, more than 1,500 people from more than 1,000 businesses and organizations have joined the platform.
To find the latest updates on the Platform, check out our recently-launched highlights blog.
A new strain of Coronavirus, COVID 19, is spreading around the world, causing deaths and major disruption to the global economy.
Responding to this crisis requires global cooperation among governments, international organizations and the business community, which is at the centre of the World Economic Forums mission as the International Organization for Public-Private Cooperation.
The Forum has created the COVID Action Platform, a global platform to convene the business community for collective action, protect peoples livelihoods and facilitate business continuity, and mobilize support for the COVID-19 response. The platform is created with the support of the World Health Organization and is open to all businesses and industry groups, as well as other stakeholders, aiming to integrate and inform joint action.
As an organization, the Forum has a track record of supporting efforts to contain epidemics. In 2017, at our Annual Meeting, the Coalition for Epidemic Preparedness Innovations (CEPI) was launched bringing together experts from government, business, health, academia and civil society to accelerate the development of vaccines. CEPI is currently supporting the race to develop a vaccine against this strand of the coronavirus.
In addition to Khan, participants on this week's webinar included: Sigrid Kaag, Minister for Foreign Trade and Development Cooperation, Netherlands; Werner Baumann, Chief Executive Officer, Bayer AG, Germany; and Meenakshi Gupta, Co-founder, Goonj, India.
Here are some key quotes from the session:
"Debt relief is the key issue...if the weakest link in the chain is not supported effectively, we will all be damaged."
"The response has to be global. There has to be a way of picking up countries that are struggling right now, especially in the developing world."
"When no vaccine is available, the name of the game is testing, testing, testing...[and] as we learn more about the virus, we are more and more concerned about how dangerous it really is."
"In the past, India's informal economy has been its strength - but in a lockdown situation where daily wages aren't possible, it leaves many with no choice."
License and Republishing
World Economic Forum articles may be republished in accordance with our Terms of Use.
The views expressed in this article are those of the author alone and not the World Economic Forum.
Good morning, good afternoon and good evening.
Yesterday, we concluded a very productive World Health Assembly.
We saw unprecedented solidarity with Heads of Government from around the world beaming into the World Health Assembly to discuss lessons, challenges and collective next steps to tackle the pandemic.
I would like to use this opportunity to thank Heads of Government who participated.
I thank President Sommaruga, President Ramaphosa, President Xi, President Moon, President Macron, President Duque, President Benitez, Chancellor Merkel, Prime Minister Mottley, Prime Minister Tshering, Prime Minister Pedro Sanchez, Prime Minister Conte, Prime Minister Natano, Prime Minister Nguyn Xun Phc, President von der Leyen, Secretary-General Guterres and all Member State representatives and minsters for joining the Assembly and signing up to a historic consensus resolution on COVID-19 and the way ahead.
The resolution sets out a clear roadmap of the critical activities and actions that must be taken to sustain and accelerate the response at the national and international levels.
It assigns responsibilities for both the WHO and its member states, and captures the comprehensive whole of government and whole of society approach we have been calling for since the beginning of the outbreak.
If implemented, this would ensure a more coherent, coordinated and fairer response that saves both lives and livelihoods.
The landmark resolution underlines WHOs key role in promoting access to safe, effective health technologies to fight the pandemic.
I welcome Member States commitment to lift all barriers to universal access to vaccines, diagnostics and therapeutics.
This includes four critical points from the resolution:
First: that there is a global priority to ensure the fair distribution of all quality essential health technologies required to tackle the COVID-19 pandemic.
Second: that relevant international treaties should be harnessed where needed, including the provisions of the TRIPS agreement.
Third: that COVID-19 vaccines should be classified as a global public good for health in order to bring the pandemic to an end.
And fourth: that collaboration to promote both private sector and government-funded research and development should be encouraged. This includes open innovation across all relevant domains and the sharing of all relevant information with WHO.
An important collaborative response to this resolution will be the COVID-19 technology platform proposed by Costa Rica, which we will launch on the 29th of May, which aims to lift access barriers to effective vaccines, medicines and other health products. We call on all countries to join this initiative.
Im glad we are making progress on the research and development agenda, which was mapped out in February at the research and development meeting convened by WHO.
That roadmap has now given rise to the solidarity trials, which now include 3,000 patients in 320 hospitals across 17 countries and to the Access to COVID-19 ToolsAccelerator.
===
We still have a long way to go in this pandemic.
In the last 24 hours, there have been 106,000 cases reported to WHO the most in a single day since the outbreak began. Almost two thirds of these cases were reported in just four countries.
But, in good news, it has been particularly impressive to see how countries like the Republic of Korea have built on their experience of MERS to quickly implement a comprehensive strategy to find, isolate, test and care for every case, and trace every contact.
This was critical to the Republic of Korea curtailing the first wave and now quickly identifying and containing new outbreaks.
However, were very concerned about the rising numbers of cases in low- and middle-income countries.
Governments in the Assembly outlined their primary goal of supressing transmission, saving lives and restoring livelihoods.
And WHO is supporting Member States to ensure supply chains remain open and medical supplies reach health workers and patients.
As we battle COVID-19, ensuring health systems continue to function is an equally high priority as we recognize the risk to life from any suspension of essential services, like child immunisation.
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COVID-19 is not the only challenge the world is facing.
The climate crisis is causing increasingly strong storms, abnormal weather patterns and catastrophic shocks.
Super cyclone Amphan is one of the biggest in years and is currently bearing down on Bangladesh and India.
Our thoughts are with those affected and we recognize that like with COVID-19 there is a serious threat to life, particularly the poorest and most marginalized communities.
WHO continues to offer support to Bangladesh and India to tackle both COVID-19 and the effects of the super cyclone.
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I want to end by emphasizing that there is continued hope.
The last person who was being treated for Ebola in the Democratic Republic of Congo recovered and was discharged on May 14.
On that day, the DRC Ministry of Health announced the beginning of the 42-day countdown to the end of the outbreak.
We now have 36 days to go but new cases could still emerge, as we have seen before.
The pandemic has taught and informed many lessons:
Health is not a cost; its an investment.
To live in a secure world, guaranteeing quality health for all is not just the right choice; its the smart choice.
I thank you.
The press has a natural affinity for catastrophes, which make compelling viewing and good copy. The pandemic is indeed a once-in-a-generation story. So the media is naturally loath to shift gears and acknowledge that the coronavirus has begun to loosen its grip.
Meanwhile, progressives and many journalists have developed a near-theological commitment to the lockdowns, such that any information that undermines them is considered unwelcome, even threatening. This accounts for the widespread sense that no one should say things have gotten better ... or people are going to die.
Usually when it is thought the public cant handle the truth, it is a truth about some threat that could spark panic. In this case, the truth is information that might make people think its safe to go outside again.
Almost all the discussion about reopening is framed by worries that we will reopen too soon, not that we might reopen too latethat is literally unthinkable.
None of this is to minimize the seriousness of this pandemic. New York and its surrounding suburbs have been through hell. Whats happened in the countrys nursing homes is a tragedy. We want to be cautious about reopeningas even the most forward-leaning governors have beenand vigilant about new outbreaks.
But we have entered a new phase. As Nate Silver pointed out on Tuesday, the seven-day rolling average for deaths is 1,362, down from 1,761 the week prior and a peak of 2,070 on April 21. Thats still much too high, but the trend is favorable.
Testing capacity, such a concern for so long, has really begun to expand after hitting a plateau for weeks. Testing nationally on some days has been in the high 300,000s or (on May 17) over 400,000. The issue in some states now is not capacity but actually finding enough people to test.
Scott Gottlieb of the American Enterprise Institute notes that the positivity rate, or percentage of people testing positive, has continued to fall throughout May. In New York City, the countrys epicenter, the positivity rate was below 5 percent as of the middle of the week.
The reopenings could certainly still go awry, but so far there is no clear indication of it. Cases are still falling in Austria, Denmark and Norway, despite those countries being relatively far along on reopening. Denmark has been mystified why it is almost five weeks into reopening and hasnt yet seen increases in infections.
On Tuesday, Georgia, so widely criticized for its reopening, had its lowest number of Covid-19 patients in the hospital since April 8, when such data began being reported. The number has dropped 12 percent since the week before, and 34 percent since May 1.
The press has often, out of sloppiness or willfulness, tried to create negative news around the reopenings. CNN tweeted last weekend, Texas is seeing the highest number of new coronavirus cases and deaths just two weeks after it officially re-opened. As Sean Trende of RealClearPolitics pointed out, the seven-day rolling average of new cases had indeed been trending up, but the seven-day rolling average of the number of tests had gone up, toowhich would naturally turn up more cases.
The key indicator is the positivity rate, and it was down in Texas.
A North Carolina TV station tweeted, Breaking News: NC sees largest spike in coronavirus cases since pandemic began. That referred to 800 new cases over the past 24 hours on May 16. But tests had been going sharply up and the positivity rate trending down. Hospitalizations were basically flat.
The other day, headlines noted that Florida recorded 500 new cases on one day. It generated fewer headlines, and perhaps none, when Gov. Ron DeSantis pointed out that the state had received a dump of 75,000 test results, yielding the 500 new cases, for a minuscule positivity rate of 0.64 percent.
Its not as though we havent had a cataract of unassailably legitimate bad news over the past few months. Weve been experiencing a wrenching public health crisis and a steep recession on top of it. There shouldnt be a need to obscure favorable trends. We can handle the truth.
Less than 1% of Americans live in nursing homes, yet these facilities account for between 15% and 25% of Covid-19 cases and half of all deathsfrom the disease in some states; in Minnesota, nursing home residents and workers account for81% of all Covid-19 deaths.
If we hope to contain SARS-CoV-2, the virus that causes Covid-19, until we have better treatments or a vaccine, we need a concerted national testing effort focused on nursing homes. From a public health perspective, they are not only areas of focused harm but are also wells of infection that may keep the pandemic rolling unless we take drastic steps.
The transmission rate for the virus was as high as five in February and March, meaning each person infected with it spread it to five others. The transmission rate is now probably down to two, with some local variation, so we have made progress. More is needed: to contain the spread of the virus we must drive the transmission rate below one.
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Nursing homes offer a potential opportunity to contain the virus in a targeted way that benefits those who live in them, those who work in them, and everyone else. If we focus our efforts on testing all nursing home residents and workers, we may be able to drive down transmission rates in ways that have eluded us so far.
Workers in nursing homes care for the most vulnerable members of society in intimate ways, helping them dress, bathe, eat, and go to the toilet. They are vital to the care system of the elderly in our nation, though they are not paid that way and most are not given enough personal protective equipment and do not receive paid sick time.
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This reality is likely behind the initial outbreak at the Life Care Center of Kirkland, a nursing home near Seattle.
Workers in these facilities are at great risk of occupational exposure to the coronavirus, but they also pose a risk of transmitting it more widely bringing it into nursing homes from the community and spreading it to the community from nursing homes. This transmission risk is heightened by the fact that many individuals work in more than one facility. Another source of infection entering nursing homes is elderly people who have been discharged from the hospital to nursing homes after things like hip fractures or heart procedures for short rehabilitation stays. In many nursing homes, long-term patients live just down the hall from those who will be there for a few days or weeks only, and this mixing helps spread SARS-CoV-2.
The nation must mobilize so every state has the capacity to test all patients and workers in every nursing home across the country. We need to do this in a way that generates solid scientific evidence about how testing should be undertaken in nursing homes. That effort should answer a series of critical questions, including what tests should be deployed, how often asymptomatic workers and residents should be tested, and how long sick workers must be quarantined before they can return to work. We should also investigate how to most effectively isolate infected patients within nursing facilities, and whether a testing program can safely enable family members visit their loved ones.
There are numerous details to be ironed out, and this work will be hard and expensive. But there are experts who have given their lifes work to these topics, and we need to empower them to work out the details about how to implement testing programs in nursing homes while ensuring that a focused national effort provides the needed resources to support this effort.
It will take federal money to do this testing all residents and nursing home staff nationally just once would cost $440 million, and repetitive testing will be needed for some time to control the spread of SARS-CoV-2 in nursing homes. The cost of widespread testing will be enormous, but so too is the cost of the quiet default that we seem to be settling for that normalizes infection, death, and isolation of elderly nursing home residents and continues to put the workers who care for them at risk.
We cant know for certain if this approach will completely halt the devastating progress of SARS-CoV-2 across the nation. If it falls short, the worst that can be said is that we sought first to protect the least of these while also protecting vulnerable workers who show up daily to help our parents and grandparents to live as best they can each day.
The best outcome is that we control the coronavirus pandemic while rediscovering the common good and that we can work toward it together.
Donald H. Taylor Jr. is a professor of public policy in Duke Universitys Sanford School of Public Policy, a founding faculty member of the Duke-Margolis Center for Health Policy, and director of the Social Science Research Institute.
