Category: Covid-19

Got a minute? Here's how you can help slow the spread of Coronavirus COVID-19 in under 60 seconds. USA TODAY

COVID-19 patients may be most infectious in the days before they began showing symptoms, a new study from researchers in China found.

Researchersexamined "viral shedding" in 94 patients withCOVID-19admitted to Guangzhou Eighth Peoples Hospital, according to a small studypublished Wednesday in the peer-reviewed journal "Nature."

Scientists took throat swabs from thepatientsand found that viral loads were highest when symptoms began andgradually decreased towards the detection limit at about day 21. This finding is consistent with other small studies done attwo hospitals in Hong Kong and withpatients inZhuhai in the Guangdong province ofChina.

The study also modeled COVID-19's infectiousness from a separate sample of 77 pairs of peoplein which one had infected the other with coronavirus.

Using pairs obtained from publicly available sources within and outside mainland China,researchers estimated that 44% of the transmissions occurred during the index patient's presymptomatic stage,"in settings with substantial household clustering, active case finding and quarantine outside the home."

They were then able to inferthat infectiousness started 2.3 days and peaked 0.7 daysbefore symptoms appeared. Infectiousness was estimated to decline quickly within a week.

"Our analysis suggests that viral shedding may begin 2 to 3 days before the appearance of the first symptoms," researchers wrote. "More inclusive criteria for contact tracing to capture potential transmission events 2 to 3 days before symptom onset should be urgently considered for effective control of the outbreak."

These findings align with previous guidance from the World Health Organization which found infected people can be contagious and test positive 1 to 3 days before they develop symptoms. Presymptomatic transmissionwas seen in several casesinSingapore.

Tara Smith, a professor of epidemiology at Kent State University who was not involved in the study, said the research confirms both previous findings ofpresymptomatic transmission and that infected people seem to have a high viral load right around the time they began showing symptoms.

"That seems to be when they are maximally infectious," Smith said.

Presymptomatic transmissionis also seen in viruses like influenza and measles, Smith said, but is not seen withother coronaviruses like SARS and MERS.

Smithsaid more testing needs to be done to determine the rolepresymptomatic and asymptomatic transmission is playing in the current pandemic. She said these findings emphasize how important it is to keep social distancing measures in place to prevent those kinds oftransmission.

"That's why its important to avoid people as much as possible, to wash your hands, to wear masks," she said."To prevent you from spreading the virus."

Follow N'dea Yancey-Bragg on Twitter: @NdeaYanceyBragg

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COVID-19 patients may be most contagious one to two days before symptoms appear, study finds - USA TODAY

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As a small business owner in Oakland County, we recognize that you are facing difficult times and are impacted greatly by the onset of COVID-19. Our goal is to conduct the competitive grant and loan review process as quickly as possible. We have received more than 4,000 grant and loan applications in total.

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Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, recently said that a COVID-19 could take 12 to 18 months to develop, test and approve for public use. But new vaccines typically take years to earn approval can we really expect a coronavirus vaccine to be ready by summer 2021?

Experts told Live Science that, for any other vaccine, the timeline would be unrealistic. But given the current pressure to stave off the pandemic, a COVID-19 vaccine could be ready sooner, as long as scientists and regulatory agencies prove willing to take a few shortcuts.

Here's why it probably can't be developed any sooner than 12 to 18 months.

More than 60 candidate vaccines are now in development, worldwide, and several have entered early clinical trials in human volunteers, according to the World Health Organization.

Related: Treatments for COVID-19: Drugs being tested against the coronavirus

Some groups aim to provoke an immune response in vaccinated people by introducing a weakened or dead SARS-CoV-2 virus, or pieces of the virus, into their bodies. The vaccines for measles, influenza, hepatitis B and the vaccinia virus, which causes smallpox, use these approaches, according to the U.S. Department of Health & Human Services. Although tried-and-tested, using this approach to develop these conventional vaccines was labor-intensive, requiring scientists to isolate, culture and modify live viruses in the lab.

That initial process of just creating a vaccine can take 3 to 6 months, "if you have a good animal model to test your product," Raul Andino-Pavlovsky, a professor in the Department of Microbiology and Immunology at the University of California, San Francisco, told Live Science.

Given the current time crunch, some groups have opted for faster, if less conventional, approaches.

The first COVID-19 vaccine to enter clinical trials in the United States, for example, uses a genetic molecule called mRNA as its base. Scientists generate the mRNA in the lab and, rather than directly injecting SARS-CoV-2 into patients, instead introduce this mRNA. By design, the vaccine should prompt human cells to build proteins found on the virus' surface and thus trigger a protective immune response against the coronavirus. Other groups aim to use related genetic material, including RNA and DNA, to build similar vaccines that would interfere with an earlier step in the protein construction process.

Related: 10 deadly diseases that hopped across species

But there's one big hurdle for mRNA vaccines. We can't be sure they will work.

As of yet, no vaccine built from a germs' genetic material has ever earned approval, Bert Jacobs, a professor of virology at Arizona State University and member of the ASU Biodesign Institute's Center for Immunotherapy, Vaccines and Virotherapy, told Live Science. Despite the technology having existed for almost 30 years, RNA and DNA vaccines have not yet matched the protective power of existing vaccines, National Geographic reported.

Assuming these unconventional COVID-19 vaccines pass initial safety tests, "will there be efficacy?" Jacobs said. "The animal models suggest it, but we'll have to wait and see."

"Because of the emergency here, people are going to try many different solutions in parallel," Andino-Pavlovsky said. The key to trialing many vaccine candidates at once will be to share data openly between research groups, in order to identify promising products as soon as possible, he said.

Metrics used to measure efficacy whether a vaccine sparks an adequate response from a persons immune system in animal studies and early clinical trials will also need to be clearly defined, he added. In other words, researchers should be able to use these early studies to determine which vaccines to move forward with, which to modify and which to abandon. That whole process from lab dish to animal studies can take 3 to 6 months, Andino-Pavlovsky said.

Designing a vaccine that grants immunity and causes minimal side effects is no simple task. A coronavirus vaccine, in particular, poses its own unique challenges. Although scientists did create candidate vaccines for the coronaviruses SARS-CoV and MERS-CoV, these did not exit clinical trials or enter public use, partly because of lack of resources, Live Science previously reported.

"One of the things you have to be careful of when you're dealing with a coronavirus is the possibility of enhancement," Fauci said in an interview with the journal JAMA on April 8. Some vaccines cause a dangerous phenomenon known as antibody dependent enhancement (AED), which paradoxically leaves the body more vulnerable to severe illness after inoculation.

Related: Could a 100-year-old vaccine protect against COVID-19?

Candidate vaccines for dengue virus, for example, have generated low levels of antibodies that guide the virus to vulnerable cells, rather than destroying the pathogen on sight, Stat News reported. Coronavirus vaccines for animal diseases and the human illness SARS triggered similar effects in animals, so there's some concern that a candidate vaccine for SARS-CoV-2 might do the same, according to an opinion piece published March 16 in the journal Nature. Scientists should watch for signs of AED in all upcoming COVID-19 vaccine trials, Fauci said. Determining whether enhancement is occurring could happen during initial animal studies, but "it is still unclear how we will look for AED," Jacobs said.

"Once there is a good animal model which gives symptoms after SARS-CoV-2 infection, we can ask if vaccination decreases or enhances pathogenesis," he said. "These may be longer term studies that could take several months." The AED studies could be done in parallel with other animal trials to save time, Andino-Pavlovsky added.

There's another challenge too.

A successful coronavirus vaccine will snuff the spread of SARS-CoV-2 by reducing the number of new people infected, Andino-Pavlovsky said. COVID-19 infections typically take hold in so-called mucosal tissues that line the upper respiratory tract, and to effectively prevent viral spread, "you need to have immunity at the site of infection, in the nose, in the upper respiratory tract," he said.

These initial hotspots of infection are easily permeated by infectious pathogens. A specialized fleet of immune cells, separate from those that patrol tissues throughout the body, are responsible for protecting these vulnerable tissues. The immune cells that protect mucosal tissue are generated by cells called lymphocytes that remain nearby, according to the textbook Immunobiology: The Immune System in Health and Disease (Garland Science, 2001).

"It's like your local police department," Andino-Pavlovsky told Live Science. But not all vaccines prompt a strong response from the mucosal immune system, he said. The seasonal influenza vaccine, for example, does not reliably trigger a mucosal immune response in all patients, which partly explains why some people still catch the respiratory disease after being vaccinated, he said.

Even if a COVID-19 vaccine can jumpstart the necessary immune response, researchers arent sure how long that immunity might last, Jacobs added. While research suggests that the coronavirus doesn't mutate quickly, "we have seasonal coronaviruses that come, year in [and] year out, and they don't change much year to year," he said. Despite hardly changing form, the four coronaviruses that cause the common cold keep infecting people so why haven't we built up immunity?

Perhaps, theres something odd about the virus itself, specifically in its antigens, viral proteins that can be recognized by the immune system, and that causes immunity to wear off. Alternatively, coronaviruses may somehow fiddle with the immune system itself, and that could explain the drop-off in immunity over time, Andino-Pavlovsky said. To ensure a vaccine can grant long-term immunity against SARS-CoV-2, scientists will have to address these questions. In the short term, they'll have to design experiments to challenge the immune system after vaccination and test its resilience through time, Jacobs said.

In a mouse model, such studies could take "at least a couple of months," he said. Scientists cannot conduct an equivalent experiment in humans, but can instead compare natural infection rates in vaccinated people to those of unvaccinated people in a long-term study.

"When you have the luxury, you look at this for five years, 10 years to see what happens," Andino-Pavlovsky added.

Unlike an antiviral treatment for COVID-19 that can be given to patients already infected with the virus, a vaccine must be tested in diverse populations of healthy people.

"Because you give it to healthy people, there's an enormous pressure to make sure it's absolutely safe," Andino-Pavlovsky said. What's more, the vaccine must work well for people of many ages, including the elderly, whose weakened immune systems place them at heightened risk of serious COVID-19 infection.

"Initially, safety studies will be done in small numbers of people," likely fewer than 100, Jacobs said. A vaccine may be approved based on these small studies, which can take place over a few months, and then continually monitored as larger populations become vaccinated, he added. "That's just my guess."

Related: COVID-19 is now the leading cause of death in the United States

A future vaccine may require an additional ingredient, called an adjuvant, that rallies the aged immune system into action, like that found in the shingles vaccine, Jacobs said.

While some existing drugs, whose safety risks doctors understand, may be repurposed as COVID-19 treatments, equivalent data does not exist for a vaccine because no coronavirus vaccine has ever entered widespread use. Jacobs said he and his team aim to exploit a potential loophole to develop a powerful vaccine, fast. "We use surrogate live attenuated vaccines, where we put parts of SARS-CoV-2 into vaccinia virus [which guards against smallpox], and this can be done initially within a month," Jacobs said. In general, many vaccine developers are starting from scratch.

Despite the many challenges ahead, certain shortcuts could allow scientists to bring a COVID-19 vaccine faster than anticipated.

First, partnering with the U.S. Food and Drug Administration and other regulatory bodies can help scientists leap the logistical hurdles associated with clinical trials, such as recruiting healthy volunteers, Andino-Pavlovsky said. "It can save six months, doing that," he said.

Any potential vaccine will need to pass a safety trial, known as a Phase 1 trial, which also helps determine the needed dose. The next step is a larger trial in 100 to 300 people, called a Phase 2, which looks for some biological activity, but can't say for sure if the drug is effective.

If a vaccine candidate prompts a promising immune response in Phase 2 clinical trials, after passing safety tests in Phase 1, it's possible that the FDA could approve such a vaccine for emergency use "before the 18-month period that I said," Fauci said in the JAMA interview.

"If you get neutralizing antibodies," which latch onto specific structures on the virus and neutralize it, "I think you can keep moving forward on it," Jacobs said. Normally, a vaccine would then enter Phase 3 clinical trials, which include hundreds to thousands of people.

So adding up these steps, each of which will likely take 3 to 6 months, it's very unlikely we would be able to find a vaccine that is safe and effective in less than 12 months even if many of these steps could be done in parallel.

Then comes the issue of manufacturing billions and billions of doses of a new vaccine whose ingredients we don't yet know. Bill Gates has said that the Gates Foundation will fund the construction of factories for seven coronavirus vaccine candidates, equipping the sites to produce a wide variety of vaccine types, Business Insider reported.

"Even though we'll end up picking at most two of them, we're going to fund factories for all seven, just so that we don't waste time in serially saying, 'OK, which vaccine works?' and then building the factory," Gates said.

Even if a fairly promising vaccine surfaces by 2021, and can be mass-produced, the search won't end there. "Especially with trying to get something out this quickly, we may not get the best vaccine out there right away," Jacobs said. Ideally, an initial vaccine will grant immunity for at least one to two years, but should that immunity wane, a longer lasting vaccine may have to be deployed. Historically, so-called live attenuated vaccines that contain a weakened virus tend to perform most reliably over extended periods of time, Andino-Pavlovsky said.

"That may be what we need in the long run," he said. And research into coronavirus immunity should continue, regardless, "not only for COVID-19, but for the next coronavirus that comes."

Originally published on Live Science.

Read more:

When will a COVID-19 vaccine be ready? - Live Science

A coalition of EU scientists and technologists thats developing whats billed as a privacy-preserving standard for Bluetooth-based proximity tracking, as a proxy for COVID-19 infection risk, wants Apple and Google to make changes to an API theyre developing for the same overarching purpose.

The Pan-European Privacy-Preserving Proximity Tracing (PEPP-PT) uncloaked on April 1, calling for developers of contact tracing apps to get behind a standardized approach to processing smartphone users data to coordinate digital interventions across borders and shrink the risk of overly intrusive location-tracking tools gaining momentum as a result of the pandemic.

PEPP-PT said today it has seven governments signed up to apply its approach to national apps, with a claimed pipeline of a further 40 in discussions about joining.

We now have a lot of governments interacting, said PEPP-PTs Hans-Christian Boos, speaking during a webinar for journalists. Some governments are publicly declaring that their local applications will be built on top of the principles of PEPP-PT and also the various protocols supplied inside this initiative.

We know of seven countries that have already committed to do this and were currently in conversation with 40 countries that are in various states of onboarding.

Boos said a list of the governments would be shared with journalists, though at the time of writing we havent seen it. But weve asked PEPP-PTs PR firm for the info and will update this report when we get it.

The pan-European approach has worked, he added. Governments have decided at a speed previously unknown. But with 40 more countries in the queue of onboarding we definitely have outgrown just the European focus and to us this shows that privacy as a model and as a discussion point is a statement and it is something that we can export because were credible on it.

Paolo de Rosa, the CTO at the Ministry of Innovation Technology and Digital Transformation for the Italian government, was also on the webinar and confirmed its national app will be built on top of PEPP-PT.

We will have an app soon and obviously it will be based on this model, he said, offering no further details.

PEPP-PTs core privacy-preserving claim rests on the use of system architectures that do not require location data to be collected. Rather devices that come near each other would share pseudonymized IDs which could later be used to send notifications to an individual if the system calculates an infection risk has occurred. An infected individuals contacts would be uploaded at the point of diagnosis allowing notifications to be sent to other devices with which had come into contact.

Boos, a spokesman for and coordinator of PEPP-PT, told TechCrunch earlier this monththe project will support both centralized and decentralized approaches. The former meaning IDs are uploaded to a trusted server, such as one controlled by a health authority; the latter meaning IDs are held locally on devices, where the infection risk is also calculated a backend server is only in the loop to relay info to devices.

Its just such a decentralized contacts tracing system that Apple and Google are collaborating on supporting fast-following PEPP-PT last week by announcing a plan for cross-platform COVID-19 contacts tracing via a forthcoming API and then a system-wide (opt-in) for Bluetooth-based proximity tracking.

That intervention, by the only two smartphone platforms that matter when the ambition is mainstream adoption, is a major development putting momentum behind decentralized contacts tracing for responding digitally to the coronavirus crisis in the Western world, certainly at the platform level.

In a resolution passed today the European parliament also called for a decentralized approach to COVID-19 proximity tracking.

MEPs are pushing for the Commission and Member States to be fully transparent on the functioning of contact tracing apps, so that people can verify both the underlying protocol for security and privacy and check the code itself to see whether the application functions as the authorities are claiming. (The Commission has previously signaled a preference for decentralization too.)

However, backers of PEPP-PT, which include at least seven governments (and the claim of many more), arent giving up on the option of a privacy-preserving centralized option which some in their camp are dubbing pseudo-decentralized with Boos claiming today that discussions are ongoing with Apple and Google about making changes to their approach.

As it stands, contacts tracing apps that dont use a decentralized infrastructure wont be able to carry out Bluetooth tracking in the background on Android or iOS as the platforms limit how general apps can access Bluetooth. This means users of such apps would have to have the app open and active all the time for proximity tracking to function, with associated (negative) impacts on battery life and device usability.

There are also (intentional) restrictions on how contacts tracing data could be centralized, as a result of the relay server model being deployed in the joint Apple-Google model.

We very much appreciate that Google and Apple are stepping up to making the operating system layer available or putting what should be the OS actually there, which is the Bluetooth measurement and the handling of crypto and the background running of such tasks which have to keep running resiliently all the time if you look at their protocols and if you look at whom they are provided by, the two dominant players in the mobile ecosystem, then I think that from a government perspective especially, or from lots of government perspectives, there are many open points to discuss, said Boos today.

From a PEPP-PT perspective there are a few points to discuss because we want choice and implementing choice in terms of model decentralized or centralized on top of their protocol creates actually the worst of both worlds so there are many points to discuss. But contrary to the behavior that many of us who work with tech companies are used to Google and Apple are very open in these discussions and theres no point in getting up in arms yet because these discussions are ongoing and it looks like agreement can be reached with them.

It wasnt clear what specific changes PEPP-PT wants from Apple and Google we asked for more detail during the webinar but didnt get a response. But the group and its government backers may be hoping to dilute the tech giants stance to make it easier to create centralized graphs of Bluetooth contacts to feed national coronavirus responses.

As it stands, Apple and Googles API is designed to block contact matching on a server though there might still be ways for governments (and others) to partially work around the restrictions and centralize some data.

We reached out to Apple and Google with questions about the claimed discussions with PEPP-PT. At the time of writing, neither had responded.

As well as Italy, the German and French governments are among those that have indicated theyre backing PEPP-PT for national apps which suggests powerful EU Member States could be squaring up for a fight with the tech giants, along the lines of Apple versus the FBI, if pressure to tweak the API fails.

Another key strand to this story is that PEPP-PT continues to face strident criticism from privacy and security experts in its own backyard including after it removed a reference to a decentralized protocol for COVID-19 contacts tracing thats being developed by another European coalition, comprised of privacy and security experts, called DP-3T.

Coindesk reported on the silent edit to PEPP-PTs website yesterday.

Backers of DP-3T have also repeatedly queried why PEPP-PT hasnt published code or protocols for review to-date and even gone so far as to dub the effort a trojan horse.

ETH Zrichs Dr. Kenneth Paterson, who is both a part of the PEPP-PT effort and a designer of DP-3T, couldnt shed any light on the exact changes the coalition is hoping to extract from Gapple when we asked.

Theyve still not said exactly how their system would work, so I cant say what they would need [in terms of changes to Apple and Googles system], he told us in an email exchange.

Today Boos couched the removal of the reference to DP-3T on PEPP-PTs website as a mistake which he blamed on bad communication. He also claimed the coalition is still interested in including the formers decentralized protocol within its bundle of standardized technologies. So the already sometimes fuzzy lines between the camps continue to be redrawn. (Its also interesting to note that press emails to Boos are now being triaged by Hering Schuppener, a communications firm that sells publicity services, including crisis PR.)

Were really sorry for that, Boos said of the DP-3T excision. Actually we just wanted to put the various options on the same level that are out there. There are still all these options and we very much appreciate the work that colleagues and others are doing.

You know there is a hot discussion in the crypto community about this and we actually encourage this discussion because its always good to improve on protocols. What we must not lose sight of is that were not talking about crypto here, were talking about pandemic management and as long as an underlying transport layer can ensure privacy thats good enough because governments can choose whatever they want.

Boos also said PEPP-PT would finally be publishing some technical documents this afternoon opting to release information some three weeks after its public unveiling and on a Friday evening (a seven-page high level overview has since been put on their GitHub here [this link has since been deleted Ed.] but still a far cry from code for review) while making a simultaneous plea for journalists to focus on the bigger picture of fighting the coronavirus rather than keep obsessing over technical details.

During todays webinar some of the scientists backing PEPP-PT talked about how theyre testing the efficacy of Bluetooth as a proxy for tracking infection risk.

The algorithm that weve been working on looks at the cumulative amount of time that individuals spend in proximity with each other, said Christophe Fraser, professor at the Nuffield Department of Medicine and Senior Group Leader in Pathogen Dynamics at the Big Data Institute, University of Oxford, offering a general primer on using Bluetooth proximity data for tracking viral transmission.

The aim is to predict the probability of transmission from the phone proximity data. So the ideal system reduces the requested quarantine to those who are the most at risk of being infected and doesnt give the notification even though some proximity event was recorded to those people whore not at risk of being infected.

Obviously thats going to be an imperfect process, he went on. But the key point is that in this innovative approach that we should be able to audit the extent to which that information and those notifications are correct so we need to actually be seeing, of the people who have been sent the notification how many of them actually were infected. And of those people who were identified as contacts, how many werent.

Auditing can be done in many different ways for each system but that step is crucial.

Evaluating the effectiveness of the digital interventions will be vital, per Fraser whose presentation could have been interpreted as making a case for public health authorities to have fuller access to contacts graphs. But its important to note that DP-3Ts decentralized protocol makes clear provision for app users to opt-in to voluntarily share data with epidemiologists and research groups to enable them to reconstruct the interaction graph among infected and at risk users (aka to get access to a proximity graph).

Its really important that if youre going to do an intervention that is going to affect millions of people in terms of these requests to [quarantine] that that information be the best possible science or the best possible representation of the evidence at the point at which you give the notification, added Fraser. And therefore as we progress forwards that evidence our understanding of the transmission of the virus is going to improve. And in fact auditing of the app can allow that to improve, and therefore it seems essential that that information be fed back.

None of the PEPP-PT-aligned apps that are currently being used for testing or reference are interfacing with national health authority systems, per Boos though he cited a test in Italy thats been plugged into a companys health system to run tests.

We have supplied the application builders with the backend, we have supplied them with sample code, we have supplied them with protocols, we have supplied them with the science of measurement, and so on and so forth. We have a working application that simply has no integration into a countrys health system on Android and on iOS, he noted.

On its website PEPP-PT lists a number of corporate members as backing the effort including the likes of Vodafone alongside several research institutions including Germanys Fraunhofer Heinrich Hertz Institute for telecoms (HHI) which has been reported as leading the effort.

The HHIs executive director, Thomas Wiegand, was also on todays call. Notably, his name initially appeared on the authorship list for the DP-3Ts white paper. However, on April 10 he was removed from the README and authorship list, per its GitHub document history. No explanation for the change was given.

During todays press conference Wiegand made an intervention that seems unlikely to endear him to the wider crypto and digital rights community describing the debate around which cryptography system to use for COVID-19 contacts tracing as a side show and expressing concern that what he called Europes open public discussion might destroy our ability to get ourselves as Europeans out of this.

I just wanted to make everyone aware of the difficulty of this problem, he also said. Cryptography is only one of 12 building blocks in the system. So I really would like to have everybody go back and reconsider what problem we are in here. We have to win against this virus or we have another lockdown or we have a lot of big problems. I would like to have everybody to consider that and to think about it because we have a chance if we get our act together and really win against the virus.

The press conference had an even more inauspicious start after the Zoom call was disrupted by racist spam in the chat field. Right before that Boos had kicked off the call saying he had heard from some more technically savvy people that we should not be using Zoom because its insecure and for an initiative that wants security and privacy its the wrong tool.

Unfortunately we found out that many of our international colleagues only had this on their corporate PCs so over time either Zoom has to improve or we need to get better installations out there. Its certainly not our intention to leak the data on this Zoom, he added.

Read more here:

Europes PEPP-PT COVID-19 contacts tracing standard push could be squaring up for a fight with Apple and Google - TechCrunch

CEDAR RAPIDS, Iowa (KCRG) - The Iowa Department of Public Health on Friday announced 191 new cases of COVID-19 in Iowa as well as four new deaths.

That brings the totals in Iowa to 2,332 confirmed cases and 64 deaths. These most recent deaths were in Black Hawk, Scott, Washington and Tama Counties.

21,792 people have been tested in the state and 1,007 confirmed cases have recovered.

On Thursday Gov. Reynolds announced that the Regional Medical Coordination Center (RMCC), which divides Iowa into six regions and shows how hospitals are keeping up during the outbreak, classifies Region 6 is now a 10 out of 10.

Region 6 includes Allamakee, Benton, Black Hawk, Bremer, Buchanan, Clayton, Delaware, Dubuque, Fayette, Grundy, Howard, Jones, Linn, and Winneshiek counties.

In response to this, Gov. Reynolds on Thursday said she was banning all gatherings for social, community, recreational and leisure purposes in the region.

For a more detailed breakdown of the numbers visit: coronavirus.iowa.gov.

See the rest here:

191 new cases of COVID-19 and four additional deaths in Iowa - KCRG

Mary Agyeiwaa Agyapong, who worked at Luton and Dunstable University Hospital, northwest of London, was admitted to the hospital on April 7 after testing positive for the virus two days earlier.

The 28-year-old died on Sunday, Bedfordshire Hospitals NHS Foundation Trust confirmed in a statement on Wednesday. She had worked for the hospital system for five years.

More than 13,700 people have died of coronavirus in the UK and more than 100,000 have tested positive, according to the UK government.

David Carter, CEO of Bedfordshire Hospitals NHS Foundation Trust, confirmed Agyapong's death "with great sadness."

"Mary worked here for five years and was a highly valued and loved member of our team, a fantastic nurse and a great example of what we stand for in this Trust," Carter said in a statement on Wednesday.

"She tested positive for Covid-19 after being tested on 5th of April and was admitted to the hospital on the 7th April. Our thoughts and deepest condolences are with Mary's family and friends at this sad time. We ask that the family's privacy is respected at this time," he added.

More than 117,000 (about $146,000) has been donated to a GoFundMe page, which was set up to support Agyapong's husband and baby, just 24 hours after the page was published with an original goal of raising 2,000 (about $2,500).

Agyapong -- also known as Mary Mo -- was a "blessing to everyone she came across and her love, care and sincerity will be irreplaceable," a statement on the fundraising website reads.

Catherine Clewes, who donated, said "I couldn't have wished for a better mentor in my sign-off placement. You helped shape the nurse I have become."

Describing the nurse as "such a lovely person," another contributor wrote "it broke our heart when we got the news," adding "thank you Mary for your smile, your strength."

Go here to read the rest:

Pregnant nurse dies of Covid-19 but baby survives after emergency C-section - CNN

A wave of planned anti-lockdown demonstrations that have broken out around the country to protest against the efforts of state governments to combat the coronavirus pandemic with business closures and stay-at-home orders have included far-right groups as well as more mainstream Republicans.

While protesters in Michigan, Ohio, Kentucky and other states claim to speak for ordinary citizens, many are also supported by street-fighting rightwing groups like the Proud Boys, conservative armed militia groups, religious fundamentalists, anti-vaccination groups and other elements of the radical right.

On Wednesday in Lansing, Michigan, a protest put together by two Republican-connected not-for-profits was explicitly devised to cause gridlock in the city, and for a time blocked the entrance to a local hospital.

It was organized by the Michigan Conservative Coalition, which Michigan state corporate filings show has also operated under the name of Michigan Trump Republicans. It was also heavily promoted by the Michigan Freedom Fund, a group linked to the Trump cabinet member Betsy DeVos.

But the protest also attracted far-right protest groups who have been present at pro-Trump and gun rights rallies in Michigan throughout the Trump presidency.

Placards identified the Michigan Proud Boys as participants in the vehicle convoy. Near the state house, local radio interviewed a man who identified himself as Phil Odinson.

In fact the man is Phil Robinson, the prime mover in a group called the Michigan Liberty Militia, whose Facebook page features pictures of firearms, warnings of civil war, celebrations of Norse paganism and memes ultimately sourced from white nationalist groups like Patriot Front.

The pattern of rightwing not-for-profits promoting public protests while still more radical groups use lockdown resistance as a platform for extreme rightwing causes looks set to continue in events advertised in other states over coming days.

In Idaho on Friday, protesters plan to gather at the capitol building in Boise to protest anti-virus restrictions put in place by the Republican governor, Brad Little.

The protest has been heavily promoted by the Idaho Freedom Foundation (IFF), which counts among its donors dark money funds linked to the Koch brothers such as Donors Capital Fund, and Castle Rock, a foundation seeded with part of the fortune of Adolph Coors, the rightwing beer magnate.

IFF have added their slogan for the event, Disobey Idaho, to stickers which they plan to distribute among the crowd.

The event is also being promoted on a website dedicated to attacking Little for his response to Covid-19. That website was set up by the Idaho businessman, pastor and one-time Republican state senate candidate, Diego Rodriguez.

Rodriguez launched the website at an Easter service held in defiance of the governors orders on Easter Sunday, which was also addressed by Ammon Bundy, the leader of the militia occupation of the Malheur national wildlife refuge in 2016 that become a rallying point for the anti-government right in the US.

Bundy has been holding similar gatherings for weeks in Emmett, Idaho, where he now lives. On Sunday, he repeated his opposition to the Idaho orders, writing on Facebook: We all have a duty to defend what is right and to make sure, that what God has given, man does not take away. Especially that great gift of agency, YES freedom!

Ada county, Idaho, where the capital, Boise, is located, has so far suffered 541 cases of Covid-19 and nine deaths, in a state which has a far worse outbreak than neighboring Oregon, which is 2.4 times more populous.

Nevertheless, the ad for the rally on Rodriguezs website advises, We feel that wearing face masks and gloves is counterproductive to the movement, and should be avoided.

In Washington state, meanwhile, which for now has brought one of the worst outbreaks in the country under a measure of control, a Republican state committeeman, Tyler Miller, has organized a protest at the state capitol on Saturday.

Miller, who is active in the Kitsap county Republican party, was involved in passing a resolution in January in support of representative Matt Shea, who was excluded from the state houses GOP caucus after a report commissioned by house found that he had participated in domestic terrorism.

Hundreds of Facebook users have indicated that they will be attending his Hazardous Liberty rally, and a parallel event in Richland, Washington.

Included in that number are members of the 3% of Washington, a group which has held a series of open-carry rallies in Seattle, featuring speeches from the far-right protest leader, Joey Gibson.

As for Shea, he is speaking on Saturday at an online Saving America conference which will discuss an alleged erosion of rights thats been ramped up in unprecedented ways during this Covid-19 crisis.

He is scheduled to appear alongside the likes of close ally Pastor Ken Peters, who has been holding monthly services outside Spokanes planned parenthood clinic; the actor, Maga personality and congressional candidate Mindy Robinson; and the New Zealand-based anti-communist speaker and author Trevor Loudon.

Other similar events have been advertised for Saturday by an anti-vaccination activist in Oregon, and for Friday by a Boston group with alt-right connections.

Original post:

The rightwing groups behind wave of protests against Covid-19 restrictions - The Guardian

Games Done Quick (GDQ), an organization that raises money for charity with speedrunning events, is hosting an online-only speedrunning marathon all weekend in support of COVID-19 relief. The event, titled Corona Relief Done Quick (CRDQ), is scheduled to run through Sunday. You can watch the event on Twitch.

CRDQ will be raising money for Direct Relief, a humanitarian aid organization. Direct Reliefs COVID-19 efforts include getting personal protective equipment to health care workers, providing chronic disease medications to community clinics and health centers across the US, and more.

You can see the full schedule and lineup of games right here. Im most looking forward to The Legend of Zelda: Ocarina of Time randomizer co-op run later today, the Sonic the Hedgehog 2 any-percent run on Saturday, and the Super Metroid 100 percent run on Sunday, which will be the penultimate run of the show.

When GDQ announced CRDQ in March, the organization also said that its usual summer speedrunning marathon, Summer Games Done Quick, was postponed from June until August 16th23rd. The summer event will raise money for Doctors Without Borders.

Read more from the original source:

PSA: Games Done Quicks speedrunning marathon for COVID-19 relief is happening this weekend - The Verge

TaNefer Camara, a lactation consultant at Highland Hospital, is also preparing for the birth of her fourth child. Photo: Pete Rosos

In the age of coronavirus, some medical needs can be postponed. Childbirth isnt one of them. Oakland midwives, doulas and obstetricians are reimagining how they work with and support pregnant women during this crisis, and the challenges are immense.

Reproductive health workers are swapping in-person visits for virtual appointments and navigating equipment shortages and new hospital rules that can make childbirth lonelier and riskier.

More mothers are discharging early from the hospital against medical advice, and in some cases, they dont show up at all, opting to give birth at home rather than risk COVID-19 exposure at the hospital.

Lactation consultants and doulas have started offering late-night breastfeeding video consults to help new mothers struggling with the dual isolation of the postpartum period and quarantine.

Some practitioners say hospitals havent fully thought through the realities of giving birth in the midst of this crisis, and how pregnant women will be impacted by new emergency measures.

The community and individuals are stepping up, but health systems are not acknowledging that they cant think about anything beyond COVID-19, said TaNefer Camara, a lactation consultant at Highland Hospital who is currently pregnant herself, expecting her fourth child. Its sad that our health systems are so dysfunctional that one disease can shut down all other care.

We spoke with a number of local health care providers and pregnant women to understand what its like to be expecting in Oakland right now, how local hospitals and support workers are adjusting, and what resources are out there to help ensure a safe and healthy pregnancy in an extremely challenging time.

Kaiser Permanente Hospital, a major East Bay delivery center, has canceled in-person classes that help new parents prepare for labor and delivery, breastfeeding and life with a newborn.

We signed up for all the classes at Kaiser, and every single one was canceled, said Emily Ahsoon Wightman, a teacher at Urban Montessori Charter School who is set to deliver in May. For each cancellation, I got an email and a phone call. So it was another nail in the coffin: Oh, there goes breastfeeding, there goes the newborn care.

Dr. Amanda Williams, physician maternity director of Kaiser Permanente East Bay, said prenatal and breastfeeding videos are available online. Some prenatal appointments, such as scheduled ultrasounds, still happen in person. Kaiser has offered telemedicine for many years, but it has become more important since the COVID-19 pandemic began. We customize the plan for combining in-person and virtual visits based on the status of the individual pregnancy, with shared decision making between the prenatal care provider and the patient, said Williams.

Ahsoon Wightman said shes checked out the videos online, but so far, she hasnt found them as useful as an in-person class or a lesson with a doula. They kind of look like a PowerPoint presentation that theyre talking over, she said.

Telemedicine certainly has advantages. Health workers dont need to don personal protective equipment to talk to patients by phone, conserving valuable resources for those on the frontlines of the COVID-19 response. It also protects the patient from unnecessary exposure to the virus.

Patients who visit Oaklands public Highland Hospital, many of whom have lower incomes and rely on MediCal insurance, often struggle with the time and money it takes to get to and from doctor appointments. The shift to more phone appointments has alleviated some of that burden, said Simone Lance, a midwife at Highland.

Some local midwives and doulas have also transitioned from in-person support to virtual support. Linda Jones, a co-founder of Black Women Birthing Justice, has worked as a pregnancy and postpartum doula for 30 years. Shes offering prenatal, labor, and postnatal support through phone and video calls. Whether or not a video call is permitted during labor depends largely upon the physicians preference and hospital policy.

I feel for the women who are pregnant during this, Jones said. I tell people its like theyre having to grieve what theyve lost. Theyve been planning birth to look a certain way, and now its not anything like they imagined.

New rules about who can accompany women in the delivery room can compound the anxiety. In an effort to combat the spread of COVID-19, only one visitor is allowed in the delivery room at Kaiser Oakland and Highland Hospital. A pregnant woman who may have been counting on several people supporting her through labora partner, friends or relatives, a doulamust now pick only one.

The visitor policy has been a really heartbreaking adaptation, said Lance, a certified nurse-midwife at Highland.

Midnight Milk Club, led by lactation consultant TaNefer Camara, is open to mothers who are looking for breastfeeding support, advice, and community.

The Bay Area Breastfeeding Support Group is led by lactation consultant and nurse Serena Meyer, and is open to birth workers and breastfeeding professionals.

Evidence Based Birth created a crash course on birthing in the time of COVID-19 available for free on YouTube and has built a directory of virtual doulas. This site is a resource used by local midwives Mason Cornelius and Simone Lance.

Kaiser Permanentes Baby 101 module offers important information for new mothers and their partners from the first trimester to the first few weeks at home with your baby. Kaiser Permanentes YouTube Channel offers a number of videos about prenatal, labor and delivery, and postpartum care for mothers and infants.

Highland Hospital and Kaiser have differing policies if a woman in labor, or her support partner, comes into the hospital with COVID-19-like symptoms such as a fever or a dry cough.

As doulas, our superskill is that we adapt well to changes and we keep calm in times that might seem stressful for a lot of people, said Katelyn Gonzalez, a Hayward-based doula with many Oakland clients who is also pregnant, and due in July. Research has shown that women who have good support during labor can experience lower rates of C-sections and better birth outcomes than those who give birth alone.

At Kaiser, a person with symptoms gets tested, according to Lisa Cowan, director of regional services for maternal and child health. If they are COVID-19-positive, have symptoms, or have been exposed, hospital health workers will don protective equipment, mask the mother and her companion, and manage the labor as they would for any other patient.

Highland Hospitals current policy is to separate the mother from her support person if either the mother or support person screen positive for COVID-19. In that situation, the mother would be tested for COVID-19 and separated from her support person. It usually takes about 24 hours to get the COVID-19 test results back.

I understand that desperate times call for desperate measures, but I think we need to acknowledge the risk were taking by not allowing a woman to have continuous labor support, said Lance. It doesnt have to be a doula, but I do think the potential risk of having a woman birth alone needs to be acknowledged. Its more than just sad or a pityit has a potential negative impact.

Usually, mothers will stay in the hospital for at least 24 hours after a vaginal delivery, said Serena Meyer, nurse and lactation consultant at Kaiser. During that time, nurses will monitor the baby for jaundice and other potential problems, and lactation consultants will help establish breastfeeding and keep an eye out for dehydration, tongue ties, or other feeding problems.

Meyer is the founder of the Bay Area Breastfeeding Support Group, a Facebook group for related professionals. She said that since the COVID-19 pandemic, shes seen more people discharging quickly from the hospital, against medical advice, than she has ever seen at any other point in her career.

Ive never seen so many people try to have their baby and bounce up off the floor so fast. Theyre just headed out the door, and I dont know what theyre heading out the door to, said Meyer. We cant stop them, but we are scared for them.

Normally, lactation consultants with a private practice would offer in-home visits after birth, but due to COVID-19 concerns, Meyer shut-down her private practice entirely, while Camara moved hers to virtual visits only.

There are also a growing number of online support groups. Camara runs the Midnight Milk Club, a Facebook group that provides nighttime breastfeeding support for new moms. Since the COVID-19 pandemic, shes been contacted by panicked mothers who are seeing the supply of formula, diapers and other essential baby-care items dwindling in stores. To help answer new questions and manage stress, she has increased the number of group calls to twice a week.

I dont feel that there is enough being done to really support pregnant women at this time, in terms of just the increase in anxiety and depression around having a baby and being confined to the home and not being able to have visitors, said Camara, who is due in August.

Will we see an increase in preterm birth because of the stress that women are under? How is this affecting my baby? How is this affecting me emotionally in the long term?

Wary of new rules and aware that local hospitals are also treating COVID-19 patients, some pregnant women are now completely rethinking their birth plans.

Mason Cornelius, a licensed midwife at Nova Midwifery in Oakland, said that East Bay midwives have recently received an increase in requests from women who want to switch from a hospital birth to a home birth. Sometimes these calls come as soon as two or three weeks before the due date.

Theyre worried that they are going to arrive in labor, and that the hospitals will change policy and they will have to birth alone, said Cornelius. They dont feel safe there without an advocate.

Reproductive health experts worry some mothers will be caught in the middle: too afraid to go to the hospital, but unable to afford a midwife or a doula to assist with a safe home birth. This is most likely to affect women who already face other disparities in the healthcare system. Black women are more likely to die in childbirth than any other population, and black babies are more likely to be born preterm or face other adverse outcomes, which makes giving birth without the support of a doctor or midwife that much riskier.

I am fearful that were going to lose Black women that will do this, said Linda Jones of Black Women Birthing Justice. We need to have alternatives.

The American College of Obstetrics and Gynecology generally cautions against home births, particularly for women with complicated pregnancies and those who are considered high-risk. Some of the factors that might make a pregnancy high-risk, or more likely to deliver preterm, include pre-existing medical conditions such as high blood pressure, diabetes, obesity or past preterm births, according to the National Institutes for Health.

Camara, the lactation consultant at Highland, has always had healthy pregnancies and opted for home births. Currently pregnant herself, she will be giving birth to her fourth child at her home in Oakland. Now that her prenatal appointments are all virtual, Camara is self-monitoring her pregnancy by measuring her belly, tracking her blood pressure, and staying vigilant about her physical health and safety.

Ive just had more anxiety. My heart rate has been elevated because of these things I havent really struggled with before, said Camara. Ive already had healthy pregnancies and natural births, and I want things to go good with this baby as well.

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The rest is here:

What to expect when you're expecting during the COVID-19 crisis - Berkeleyside

Polluting industries around the world are using the coronavirus pandemic to gain billions of dollars in bailouts and to weaken and delay environmental protections.

The moves have been described as dangerous and irresponsible by senior figures. They say the unprecedented sums of money being committed to the global recovery are a historic opportunity to tackle the climate crisis, but such action has not been taken to date.

The fossil fuel industry, which already benefits from a $5tn-a-year subsidy, according to the IMF, has had the biggest wins during the coronavirus pandemic in the US and Canada.

In China, as the worst impacts of the virus outbreak passed, there was a surge in permits for new coal-fired power plants. From 1 to 18 March, more coal-fired capacity was approved than in the whole of 2019. In South Korea, the major coal plant builder Doosan Heavy Industries got a $825m government bailout; green groups say the company was in deep financial trouble before the pandemic. In Australia, lobbyists welcomed the South Australia governments move to defer taxes and other commitments to oil and gas explorers.

In the US, assistance for the green energy sector was not included in the $2tn support package on 26 March, three days after 24 rightwing thinktanks, including the Competitive Enterprise Institute, said they were deeply disturbed by possibility of funding for unreliable green energy programs. However, New York state did pass new laws to speed up clean energy projects.

In Brazil, the energy regulator has indefinitely postponed green power auctions scheduled for 2020 and in South Africa, the state-owned power giant Eskom, which relies heavily on coal, said it will cut the wind power it had committed to buy.

In the US, the EPA finalised its rollback of Obama-era rules that made cars less polluting. In the EU, lobby groups argued for a delay in emissions reduction laws, although VW, BMW and Daimler say they are aiming to comply regardless of the virus crisis.

A leaked letter from the International Air Transport Association describes its aggressive lobbying approach and includes a call for relief from corporate taxes, sales taxes, employer-paid payroll taxes and passenger ticket taxes.

In the US, aviation got a $60bn bailout package and the suspension of many taxes. In the UK, major carrier easyJet got a 600m soft loan, weeks after its biggest shareholder received almost 60m in dividends.

In the EU, the farmers association Copa-Cogeca called for a further postponement of the farm to fork strategy, which is aimed at making agriculture less polluting. The call is backed by the rightwing EPP bloc, the largest group in the European parliament.

In Germany, its farming lobby pushed for an easing of environmental standards, particularly those restricting fertiliser use, which are intended to reduce pollution. In the US, the American Farm Bureau Federation and the National Cattlemens Beef Association lobbied heavily and won a $23.5bn bailout package. Agricultural pollution is the cause of a huge dead zone in the Gulf of Mexico.

In the US, the plastic industry lobbied to remove bans on single-use plastic bags, citing hygiene concerns, and saw bans lifted in Maine, New Hampshire, Oregon and Massachusetts. The EPA also weakened the Toxic Substances Control Act for many chemical and petrochemical manufacturers.

In the EU, plastic industry lobbyists asked the European commission to postpone implementation of the single-use plastic directive, intended to cut plastic pollution. However, the commission rejected this call. In England, a ban on plastic straws, stirrers and cotton buds that was due in April has been postponed.

In Indonesia, the trade ministry revoked rules requiring basic certification that wood exports were legally produced in response to lobbying from the furniture and logging industries, according to campaign group Mighty Earth.

The Covid-19 crisis has seen some backing for a sustainable recovery and rejections of polluter lobbying. G20 finance ministers committed to an environmentally sustainable and inclusive recovery and EU leaders backed measures necessary to get back to a normal functioning of our societies and economies and to sustainable growth.

The European commission has not delayed its consultation on a new green finance strategy and is now considering imposing new requirements on firms to reduce the risk of biodiversity loss and pandemics. This is despite coal-heavy states including Poland and the Czech Republic urging the bloc to abandon its Green Deal plan and emissions trading scheme.

In France, the government has approved 288 wind and solar energy projects and has relaxed deadlines and cancelled a planned withdrawal of rooftop solar subsidies. Germany rejected calls to ease the planned shutdown of its coal industry, while in Canada prime minister Justin Trudeau rejected the call from Albertan companies to postpone an increase in the federal carbon tax.

The fallout from the pandemic is also delaying a number of big fossil fuel projects, from LNG terminals in Australia to coal plants in Indonesia.

The rest is here:

Polluter bailouts and lobbying during Covid-19 pandemic - The Guardian