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  1. 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)
  2. 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)
  3. 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)
  4. The Elegant Mathematics of Social Distancing Schools and sports leagues are shutting down. But experts say it's still safe for most people to shop for groceries and meet in small groups. Photograph: Laurence Griffiths/Getty Images My cousin had to cancel his bar mitzvah, which was planned for Saturday in Washington, DC. Some 100 people were scheduled to be there, but like many houses of worship this week, the synagogue suspended its services to help prevent the spread of the coronavirus. For my cousin, it means postponing the payoff from years of study, and a celebration with friends and family. Many other Americans are in similar situations during the outbreak of Covid-19, which has sickened more than 1,700 Americans and killed more than 40, according to an online tally being kept by Johns Hopkins University. Schools, religious institutions, and sports and concert venues have closed. Those who can work from home have been urged to do so. The White House reportedly overruled a proposal from the Centers for Disease Control that would have urged anyone over 60 to avoid airplane travel. In states and cities around the country, gatherings of 500, 250, or sometimes even 75 people have been forbidden. The term “social distancing”—that is, public health measures to reduce the spread of a highly contagious disease—has become one of those particular pieces of field-specific esoterica that’s vaulted into the American vernacular, like “obstruction of justice” or “security theater.” But people have lives: weddings to attend, kids’ birthday parties to endure, commutes to make, bonkers grocery store lines to stand in. What is safe right now? What isn’t? The answer isn’t clear, given what researchers know—and don’t know—about the disease. And even experts aren’t united in their responses. “This is not black and white,” says Ben Lopman, an infectious disease epidemiologist at Emory University’s Rollins School of Public Health. “We're trying right now to increase social distancing to slow down transmission of this infection. But that doesn't mean no human contact for the foreseeable future. It means us all taking sensible steps and doing our part to reduce the amount of interactions we have.” “This is not black and white.” Ben Lopman, infectious disease epidemiologist, Emory University Go to the grocery store, Lopman says, but maybe take one big trip rather than three smaller ones. Other experts suggest staying about six feet away from other people, if you can. If the person in front of you keeps coughing, maybe choose another line. To some degree, the sorts of things you should be doing right now depend on who you are. Are you someone at higher risk, like over age 60, or someone with a chronic medical condition like heart disease, diabetes or lung disease? Do you often come into contact with someone with those conditions? Are you exhibiting any Covid-19 symptoms, like fever, cough, or shortness of breath? Have you been in contact with anyone who has? Check any of those boxes, and you might want to be more careful about where you go and who you interact with. But “if you feel pretty sure that those answers to those questions are ‘no,’ you can get together [with others with similar answers] and play board games,” says Katie Colborn, a biostatistician and assistant professor at the University of Colorado at Denver. “We all have to make contacts with people while we live our lives, what we should aim to do is to limit them, and certainly not to add more,” says William Hanage, an associate professor of epidemiology at Harvard’s Chan School of Public Health. “This may seem silly if your community is not yet reporting infections, but it is best to get used to thinking this way.” From a mathematical perspective, determining how big a crowd is safe depends on a couple of key questions: How many people in a given area are infected with the disease? And how big is the event? If you know those things, you can estimate the probability of someone getting infected at the event. An elegant “Covid-19 Event Risk Assessment Planner” by the Georgia Tech quantitative biologist Joshua Weitz makes the following calculation: If, say, 20,000 cases of infection are actively circulating the US (far more than are known so far), and you host a dinner party for 10 folks, there’s a 0.061 percent chance that an attendee will be infected. But if you attend a 10,000-person hockey match, there’s a 45 percent chance. Hence the suspension of the NHL season, along with the NBA, March Madness, and Major League Baseball. Unlike in a flu epidemic, there’s no underlying immunity in the population, meaning if you come in contact with the fluids of an infected person, you’re likely to get sick. In light of these sorts of calculations, and the fact that the virus seems to be spreading throughout a number of American communities, “it makes sense to do things like cancel mass gatherings and schools,” says Lopman. Public health experts like social distancing for three reasons. For one, it likely “flattens the curve,” or decreases the number of infections at one time, or even overall. That helps prevent overloading the health care system, with its limited number of doctors, nurses, beds, and equipment like ventilators. Also, it buys time for a vaccine to be developed, says Catherine Troisi, an infectious disease epidemiologist at the University of Texas Health Science Center at Houston and the former assistant director of the Houston Health Department. (Officials hope to have a coronavirus vaccine available in 12 to 20 months.) “We all have to make contacts with people while we live our lives." William Hanage, epidemiology professor, Harvard Data from China and South Korea have given researchers a general sense of the severity of the disease: It seems, right now, that 3.4 percent of known Covid-19 infections result in death. But that number isn’t for sure. And researchers still don’t know how contagious the disease is—that is, how many other people a single infected person may infect. And they don’t know how many cases there are in the US, because testing in most of the country has been slow to ramp up. All those unknown variables mean that everything at this point is a guesstimate. When public officials set cut offs for mass gatherings—500, or 250, or 150 people—they’re deciding how risk averse they are, and balancing economic and social concerns. “There’s a lot of other consequences of canceling gatherings, and you have to weigh those. Workers need to work to pay their rent and not go homeless, because that might create a worse public health situation,” says Troisi, the epidemiologist and former public health official. Troisi is making her own personal tradeoffs. “We are going, hell or high water, to St. Louis next week because we haven't seen those grandbabies in a long time,” she says. She and her husband plan to take an airplane from their home in Houston. She notes that, yes, they are both over 60, and therefore at higher risk. No, she will not travel if she comes down with a fever. Stay tuned for the invite to my cousin’s rescheduled bar mitzvah. Like many plans right now, his are up in the air. Source: The Elegant Mathematics of Social Distancing (Wired)
  5. Apple to close US retail stores and all others outside China until March 27th The company’s online store will remain operational Photo by Amelia Holowaty Krales / The Verge Apple is temporary closing all of its retail stores “outside of Greater China” until March 27th, CEO Tim Cook announced in a letter posted on the company’s website late Friday night. “The most effective way to minimize risk of the virus’s transmission is to reduce density and maximize social distance,” Cook wrote. “We are committed to providing exceptional service to our customers.” The nationwide closure is among the first from a major retailer in the United States. But this extends far beyond the US, with every Apple location globally shutting down effective immediately — except for those in China. Apple’s online store will remain operational (as will the Apple Store app) during the downtime for physical retail locations, and customers seeking customer support can visit support.apple.com to find authorized repair shops that remain open or arrange mail-in service. “The global spread of COVID-19 is affecting every one of us,” Cook wrote. “At Apple, we are people first, and we do what we do with the belief that technology can change lives and the hope that it can be a valuable tool in a moment like this.” Employees affected by the stores closing up shop will still be paid. Here’s what Cook said on that and other adjustments Apple is making to accommodate workers impacted by the virus: All of our hourly workers will continue to receive pay in alignment with business as usual operations. We have expanded our leave policies to accommodate personal or family health circumstances created by COVID-19 — including recovering from an illness, caring for a sick loved one, mandatory quarantining, or childcare challenges due to school closures. Apple’s “committed donations” to COVID-19 have reached $15 million, according to Cook, and the company will be “matching our employee donations two-to-one to support COVID-19 response efforts locally, nationally and internationally.” Like other large companies with a worldwide presence, Apple is strongly encouraging employees to work from home if their job allows for it. Apple recently reopened the China stores it closed soon after the initial spread of the novel coronavirus and COVID-19. “Though the rate of infections has dramatically declined, we know COVID-19’s effects are still being strongly felt. I want to express my deep gratitude to our team in China for their determination and spirit,” Cook said in his note. Earlier on Friday, Apple announced that WWDC 2020 will shift to an online-only experience — still with a keynote and developer sessions — when the conference happens this June. In that press release, Apple only mentioned the “current health situation” without addressing COVID-19 directly. Cook struck a somber but hopeful tone to close his letter. There is no mistaking the challenge of this moment. The entire Apple family is indebted to the heroic first responders, doctors, nurses, researchers, public health experts and public servants globally who have given every ounce of their spirit to help the world meet this moment. We do not yet know with certainty when the greatest risk will be behind us. And yet I have been inspired by the humanity and determination I have seen from all corners of our global community. As President Lincoln said in a time of great adversity: “The occasion is piled high with difficulty, and we must rise with the occasion. As our case is new, so we must think anew, and act anew.” That’s always how Apple has chosen to meet big challenges. And it’s how we’ll rise to meet this one, too. Apple operates some of the most high-profile retail stores in the world and ranks first in the US for highest sales per square foot. Source: Apple to close US retail stores and all others outside China until March 27th (The Verge)
  6. Don’t Go Down a Coronavirus Anxiety Spiral Here’s what you can do to relieve your worries, while still keeping you and your family safe. Photograph: Richard Drury/Getty Images The past few days have made clear how serious the escalating coronavirus pandemic is for many people in the United States. Schools and workplaces across the country closed, major events were canceled, and testing delays made it impossible to confirm how many people were infected. The stock market had its biggest decline in decades, Sarah Palin rapped to “Baby Got Back” dressed in a bear suit—it feels like the world is unraveling. There is so much going on, and so much uncertainty, it is all too easy to get trapped watching cable news or scrolling through Twitter all day. If all this news is making you feel stressed, you’re far from alone. Many people are sharing their worries online; there’s a whole subreddit devoted to coping with these feelings. Experts say overloading on information about events like the coronavirus outbreak can make you particularly anxious, especially if you’re stuck inside with little to do but keep scrolling on Twitter and Facebook. But you can take steps to mitigate the amount of stress you feel, while still keeping you and your family safe. Reducing anxiety won’t only make this difficult time more bearable, it will help keep you physically healthy and your immune system strong. Why the Coronavirus Is Uniquely Stressful “All of our attention is being focused on the threatening aspects of the situation,” says Ethan Kross, a professor of psychology at the University of Michigan, where he runs a lab studying emotion and self-control “We’re zoomed in on the potential threat.” Headlines are dominated by places where the pandemic is currently hitting the hardest, like Italy and Washington state. Health authorities are cautioning about the dangers of once mundane activities, like gathering in large groups or shaking hands. As the US rolls out more testing, the number of confirmed Covid-19 cases is inevitably going to increase. The safety measures people are taking may be more immediate and visible, too, whether it’s public places looking less crowded or long lines outside of stores as people stock up on food. “That probably increased the perception that this is something dangerous,” says Thomas Rodebaugh, a clinical psychologist focused on anxiety disorders and the director of clinical training at Washington University in St. Louis. Even though most precautions in the US are being taken out of an abundance of caution, they can cause you to feel like everyone is panicking. “We are motivated to pay attention to what other people are doing,” he says. To make matters worse, you don’t have much control over the situation, which often makes people anxious, says Anu Asnaani, a clinical psychologist at the University of Utah specializing in fear-based disorders. No one knows when the pandemic will be over or when things will be back to normal, which can be maddening. “Control and certainty are at the core, from an evolutionary standpoint, of what has kept our species alive,” she says. “When we are uncertain, we take precautions to make sure we aren’t killed or we don’t die.” It can feel like everyone is trying to scare you, which, in some ways, they are. The intention is to motivate people to take actions that will keep them safe, but a side effect is that you may feel an overwhelming amount of anxiety that ceases to be helpful. Tips to Reduce Your Anxiety First, if you know you struggle with overcoming anxiety, this is a great time to reach out to a mental health professional, even if you can’t meet with them in person. “A lot of therapists are doing telehealth and phone sessions,” says Asnaani. If you’ve seen a therapist or counselor before, even if it was a while ago, she adds, “consider reaching back out to an old therapist and proactively keeping up with your mental health care.” On your own, Kross says it may be helpful to reframe the coronavirus outbreak by using a tactic called temporal distancing, or focusing your attention on a longer timescale. For example, imagine how you might look back on these events in a year, or even a few years from now. “Those kinds of perspective-broadening tools can really relieve emotions,” he says. You can also try putting the outbreak in historical context. “We have experienced these kinds of things as a society before, we have gotten through them.” (But don’t immediately jump to comparisons with the Spanish flu.) Another step is to limit how much information you consume about the coronavirus outbreak. Try to find a balance between being informed enough to make decisions about your life, but not so overloaded with information that it becomes stressful. Pick a handful of sources you know you can trust, like the Centers for Disease Control and Prevention. If you have a local newspaper, it might also be a good source for what’s happening in your community. National news outlets like The New York Times and Bloomberg BusinessWeek have daily coronavirus newsletters you can sign up for. (And, of course, continue reading WIRED.) “Even for me as a psychologist, I’m going to check in once a day in the morning,” says Asnaani. “What’s happening today and what are the guidelines? That’s it, I’m going to shut off from any Covid-19 media.” While social media can sometimes be helpful, sites like Facebook and Twitter also place us into filter bubbles, often amplify the most extreme voices, and are fervent breeding grounds for conspiracy theories and misinformation. If you find yourself growing more anxious reading them, put down your phone or step away from your computer. (And if that seems impossible, consider using tools that manage your screen time.) Do Something Else Now that you’ve shut down your phone and turned off the news, it’s a good time for stress-reducing activities. It isn’t a bad idea to try out meditation, says Rodebaugh, but there’s also no need to reinvent the wheel if you already have an anxiety-busting method that works. “When you’re feeling kind of overwhelmed, it’s a lot easier to use a coping strategy you’ve practiced a lot then to come up with a new one,” he says. Asnaani suggests to look for things that are future-oriented and pleasurable. Now is a good opportunity to do tasks around the house you have putting off and would feel happy to have accomplished, for example. Other ideas include cooking or baking, following an exercise or video on YouTube, and journaling. As more people stay home and take other precautions to avoid spreading the disease, that isolation can be its own source of stress. So can worries about family and friends, especially those who may be at higher risk for serious illness. But there are still plenty of things people can do for one another, even from a distance—and that can improve mental health for everyone involved. “Think about pro-social things you can do for them that distinctly goes against that anxiety voice,” says Asnaani, like making a photo album for grandma, playing an online game with your dad, or reading the same book as your aunt and agreeing to discuss it together. The ultimate goal is to find a way to mitigate your stress, while still keeping up to date on information that will keep you and your family safe. “We want to maintain the gravity of the situation,” says Kross. “But we don’t, to use a very technical term, need to freak out when doing it. We can remain cognizant of the big picture.” Source: Don’t Go Down a Coronavirus Anxiety Spiral (Wired)
  7. Singapore was ready for COVID-19—other countries, take note Singapore built a robust system for tracking and containing epidemics after SARS and H1N1. Enlarge / South Korean soldiers wearing protective masks sit at a temperature screening point at Incheon International Airport in Incheon, South Korea, on Monday, March 9, 2020. The coronavirus outbreak in South Korea is showing signs of slowing as the rate of new daily infections falls and health authorities almost finished testing members of a religious sect at the center of the epidemic, the country's health minister said. Getty Images 206 with 83 posters participating This pandemic—the new disease COVID-19, the virus SARS-CoV-2—is not Singapore’s first epidemiological nightmare. In 2002 and 2003, Severe Acute Respiratory Syndrome, the original SARS, tore out of China and through Asia, killing 33 people in Singapore and sparking wholesale revisions to the city-state’s public health system. “They realized they wanted to invest for the future to reduce that economic cost if the same thing were to happen again,” says Martin Hibberd, an infectious disease researcher now at the London School of Hygiene and Tropical Medicine who worked in Singapore on SARS. So Singapore instituted new travel controls and health infrastructure. Then, in 2009, it got hit again—with H1N1 influenza, the so-called swine flu. “Pandemic flu came from Mexico, an Americas event, and Singapore tried to put in place in 2009 what they learned with SARS,” Hibberd says. “But flu was much more difficult to contain than SARS was, and they realized what they thought they’d learned didn’t work. It was another lesson.” When COVID-19 came around, Singapore was, it seems, ready. Along with Hong Kong, Taiwan, Japan, and South Korea, Singapore instituted strict travel controls and protocols for identifying sick individuals—to get them help as well as to find the people they’d been in contact with. The Singaporean government posted detailed accounting for how many people had been tested for the virus, and the locations and natures of those people’s social contacts. All these governments instituted strict social distancing measures, like canceling events, closing schools, and telling people to stay home. As a result (at least in part), all have lower numbers of infected people and lower fatalities than China or Italy, proportionately. They “flattened the curve,” as public health experts now say—lowering a probable spike of infections, perhaps pushing that surge of seriously ill people further out in time so that health care systems don’t get overburdened. The lessons these countries learned could be instructive for places further out on the timeline—like the United States or most of Europe, which still lags a couple of weeks behind the virus’ spread through Italy, where there have been hundreds of deaths and the hospital system is so slammed with seriously ill people that it’s beginning to institute triage measures. These places offer models for what to do next, laying out best practices for how to respond to the pandemic with fewer deaths, to get a case fatality rate closer to South Korea’s apparent 0.8 instead of Italy’s 6.6. Detailed data can also tell epidemiologists what to expect about the dynamics of the disease, helping guide more targeted responses. “Highly detailed surveillance data will be critical for understanding the outbreak,” says Justin Lessler, an epidemiologist at the Johns Hopkins School of Public Health. “It is this sort of detailed analysis that will be critical for answering key questions about the role of asymptomatic people and children in transmission.” How they did it Here’s how those Asian countries are doing it: According to a new article in The Lancet, Hong Kong, Japan, and Singapore all developed their own tests for COVID-19 as soon as the genetic sequences for the virus were published and ramped up production of the materials necessary for those tests. (That’s a sharp contrast with the US, which still doesn’t have enough tests for nationwide use, and may actually be running out of the materials necessary to make them.) Each country instituted controls over immigration (a controversial move that the WHO recommended against, but that they did anyway). They rejiggered their national financial systems to make sure people didn’t have to pay for tests or treatment. (Easier in places where most health care is already nationalized, to be sure—and in some more progressive American states like California, Washington, and New York. In fact, New York Governor Andrew Cuomo even ordered paid sick leave for quarantined people and free hand sanitizer. Taiwan actually combined its national health care and immigration databases to generate automated alerts based on travelers’ potential for being infected. On January 20, when China had reported only a few cases of the disease, Taiwan spun up a Central Epidemic Command Center—created after SARS—to coordinate the national effort. Among other things, the CECC put limits on the prices of personal protective equipment like masks and deployed military personnel to manufacture more. In the US, mask shortages led the Food and Drug Administration to relax the rules on what kinds of masks health care workers can use; on January 20, Taiwan’s equivalent of the Centers for Disease Control and Prevention announced that it had “44 million surgical masks, 1.9 million N95 masks, and 1,100 negative pressure isolation rooms” ready to go, according to an article in the Journal of the American Medical Association. People in Singapore, for now, get information from multiple government websites, frequently updated, as well as from a government WhatsApp account. People get their temperatures taken before they can enter most buildings, including businesses, schools, gyms, and government agencies, because fever is one of the main symptoms of COVID-19. (According to my sister-in-law, whose family has lived in Singapore for six years, everyone whose temperature is normal gets a sticker, and people are expected to acquire two or three stickers every day.) Hibberd, who’s in Singapore now working on the new coronavirus, says, “On every lift I ride, there’s a notice saying what I have to do. Everywhere you walk there’s information… There’s a confidence in that information, in the government and what they’re saying, and there’s an expectation you should follow it.” The country gives a bit of money to people who don’t have the kinds of jobs that support being out of work—and fines people who don’t follow the rules. In at least one hospital, the experience of SARS led to a complete reimagining of the ways physicians deal with patients. One article from personnel in the radiology department at Singapore General Hospital describes keeping teams of health care workers separate from one another in case one has to be quarantined, and physical separations for different kinds of patients—all sorts of seemingly small systematic changes that limit the spread of an infectious disease. As one Singaporean researcher told The Guardian, “We don’t do anything different, we just do it well.” These countries all have social structures and traditions that might make this kind of surveillance and control a little easier than in the don’t-tread-on-me United States. But then, none of those countries are China, either, with its full-on surveillance state. “Copying China would have a big impact on the economy,” Hibberd says of Singapore. “But everybody getting the disease quickly and the country panicking would also have a big impact on the economy.” So Singapore is taking a middle path, he says. Of course, if the disease continues to spread, that approach might get more draconian. “If COVID-19 turns out not to be controllable,” Hibberd says, “then the containment process will change, to not looking for every case but identifying and supporting those cases at most risk of severe disease instead.” Even that data will be helpful in a broader way, though. Wide-scale testing, as these countries are doing, sweeps up mild cases, people who don’t go to the hospital. That increases the denominator, so to speak. It gives a better picture of how fast and how far the disease spreads overall, which can be compared to the number of people who get sick or die, allowing for a more accurate calculation of the case fatality rate, or CFR. It’ll also bring more clarity to questions about which people are more vulnerable—so far, older people seem much more likely to suffer complications from COVID-19, but is that due to lung damage, immunological weakness, or something else? “That said, we have to be very careful not to generalize case fatality rate estimates from any one country to another,” says Maia Majumder, a computational epidemiologist at Harvard Medical School and Boston Children’s Hospital. “As much as the CFR is a function of case-finding, it’s also a function of quality of care and population demographics.” Singapore’s health system is much better than, say, the one in China’s Hubei province, which got overwhelmed early, and seeing what was going on in China allowed all these other countries time to prepare. Singapore, Hong Kong, Taiwan, and South Korea all share the characteristic of using their experiences with prior outbreaks to build a system—and then sustaining it. None of them had to deal with the fear of being a first-mover, of being the first city or country to institute seemingly severe countermeasures. Their countermeasures were already in place, waiting to be reactivated. In the United States, all the people ringing the bell the hardest for a Singapore-like approach hope they’ll be heard, and that it’ll work—and so, by next autumn, they’ll seem like fools for having been so worried. This story originally appeared on wired.com. Source: Singapore was ready for COVID-19—other countries, take note (Ars Technica)
  8. Prime minister delivers address from self-imposed quarantine Parliament shuttered and curbs on international travel Canada has unveiled aggressive new measures to contain the coronavirus outbreak, shutting down parliament and advising against foreign travel, even as Justin Trudeau urged citizens to remain calm in a national address delivered from self-imposed quarantine. “We have an outstanding, we have outstanding public health authorities who are doing an outstanding job. We will get through this together,” said the prime minister, who has been in self-isolation after his wife, Sophie Grégoire Trudeau tested positive for Covid-19 on Thursday.In his address on Friday, Trudeau said he remained symptom free. “Of course, [working from home] is an inconvenience and somewhat frustrating. We are all social beings after all,” he said. “But we have to do this because we have to protect our neighbours and our friends – especially our more vulnerable seniors and people with pre-existing conditions.” Officials announced a raft of new measures including closing parliament for five weeks and redirecting incoming international flights to a small number of airports as part of enhanced screening measures. The government also announced it will ban cruise ships with 500 people from docking in the country’s ports until 1 July – but stopped short of closing the borders. “Borders don’t stop travellers. Travellers find other ways into countries. Travellers become less honest,” said Patty Hajdu, the county’s health minister. “Canada’s approach from the very beginning has been to use science and evidence.” Instead, the government has asked Canadians to avoid non-essential travel outside the country and to limit contact with crowds. “Social distancing is an important contribution that everyone can make to our control efforts,” said Theresa Tam, the country’s chief public health officer. “This means avoiding crowded places and non-essential gatherings, considering shopping or taking public transport in off-peak hours and greeting one another with a wave or elbow instead of a handshake, kiss or hug.” So far, Canada has conducted more than 15,000 tests and has 157 confirmed cases of the virus, most of which have been found in the provinces of Ontario and British Columbia, she said. Despite the relatively low number of cases, the federal government and provinces have acted swiftly in recent days. British Columbia, Alberta and Quebec have all banned events larger than 250 people. Ontario, the country’s most populous province, will close schools for two additional weeks following spring break, as will Quebec. “The actions you take today will save lives,” Hajdu said. “This is a serious public health threat, and a crisis as well as an emergency.” As the country prepares for a slowdown, driven by both the coronavirus and a plunge in oil prices, Trudeau said his government plans to green-light a wide-scale economic stimulus plan in the coming days. “We are in the enviable position of having significant fiscal firepower available,” he said. Alberta’s premier, Jason Kenny, has called on the federal government to announce a stimulus of at least C$20bn (US$14.3bn) – roughly 1% of the country’s gross domestic product – to offset the looming economic impact of the virus. “We need to design policies that will really help liquidity and cashflow for businesses that are uniquely affected right now,” he said on Thursday. The prime minister has not yet put a figure on the stimulus plan, but said the action will target Canadians who are most vulnerable to a downturn. “No one should have to worry about paying rent, buying groceries, or additional childcare because of Covid-19. We will help Canadians financially.” Source
  9. 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
  10. 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...
  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. 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)
  13. First person-to-person transmission of coronavirus reported in the United States A patient who traveled to China passed the virus to her husband View of St. Alexius Medical Center in Hoffman Estates, Illinois on January 24, 2020 where a Chicago woman affected by the coronavirus is treated in isolation. Photo by DEREK R. HENKLE/AFP via Getty Images The first case of person-to-person transmission of the new coronavirus has been confirmed in the United States by the Centers for Disease Control and Prevention. The husband of a female patient with confirmed coronavirus in Chicago, Illinois tested positive for the virus. The risk to the general public in the US and in Illinois remains low, the CDC said in a press call today. “CDC experts have expected to identify some person-to-person spread in the US,” said CDC Director Robert Redfield. There are now six confirmed cases of the virus in the US. As of January 29th, 92 people are being tested for the virus. Sixty-eight people who were under investigation in the US have tested negative. In China, the coronavirus has passed between individuals since December, but the majority of cases outside of China have been in patients who had recently traveled there. A handful of people, though — in Germany, Japan, Vietnam, and now the US — were infected by other people outside of China. During outbreaks of diseases, health officials hope to break the chain of illness by keeping sick people from infecting others. Although one case of person-to-person transmission in the US does not mean that the virus is circulating freely, it does mean that cases are no longer confined to people who traveled to the center of the outbreak. Over 8,000 people worldwide have confirmed cases of the new coronavirus, and the vast majority are in China. There have been 171 deaths. The new patient was being monitored by the Illinois Department of Public Health after his wife tested positive for coronavirus last week. She is believed to have contracted the disease during a recent trip to China. When her husband started experiencing symptoms, he was admitted to the hospital and placed in isolation. Both husband and wife are in their 60s and remain hospitalized. Public health officials are tracking his close contacts, and Illinois currently has 21 patients under investigation. The two patients were in very close contact for an extended period of time, and health officials believe that the female patient was symptomatic when she passed on the virus. Source: First person-to-person transmission of coronavirus reported in the United States (The Verge)
  14. Anthony Fauci said Thursday the global coronavirus outbreak will not be a pandemic for "a lot longer" because of the development of vaccines, striking a hopeful note even as the situation worsens in the short term. "Certainly it's not going to be pandemic for a lot longer because I believe the vaccines are going to turn that around," Fauci said at an event hosted by the think tank Chatham House. Fauci, the nation's top infectious disease expert, said that while the virus will likely cease raging across the globe as it is now, it could circulate quietly below the surface, at least in certain areas. "Putting it to rest doesn't mean eradicating it," he said. "I doubt we're going to eradicate this, I think we need to plan that this is something we may need to maintain control over chronically, it may be something that becomes endemic that we have to just be careful about." Still, Fauci clearly thinks that vaccines will be a major boost in the fight against the virus. Pfizer reported this week that an interim analysis shows its vaccine was more than 90 percent effective, higher than expectations. Moderna said trial results for its own vaccine candidate may be available by the end of the month. In the meantime, though, coronavirus infections in the U.S. and around the globe are surging. Case numbers are rising in every single state, the U.S. this week set a single-day high for new infections and a record number of people are hospitalized with the disease. Still, Fauci said knowing an end is in sight is all the more reason to keep up precautions like mask-wearing, distancing, and washing hands in the short term. The general public in the U.S. could start getting a vaccine sometime in the spring, officials have said, and high priority groups like health care workers and the elderly, as soon as December. "Ever since it became clear a few days ago that we have a really quite effective vaccine getting ready to deploy, [the message] is rather than 'Hey don't worry you're OK,' it's 'Don't stop shooting, the cavalry is coming but don't put your weapons down, you better keep fighting because they're not here yet,' " Fauci said. Source
  15. Experts worry that social distancing and stay-at-home-orders are exacerbating abuse. For weeks, experts and advocates have been raising alarms that the coronavirus outbreak could be disastrous for people in abusive relationships. With nearly three in four Americans being asked not to go out, more victims are isolated in unsafe homes. Abusers may be aggravated by mounting financial pressure and stress. And domestic violence organizations are already strained by social distancing requirements. Barbara Paradiso, director of the Center on Domestic Violence at the University of Colorado-Denver, says the current moment “feels almost like a petri dish for the levels of violence to increase within family relationships.” Data from police departments and local news coverage from around the country suggests that these concerns are justified. Mother Jones has identified 13 cities and counties that have reported increases in emergency calls to 911 or domestic violence hotlines over the past month. Several places have seen double-digit increases: Police in Seattle, the first US city hit by a wave of coronavirus cases, received 22 percent more domestic violence calls in the first two weeks of March than they did during same period last year. Police in San Antonio, Texas, reported a 21 percent increase in family violence calls, with more than 500 additional calls during the first three weeks in March compared to the same period last year. Charlotte-Mecklenberg Police Department in North Carolina reported nearly 400 more domestic violence calls in March compared to the previous year—a 16 percent increase. Nassau County, on western Long Island, has seen a 10 percent increase in domestic violence 911 calls since January compared to last year, leading the county to announce last week that it was opening a second domestic violence shelter. Police in Portland, Oregon, made 38 domestic violence arrests during a 10-day period in mid-March—a 27 percent increase from the 30 arrests over the same period last year. As of March 22, New York City police had received 7 percent more complaints for domestic violence involving felony assault since January 1 compared to the same period last year. Law enforcement in Salt Lake City; Charleston, South Carolina; and Collier County (which includes Naples), Florida, have also reported upticks in domestic violence calls. During the week that Californians were ordered to shelter in place, domestic violence calls to police in Fresno, went up by more than 50 percent before returning to normal the following week. Some local domestic violence hotlines are reporting a spike in call volume too, including those in Philadelphia, Cincinnati, Austin, and Charlotte. Some cities, including Los Angeles, Miami, and Denver have had no notable increases in domestic violence call volume in recent weeks. In East Baton Rouge, Louisiana, there was a downturn in calls. Ruth Glenn, the president of the National Coalition Against Domestic Violence, points out that police data is not a perfect gauge of whether domestic violence is getting worse. More 911 calls could indicate more violence, but they also could indicate greater trust of local law enforcement during times of crisis—or, simply, more neighbors overhearing arguments or disturbances. “My concern is victims that don’t report,” Glenn says. It’s still early in the coronavirus crisis, and domestic violence tends to escalate as people spend more time in close quarters. In Seattle, most of the 911 calls were for “disturbances”—arguments that did not lead to arrests or criminal charges. With time, Glenn says, “we may see an escalated type of domestic violence calls being made: threats with guns, ‘he strangled me,’ that kind of thing. Abusers escalate.” Isolation is already a well-known tactic of domestic abusers. But now, quarantines and shelter-in-place orders meant to protect public health may be fueling abusive relationships. With families being urged or required to stay home, “essentially, you’re sentencing victims and their children to being 24/7 with their abuser,” Paradiso says. “And that can be a terrifying prospect.” And because many workplaces are closed and visits to family and friends are off the table, many of techniques survivors rely on to deescalate tensions at home have vanished. So have the safety plans many survivors make to escape their abusers during violent episodes. “If things are beginning to get too hot, then they go visit mom for a while,” Paradiso says. “Or, when their partner is away at work for eight hours, the chances of things being able to deescalate are much higher.” Advocates on the ground report that abusers are using social distancing as a means of exerting control over their partners and victims. Twahna Harris, an advocate for survivors in Baton Rouge, Louisiana, has been taking calls from victims who say the coronavirus has already intensified the fear and controlling behavior they live with on a daily basis. One woman who called Harris’ nonprofit, The Butterfly Society, wasn’t able to go to the grocery store to get essential supplies for her family because her husband controlled all their money. Another, a teacher stuck at home because schools are closed, said her partner demanded to review the receipt when she left the house to shop. “He looks over the receipt, what she’s paid, what time did she leave home, how long it took her to make it to Walmart, if the timeline adds up,” Harris says. She recalls the teacher telling her, “I am enslaved to him.” Over the last few weeks, Paradiso has heard stories of injured victims who would not go to a hospital for help because the were afraid of becoming infected with the coronavrius. She’s also heard of abusers threatening to expose their partners to the virus by kicking them out of their homes. Abusers may weaponize fears of contagion by withholding medical supplies or hand sanitizer from their victims, reports the National Domestic Violence Hotline. “An abusive partner will use any tool in the toolbox to exert power and control,” says Crystal Justice, the hotline’s communications officer. On top of all of this, financial insecurity can increase aggression in abusive relationships, according to Paradiso. Uncertainty around money, or job security, or ability to make the next rent payment or put food on the table—all of this stress adds fuel to the fire. “Any time that somebody who chooses to use violence experiences heightened levels of a lack of control in their lives, the tendency for violence escalates,” Paradiso says. Politicians are urging victims to leave their homes if they’re facing abuse. “I can’t stress enough: you do not need to stay in your home in a dangerous situation,” said Minnesota Gov. Tim Walz during a Monday press briefing. “There are places of sanctuary for you to get out of that.” But domestic violence shelters are in a tough spot, simultaneously facing increased demand in some places and the need observe social distancing guidelines. Some organizations have reduced their bed count or sent survivors to motels. Many, like Charlotte’s Safe Alliance, have asked for donations to help with increased costs for food and cleaning. Last week, two dozen US senators sent a letter to the Department of Health and Human Services urging the Trump administration to ensure that domestic violence organizations, many of which receive federal grants, have the “flexibility, resources, and information” needed to help survivors and their families during the pandemic. In the absence of other options, some advocates are suggesting that victims stay in cars or trailers. Harris has been telling people who can’t or won’t leave their homes to find safe spaces like closets, attics, or bedrooms with a lock, where they can take a few minutes alone to unwind. She encourages them to reconnect with family or friends digitally if they can, or plan a trip to the grocery store with a neighbor. Harris also knows the mental and physical toll that social isolation can take on someone living with abuse. She’s been through it herself, with a former partner who threatened to kill her if she left him. She was eventually able to escape with help from her boss. It’s not difficult for Harris to imagine how the current situation might have exacerbated her former partner’s attempts to control her. “If I was where some of these victims are right now, with my ex-abuser,” Harris says, “I don’t think I would have made it.” Despite the new constraints facing many survivors and the organizations that serve them, experts and advocates resoundingly encourage those in abusive relationships to reach out for help. “I think the most important message to get out there is that people should call,” Paradiso says. “Call 911 if you’re in fear.” The National Domestic Violence Hotline takes calls 24/7 at 1-800-799-SAFE (7233), or 1-800-799-7233 for TTY. If you’re unable to speak safely, you can log onto thehotline.org or text LOVEIS to 22522. The Department of Health and Human Services has compiled a list of organizations by state. Source : Mother Jones
  16. Tech supply chains are still a complete mess Coronavirus lockdowns are wreaking havoc on our fragile manufacturing system Last week, we made the case that tech manufacturing was uniquely vulnerable to pandemic problems, from a combination of just-in-time manufacturing practices and a far-flung network of suppliers. But just a week later, the news is even worse. On Friday morning, analysts at S&P’s Panjiva Research laid out a grim picture, with US sea imports from China (which includes most of the electronics you buy) down more than 50 percent in the first three weeks of March, a result of the countrywide lockdown in China. At the same time, the subcontracting companies that actually build the hardware (the most famous is Foxconn, but of course there are a lot of them) are thinking about getting out of China entirely, at least as much as they can. Wistron Corp, which does a lot of work for Apple, boasted last week that it could move as much as half of its business outside Chinese borders within a year. It’s a huge sea change for tech manufacturing, and while it has been building for a long time, it’s going to be a lot faster and messier because of the pandemic. It also means that, while these companies are scrambling for labor and parts, they’re also going to be scrambling to stand up a whole new set of factories. At the same time, there are real concerns about the supply chain for lithium. A Benchmark report lays out the quarantine situation for a number of major lithium exporters, from Australia to Chile, and while there haven’t been any intense shortages yet, mines are having a lot of trouble getting shipments out. “It’s not the orders and it’s not the production, it’s [about] can we get it shipped?” one mining CEO said. “Can we get the vessels? Can we get the containers?” The result will be a lot less lithium for manufacturers, which could be a huge problem for anything with a battery. It’s hard to say what all this adds up to. It’s getting harder to make electronics, but with so many people out of work, there is less demand to meet. If the factories are half-closed, maybe it doesn’t matter if the lithium shipment comes in a little late. The current situation is so chaotic that it’s hard to be sure of anything. But the result is scary news for anyone trying to get a shipment of phones out on time — and you can be sure there is a lot of chaos happening behind the scenes. Source: Tech supply chains are still a complete mess (The Verge)
  17. New York hospitals will trial using antibodies to treat coronavirus cases It's a relatively simple means of potentially helping the worst cases. Enlarge / The machine at right can separate out blood plasma and simultaneously return red blood cells to the donor. Mikhail Tereshchenko/Getty Images 59 with 38 posters participating Back in our exhaustive review of potential treatments for SARS-CoV-2 infections, we mentioned one option that was relatively quick, easy, and required no further approval for use: transfer of blood plasma from those who had previously had an infection. The reasoning being that this plasma will contain antibodies that could neutralize coronaviruses in the blood stream, severely limiting the progression of an active infection. Now, trials of this method are starting in New York City, the hardest hit location in the US. We'll quote our earlier coverage of this potential therapy, which explains why it might be a quick route to a treatment, albeit with limitations: Spike is a complicated protein that provides a wealth of targets for potential therapies. As the most prominent feature of the virus' exterior, spike is the main target of antibodies against the virus produced by the immune system. This has already led to one option for therapies: purifying plasma from people who have fought off a coronavirus infection, on the assumption that the plasma contains antibodies that can neutralize the virus. This plasma can then be infused into sick people, where the antibodies should help the immune system clear the virus. While it's only a temporary fix—antibodies don't survive indefinitely in the blood stream—it may give a patient's immune system sufficient time to develop its own antibodies. There are unknowns about whether infected individuals produce effective antibodies. But the big issue here is scaling, as plasma treatment relies on having enough healthy, formerly infected individuals who are willing to donate blood plasma. If used strategically—on the most at-risk patients, or to help infected health care professionals—it could be a helpful tool but isn't likely an effective general therapy. There have been some anecdotal reports of the approach being used by countries like China, which were hit hard early in the pandemic; one published today indicated that plasma treatment improved the condition of five critically ill patients. But no detailed studies of its effectiveness have been reported so far (at least to our ability to determine). That may now be about to change, according to the New York Times. Several New York City hospitals are planning a joint test of plasma transfusions as a therapy, relying on the large and growing population of formerly infected people in the area. Initially, it will be tested in those who are suffering COVID-19 symptoms who require hospitalization but who have not progressed to severe breathing impairment. The Food and Drug Administration approved the research on Tuesday. The plan is to use the New York Blood Center, which normally coordinates blood, platelet, and bone marrow donations, as a sort of clearing house for the plasma. It will obtain it from donors and screen it for additional infections before approving it for use. (As a side benefit, this may help us better understand how long after infection the coronavirus persists in individuals.) The Blood Center will also ensure that the plasma has high titers of antibodies against the coronavirus. One good aspect of this method is that we have the ability to separate the plasma from the oxygen-carrying red blood cells and re-inject the latter during the donation. Since plasma is replenished more rapidly than red blood cells, this will allow a single donor to make repeated contributions. We still don't know whether antibodies are effective against an infection in progress; the therapy may do nothing, or only slightly slow the progression. But there's a reasonable chance it will help, and this trial will be a good opportunity to understand if it does. Source: New York hospitals will trial using antibodies to treat coronavirus cases (Ars Technica)
  18. 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)
  19. 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
  20. Google is hiding 'coronavirus' apps from the Play Store – and it's not alone Misinformation is contagious (Image credit: Shutterstock) Google appears to have hidden apps related to coronavirus from search results in the Google Play store. The change, as reported by 9to5Google, is likely an attempt to stop the spread of misinformation about the virus. At the time of writing, searches for 'coronavirus' and 'Covid-19' (the official name for the disease caused by the virus) yield no results. Such searches worked as expected until very recently, and a search for 'covid' reveals dozens of apps containing both terms. Some apps about protecting yourself from the virus might be benign or even helpful guides, with information about correct hand-washing and how to quarantine yourself. However, apps could also be used to spread misinformation that's unhelpful at best, and dangerous at worst. It's also possible that unethical developers are attempting to cash in on the crisis, pushing out very simple apps that contain little information at all, and are mostly a means of showing ads or convincing worried users to sign up for premium features. Stopping the spread Google isn't the only tech company stepping in to curb the spread of misleading information about the virus. Last year, Pinterest decided to intervene when users search for information about vaccinations and cancer, showing only information from reputable medical publications. It's now taken the same approach with coronavirus, showing a set of information cards created by the World Health Organization (WHO) offering advice on limiting the spread of the virus. Facebook is taking a similar approach. Mark Zuckerberg says that the social network is giving WHO free advertising space, and redirecting searches for 'coronavirus' to information from the WHO or a local health authority. False claims and conspiracy theories will be swiftly removed, and anyone trying to exploit the situation by advertising miracle cures will find their accounts blocked. (Image credit: Twitter) Twitter isn't going so far as to block content, and a search for the virus brings up tweets containing all sorts of false information (including a tutorial on making an effective face mask using a piece of toilet paper and rubber bands). These are preceded by a notification box marked 'Know the facts' with a link to a verified local health provider, but the site might choose to follow Google and Facebook's example, and tighten up its policy in the coming weeks. Source: Google is hiding 'coronavirus' apps from the Play Store – and it's not alone (TechRadar)
  21. Mobile World Congress canceled due to coronavirus [Updated] Decision comes after a number of vendors pull out of world's biggest telecom show. Enlarge / MWC in 2017. Ron Amadeo [Update 2:32pm ET, February 12. 2020] Mobile World Congress 2020 (MWC) organizer the GSMA has announced that the annual technology event in Barcelona is canceled this year. Part of the GSMA's statement on the decision says: "Global concern regarding the coronavirus outbreak, travel concern, and other circumstances, make it impossible for the GSMA to hold the event." The cancellation followed news of several major exhibitors backing out due to travel restrictions and concerns related to the coronavirus outbreak in China. See below for details on that developing story. Original story 6:05pm ET, February 10, 2020] Mobile World Congress 2020 (MWC) is supposed to be the biggest week of the year for mobile technology, but the coronavirus public health scare and related travel restrictions have led to a great deal of uncertainty amidst the usual fanfare. Several major tech companies, including Sony, Amazon, LG, Ericsson, and Nvidia, have cancelled plans to appear at the conference, and some, like Samsung, still plan to attend but with a reduced presence. The GSMA was quick to point out, as quoted in the BBC, that the event remains "more than 2,800 exhibitors strong." The announcements have trickled in over the past few days. Many of these companies are usually key players at the event, and while many more companies still plan to attend, this year's show looks like it's going to be very different from what we saw in 2019 or 2018. Organized by the GSMA mobile interest group and held annually in Barcelona, MWC has become arguably the most significant event of the year for the mobile and wireless technology industry. Many mobile companies skip the noise of CES to unveil their plans and do business at this more focused event. This year's event was expected to be a major one: it will open the floodgates for the 5G transition, mobile companies have predicted. In 2019, 109,000 people from 198 countries and territories attended MWC. Six percent of those attendees were from China, and 16 percent were from the wider Asia-Pacific region, according to the GSMA's annual report. Yesterday, the GSMA responded to the back-outs by clarifying the safeguards the organization is taking to protect attendees and exhibitors at MWC. They include a ban on all travelers from China's Hubei province and a requirement for travelers to show proof they've been away from China for the 14 days preceding the event. Additionally, attendees must state that they have not been in contact with any infected persons and subject themselves to temperature screenings. The GSMA will also give "advice" that visitors not shake hands at the event. Barcelona Mayor Ada Colau recently reassured visitors that the city is ready to handle the event in these circumstances. "I would recommend that we listen to the experts, scientists, and health authorities who tell us that the Mobile (World Congress) can go on with complete normality," she said. Catalan Health Minister Alba Vergés was quoted in the GSMA's statement on the subject, saying, "the Catalan health system is prepared to detect and treat coronavirus, to give the most appropriate response, and this must be clear to those attending MWC Barcelona." The coronavirus outbreak's effect on the tech industry is not just about conferences; several companies have placed business travel restrictions on their employees, including Apple, Google, Facebook, Microsoft, Airbnb, and more. And both Apple and Amazon told investors on their most recent quarterly earnings calls that they are uncertain how severely the outbreak will impact their supply lines in China. There have been numerous reports of key factories for those companies closing or operating with reduced staff. The outbreak is also affecting other industries. The Singapore Airshow has seen some back-outs by major exhibitors, including Lockheed Martin. And in one of many examples for the gaming industry, popular video game PlayerUnknown's Battlegrounds saw the postponing of an esports event planned in Berlin. As Ars has previously reported, there are now 40,500 confirmed cases of the virus, and there have been 910 deaths. The majority of the cases occurred in China, and only one death has been confirmed outside of China. Source: Mobile World Congress canceled due to coronavirus [Updated] (Ars Technica)
  22. Australia's CovidSafe tracking app is now available – here's what you need to know Now available for Android and iOS (Image credit: Australian Department of Health) Following on from the release of its official coronavirus information app, the Australian Government has now launched its voluntary CovidSafe tracking app with the goal of tracing the spread of Covid-19 more accurately. Available now for Android and iOS, the CovidSafe app works by recognising and keeping track of other devices with the app installed and Bluetooth switched on, essentially keeping a record of the people (who have also opted in) who come within 1.5 metres of you for a period of at least 15 minutes. The idea is that the app will speed up the current process of notifying people who have been in close proximity to someone with Covid-19. The CovidSafe app will take note of the "date, time, distance and duration of the contact," as stated by the Department of Health's website. If diagnosed with Covid-19, users will have the option of consenting to the release of their contact data, in turn allowing the app to get in touch with other users who have been in close proximity to the affected patient. While the app's source code has not been released at this time, Twitter developer Matthew Robbins has independently decompiled the Android app and has found it to be "above board, very transparent and follows industry standard," as reported by Ausdroid. Privacy According to the CovidSafe app's privacy policy, the Australian Government will ask for your consent to collect your mobile phone number, name, age range and postcode. The collected personal data will reportedly be encrypted and stored on your device alone and will be automatically deleted after 21 days. If you are under 16 years of age, a parent or guardian will have to consent for you. For the app to work, the site admits that some data will have to be recorded elsewhere. This includes "the encrypted user ID, date and time of contact and Bluetooth signal strength of other COVIDSafe users with which you come into contact." The policy states that a new "encrypted user ID will be created every 2 hours," however, this information "will be logged in the National COVIDSafe data store, operated by the Digital Transformation Agency, in case you need to be identified for contact tracing." The data store is described as a "cloud-based facility, using infrastructure located in Australia, which has been classified as appropriate for storage of data up to the ‘protected’ security level." As for how long your data will remain in the cloud, the Department of Health's website states that "We will delete all data in the data store after the COVID-19 pandemic has concluded as required by the Biosecurity Determination." Your data will reportedly also be deleted if you uninstall the CovidSafe from your device or if you "upload your contact data to the data store." The policy stresses that "No location data (data that could be used to track your movements) will be collected at any time." The Australian Government has also released a more thorough 78-page Privacy Impact Assessment in PDF form. Other issues and concerns For the CovidSafe app to work effectively, your device's Bluetooth will need to remain switched on at all times so that the app can continuously ping other users. Of course, this is expected to drain your phone's battery life quicker than usual. While Android devices will be able to run the CovidSafe app in the background, meaning "you can use your phone as normal without having to open or check COVIDSafe," the app FAQ stipulates that iOS devices will need to "Keep COVIDSafe running and notifications on when you're out and about, especially in meetings and public places" – a barrier which could prove a nuisance for many. That said, while the app certainly has its drawbacks, it appears to be secure and seems to take users' privacy into consideration. With this in mind, potential users will need to weigh these minor downsides against the app's proposed benefits – namely, a far more accurate way of tracing the spread of coronvirus, which should in turn help speed up Australia's return to normalcy (or something like it). Source: Australia's CovidSafe tracking app is now available – here's what you need to know (TechRadar)
  23. Outbreak update — Symptomless spread of new coronavirus questioned as outbreak mushrooms The main source of infections is most likely people coughing and sneezing. Enlarge / Information officer wearing protective mask, gloves, and goggle, as prevention of novel coronavirus epidemic, at international arrival gate of Bali Ngurah Rai International Airport in Kuta, Bali, Indonesia on February 4, 2020. Getty | Nur Photo The Chinese businesswoman who spread the 2019 novel coronavirus (2019-nCoV) to four colleagues in Germany while reportedly experiencing no symptoms of the infection actually did have symptoms, according to a news report in Science. The woman’s case, published January 30 in The New England Journal of Medicine, was considered the most clearly documented evidence that the novel viral infection could spread silently from asymptomatic people. Public health experts have been particularly anxious about such transmission because it could potentially ease disease spread and negate outbreak control efforts, including screening travelers for symptoms, such as fever. “The fact that asymptomatic persons are potential sources of 2019-nCoV infection may warrant a reassessment of transmission dynamics of the current outbreak,” the authors of the NEJM article concluded. But that conclusion now appears to be based on false information. And, while the new information on these specific cases doesn’t rule out the possibility that asymptomatic spread has occurred or is occurring in other cases, it could help ratchet down fears that asymptomatic spread is driving the now mushrooming outbreak. Experts at the World Health Organization have said repeatedly that even if asymptomatic spread is occurring, it is likely a minor source of infection; coughing and sneezing people are simply much more likely to spread the virus. Moreover, the corrected version of the NEJM article may highlight a more pressing threat to outbreak control—the fact that all five cases in the cluster were mild and unremarkable amid standard cold and flu season. Missed signs According to the new report in Science, the businesswoman’s 2019-nCoV infection symptoms went unrecognized because they were mild, masked by over-the-counter medications, and—most notably—the authors of the NEJM article didn’t speak with her before the article was published. The woman, a Shanghai resident who had visited Germany from January 19 to 21, tested positive for 2019-nCoV in China on January 26. The other four cases were identified in Germany by January 28, and the case report appeared in NEJM just two days later. Without direct communication with her prior to the publication, the NEJM article’s authors relied on the accounts of her four sickened colleagues in Germany, who said she didn’t seem sick during her visit. But government health officials in Germany were later able to reach the Shanghai woman by telephone. People privy to details of the call told Science that she said she felt tired, had muscle pains, and took a fever-reducer during her visit. Officials at the Robert Koch Institute (RKI), the German government’s public health agency, have sent a letter to NEJM informing them of the error in the article, according to an RKI spokesperson who spoke with Science. One of the NEJM authors, Michael Hoelscher of the Ludwig-Maximilians University of Munich Medical Center, told Science that they should have been clearer about where they had gotten the information about the woman’s symptoms. “If I was writing this today, I would phrase that differently,” he said. Another author on the article, virologist Christian Drosten of the Charité University Hospital in Berlin, said, “I feel bad about how this went, but I don’t think anybody is at fault here. Apparently, the woman could not be reached at first and people felt this had to be communicated quickly.” Drosten went on to say that—despite the correction—the five cases highlight a potentially dangerous feature of this outbreak—that is, that the infection may not be very dangerous. “There is increasingly the sense that patients may just experience mild cold symptoms, while already shedding the virus,” he said. “Those are not symptoms that lead people to stay at home.” Circulating unknowns Indeed, as the outbreak has continued to escalate, experts have noted that the virus appears more contagious than initially thought and that the early outbreak responses focused heavily on identifying the most severe cases, such as those involving pneumonia and respiratory distress. That focus may have potentially missed the spread of mild disease, which may be far more extensive than what is known even now. As of Tuesday morning, there are reports of 20,704 cases worldwide and 427 deaths. According to the World Health Organization’s latest figures, approximately 13.5 percent of cases are severe—though that estimate could change dramatically if many mild cases are missing, which is likely. Of the outbreak cases, a little over 200 are outside of mainland China, scattered in around two dozen countries. Some of those countries have reported limited person-to-person spread, including the United States. The US Centers for Disease Control and Prevention has confirmed 11 cases in the country so far, including nine travel-related cases and two cases of person-to-person transmission within the US among close contacts. The first case identified in the US, a 35-year-old in Washington state, has been released from the hospital and is now in isolation at home. The second identified case, a Chicago woman in her 60s, has been described as doing “quite well” and is primarily being hospitalized for isolation purposes. “The look and feel of the exported cases, I think, really support the argument that there’s a lot of mild disease that is not being detected in China at the moment for the very good reason that they just can’t do it,” Dr. Allison McGeer told Stat News recently. McGeer is an infectious diseases researcher at Toronto’s Mount Sinai Hospital, who helped respond to other outbreaks of emerging coronaviruses, namely those behind SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome). Public health experts and media are now volleying predictions of how the outbreak will play out—whether it will be contained and fizzle out or become a pandemic (that is, with worldwide spread), and whether it could resurge occasionally or join its four common coronavirus cousins in continually circulating among humans. The answer is still unclear, of course, and, for now, the CDC still considers the risk to the general American public to be low. Source: Symptomless spread of new coronavirus questioned as outbreak mushrooms (Ars Technica)
  24. How do we test for coronavirus, anyway? A rundown of the biology behind testing for a virus we hadn't seen before. Enlarge / Centers for Disease Control and Prevention Director Robert Redfield speaks during a press conference about the 2019-nCoV outbreak. Samuel Corum/Getty Images As the recently discovered coronavirus has rapidly spread beyond its origins in China, health authorities around the world have needed to quickly develop testing capabilities. In the United States, that task has been performed by the Centers for Disease Control (CDC), which has published its methodology and is currently in the process of applying for an emergency waiver to allow medical-testing facilities to perform these tests. But if you're not familiar with the tools of molecular biology, the CDC's testing procedure might as well be written in another language. What follows is a description of how to go from an unknown virus to a diagnostic test in less than a month. Starting from nothing When Chinese health authorities were first confronted with the outbreak, it had a disturbing familiarity. They had already dealt with a similar set of symptoms during the SARS outbreak in the early 2000s and had seen the spread of MERS a decade later. Thanks to these and related viruses, we already had a detailed description of the structure of the typical coronavirus genome as early as 2005. That knowledge would undoubtedly prove essential for the first step in developing a rapid diagnostic test: characterization of the genome of the new virus, 2019-nCoV. Because we know what the average coronavirus looks like, we have been able to identify areas that don't change much over the evolution of new members of this family of viruses. And that allows us to obtain sequences of its genome without first isolating the virus. The first challenge of sequencing a coronavirus genome is that it's made of RNA rather than DNA. Most of our tools for working with nucleic acids are specific to DNA. Fortunately, we've discovered an enzyme called "reverse transcriptase" that takes RNA and makes a DNA copy of it—transcription is the copying of DNA into RNA; this enzyme does the opposite, hence the name. (Reverse transcriptase was first identified in other RNA viruses that need to be copied into DNA as part of infection.) Using reverse transcriptase, researchers were able to make DNA copies of parts of 2019-nCoV as a first step to studying its genome. But reverse transcription of samples from infected individuals would simply create a mess of DNA fragments from everything present: the patient's own cells, harmless bacteria, and so on. Fortunately, DNA sequencing and analysis techniques have become so advanced that it's now possible to just sequence the whole mess, irrelevant stuff and all, and let computers sort out what's present. Software is able to take what we know about the average coronavirus genome and identify all of the fragments of sequence that look like they came form a coronavirus. Other software can determine how all these fragments overlap and then stitch them together, producing a near-complete coronavirus genome. At this point, Chinese health authorities recognized that the virus involved in these infections was new, and they rapidly published the virus's genome sequence so that other health organizations could be prepared. From genome to sampling To make a diagnostic test specific to 2019-nCoV, researchers had to look for areas of its genome that don't change rapidly over coronavirus evolution but have changed enough in this branch of the family that they can be viewed as its distinctive signature. Those sequences can be used to design a means of amplifying a piece of the 2019-nCoV genome using a technique called the polymerase chain reaction, or PCR. We won't go into all of the technical details of how PCR works, in part because we've already done so. For the purposes of understanding the diagnostic test, all you have to know is that you need to design two small pieces of DNA that match (meaning they can base pair with) two sections of the genome a few hundred base pairs apart. These small pieces of DNA are called "primers." PCR will amplify the section of DNA between the two primers. It does this by putting the DNA through heating and cooling cycles in the presence of enzymes that copy DNA. Each time through the cycle, the enzymes can make two new copies of the section between the primers. Using this process, it's possible to take a stretch of DNA that's extremely rare and produce billions of copies of it. But PCR works with DNA, and the coronavirus is made of RNA. So we need to use reverse transcriptase first before trying to perform PCR. Fortunately, companies have developed solutions that have all the enzymes and raw materials that both reactions need, allowing for coupled reverse transcriptase-PCR reaction mixes. The combination of reactions has been termed RT-PCR. With the right primers, RT-PCR can allow us to start with a chaotic mix or RNA and leave us with a lot of copies of a specific piece of the 2019-nCoV, provided any was present in the original sample. The problem is that PCR is so sensitive that it can also amplify small errors—primers sticking to a distantly related sequence, a distantly related coronavirus in the sample, or even contamination from the previous sample. Even though these errors are rare, the exponential amplification provided by PCR can eventually allow one to dominate the sample. Fortunately, people have devised a way of taking advantage of the rarity of these errors. Get real If the right sequence for the primers is present—meaning 2019-nCoV is present in the sample—amplification will typically start with the very first cycle and grow rapidly. Errors, in contrast, may take a few cycles to occur and amplification therefore lags for a bit. To figure out when 2019-nCoV is really present, we have to identify when the amplification happens quickly and when it lags. We have to observe the progress of the PCR cycles in real time. To do so, scientists developed a dye that only fluoresces if double-stranded DNA is present. As the reaction starts, there's very little of that around, so fluorescence is low. But as more amplifications occur, the glow rapidly rises until there's so much DNA that sensing the difference between cycles becomes impossible. If the amplification starts early, this rise and saturation occurs early; if it depends on an error, then it takes longer to see them. Thus, real-time RT-PCR (RRT-PCR, for those excited about jargon) gives us a way to determine whether a PCR amplification occurs because our sequence of interest is present. (It can also be used to get an estimate of the relative amount of that sequence is present, but that's not needed for this test.) Because this is such an important technique, companies have developed products based around it. You can buy the fluorescent dye, enzymes, etc., as well as a machine that integrates the thermal hardware to cycle the reaction and has a light sensor to monitor the fluorescence. If you wanted to do this yourself, appropriate hardware seems to be available on eBay for somewhere in the neighborhood of $2,000. Kits aren’t all you need If you look at the CDC's instructions, however, you'll see little discussion of the hardware or enzymes. Instead, you'll find discussion of ways to avoid contamination. If a facility is doing lots of sample testing, there's going to be no shortage of 2019-nCoV DNA around, both from the samples and from the previous PCR reactions. Given the ease with which PCR can amplify rare sequences, this can create the risk of hordes of false positives. So the CDC details reams of best practices, like preparing RT-PCR reaction mixes with a separate set of hardware than that used to handle samples. Another big chunk of instructions involves the details of appropriate controls. Some of those leave out key reaction components like enzymes or sample RNA, in order to make sure that contamination is not producing spurious results. This will tell you whether you should trust positive results. There's also a positive control, to make sure that there isn't something wrong with the reaction mix, thus telling you whether you can trust negative results. That said, the tests aren't going to be definitive. We don't know enough of the virus' lifecycle to know the dynamics of infection yet: how long after infection does the virus become detectable, and when does that compare with the onset of symptoms. It's quite possible that asymptomatic infected people won't have enough virus for this test to pick up the virus consistently. So the CDC is still advising caution with people considered to be at risk of infection. Still, as cases of person-to-person transmission outside China appear to be ramping up, testing without the need to ship samples to CDC headquarters in Atlanta could help significantly with our ability to respond to a rapidly changing outbreak. Source: How do we test for coronavirus, anyway? (Ars Technica)
  25. Coronavirus Is Bad. Comparing It to the Flu Is Worse The whataboutism of infectious disease is as dangerous as it is hackneyed. Photograph: MLADEN ANTONOV/Getty Images There's a deadly virus spreading throughout China right now, but SELF Magazine has a calming message for Americans: "For perspective," the publication tweeted Thursday, "the flu is a bigger threat in the U.S." This was just the latest in an epic run of such comparisons: “The virus killing U.S. kids isn’t the one dominating headlines,” the Daily Beast advised; “Don’t worry about the new coronavirus, worry about the flu,” said Buzzfeed. Even the U.S. Surgeon General has gotten in on this idea. There are as many as 5 million severe cases of flu worldwide each year, and 650,000 deaths; in other words, says Axios, “If you’re freaking out about coronavirus but you didn’t get a flu shot, you’ve got it backwards.” Call it “viral whataboutism.” The appeal to hypocrisy has long been endemic to our political discourse; and in recent years the pox has spread. Now this mutant form of rhetoric has come into discussions of what could be a massive epidemiological threat. Is the new coronavirus something to worry about? Yeah, sure, but so’s the flu… and you don’t seem to care too much about that! For goodness’ sake, stop. Yes, we know the flu is bad—no one likes the flu. But the gambit of positioning the influenza virus as the scarier of two foes is as dangerous as it is hackneyed. During the outbreak of deadly hemorrhagic fever that hit West Africa in 2014, Americans were reassured, again and again, that “Ebola is bad. The flu is worse.” It’s true that Ebola didn’t become a true threat in the United States, where two people returning from Africa with the disease died, and only two cases of new infection were recorded. It’s also true that 148 children in America—and thousands of adults—would die from influenza over the following winter. But these whatabout statistics aren’t really meant to sharpen our vigilance around the flu, or even to encourage us toward higher rates of vaccination. They’re just supposed to calm us down, and make us realize that we needn’t go to pieces over some other, more exotic-sounding disease. Stemming panic can be a righteous goal, especially when that panic is unfounded. Ebola certainly hasn’t vanished from the Earth—a recent outbreak in Congo has infected more than 3,000 people since August. But we now have a vaccine against the illness, and we’re better equipped to quell its spread. In the meantime, panic has unintended, harmful consequences. For example, just in the last week, we learned that the hoarding of face masks by healthy consumers might cause a dangerous shortage for the health workers who need them most. In contrast to Ebola, which was discovered decades ago, the coronavirus strain behind the outbreak that began in China is brand-new to scientists. So far this pathogen has claimed 638 lives, and we simply don’t know how it will behave in weeks and months to come. By telling people not to worry—or that we should worry “more” about the flu—we may end up eroding public trust in the media. What happens if this coronavirus proves much worse than we expected? The Chinese government is already under scrutiny for downplaying the risks. Why would American news outlets want to repeat the error? Even taken on their own terms, the flu comparisons rely on wonky and myopic math. Flu can kill Amercans by the tens of thousands, but that’s because it’s been around so long and has had so much time to spread. Millions get the virus every year, and fewer than 0.1 percent of them perish from it. What’s the rate of death from the new coronavirus? No one can say for certain, but estimates have hovered at around 20 times the rate for influenza, or 2 percent. Some virologists assert this is an overestimate, because milder cases might be getting overlooked; others counter that, given lack of access to diagnostic testing, many deaths may be uncounted. In short, it’s too soon to say. It’s also unclear how efficiently this coronavirus spreads from person to person. The total number of confirmed cases has grown from 282 on Jan. 21 to 31,211 on Feb. 7. It’s possible the spread will slow. Or else it might accelerate. In light of this uncertainty, perhaps we shouldn’t be so quick to counsel everyone to “get a Grippe” on their concerns. All I’m saying is, I wouldn’t want to have been the person telling people to worry about heart disease instead of the flu in 1918. Before that outbreak was over, it had killed an estimated 50 million people worldwide; and, in the U.S., the number of deaths from respiratory illness surpassed those from heart disease for the first time in a decade. When it comes to disease—and particularly infectious ones—it’s best to avoid pitting pathogens against one another in a sort of “mortality rate Olympics”. Mother Nature doesn’t let us choose, à la carte, which problems to digest and when. It’s more like she’s piling our plates with stuff we didn’t ask for, and then adding to it even though we’re full. I get it—there are enough things to worry about already. Democracy is crumbling, climate change is advancing, children are being held in cages, healthcare is increasingly unaffordable and bills are looming. It’s hard to pile on concern about something that’s happening on the other side of the planet. Still we shouldn’t let ourselves be swindled of our capacity for empathy. As rhetoric, viral whataboutism tends to paper over the suffering of other people. There are more than 50 million people on lockdown at the heart of the new coronavirus epidemic, and hospitals are struggling to keep apace. Tragic stories have been mounting up, like that of the 16-year-old boy with cerebral palsy who died in Hubei province when his father—his sole caregiver—was placed in quarantine. When news articles tell us that we should focus on the flu instead, they tacitly allow us to ignore this suffering in China. When they suggest that the so-called ‘2019nCov’ coronavirus appears to be of greatest threat to the old and already infirm, they encourage us to ignore the plights of people in those groups, and take an ageist and ableist point of view. In fact, scientists are still amassing data to know exactly who is most vulnerable to developing severe disease. Rather than returning time and time again to these flu comparisons, let’s focus on a problem we can fix. The global infrastructure for quelling outbreaks of new pathogens has been weakened by unstable funding: The World Health Organization has said that it needs $675 million to cover the cost of its response plan to the new coronavirus from February through April; and one academic paper notes that the organization’s entire 2018-2019 budget came to about $4.4 billion—just a fraction of the $33 billion annual healthcare and social services budget of Quebec, the Canadian province where I live. (The same paper notes that the WHO’s budget is “less than the budget of many major hospitals in the United States.”) Meanwhile, the U.S. Centers for Disease Control and Prevention is running out of money for global epidemic prevention, and reducing efforts in 39 out of 49 countries. I know, I know: Budget shortfalls are affecting lots of important projects, not just those aimed at preventing epidemics of disease. Some might claim, in this age of whataboutism, that while defunding the CDC is bad, cutting food stamps is worse. But when we play this zero-sum game, we end up shortchanging ourselves. We need to say ‘enough,’ or the whatabouts will never end. Source: Coronavirus Is Bad. Comparing It to the Flu Is Worse (Wired)
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