Category: Covid-19

Early detection and early response. In an ideal world, this will contain an outbreak of infectious disease and prevent it from establishing in a population and becoming an epidemic.

Containment typically involves isolating and testing suspected cases, tracing their contacts, and quarantine in case any of these people are infected. The more thorough the testing and contact tracing early on, the better the chance of containment. These measures work well, especially for diseases like Sars, where symptoms coincide with infectiousness it is easy to recognise people who are infected.

In the case of Covid-19, detection is much harder because some transmission is possible before people show obvious symptoms, in this case a fever and cough. If there are no symptoms, it is impossible to identify people who are infected unless they are tested and their infection is confirmed in a laboratory, which is why airport screening at arrival is not very effective for Covid-19. This makes the virus much harder to control. Sooner or later, an infected case escapes detection and starts a chain of transmission, and quickly leads to a growing number of cases, which can become impossible to contain. As a result, containment has failed in a number of countries and the World Health Organization has declared a pandemic that is here to stay for months, if not longer.

So how does an epidemic spread through a population and how do we control it? In outbreak analysis, we measure transmission using the reproduction number (otherwise known as R), which tells us how many other people a typical Covid-19 case will infect on average. If one person is expected to infect more than one other person, the infection will grow and create an outbreak; if a person infects less than one other, the infection will peter out.

The larger the value of R, the easier the virus spreads through a population and the higher the number of infections. For seasonal flu, one infection leads on average to 1.4 new infections. For Covid-19, one infection leads to 2-3 others in the early stages of an outbreak. How many other people we end up infecting depends on several things: how many susceptible people there are in the population, how long we are infected for (the longer we are infected the more chances there are to pass on the infection), the number of people we come into contact with, and the probability of passing on the infection to those contacts.

In order to control the epidemic, we need to reduce R below 1. For diseases such as measles, we can achieve this by vaccinating a large enough proportion of the population so that the disease can no longer spread. Exactly what proportion we need to vaccinate to reach community immunity depends again on R. For R of 2, we need to immunise half of the population to interrupt transmission; for R of 3 we need to immunise two thirds of the population to get R below 1.

However, an effective vaccine for Covid-19 is unlikely to be available for another 12-18 months at best.

Shortening the duration of infection could also reduce transmission, and for some infections, such as influenza, this can be achieved with antiviral therapy. There are currently more than a hundred clinical studies in progress, which could produce therapies that reduce the duration of infection or infectivity. However, both of these control options are not yet available.

Another option to reduce the duration of infection is continued testing; this is a measure that can be effective throughout the epidemic. Finding infected people and advising them to self-isolate for the duration of the infection minimises the risk of them passing on the infection, which therefore slows down the spread. This is again a basic intervention method that we know works well, but in order for it to be most effective, results need to be processed quickly (in the UK it takes 2-4 days to get the results, in Wuhan it is under 4 hours).

If we cant easily reduce susceptibility or duration, we are left with two things: the probability of transmitting the infection upon contact and the number of different people we come into contact with. Both of these are things we as individuals can change by modifying our behaviour. Washing hands frequently for 20 seconds with hot water and soap, not touching our faces, covering our coughs and sneezes, staying at home if we are sick all of these reduce the risk of getting infected or passing on the infection to someone else.

Cancelling large gatherings, working from home and school closures are all social distancing measures aimed at reducing the number of contacts between people, each of which is an opportunity for passing on an infection. But this will not be a simple case of just cancelling events and closing schools for a couple of weeks. More severe measures will be necessary to bring the infections to low enough levels to keep the pressure off the health-system long-term. As individuals, we must all reduce the number of different people we come into contact with on a daily basis, and be prepared to do so for a prolonged period of time.

But what sorts of contacts are most important for transmission? Together with Adam Kucharski, also from the London School of Hygiene and Tropical Medicine, I have recently collaborated with the BBC on a massive citizen science project, led by Professor Julia Gog from Cambridge University. Called BBC Pandemic, the project collected information on how people of different ages interact with one another in different contexts (home, work, school, other) from over 35,000 volunteers. We have recently been fast-tracking the release of contact data to help inform UK Covid-19 modelling efforts and potential intervention strategies.

What we have found in this data is that adults aged 20-50 make most of their contacts in workplaces. If those of us who can work remotely start doing so now, it will contribute to lowering overall transmission in the population. Another important finding is that people over 65 who are particularly at risk from severe Covid-19 illness make over half of their contacts in other settings (not home, school or work), such as shops, restaurants and leisure centres. By avoiding these interactions, people who are most at risk from the new coronavirus could halve their risk of infection. By changing our behaviour now, and sustaining these changes throughout the outbreak, we can significantly reduce our own risk of infection, and the risk to others, and by doing so help protect those most vulnerable.

Sustainability is key here; these measures may reduce the reproduction number R, but as soon as they are lifted we could see transmission again, and another outbreak.

We must all take individual action to reduce Covid-19 transmission and slow down its spread, limit the number of infections and reduce the pressure on the health system so that everyone who needs medical care can get it. Starting now, and for the duration of this epidemic, we all have a role to play and a responsibility to modify our behaviour in order to protect the ones who are most at risk.

Dr Petra Klepac is assistant professor of infectious disease modelling at the London School of Hygiene and Tropical Medicine

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What we scientists have discovered about how each age group spreads Covid-19 - The Guardian

Here is a 3D image of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), formerly ... [+] known as the 2019 novel coronavirus (2019-nCoV). (Image: Getty)

Dont you just love conspiracy theories? Especially when two groups of people have pretty much the same conspiracy theory about each other?

Some folks including politicians in the U.S. and China have both suggested that the COVID-19 coronavirus (SARS-CoV2) thats causing the pandemic may actually be a bioweapon that was manufactured in a lab. The only difference between their conspiracy theories is whos being accused of doing the manufacturing.

On the one corner are some people in the U.S. who are hinting or in some cases openly claiming that China put together this virus. For example, look at what Senator Tom Cotton (R-Arkansas) tweeted out back on January 30:

Then, Steve Mosher wrote on February 22 an opinion piece for the New York Post entitled, Dont buy Chinas story: The coronavirus may have leaked from a lab. Take a wild guess at what Mosher wrote about in his piece. By the way, Mosher is not a biomedical scientist, but instead is the president of the Population Research Institute and author of book called Bully of Asia: Why Chinas Dream Is the New Threat to World Order. So chances are that he didnt love China in the first place. But who knows, love works in mysterious ways.

So what evidence have Cotton, Mosher, and others provided to support these suggestions or claims? Incriminating pictures? Suspicious emails? Some awkward selfies? Any kind of scientific evidence?

Well, as Cotton picked out, there just happens to be a biosafety level-four (BSL-4) laboratory situated in Wuhan, China, the city where the whole outbreak started. Oh, and the lab had housed some types of coronaviruses among other pathogens. Yep, thats the evidence.

As you probably know, proximity alone should not imply guilt. That would be like claiming that you farted whenever theres a bad smell and you happen to be in the vicinity. Sure you may have intestines but that doesnt mean that every foul stench emanated from your guts.

Plus, its a lot easier to leak a pocket of air though your butt than a virus from a BSL-4 facility. BSL-4 facilities maintain the highest level of security among bio-laboratories since they do work on dangerous potentially life-threatening agents such as the Ebola, Lassa fever, and Marburg viruses. So its not as if the people inside these labs are playing throw and catch with the viruses and stuffing them into their pockets. To be designated as a BSL-4, the lab has to have the appropriate ventilation systems, reinforced walls, security systems, and construction to keep the wrong things inside and the right things outside.

Is it unusual then to have a BSL-4 facility in a city like Wuhan, China? Not really. There are already at least six BSL-4 facilities in the U.S. in Atlanta, GA, Frederick, MD, Galveston, TX, Hamilton, MT, and San Antonio, TX. According to the Federation of American Scientists website, seven others may be planned, under construction, or possibly finished in various cities such as Boston, MA, and Richmond, VA. These labs in the U.S. also study and house a range of dangerous pathogens. So again having a lab that studies bad pathogens does not mean that the lab released anything.

Not to be outdone, some in China have made similar suggestions, except that its the U.S. that built the virus and released it in China. Well, thats original. For example, take a look at these three tweets from Zhao Lijian, Spokesperson and Deputy Director General, Information Department for the Foreign Ministry of China:

Yes, the claim is that the U.S. released a virus in China so that the U.S. can then eventually suffer the consequences of the spreading virus just a couple months later. Makes a whole lotta sense, except that it doesnt. Where exactly is the real evidence that the U.S. military created SARS-CoV2?

The back-and-forth dialogue has continued with President Donald Trump then referring to SARS-CoV2 as the Chinese Virus as can be seen here:

When questioned why he was using this label rather than the real scientific name of the virus, Trump claimed that it was in response to the claim that the U.S. military had created the virus. The video accompanying the following tweet shows the exchange:

Back and forth. Back and forth. Back and forth.

So, it looks like conspiracy theorists on both sides havent really provided any compelling evidence that SARS-CoV2 was produced in a lab, whether in the U.S., in China, or in the Hogwarts School of Witchcraft and Wizardry.

In fact, there is not only a lack of evidence supporting these conspiracy theories, there has been growing strong scientific evidence against both of them. Scientists, you know the ones who are actually trying to find the truth and solve a problem rather than blame people, have been conducting genetic analyses to determine where the virus came from and how it ended up infecting humans. Although viruses arent exactly like people as they dont seem to have feelings or spread rumors, viruses do have genetic material like people, except their genetic material is not quite as complex as those of humans. Nevertheless, like humans, viruses still pass along such materials when they replicate and evolve. Its not as simple as The Jerry Springer Show using genetic testing to find out if a guy is someones father, but scientists can use more advanced genetic analysis to figure out the origins, the family tree of SARS-CoV2.

Indeed, strong clues had already emerged by February 26, 2020, when a Perspectives piece was published in the New England Journal of Medicine. In the piece, David M. Morens, M.D. and Peter Daszak, Ph.D. from the National Institute of Health (NIH) and Jeffery K. Taubenberger, M.D., Ph.D. wrote: Of course, scientists tell us that SARS-CoV-2 did not escape from a jar: RNA sequences closely resemble those of viruses that silently circulate in bats, and epidemiologic information implicates a bat-origin virus infecting unidentified animal species sold in Chinas live-animal markets.

This wasnt exactly a case of same bat channel, same bat time. But the first, more deadlier SARS virus seemed to cause the 2002-2003 outbreak after it had managed to jump from bats to humans via intermediate hosts such as masked palm civets. Yes, some masked beings may have inadvertently partnered with bats to bring the original SARS virus to humans. So it wouldnt be too surprising if something like that happened again for SARS-CoV2.

This illustration shows a close-up of the protein spikes on SARS-CoV2. (Image: Getty)

Even more evidence of a natural rather than human-made origin for SARS-CoV2 has emerged from a study described in a research letter just published in Nature Medicine. In the letter, a research team (Kristian G. Andersen from The Scripps Research Institute, Andrew Rambaut from the University of Edinburgh, W. Ian Lipkin from the Mailman School of Public Health of Columbia University, Edward C. Holmes from The University of Sydney and Robert F. Garry from Tulane University) described how they had analyzed the genetic sequences that code for the protein spikes on the surface of SARS-CoV2. The virus looks sort of like a medieval mace with multiple spikes sticking out from its spherical shape. These spikes arent just for show as the virus uses them to latch on to a cell that it wants to invade and then push its way into the cell. Very medieval stuff.

Apparently, portions of these spike proteins are so effective in targeting specific receptors on human cells that it is hard to imagine humans manufacturing them, not with known existing technology. The researchers then concluded that this feature and thus the new coronavirus could have in all likelihood only evolved over time naturally. You see humans can make useful stuff like ride-sharing apps but are still quite puny compared to nature when it comes to making stuff like viruses.

In fact, the research team found that the SARS-CoV-2 structure in general is quite different from what humans would have likely concocted. If a human had wanted to create a viral weapon, he or she would have started with the structure of a virus thats already known to cause illness in people. Naturally, if you want to make a weapon, you may want to start with something like a grenade launcher rather than a smoothie maker, not that the virus looks like either. Instead, the structure of SARS-CoV2 is quite similar to those of viruses known to infect bats and pangolins.

So all of this further supports the theory that the virus jumped from bats to humans via some intermediate animal host. This doesnt necessarily mean that the virus started causing trouble as soon as it started infecting humans. An alternative possibility is that it jumped a longer time ago and hung out among humans for a while before eventually evolving into its current troublesome selves. This latter possibility would be somewhat analogous to inviting someone to live with you because he or she initially seemed relatively harmless but then over time finding out that this flat mate has become a terror.

The findings from the genetic analyses are consistent with how SARS-CoV2 is currently behaving. The virus is not acting like a bio-weapon right now. The best bio-weapons kill at a much higher rate and can be readily transported and released. Imagine being told that a bio-weapon might take the lives of 1% to 3.4% of the people that it infects but you dont quite know specifically which ones. The difference between SARS-CoV2 and pathogens like the Ebola Virus or anthrax is like the difference between a bunch of sofas and a collection of missiles. Sure, the former can cause harm but not in a predictable and consistent manner. If someone actually decided to develop SARS-CoV2 as a bio-weapon, that person needs to find a new job.

So there you have it: scientific evidence trumping conspiracy theories. Will all of these scientific findings finally quash the virus-was-made-in-a-lab-and-it-is-your-fault rhetoric between the politicians and on social media? Probably not. Since when has science stopped such political rhetoric. Maybe, though, it will get more people to focus on the much more important matter at hand: trying to control this pandemic together.

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Is COVID-19 Coronavirus A Bioweapon From A Lab? Here Is What Debunks This Theory - Forbes

At first blush, it seems like the coronavirus pandemic is shutting down the economy everywhere, equally, with frightening force and totality. In many respects, thats true: Across the country, consumer spendingwhich supports 70% of the economyis crashing in community after community, as people avoid stores, restaurants, movie theaters, offices, and other public places. Already, the layoffs have begun, with reports coming in from both big cities including Seattle and Atlanta as well as small heartland towns.

But as recession forecasts proliferate, its not necessarily true that all areas will be hit equally hard. In a huge nation made up of diverse places and varied local economies, a look at the geography of highly exposed industries makes clear that the economic toll of any coming recession will hit different regions in disparate, uneven ways.

To illustrate this, we mapped the employment geography of an array of industries vulnerable to disruption by virus-related demand declines, shutdowns, and layoffs.

To do this, we used an identification of the most at risk industry groups included in the recent (and quite dire) research note from Mark Zandi, chief economist at Moodys. Zandi composed a list of five especially vulnerable sectors: mining/oil and gas, transportation, employment services, travel arrangements, and leisure and hospitality. With this list in hand, we mapped those industries presence as a share of the economy within the nations various metropolitan areas.

Add the numbers up and the gargantuan scale of the current problem emerges. More than 24.2 million Americans work in the five high-risk sectors facing a sharp slowdown. This will likely prompt significant work disruptions, furloughs, and other uncertainties in the coming months.

But what do we find on a metro-area level? The most affected places are a whos who of energy towns and major resort, leisure, and amusement destinations across the nation.

The most exposed metro area nationwide is the oil-and-gas town of Midland, Texas, with 42% of its workforce in high-risk industries. Other major energy producers such as Odessa and Laredo, Texas as well as Houma-Thibodaux, La. also land in the top 10 most affected.

The numbers also underscore the massive size of the nations reeling leisure and hospitality sector. Kahului, Hawaii, Atlantic City, N.J., and Las Vegas all fall into the top five most recession-vulnerable metro areas, each with more than a third of their workforce in industries threatened by coronavirus-related uncertainties. Other noteworthy affected tourist destinations across the U.S. include Ocean City, N.J., Myrtle Beach, S.C., Flagstaff, Ariz., and the Gulf Coast of Mississippi and Alabama.

The same pattern holds across larger cities. Among the nations 100 largest metro areas, Las Vegas is most exposed, followed by Orlando, Fla., the theme park capital of the country. Rounding out the top five in this group are New Orleans, which has ties to both the energy and tourism/hospitality sectors, Honolulu, and Oklahoma City.

On the other end of the spectrum, the metro areas positioned to be least directly affected by COVID-19 are a diverse group consisting of older, manufacturing-heavy industrial cities, agricultural towns, and some already-distressed places. Agriculture communities Madera, Calif. and Yakima, Wash. are the two least exposed metro areas nationwide, with less than 10% of their workforce in affected industries. Elkhart-Goshen, Ind., the RV capital of the world, rounds out the top three, however its numbers may belie potential manufacturing sector exposure from increased automation, which tends to concentrate in economic downturns.

Among the 100 largest metro areas, the economically safest are mostly tech-oriented university towns. Provo, Utah is the least exposed, followed by Durham-Chapel Hill, N.C., Hartford, Conn., Albany, N.Y., and San Jose, Calif.

From these lists, we can see that the places most vulnerable to immediate, short-term economic shocks from COVID-19 are geographically varied, but with common industry themes. But because the variations are driven by the nations enormous leisure sector in particular, our map provides only an initial glance at which places are going to be affected. In the event that the pandemic tips the economy into a significant nationwide recession, very few places or industries will emerge unscathed. And if that happens, other large sectorsincluding construction, manufacturing, retail, education, and even the motion picture industrywill be affected regardless of geography.

This suggests an important takeaway for policymakers: While essentially all of America will likely be affected by COVID-19s economic effects, those effects will be distinct and varied from place-to-place. Given that, we must not only act quickly, but also attend to the unique regional and local impacts within this national crisis.

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The places a COVID-19 recession will likely hit hardest - Brookings Institution

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CHICAGO Gov. JB Pritzker announced the first COVID-19 related death in Illinois Tuesday.

"I'm deeply saddened to share the news that I have dreaded since the earliest days of this outbreak," Pritzker said at a news conference.

The Cook County Medical Examiner's office identified the patient as Patricia Frieson, 61, of Chicago. She died late Monday night at theUniversity of ChicagoMedicalCenter.

Pritzker said the woman did have an underlying health condition, but she was not a resident at a nursing home. She did have contact with another COVID-19

Illinois health officials reported 55 new cases of COVID-19 in the state Tuesday. In total, there are now 160 cases of COVID-19 in 15 Illinois counties. Cases have occurred in ages 9 to 91.

Late Tuesday, Pritzker activated 60 service members from the Illinois National Guard.

Among those new cases, Pritzker said testing revealed an outbreak among the residents and staff of a private long-term facility in DuPage County.

On Saturday, a woman at Chateau Nursing and Rehabilitation Center in Willowbrook tested positive for coronavirus, so all residents and staff were tested. Testing revealed 22 positive confirmed cases, including 18 residents and 4 staff members.

All of the individuals who have tested positive are now isolated at the facility or at a hospital, and visitors are now restricted, Pritzker said.

Some of the residents have been transferred to area hospitals

An employee who works on the eighth floor of the Dirksen Federal Courthouse has tested positive for COVID-19.

In a letter sent to building occupants Tuesday, U.S. District Chief Judge Rebecca Pallmeyer said she is not closing the building but that extensive cleaning is planned. The employee was last in the building Thursday.

Mayor Lori Lightfoot also confirmed a Chicago Fire Department paramedic tested positive for COVID-19 and is now quarantined, the first case among the city's first responders.

Chicago health officials said they do not believe the paramedic contracted the virus during a service call, and that they are doing well at home.

That individual's close contacts are in quarantine, and the city is sanitizing the station where this individual worked and screening employees there.

Pritzker put the heat on the federal government again, demanding a rapid increase in testing kits.

"I've requested, and now I'm demanding, the White House, FDA and CDC produce rapid increase in test deployment or get out of the way and allow us to obtain them elsewhere ourselves," he said.

Tuesday is the first day of school closures, as well as on-site dining at restaurants and bars. As far as the financial impact, Pritzker said there is a moratorium on utility bills, and he is working to expand medicaid and ease the requirements for WIC and SNAP food access.

He also issued a statewide economic injury declaration, allowing small business owners to apply for coronavirus assistance loans.

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Chicago woman becomes Illinois first COVID-19 related death; 160 total cases in the state - WGN TV Chicago

Someone with health insurance from their employer could pay $1,300 or more out of pocket for treatment if theyre hospitalized with a severe case of COVID-19, the disease caused by the novel coronavirus, according to one analysis. Health researchers based that prediction off of the costs associated with hospitalization for pneumonia.

The thought is, how we treat pneumonia is going to look at lot like how we treat the coronavirus, said Matthew Rae, associate director for the Program on the Health Care Marketplace at the Kaiser Family Foundation, who worked on the analysis. Both are respiratory illnesses.

Rae and his co-authors analyzed a database of insurance claims for people enrolled in employer insurance plans. They found that the total cost of treatments for people on those insurance plans who were hospitalized with severe pneumonia with complications was, on average, around $20,000 though it ranged from around $11,000 to around $24,000. Insurers covered most of that cost, but the out-of-pocket expense for most people usually reached or exceeded $1,300.

The analysis, though, only captured the costs associated with an insurance plan. It doesnt capture out-of-network billing charges, Rae says also known as surprise medical bills, which can happen when a doctor who isnt in a patients insurance network stops by to see the patient. Around 18 percent of people with severe pneumonia end up with a surprise medical bill.

The costs for pneumonia treatment may not map exactly onto the costs for COVID-19 treatment. It doesnt include the costs of protective equipment and isolation, for instance. Those things will make it more expensive, Rae says. Its hard to estimate those costs, he says, because there isnt much data in insurance claims databases that includes them.

This analysis would only apply to patients who are insured through employer plans, which tend to have low deductibles and be fairly generous. People insured with Affordable Care Act plans may face different out-of-pocket costs, Rae says. It could really range, he says. But I wouldnt say that it would be magnitudes different.

For people who arent insured, though, the cost could be significantly higher. Around 8 percent of people in the US dont have insurance.

Policies and legislation enacted in response to the pandemic might affect costs of COVID-19 treatments. Insurance companies agreed to waive co-pays for testing, and the bill currently before Congress includes free testing, regardless of insurance status. The White House originally said that insurance companies would cover the cost of treatment in full, but the insurance lobby clarified that they would not be doing so. The insurance companies also said there would not be surprise medical bills associated with COVID-19 treatment, but Rae says its not clear how that would work because those charges are made by hospitals and doctors.

Its all an open question, he says. Were just trying to take our best guess right now.

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People with insurance could pay over $1,300 for COVID-19 treatment - The Verge

Mayibout 2 is not a healthy place. The 150 or so people who live in the village, which sits on the south bank of the Ivindo River, deep in the great Minkebe Forest in northern Gabon, are used to occasional bouts of diseases such as malaria, dengue, yellow fever and sleeping sickness. Mostly they shrug them off.

But in January 1996, Ebola, a deadly virus then barely known to humans, unexpectedly spilled out of the forest in a wave of small epidemics. The disease killed 21 of 37 villagers who were reported to have been infected, including a number who had carried, skinned, chopped or eaten a chimpanzee from the nearby forest.

I travelled to Mayibout 2 in 2004 to investigate why deadly diseases new to humans were emerging from biodiversity hotspots such as tropical rainforests and bushmeat markets in African and Asian cities.

It took a day by canoe and then many hours along degraded forest logging roads, passing Baka villages and a small goldmine, to reach the village. There, I found traumatised people still fearful that the deadly virus, which kills up to 90% of the people it infects, would return.

Villagers told me how children had gone into the forest with dogs that had killed the chimp. They said that everyone who cooked or ate it got a terrible fever within a few hours. Some died immediately, while others were taken down the river to hospital. A few, like Nesto Bematsick, recovered. We used to love the forest, now we fear it, he told me. Many of Bematsicks family members died.

Only a decade or two ago it was widely thought that tropical forests and intact natural environments teeming with exotic wildlife threatened humans by harbouring the viruses and pathogens that lead to new diseases in humans such as Ebola, HIV and dengue.

But a number of researchers today think that it is actually humanitys destruction of biodiversity that creates the conditions for new viruses and diseases such as Covid-19, the viral disease that emerged in China in December 2019, to arise with profound health and economic impacts in rich and poor countries alike. In fact, a new discipline, planetary health, is emerging that focuses on the increasingly visible connections between the wellbeing of humans, other living things and entire ecosystems.

Is it possible, then, that it was human activity, such as road building, mining, hunting and logging, that triggered the Ebola epidemics in Mayibout 2 and elsewhere in the 1990s and that is unleashing new terrors today?

We invade tropical forests and other wild landscapes, which harbour so many species of animals and plants and within those creatures, so many unknown viruses, David Quammen, author of Spillover: Animal Infections and the Next Pandemic, recently wrote in the New York Times. We cut the trees; we kill the animals or cage them and send them to markets. We disrupt ecosystems, and we shake viruses loose from their natural hosts. When that happens, they need a new host. Often, we are it.

Research suggests that outbreaks of animal-borne and other infectious diseases such as Ebola, Sars, bird flu and now Covid-19, caused by a novel coronavirus, are on the rise. Pathogens are crossing from animals to humans, and many are able to spread quickly to new places. The US Centers for Disease Control and Prevention (CDC) estimates that three-quarters of new or emerging diseases that infect humans originate in animals.

Some, like rabies and plague, crossed from animals centuries ago. Others, such as Marburg, which is thought to be transmitted by bats, are still rare. A few, like Covid-19, which emerged last year in Wuhan, China, and Mers, which is linked to camels in the Middle East, are new to humans and spreading globally.

Other diseases that have crossed into humans include Lassa fever, which was first identified in 1969 in Nigeria; Nipah from Malaysia; and Sars from China, which killed more than 700 people and travelled to 30 countries in 200203. Some, like Zika and West Nile virus, which emerged in Africa, have mutated and become established on other continents.

Kate Jones, chair of ecology and biodiversity at UCL, calls emerging animal-borne infectious diseases an increasing and very significant threat to global health, security and economies.

In 2008, Jones and a team of researchers identified 335 diseases that emerged between 1960 and 2004, at least 60% of which came from animals.

Increasingly, says Jones, these zoonotic diseases are linked to environmental change and human behaviour. The disruption of pristine forests driven by logging, mining, road building through remote places, rapid urbanisation and population growth is bringing people into closer contact with animal species they may never have been near before, she says.

The resulting transmission of disease from wildlife to humans, she says, is now a hidden cost of human economic development. There are just so many more of us, in every environment. We are going into largely undisturbed places and being exposed more and more. We are creating habitats where viruses are transmitted more easily, and then we are surprised that we have new ones.

Jones studies how changes in land use contribute to the risk. We are researching how species in degraded habitats are likely to carry more viruses which can infect humans, she says. Simpler systems get an amplification effect. Destroy landscapes, and the species you are left with are the ones humans get the diseases from.

There are countless pathogens out there continuing to evolve which at some point could pose a threat to humans, says Eric Fevre, chair of veterinary infectious diseases at the University of Liverpools Institute of Infection and Global Health. The risk [of pathogens jumping from animals to humans] has always been there.

The difference between now and a few decades ago, Fevre says, is that diseases are likely to spring up in both urban and natural environments. We have created densely packed populations where alongside us are bats and rodents and birds, pets and other living things. That creates intense interaction and opportunities for things to move from species to species, he says.

Pathogens do not respect species boundaries, says disease ecologist Thomas Gillespie, an associate professor in Emory Universitys department of environmental sciences, who studies how shrinking natural habitats and changing behaviour add to the risk of diseases spilling over from animals to humans.

I am not at all surprised about the coronavirus outbreak, he says. The majority of pathogens are still to be discovered. We are at the very tip of the iceberg.

Humans, says Gillespie, are creating the conditions for the spread of diseases by reducing the natural barriers between host animals in which the virus is naturally circulating and themselves. We fully expect the arrival of pandemic influenza; we can expect large-scale human mortalities; we can expect other pathogens with other impacts. A disease like Ebola is not easily spread. But something with a mortality rate of Ebola spread by something like measles would be catastrophic, Gillespie says.

Wildlife everywhere is being put under more stress, he says. Major landscape changes are causing animals to lose habitats, which means species become crowded together and also come into greater contact with humans. Species that survive change are now moving and mixing with different animals and with humans.

Gillespie sees this in the US, where suburbs fragment forests and raise the risk of humans contracting Lyme disease. Altering the ecosystem affects the complex cycle of the Lyme pathogen. People living close by are more likely to get bitten by a tick carrying Lyme bacteria, he says.

Yet human health research seldom considers the surrounding natural ecosystems, says Richard Ostfeld, distinguished senior scientist at the Cary Institute of Ecosystem Studies in Millbrook, New York. He and others are developing the emerging discipline of planetary health, which looks at the links between human and ecosystem health.

Theres misapprehension among scientists and the public that natural ecosystems are the source of threats to ourselves. Its a mistake. Nature poses threats, it is true, but its human activities that do the real damage. The health risks in a natural environment can be made much worse when we interfere with it, he says.

Ostfeld points to rats and bats, which are strongly linked with the direct and indirect spread of zoonotic diseases. Rodents and some bats thrive when we disrupt natural habitats. They are the most likely to promote transmissions [of pathogens]. The more we disturb the forests and habitats the more danger we are in, he says.

Felicia Keesing, professor of biology at Bard College, New York, studies how environmental changes influence the probability that humans will be exposed to infectious diseases. When we erode biodiversity, we see a proliferation of the species most likely to transmit new diseases to us, but theres also good evidence that those same species are the best hosts for existing diseases, she wrote in an email to Ensia, the nonprofit media outlet that reports on our changing planet.

Disease ecologists argue that viruses and other pathogens are also likely to move from animals to humans in the many informal markets that have sprung up to provide fresh meat to fast-growing urban populations around the world. Here, animals are slaughtered, cut up and sold on the spot.

The wet market (one that sells fresh produce and meat) in Wuhan, thought by the Chinese government to be the starting point of the current Covid-19 pandemic, was known to sell numerous wild animals, including live wolf pups, salamanders, crocodiles, scorpions, rats, squirrels, foxes, civets and turtles.

Equally, urban markets in west and central Africa sell monkeys, bats, rats, and dozens of species of bird, mammal, insect and rodent slaughtered and sold close to open refuse dumps and with no drainage.

Wet markets make a perfect storm for cross-species transmission of pathogens, says Gillespie. Whenever you have novel interactions with a range of species in one place, whether that is in a natural environment like a forest or a wet market, you can have a spillover event.

The Wuhan market, along with others that sell live animals, has been shut by the Chinese authorities, and last month Beijing outlawed the trading and eating of wild animals except for fish and seafood. But bans on live animals being sold in urban areas or informal markets are not the answer, say some scientists.

The wet market in Lagos is notorious. Its like a nuclear bomb waiting to happen. But its not fair to demonise places which do not have fridges. These traditional markets provide much of the food for Africa and Asia, says Jones.

These markets are essential sources of food for hundreds of millions of poor people, and getting rid of them is impossible, says Delia Grace, a senior epidemiologist and veterinarian with the International Livestock Research Institute, which is based in Nairobi, Kenya. She argues that bans force traders underground, where they may pay less attention to hygiene.

Fevre and colleague Cecilia Tacoli, principal researcher in the human settlements research group at the International Institute of Environment and Development (IIED), argue in a blog post that rather than pointing the finger at wet markets, we should look at the burgeoning trade in wild animals.

It is wild animals rather than farmed animals that are the natural hosts of many viruses, they write. Wet markets are considered part of the informal food trade that is often blamed for contributing to spreading disease. But evidence shows the link between informal markets and disease is not always so clear cut.

So what, if anything, can we do about all of this?

Jones says that change must come from both rich and poor societies. Demand for wood, minerals and resources from the global north leads to the degraded landscapes and ecological disruption that drives disease, she says. We must think about global biosecurity, find the weak points and bolster the provision of health care in developing countries. Otherwise we can expect more of the same, she adds.

The risks are greater now. They were always present and have been there for generations. It is our interactions with that risk which must be changed, says Brian Bird, a research virologist at the University of California, Davis School of Veterinary Medicine One Health Institute, where he leads Ebola-related surveillance activities in Sierra Leone and elsewhere.

We are in an era now of chronic emergency, Bird says. Diseases are more likely to travel further and faster than before, which means we must be faster in our responses. It needs investments, change in human behaviour, and it means we must listen to people at community levels.

Getting the message about pathogens and disease to hunters, loggers, market traders and consumers is key, Bird says. These spillovers start with one or two people. The solutions start with education and awareness. We must make people aware things are different now. I have learned from working in Sierra Leone with Ebola-affected people that local communities have the hunger and desire to have information, he says. They want to know what to do. They want to learn.

Fevre and Tacoli advocate rethinking urban infrastructure, particularly within low-income and informal settlements. Short-term efforts are focused on containing the spread of infection, they write. The longer term given that new infectious diseases will likely continue to spread rapidly into and within cities calls for an overhaul of current approaches to urban planning and development.

The bottom line, Bird says, is to be prepared. We cant predict where the next pandemic will come from, so we need mitigation plans to take into account the worst possible scenarios, he says. The only certain thing is that the next one will certainly come.

This piece is jointly published with Ensia

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'Tip of the iceberg': is our destruction of nature responsible for Covid-19? - The Guardian

By ClarksvilleNow.com March 16, 2020 3:57 pm

NASHVILLE, Tenn. (CLARKSVILLENOW) The Tennessee Department of Health is now reporting 52 confirmed cases of coronavirus (COVID-19) in the state. The number of cases in Davidson and Williamson County continues to increase. There are still no reported cases in Montgomery County.

Campbell 1 (note: For those who may be un-aware there is a county in Tennessee named Campbell County)Davidson 25Hamilton 1Jefferson 1Knox 1Rutherford 1Sevier 1Shelby 2Sullivan 1Williamson 18

Governor Lee has asked all Tennessee schools to close as soon as possible. (Read more) Practicing social distancing is one way the CDC has recommended limiting the spread of the virus.

In response, ,any retailers have begun to limit their hours and events have been postponed to decrease large gatherings.

The Tennessee Department of Health has now released additional information regarding individuals who have contracted the virus.

Age Range | Number of CaseNull 235-18 years old 119 30 years old 631 40 years old 341 50 years old 1151 64 years old 565+ years old 2

The Centers for Disease Control continues to remind all Americans that proper hygiene and good judgement will help to combat the spread of the virus.

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COVID 19: Tennessee confirmed cases reaches 52, Dept of Health releases age ranges of those infected - Clarksville Now

Housing associations are under pressure to offer rent holidays after only one pledged not to evict any tenant in arrears due to self-isolating because of the coronavirus.

Millions of people live in 2.4m homes let by housing associations across England, Scotland and Wales. Rents are expected to rise by 2.7% from next month and there are fears many people will be unable to pay after losing work or due to being in self-isolation.

The Labour party has urged the government to ban the eviction of tenants whose income has been hit by the outbreak and to allow rent deferrals. On Tuesday, the government said homeowners in financial difficulty due to coronavirus would be offered a three-month mortgage holiday.

However, those who live in housing association accommodation are more likely to work in the gig economy or have precarious contracts, with some out of work because of the impact of the pandemic.

Research by the homeless charity Crisis suggests there were more than 25,000 households evicted from housing associations in 2018, the lowest level since 2000, after a gradual exclusion of the poorest tenants from newly available properties.

The Guardian contacted scores of housing associations some of which describe themselves as companies with a heart but only one confirmed it would introduce measures to prevent the evictions of those who could not pay their bills because of Covid-19.

We will stay in regular contact and not initiate any action for rent arrears while they are experiencing difficulties as a result of the virus, said Sarah Sargent from Radian Group, which has 80,000 tenants across south and south-west England.

Our goal is always for our customers to maintain their tenancies and our tenancy sustainment team already provide support to customers.

Other large housing associations said they relied on rental income but were monitoring the situation closely amid business continuity planning, while others said they rarely evicted people.

Symptoms are defined as either:

NHS advice is that anyone with symptoms shouldstay 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.

After 14 days, anyone you live with who does not have symptoms can return to their normal routine. But, if anyone in your home gets symptoms, they should stay at home for 7 days from the day their symptoms start.Even if it means they're at home for longer than 14 days.

Information: If you live with someone who is 70 or over, has a long-term condition, is pregnant or has a weakened immune system, try to find somewhere else for them to stay for 14 days.

If you have to stay at home together, try to keep away from each other as much as possible.

After 7 days, if you no longer have a high temperature you can return to your normal routine.

If you still have a high temperature, stay at home until your temperature returns to normal.

If you still have a cough after 7 days, but your temperature is normal, you do not need to continue staying at home. A cough can last for several weeks after the infection has gone.

Source:NHS Englandon 18 March 2020

A source with knowledge of discussions between housing associations regarding the scheduled rent increase said events were developing quickly and there was a concern people would not be able to pay rents at all. In 2017, the UKs housing associations made record operating profits of 3.5bn.

Crisis called on the government to ensure renters were not put at greater risk of eviction and homelessness.

Crisis is calling for a temporary suspension of evictions of both social and private tenants, said Matt Downie the charitys policy director. We are already seeing other countries implement such measures and urge the UK to take similar action as a matter of urgency.

We would expect all social landlords to adopt the practice of the best, and ensure tenants who experience loss of earnings because of the pandemic are supported so that they are not at risk of homelessness.

The G15 housing associations, which are responsible for about 600,000 homes in London, welcomed the extension of statutory sick pay 94 a week to include people advised to self-isolate because of Covid-19 and urged those ineligible to claim universal credit or employment support allowance.

We are continuing our rent collection processes as normal, which include significant support for tenants experiencing hardship for whatever reason, a spokesperson said. G15 housing associations only use evictions in the absolute last resort.

Chyrel Brown, the chief operating officer at One Housing, said: We will continue to collect rents as we rely on this income to deliver essential services. We always offer advice and support to residents who find it difficult to pay their rent and will continue to offer this vital support.

Simon Nunn, an executive director at the National Housing Federation, said: As charitable organisations [housing associations] are set up to support vulnerable residents and this includes helping those who may struggle financially by providing advice, help with budgeting and access to benefits.

Many are working to put additional measures in place to support residents that may fall into rent arrears to get back on their feet.

Link:

Housing associations under pressure to offer Covid-19 rent holidays - The Guardian

There have now been 11 coronavirus-related deaths in California. Among the people who have died is a woman who was a substitute teacher in the Sacramento City Unified School District. The woman was identified as Gayle Alexis. KCRA3 reached out to her family, but they are not ready to speak publicly. Longtime friend Carolyn Tillman said Alexis was also an active member at Faith Presbyterian Church in Sacramento's Pocket neighborhood.The minister sent out an email Sunday evening," Tillman said. She was cheerful, upbeat, loved children -- a joy to be around -- and will just really be missed because of her positive attitude about life and the fact that she helped me with a childrens choir for quite a few years, (which) was just a real positive thing for me." Tillman said the two knew each other for more than 20 years at church, and that Alexis retired from Matsuyama Elementary in Sacramento and then continued as a substitute teacher.She certainly didnt need it for the income -- she did it because she loved children," Tillman said. "And she was doing it, at times I think, to help out a friend. Because she enjoyed the classroom and was good in the classroom. Although Sacramento City Unified would not directly confirm the identity of the substitute teacher who died, in a statement it said it became aware Wednesday of an individual who worked in a Sutterville Elementary classroom as a temporary volunteer. The district said a substitute teacher in February had tested positive for COVID-19. The school was disinfected immediately after the district was notified. On the churchs website, the pastor said that as of Saturday, five members of the church have tested positive for COVID-19 and that others were symptomatic, awaiting testing results. "To date, there have been a small number of confirmed positive cases in the congregation. Sadly, one of those has died," Faith Presbyterian Church said in a statement to KCRA3. "On March 12, Faith Presbyterian Church staff discovered that a small number of church members were displaying symptoms potentially associated with COVID-19. That evening, the church leadership met and made the immediate decision to close the church facility on Florin Road to prevent spread of the virus in our congregation and community."The church added it is closed until at least April 3. Its dismaying that testing is still so limited because based on those five (people), that probably every active church member should be tested," Tillman said. "Because who knows? I could be a carrier. So it would probably be reassuring to know that I am not carrying it, and therefore I am not risking my grandchildren carrying it to somebody else.

There have now been 11 coronavirus-related deaths in California. Among the people who have died is a woman who was a substitute teacher in the Sacramento City Unified School District.

The woman was identified as Gayle Alexis. KCRA3 reached out to her family, but they are not ready to speak publicly.

Longtime friend Carolyn Tillman said Alexis was also an active member at Faith Presbyterian Church in Sacramento's Pocket neighborhood.

The minister sent out an email Sunday evening," Tillman said. She was cheerful, upbeat, loved children -- a joy to be around -- and will just really be missed because of her positive attitude about life and the fact that she helped me with a childrens choir for quite a few years, (which) was just a real positive thing for me."

Tillman said the two knew each other for more than 20 years at church, and that Alexis retired from Matsuyama Elementary in Sacramento and then continued as a substitute teacher.

Courtesy of Carolyn Tillman

She certainly didnt need it for the income -- she did it because she loved children," Tillman said. "And she was doing it, at times I think, to help out a friend. Because she enjoyed the classroom and was good in the classroom.

Although Sacramento City Unified would not directly confirm the identity of the substitute teacher who died, in a statement it said it became aware Wednesday of an individual who worked in a Sutterville Elementary classroom as a temporary volunteer. The district said a substitute teacher in February had tested positive for COVID-19. The school was disinfected immediately after the district was notified.

On the churchs website, the pastor said that as of Saturday, five members of the church have tested positive for COVID-19 and that others were symptomatic, awaiting testing results.

"To date, there have been a small number of confirmed positive cases in the congregation. Sadly, one of those has died," Faith Presbyterian Church said in a statement to KCRA3. "On March 12, Faith Presbyterian Church staff discovered that a small number of church members were displaying symptoms potentially associated with COVID-19. That evening, the church leadership met and made the immediate decision to close the church facility on Florin Road to prevent spread of the virus in our congregation and community."

The church added it is closed until at least April 3.

Its dismaying that testing is still so limited because based on those five (people), that probably every active church member should be tested," Tillman said. "Because who knows? I could be a carrier. So it would probably be reassuring to know that I am not carrying it, and therefore I am not risking my grandchildren carrying it to somebody else.

View original post here:

Sacramento woman dead from COVID-19 attended church with others who have virus - KCRA Sacramento

Mark Gallagher, a consultant cardiologist, is at home with a temperature of 38 and is pretty certain he has Covid-19. But the NHS will not test him for it. Instead, he has paid for a test kit from a private UK clinic and a colleague in China is sending him another.

Gallagher has been in and out of his London hospital every day for the last 28 in a row. In the past couple of weeks he saw maybe 70 people in outpatients, he said.

He cannot understand why the NHS will not test him or other healthcare workers who are put at risk by their work and risk infecting other vulnerable patients in turn, as well as their families. The policy is that I dont need to be tested and even the people who have been in contact with me arent going to be tested, he said.

They are abandoning the basic principles for dealing with an epidemic, which are to test whenever possible, trace contacts and contain. Almost all individual physicians I know feel that what they are doing is wrong.

Last week, a woman of 79 was admitted to his care for an elective, non-urgent procedure. She was then diagnosed with Covid-19, which, he says, she almost certainly acquired on our wards. She was put on a ventilator but died on Monday night.

Im sure she will go down as an elderly patient with underlying conditions, but she should have lived to 90, he said. Approximately 50 nurses dealt with her and many doctors. None has been tested. All are still at work.

Gallagher says he needs to know whether he has Covid-19. Of the colleague in China who is sending him a test kit, he says: He runs a similar unit to ours. They had to shut half the hospital for six weeks and make it a Covid-19 hospital, but for the last two weeks they are up pretty much as normal.

Except, he says, that every patient scheduled to come in is tested first for Covid-19. If the test is negative as these days it usually is they will be admitted after a second negative test on arrival. They went through a total lockdown and they tested and tracked the contacts of every single suspected case and tested them as well. Thats how you kill an epidemic, he said.

Although the self-isolation policies announced by the prime minister on Monday were a slight improvement, Gallagher feels they are not enough. It could be eliminated if we worked really hard, but there is a policy of surrender, he said.

Our in-house occupational health and infection control teams are competent and hard-working and the infection control people have been at excellent and brave, circulating on the affected wards, he said.

The problem is the instructions coming out of Public Health England and the government, which is attempting to control the UK epidemic by mathematical modelling.

Any such model is only as good as the input data, and the data going into this one are not necessarily applicable to the UK being based on countries with very different behaviour patterns, he said. They are also solely intended to flatten the curve, when even a flat curve will kill thousands. These approaches would be an acceptable experiment if there were no alternatives but we have strategies from elsewhere that have been shown to work.

We should be learning the lessons, he says, from the sharp lockdown in Hubei and the very energetic contact tracing that has taken place in South Korea, Hong Kong and Singapore. The approach of the UK falls far short of that.

The rest is here:

There is a policy of surrender: doctor on UKs Covid-19 failures - The Guardian