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  1. COVID-19 anxiety taking a toll? There’s a subreddit for that Reddit might not be reliable for COVID-19 information, but it could be the internet’s best support group COVID-19 is all anyone can talk about in real life, which means it’s all anyone can talk about on the internet, which means it’s all anyone is discussing on Reddit. There’s r/Coronavirus (1.4 million members), r/Covid19 (101,000 members), and the racist-ly named r/China_flu (101,000 members, disappointingly). These subreddits have quickly been overflowed with people seeking news about how the pandemic has thrown world economies and health care systems into collapse. They exist to disseminate information — and of course, are victim to misinformation. But there’s one much smaller, more intimate COVID-19 subreddit — Covid19_support, which boasts only 11,900 members — that is doing something different. The service it provides Reddit users is not one of news and information, but emotional support. One post in the r/Covid19_support group asked if anyone else had trouble going grocery shopping for fear of being sick, with one user responding, “I’m not so worried I’ll get the virus, I think just seeing shelves empty or a ton of people buying it will stress me out.” Others replied with worries for workers who have been deemed “essential.” Many of the posts focus on a topic that concerns many people. What about our parents and grandparents? People are having to make the difficult decision to isolate from family during a period that you want to be with them more than ever. Luckily, on r/Covid19_support, members are not alone in this struggle. Governments around the world have laid out varying instructions on how to mitigate the spread of COVID-19 which, for many people, has meant staying at home. But there’s been little direction on how to actually live through a pandemic. How does one reckon with quarantine life? What about those with mental health issues strained by isolation? How about the self-quarantining individuals who are navigating symptoms but are not in need of immediate hospitalization — who is speaking to them? As people spend more time inside the house globally, those with the privilege of having access to a phone or a computer with a clear Wi-Fi signal can try to find support for the varied problems that inevitably come with staying put, avoiding illness, or simply attempting to navigate the financial hardship that has already hit many working class people. r/Covid19_support also offers a space for those who have been let down the most by our systems — those who may not be guaranteed sick leave and can’t work from home — to seek some sort of advice on how to handle the realities they face. One member with asthma (and elderly parents) posted about having to leave work early because co-workers were joking about “survival of the fittest” and they couldn’t take it anymore. “I do think people need online forums more as the outbreak goes on, though,” moderator u/JenniferColeRhuk tells The Verge. “They want to ask questions that are very specific to them and to their situation, which aren’t going to be easily answered by FAQs or government advice. Or they see something they don’t quite understand and want someone to clarify it for them.” Unlike most subreddits, which are a free-for-all, r/Covid19_support has strict rules about who can post. It’s not that they want to censor the way people cope with the crisis, but moderators are attempting to make the community “troll-proof.” u/JenniferColeRhuk considers this paramount when “you’ve got people who are looking for reassurance and support” in creating a space for people to feel their emotions freely about a grim reality. The subreddit requires only a little moderation for misinformation, since most users are sharing their personal stories, not news. Naturally, the moderators come down the hardest on things that are emotional. u/JenniferColeRhuk explains there is zero tolerance for redditors who don’t show other users support, especially if they’re provoking others. People can get banned for telling someone to “get a grip.” r/Covid19_support originated out of a post in r/Coronavirus by u/thatreddittherapist inquiring what everyone was doing for their mental health. That idea got picked up by u/JenniferColeRhuk, so the two of them created r/Covid19_support. “[The] main difference from the other COVID-19 subs is that it’s mainly self-posts from people who are struggling with various aspects of the outbreak — worried about their friends and family, or their own health, or what will happen to their jobs,” u/JenniferColeRhuk says. Those realities are existential. Members of the subreddit, like the rest of the world, brace for the “new normal” as we look onward at a pandemic that has yet to be contained, an economy collapsing, and a global workforce no longer able to work. Internet access has become an indisputable necessity as many people socially distance in their homes or nervously await news of what is to come as they journey to their jobs, risking illness to be able to pay their rent. Subreddits such as r/Covid19_support will continue to be more important as this pandemic tolls on. As the world awaits what is to come, there is some solace to be found in anonymous strangers on the internet sharing that they too miss their parents, that they also can’t handle the boredom with their ADHD, and that they as well have struggled with layoffs due to the virus. There is an understanding hand of humanity reaching out in a latex glove to give you a pat on the back. Having been in my own house for eight days, I’ve often visited r/Covid19_support to find some sort of relief for the various stresses that this has brought on. I scroll the subreddit as I stress about whether there will actually be a rent freeze, as I wait for phone calls from home about my family members getting sick because they’re in jobs deemed “essential,” as the boredom only heightens all of my anxieties. Until the pandemic is over, whenever that is, r/Covid19_support may be one of the many ways that people are trying to cope with the crisis, together and alone in our bedrooms. Source: COVID-19 anxiety taking a toll? There’s a subreddit for that (The Verge)
  2. What Coronavirus Isolation Could Do to Your Mind (and Body) Social distancing can lead to adverse psychological and physiological effects. But there are things you can do to maintain your overall health. Photograph: Klaus Vedfelt/Getty Images By now, you may have noticed a divide among your friends. As social distancing and self-imposed quarantine wear on and more workplaces urge employees to avoid the office, the Covid-19 outbreak has left many people more alone than they’ve been in a long time, or ever. Some are responding by hunkering down into cozy domesticity: baking bread, reading books, taking long baths. Others have begun to fray: FaceTiming with friends is a necessity, not a luxury; the closure of a favorite coffee shop is cause for tears; the walls seem to be closing in. Be kind to your local extroverts. They’re having a hard time. Still, no matter how hygge you’re feeling at this moment, experts suggest that the negative feelings and experiences associated with prolonged isolation will come for us all. Humans are social creatures—yes, all of us. While the coronavirus pandemic is an extreme, largely unprecedented moment, the kind of seclusion that’s been eating at people over the last few weeks is not as uncommon an experience as you might imagine. The impacts of social isolation on our bodies and minds have been felt and studied in a variety of different groups, from astronauts to incarcerated people to immunocompromised children to Antarctic researchers to the elderly. The patterns that have emerged from their experiences with radical aloneness illuminate ways to understand and improve your own. First off, it’s important to remember that isolation doesn’t just numb your brain with boredom. “People start getting lethargic when they don’t have positive inputs into their small worlds,” says John Vincent, a clinical psychologist at the University of Houston. “We can expect depression to kick in, and depression and anxiety are kissing cousins.” These symptoms are likely to be particularly intense during coronavirus-related isolation, according to Lawrence Palinkas, who researches psychosocial adaptation to extreme environments at the University of Southern California. “Oftentimes, if you have a very well defined period of time in which you’re isolated people do pretty well up until the halfway point,” Palinkas says. “Then they experience a let down. But when you’re in a situation like we are now, when you’re not certain how long you’ll be asked to maintain social distance, that produces anxiety as well.” When people, like those kept in solitary confinement or scientists working in a remote region, know their sentence is nearly up, their mood lifts again in anticipation. Those practicing social distancing due to Covid-19 may not get that any time soon. “Open, transparent, consistent communication is the most important thing governments and organizations can do: Make sure people understand why they are being quarantined first and foremost, how long it is expected to last,” says Samantha Brooks, who has studied the psychological impact of quarantine at King’s College London. “A huge factor in the negative psychological impact seems to be confusion about what's going on, not having clear guidelines, or getting different messages from different organizations.” So far, many governments, including the United States’, haven’t been heeding this advice. Perhaps even more concerning is that the psychological strain of loneliness manifests physiologically, too. Harry Taylor, who studies social isolation in older adults, particularly in the black community, says that it’s one of the worst things that humans can do to their overall well-being, adding that “the mortality effect of social isolation is like smoking 15 cigarettes per day.” In older people, social isolation seems to exacerbate any preexisting medical conditions, from cardiovascular diseases to Alzheimer’s, but its ill effects aren’t limited to those over 60. Alexander Chouker, a physician researcher who studies stress immunology at the University of Munich, has seen radical changes in the bodies of people participating in simulations of manned spaceflight missions like Mars-500. “They were young and trained people not in a condition of real threat,” he says. “The pure fact of being confined affects the body. If you change your environment in a quite extreme way, it is changing you.” Participants, some of whom were only isolated for three months, experienced changes to their sleep, changes to their immune, endocrine, and neurocognitive systems, and alterations to their metabolisms. “Being confined and isolated affects the human physiology as a whole,” Chouker says. Does this mean your body will go wonky like an astronaut trapped on fake Mars for over a year? Not necessarily. You probably aren’t truly socially isolated, at least not to that extreme degree. And even those who study the negative consequences of social isolation still think practicing social distancing is a good idea. “Covid-19 is flipping everything on its head,” Taylor says. “This is the first time since we have been alive that actively practicing social isolation is a method to improve health.” The people who are most at risk from the isolation associated with Covid-19 are the people who are at heightened risk of social isolation in the first place. “Among older adults, lower income people and men experience isolation at a different level,” says Thomas Cudjoe, a geriatrician researching the intersection of social connections and aging at Johns Hopkins University. (In both cases, Cudjoe says that a lack of time or inclination to develop social ties outside of work creates the disparity between those groups and their female or higher income counterparts.) Taylor points out that anyone who is marginalized is more likely to have a more limited social network, whether they are a member of the LGBTQ+ community, a survivor of domestic abuse, or just live in a more isolated rural area. These people may not have friends or family to call, or may be unable to do so. “Some people have posited technology as a means of connecting people, but lower income groups might not even have FaceTime or Skype or minutes on their phone,” Cudjoe says. “People take that for granted, using their devices can be a strain on people’s incomes.” Particularly if Covid-19 has left them out of a job. “Minority bodies are going to be hit particularly hard because they often work in service industries, which increases risk for social isolation and loneliness and coronavirus,” says Taylor. “It could create an economic and social recession.” No matter what your unique situation is, there are many things you can do to improve your experience while being socially isolated. Chouker and others recommend exercise as a mood boost. “Create as much structure and predictability as you can with the pieces of your life that you do have control over,” Vincent says. Pursue neglected projects, get on with life, but also be patient with yourself—both now and when this strange time eventually ends. People who go through a period of isolation, whether they’ve been on the International Space Station or in quarantine, often experience PTSD symptoms and struggle while reintegrating back into their ordinary routine. Social isolation may gradually become your normal, and losing it may still be a jolt. Fortunately, you’re not in this alone, and you shouldn’t leave others that way, either. “For the general public who are not isolated, think about those people who were in your network that you haven’t heard from in a while, and give them a call or write a letter,” Cudjoe says. “Strengthen those weak connections.” With any luck, you’ll emerge from social distancing a whole lot closer. WIRED is providing unlimited free access to stories about the coronavirus pandemic. Sign up for our Coronavirus Update to get the latest in your inbox. Source: What Coronavirus Isolation Could Do to Your Mind (and Body)
  3. The Covid-19 Pandemic Is a Crisis That Robots Were Built For Robots can help doctors distance from patients, and help those in isolation cope. But getting the machines into hospitals is fraught with difficulties. An engineering student configures a robot modified to screen and observe COVID-19 patients. A group of roboticists is today calling for the field to fast-track development of such medical machines.Photograph: Lillian Suwanrumpha/Getty Images We humans weren’t ready for the novel coronavirus—and neither were the machines. The pandemic has come at an awkward time, technologically speaking. Ever more sophisticated robots and AI are augmenting human workers, rather than replacing them entirely. While it would be nice if we could protect doctors and nurses by turning more tasks over to robots, medicine is particularly hard to automate. It’s fundamentally human, requiring fine motor skills, compassion, and quick life-and-death decision-making we wouldn’t want to leave to machines. But this pandemic is a unique opportunity to jumpstart the development of medical robot technologies, argue a dozen roboticists in an editorial out today in the journal Science Robotics. Perhaps “people start to reflect that for situations such as this, how robots can be used not only to help with in terms of social distancing, but also that can be used for increasing social interaction,” said Guang-Zhong Yang, founding editor of the journal, during a press conference. The editorial serves as a call to arms for more research. “Robotics and automation could play a major role in combating infectious diseases, such as COVID-19,” Yang and his fellow editors write in their piece. In particular, they argue: “Robots have the potential to be deployed for disinfection, delivering medications and food, measuring vital signs, and assisting border controls. As epidemics escalate, the potential roles of robotics are becoming increasingly clear.” Additionally, robots could enable a form of telemedicine that would keep humans out of areas of contagion. “COVID-19 could be a catalyst for developing robotic systems that can be rapidly deployed with remote access by experts and essential service providers without the need of traveling to front lines,” they write. A cruel irony of the coronavirus pandemic is that medical professionals know better than anyone that social distancing is critical for slowing the rate of new infections, yet they’re forced to be the closest to the disease. And those that need social interaction perhaps more than anybody—the elderly—are the ones who need to isolate the most, as they’re the most susceptible to the disease. But if machines can help care for patients, it’s less likely that human caregivers will themselves get infected. Autonomous robots, for instance, can roam rooms, disinfecting surfaces with UV light. Or they can deliver supplies, as a robot named Tug is already doing. Smarter AI can help diagnose people with Covid-19, and the article’s authors suggest that engineers might develop mobile robots to perform simple tasks like taking a patient’s temperature. This could all go a long way to lightening the burden on human health care providers and helping them keep their distance from the infected. That could help stave off future bottlenecks, in which so many workers are ill or quarantined after potential exposure that hospital staff cannot adequately care for incoming patients. There’s plenty of precedent for machines helping humans do their jobs, notes MIT roboticist Kate Darling, who wasn’t involved in the editorial. “ATMs allowed banks to expand teller services,” she says. “Bomb disposal robots let soldiers keep more distance between themselves and danger. There are cases where automation will replace people, but the true potential of robotics is in supplementing our skills. We should stop trying to replace and start thinking more creatively about how to use technology to achieve our goals.” It’s not hard to imagine a future in which delivery robots bring food and supplies to quarantined people’s homes, preventing delivery workers from potentially infecting them. Quarantined folks are already keeping in touch with friends and relatives via Zoom and FaceTime, but social robots could also keep people company in the absence of human peers. The telepresence robot, often something as simple as a screen on wheels, has begun appearing in nursing homes to help family members connect with otherwise isolated elders. In hospitals, such robots could “teleport” a specialist doctor in London to a patient in San Francisco. Still, you’d be hard-pressed to find a more sensitive interaction between humans than the doctor-patient relationship, and this has remained a thorny problem in hospital robotics. A doctor has to keep people alive, but also keep them well, empathizing in a particularly difficult time. Robots don’t do empathy. How well a robot can tackle a health worker’s task depends, in some measure, on whether it’s replacing that human interaction, or simply channeling it. “It does depend on: Is the robot acting as a medium for a doctor or another healthcare provider or professional? Or is the robot in itself supposed to be running some sort of task?” asks Julie Carpenter, a roboticist and research fellow at the Ethics and Emerging Sciences Group at Cal Poly San Luis Obispo, who wasn’t involved in the new paper. “Certainly making them less threatening to people is important.” Take that Tug robot, for example. It’s more or less a rolling box that autonomously roams hospital corridors. It tells you in a friendly voice if it’s waiting for an elevator, and some hospitals even dress it up in costumes for the kids. Robots need to balance functionality and the patient experience. “For example, a robot may need to be very big in order to lift a patient, but then its sheer size can be intimidating,” says Carpenter. “Mitigating someone's psychological stress should absolutely be a significant and thoughtful part of designing robots, especially in caregiving scenarios.” Engineers also have to consider their hospital worker users when designing medical robots—which they haven’t really been doing up to this point. “They’re designed by engineers, for engineers,” says Henrik Christensen, the director of the UC San Diego Contextual Robotics Institute and a coauthor on the editorial. Nurses and doctors are already stressed and strapped for time. If you tell them it’ll take two hours to teach them to use a robot, “then you've already lost them,” Christensen adds. “We're not good enough today at designing robots that are truly fluent.” One of the bolder ideas to come out of the Science Robotics press conference was a competition for medical robots. Darpa famously ran a robotics competition in 2015 that pitted humanoid machines against one another, greatly furthering research in robot autonomy. Now Darpa is running another challenge for robots to navigate underground environments. (Not to mention the Darpa Grand Challenge, which offered $2 million to the first team that could race an autonomous vehicle between cities in California and Nevada; the Stanford Racing Team won the prize in 2005.) So why not set up a robotics challenge in a hospital? “No doubt," says Christensen, "this is a way of crowdsourcing innovation.” WIRED is providing unlimited free access to stories about the coronavirus pandemic. Sign up for our Coronavirus Update to get the latest in your inbox. Source: The Covid-19 Pandemic Is a Crisis That Robots Were Built For (Wired)
  4. Employees at nine Amazon warehouses have contracted the coronavirus Amazon has more than 750,000 workers worldwide. Enlarge Lawrence Glass / Getty 82 with 52 posters participating A week after the first Amazon warehouse worker tested positive for COVID-19 at a facility in Queens, New York, a total of nine Amazon warehouses have seen employees contract the virus, according to local news reports. Workers have tested positive for the virus at Amazon distribution facilities near Oklahoma City, Louisville, Houston, Jacksonville, and Detroit. There have also been coronavirus cases at Amazon facilities on Staten Island, New York; Wallingford, Connecticut, and most recently Moreno Valley, California, east of Los Angeles. “We are supporting the individuals, following guidelines from local officials, and are taking extreme measures to ensure the safety of all the employees at our sites,” an Amazon spokesman told Ars. Amazon has more than 750,000 employees, many of whom work at distribution facilities around the country. So recent cases represent a tiny fraction of Amazon's warehouse workforce. Amazon says that it is taking a number of precautions to minimize the spread of the virus. The company has stepped up efforts to clean and sanitize its distribution facilities. It has also limited face-to-face meetings and staggered start and break times to promote social distancing. But some workers say Amazon isn't doing enough to protect workers. A worker petition calls on Amazon to offer paid sick leave to all workers, offer workers time-and-a-half hazard pay, and suspend productivity quotas that could make it impractical for workers to take precautions against the spread of the coronavirus. Customers have become increasingly reliant on Amazon deliveries as they have limited travel outside their homes. Amazon has seen customer demand surge in recent weeks, forcing the company to delay deliveries of non-essential items so it can focus on delivering essential goods like baby products, health items, and pet food. The company announced last week that it is looking to hire 100,000 more workers to help deal with increasing order volumes. Source: Employees at nine Amazon warehouses have contracted the coronavirus (Ars Technica)
  5. The US Army Corps of Engineers Deploys Against Coronavirus The US is desperate for hospital beds. The USACE can build thousands of them in a matter of days. Rather than responding to a disaster, the US Army Corp of Engineers is racing to help avert one by converting sites like New York’s Javits Center into field hospitals.Photograph: BRYAN R. SMITH/Getty Images The Jacob K. Javits Center occupies over 22 million square feet on the west side of New York City, a block or so down from where the Lincoln Tunnel splashes into the Hudson River. This week, it had been scheduled to host the World Floral Expo until coronavirus fears scuttled those and most other nonessential plans. Instead, thanks to the US Army Corps of Engineers, the convention center is being transformed into four field hospitals with 1,000 total beds. And that’s only the beginning. Since its founding in 1802, the USACE has often played a central role in times of crisis; its mission is to provide engineering services that strengthen national security and reduce risks from disasters. Recently, that has meant stepping in to speed recovery after the attacks of 9/11 and the devastation of Hurricane Katrina. The novel coronavirus presents a different kind of challenge. It requires national mobilization, not the localized efforts that those specific traumas demanded. Rather than responding to a disaster, the USACE is racing to help avert one by providing enough hospital beds to keep the health care system afloat. “I’ve never seen anything as unique as this in my lifetime,” says Fletcher Griffis, a professor at New York University’s Tanden School of Engineering who spent decades in the USACE, including as commander and chief engineer in the New York district. For parallels to the scale and scope of the Corps’ coronavirus mission, Griffis reaches back to World War II, and even further to helping map out the railroads that drove westward expansion in the 1800s. The stakes are impossibly high. Take New York City, the current epicenter of the coronavirus in America and also the locus of the USACE’s efforts. New York governor Andrew Cuomo estimated Tuesday that the state would need 140,000 hospital beds to care for the incoming wave of Covid-19 patients, with an apex coming within 14 to 21 days. There are 53,000 beds under normal circumstances. Cuomo has ordered hospitals to increase capacity by 50 percent, and more if they’re able, but that still leaves a shortfall. Enter the USACE. New York governor Andrew Cuomo toured construction of temporary hospital space at the Javitz Center this week.Photograph: Don Pollard/Office of Governor Andrew M. Cuomo Specifically, enter a standardized design, created by the Corps, that with a few site-specific modifications can turn any hotel or dorm space—or convention center—into a makeshift hospital. The USACE has created a model that can be replicated in any city in the country, quickly. “This is an unbelievably complicated problem, and there’s no way we’re going to be able to do this with a complicated solution,” Lieutenant General Todd Semonite said in a briefing last week. “We need something super simple.” That simplicity belies the incredible logistical efficiency required to go from design to construction, from the USACE, state governments, and the Federal Emergency Management Agency, which funds the efforts and helps prioritize where to send the Corps. Take the timeline of New York, as described by Semonite and Cuomo’s office. FEMA approved the funds to identify and refit the sites last Tuesday. That Thursday, a USACE inspection team and New York state officials toured Javits and some State University of New York dorms. By the end of the week, they’d hit 10 more potential sites, and narrowed down the group to four viable candidates for field hospitals on Saturday. On Monday, the Javits conversion was already well underway. It should be finished sometime next week. “This was never an anticipated use, but you do what you have to do,” Cuomo said at a press conference at Javits Monday. “That’s the New York way, that’s the American way.” The USACE has created standard plans that allow contractors to convert any convention space, or hotel or dorm, into makeshift hospitals in a matter of days.Photograph: Ron Adar/Getty Images Each of the four hospitals that will occupy Javits will take up about 40,000 square feet on the main floor. Together, the hospitals will provide 1,000 beds, staffed by 320 federal workers total. The USACE is also working on a separate facility at Javits that can support an additional 1,000 beds. The Westchester Convention Center will get a similar large-space makeover. But it’s the dorm locations, at SUNY Stony Brook and SUNY Old Westbury, that will follow the template the USACE hopes to replicate more broadly. Like most higher learning institutions, the SUNY campuses are closed for the remainder of the semester. “Think of the second floor of a standard hotel,” Semonite said at last week’s briefing. “The rooms would be like a hotel room, and then we would build nurse’s stations in the halls, we would have all of the equipment, wireless, going into the nurses stations so you could monitor.” Hotels and dorms are the preferred sites for these kinds of conversions not only because they're largely empty at the moment. They also often have self-contained air-conditioning units, which you can adjust to create negative pressure inside the room, a measure taken in hospitals to reduce the chances of cross-contamination. “You adjust that unit to be able to suck more air out down through the bathroom vent to be able to have negative pressure,” said Semonite. “On the door you put a great big piece of plastic with a zipper on it so you can zip in, go into the room. It’s a relatively simple process.” Each room will have the same standardized set of supplies, as determined by FEMA and the Department of Health and Human Services. Elsewhere, the plan allows for modifications if, say, the hotel has central air or other deviations. The Corps itself typically won’t do the actual construction, but will issue contracts to its expansive network of builders. Each room comes with standardized medical supplies like those pictured here.Photograph: BRYAN R. SMITH/Getty Images New York is the first state to implement the Corps' coronavirus plan. Where exactly the USACE sets up shop from here depends on state governments and FEMA. States nominate proposed sites for pop-up hospitals, FEMA cuts a check, and Corps engineers and their outside contractors make the necessary modifications. The USACE is looking at California and Washington as likely places to expand the project next, but the Corps has people ready in all 50 states to assess potential sites. Semonite also urged states to move forward without their help if they have the means. The Corps can’t be everywhere at once, but its network of partners can. And they've given states a playbook for how to use them. “They have a team of contractors and engineers and architects that they use, and depending on how they use that team they can do almost unlimited work,” says Griffis. “The Corps provides the leadership. It’s just a very effective way of getting construction done.” New York will likely need more than the Javits Center and some dormitories to weather its Covid-19 outbreak. Other cities will likely find that there simply aren’t enough empty hotels and dorms to accommodate the impending overflow. But each additional bed represents one patient that doesn’t get turned away, and buys just a little more time before the health care system becomes totally overwhelmed. Creating that kind of capacity in a matter of weeks is unlike anything the Army Corps of Engineers has ever done before. It’s also exactly what the Corps was built to do. WIRED is providing unlimited free access to stories about the coronavirus pandemic. Sign up for our Coronavirus Update to get the latest in your inbox. Source: The US Army Corps of Engineers Deploys Against Coronavirus (Wired)
  6. At Trump’s request, Ford and GM help ventilator makers boost output It's not easy to build a ventilator assembly line from scratch. Enlarge Taechit Taechamanodom 90 with 51 posters participating One of the most crucial things the United States can do to prepare for the surging coronavirus outbreak is to beef up our stockpile of ventilators. These mechanical breathing machines are crucial for keeping patients with severe cases of COVID-19 alive. The United States currently has around 170,000 of the devices; experts say that may not be enough if the number of coronavirus cases continues to grow exponentially. On Sunday, President Donald Trump tweeted that "Ford, General Motors and Tesla are being given the go ahead to make ventilators and other metal products, FAST!" (Presumably he meant "medical products.") This is an apparent reference to new guidance from the Food and Drug Administration, published Sunday, that dramatically loosens the agency's normally strict oversight of ventilator technology. The new policy not only gives medical professionals broader latitude to modify existing FDA-approved ventilators, it also creates a streamlined process for complete newcomers to the ventilator market to get FDA approval. So car companies have been swinging into action. GM announced a partnership with ventilator manufacturer Ventec last Friday. On Tuesday morning, Ford announced its own ventilator partnership with GE Healthcare. But ventilators are complex machines that can cost as much as $50,000 apiece. Reliability is crucial, since even a brief malfunction or loss of power could cost a patient his or her life. So it wouldn't be practical for any company to design and build ventilators from scratch in a few months. Instead, car companies are looking for ways to help existing vendors expand their output. GM and Ford are supporting existing ventilator companies Enlarge / Operators and assemblers assemble medical face shields. Ford is aiming to produce 100,000 plastic face shields per week. In a Friday press release, GM announced a partnership with medical device company Ventec. "Ventec will leverage GM’s logistics, purchasing and manufacturing expertise to build more of their critically important ventilators," the two companies wrote in a joint press release. GM's main contribution seems to be helping Ventec beef up its supply chain. Like other automakers, GM sits at the apex of a vast network of suppliers, some of which have sophisticated manufacturing capabilities. GM is working to connect Ventec with suppliers who can supply scarce parts, allowing Ventec to boost output. Dustin Walsh, writing for Crain's Detroit, points to one example where GM has been helping Ventec. A GM supplier called Meridian is "helping GM procure six different ventilator compressor parts made of magnesium for an estimated 200,000 ventilators," Walsh wrote. Meridian's own machines couldn't produce the necessary parts, but Meridian connected GM with two other companies—competitors of Meridian—that were able to produce them. Another GM supplier "plans to start manufacturing foam parts for ventilators," according to Walsh. On Tuesday, Ford announced it was also getting into the ventilator business, though the details remain hazy. "Ford and GE Healthcare are working together to expand production of a simplified version of GE Healthcare’s existing ventilator design to support patients with respiratory failure or difficulty breathing caused by COVID-19," Ford said in a press release. "These ventilators could be produced at a Ford manufacturing site in addition to a GE location." Ford says that "work on this initiative ties to a request for help from US government officials." Ford is also planning to manufacture other medical equipment, including respirators (in partnership with 3M) and face shields. Other ventilator makers are expanding on their own Tesla, meanwhile, has talked to leading medical device company Medtronic. "Just had a long engineering discussion with Medtronic about state-of-the-art ventilators," Elon Musk tweeted on Saturday. "Very impressive team!" Medtronic's own tweet about the meeting was cordial but noncommittal: " We are grateful for the discussion with @ElonMusk and @Tesla as we work across industries to solve problems and get patients and hospitals the tools they need to continue saving lives," the company wrote. Medtronic has been working to boost its output without help from Tesla. Last week, the company announced that it was on track to double its rate of ventilator production and said it intended to double the workforce at its ventilator factory in Ireland. "Ventilator manufacturing is a complex process that relies on a skilled workforce, a global supply chain and a rigorous regulatory regime to ensure patient safety," Medtronic said in its press statement. Meanwhile, existing ventilator makers have been rushing to increase their output. GE's Health Care division announced plans to increase ventilator production—including having staff work around the clock. Swedish medical device company Getinge, Swiss company Hamilton, and Dutch electronics giant Philips are also working to boost ventilator production. The importance of government orders One of the most important things governments can do to promote ventilator production is to commit to buying ventilators in the future. Right now, medical device companies are able to sell ventilators as fast as they come off their existing assembly lines. But big increases in ventilator output will require companies to make expensive investments in new manufacturing capacity. That's a risky bet because the investments might become worthless if the coronavirus crisis peters out after a few months. The world could wind up with a big surplus of ventilators. Hospitals, too, may be reluctant to spend tens of thousands of dollars on ventilators that they might only need for a few months. Governments can reduce the risk manufacturers face by placing big orders for ventilators now. Having big orders in hand will make manufacturers more willing to make up-front investments to fill those orders. Of course, that creates a risk that the government will end up with a glut of ventilators it doesn't need. But it seems better to risk having too many ventilators in a few months than to risk having too few. Source: At Trump’s request, Ford and GM help ventilator makers boost output (Ars Technica)
  7. Tim Cook says Apple is reopening factories as China gets ‘coronavirus under control’ He made the comments in a new interview Apple CEO Tim Cook said today that factories in China that manufacture the company’s products are reopening as “China is getting the coronavirus under control.” The comments came from a preview of an upcoming interview with Fox Business. Here is a transcript of what Cook said in the snippet shared by Fox Business (Cook’s comments begin at 0:40): It feels to me that China is getting the coronavirus under control. I mean you look at the numbers, they’re coming down day by day by day. And so I’m very optimistic there. On the supplier side, we have suppliers — you know, iPhone is built everywhere in the world. We have key components coming from the United States, we have key parts that are in China, and so on and so forth. When you look at the parts that are done in China, we have reopened factories, so the factories were able to work through the conditions to reopen. They’re reopening. They’re also en-ramp, and so I think of this as sort of the third phase of getting back to normal. And we’re in phase three of the ramp mode. Technically, Cook is correct — the number of new cases within China is actually slowing, according to Chinese authorities. But there are new outbreaks in other areas of the world, including South Korea, Italy, and Iran. So the coronavirus will still likely have global economic effects, and it’s unclear how its continued spread will impact other aspects of business, travel, public health, and policy. There’s also the matter of why Cook may be saying this now. His comments are likely intended to reassure investors that the company’s business is on solid footing, as Apple and other tech stocks have fallen in recent days over continued worries and news about the coronavirus. Last week, the company said in a rare investor update that the global effects of the coronavirus outbreak would lead to lower second quarter revenue than expected, in part because of the outbreak’s effect on iPhone manufacturing. In that update, Apple said its iPhone factories had reopened but that they were “ramping up more slowly than we had anticipated.” Coronavirus hasn’t affected just Apple — it’s had a wide-ranging impact on the tech industry. The Verge has a guide to the coronavirus right here if you want to learn more about it. Source: Tim Cook says Apple is reopening factories as China gets ‘coronavirus under control’ (The Verge)
  8. Coronavirus: Advice from an epidemiologist Some coronavirus advice I've gleaned from folks who've worked in or studied other epidemics. Please take seriously and pass on to family and friends... 1. Many countries like UK are currently in containment phase. But likely at some point infection will start spreading via local transmission. At that point, top priority is to slow the spread, and what we do as individuals and communities will be critical. 2. Fortunately risk of serious illness is low, especially for children. But risk is higher for elderly and people with existing health conditions. Everything we can do to slow the spread will help protect people at higher risk, and less people overall will get infected. 3. There are practical things everyone can do to reduce the risk of getting infected. These need practice, so start doing them now. You may still get infected, but it is worth really trying to avoid infection, because the more we slow spread the better. Slow the spread, buy time. 4. Stop touching your face. Especially stop touching your eyes, nose or mouth. This is much much harder than it sounds, and takes practice. But if you start practising now, you will quickly get a lot better at it. 5. Wash your hands often. Wash with soap and water for 20 seconds, or rub hands with alcohol hand gel. Especially wash hands before eating or touching food. 6. If you or a friend or family member takes any prescription medication, make sure you have a good supply, e.g., at least 4 weeks worth. 7. Don't panic buy enough food to survive a zombie apocalypse. But do buy a few extra provisions. Do it a bit at a time, add a few extra things in when you normally go shopping. Have 2 weeks worth of provisions, including some chocolate or other treats. Don't forget about pets. 8. When local transmission does start, keep your distance from people, at least 2 metres. Especially people showing symptoms, but some people may carry the virus and transmit without symptoms, so generally keep some distance where you can. Stop shaking hands etc. 9. While a mask seems like a good idea, it can give a false sense of security. There isn’t a lot of good evidence that shows a mask to reliably prevent infection when worn by the public. But they are useful to put on a sick person to reduce their spreading of the virus. 10. If you or a loved one becomes sick, follow the practices of the day. Call ahead before going to a Doctor, fever clinic or hospital and get advice on what to do. Think through now how to take care of sick family members while trying not to get infected. 11. Talk things through with friends and family. Be prepared that some people will be very willing to talk about it, others may be reluctant or frightened. But general advice is that it's a good way to prepare emotionally for life not as usual. 12. Unfortunately it doesn't look like this will be over quickly. The new coronavirus may be with us into next year. It might even become a seasonal infection, returning each winter. This is probably going to be a marathon, not a sprint. 13. If you end up stuck at home for a couple of weeks, don't forget about skype/facetime/google hangouts/etc., a great way to catch up, check in and hang out with friends and family. 14. If you manage a business or organisation, cross-train key staff at work so one person’s absence won’t derail our organisation’s ability to function. Some good further reading: So you think you're about to be in a pandemic? by Ian M Mackay, PhD and Katherine E Arden PhD The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 [1]) has spread to over 30 countries and regions outside mainland China. Currently, dise… https://virologydownunder.com/so-you-think-youve-about-to-be-in-a-pandemic/ Past Time to Tell the Public: “It Will Probably Go Pandemic, and We Should All Prepare Now” by Jody Lanard and Peter M. Sandman NOTE FROM IAN: The expert risk communication team of Lanard and Sandman has given me permission to post their very well-considered reply to my question of them jus… https://virologydownunder.com/past-time-to-tell-the-public-it-will-probably-go-pandemic-and-we-should-all-prepare-now/ The Wuhan Virus: How to Stay Safe As China’s epidemic continues to spread, things may seem scary. Here are 10 simple precautions that can protect you from contracting the coronavirus. https://foreignpolicy.com/2020/01/25/wuhan-coronavirus-safety-china/ Some good people to follow: @PHE_uk @CDCgov @WHO @DrTedros @kakape @HelenBranswell @MackayIM @JeremyFarrar @mlipsitch @BillHanage @Laurie_Garrett @ChristoPhraser @neil_ferguson Adding one more... 15. If you know someone who works in healthcare, reach out and say hi, and thank you. Source: https://threadreaderapp.com/thread/1232693018295250946.html (Alistair Miles @alimanfoo )
  9. SAN FRANCISCO/TAIPEI (Reuters) - Travel restrictions to China because of the coronavirus have come just as Apple Inc’s engineers usually jet off to Asia to perfect the production of this fall’s new iPhones, former employees and supply chain experts told Reuters. FILE PHOTO: People wearing protective masks wait for checking their temperature in an Apple Store, in Shanghai, China, as the country is hit by an outbreak of the novel coronavirus, February 21, 2020. High-volume manufacturing is not scheduled until summer, but the first months of the year are when Apple irons out assembly processes with partners such as Hon Hai Precision Industry Co’s Foxconn, two former Apple employees said. “They probably have one assembly line they’re trying things out on,” said one of the former employees who asked not to be named discussing production matters. “Are Apple’s engineers with the Foxconn engineers? If they are, they’re probably making progress. But if they’re not, if they’re quarantined, that could be bad.” While Apple uses other contract manufacturers such as Wistron Corp to make some iPhones, Taiwan’s Foxconn tends to handle the introduction of new models because its capabilities are the most advanced, supply chain experts said. Foxconn, the world’s largest contract electronics maker, delayed reopening key iPhone factories in Shenzhen and Zhengzhou after the Lunar New Year holiday but hopes to resume half of its Chinese production by the end of February. Senior Foxconn officials who have been working remotely from Taipei since the holiday have not yet returned to China on a large scale, a person with knowledge of the matter told Reuters, speaking of company officials generally. Apple declined to comment. Foxconn Technology Group said in an emailed statement on Tuesday that the company is following all legally required health and safety practices at its factories to protect employee welfare. “Consistent with this, we are taking a cautious approach in the implementation of our post-holiday production schedules in each of our facilities in China,” the company said. Last week, Apple warned investors it was unlikely to meet revenue targets for the first three months of 2020 and that global iPhone supplies would be limited as manufacturing sites in China were not ramping up production as quickly as expected. Foxconn said this month that the coronavirus outbreak would lower its revenue this year. Earlier this month, United Airlines, which has disclosed that Apple is a major customer, said it was cancelling all fights to China until late April. Apple, meanwhile, said on Jan. 28 that it was restricting employee to travel to China to “business-critical” situations. COLLABORATION CRITICAL For new iPhone models, the transition from prototype to the assembly of millions of units starts in earnest when the Lunar New Year holiday in China ends in late January and early February, people familiar with the process said. At that point, Apple has tested numerous prototypes and is in the late stages of what is called engineering validation, in which Foxconn workers assemble small numbers of devices while engineers from both firms troubleshoot. If delays occur at this stage it would eat into the time Apple needs to finalize orders for chips and other parts, almost all of which are custom-made for the iPhone. Because of the huge volumes needed, “they can’t wait to make component selections”, said Ron Keith, founder of Supply Chain Resources Group, which works with electronics makers such as Alphabet Inc’s Nest. In March and April, Apple engineers typically work with Foxconn counterparts to set up new assembly lines and do trial runs, before making final adjustments in April and May. The aim is to have production lines up and running in June so others can be added progressively to ramp up output. “It’s very complicated. There are so many variables in the environment, including small factors such as air pollution,” one of the people familiar with the process said. Anna-Katrina Shedletsky, a former Apple engineer and founder of Instrumental, a startup focused on factory automation based in Mountain View, California, said on-the-ground engineering collaboration was critical for new products. “You can fly those engineers somewhere else but there’s knowledge about how you make a product in that environment. It’s not that it can’t be taught but it’s a hard thing to move,” she said. While supply chain experts and industry insiders say Apple still has time to keep its annual iPhone schedule on track, travel restrictions have left it in a tough spot. “There is no face-to-face work being done,” an executive at a semiconductor firm that supplies smartphone companies and works with teams in China said, speaking generally about phone production cycles. “And the word is, that’s probably not going to change for another month at best. You’re really talking about two lost months, which in the consumer electronics cycle is huge.” Source
  10. Redmond no longer expects to meet quarter guidance for personal computing unit In response to the effect of the coronavirus outbreak on Chinese suppliers, Microsoft has cut its sales forecast for Surface tablets and Windows OEM licences. In a statement to investors last night, the global software powerhouse said although it had accounted for the impact of the virus on its operations in January's second-quarter guidance, it now expects the supply chain to return to normal more slowly than predicted. "As a result, for the third quarter of fiscal year 2020, we do not expect to meet our More Personal Computing segment guidance as Windows OEM and Surface are more negatively impacted than previously anticipated," Redmond said. However, Windows sales are not a huge source of growth for Microsoft, neither is hardware, which is not being helped by reports that new Surface laptops can break at the hint of a sneeze. The software giant is a well-diversified biz – unlike a certain fruit-based phone flinger. On 17 February, Apple said the virus-related shutdown of Chinese factories had resulted in a shortage of iPhone components. The "temporarily constrained" supply of iPhones and a fall in Chinese shopper numbers meant it would fail to meet its quarterly revenue target, the company said. HP also warned that the outbreak would have an impact on company performance, resulting in a $0.08 hit on earnings per share, though CFO Steve Fieler added: "We do view the situation as a temporary situation." COVID-19 has taken out IT industry events across the globe, too. GSMA called off Mobile World Congress, due in February, as big names including Cisco, Nokia, Facebook and BT all cancelled their plans to attend. Analyst firm Forrester said the quarantine in China's Wuhan city and Hubei province would affect production of electronic components. "Some factories, including auto plants and tech production facilities, are starting to reopen but at reduced levels," it said. But for computer and communications equipment, demand in China would be delayed but recover quickly, Forrester said. "Sales of durable goods that might have occurred in Q1 2020 will resurface in Q2 or Q3 when quarantines are lifted, and production returns to normal. Of all the segments of the tech market, sales of computer and communications equipment are most likely to see this pattern." Fellow analyst IDC has predicted that China's device sales would fall between 30 and 40 per cent in the first quarter before recovering. But Antonio Wang, associate vice president at IDC China, said there would be "a positive side" as Chinese consumers become aware of the importance of access to internet information as a result of the outbreak. As Romania, Estonia and Norway report their first COVID-19 cases this morning, and Northern California reports an instance with no known contact with other virus carriers, The Register suspects it is too soon to be looking for upsides. Source
  11. An experimental treatment for the new coronavirus is being tested in the US Research on unapproved drugs builds on experience gained during Ebola outbreaks The new coronavirus (yellow), isolated from a patient in the US. Researchers in the US are conducting a clinical trial of a treatment for COVID-19, the illness caused by the new coronavirus, the National Institutes of Health announced yesterday. There are currently over 80,000 confirmed cases of the disease around the world, and it has killed 2,770 people. Two trials of the drug, an experimental antiviral called remdesivir, have already been up and running in China for a few weeks — and preliminary results appear promising. “There is only one drug right now that we think may have real efficacy and that’s remdesivir,” said Bruce Aylward, an assistant director-general of the World Health Organization (WHO), at a press conference this week. The US trial is centered at the University of Nebraska Medical Center. The first patient enrolled was passenger repatriated to the US after being on the Diamond Princess cruise ship, which was quarantined off the coast of Japan and had an outbreak of the virus on board. It aims to enroll around 400 people with COVID-19 who are experiencing severe symptoms. Patients with a mild case of the disease who don’t need extra oxygen won’t be included. Participants will be randomly assigned to either receive the drug or a placebo. If the study starts to show that the drug works, the patients in the placebo group will also receive it. “This is probably the most rapid trial initiation we’ve seen in American history, because the trial was just designed a few weeks ago at the NIH, and we were able to get started right away,” lead investigator Andre Kalil, a professor of internal medicine at the University of Nebraska Medical Center, told The Wall Street Journal. In lab experiments, remdesivir blocks the activity of the new coronavirus in cells. It’s also effective against MERS and SARS, which are also coronaviruses, in cells. It hasn’t yet been tested against those particular diseases in humans. It was first developed by the pharmaceutical company Gilead to treat Ebola. The first patient in the US with a confirmed case of the virus was given the drug as part of his treatment, but that wasn’t as part of a clinical trial. He received an infusion under compassionate use, which allows doctors to give experimental drugs to patients when no other options are available. The treatment appeared to help (and it appeared to help individual patients in other countries), but it takes a clinical trial, like the ones that are underway, for experts to conclusively know if it works. Results from the remdesivir trials in China may be available as soon as April. The US-run trial is scheduled to run through 2023, but there may be preliminary data within the year. Experts discuss remdesivir during a conference in Wuhan. Photo by Xinhua / Cheng Min via Getty Images The remdesivir trials are just a few of the dozens of ongoing clinical trials testing treatments for COVID-19, targeting tens of thousands of patients. The scale and speed of the tests are remarkable — even more so given that, only a few years ago, the public health community was reluctant to use experimental treatments during active outbreaks. Like with the new coronavirus, there were no proven treatments available for Ebola in 2014 when an epidemic broke out in West Africa. At the start, the WHO was concerned that experimental products would increase the already-high levels of mistrust in health workers, and experts worried that focusing on research studies would take resources away from providing active care to sick patients. But the WHO quickly outlined recommendations for conducting research during the crisis, and trials on various treatment options started up. Scientists learned useful ways to structure trials and thought through some of the ethical issues involved. Those approaches were refined in the still-ongoing epidemic of Ebola in Congo, which started in 2018. A study of four different drugs found that two were effective — and did so in the middle of the ongoing outbreak. “This is the first time that a randomized, controlled trial has shown quickly and successfully what the best drugs are in the middle of an ongoing outbreak,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, which is part of the National Institutes of Health, told The Verge at the time. Researchers will hope to repeat that success now. The ongoing outbreak of the new coronavirus is different from the Ebola epidemics because it’s less deadly, but it’s affecting far more people in many more countries around the world. But the ongoing response benefits from those experiences, as will the response to any future public health crises. Source: An experimental treatment for the new coronavirus is being tested in the US (The Verge)
  12. Coronavirus case confirmed at Samsung's mobile device factory in South Korea Samsung has confirmed that one of its employees working at its mobile device factory in Gumi City, South Korea has been infected with coronavirus. The company says it has already closed that facility and the shutdown will last until Monday. In a press statement, the tech giant announced that other workers who came in contact with the infected employee have been put under self-quarantine. They will also be tested for possible infection. The floor where the infected employee worked has also been shut down until February 25, Tuesday. The Gumi factory is responsible for producing smartphones meant mostly for the domestic market of Samsung. That said, the company will continue operations at its chip and display factories in other parts of South Korea. Coronavirus has disrupted the tech community over the past couple of months, most notably when tech companies such as LG, Nvidia, ZTE, and Ericsson have started withdrawing from the Mobile World Congress that was set to take place in Barcelona later this month. Samsung was also reported to be cutting back on its MWC presence due to safety concerns related to the virus. Eventually, the GSM Association decided to cancel the event entirely following an escalation of "global concern regarding the coronavirus outbreak". Source: Coronavirus case confirmed at Samsung's mobile device factory in South Korea (Neowin)
  13. Call to war — CDC tells Americans to brace for coronavirus WHO's insights from China suggest that the virus can be contained. Enlarge / Team leader of the joint mission between World Health Organization (WHO) and China on COVID-19, Bruce Aylward shows graphics during a press conference at the WHO headquarters in Geneva on February 25, 2020. Getty | Fabrice Coffrini Fresh off a plane from China, epidemiologist Bruce Aylward sat before members of the press at the World Health Organization’s headquarters in Geneva, Switzerland on Tuesday and laid out key insights from the coronavirus front lines. Aylward, a nearly 30-year veteran of outbreak and emergency responses with the WHO, had just led a joint mission through the COVID-19 trenches to appraise the outbreak and China’s control efforts. His assessment was glowing: China had responded swiftly, on a mind-boggling large scale, and with differential outbreak responses tailored to curb disease spread in different settings—from the outbreak’s blazing epicenter in a highly populated city to the spotty disease clusters in rural areas. He pointed to humped graphs of cases over time—they are the shape of an epidemic that has been hobbled, he said. Disease spread has been in decline since the beginning of the month, and doctors in China are honing their ability to treat patients. “If I had COVID-19, I’d want to be treated in China,” he said candidly. Based on the data, China’s massive efforts have been generally successful and indicate that the virus can be contained, Aylward reported. Yet Chinese officials remain vigilant, he added, in case this never-before-seen virus (which has plagued humanity for mere weeks) presents any surprises. While Aylward was impressed with the Chinese government response, he noted early in the briefing that he was also taken by the response of Chinese citizens—their cooperation and individual sense of duty to try to help quash the outbreak. “We spoke to hundreds of people... and they all shared this sense of responsibility, accountability to be part of this,” Aylward said, noting that there didn’t appear to be any government pressure or presence forcing that sense of duty. People were adhering to quarantine protocols on their own, he noted, and medical staff were volunteering to go to the hardest hit areas in Hubei province. “Every person you talk to there has a sense that they’re mobilized, like in a war against this virus,” Aylward said. Call to war The significance of that solidarity and cooperation was not lost on officials in the United States. Just as Aylward was making his remarks in Geneva, officials thousands of miles away at the US Centers for Disease Control and Prevention were making their own wartime rallying cry. In a press conference Tuesday, Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, said that the American public and businesses should prepare for the possibility that the new coronavirus will spread in the US. Given the rapid increase of COVID-19 in other countries outside of China in recent days, “we expect we will see community spread in this country,” Messonnier said. “It’s not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen and how many people in this country will have severe illness.” Parents should talk with schools and daycares about outbreak responses and closure plans, and they should ask about tele-school options, she advised. Companies and employees should think about remote working arrangements and alternative childcare. And people should look into the availability of tele-medicine options with their healthcare providers. “I had a conversation with my family over breakfast this morning,” Dr. Messonnier said. “I told my children that, while I didn’t think they were at risk right now, we as a family need to be preparing for significant disruption of our lives.” Practical measures In the event of community spread of the virus, additional measures might also take effect, such as cancellation of mass gatherings, extra sanitation measures, and the delay of elective medical procedures. As always, people should be following good hygiene measures, including washing hands frequently and rigorously, covering coughs and sneezes, staying home when sick, and getting a flu shot. In terms of preparation that public officials should be doing to prepare, Aylward said there were key takeaways from China’s successful responses. “There are really practical things” to prepare, he said, such as making sure that hospital beds are available, isolation measures are in place, health facilities have adequate amounts of ventilators and oxygen, and public health workers are ready to trace contacts of new cases as they’re identified. Aylward also noted that based on the large amount of disease screening that’s been done in China so far, there does not seem to be a huge number of mild cases that are going undetected. And while asymptomatic spread of disease may happen, it does not seem to be a driver of the outbreak, he said. This assessment may dampen concern that the virus will become a pandemic by spreading widely in communities from unrecognized asymptomatic or mild cases. So far, household-level transmission appears to be the main driver of the outbreak, he said. As of Tuesday, the COVID-19 outbreak has reached more than 80,300 cases worldwide, with 2,704 deaths. Source: CDC tells Americans to brace for coronavirus (Ars Technica)
  14. Not the time to focus on a word — WHO tries to calm talk of pandemic, says the word “does not fit the facts” Meanwhile, US coronavirus cases hit 53 as more cruise passengers test positive. Enlarge / World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus gives a press conference on the situation regarding the COVID-19 at Geneva's WHO headquarters on February 24, 2020. Getty | Fabrice Coffrini As outbreaks of the new coronavirus flare up in several countries beyond China, experts at the World Health Organization on Monday tried to rein in fears and media speculation that the public health emergency will become a pandemic. “I have spoken consistently about the need for facts, not fear,” WHO Director-General Tedros Adhanom Ghebreyesus said in a press briefing Monday. “Using the word ‘pandemic’ now does not fit the facts, but it may certainly cause fear.” As always, the director-general (who goes by Dr. Tedros) and his colleagues at WHO tried to shift the conversation away from speculation and worst-case scenarios. Instead, they want to focus on data and preparation. In doing so, though, Dr. Tedros noted that some of the latest figures in the epidemic are “deeply concerning.” Since last week, officials have reported rapid increases in COVID-19 cases in several countries, namely South Korea, Iran, and Italy. As of Monday, February 24, South Korea has confirmed 763 cases and seven deaths—a dramatic rise from the 30 cases and zero deaths it had tallied just a week ago. The situation in Italy, likewise, went from three cases at the start of last week to 124 confirmed cases and two deaths Monday. Iran went from zero to 43 cases in the same period and has reported eight deaths. The figures have led to many media reports over the weekend speculating as to whether the new coronavirus outbreak is or would become a pandemic. For now, Dr. Tedros said, it is not. “Our decision about whether to use the word ‘pandemic’ to describe an epidemic is based on an ongoing assessment of the geographical spread of the virus, the severity of disease it causes and the impact it has on the whole of society,” he explained. “For the moment, we are not witnessing the uncontained global spread of this virus, and we are not witnessing large-scale severe disease or death.” Assessing risk Dr. Tedros summarized some of the latest data on cases and disease from China, noting that cases there are in decline and have been declining since February 2. In Wuhan, where the outbreak began in December, the COVID-19 fatality rate appears to be between 2 percent and 4 percent. US experts have noted that this high fatality rate may partly reflect the fact that health systems in the city have been extremely overwhelmed by the outbreak, and facilities have run short on medical supplies. Outside of Wuhan, the COVID-19 fatality rate in China is approximately 0.7 percent, Dr. Tedros said. But many public health experts have suggested that even that figure may be higher than the actual fatality rate because many mild, nonfatal cases may have gone uncounted. If counted, they would dilute the death toll, leading to a lower fatality rate. For people who have mild infections—which is over 80 percent of cases, according to Chinese data—recovery takes about two weeks. More severe infections can take three to six weeks until recovery. Dr. Tedros also reported that the coronavirus itself does not appear to be mutating. “The key message that should give all countries hope, courage, and confidence is that this virus can be contained,” Dr. Tedros said of the latest assessment from China. “Does this virus have pandemic potential? Absolutely, it has. Are we there yet? From our assessment, not yet.” Tomorrow, a team of experts from WHO and China will reveal more details on a technical report about the situation, including 22 recommendations on how best to address the epidemic. Worldwide As of Monday, there are over 79,400 cases worldwide, with 2,622 deaths. The vast majority of cases and deaths are in China. About 2,100 cases and 23 deaths are scattered among 31 countries outside of China, as well as the Diamond Princess cruise ship, docked in Yokohama, Japan. Also Monday, the US Centers for Disease Control and Prevention updated the number of cases in the country from 34 on Friday to 53 today. The jump is largely due to a rise in cases among repatriated passengers from the Diamond Princess. The case count among those travelers rose from 18 to 36. All of the cases in the United States so far are linked to travel or are in people who have been repatriated from outbreak areas and were therefore already considered at high risk. The risk to the general American public at this time is still considered to be low. However, the CDC has said that it expects that cases will continue to be identified and that community-based spread may occur. The agency says it is working with state and local health systems to prepare for that possibility. Source: WHO tries to calm talk of pandemic, says the word “does not fit the facts” (Ars Technica)
  15. It’s going to take a lot longer to make a COVID-19 vaccine than a treatment Scientists have a head start on treatments Photo by Sylvain Lefevre / Getty Images Scientists and drug companies are racing to develop and test treatments and vaccines that address COVID-19, the disease caused by the novel coronavirus. Work on both is progressing at an unprecedented speed — but researchers are starting essentially from scratch on vaccine development, so the process is going to take a long time. Treatments, on the other hand, were further along when the outbreak started and might be available sooner. “They’re in vastly different situations right now,” says Florian Krammer, a professor and vaccine development expert at the Icahn School of Medicine at Mount Sinai. Both treatments and vaccines are important for a robust and effective response to the outbreak. Treatments help people after they already have a disease; in the case of COVID-19, researchers hope to treat the around 15 percent of COVID-19 patients who have non-mild symptoms. Vaccines, on the other hand, help prevent people from getting sick in the first place. Scientists started work on drugs to treat coronaviruses during the SARS and MERS outbreaks, but because the outbreaks died down, the job was never completed. Now, they’re able to dust off that old research and start building on it. The leading candidate is a drug called remdesivir, which was developed by the pharmaceutical company Gilead. Research showed that it could block SARS and MERS in cells and in mice. In addition, remdesivir was used in a clinical trial looking for treatments for Ebola — and therefore, it had already gone through safety testing to make sure it doesn’t cause any harm. That’s why teams in China and the US were able to start clinical trials testing remdesivir in COVID-19 patients so quickly. There should be data available showing if it helps them get better as soon as April. If it proves effective, Gilead would presumably be able to ramp up production and get the drug in the hands of doctors fairly quickly, Krammer says. The vaccine development process will take much longer. Experts say that it will be between a year and 18 months, or maybe longer, before they’re available to the public. One of the strategies for creating a vaccine involves making copies of one part of the virus (in this case, the bit that the novel coronavirus uses to infiltrate cells). Then, the immune system of the person who receives the vaccine makes antibodies that neutralize that particular bit. If they were exposed to the virus, those antibodies would be able to stop the virus from functioning. The pharmaceutical company Moderna is the furthest along in the process; it already has that type of vaccine ready for testing. A trial in 45 healthy people to make sure that it’s safe will start in March or April and will take around three months to complete. After that, it’ll have to be tested in an even larger group to check if it actually immunizes people against the novel coronavirus. That will take six to eight months. And then, it’ll have to be manufactured at a huge scale, which poses an additional challenge. Making vaccines is always challenging. Developing this one is made more difficult because there has never been a vaccine for any type of coronavirus. “We don’t have a production platform, we have no experience in safety, we don’t know if there will be complications. We have to start from scratch, basically,” Krammer says. It was much easier to make a vaccine for H1N1, known as swine flu, which emerged as a never-before-seen virus in 2009. “There are large vaccine producers in the US and globally for flu,” Krammer says. Manufacturers were able to stop making the vaccine against the seasonal flu and start making a vaccine for this new strain of flu. “They didn’t need clinical trials, they just had to make the vaccine and distribute it,” he says. There won’t be a vaccine done in time to hold off any approaching outbreak of COVID-19 in the US or in other countries where it’s still not widespread. That’s why treatments are so important: along with good public health practices, they can help blunt the impact of the disease and make it less of an unstoppable threat. The best experts can hope for is that a vaccine can help prevent other outbreaks in the future if the novel coronavirus sticks around. Source: It’s going to take a lot longer to make a COVID-19 vaccine than a treatment (The Verge)
  16. https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 this is updated with all the known cases of this... it gets scarier every day...
  17. Could China's New Coronavirus Become a Global Epidemic? Scientists are racing to understand just how bad things could get with a pneumonia-like disease that first appeared in China and has now spread to the US. Photograph: Jason Lee/Reuters What began in mid-December as a mysterious cluster of respiratory illnesses has now killed at least six people, sickened hundreds more, and spread to five other countries, including the US. On Tuesday, American health officials confirmed the nation’s first case of the novel coronavirus: a Washington man hospitalized outside of Seattle last week with pneumonia-like symptoms. According to reports, he had recently traveled to Wuhan, but he says he did not visit the seafood market believed to be at the center of the outbreak. The case adds to the mounting evidence that the virus is able to spread from person to person. Last week, the World Health Organization warned such transmission appeared possible. Newly released data makes it seem nearly certain. On Monday, Chinese authorities reported a sharp uptick in confirmed cases—from a few dozen to nearly 300, including more people like the US patient who’ve had no contact with the market in Wuhan. On Wednesday, the WHO will decide whether to declare the outbreak an international public health emergency. The question on their minds: “Just how bad could this thing get?” If you’re asking yourself the same thing right now, you’ll be relieved to know it’s probably not pandemic bad. “The only agent that can do that, that we know of today, is influenza,” says Mike Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. Coronaviruses just don’t have pandemic potential. At most, they can cause multiple, geographically localized outbreaks. But how big and deadly those outbreaks might get is still a puzzle waiting to be put together. And unfortunately, the information essential to assembling it—to understanding what the virus catchily labeled 2019-nCoV will do next—is only starting to trickle in. Is it going to spread hot and fast like its deadly SARS-causing cousin? Or will it lie low in an animal reservoir, periodically popping out to cause a few dozen deaths each year, like the related virus that causes MERS? Scientists who’ve analyzed the DNA of patients say it’s too soon to tell. Trevor Bedford is an infectious disease biologist at the University of Washington and the Fred Hutchinson Cancer Center who has built open-source software to track emerging diseases using genetic data. When he plugged in 15 viral genomes released by Chinese and Thai health authorities, he discovered almost no mutations between them. The viruses inside each patient split off from a common ancestor in November 2019. That likely means one of two things: The virus is spreading rapidly in animals in Wuhan and repeatedly crossing over to humans; or animals infected humans once or twice and it is now spreading rapidly among humans. “The DNA can’t distinguish those two scenarios,” says Bedford. “Only epidemiological data or DNA from the reservoir animal can.” Although technologies have advanced considerably since SARS killed nearly 800 people in 2003, figuring out how new diseases spread is still an exercise in shoe-leather epidemiology. It all comes down to identifying new cases, interviewing patients, tracking down anyone they came in contact with, and then monitoring the heck out of them. Only then can you start plotting cases over time to see the shape and scope of an epidemic. None of that’s out there yet. “We don’t even know what the incubation period is or how lethal it is at this point,” says Anne Rimoin, an epidemiologist who studies emerging diseases at UCLA. So far, Chinese health authorities have followed 988 people who’ve come into contact with infected patients in Wuhan, cleared 739 of them, and are still monitoring 249, according to official reports. They have yet to share information about individual cases with the rest of the world—essential details such as what their age and sex are, when they started developing symptoms, what they might have been exposed to, and what condition they’re currently in. That information could be vital to assessing the mortality risk factors associated with 2019-nCoV, says Maia Majumder, a public health researcher at the Computational Health Informatics Program based out of Harvard Medical School and Boston Children’s Hospital. “Then we could analyze what makes people who die from the infection different from the ones that recover.” Lacking this data, researchers can only make vague estimates of the virus’s fatality. The math is pretty simple: Divide the number of deaths by the number of people known to have died or survived. It can be tempting to include hospitalized individuals, but because their outcomes are unknown, they can provide a false sense of security. In Wuhan, six out of 258 infected people have died. Doesn’t seem so bad. But if you exclude the 227 patients who are still hospitalized—who may yet die or survive—now you have a 19 percent death rate. Is that closer to the real death rate? Hard to say. The point is, it’s all just guesses if you only have case numbers at this point in an outbreak. At least one piece of the puzzle is starting to come to light, according to Osterholm. On Monday, a Chinese health official confirmed that 14 healthcare workers have tested positive for 2019-nCoV, and indicated that all 14 of them were infected by a single patient. If true, it suggests the presence of a “super-spreader,” someone who sheds huge amounts of the virus, infecting lots of people at once. “That would be a major amplification, much more akin to what we saw with SARS,” says Osterholm. Where there’s one super-spreader, he says, there are likely others. Still, he’s much less worried about a major 2019-nCoV outbreak on American soil than he is about what happens if things get worse in China, where the US has offshored much of its drug and medical supply manufacturing. If those industrial centers get shut down amidst tightening public health measures, or supply chains get quarantined, the result could be major drug shortages for Americans. “That’s what really scares me right now,” says Osterholm. Source: Could China's New Coronavirus Become a Global Epidemic? (Wired)
  18. We can do this — The doctor who helped defeat smallpox explains what’s coming We can beat the novel coronavirus—but first, we need lots more testing. Enlarge / Producer Larry Brilliant speaks onstage at the HBO Documentary "Open Your Eyes" Special Screening At The Rubin Museum at Rubin Museum of Art on July 13, 2016 in New York City. Paul Zimmerman | Getty Images 141 with 71 posters participating Larry Brilliant says he doesn’t have a crystal ball. But 14 years ago, Brilliant, the epidemiologist who helped eradicate smallpox, spoke to a TED audience and described what the next pandemic would look like. At the time, it sounded almost too horrible to take seriously. “A billion people would get sick," he said. “As many as 165 million people would die. There would be a global recession and depression, and the cost to our economy of $1 to $3 trillion would be far worse for everyone than merely 100 million people dying, because so many more people would lose their jobs and their health care benefits, that the consequences are almost unthinkable.” Now the unthinkable is here, and Brilliant, the Chairman of the board of Ending Pandemics, is sharing expertise with those on the front lines. We are a long way from 100 million deaths due to the novel coronavirus, but it has turned our world upside down. Brilliant is trying not to say “I told you so” too often. But he did tell us so, not only in talks and writings, but as the senior technical advisor for the pandemic horror film Contagion, now a top streaming selection for the homebound. Besides working with the World Health Organization in the effort to end smallpox, Brilliant, who is now 75, has fought flu, polio, and blindness; once led Google’s nonprofit wing, Google.org; co-founded the conferencing system the Well; and has traveled with the Grateful Dead. We talked by phone on Tuesday. At the time, President Donald Trump’s response to the crisis had started to change from “no worries at all” to finally taking more significant steps to stem the pandemic. Brilliant lives in one of the six Bay Area counties where residents were ordered to shelter in place. When we began the conversation, he’d just gotten off the phone with someone he described as high government official, who asked Brilliant “How the fuck did we get here?” I wanted to hear how we’ll get out of here. The conversation has been edited and condensed. Steven Levy: I was in the room in 2006 when you gave that TED talk. Your wish was “Help Me Stop Pandemics.” You didn't get your wish, did you? Larry Brilliant: No, I didn't get that wish at all, although the systems that I asked for have certainly been created and are being used. It's very funny because we did a movie, Contagion— We're all watching that movie now. People say Contagion is prescient. We just saw the science. The whole epidemiological community has been warning everybody for the past 10 or 15 years that it wasn't a question of whether we were going to have a pandemic like this. It was simply when. It's really hard to get people to listen. I mean, Trump pushed out the admiral on the National Security Council, who was the only person at that level who's responsible for pandemic defense. With him went his entire downline of employees and staff and relationships. And then Trump removed the [early warning] funding for countries around the world. I've heard you talk about the significance that this is a “novel” virus. It doesn't mean a fictitious virus. It’s not like a novel or a novella. Too bad. It means it's new. That there is no human being in the world that has immunity as a result of having had it before. That means it’s capable of infecting 7.8 billion of our brothers and sisters. Since it's novel, we’re still learning about it. Do you believe that if someone gets it and recovers, that person thereafter has immunity? So I don't see anything in this virus, even though it's novel, [that contradicts that]. There are cases where people think that they've gotten it again, [but] that's more likely to be a test failure than it is an actual reinfection. But there's going to be tens of millions of us or hundreds of millions of us or more who will get this virus before it's all over, and with large numbers like that, almost anything where you ask “Does this happen?” can happen. That doesn't mean that it is of public health or epidemiological importance. Is this the worst outbreak you’ve ever seen? It's the most dangerous pandemic in our lifetime. We are being asked to do things, certainly, that never happened in my lifetime—stay in the house, stay six feet away from other people, don’t go to group gatherings. Are we getting the right advice? Well, as you reach me, I'm pretending that I'm in a meditation retreat, but I'm actually being semi-quarantined in Marin County. Yes, this is very good advice. But did we get good advice from the president of the United States for the first 12 weeks? No. All we got were lies. Saying it’s fake, by saying this is a Democratic hoax. There are still people today who believe that, to their detriment. Speaking as a public health person, this is the most irresponsible act of an elected official that I've ever witnessed in my lifetime. But what you're hearing now [to self-isolate, close schools, cancel events] is right. Is it going to protect us completely? Is it going to make the world safe forever? No. It's a great thing because we want to spread out the disease over time. Flatten the curve. By slowing it down or flattening it, we're not going to decrease the total number of cases, we're going to postpone many cases, until we get a vaccine—which we will, because there's nothing in the virology that makes me frightened that we won’t get a vaccine in 12 to 18 months. Eventually, we will get to the epidemiologist gold ring. What’s that? That means, A, a large enough quantity of us have caught the disease and become immune. And B, we have a vaccine. The combination of A plus B is enough to create herd immunity, which is around 70 or 80 percent. I hold out hope that we get an antiviral for Covid-19 that is curative, but in addition is prophylactic. It's certainly unproven and it's certainly controversial, and certainly a lot of people are not going to agree with me. But I offer as evidence two papers in 2005, one in Nature and one in Science. They both did mathematical modeling with influenza, to see whether saturation with just Tamiflu of an area around a case of influenza could stop the outbreak. And in both cases, it worked. I also offer as evidence the fact that at one point we thought HIV/AIDS was incurable and a death sentence. Then, some wonderful scientists discovered antiviral drugs, and we've learned that some of those drugs can be given prior to exposure and prevent the disease. Because of the intense interest in getting [Covid-19] conquered, we will put the scientific clout and money and resources behind finding antivirals that have prophylactic or preventive characteristics that can be used in addition to [vaccines]. When will we be able to leave the house and go back to work? I have a very good retrospect-oscope, but what's needed right now as a prospecto-scope. If this were a tennis match, I would say advantage virus right now. But there's really good news from South Korea—they had less than 100 cases today. China had more cases imported than it had from continuous transmission from Wuhan today. The Chinese model will be very hard for us to follow. We're not going to be locking people up in their apartments, boarding them up. But the South Korea model is one that we could follow. Unfortunately, it requires doing the proportionate number of tests that they did—they did well over a quarter of a million tests. In fact, by the time South Korea had done 200,000 tests, we had probably done less than 1,000. Now that we've missed the opportunity for early testing, is it too late for testing to make a difference? Absolutely not. Tests would make a measurable difference. We should be doing a stochastic process random probability sample of the country to find out where the hell the virus really is. Because we don't know. Maybe Mississippi is reporting no cases because it's not looking. How would they know? Zimbabwe reports zero cases because they don't have testing capability, not because they don't have the virus. We need something that looks like a home pregnancy test, that you can do at home. If you were the president for one day, what would you say in the daily briefing? I would begin the press conference by saying "Ladies and gentlemen, let me introduce you to Ron Klain—he was the Ebola czar [under President Barack Obama], and now I’ve called him back and made him COVID czar. Everything will be centralized under one person who has the respect of both the public health community and the political community." We're a divided country right now. Right now, Tony Fauci [head of the National Institute of Allergy and Infectious Diseases] is the closest that we come to that. Are you scared? I'm in the age group that has a one in seven mortality rate if I get it. If you're not worried, you're not paying attention. But I'm not scared. I firmly believe that the steps that we're taking will extend the time that it takes for the virus to make the rounds. I think that, in turn, will increase the likelihood that we will have a vaccine or we will have a prophylactic antiviral in time to cut off, reduce, or truncate the spread. Everybody needs to remember: This is not a zombie apocalypse. It's not a mass extinction event. Should we be wearing masks? The N95 mask itself is extremely wonderful. The pores in the mask are three microns wide. The virus is one micron wide. So you get people who say, well, it's not going to work. But you try having three big, huge football players who are rushing for lunch through a door at lunchtime—they're not going to get through. In the latest data I saw, the mask provided 5x protection. That's really good. But we have to keep the hospitals going and we have to keep the health professionals able to come to work and be safe. So masks should go where they’re needed the most: in taking care of patients. How will we know when we’re through this? The world is not going to begin to look normal until three things have happened. One, we figure out whether the distribution of this virus looks like an iceberg, which is one-seventh above the water, or a pyramid, where we see everything. If we're only seeing right now one-seventh of the actual disease because we're not testing enough, and we're just blind to it, then we're in a world of hurt. Two, we have a treatment that works, a vaccine or antiviral. And three, maybe most important, we begin to see large numbers of people—in particular nurses, home health care providers, doctors, policemen, firemen, and teachers who have had the disease—are immune, and we have tested them to know that they are not infectious any longer. And we have a system that identifies them, either a concert wristband or a card with their photograph and some kind of a stamp on it. Then we can be comfortable sending our children back to school, because we know the teacher is not infectious. And instead of saying "No, you can't visit anybody in nursing home," we have a group of people who are certified that they work with elderly and vulnerable people, and nurses who can go back into the hospitals and dentists who can open your mouth and look in your mouth and not be giving you the virus. When those three things happen, that's when normalcy will return. Is there in any way a brighter side to this? Well, I'm a scientist, but I'm also a person of faith. And I can't ever look at something without asking the question of isn't there a higher power that in some way will help us to be the best version of ourselves that we could be? I thought we would see the equivalent of empty streets in the civic arena, but the amount of civic engagement is greater than I've ever seen. But I'm seeing young kids, millennials, who are volunteering to go take groceries to people who are homebound, elderly. I'm seeing an incredible influx of nurses, heroic nurses, who are coming and working many more hours than they worked before, doctors who fearlessly go into the hospital to work. I've never seen the kind of volunteerism I'm seeing. I don't want to pretend that this is an exercise worth going through in order to get to that state. This is a really unprecedented and difficult time that will test us. When we do get through it, maybe like the Second World War, it will cause us to reexamine what has caused the fractional division we have in this country. The virus is an equal opportunity infector. And it’s probably the way we would be better if we saw ourselves that way, which is much more alike than different. This story originally appeared on wired.com. Source: The doctor who helped defeat smallpox explains what’s coming (Ars Technica)
  19. Spring arrived muted and virtually overlooked last week, drained of much of the hope and buoyancy normally associated with winter’s end. What we face next, according to Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, is a “coronavirus winter,” ruled by the menace of molecules coiled deep in a rampaging virus. This coming season has no known end, no equinox or solstice to mark its conclusion as it stretches ragged and bleak into an unknown future. Meanwhile, we’re ordered to settle like cats in cages, without rent money, or baseball, or the chance to check on Grandpa. Was there ever a moment like this? “At no time in the history of America,” said David Elesh, emeritus professor of sociology at Temple University, “have people been asked to shut down their normal day-to-day lives and convert them as radically as we are being asked. "In the short term, we’re probably being asked to do more as Americans than ever before.” A pandemic not unprecedented All this requires some perspective. First of all, the spread of virus is nothing new, scholars stress. Image: In June 2013, Reggie Batiste, program manager with AIDS Healthcare Foundation, administers a free HIV test as part of National HIV Testing Day in Atlanta. Epidemics have ravaged the globe to a far greater extent than we’re seeing now,” said Matt Ray, a Temple medical sociologist and an expert on pandemics. He added that HIV/AIDS, in fact, has continued to be a slow-moving plague for the last 40 years, thus far taking 32 million lives, according to the World Health Organization. In ancient times, the Plague of Justinian, identified as the bubonic plague, flew throughout Europe, Asia, North Africa, and Arabia, killing an estimated 30 million to 50 million people — believed to be half the world’s population — in A.D. 541. The Black Death, also a bubonic plague, killed around 25 million Europeans between 1348 and 1350. In 1793, yellow fever wiped out 5,000 of 50,000 citizens of Philadelphia, then the nation’s capital, forcing President George Washington to decamp to Germantown, according to Morris Vogel, professor emeritus of history at Temple and an expert on the history of medicine and public health. Nursing was considered man’s work back then, and as women and children were sent away, wealthy men like Philadelphia banker Stephen Girard stepped up to care for the sick, according to Pat D’Antonio, a professor at the University of Pennsylvania School of Nursing and an expert in the history of the profession. Meanwhile, smallpox, cholera, SARS, MERS, Ebola, and other catastrophic illnesses upended life at different intervals throughout the years. Flu of 1918 In 1918 came the so-called Spanish flu, named not because it started in Spain, but because nations during that year, which coincided with World War I, were observing a news blackout and not reporting major stories like battles and pandemics. Because Spain never honored the blackout, its newspapers wrote about the flu, and the country’s name became forever affixed to the malady, D’Antonio said. Troops from around the world transmitted the disease wherever they went, with American soldiers eventually bringing it home. It is that pandemic, which killed 50 million people worldwide and nearly 700,000 Americans, that scholars say is the historic event most closely associated with the coronavirus. In Philadelphia, 20,000 died, many of them felled from illness generated by close contact during a Broad Street parade in September honoring the military. “That means this virus today is not unprecedented,” D’Antonio said. “It’s a 100-year event. The last time we had a pandemic like this was that 1918-1919 flu.” During that time in Philadelphia and elsewhere, people flocked to churches to pray for the scourge’s end. “And that became part of the problem of spread,” Vogel said. It was a consequence of not knowing enough about the nature of disease a century ago, D’Antonio said. With the coronavirus today, Wray said, “I don’t think we’ll see the same body count as we did with the 1918 flu,” partly because of social distancing. But, he added, there is a “shocking difference” that worries him “This pandemic is taking its toll in just a matter of months. From Wuhan [China, where the virus was first reported], to Iran, to Milan almost immediately. In the mid-20th Century, it would have taken a lot longer.” Image: People wearing protective masks prepare to enter the departure area of Manila's International Airport, Philippines on Wednesday. American sacrifice With the coronavirus taking up so much room in our lives so suddenly, it may be easy to forget that Americans historically have made sacrifices when calamities befell them. During the American Revolution, when men were pressed into battle against an elite foe, women rearranged their days to sew soldiers’ uniforms; in the Civil War, which generated nearly 500,000 deaths, people’s houses were taken over to serve as hospitals, said Lindsay Drane Amaral, a historian at the University of Houston. During World War II, when we lost around 405,000 military men, Americans bought bonds, rationed food, turned out the lights at night to avoid becoming bombing targets. The Rosie the Riveter poster stirred Americans to do their part during World War II. As the war progressed, Rosie the Riveter became a symbol of American resolve — a no-nonsense woman rolling up her sleeves to reveal the muscle and grit required to build bombers and bombs. The image stirred citizens to action. The common denominator, from 1776 to Pearl Harbor, Amaral said, was that people were asked to do things, and they complied, finding direct and immediate ways to help. “But it’s not so tangible now," Amaral continued. "Asking people to stay at home because they may or may not have a virus that may or may not spread to a stranger is intangible, and may be hard to take seriously for some.” After 9/11, when Americans suffered the “outside shock of terrorism," a stunned populace stoked by nationalism felt the need to get involved, said Jared Bernstein, economist and senior fellow at the Center on Budget and Policy Priorities in Washington. “So President Bush told us to take our money and go to Disney World” to aid the economy. It didn’t seem like a big ask then. But today, Bernstein said, "even that doesn’t work for us, leaving us a tougher problem to solve.” Today, to do our part, we’re told to stay in the house and play Jenga with the kids. ‘Fragility and mortality’ Unlike any time in memory, we must change the basic way we interact with one another, “depriving some of us of crucial income, and limiting ways to get the economy moving,” said Deborah Weinstein, executive director of the Coalition on Human Needs, a Washington nonprofit of aligned national organizations that help low-income Americans. We cannot rally in the public square, or decompress at the movies, or play volleyball in the park. We must isolate, which is against Americans’ gregarious nature, and our own Constitution, which guarantees the right to peaceably assemble We must regard others in the frozen-food aisle with suspicion. Neighbors who fed your cat while you were on vacation are now to be avoided. We are starkly facing our fragility and mortality,” said Cristina Bicchieri, a professor of philosophy and psychology from the University of Pennsylvania, and an expert on social norms. During our wars, our enemies were 3,000 miles away. Today, Bicchieri said, the foe is fighting us on our own soil. “And that is a much different experience.” From the standpoint of evolution, this pandemic will be seen as “just a blip” in the totality of human experience, Bicchieri added. “But for us as we live it, it’s hug She stressed that some good can be derived from hard times: "We are spending more time with family, and we can rediscover the important things that made us families in the first place. “In the end, that can bring positive feelings we take with us as we learn to survive this unusual moment." Source
  20. What are the rules of social distancing? Staying home will stem the coronavirus outbreak, but what if you’re healthy — and bored? Is it ethical to go to the gym, get your hair done, or order delivery? Many Americans in recent days have received emails directing them to start working remotely, or announcing that schools would be canceled for weeks in light of the coronavirus pandemic. Major events are also being called off with a domino-like effect, including Coachella and South by Southwest, March Madness and virtually all sports events, business conferences, even religious services across the country. In many cases, the action is prophylactic — no one at work or school may be sick yet — though with each passing day, more of these decisions are being made in response to a community member testing positive for Covid-19, or the risk that contact with large groups of people could exacerbate transmission of the virus. The closures are a way to enforce social distancing, a crucially important public health intervention that can help stop coronavirus transmission by avoiding crowds and large gatherings such as weddings, concerts, conferences, sporting events, and mass transit. Best practice requires maintaining at least a six-foot distance between yourself and others. You may have already come into contact with an infected person — the woman who rode the bike before you at SoulCycle, the kindly fellow who coughed while standing next to you in line at Costco, or someone who touched your mail as it made its way to your mailbox. (At least one study estimates that about 25 percent of transmissions of coronavirus may have occurred in pre-symptomatic stages — meaning it may be spread by people who don’t yet know they have the virus.) With Covid-19, “many people in the US will at some point, either this year or next, get exposed to this virus,” the Centers for Disease Control and Prevention’s immunization czar announced this month. Social distancing, health authorities argue, can dramatically slow the rate at which the infection is spreading, easing the burden on the health care system. To that end, the CDC is now urging all gatherings of more than 50 people to stop for the next eight weeks. But how should social distancing affect your visits to the gym? Your weekly manicure? Play dates for your kids? Your weekend reservation at the buzzy Michelin-starred omakase spot you’ve been dying to try? Are those risky for an ostensibly healthy person like yourself? What do you, as a responsible, socially conscious human being, owe to your fellow men and women — particularly those who are sick, immunocompromised, and older? Are you breaking the social contract by going to hot yoga? Or, by not going, are you overreacting and hurting the economy? Vox spoke with six experts in public health, medicine, psychology, and bioethics for answers. (Please remember that as the Covid-19 landscape transforms week by week, so, too, will the advice.) I feel healthy. Why shouldn’t I get out a little bit to make this time pass easier? Vox’s Kelsey Piper makes a strong argument for choosing to stay home as much as possible, inconvenient as it may seem, to help your fellow human. “If you are young and healthy, you ought to take precautions because doing so can end up saving someone’s life,” she writes. Leah Lagos, a New York City-based psychologist and author of Heart, Breath, Mind, agrees. “Now is the time to do something for your fellow community members,” she says. Staying home as much as possible, even if you believe you aren’t infected, is the type of altruistic decision that, when performed en masse, has the potential to slow the infection rate, Lagos says. Christina Animashaun/Vox Considering — and prioritizing — the welfare of strangers is difficult, she acknowledges, but it helps to think of them instead as someone else’s parent, grandparent, or child. “It can be an interesting experiment in compassion for people we don’t know.” “A lot of us might be relatively healthy and think we might be able to withstand the rigors of an infection,” adds Jonathan Kimmelman, director of the Biomedical Ethics Unit at McGill University in Montreal, “but there’s the concern about spreading it to vulnerable individuals, as well as the pressure this outbreak will place on our health care system.” Kimmelman invokes the idea of “social solidarity,” saying “we have an ethical obligation to curtail activities, practice social distancing, and substitute activities with safer alternatives,” like teleconferencing instead of in-person work meetings, or changing a first date from a wine bar to a walk outside. But should you even be going on dates, period? If the messages are confusing, understand that “there are different levels of social distancing” in effect around the world, and that local health departments’ recommendations vary currently depending on known cases, says Syra Madad, an NYC-based special pathogens specialist who was featured in Netflix’s docuseries Pandemic: How to Prevent an Outbreak. In Washington state’s King County, for example, the current recommendation is that “social interaction is still vitally important to the mental health of young people, and it is still possible for families to have safe gatherings among children and parents.” The county recommends, however, limiting indoor groups to 10 or fewer children and outdoor groups to 50 or fewer, and for residents to avoid parties, retail spaces, and movie theaters. Still, Madad notes, “It is better to operate under the pretense that there is transmission in your community already. There’s going to be disruption to daily life, but we want people to feel empowered by this. The decisions you make will ultimately affect the trajectory of this outbreak.” An empty restaurant in New York City on March 13, 2020. Jeenah Moon/Getty Images If I have to go out, how can I do it in the safest way possible — to protect myself as well as others? Kate Vergara, a public health and infectious disease specialist based in Chicago and New York City, has spent time fighting polio in Ethiopia and helping Ebola survivors in Sierra Leone (without contracting either disease). In order to even begin to approach the ethics of social distancing, she says, we must have a firm grip on how the virus is spreading. “Covid-19 is not airborne,” she says. “It is transmitted through droplets — being coughed on, or touching something that someone coughed on, for example, and then touching your face and allowing that pathogen to get into your system through your eyes, nose, or mouth.” The CDC and the WHO recommend several basic measures to help prevent the spread of Covid-19: Wash your hands often for at least 20 seconds. Cover your cough or sneeze with a tissue, then throw the tissue in the trash. Clean and disinfect frequently touched objects. Stay home when you are sick. Contact a health worker if you have symptoms; fever and a dry cough are most common. DON’T touch your face. DON’T travel if you have a fever and cough. DON’T wear a face mask if you are well. Guidance may change. Stay informed, and stay safe, with Vox’s guide to Covid-19. It’s important to practice good hygiene, like hand-washing — which protects not only you but others as well. When considering the ethics of spending time out and about, Vergara suggests reframing your view of hand-washing in the following way: “Wash your hands before you go out to protect others, and wash them again after the activity to protect yourself.” If you’re low-risk and itching to hit the gym, wash your hands first so you’re touching machines and weights with pristine hands; that protects others. Then, after your workout, wash them again to scrub off anything you may have picked up. And wipe down your exercise equipment, or anything else you might have touched. The same goes for getting a haircut, visiting the ATM, and the like. Should I feel guilty for wanting to go to the gym, or on a date? Between the relentless news alerts, social media memes, and gossipy texts, it’s easy to feel overwhelmed, anxious, and scared. We need self-care more than ever, says LaMar Hasbrouck, a public health physician and past medical epidemiologist with the CDC. “It’s important during these times to hold fast to any sense of normalcy that you can.” But try to find prudent ways to do so. Hasbrouck now picks off-peak hours to exercise to minimize contact with others; other options include walking, jogging, or biking outdoors. The more ventilated an area, the lower the risk of transmission, plus “if you cough, nobody is around and the droplets just fall and hit the ground,” he says. Better yet: breaking a sweat at home with help from an app or online video. Grocery shopping will need to happen, but instead of going at noon on a Saturday when the place is sure to be packed, try going really early on a weekday morning. If it’s still possible, order online. And wipe down any deliveries, just to be safe. Should I keep using grocery delivery services ... and ride-hailing companies … and restaurants? Hasbrouck encourages those who have access to services such as Postmates, Grubhub, Lyft, and Instacart to use them. “It’s a good way to social distance,” he says, noting that two main factors when it comes to Covid-19 transmission are closeness of contact and duration. “The handoff is five seconds, you go inside and wash your hands. Or just have them leave it at your doorstep.” (Last week, Instacart introduced a “Leave at My Door Delivery” option.) This poses some ethical questions, however: Having milk and bread delivered is convenient for you, minimizing your exposure to the virus. But what about the person doing your grocery shopping or picking up your Thai food? Or the Uber driver ferrying you to your significant other’s apartment? Is it right to ask them to assume the risk of being out and about? Yes, say both Hasbrouck and Vergara. However, contaminated hands pose a risk to drivers and riders, so be ultra-diligent about hand hygiene, washing or sanitizing hands before getting in the car and not touching your face at all. Cracking a window is a smart move for both you and the driver, as it promotes airflow. As for restaurants, honor upcoming reservations or attend gatherings as necessary. Unlike norovirus or hepatitis A, “food isn’t known to be a way of transmitting this or other respiratory viruses,” says Benjamin Chapman, a professor and food safety extension specialist at North Carolina State University. “You mainly need to be mindful about the surfaces you touch: menus, the table, condiments, things that other patrons might have used.” But the choice to dine out may soon be very limited for many Americans: Governors of several states, including Illinois and Washington, this week ordered all restaurants and bars closed; major cities such as New York and Los Angeles are following suit. Chapman, who continues to dine out, says that while he might not know who touched that soy sauce bottle or pepper shaker before him, “I do know I can break the pathway of transmission by using hand sanitizer or washing my hands.” With social distancing in mind, opt for establishments where it’s easy to keep six to eight feet between yourself and other diners (maybe save sitting at the packed bar for after the pandemic ends) and feel free to be “a public health nerd” like Chapman and ask if they’re using Environmental Protection Agency-approved sanitizing products, which they should be. Chapman notes that he lives in North Carolina, which is not currently a Covid-19 hot spot. “I’d have a different response if I was in New Rochelle, New York, or Seattle,” he says, two cities where the risk of transmission is greater due to higher numbers of community-acquired infections. In cities such as those, he would advocate taking advantage of the “great infrastructure we have set up for home delivery of food.” Should I cancel play dates? What are the rules for my kids? In Ireland, public health officials are encouraging a “no parties, no playdates, no playground” policy, per the Irish Times. Muireann Ní Chrónín, a consultant respiratory pediatrician at Cork University Hospital, told the paper: “Children will get through this no problem. [But] remember with corona, children are vectors, not victims. In most epidemics, young children are the transmitters.” Here in the US, school closures are smart, Vergara says. “It’s a responsible practice for schools to shut down. That’s several hundred kids interacting in close quarters, and kids aren’t known for washing their hands very well.” But that leaves millions of working parents frantic about career responsibilities, and unsure of whether it’s appropriate to schedule play dates or try to split child care duties with friends. The experts interviewed for this story had differing opinions about whether play dates should continue in a pandemic. Vergara says that, if following healthy practices, small play dates are feasible, but before the kids come over, use disinfecting wipes to clean high-touch items like doorknobs, remote controls, and the table where they’ll be playing. Replace the hand towel in the bathroom with a fresh one, and when the visiting kiddos show up, everyone — your children included — should wash their hands thoroughly. Lagos worries that play dates during school closures are essentially “quasi-quarantines, defeating the purpose of social distancing.” Kimmelman concurs, and though he says no one knows the exact right answer, “we don’t know how things are going to unfold, and from my standpoint, the risks of underreaction are so much more catastrophic than the risks of overreaction.” Alyssa F. Westring and Stewart D. Friedman, co-authors of Parents Who Lead, writing in the Harvard Business Review, recommended finding inventive ways for children to play together virtually. “While it may not be feasible to trade-off childcare responsibilities (depending on quarantine restrictions),” they wrote, “consider other ways in which you can make things easier for one another — whether it’s sharing creative activities to keep the kids entertained or taking turns grocery shopping. … Be open to new ways of doing things.” When should I completely self-quarantine? The CDC has issued recommendations for travelers arriving from dozens of countries with widespread cases to stay home for 14 days. If someone at your work or school was definitely exposed, it’s also time to assess your own risk of exposure, and of spreading the coronavirus. “If you say, ‘Well, I know I’ve been mostly in my office, avoiding meetings and conference rooms, and I’ve been washing hands a lot,’ you could probably go about your daily routine with some social distancing to protect yourself, not so much to avoid infecting others,” Hasbrouck says. But if you have a fever or receive new information — that it was John, in the cubicle next to you, who was exposed — “you’re going to want to radically change your assessment.” That likely means self-quarantining, because that’s “the ethical decision and you don’t want to expose others. It’s a constant risk assessment, and it’s more of an art than a science. It’s about protecting yourself but also being socially responsible.” How far should we take social distancing advice? “Look at the trajectory of what’s happening in Italy. We’re 11 days behind Italy,” where a national lockdown that began March 10 has curtailed all travel and shuttered nearly all shops, schools, museums, movie theaters, and bars, says Madad. “Measures like travel bans and quarantining entire localities — you may not see that here,” she says. But we can undertake distancing measures ourselves. “One of the things we’ve learned from the H1N1 pandemic is that if you educate people, they will listen. You have to give them the facts, and speak with one voice.” The Vox guide to Covid-19 coronavirus Source: What are the rules of social distancing? (Vox)
  21. Amazon Prime deliveries delayed by coronavirus Spike in shopping and disrupted supplies may impact Prime deliveries (Image credit: Future) Amazon has revealed that the coronavirus outbreak may be impacting some of its Prime deliveries. The company has said that due to the sudden spike in online purchases, many household items are going out of stock, and as its supply chain is also impacted currently, the “delivery promises are longer than usual”. A notice has been added to the website informing customers that “Inventory and delivery may be temporarily unavailable due to increased demand. Confirm availability at checkout.” Coronavirus impact In a blog post, Amazon revealed that it is working round the clock with its supplier partners to get the products back in stock, as well as getting additional capacity to cover increased demand. Amazon has not revealed how much of the delay is caused due the unavailability of the staff. The company had advised its employees to work remotely like most other companies and also offered unlimited unpaid time off for the rest of March to its warehouse workers. Amazon has also offered two weeks of paid “quarantine time” for the employees, both full time and part-time warehouse workers, who’re diagnosed with the coronavirus. This could be one of the rare events when Amazon’s Prime delivery service, which offers one day and two-day deliveries, may face a disruption. Prime is a paid-for service where users pay an extra amount as a subscription or one-time charge to get the products delivered faster. As of now, there are approximately 150 million Prime members across the globe. The virus outbreak has infused panic among the shoppers and has resulted in people hoarding products like bottled water, hand sanitizers, protective face masks, disinfectant wipes, and toilet papers etc. Amazon has also banned sellers who were found abusing the marketplace policies and removed thousands of listings of products with high demand for price gouging. Source: Amazon Prime deliveries delayed by coronavirus (TechRadar)
  22. 3D printing could prove a lifesaver in helping treat coronavirus Out-of-stock parts for vital medical equipment can be 3D-printed (Image credit: 3D Printing Media Network / Lonati SpA) 3D printing could be a lifesaver in the face of supply shortages caused by coronavirus, with a 3D printer providing vital medical supplies to an Italian hospital. The hospital in Brescia – located in an area of northern Italy suffering at the hands of the virus outbreak – was running out of replacement valves for ‘reanimation’ machines which provide desperately needed respiratory aid to those who have contracted coronavirus. With no way to get replacement valves thanks to the supplier running out of stock – another side-effects of the virus – the solution was to use a 3D printer. A company by the name of Isinnova responded to a call for help from Massimo Temporelli (founder of The FabLab in Milan), and Isinnova’s CEO, Cristian Fracassi, personally brought a 3D printer into the hospital, managing to replicate and produce the missing valve. The very next day, Saturday, March 14, these 3D-printed replacements were proved to work, and 10 patients were soon on functioning machines that helped them breathe while using a part produced by the 3D printer. Vital replacements Doubtless there will be other cases where replacements for vital equipment are needed, and may indeed be provided by 3D printing – a lot of lives could be potentially saved. More valves were being produced by another printing outfit, Lonati SpA – as pictured in the above image – except in this case they are using a polymer laser powder bed fusion process (as opposed to filament extrusion, which was employed by Isinnova’s CEO). Source: 3D printing could prove a lifesaver in helping treat coronavirus (TechRadar)
  23. ‘CovidLock’ Exploits Coronavirus Fears With Bitcoin Ransomware Opportunistic hackers are increasingly seeking to dupe victims using websites or applications purporting to provide information or services pertaining to coronavirus. Cybersecurity threat researchers, DomainTools, have identified that the website coronavirusapp.site facilitates the installation of a new ransomware called “CovidLock.” The website prompts its visitors to install an Android application that purportedly tracks updates regarding the spread of COVID-19, claiming to notify users when an individual infected with coronavirus is in their vicinity using heatmap visuals. CovidLock ransomware launches screen lock attack on unwitting victims Despite appearing to display certification from the World Health Organization and the Centers for Disease Control and Prevention, the website is a conduit for the ‘CovidLock’ ransomware — which launches a screen lock attack on unsuspecting users. Once installed, CovidLock alters the lock screen on the infected device and demands a payment of $100 worth of BTC in exchange for a password that will unlock the screen and return control of the device to the owner. If a victim does not pay the ransom within 48 hours, CovidLock threatens to erase all of the files that are stored on the phone — including contacts, pictures, and videos. The program displays a message intended to scare users into compliance with its demand, stating: “YOUR GPS IS WATCHED AND YOUR LOCATION IS KNOWN. IF YOU TRY ANYTHING STUPID YOUR PHONE WILL BE AUTOMATICALLY ERASED.” DomainTools claims to have reversed engineered the decryption keys for CovidLock, adding that they will publicly post the key. Coronavirus-themed website are 50% more likely to be malicious According to cyber threat analyst, Check Point, coronavirus-themed domains are 50% more likely to be a front for malicious actors than other websites. Since January 2020, the firm estimates that more than 4,000 domain names that relate to the coronavirus have been registered globally — 3% of which are deemed to be “malicious,” and 5% of which are described as “suspicious.” U.K. public lose $1 million to coronavirus scams On March 11, the U.K. Financial Conduct Authority warned of an increasing proliferation of coronavirus-themed scams - including investment scams fraudulently offering investments in crypto assets. According to the U.K. National Fraud Intelligence Bureau (NFIB), many malicious sites are offering maps and visualizations tracking the spread of coronavirus — much like CovidLock. An NFID representative stated: “They claim to be able to provide the recipient with a list of coronavirus infected people in their area. In order to access this information, the victim needs to click on a link, which leads to a malicious website, or is asked to make a payment in bitcoin.” The NFIB estimates that coronavirus-themed scams have already defrauded the British public out of roughly $1 million. Source
  24. How Long Does the Coronavirus Last on Surfaces? Researchers looked at how long the virus can survive on cardboard, plastic, and stainless steel, as well as after being aerosolized and suspended in midair. A transmission-electron microscope image of an isolate from the first US case of Covid-19.Photograph: Hannah A Bullock; Azaibi Tamin/CDC By now, let’s hope you’re safely ensconced at home—going a little stir-crazy, perhaps, but doing your part to “flatten the curve.” But let’s say you’re one of those people who can’t stay in. Maybe you deliver Amazon boxes all day long, or you still need to drive a city bus. Or maybe you’re treating sick people in a hospital while trying not to get sick yourself. Or, for that matter, maybe you just have to go to the grocery store. In that case, you might want to know: How long does SARS-CoV-2, the virus that causes Covid-19, last on surfaces we touch every day? Potentially several hours, or even days, according to a preprint published this week by researchers at the National Institutes of Health, Princeton, and the University of California, Los Angeles. The researchers exposed various materials to the virus in the lab. They found that it remained virulent on surfaces for a lengthy period: from up to 24 hours on cardboard to up to two or three days on plastic and stainless steel. It also remained viable in aerosols—attached to particles that stay aloft in the air—for up to three hours. That’s all basically in line with the stability of SARS, the coronavirus that caused an outbreak in the early 2000s, the researchers note. The researchers caution that work done in the lab may not directly reflect how long the virus can hang around on surfaces out in the world. But it’s a critical part of understanding the virus—and how to forestall the disease’s spread—all the same. That’s because transmission dynamics are difficult to study in the midst of an epidemic. In hospitals and other public spaces, people are doing their best to disinfect, making it difficult to study how microbes behave in the wild. And similarly, while the researchers tested how long the virus can survive in aerosols suspended in the air, they didn’t actually sample the air around infected people. Instead, they put the virus into a nebulizer and puffed it into a rotating drum to keep it airborne. Then they tested how long the virus could survive in the air inside the drum. The fact that it could live under these conditions for three hours doesn’t mean it’s “gone airborne”—that it hangs around so long in the air that a person can get it just from sharing airspace with an infected person. “This is not evidence of aerosol transmission,” Neeltje van Doremalen, a researcher at the NIH and a coauthor of the study, cautioned on Twitter. There’s also a difference between a finer “aerosol,” which can hang suspended in the air for a while, and a larger “droplet,” which is more likely to fall down. When an infected person coughs or sneezes, they typically spread the virus via fluid droplets. While the results suggest the virus remains infectious in the air, there’s little evidence so far that infected people are producing aerosols in significant amounts, rather than droplets. Still, Joseph Allen, a professor of public health at Harvard who wasn’t involved in the study, says the data supports the idea that people should take practical precautions to prevent airborne spread—doing things like ensuring the flow of fresh air and good ventilation. He points out that methods of transmission should be thought of as a spectrum, and that the difference between droplets and aerosols isn’t so stark. “We shouldn’t be waiting to figure out the exact split between transmission modes before we act—we should be taking an ‘all-in’ approach,” he wrote in an email to WIRED. It’s also still difficult to say how much “fomite” transmission is actually happening—that’s the term for when a bug is left on an object, which is then picked up by others. But this is more evidence to continue playing it safe. While CDC officials have said contaminated surfaces are a less important vector than droplets in person-to-person spread, the agency still advises people to heartily disinfect. The researchers also point out that, in the case of SARS, both fomite and aerosol transmission are thought to have played a role both among super-spreaders—infected people who manage to spread the virus to lots of other people—and in hospital-acquired infections. Dylan Morris, a researcher at Princeton who coauthored the study, notes that the quick spread of the virus—which is moving faster than those that cause SARS and MERS—means there are additional dynamics at play. A number of studies have suggested significant shedding of the virus early on in the infection, while people are more likely to be going about their normal lives and before they’ve developed the severe symptoms that warn them to stay home. The researchers now plan to look at how environmental conditions, like temperature and humidity, affect the virus’s ability to stick around. In addition to better understanding real-world transmission, they also want to know if the spread may slow during warm summers, as it does for the flu. Others are also trying to tackle those questions. This week, in another preprint, researchers based in Wuhan published data on aerosols gathered from hospitals and areas around the region. For the most part, the air was clear; places like the hospital intensive care unit they tested were essentially virus-free. But in some areas, they found higher concentrations: in a staff area for example, for example, where doctors and nurses were frequently removing protective gear, and in a mobile toilet for patients. They point to findings in Singapore from a group of researchers at the National Centre for Infectious Diseases, in which a small study involving Covid-19 patients in a hospital there found significant viral shedding in patients’ fecal samples. While that study didn’t find an airborne virus, the Wuhan researchers argue it’s plausible that in the Chinese hospital, toilet flushes could have sent particles into the air. The research is still early. But taken together, the studies suggest health care providers should take precautions as they ramp up to care for increasing numbers of Covid-19 patients, Morris says. “There's currently no evidence that the general public needs to worry about aerosol transmission of SARS-CoV-2, but there plausibly could exist risks in specialized hospital settings,” he writes in an email. Others, like Allen, see more reason for caution. “The guidance for hospitals already includes bringing in more fresh air and enhancing filtration,” he writes. “It strikes me as inconsistent that the public is not getting a similar message.” In any case, he points out the core advice for staying healthy remains the same: Get yourself out of crowds. Stay home if you can. And please, please, wash your hands. WIRED is providing unlimited free access to stories about the coronavirus pandemic. Sign up for our Coronavirus Update to get the latest in your inbox. Source: How Long Does the Coronavirus Last on Surfaces? (Wired)
  25. How Wikipedia Prevents the Spread of Coronavirus Misinformation A group of hawk-eyed experts operate on a special track to monitor medical information on the site. Photograph: Getty Images “This edit was VERY poor,” wrote James Heilman, an emergency-room doctor in British Columbia, to a Wikipedia contributor who had made a couple of changes toward the end of the article on the new coronavirus outbreak. Those edits recommended a special type of mask for blocking the transmission of the virus from those who have it, and Heilman, a prominent figure in reviewing medical Wikipedia articles, wanted to inform the editor that this advice was too sweeping and based on insufficient evidence. More than that, he aimed to send a warning. “Please do not make edits like this again,” he wrote. Wikipedia’s reputation is generally on the ascent. Just last month, no less a publication than Wired deemed it “the last best place on the Internet.” What was once considered the site’s greatest vulnerability—that anyone can edit it—has been revealed to be its greatest strength. In the place of experts there are enthusiasts who are thrilled to share their knowledge of a little part of the world with all of humanity. As Richard Cooke, who wrote the Wired essay, observed: “It’s assembled grain by grain, like a termite mound. The smallness of the grains, and of the workers carrying them, makes the project’s scale seem impossible. But it is exactly this incrementalism that puts immensity within reach.” His point, and it’s really indisputable, is that this mammoth online project has developed a personality, a purpose, a soul. Now, as the new coronavirus outbreak plays out across its many pages, we can see that Wikipedia has also developed a conscience. The coronavirus articles on English Wikipedia are part of WikiProject Medicine, a collection of some 35,000 articles that are watched over by nearly 150 editors with interest and expertise in medicine and public health. (A survey for a paper co-written by Heilman in 2015 concluded that roughly half of the core editors had an advanced degree.) Readers of Wikipedia wouldn’t know that an article is part of the project—the designation appears on a separate talk page and really serves as a head’s up to interested editors to look carefully at the entries. Once an article has been flagged as relating to medicine, the editors scrutinize the article with an exceptional ferocity. While typically an article in The New York Times or The Wall Street Journal would be a reliable source for Wikipedia, the medical editors insist on peer-reviewed papers, textbooks or reports from prominent centers and institutes. On these subjects, Wikipedia doesn’t seem like the encyclopedia anyone can edit, striving to be welcoming to newcomers; it certainly doesn’t profess a laid-back philosophy that articles improve over time and can start off a bit unevenly. The editor chastised by Heilman hasn’t returned to the article and instead is improving articles about sound-recording equipment. By having these different standards within its pages, Wikipedia can be a guide to the big commercial platforms that have become way stations for fake cures, bogus comparisons to past outbreaks, and political spin. Twitter, Amazon, YouTube, and Facebook have all promised to cleanse their sites of this dangerous disinformation; but they are doing so in fits and starts and by relying in part on familiar, passive tools like acting when others flag dangerous content. Here is how Facebook's Mark Zuckerberg put it in a post on March 3: “It’s important that everyone has a place to share their experiences and talk about the outbreak, but as our community standards make clear, it’s not okay to share something that puts people in danger. So we’re removing false claims and conspiracy theories that have been flagged by leading global health organizations. We’re also blocking people from running ads that try to exploit the situation—for example, claiming that their product can cure the disease.” Wikipedia shows, however, that extreme circumstances, especially when related to public health, require different, more stringent rules, not better application of existing rules. The stakes are simply too high. I spoke this week with the Wikipedia editor who guided the article about the new coronavirus from a one-sentence item in early January to a substantial article with charts of infections around the world. She goes by the handle Whispyhistory, and is a doctor in South London; she spoke via Skype from her office, which she proudly noted had a new thermometer that looks like a laser gun. Whispyhistory has only been contributing for three years; she was recruited through an edit-a-thon at a medical library. While at first she was open with her colleagues about her side project, now she prefers to remain anonymous. “You start getting hounded by people about what you are writing,” she said. “It’s just so much easier to not use your real name.” WikiProject Medicine welcomed her, she said, but she’s had to build a reputation for accuracy and responsibility. “You have to know what you are saying,” she said, and even so it can be intimidating. “You’ve got so many people watching you.” The picture she paints of the project’s contributors is akin to the staff of a demanding teaching hospital. The editors confer on a talk page she calls “the doctors’ mess” where they perform “triage” to assess which articles require attention immediately. Science and data reign; and above all else, the pledge is to do no harm. On January 6, she said, a colleague asked her if she had heard of an outbreak of atypical pneumonia in China. She hadn’t, but “being someone who writes for Wikipedia, the first thing you do is see if it’s on Wikipedia. Someone had written the article the day before.” The article was thin, but Whispyhistory had the sense that “this might be something big,” so she added the WikiProject Medicine tag to the article and wrote a note informing her colleagues to pay attention to the outbreak, which they did. Like a young resident, she pulled all-nighters before showing up at the office at 6 a.m., keeping a watch over the article as the virus spread. In those early days, for instance, she saw a note on the doctors’ mess that linked to a news report claiming that the new coronavirus could survive on surfaces for nine hours. The author wanted to add that information to the Wikipedia page immediately. “That already sends an alert since there is nothing that’s really so important that you’ve got to add something straight away,” she recalled. She went from the news article to the paper that it cited, and discovered that it was looking at the SARS virus, not the (very similar) one that causes Covid-19. She decided not to include the research. As Heilman put it in an email, “Keeping Wikipedia reliable and up-to-date involves deleting material just as much as adding it.” I asked both him and Whispyhistory how the article on the new coronavirus managed to exclude the arguments that were being made (at least until recently) by President Trump and his supporters—that the disease is being hyped by Democrats and that it’s comparable to the flu. Don’t they have angry wannabe contributors accusing Wikipedia of bias? “That’s really easy to answer. ... You have to cite everything you write,” Whispyhistory said. Heilman agreed that a requirement for legitimate sourcing filters out unfounded notions. Bogus claims about the pandemic do show up on Wikipedia, but in a separate article: “Misinformation related to the 2019–20 coronavirus pandemic,” under the heading “Misinformation by governments/United States.” Heilman noted that Wikipedia has a structural advantage over the big social networks: “It takes more time and effort to disrupt Wikipedia than it does to restore Wikipedia to a reliable level. It’s the exact opposite on Twitter and Facebook, where it takes a second to spread false news,” while getting those lies removed will take a lot of time and effort. Unless Twitter, Facebook and the others can learn to address misinformation more effectively, Wikipedia will remain the last best place on the Internet. WIRED is providing unlimited free access to stories about the coronavirus pandemic. Sign up for our Coronavirus Update to get the latest in your inbox. Source: How Wikipedia Prevents the Spread of Coronavirus Misinformation (Wired)
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