Where is the UK compared with other EU countries?
A total of 7,097 deaths have been recorded in hospitals across the UK to date. Although this is lower than the death tolls in Italy, the US, Spain and France, the daily increase in the volume of fatalities now puts the UK on a par with rises seen in Italy and Spain.
The deadliest day reported in Italy was on 28 March with 971 deaths and in Spain on 3 April with 950 fatalities, according to the European Centre for Disease Prevention and Control. Death tolls in both countries now appear to have hit their peak on those dates, with lower numbers reported since.
But are the UKs figures accurate?
However, the figures we focus on dont tell us the full picture of how many deaths are actually happening. Guardian analysis showed that due to delays in reporting we cant accurately say how many deaths take place each day.
This means as previous days figures are continuously revised upwards, we dont have a true picture of where the country is on the curve at any current point in time. It also means, as the headline death toll increases, we wont know when we reach and pass the peak in real time. Similar issues are also faced in recording Covid-related deaths in other countries.
It also bears repeating that the true death toll is likely to be significantly higher once deaths in the community are factored in. In France more than 3,000 deaths have been recorded in care homes. The inclusion of deaths in the community caused its toll to increase sharply from 8,911 to 10,328 on 7 April a daily increase of 1,417.
According to figures for England, Wales and Scotland the number of fatalities where Covid-19 has been mentioned on the death certificate is much higher than the official number we focus on. Preliminary figures from the Office for National Statistics show Covid-19 registered deaths have been 70% higher than the reported headline figure in England and Wales. These figures are anticipated to be the gold standard in Covid-19 fatalities as more deaths are registered. The equivalent figure is 61% higher in Scotland.
If these figures were to be included in Wednesdays daily death toll, the UK would likely have already topped 1,000.
LONDON Boris Johnsons war with the coronavirus has turned personal. When the prime minister was admitted to intensive care with severe symptoms on Monday night, it was a reminder to Britons that like it or not, we are all in this together.
The virus that has changed daily life across the world knows no bounds when it comes to privilege, class or high office. A leader who has repeatedly defied the laws of political gravity finds himself struck down by the very virus he had put his government on a war footing to beat.
Mr. Johnsons hospital stay comes after a week of damaging headlines over his governments handling of the outbreak and rumors of his declining health. Keen to dispel claims made earlier this year that he was a part-time prime minister, Mr. Johnson had insisted on continuing to work despite his symptoms, which included a persistent fever. Those around him now regret that decision.
Although Mr. Johnsons Conservative Party has enjoyed its best poll ratings in government since Margaret Thatcher during the Falklands War, there has been criticism of the prime ministers handling of the pandemic from his visible reluctance to impose social-distancing measures to his at times jovial approach to news conferences.
But as Mr. Johnsons hospital admission brings the national crisis to a head, such criticism has been drowned out by support. Politicians, commentators and celebrities across the spectrum have put partisanship aside to rally around the beleaguered prime minister. Social media is flooded with well wishes; theres a campaign for a moment of national applause a community act reserved until now for hospital staffs and other key workers putting their safety on the line to fight the pandemic.
So the political dynamics seem to have changed, at least for now. But the challenge ahead for the government has only increased in scale.
Aides have gone from talking down the severity of the prime ministers illness to worrying out loud over what it means for the days, weeks and months ahead. Even if Mr. Johnson makes a fast recovery, he will need time out to convalesce. At a time of national crisis, the figure supposed to lead the country is out of action.
Mr. Johnsons temporary replacement is his de facto deputy, First Secretary of State Dominic Raab. Mr. Raab was given the title when Mr. Johnson became prime minister and believed the biggest challenge of the day was Brexit. The idea was that the appointment of Mr. Raab, a committed Brexiteer, would send a clear message that even if something happened to the prime minister, his Brexit plan could not be watered down.
Mr. Raabs suitability for leading the country through a time of national crisis is another matter. While the prime minister and his team trust him more than Mr. Johnson does most senior cabinet ministers, Mr. Raab is a relative unknown to the public and is seen to lack warmth as a speaker.
But even if Mr. Raab defies his critics, there are limits to how much a high-performing de facto deputy can achieve. The British system is not built for a situation in which its leader is absent for a prolonged period of time let alone during a national crisis. There are not clear guidelines for who takes power if the prime minister is incapacitated. And Mr. Raab is not carrying out all of Mr. Johnsons duties: He is not working from 10 Downing Street, he will not meet with the queen, and he does not have the power to fire or hire members of the cabinet.
Since Mr. Johnson became prime minister, power has been broadly balanced among the four ministers tasked with heading the coronavirus subcommittees: Mr. Raab, Chancellor Rishi Sunak, Health Secretary Matt Hancock and the chancellor of the Duchy of Lancaster, Michael Gove. There have been repeated reports of egos clashing behind the scenes over who leads the public response, competing briefs and turf wars. Now they must put their differences aside and find a way to work their competing interests into a joint plan.
The government has been reluctant to even discuss what an exit strategy from the lockdown might look like, on the grounds that it could lead people to relax social distancing. In truth, its also because there are rival views in government on what should happen: Some ministers think the lockdown must be eased in the coming weeks to salvage the economy, while others see that as a damaging gamble on peoples lives.
But this is the kind of decision that should rest only with an elected prime minister. Those sending Mr. Johnson well wishes are doing so not only for his own well-being but also for the sake of the country. The best hope is that he makes as speedy a recovery as possible.
Mr. Raab used Tuesdays government news conference to tell the public that he believes Mr. Johnson will be back at the helm leading us through the crisis in short order. But if that is not possible, serious thinking needs to be done on how major policy decisions should be made and by whom. The current arrangement is not suited to a prolonged absence of the prime minister.
Katy Balls (@katyballs) is the deputy political editor of The Spectator.
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Based in Las Vegas, Three Square Food Bank previously distributed food through 180 pantries across Clark County. Since the outbreak and the sudden closing of nearly all of the citys gambling and tourism attractions the organization has restructured, with 10 pantries and 21 new drive-through distribution sites.
Larry Scott, Three Squares chief operating officer, said that the group had expected 200 to 250 cars a day at each drive-through. Theyre getting up to 500 to 600 cars instead, with lines up to four miles long. Every day, we distribute everything that we bring to a site, Mr. Scott said.
An initial glut of high-quality food from shuttered casinos is basically gone, Mr. Scott said. Now his food bank is burning through an extra $300,000 to $400,000 a week in cash to buy food.
He said that he saw no relief in sight. What we do today has to be repeated again tomorrow, and the next day, and the next day, Mr. Scott said. Hungry people are hungry each and every day.
Ericka Smrcka, an official at Food Bank for the Heartland in Nebraska, went to a recent mobile food distribution at a middle school in neighboring Council Bluffs, Iowa. She and a colleague arrived nearly an hour before it was scheduled to start to find the streets jammed in every direction and the police directing traffic.
We were overwhelmed with tears, Ms. Smrcka said. Oh, my gosh. Everywhere we looked, there were just cars.
The delivery truck had enough boxes of food produce, bread and milk for 200 vehicles. Some 400 showed up. Ms. Smrcka recalled feeling apprehensive at the prospect of walking car to car with nothing more than a flier describing alternative resources, thinking she might get yelled at.
But thats not what happened. After sitting in their car for an hour and not receiving any food, they still said thank you, she said, recalling in particular a father who had left work early and picked up his three daughters, and who departed empty-handed.
LONDON Prime Minister Boris Johnson was moved into intensive care on Monday, a worrisome turn in his 10-day battle with the coronavirus and the starkest evidence yet of how the virus has threatened the British political establishment and thrown its new government into upheaval.
The government said the decision was a precaution and that he had been in good spirits earlier in the day. But with Mr. Johnsons aides releasing few details about his condition, the nation kept a tense vigil on Monday night, hoping for the best and experiencing, together, the frightening mysteries of this disease.
In a sign of how grave the situation had become, Downing Street said in a statement on Monday that Mr. Johnson had asked the foreign secretary, Dominic Raab, to deputize for him where necessary. The pound fell against the dollar after investors reacted to the news.
After noting earlier in the day that the prime minister was still getting official papers, Mr. Johnsons aides said he had been moved to the intensive care unit in case he needed a ventilator to help his recovery. Not every patient in critical care is ventilated, medical experts said, but many are or are at least given oxygen. The prime minister remains conscious, officials said.
For Mr. Johnson, 55, it was an especially cruel reversal. Just four months ago, he engineered the greatest Conservative Party victory since Margaret Thatcher in 1987, delivered his promise to take Britain out of the European Union, and set in motion an ambitious economic program to transform his divided country.
Now, Mr. Johnson, a political phenomenon whose career has always had a quicksilver quality, finds himself in a debilitating battle after contracting a virus he initially viewed with characteristic nonchalance.
For Britain, which had so recently emerged from three and a half years of paralysis and polarization over Brexit, Mr. Johnsons illness plunges the country back into the uncertainty Britons thought they had left behind.
When the prime minister announced on March 27 that he had tested positive for the virus, he insisted he would remain firmly in charge of the governments response to the virus, chairing the daily crisis meetings by video while self-isolating.
It had been an occasionally shaky performance until then: The government initially debated how aggressively it would try to curb the spread of the pathogen. That contributed to an inadequate, poorly organized testing program, and reinforced Mr. Johnsons reluctance to impose a strict lockdown on his country.
In recent weeks, Mr. Johnson had seemed more in command. Britain has pledged to test 100,000 people a day by the end of this month. And the prime minister has become an ardent, if relentlessly cheerful, advocate of social distancing.
Even after Mr. Johnson had isolated himself in his apartment next door to 10 Downing Street he released a shaky, handheld video on Friday, in which he warned people not to crowd parks during a sunny spring weekend.
Mr. Johnsons aides predicted he would emerge from isolation that day. But he said he was running a temperature and suffering a cough. Two days later, he was admitted to St Thomas Hospital in central London, still suffering from those symptoms.
On Monday, Downing Street said in a statement, Over the course of this afternoon, the condition of the Prime Minister has worsened and, on the advice of his medical team, he has been moved to the Intensive Care Unit at the hospital.
Mr. Johnsons hospitalization coincided with a call by Queen Elizabeth II for Britons to face the pandemic with the stoicism and self-discipline they showed during World War II. Her rare televised address reassured many, but barely an hour later, they were jolted by news of Mr. Johnsons deteriorating condition.
On Monday, the government tried to put a good face on the situation. Mr. Raab told a news conference that Mr. Johnson was in good spirits after a comfortable night in the hospital, a short distance from Downing Street. He said Mr. Johnson remained in charge of the government and was working from his hospital bed.
But Mr. Raab, who chaired the daily coronavirus meeting on Monday morning, admitted he had not spoken to the prime minister since Saturday. The paucity of details on the prime ministers condition or any sign of ongoing communication between him and Mr. Raab deepened the unease.
Mr. Johnson wrote from the hospital on Twitter that he had undergone some routine tests because he was still experiencing symptoms. He also thanked health workers for taking care of him.
In a Twitter post, Andrew Neil, one of the countrys most prominent interviewers, asked why Mr. Johnson had not spoken to his stand-in, Mr. Raab, since Saturday. Something not right here, Mr. Neil added.
In Britain, patients who experience symptoms of the virus are being encouraged to stay at home if possible, a policy that suggested Mr. Johnsons condition at least crossed some threshold of seriousness to warrant hospital admission at a time when the health service is stretched.
British politicians from across the political spectrum offered their best wishes, as did the French president, Emmanuel Macron, who said he hoped Mr. Johnson would make a swift recovery. Buckingham Palace said Downing Street had informed the queen of Mr. Johnsons condition.
Lindsay Hoyle, the Speaker of the House of Commons, said in a statement, This is terrible news. I know the thoughts and prayers of everyone across the House are with the Prime Minister and his family right now.
On Monday, at his daily briefing, President Trump wished Mr. Johnson well. Americans are all praying for him, he said. Hes been a really good friend. The president suggested that American pharmaceutical companies could aid the prime minister by supplying therapeutic drugs, although there are not yet any proven treatments. He also said he and other senior officials would take more tests for the virus in light of Mr. Johnsons ordeal.
Mr. Trump has had an affinity for Mr. Johnson, whom he views as a like-minded populist. While the two leaders have similarities including their initially skeptical view of the threat posed by the virus they are quite different. Mr. Johnson, for example, has described his approach to the virus as guided by science. In news conferences, he has typically deferred to his scientific and medical advisers unlike Mr. Trump, who has constantly promoted an unproven anti-malaria drug as a potential treatment, going well beyond the advice of doctors and public health experts.
The prime minister first experienced the symptoms of the virus on March 26, was tested that day and received a positive result around midnight, going into self-isolation in Downing Street, but chairing meetings by videolink.
Even people with mild infections can have pneumonia, which is detected with CT scans. Sometimes the illness turns more severe in the second week the stage where Mr. Johnson is now with increased breathing difficulty and worsening pneumonia. Blood tests may detect greatly elevated levels of inflammation, a sign that the immune system may be overreacting to the infection. Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, has warned about some patients taking such a sudden turn for the worse after a week.
Until just weeks ago, Mr. Johnson had taken a more lax approach to the virus than had other many European leaders. At a news conference in early March, he described visiting a hospital where he said there were coronavirus patients.
I shook hands with everybody, youll be pleased to know, he said, and I continue to shake hands.
Later, the prime minister hesitated to force pubs and restaurants to close, even as he asked people to stop packing them, and he left schools open after France and Germany closed theirs.
The prime minister is not thought to have any pre-existing medical conditions though he has admitted to struggling with his weight, particularly during a period when he served as foreign secretary and traveled extensively.
In 2018, he wrote in an article that he had cut out some high-calorie foods because he had reached about 230 pounds. For Mr. Johnsons height 5 feet 9 inches that weight would medically be defined as obese, and obesity increases the risk of a more severe illness in patients with the coronavirus.
Several other key figures in the government have self-isolated after suffering symptoms of the coronavirus, including the health secretary, Matthew Hancock, and the chief medical officer, Chris Whitty, both of whom have now returned to work.
Prince Charles, the queens eldest son and heir, suffered mild symptoms and quarantined himself at his residence in Scotland. He emerged from isolation last week to dedicate, via video, a field hospital in London.
Mr. Johnsons 32-year-old partner, Carrie Symonds, who is pregnant, disclosed on Saturday that she, too, had experienced symptoms.
On Monday, Mr. Raab said that it was too early to discuss an exit strategy from Britains lockdown, arguing that the focus should remain on social distancing measures designed to curb the spread of the virus.
According to statistics released on Monday, more than 51,000 people had tested positive for the virus in Britain and 5,373 people had died, though there was some cause for optimism from figures that showed the rate of hospital admissions slowing.
Denise Grady and Pam Belluck contributed reporting.
Celebrities and politicians with large social media followings are proving to be key distributors of disinformation relating to coronavirus, according to a study that suggests the factcheckers and mainstream news outlets are struggling to compete with the reach of influencers.
The actor Woody Harrelson and the singer MIA have faced criticism after sharing baseless claims about the supposed connection of 5G to the pandemic, while comments by the likes of the Brazilian president, Jair Bolsonaro, playing down the scale of the crisis in the face of scientific evidence have attracted criticism in recent days.
What is Covid-19?
It is caused by a member of the coronavirus family that has never been encountered before. Like other coronaviruses, it has come from animals. The World Health Organization (WHO) has declared it a pandemic.
What are the symptoms this coronavirus causes?
According to the WHO, the most common symptoms of Covid-19 are fever, tiredness and a dry cough. Some patients may also have a runny nose, sore throat, nasal congestion and aches and pains or diarrhoea. Some people report losing their sense of taste and/or smell. About 80% of people who get Covid-19 experience a mild case about as serious as a regular cold and recover without needing any special treatment.
About one in six people, the WHO says, become seriously ill. The elderly and people with underlying medical problems like high blood pressure, heart problems or diabetes, or chronic respiratory conditions, are at a greater risk of serious illness from Covid-19.
In the UK, the National health Service (NHS) has identified the specific symptoms to look for as experiencing either:
As this is viral pneumonia, antibiotics are of no use. The antiviral drugs we have against flu will not work, and there is currently no vaccine. Recovery depends on the strength of the immune system.
Should I go to the doctor if I have a cough?
Medical advice varies around the world - with many countries imposing travel bans and lockdowns to try and prevent the spread of the virus. In many place people are being told to stay at home rather than visit a doctor of hospital in person. Check with your local authorities.
In the UK, NHS advice is that anyone with symptoms should stay at home for at least 7 days. If you live with other people, they should stay at home for at least 14 days, to avoid spreading the infection outside the home.
How many people have been affected?
Chinas national health commission confirmed human-to-human transmission in January. As of 6 April, more than 1.25m people have been infected in more than 180 countries, according to the Johns Hopkins University Center for Systems Science and Engineering.
There have been over 69,500 deaths globally. Just over 3,200 of those deaths have occurred in mainland China. Italy has been worst affected, with over 15,800 fatalities, and there have been over 12,600 deaths in Spain. The US now has more confirmed cases than any other country - more than 335,000. Many of those who have died had underlying health conditions, which the coronavirus complicated.
More than 264,000 people are recorded as having recovered from the coronavirus.
Research by Oxfords Reuters Institute for the study of journalism found that while politicians, celebrities and other prominent public figures were responsible for producing or spreading 20% of false claims about coronavirus, their posts accounted for 69% of total social media engagement.
The issue has gained extra prominence as Britons began vandalising mobile phone masts in recent days amid wildly sharing baseless claims linking the virus to 5G.
Social media companies were summoned to a meeting with the culture secretary, Oliver Dowden, on Wednesday afternoon to explain what they are doing to reduce the harm caused by false health claims about coronavirus on their platforms, with WhatsApp and YouTube having made tentative steps in recent days to reduce the impact.
There is growing concern that online disinformation could be having real world health impacts. Research by Dr Daniel Allington, senior lecturer in social and cultural artificial intelligence at Kings College London, suggested there was a statistically notable link between people who believed false claims about the coronavirus and people who were willing to flout the governments social distancing guidelines.
His findings, based on a experimental study conducted in coordination with the Centre for Countering Digital Hate, found that people who said they believed coronavirus was connected to 5G mobile phone masts are less likely to be staying indoors, washing their hands regularly or respecting physical distancing.
While social media platforms have moved faster than in the past to flag disinformation about coronavirus on public groups, prominent actors and entertainers with millions of followers on Twitter and Instagram have helped fan the flames of misinformation, often reaching vastly more people than mainstream news outlets.
This small amount of people have a wide reach for the content that they are spreading, said Scott Brennen, a research fellow at the Reuters Institute. The most common claims had to do with the policies and actions of public authorities, although we saw plenty of misinformation about the medical side.
He said research into coronavirus disinformation almost certainly underestimated the enormous role played by WhatsApp because there are few ways for researchers to build an accurate picture of how material is spreading on the Facebook-owned service.
In one example on Wednesday the South East Coast Ambulance Service was forced to issue a statement about a fake voicemail message going viral on the service. It purported to be from someone who works at the service claiming falsely that ambulances would not make callouts to people at home suffering from Covid-19, that ice rinks were being used as makeshift morgues, and that a third of the deaths in coming weeks would be babies, children and teenagers with no underlying health issues.
The service said: The alarmist information being shared in the message is not correct. We would urge people to disregard the message and not share it further.
Additional reporting by Martin Belam
Celebrities who have drawn criticism for spreading coronavirus disinformation
The British singer, who is also an opponent of vaccination programmes, has posted a series of tweets criticising engineers installing fibre broadband outside her London home while suggesting the supposed symptoms of being near 5G base stations were similar to those of coronavirus.
The lauded actor, who starred in Cheers and True Detective, has shared a series of posts to his Instagram page making baseless claims linking the coronavirus outbreak to the installation of 5G equipment in Chinese cities.
In a post on Instagram that combined many of the most popular coronavirus conspiracies in a single medley, the British boxer claimed that coronavirus was man-made designed to cull the worlds population and said the lockdown was used to provide cover for the rollout of 5G.
Just seven weeks after Africa recorded its first case of Covid-19 an Italian national in Algeria the virus is creeping across the continent, infecting more than 10,000 people and causing 487 deaths. Three of the regions 54 countries So Tome and Principe, Comoros, and Lesotho remain apparently virus-free.
Case numbers are increasing exponentially in the African region, said Dr Matshidiso Moeti, the World Health Organization (WHO) regional director for Africa. It took 16 days from the first confirmed case in the region to reach 100 cases. It took a further 10 days to reach the first thousand. Three days after this, there were 2,000 cases, and two days later we were at 3,000.
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In the Democratic Republic of the Congo, coronavirus has spread beyond the capital, Kinshasa, to the easternmost regions of the country, which until recently were still in the grip of an Ebola outbreak, according to the WHO.
In South Africa, which has the highest viral incidence on the continent, all provinces are now fighting the outbreak of Covid-19. Confirmed cases in Cameroon, Senegal and Burkina Faso are also widespread.
While transmission rates are still low, the key fear is over what happens next.
The issues with Africa like many places but even more so are that the lack of testing means we dont have any secure understanding of the true amounts of infection, said Dr William Hanage, professor of epidemiology at Harvard. We would expect it to be in the early stages now, given that in general the major metropolitan centres are less connected than, say, New York.
Without better understanding of the way the virus operates such as the immunological or genetic factors that may protect some people it is impossible to say how severe the impact of Covid-19 will be on the continent, said Prof Thumbi Ndungu of the African Institute for Health Research.
We dont yet have a good answer as to why rates are lower in Africa than in Europe or China. One possibility is that that coronavirus hit during the European winter and the virus doesnt spread perhaps as efficiently in warmer and more humid climates, which one study has shown. Another possibility is that Africa, in general, has a much younger population [than Europe or China].
The last possibility is that it may just be a matter of time before it hits Africa as much as its hit other places. If thats the case, and we get community transmission in sub-Saharan Africa at the rates that weve witnessed in Italy, we could be staring at a catastrophe, Ndungu said.
He added: We dont have the hospitals, the ICUs or the ventilators to deal with massive amounts of [infected] people, so if the spread is comparable to that seen in Europe or China, the outcome could be devastating.
If the spread is comparable to that seen in Europe or China, the outcome could be devastating
In South Africa, which has the highest prevalence of HIV in the world and among the highest for tuberculosis, people have already been hit by lockdowns and reduced access to health clinics, according to Dr Michelle Moorhouse, of Ezintsha, Wits Institute in Johannesburg.
We are telling people to stay home and avoid the clinics so this will impact testing, starting treatment, and potentially could see people interrupting treatment, if they are afraid to venture out and collect their medication, she said. We have been urging, where possible, that clinics dispense more antiretrovirals (ARVs) at each visit to try to keep people living with HIV out of clinics and so reduce their exposure.
We do not really have any clear idea what Covid-19 will do in a population where overcrowding, TB and HIV are highly prevalent.
In Uganda, at least 1.4 million people are living with HIV. Milly Katana, a public health specialist, told the Guardian that the coronavirus lockdown is unfortunately not locking up HIV.
I have information from Ankole districts [in western Uganda] where patients are in a desperate situation, walking for seven hours, sleeping at health facilities and going back the following day, said Katana, warning that the situation could lead to drug resistance.
Many of our friends are running out of ARVs. This is more worrying given that dolutegravir (DTG), the first-line drug of choice, has a very short temper. Miss a few doses and one gets a resistant strain of HIV. The next HIV epidemic will be resistant to not only DTG, but the drugs in the same class.
For Helen Jenkins, epidemiologist at Boston University School of Public Health, the suspension of research into and vaccination of infectious diseases is likely to have a profound impact. I am very concerned for when the pandemic truly hits a high-TB-burden country, of which there are many in Africa, she said.
HIV patients are in a desperate situation, walking for seven hours, sleeping at health facilities and going back the following day
There is likely to be greater severity of Covid-19 infection in people with TB, or damaged lungs from previous TB. In addition, research into all infectious diseases is stopping in many places, vaccination campaigns are stopping, so we are likely to see increases in vaccine-preventable diseases such as measles or polio.
Malaria symptoms can also present similarly to coronavirus, leading to confusion.
Anyone whose body temperature is higher than normal is suspected to be infected with coronavirus and put in isolation wards and in quarantine locations where people who have arrived from abroad are being observed, said Chris Macoloo, director for the US development charity World Neighbors in east and west Africa.
The possibility is that a person who has merely a raised temperature (maybe unrelated to the virus) is likely to be infected when brought closer to people under isolation. There is a likelihood that lower-order health facilities such as dispensaries are referring malaria patients to the Covid-19 health teams. So in the incubation stage, a lot of confusion is occurring.
Dr Joyce Samoutou-Wong of the Congo-based charity New Sight Eye Care says her charity has distributed more than 12,000 leaflets and posters and recorded several broadcasts in Congo and abroad regarding the virus.
We had to close our clinic on 31 March and we normally serve 200 patients per month. Cargo supplies are still running, for now, but we depend on visits from abroad to bring a lot of our supplies, which have obviously been suspended, plus weve had to postpone the construction of an eye hospital.
Samoutou-Wong said a European-style lockdown would be totally impossible in Africa. A lot of myths are out there. People think Congo bololo (a plant) or lemon and garlic can protect them from the virus.
We are on the edge of the rainforest, so there is no panic buying because people dont have the resources to stock up on supplies, and quarantine is impossible because people share clothes, beds, floor space, utensils. Water pumps are a hotspot for the virus, so the hardest measure to implement is simply hand washing.
Lauren Gardner of Johns Hopkins University, Baltimore, with her groups COVID-19 global dashboard
By Jocelyn KaiserApr. 6, 2020 , 6:25 PM
Sciences COVID-19 reporting is supported by the Pulitzer Center.
Many websites track the devastating spread of disease and death caused by the now-pandemic coronavirus, from the World Health Organizations (WHOs)global maptoThe New York Timess tally of U.S. cases at thecounty level. But one of the earliest, anonline dashboardrun by Johns Hopkins University, has become the go-to place for the latest data on coronavirus disease 2019 (COVID-19).
With its black world map strewn with red circles and global, country, and state counts of cases, deaths, and recoveries, the Coronavirus COVID-19 Global Cases tracker sticks to the basicsno fancy graphs. Yet the site, which gets more than 1 billion hits a day, has become the most authoritative source for COVID-19 case data. It is used by news organizations and government agencies around the world. Its dashboard has been copied by states and countries. It has been spotted on a wall in a photo of the U.S. Department of Health and Human Servicess coronavirus war room.
Behind the site is Lauren Gardner, co-director of Hopkinss Center for Systems Science and Engineering, whose previous work involved spatial modeling of epidemics of measles and the Zika virus. Gardner spoke with ScienceInsider on Friday, 3 April, the day COVID-19 cases surpassed 1 million worldwide, with more than 50,000 deaths. This interview has been edited for clarity and brevity.
Q: There are a lot of sites tracking COVID-19 cases. How did yours come out on top?
A: Probably because its been around the longest. We started this in January when the outbreak was pretty much just in China. My grad student Ensheng Dong, who is Chinese, was personally interested. In a few hours, we built the original dashboard. And the next day [22 January] I shared it on Twitter, and it immediately became popular.
Q: The dashboard draws on hundreds of sources, from WHO data to sites that aggregate news stories and social media reports on COVID-19. How do you make sure its accurate and not double counting?
A: There are millions of eyeballs on it all the time. So, if were off, people reach out and contact us very quickly. We get thousands of emails. Well get told, Hey, theres two new cases here that you dont know about.We also now have an anomaly detection system in place that alerts us to discrepancies in the case reports that we automatically collect.
We do have to worry about loops [where our own data are fed back to us as original cases]. There is a media aggregation site for the United States called 1point3Acresthat we follow really closely. We take U.S. data from them, and they pull global data from us. We have to be really careful to only reference their national data. But the thing is, if there is a loop no ones reports [of COVID-19 cases and deaths] would ever increase. So, we know thats not happening.
What I would like is for all the different local health authorities to keep improving their own reporting in a way that we can draw the data directly from them rather than from local media reports.
Q: Couldnt you get the U.S. data from the Centers for Disease Control and Prevention?
A: You would think so. But they only provide state-level data, and its sometimes a 24- to 48-hour delay. Theres nothing at a county level.
Q: How big is your team?
A: At first, it was my group, which is about six people. But early on, Hopkins reached out and offered support internally. Because we were blowing up Amazon [cloud computing] servers with all the demand. Now, the Applied Physics Lab [at Hopkins] helps with the back-end data curation and tech. Esri, the company that has the mapping software, helps manage the platform. People at Hopkins manage the media and communications. But the group is still way smaller than it should be for what were doing.
Q: What is the workload like? Do you work in shifts?
A: For over 2 months, we were trying to make decisions on where to collect data from, what data was trusted, how to aggregate it, validate it. We initially did everything manually. Now, almost everythings automated with various cross checks in place. The dashboard is automatically updated hourly. Were also on a 24-hour rotating shift for things like server issues and data curation. For instance, we have a Ph.D. student based in England who gets our early morning shift.
Its a big volunteer-based public service effort. We just are trying our best to make it be as good as possible, but we know its not perfect.
Q:Youve gotten flak for calling Taiwan Taiwan, and for initially placing the Diamond Princess cruise ship cases in the middle of the United States, which happens to be in Kansas.
A: Yeah, every day is a new surprise. The geopolitical implications have been stressful and distracting. I just want to report the data that will be the most useful and appropriate for the people that are trying to get access to it. The virus doesnt care about the borders.
Up until yesterday, we had a lot of cases without an assigned location on Null Island, right off the coast of Africa, which is [a location in the ocean that has] zero coordinates [latitude and longitude]. Its famous. I thought it was a great place to put everything that doesnt have a specific location yet. But that upset a lot of people, so thats gone.
Q: As the number of COVID-19 cases grows, is it more work?
A: Its actually less manual work now because its automated. Were spending more time doing other types of research now. Almost 90% of my interests and efforts are back to mathematical modeling around this disease. Were doing real-time risk assessment of whats going on in the United States, aiming to feed these results back to policymakers to say, Heres the counties that we should be worried about tomorrow.We can do it, so we should be helping with that.
Q: Are you getting much sleep?
A: Its exhausting. Weve been doing this full on since January. We dropped everything else in the lab. And its probably going to be this way for at least another couple of months. And I think well be tracking the outbreak for a year. Itll keep going and bouncing around all over the world. So, its a 110% effort for sure. I think all public health people working in this space feel the same.
On March 19, citing the virus, coalition and NATO training missions both suspended operations for two months. By March 29, Australia, Spain, France, the United Kingdom, New Zealand, Portugal and the Netherlands had withdrawn almost all of their trainers.
In parallel, the U.S. withdrew from its frontline operating bases at Mosul, Al-Qaim, Qayyarah, Kirkuk and Taqaddum in the last week of March. Most U.S. forces were redistributed inside fewer, better-protected Iraqi bases such as Al-Asad and Erbil airport, both of which are now protected by newly installed U.S. missile defenses, to prevent a recurrence of the Jan. 8 Iranian missile attacks that left more than 100 U.S. troops with mild traumatic brain injuries.
The Iraqi military are meanwhile distracted by disaster relief, enforcing a nationwide curfew, and looking after their own health and that of their families. (Officially, the virus had sickened over 1,100 and killed 65 Iraqis as of Tuesday, but lack of testing means the real number is likely significantly higher.) Rural clearance operations have almost ceased and the pace of special forces raids has slackened, in part because of the severe disruption to intelligence, planning and air support provided by the U.S.-led coalition.
For the Islamic State, this is all a godsend. In its view, the pandemic is a literal act of divine intervention as it reached its lowest ebb. Terrorism expert Aymenn Jawad al-Tamimi noted that IS newsletter, Al-Naba, called coronavirus Gods torment upon the Crusader nations, and urged fighters to take advantage of the distraction and disruption caused by the virus.
In many ways the Islamic State is quite well adapted for operations during a pandemic. Its cells are isolated, avoiding the risk of contamination by performing extreme social distancing long before the rest of us. Its leadership issued early instructions to its cadres to limit their exposure to the virusfrom the CDC-approved recommendations (washing hands and covering up coughs and sneezes) to Koranic verses involving lions and leprosy.
IS are somewhat self-contained, living in remote hideouts and underground shelters, drawing on independent food and water caches, and powering electronic devices with solar battery chargers. In every sense of the phrase, the thousands of members of this millenarian terrorist cult are the ultimate doomsday preppers.
On the ground, there have been small signs of Islamic State recovery at the tactical level, probably due to the cessation of counterinsurgency operations targeting them.
The four Iraqi military clearance operations undertaken in March were half as many as in April, and they lacked the coalition intelligence and air support that can focus such operations more effectively, instead falling into the less efficient category of unearthing arms caches but not catching enemy fighters.
Whereas U.S. and Iraqi special operations forces did a minisurge of joint raids in Februarydropping in by U.S. helicopters or tilt-rotor Osprey aircraft to raid caves and stop vehicles driven by IS membersthere were no such raids in March.
Left to operate without being pressured and chased from hideout to hideout, Islamic State has been getting more ambitious at local level. In Khanaqin District, close to the Iran-Iraq border, IS quadrupled its average number of mortar and rocket attacks in March and combined the bombardments with sustained machine-gun fire and ground assaults on security force outposts.
Over a five-day period beginning March 17, insurgents fired 15 mortar rounds into heavily populated neighborhoods of cities such as Tuz Khurmatu and Amerli, a type of attack that has not been seen for more than two years.
Islamic States next steps are easy to guess. It will increase rural assassination raids on local village leadersso-called mukhtarsand use intimidation to increase its ability to raise funds. Disruption to security force clearance operations will increase IS ability to make advanced roadside bombs in its hideouts and use these weapons, and other harassment tactics, to keep the security forces buttoned down in their bases.
If left unchecked, this kind of aggressive patrolling allows insurgents to gain psychological dominance over the local military garrisons and civilian populations. Before long, the insurgents will become the local power brokers, and it will no longer be possible to claim that IS days of territorial control are over. This is how the caliphate knits itself back together, one village at a time. This is exactly how it happened in 2012-14, after the previous U.S. withdrawal.
The only way to stop an IS resurgence, still in its infancy but now facing an improved outlook, is to reinvigorate an effective counterterrorism raiding campaign. This requires ongoing partnership between U.S. and Iraqi special forces, and between Iraqs commandos and the local Sunni populations in IS strongholds. Unlike 2011, the U.S. should not leave Iraq entirely, but should rather lower its visibility.
In all likelihood, non-U.S. military forces will never return to Iraq in the numbers that were recently withdrawn, with the virus providing a way to justify withdrawal even though Iraqi security forces are arguably not prepared to restrain an Islamic State resurgence. U.S. forces may also dwindle in terms of raw numbers in Iraq, where Iran-backed factions are promising long-term armed resistance to the open presence of U.S. advisers.
This does not have to be the end of an effective counterterrorism fight, however.
In places as diverse as Yemen, Somalia, Mali and Syria, the U.S. Special Operations Command has employed quiet partnerships with local special forces and paramilitary proxies to take on terrorist cells in a more targeted and effective manner than the large-scale train-and-equip program that appears to be eroding in Iraq. The coalition mission in Iraqdue to turn 6 years old in Septembermight expire, but the effort to prevent another IS comeback cannot afford to take a break, whether as a result of coronavirus, Iran-backed militias or a devilish combination of the two. The answer may be to take the war underground and back into the shadows.
Yet psychologists now know that only a small percentage of people develop the full-blown disorder while, on average, anywhere from one half to two-thirds of trauma survivors exhibit whats known as post-traumatic growth. After a crisis, most people acquire a newfound sense of purpose, develop deeper relationships, have a greater appreciation of life and report other benefits.
Its not the adversity itself that leads to growth. Its how people respond to it. According to the psychologists Richard Tedeschi and Lawrence Calhoun of the University of North Carolina at Charlotte, who coined the term post-traumatic growth in the 1990s, the people who grow after a crisis spend a lot of time trying to make sense of what happened and understanding how it changed them. In other words, they search for and find positive meaning.
In modern psychology research, this is known, a bit unfortunately, as benefit finding. Mr. Frankl called it the human capacity to creatively turn lifes negative aspects into something positive or constructive. Of course, some people are naturally more hopeful than others. But the success of psychological interventions like meaning-centered psychotherapy developed by Dr. William Breitbart at Memorial Sloan Kettering Cancer Center and his colleagues to help terminal patients cope with death reveals that even the most despairing individuals have the capacity to find meaning in a crisis.
It may seem inappropriate to call on people to seek the good in a crisis of this magnitude, but in study after study of tragedy and disaster, thats what resilient people do. In a study of over a 1,000 people, 58 percent of respondents reported finding positive meaning in the wake of the Sept. 11 attacks, such as a greater appreciation of life and a deeper sense of spirituality. Other research shows that benefit finders grow not only psychologically but also physically. Heart attack survivors, for example, who found meaning in the weeks after their crisis were, eight years later, more likely to be alive and in better health than those who didnt.
This doesnt mean that people should endure adversities with a smiling face. In fact, Mr. Frankl specifically said that tragic optimism is not the same thing as happiness. To the European, he wrote, it is a characteristic of the American culture that, again and again, one is commanded and ordered to be happy. But happiness cannot be pursued; it must ensue. One must have a reason to be happy.
He was right: In American culture, when people are feeling depressed or anxious, they are often advised to do what makes them happy. Much of the pandemic-related mental-health advice channels that message, encouraging people to distract themselves from bad news and difficult feelings, to limit their time on social media and to exercise.
Im not suggesting those arent worthy activities. But if the goal is coping, they do not penetrate into the psyche as deeply as meaning does. When people do things that make them happy, like playing games or sleeping in, they feel better but those feelings fade fast, according to research by Veronika Huta of the University of Ottawa and Richard Ryan of the University of Rochester.
If the current trend continues, the outlook is bleak, said Kentaro Iwata, an infection control specialist from Kobe University, who has repeatedly warned that Japan isn't doing enough to halt the spread of the virus.
"Japan needs to have the courage to change, when we are aware we are on the wrong path," Iwata said. "We might see the next New York City in Tokyo."
As of Friday, Japan had 3,329 confirmed cases and 74 deaths.
"The beginning of the burst of the infections in Spain, France, Italy, New York City -- was really like Tokyo right now," said Iwata.
He says there needs to be more testing.
As of Friday, Tokyo had tested fewer than 4,000 people in a city of 13.5 million. And just 39,466 people had been tested in this nation of 125 million, according to the Ministry of Health, Labour, and Welfare.
The Japanese government says its testing regime is adequate and suitably targeted to high risk cases.
"Testing people with a low probability of novel coronavirus would be a waste of resources," Japan's Health Ministry told CNN in a statement. "We ask people with some symptoms to stay home for a period of time."
Turned down for a test
Coronavirus patient Issei Watanabe spoke to CNN from his Tokyo hospital room. He struggled to breathe in between coughing fits. Doctors consider his a "mild case" and expect he'll be discharged on Tuesday.
Watanabe is 40, a non-smoker, in good health. His symptoms came on quickly. Body aches, chills, no sense of taste or smell.
When he asked for a coronavirus test, he says he was turned down -- and had to endure five days with a fever above 40 degrees Celsius -- 104 degrees Fahrenheit -- before he was finally allowed to take a test, which came back positive.
Watanabe says he infected at least two people during that time.
"People don't know what to do. There's a real lack of good information," Watanabe said. "Your life is in your hands. Stay home. Please stay home. Don't go out."
Watanabe worries about the tens of millions of Japanese who are older than 65. He knows he'll recover, but many in Japan's aging society won't.
Infectious disease experts warn of a steep price in human life -- if coronavirus spreads rapidly, in this rapidly aging society.
"Coronavirus is very dangerous to old people," said Masahiro Kami, executive director of Japan's nonprofit Medical Governance Research Institute. He said most coronavirus patients in Japan are likely showing few, if any, symptoms.
"When they are asymptomatic, they can transmit the coronavirus to others," Kami warned.
No lockdown
Japanese Prime Minister Shinzo Abe has repeatedly stated the situation inside Japan does not warrant declaring a state of emergency or imposing a lockdown in Tokyo.
He said such drastic measures would further damage an economy already grappling with the severe economic fallout of the coronavirus and the postponement of the Tokyo 2020 summer Olympics.
Japanese lawmakers are mulling a massive economic stimulus package that could include cash handouts to Japanese households. The government has been widely mocked for a plan to distribute two cloth face masks per household.
Japan has imposed tough new travel restrictions -- banning foreigners from more than 70 countries, including the US, the UK, and most of Europe. Japan has also beefed up health screenings at airports and is requesting all incoming travelers quarantine for 14 days, although compliance is not actively monitored.
Yet there is growing concern -- inside and outside of the country -- that the government's increasingly dire warnings about the danger of spreading the virus may have reached many people too late.
"The Japanese government's decision to not test broadly makes it difficult to accurately assess the Covid-19 prevalence rate," the alert said.
"While we have confidence in Japan's health care system today, we believe a significant increase in Covid-19 cases makes it difficult to predict how the system will be functioning in the coming weeks. In the event of a spike in cases, US citizens with pre-existing medical conditions may not be able to receive the medical care they have grown accustomed to in Japan prior to the Covid-19 pandemic."
Last week, huge crowds gathered for hanami, the viewing of the cherry blossoms. Some people were seen wearing masks, but many did not.
Tokyo Governor Yuriko Koike and Abe are pleading with the public to stay home, avoid travel, and practice social distancing. Some are listening, but many are not.
The government's policy so far has been to try to contain clusters by contract tracing positive cases and instructing suspected cases to quarantine.
Proponents of the Japanese coronavirus approach have argued the society's cultural practices -- such as bowing instead of shaking hands, widespread use of surgical face masks, and more frequent washing of the hands and mouth -- could spare Japan from the kind of rapid spread of coronavirus seen in other nations.
When asked if Japan is protected because it is not a "hug and handshake" culture, Iwata said "it is possibly one of the reasons for having less infections when compared to Europe and America."
He calls the theory "valid," but "unproven." He does not believe Japan should base its strategy on the hope that hygienic cultural practices will be enough to spare Tokyo the worst.
While Koike and Abe have urged the city's population of 13.5 million people to work from home -- advice heeded by major Japanese corporations like Honda, Toyota and Nissan -- telework is not possible for about 80% of Japanese companies, according to 2019 government data.
Scores of people are still commuting into the capital, as evidenced by packed subway trains during rush hour. And despite the temporary closure of some major Japanese department stores and around 500 Starbucks locations, many bars and restaurants remain open and full of customers.
Governor Koike announced Friday that 628 of the 750 beds Tokyo has secured for coronavirus patients are occupied, mostly by people with mild symptoms.
Health authorities are in negotiations to move patients who are asymptomatic or reasonably well to separate lodgings such as hotels, she said.
Once again, Koike warned of an impending crisis and urged people to stay at home.
The curve does not appear to be flattening in Tokyo. If anything, the situation seems to be getting worse.
