Pandemic: COVID-19

photo by: tim mossholder (unsplash)

Contents

  1. Why do some COVID-19 patients infect many others, whereas most don’t spread the virus at all?
  2. Is there more than one strain of the new coronavirus?
  3. Will Covid-19 show us how to design better cities?
  4. COVID-19 has blown away the myth about ‘First’ and ‘Third’ world competence
  5. How COVID-19 is amplifying gender inequality in India
  6. Covid-19 hurts the most vulnerable – but so does lockdown. We need more nuanced debate
  7. Not all kids have computers – and they’re being left behind with schools closed by the coronavirus
  8. Counting the human cost of Covid-19: 'Numbers tell a story words can't'
  9. Which Covid-19 Data Can You Trust?
  10. Why are more men dying from COVID-19?
  11. How the COVID-19 lockdown will take its own toll on health
  12. Antarctic endeavours, primary health-care research and dark matter exploration – the coronavirus casualties you haven’t heard of
  13. The Scariest Pandemic Timeline
  14. Open science takes on the coronavirus pandemic
  15. How pandemics shape society
  16. Coronavirus is spreading panic. Here’s the science behind why.
  17. Social distancing prevents infections, but it can have unintended consequences
  18. Using sociology to make sense of the coronavirus pandemic
  19. Sociologist explains how coronavirus might change the world around us
  20. Poor city dwellers run greatest coronavirus risk

Why do some COVID-19 patients infect many others, whereas most don’t spread the virus at all?

 

Science’s COVID-19 reporting is supported by the Pulitzer Center.

When 61 people met for a choir practice in a church in Mount Vernon, Washington, on 10 March, everything seemed normal. For 2.5 hours the chorists sang, snacked on cookies and oranges, and sang some more. But one of them had been suffering for 3 days from what felt like a cold—and turned out to be COVID-19. In the following weeks, 53 choir members got sick, three were hospitalized, and two died, according to a 12 May report by the U.S. Centers for Disease Control and Prevention (CDC) that meticulously reconstructed the tragedy.

Many similar “superspreading events” have occurred in the COVID-19 pandemic. A database by Gwenan Knight and colleagues at the London School of Hygiene & Tropical Medicine (LSHTM) lists an outbreak in a dormitory for migrant workers in Singapore linked to almost 800 cases; 80 infections tied to live music venues in Osaka, Japan; and a cluster of 65 cases resulting from Zumba classes in South Korea. Clusters have also occurred aboard ships and at nursing homes, meatpacking plants, ski resorts, churches, restaurants, hospitals, and prisons. Sometimes a single person infects dozens of people, whereas other clusters unfold across several generations of spread, in multiple venues.

Other infectious diseases also spread in clusters, and with close to 5 million reported COVID-19 cases worldwide, some big outbreaks were to be expected. But SARS-CoV-2, like two of its cousins, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), seems especially prone to attacking groups of tightly connected people while sparing others. It’s an encouraging finding, scientists say, because it suggests that restricting gatherings where superspreading is likely to occur will have a major impact on transmission, and that other restrictions—on outdoor activity, for example—might be eased.

“If you can predict what circumstances are giving rise to these events, the math shows you can really, very quickly curtail the ability of the disease to spread,” says Jamie Lloyd-Smith of the University of California, Los Angeles, who has studied the spread of many pathogens. But superspreading events are ill-understood and difficult to study, and the findings can lead to heartbreak and fear of stigma in patients who touch them off.

Most of the discussion around the spread of SARS-CoV-2 has concentrated on the average number of new infections caused by each patient. Without social distancing, this reproduction number (R) is about three. But in real life, some people infect many others and others don’t spread the disease at all. In fact, the latter is the norm, Lloyd-Smith says: “The consistent pattern is that the most common number is zero. Most people do not transmit.”

That’s why in addition to R, scientists use a value called the dispersion factor (k), which describes how much a disease clusters. The lower k is, the more transmission comes from a small number of people. In a seminal 2005 Nature paper, Lloyd-Smith and co-authors estimated that SARS—in which superspreading played a major role—had a k of 0.16. The estimated k for MERS, which emerged in 2012, is about 0.25. In the flu pandemic of 1918, in contrast, the value was about one, indicating that clusters played less of a role.

Estimates of k for SARS-CoV-2 vary. In January, Julien Riou and Christian Althaus at the University of Bern simulated the epidemic in China for different combinations of R and k and compared the outcomes with what had actually taken place. They concluded that k for COVID-19 is somewhat higher than for SARS and MERS. That seems about right, says Gabriel Leung, a modeler at the University of Hong Kong. “I don’t think this is quite like SARS or MERS, where we observed very large superspreading clusters,” Leung says. “But we are certainly seeing a lot of concentrated clusters where a small proportion of people are responsible for a large proportion of infections.” But in a recent preprint, Adam Kucharski of LSHTM estimated that k for COVID-19 is as low as 0.1. “Probably about 10% of cases lead to 80% of the spread,” Kucharski says.

That could explain some puzzling aspects of this pandemic, including why the virus did not take off around the world sooner after it emerged in China, and why some very early cases elsewhere—such as one in France in late December 2019, reported on 3 May—apparently failed to ignite a wider outbreak. If k is really 0.1, then most chains of infection die out by themselves and SARS-CoV-2 needs to be introduced undetected into a new country at least four times to have an even chance of establishing itself, Kucharski says. If the Chinese epidemic was a big fire that sent sparks flying around the world, most of the sparks simply fizzled out.

Why coronaviruses cluster so much more than other pathogens is “a really interesting open scientific question,” says Christophe Fraser of the University of Oxford, who has studied superspreading in Ebola and HIV. Their mode of transmission may be one factor. SARS-CoV-2 appears to transmit mostly through droplets, but it does occasionally spread through finer aerosols that can stay suspended in the air, enabling one person to infect many. Most published large transmission clusters “seem to implicate aerosol transmission,” Fraser says.

Individual patients’ characteristics play a role as well. Some people shed far more virus, and for a longer period of time, than others, perhaps because of differences in their immune system or the distribution of virus receptors in their body. A 2019 study of healthy people showed some breathe out many more particles than others when they talk. (The volume at which they spoke explained some of the variation.) Singing may release more virus than speaking, which could help explain the choir outbreaks. People’s behavior also plays a role. Having many social contacts or not washing your hands makes you more likely to pass on the virus.

The factor scientists are closest to understanding is where COVID-19 clusters are likely to occur. “Clearly there is a much higher risk in enclosed spaces than outside,” Althaus says. Researchers in China studying the spread of the coronavirus outside Hubei province—ground zero for the pandemic—identified 318 clusters of three or more cases between 4 January and 11 February, only one of which originated outdoors. A study in Japan found that the risk of infection indoors is almost 19 times higher than outdoors. (Japan, which was hit early but has kept the epidemic under control, has built its COVID-19 strategy explicitly around avoiding clusters, advising citizens to avoid closed spaces and crowded conditions.)

Some situations may be particularly risky. Meatpacking plants are likely vulnerable because many people work closely together in spaces where low temperature helps the virus survive. But it may also be relevant that they tend to be loud places, Knight says. The report about the choir in Washington made her realize that one thing links numerous clusters: They happened in places where people shout or sing. And although Zumba classes have been connected to outbreaks, Pilates classes, which are not as intense, have not, Knight notes. “Maybe slow, gentle breathing is not a risk factor, but heavy, deep, or rapid breathing and shouting is.”

Probably about 10% of cases lead to 80% of the spread.

-Adam Kucharski, London School of Hygiene & Tropical Medicine

Timing also plays a role. Emerging evidence suggests COVID-19 patients are most infectious for a short period of time. Entering a high-risk setting in that period may touch off a superspreading event, Kucharski says; “Two days later, that person could behave in the same way and you wouldn’t see the same outcome.”

Countries that have beaten back the virus to low levels need to be especially vigilant for superspreading events, because they can easily undo hard-won gains. After South Korea relaxed social distancing rules in early May, a man who later tested positive for COVID-19 visited several clubs in Seoul; public health officials scrambled to identify thousands of potential contacts and have already found 170 new cases.

If public health workers knew where clusters are likely to happen, they could try to prevent them and avoid shutting down broad swaths of society, Kucharski says. “Shutdowns are an incredibly blunt tool,” he says. “You’re basically saying: We don’t know enough about where transmission is happening to be able to target it, so we’re just going to target all of it.”

But studying large COVID-19 clusters is harder than it seems. Many countries have not collected the kind of detailed contact tracing data needed. And the shutdowns have been so effective that they also robbed researchers of a chance to study superspreading events. (Before the shutdowns, “there was probably a 2-week window of opportunity when a lot of these data could have been collected,” Fraser says.)

The research is also prone to bias, Knight says. People are more likely to remember attending a basketball game than, say, getting a haircut, a phenomenon called recall bias that may make clusters seem bigger than they are. Clusters that have an interesting social angle—such as prison outbreaks—may get more media coverage and thus jump out to researchers, while others remain hidden. Clusters of mostly asymptomatic infections may be missed altogether.

Privacy is another concern. Untangling the links between patients can reveal who was at the origin of a cluster or expose information about people’s private lives. In its report about the chorus, CDC left out a seating map that could show who brought the virus to the practice. Some clubs involved in the new South Korean cluster were gay venues, which resulted in an antigay backlash and made contact tracing harder.

Fraser, who is tracking HIV transmission in Africa by sequencing virus isolates, says it is a difficult trade-off, but one that can be managed through good oversight and engagement with communities. Epidemiologists have “a duty” to study clusters, he says: “Understanding these processes is going to improve infection control, and that’s going to improve all of our lives.”

 

Kai is a contributing correspondent for Science magazine based in Berlin, Germany. He is the author of a book about the color blue, published in 2019.

 

By                     :                       Kai Kupferschmidt

Date                  :                       May 19, 2020

Source              :                       ScienceMag.org

https://www.sciencemag.org/news/2020/05/why-do-some-covid-19-patients-infect-many-others-whereas-most-don-t-spread-virus-all

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Is there more than one strain of the new coronavirus?

 

Since the emergence of the new coronavirus, called SARS-CoV-2, several researchers have proposed that there is more than one strain, and that mutations have led to changes in how infectious and deadly it is. However, opinions are divided.

Genetic mutations are a natural, everyday phenomenon. They can occur every time genetic material is copied.

When a virus replicates inside the cell it has infected, the myriad of new copies will have small differences. Why is this important?

When mutations lead to changes in how a virus behaves, it can have significant consequences. These do not necessarily have to be detrimental to the host, but in the case of vaccines or drugs that target specified viral proteins, mutations may weaken these interactions.

Since the emergence of SARS-CoV-2, several research studies have highlighted variations in the virus’s genetic sequence. This has prompted discussion about whether or not there are several strains, if this has an impact on how easily the virus can infect a host, and whether or not this affects how many more people are likely to die.

Many scientists have called for caution. In this Special Feature, we summarize what researchers currently know about SARS-CoV-2 mutations and hear from experts about their views on what these mean for the pandemic.

 

Why are mutations significant?

SARS-CoV-2 is an enveloped RNA virus, which means that its genetic material is encoded in single-stranded RNA. Inside a host cell, it makes its own replication machinery.

RNA viruses have exceptionally high mutations rates because their replications enzymes are prone to errors when making new virus copies.

Virologist Prof. Jonathan Stoye, a senior group leader at the Francis Crick Institute in London in the United Kingdom, told Medical News Today what makes virus mutations significant.

“A mutation is a change in a genetic sequence,” he said. “The fact of a mutational change is not of primary importance, but the functional consequences are.”

If a particular genetic alteration changes the target of a drug or antibody that acts against the virus, those viral particles with the mutation will outgrow the ones that do not have it.

“A change in a protein to allow virus entry into a cell that carries very low amounts of receptor protein could also provide a growth advantage for the virus,” Prof. Stoye added.

“However, it should be stressed that only a fraction [of] all mutations will be advantageous; most will be neutral or harmful to the virus and will not persist.”

“Mutations in viruses clearly do matter, as evidenced by the need to prepare new vaccines against [the] influenza virus every year for the effective prevention of seasonal flu and the need to treat HIV-1 simultaneously with several drugs to [prevent the] emergence of resistant virus.” – Prof. Jonathan Stoye

 

Researchers find mutations

MNT recently featured a research study by a team from Arizona State University in Tempe. The paper described a mutation that mimics a similar event that occurred during the SARS epidemic in 2003.

The team studied five nasal swab samples that had a positive SARS-CoV-2 test result. They found that one of these had a deletion, which means that a part of the viral genome was missing. To be precise, 81 nucleotides in the viral genetic code were gone.

Previous research indicated that similar mutations lowered the ability of the SARS virus to replicate.

Another study, this time in the Journal of Translational Medicine, proposed that SARS-CoV-2 had picked up specific mutation patterns in distinct geographical regions.

The researchers, from the University of Maryland in Baltimore and Italian biotech company Ulisse Biomed in Trieste, analyzed eight recurrent mutations in 220 COVID-19 patient samples.

They found three of these exclusively in European samples and another three exclusively in samples from North America.

Another study, which has not yet been through the peer review process, suggests that SARS-CoV-2 mutations have made the virus more transmissible in some cases.

In the paper, Bette Korber — from the Los Alamos National Laboratory in New Mexico — and collaborators describe 13 mutations in the region of the viral genome that encodes the spike protein.

This protein is crucial for infection, as it helps the virus bind to the host cell.

The researchers note that one particular mutation, which changes an amino acid in the spike protein, “may have originated either in China or Europe, but [began] to spread rapidly first in Europe, and then in other parts of the world, and which is now the dominant pandemic form in many countries.”

Prof. Stoye commented that the results of this study are, in some ways, not surprising.

“Viruses are typically finely tuned to their host species. If they jump species, e.g., from bat to human, a degree of retuning is inevitable both to avoid natural host defenses and for optimum interaction with the cells of the new host,” he said.

“Random mutations will occur, and the most fit viruses will come to predominate,” he added. “Therefore, it does not seem surprising that SARS-CoV-2 is evolving following its jump to, and spread through, the human population. Clearly, such changes are currently taking place, as evidenced by the apparent spread of the [mutation] observed by Korber [and colleagues].”

However, Prof. Stoye does not think that it is clear at this point how mutations will drive the behavior of SARS-CoV-2 in the long term.

“Fears about SARS-CoV-2 evolution to resist still-to-be-developed vaccines and drugs are not unreasonable,” he explained. “Nevertheless, it is also possible that we will see evolution to a less harmful version of the virus, as may well have occurred following initial human colonization by the so-called seasonal coronaviruses.”

 

Opinions remain divided 

Earlier this year, researchers from Peking University in Beijing, China, published a paper in National Science Review describing two distinct lineages of SARS-CoV-2, which they termed “S” and “L.”

They analyzed 103 virus sequence samples and wrote that around 70% were of the L lineage.

However, a team at the Center for Virus Research at the University of Glasgow in the U.K. disagreed with the findings and published their critique of the data in the journal Virus Evolution.

“Given the repercussions of these claims and the intense media coverage of these types of articles, we have examined in detail the data presented […] and show that the major conclusions of that paper cannot be substantiated,” the authors write.

Prof. David Robertson, head of Viral Genomics and Bioinformatics at the Centre for Virus Research, was part of the team. MNT asked his views on the possibility of there being more than one strain of SARS-CoV-2.

“Until there is some evidence of a change in virus biology, we cannot say that there are new strains of the virus. It’s important to appreciate that mutations are a normal byproduct of virus replication and that most mutations we observe won’t have any impact on virus biology or function,” he said.

“Some of the reports of, for example, amino acid changes in the spike protein are interesting, but at the moment, these are at best a hypothesis. Their potential impact is currently being tested in a number of labs.”

Prof. Stoye thinks that it is “more a case of semantics rather than anything else” at the moment.

“If we have different sequences, we have different strains. Only when we have a greater understanding of the functional consequences of the evolutionary changes observed does it make sense to reclassify the different isolates,” he said.

“At that point, we can seek to correlate sequence variation with prognostic or therapeutic implications. This may take a number of years.”

 

Serotypes and future research

So, what kind of evidence are skeptical scientists looking for in the debate around multiple SARS-CoV-2 strains?

MNT asked Prof. Mark Hibberd, from the London School of Hygiene and Tropical Medicine in the U.K., to weigh in on the debate.

“For virologists, ‘strain’ is rather a subjective word that does not always have a clear specific meaning,” he commented.

“More useful in the SARS-CoV-2 situation would be the idea of ‘serotype,’ which is used to describe strains that can be distinguished by the human immune response — an immune response to one serotype will not usually protect against a different serotype. For SARS-CoV-2, there is no conclusive evidence that this has happened yet.”

“To show that the virus has genetically changed sufficiently to create a different immune response, we would need to characterize the immune protection and show that it worked for one serotype and not for another,” he continued.

Prof. Hibberd explained that scientists are studying neutralizing antibodies to help them define a serotype for SARS-CoV-2. These antibodies can prevent the virus from infecting a host cell, but they may not be effective against a new strain.

“Several groups around the world have identified a specific mutation in the SARS-CoV-2 spike protein, and they are concerned that this mutation might alter this type of binding, but we cannot be sure it does that at the moment. More likely, this mutation will likely affect the virus binding to its receptor […], which might affect transmissibility.”– Prof. Mark Hibberd

“We ideally need experimental evidence, [such as a] demonstration of a mutation leading to a functional change in the virus in the first instance, and secondly a demonstration that this change will have an impact in [people with the infection],” Prof. Robertson suggested.

He pointed to lessons that experts learned during the 2014–2018 Ebola outbreak in West Africa, where several research groups had suggested that a mutation had resulted in the virus becoming more easily passed between people and more deadly.

Cell culture experiments showed that the mutated virus was able to replicate more rapidly. However, when scientists subsequently studied this in animal models, they found that it did not behave any differently than stains without the mutation.

Scientists around the world continue to search for answers to the many outstanding questions around SARS-CoV-2. No doubt, we will see more research emerge in the coming months and years that will assess the impact of SARS-CoV-2 mutations on the COVID-19 pandemic and the future of this new coronavirus.

 

By                    :     Yella Hewings-Martin, Ph.D. 

Fact checked   :    Jasmin Collier

Date                 :    May 22, 2020

Source             :    Medical News Today

https://www.medicalnewstoday.com/articles/is-there-more-than-one-strain-of-the-new-coronavirus

 

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Will Covid-19 show us how to design better cities?

 

Around the world, cities are cleaner and quieter. Can we reinvent them – and ensure that the changes forced upon them in the last few months are not squandered?

Covid-19 has changed the way that towns and cities look. It has offered views of public places with fewer cars and cleaner air, roads you can stroll down, cycling without danger. It has made some things seem more precious, such as green spaces and parks. It has renewed appreciation of the social infrastructures of support and care. It has heightened awareness of the ways in which one person’s actions can affect another’s. It has made everyone more conscious of the ways they occupy space in relation to other people.

It has also prompted the idea that big cities have taken a hit from which they won’t fully recover. The virus first appeared in Wuhan, population 11 million, and some of its worst outbreaks have been in New York, London, Milan and São Paulo. Crowds and public transport, goes the theory, are bad for your health. Remote working, boosted by lockdowns, will be here to stay. Balaji Srinivasan, a Silicon Valley venture capitalist summed this view up in a pithy tweet: “Sell city, buy country.”

So cities appear both more and less attractive. It’s a contradiction. To which the best response might not be a rush away from everything urban, but a less violent redistribution from one kind of city to another. For several decades wealth and population have been tending to concentrate in a few privileged urban centres, to the disadvantage both of other towns and cities – and of themselves. This has been particularly true in Britain, with its gross imbalance between London and its satellites and much of the rest of the country. What if there were a shift in intensity away from the biggest cities towards the others, such that the enjoyment of life was increased all round?

Much or most of the lockdown’s changes are temporary. But what if this crisis were not allowed to go to waste? What if the glimpses of alternative realities became guides to the future? There have already been some rapid responses both in Britain and elsewhere, such as the closing of several central London streets to traffic by mayor Sadiq Khan, the pedestrianisation of Grey Street in Newcastle and the permanent closure of Seattle streets that had been temporarily blocked.

These initiatives are welcome attempts to make selected urban areas more sociable and pleasurable. There is also the chance to steer the decentralising effects of the pandemic towards towns and cities that already have most of what it takes to support successful communities, but could do with a bit more economic and social energy. This is surely preferable to a flight towards car-dependent detached houses, scattered around rural areas that would hardly welcome them.

Some situations that were under strain before the virus have been revealed as all-but unsupportable. In the capital, there was scarce and expensive housing, air pollution, long commuting times on crowded public transport. Lockdown has made confined living conditions less tolerable while also removing the compensations of a metropolitan social life.

Elsewhere there was a lack of investment and opportunity, alongside decaying buildings and public spaces. A three-bedroom Victorian terraced house in Fulham, to take property prices as a measure, goes for at least £1m. An essentially identical house in Gateshead might sell for £100,000, in Portsmouth maybe £250,000. London is overcrowded, Doncaster is depopulated. Empty space is at a premium in the capital and in its south-eastern penumbra. In high streets across the country there is all too much of it.

Meanwhile attempts to mitigate the London-centred housing crisis have foundered on familiar rocks. Residents of green belts don’t want new homes near them. Almost any land inside London that is easy to develop has been built on by now. Property companies can’t and won’t build homes of the quantity and affordability that are needed. There are ways to confront these problems – good planning, state housebuilding, some determination – which shouldn’t be abandoned, but contemporary Britain has so far proved sluggish to adopt them.

Another approach is to make best use of the already-there. Ease the pressure on London and on some other mostly southern hotspots and reflate the many towns and cities that often have good housing stock, handsome if neglected high streets, a legacy of past investment in public amenities like parks and libraries, and access to beautiful countryside. Places roughly answering this description include Preston, Walsall, Sheffield, Plymouth, Colchester, Derby, Dundee, Hull, Wakefield and Wrexham, to name but a few. Such a shift would have the added environmental benefit of reducing the large costs in energy and carbon of a mass housebuilding programme.

It’s been widely pointed out, especially since the pandemic started, that modern attitudes to cities have been closely linked to health. A century or so ago, for planning theorists from Ebenezer Howard to Le Corbusier, diseases such as tuberculosis made density a killer, and so cities had to be depopulated, their teeming streets replaced with green open spaces. Patrick Abercrombie’s Greater London Plan of 1944 put these ideas into practice, directing that a large number of Londoners should be moved to healthy new towns.

Once antibiotics had pushed back TB, the virtues of city life were reasserted. Jane Jacobs celebrated these virtues in The Death and Life of Great American Cities of 1961, after which it became the creed of right-thinking urbanists that the density and vibrancy of cities were to be encouraged. Theory was eventually put into practice with spectacular success, at least in economically powerful and good-looking cities including London and New York.

Populations started growing after decades of decline, money poured in, shops and restaurants boomed, property prices soared, derelict buildings were done up. The 1980s phrase “inner-city deprivation” gave way to the estate agents’ buzz-term “urban lifestyle”. The term “world cities” came into use in the 1990s, to describe urban economies that were competing with rivals of a global scale for business and attractiveness. Cities were good. Big was good. Big cities were best.

In the process something was lost. Supercharged property prices turned cities’ best features into commodities. If Jacobs talked of the “ballet of the street” – the choreography of people of different backgrounds and trades going about their lives in shared spaces – it became hard to find in the sealed glass towers of the world cities’ newest real estate. It is more likely to be found in, well, streets, of which there are countless numbers across the country, not just in the most privileged metropolitan centres.

So the proposition is not to rush from dense city to atomised exurb. Rather it is to encourage an adjustment of priorities towards towns and cities in general. It is not about mass internal migration but about incremental change. Most people will stay where they are. Most people’s lives will not be transformed by remote working. But for at least some people, some of the time, the advantages of online interactions will outweigh the disadvantages. It might mean that you only need to visit a big-city office once a week, for example, rather than every day.

It should be possible to imagine that Person A decides that the possibility of having a house and a garden outweighs the attractions of the big city. The development of remote working makes this a little more possible. Perhaps there are enough people like her to form a social network in her area, perhaps she persuades some friends to join her. Their choices might be influenced by the rediscovery, during the lockdown, of activities that don’t require a sophisticated urban pleasure dome within easy reach: cooking, talking to family or friends, going to shops that are not supermarkets, tending a garden, online socialising and entertainment. They might be less driven than before by the prestige and desirability of a metropolis.

Perhaps they work for companies who see the benefits of helping their employees live like this, or who spread their operations around regional bases more than they would have done previously. Perhaps they make an empty shop into a shared workspace and meeting place. A cafe, you could call it. Perhaps this helps to bring some life back to a high street. They would not be moving into a void, but into an existing set of businesses and activities, with which they could be mutually supportive.

Such a shift won’t happen all by itself. Successful high streets, as the Centre for Cities thinktank has shown, are symptoms of more general strengths in local economies. Brighton, York and Cambridge were doing just fine before the pandemic, and are the most likely places to bounce back; Newport, Bradford and Wigan less so. It will, as well as the resourcefulness of individuals and companies, require some positive contributions from government.

Partly this would be a matter of supporting those things that support quality of life – parks, nurseries, street maintenance. Reversing austerity, you could call it. Partly it would be a case of investing in local transport systems and broadband. It would require creative use of the planning system – not just allowing individuals to convert shops into homes, which can create poor homes and inactive streets, but encouraging initiatives that work out new futures for whole streets at a time. Vacant shopping centres should be taken into public ownership so that, as happened with empty docklands in the 1980s, they can be made available to whoever might make the most of them. Versions of Tainan Spring in Taiwan, where an old shopping mall was made into a water garden, could be realised in Britain.

The vast financial and environmental costs of projects like HS2 and Heathrow’s third runway, together with the long time they will take to deliver any kind of return, now look – in a future that will definitely be poorer than expected – preposterous. Their main effect would be to bring more people from less-favoured parts of the country to the more favoured. It would be far better to spend the tens of billions they require on local and regional projects. Rather than bring people to where the work is, the plan should be to bring work to people, wherever they are.

This is hardly a new idea. Its most recent manifestation has been the Conservative party’s policy of “levelling up” the British regions. Last year the government launched a future high streets fund as a gesture in this direction, although its £1bn budget is very much smaller than the sums previously extracted through austerity. The overheating of London has already been causing people to live further out – commuters using improved trains from Rugby, creatives relocating to Margate. These changes might be seen as the enlargement of London’s orbit, but they at least tend towards greater decentralisation.

Other future developments might help this transfer of energy from world cities to urban settlements in general. Cars that are both driverless and electric could, for example, by using road space in a more efficient and less polluting way, allow urban density without centralised public transport systems. A virus can’t change city planning all by itself, but it can be used as a chance to push changes whose time has come.

 

By            :              Rowan Moore

Date        :               May 24, 2020

Source    :               The Guardian 

https://www.theguardian.com/society/2020/may/24/will-covid-19-show-us-how-to-design-better-cities     

 

 

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COVID-19 has blown away the myth about ‘First’ and ‘Third’ world competence

 

One of the planet’s – and Africa’s – deepest prejudices is being demolished by the way countries handle COVID-19.

For as long as any of us remember, everyone “knew” that “First World” countries – in effect, Western Europe and North America – were much better at providing their citizens with a good life than the poor and incapable states of the “Third World”. “First World” has become shorthand for competence, sophistication and the highest political and economic standards.

So deep-rooted is this that even critics of the “First World” usually accept it. They might argue that it became that way by exploiting the rest of the world or that it is not morally or culturally superior. But they never question that it knows how to offer (some) people a better material life. Africans and others in the “Third World” often aspire to become like the “First World” – and to live in it, because that means living better.

So we should have expected the state-of-the-art health systems of the “First World”, spurred on by their aware and empowered citizens, to handle COVID-19 with relative ease, leaving the rest of the planet to endure the horror of buckling health systems and mass graves.

We have seen precisely the opposite.

 

Fatal errors

“First World” is often code for countries run by Europeans or people of European descent; some of the worst health performers on the globe in recent weeks have been “First World”. For Anglophone Africans, it is doubly interesting that two of the greatest failures in handling COVID-19 are the former coloniser, Britain, and the English-speaking superpower, the United States of America.

Both countries’ national governments have made just about every possible mistake in tackling COVID-19.

They ignored the threat. When they were forced to act, they sent mixed signals to citizens which encouraged many to act in ways which spread the infection. Neither did anything like the testing needed to control the virus. Both failed to equip their hospitals and health workers with the equipment they needed, triggering many avoidable deaths.

The failure was political. The US is the only rich country with no national health system. An attempt by former president Barack Obama to extend affordable care was watered down by right-wing resistance, then further gutted by the current president and his party. Britain’s much-loved National Health Service has been weakened by spending cuts. Both governments failed to fight the virus in time because they had other priorities.

And yet, in Britain, the government’s popularity ratings are sky high and it is expected to win the next election comfortably. The US president is behind in the polls but the contest is close enough to make his re-election a real possibility. Can there be anything more typically “Third World” than citizens supporting a government whose actions cost thousands of lives?

Western European countries such as Spain, Italy and Africa’s other wholesale coloniser, France, also battled to contain the virus. Some European countries have coped reasonably well, as have some run by the descendants of Europeans such as New Zealand and Australia. But the star performers are not in the historical “First World”.

 

Effective responses

The most effective response was probably South Korea’s, followed by other East Asian states and territories. This is partly because they are used to dealing with coronavirus outbreaks. But it is also because they learned from experience: South Korea’s success is due to very effective testing and tracing of infected people. Whatever the reason, it is East Asia, not “the West”, which has done what the “First World” is expected to do.

Some would reply that East Asia is now “First World”. So, it is still superior; it has simply changed its address. This is debatable. But, even if it is accepted, some places have contained the virus in distinctly “Third World” conditions.

Kerala was the first Indian state to encounter the virus but has kept deaths down to three. It had largely curbed COVID-19 but is now dealing with nearly 200 cases, all people arriving from other parts of India. Judging by its record so far, it will contain this outbreak too.

Kerala, too, has learnt from handling previous epidemics. It also has a strong health system. But one of its key tools is citizen participation: it has worked with neighbourhood watches and citizen volunteers to track the contacts of infected people. Students were recruited to build kiosks at which citizens were tested. Kerala also had the capacity to ensure that all children entitled to school meals received them after schools were closed: non-governmental organisations were mostly responsible, emphasising the partnership between the government and citizens.

Kerala’s performance is not a fluke: it has, for years, produced better health outcomes and literacy rates than the rest of India.

Nor has Africa’s response to the virus confirmed prejudices. When COVID-19 began spreading, it became almost routine for reports, commentaries – and Melinda Gates, who, with her husband Bill, heads the couple’s development foundation – to predict that Africa would be engulfed in death as the virus ripped through its weak health systems. This is, after all, what is meant to happen in the “Third World” and particularly in Africa, which is always considered the least capable continent on the planet.

So far, it has not happened. It still might but, even if it does, some countries are coping better than the dire predictions claimed (and, perhaps, better than the “First World”). One stand-out is Senegal, which has devised a cheap test for the virus and has used 3-D printing to produce ventilators at a fraction of the going price. Africa, too, has experienced recent outbreaks, notably of Ebola, and seems to have learned valuable lessons from them.

 

Inspiring

The “First World” is still far richer than the rest of the planet and may well remain so. So its politicians, academics and journalists will probably still believe they are better than the rest.

But the COVID-19 experience may just trigger new thinking in the “Third World”. The most basic function of a government is to protect the safety of its citizens. Ensuring that people remain healthy is at least as important a guarantee of safety as protecting them from violence.

Reasonable people would surely much rather be living in Kerala or Senegal (or East Asia) right now than in Europe and North America, raising obvious questions about who really does offer a better life.

That should inspire Africans and others in the “Third World” to ask themselves whether it makes sense to want to be America, Britain or France. COVID-19 has made a strong argument for wanting to be East Asia – or, given Africa’s circumstances, Kerala.

 

By                     :                    Steven Friedman (Professor of Political Studies, University of Johannesburg)

Date                 :                     May 13, 2020

Source             :                     The Conversation  

https://theconversation.com/covid-19-has-blown-away-the-myth-about-first-and-third-world-competence-138464

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How COVID-19 is amplifying gender inequality in India

 

Women are bearing a disproportionate amount of the burden that the imposition of lockdowns, shrinking of economic opportunity has created.

While much of COVID-19’s epidemiology remains shrouded in mystery, we know that it claims the lives of men more than women — at double the rate in some countries. Other coronavirus outbreaks, such as the 2003 SARS and 2012 MERS epidemics, were also more deadly for men than women.

But this epidemiological fact risks obscuring another gender dimension of the pandemic. While men’s immune systems may be less equipped to fight the virus, the socio-economic consequences of COVID-19 are stacking the deck against women. These effects are clearest in developing countries like India, where gender inequality is a persistent challenge. Follow lockdown 4.0 guidelines live updates

Our research on the virus’s impact in slum communities in Mumbai, India’s financial capital and the biggest COVID-19 hotspot, is revealing the ways in which lockdowns exacerbate the marginalisation of women, especially poor women.

Even in normal times, women face extra burdens when infrastructure is inadequate. According to Sitaram Shelar of Pani Haq Samiti, a non-profit focused on water access, about 4.5 million people in Mumbai lack access to a household water connection, forcing them to line up at community water taps. In her 2012 award-winning book Behind the Beautiful Forevers, Katherine Boo writes: “[S]he lost two hours of her morning standing in line for water at a dribbling tap…” The operative word here is she; this task almost always falls to women.

Under India’s strict COVID-19 lockdown, household water needs have swelled, owing to high summer temperatures, all family members being at home, and the emphasis on frequent hand-washing. The result: Women are spending more time queuing up. Some are also turning to an underground water market, which operates under the cloak of darkness. Shelar explained that as women step out in the wee hours of the morning to buy water, they often face sexual and verbal harassment. Follow Covid India live updates

Harassment, however, is mostly escalating behind closed doors. Aparna Joshi, Project Director of iCall, a mental health helpline, called the current situation “a brewing pot”. Frustrated, unemployed, and/or struggling to access tobacco and alcohol, several men are unloading their anger through physical, verbal and sexual assault. The surge of violence is affecting millions of women of all classes.

Some non-profits in India are finding creative tactics to support women, like hiding phone numbers for domestic abuse hotlines inside food rations. Yet, these laudable efforts pale in comparison to the scale of the challenge. The UNFPA warns that the pandemic could reduce progress against gender-based violence by one-third.

COVID-19 is shifting other household dynamics, too. Domestic responsibilities that women bear, like cooking and cleaning, have ballooned. Even worse, because women in Indian families tend to eat last and the least, research has shown that financial strain and food shortages affect women’s nutrition more than men’s. The same pattern is visible across the developing world, from Zimbabwe to Bangladesh.

To make matters worse, the lockdown has cut off most formal and informal support systems for women. In developing countries, low-income families often share one smartphone, owned by the husband. According to Joshi, women’s lack of digital access is making them more vulnerable to misinformation.

Unequal access to technology will fuel other consequences for women — especially in education and employment. As many of the world’s children switch to online learning, girls in countries like India may lose out, given that they are less likely than boys to have access to the internet. And as analysts foresee more jobs moving online post-pandemic, the digital divide might exacerbate job market inequalities.

In fact, many aspects of the COVID-19 economic fallout are likely to reduce job prospects for women.

As India eases its lockdown with requirements that businesses operate with fewer employees, trends toward mechanisation could accelerate. Because women are generally relegated to menial tasks within production processes, their jobs are often the first to go when firms automate. And with partial lockdowns involving reduced public transit, women might find their access to work curtailed, given their disproportionate reliance on buses and trains for commuting.

India already struggles with declining female labour force participation — on par with Saudi Arabia at 24 per cent. If women’s employment continues to drop post-COVID, this will only magnify the damage to their position in families and society, given that employment is one of the strongest predictors of women’s empowerment, not to mention important for boosting GDP.

What would a gender-sensitive pandemic response look like? It begins with a full-throttled focus on supporting women who face domestic violence. A recent court ruling in Delhi provides a roadmap: Publicising helplines, relaxing lockdown rules for women to leave home and seek support, and sensitising the police.

And women’s employment must become a priority in recovery efforts. Initiatives to enhance digital access and skills should be scaled up and targeted specifically to low-income women. Direct employment programmes to provide necessary supplies should be expanded; for example, the government in the state of Andhra Pradesh is employing thousands of women to stitch masks.

Not only in India, but in every part of the world, the social and economic crisis of COVID-19 must be understood through the lens of gender. The policy response must be structured around rebuilding economies and societies in ways that empower women to lead safe, productive and fulfilling lives.

 

Shah is a senior associate at IDFC Institute, a think tank in Mumbai, Gandhi a visiting scholar at Brookings India and is a postdoctoral scholar at the Lusk Center for Real Estate at the University of Southern California and Randolph is founding partner of the JustJobs Network and a PhD candidate in urban planning at the University of Southern California

 

By          :           Kadambari Shah, Sahil Gandhi, and Gregory Randolph

Date      :            May 17, 2020

Source  :            India Express 

https://indianexpress.com/article/opinion/coronavirus-gender-inequality-india-6414659/

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Covid-19 hurts the most vulnerable – but so does lockdown. We need more nuanced debate

 

The class and racial consequences of this crisis mean we must think more carefully about how we ‘reopen’ the economy

The argument over lockdown seems to have crystallized into a simple – and simplistic – binary: health versus the economy. If you position yourself on the left, you value health over money, and so support the lockdown. That’s a mistake.

The “health versus the economy” frame ignores how disastrous the lockdown has been to America’s poor. Despite rhetoric about “shared sacrifice”, the ability to self-isolate is overwhelmingly correlated to income. While middle-class professionals congratulate themselves for staying inside, their isolation is dependent on a class of workers who often labor without essential equipment or while ill. Making matters worse, these exposed workers also tend to have more of the health conditions – including hypertension and diabetes – that make Covid-19 so deadly. In America, getting sick is a class condition.

This pandemic is an X-ray, exposing the racial and class inequalities of our society. Look at the data on the communities that are hardest hit by the virus. New York City is often described as the “center of the pandemic”, but a map of the most affected areas clearly shows that poorer neighborhoods are bearing the brunt. In Chicago, 70 of the first 100 Covid-19 victims were black; Milwaukee tells a similar story.

To make matters worse, the government’s measures to mitigate the economic effects of Covid-19 lockdowns exacerbate previously existing inequalities. Trump’s much-vaunted bailout has created a multitrillion-dollar money supply for the largest corporations in the country, with almost no critical oversight requirements. At the same time, people whose livelihoods are being destroyed are being asked to make do with a one-off $1,200 payment, the conditions for which exclude many of those who need it most.

This amounts to a massive transfer of wealth from the poor to the rich. Just like in 2008, capital has taken hold of the crisis, and turned it to its own advantage.

Yet at this stage simply lifting the lockdown to get the economy going would do more harm than good. The lockdown has generated its own crisis. Immediately lifting the lockdown would risk exacerbating the damage already suffered by America’s poorest.

In April, at least 20 million people filed for unemployment. The sectors most affected by these job losses – those predicated on face-to-face interaction – are overwhelmingly peopled by precariously employed, low-paid laborers who have little in the way of savings or capacity to weather this catastrophe. The lockdown thus doubly damns the poor: most likely to be made ill at work, they are also most likely to lose their jobs.

That doesn’t mean it makes sense to rush people back to work in unsafe conditions that might lead to a new spike of infections. Many workers are rightly scared of returning to workplaces that do not properly ensure their safety. Given the intense competition that is likely to emerge over the few jobs that remain in America, many big employers may create a “race to be bottom” that forces workers to compete to accept dangerous working conditions.

Taking the class and racial consequences of this crisis seriously means thinking more carefully about how we “reopen” the economy.

One way to do this would have been a program of contact tracing, aimed at identifying, isolating and taking care of those who actually have the disease (or are most vulnerable to it), while allowing others to keep the economy going. Such a program was successfully undertaken in South Korea. Unfortunately, it may already be too late for this approach. In any event, Trump’s Republican base would never tolerate what they view as a violation of privacy.

The strategy adopted by some northern European countries – such as Sweden – was another possibility. Keeping the economy going, while offering quality healthcare and other benefits to those who get sick, is less irrational than it might seem. That approach involves less economic disruption. Whether it leads to more deaths in the long run is still an open question. The problem is that the Swedish model pre-supposes a well-functioning healthcare system, whereas American healthcare has suffered decades of contraction under the brunt of neoliberal policies; South Korea has three times as many hospital beds per 1,000 people as the US does.

Neither the Swedish nor South Korean models are possible in America today, and neither resolve the true crisis that the US faces, which is dealing with the disaster caused by the lockdown. Rather than insisting on staying at home, the left should argue for implementing an end to the lockdown that actually answers the demands of the workers striking at Amazon, Checkers, Instacart, and elsewhere for safe working conditions and worker’s rights.

A recent bill proposed by senators Sanders, Harris and Markey – which includes expanded unemployment insurance and the waiving of all student loan payments during the crisis – is a good start. But more must be done to address the structural inequalities that have made the coronavirus so deadly in the first place.

Universal healthcare and a complete overhaul of working conditions and unemployment benefits must be part of any comprehensive strategy for economic recovery. So is a massive public investment program that doesn’t just focus on propping up the stock market, but actually creates long-lasting and well-paid jobs.

The objections that were routinely raised against such proposals before the Covid-19 emergency centered on the difficulty of financing such programs. But if the way we have responded to the crisis has taught us anything, it’s that the money can be found when there’s a political will for it. It’s just a question of who we want it to benefit.

 

By            :          Joshua Craze and Carlo Invernizzi-Accetti

Date        :           May 16, 2020

Source    :           The Guardian 

https://www.theguardian.com/commentisfree/2020/may/16/covid-19-coronavirus-lockdown-economy-debate  

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Not all kids have computers – and they’re being left behind with schools closed by the coronavirus

 

The big idea

Since 2014, the Dornsife Center for Economic and Social Research, located at the University of Southern California, has been tracking trends in health economic well-being, attitudes and behaviors through a nationwide survey for its Understanding America Study, asking the same individuals questions over time.

The nationally representative survey is now assessing how COVID-19 is affecting U.S. families. This includes their health, economic status and, for the first time, educational experiences. With two other education researchers Amie Rapaport and Marshall Garland, we analyzed the educational experience data that have recently been added to the study.

What we did

We worked with the broader Understanding America Study team to ask Americans about the effects the pandemic is having on students and their families.

About 1,450 families with children answered these questions between April 1 and April 15.

We found that nearly all – about 85% – of families with at least one child between kindergarten and their senior year of high school have internet access and a computer they can use for distance learning while school buildings are shuttered.

However, we found large disparities in technology access based on family income. Among the 20% of American households who make US$25,000 or less a year, just 63% of schoolchildren have access to a computer and the internet. In comparison, essentially all students from the most affluent families – those whose parents make $150,000 annually or more – do.

To be sure, that doesn’t mean a third of poor kids are being locked out of getting an online education. Many of those students are also using tablets and smartphones to participate in educational activities. However, the types of educational activities a student can easily engage in with a computer and wireless internet –such as writing long essays – are broader than the types possible on a tablet or an even smaller screen and with just a cellular connection.

These inequities can leave low-income families scrambling for wireless access. Some of the limited options available can include include working from a car parked outside a local library or a McDonald’s parking lot.

Why it matters

There’s a big gap between how much access rich and poor children have to technology. This is known as the “digital divide.”

This disparity contributes to the achievement gaps between students based largely on their economic status.

These findings show that the digital divide is playing out in real time during this pandemic in ways that are sure to lead to unequal negative effects on already disadvantaged students.

What’s next?

Most schools in the country are likely to remain closed for months – long after we collected this initial data. We believe that it’s possible that this divide will narrow once more districts distribute computers, tablets and other hardware, more communities take steps to expand broadband access to those who can’t afford it and teachers get better at educating kids online.

There’s a chance that federal help could arrive, should Congress pass the Emergency Educational Connections Act of 2020, a measure authored and backed by House Democrats aimed at narrowing the digital divide. It would normally be states – which provide the largest share of funding for public schools – that would address issues like technology in schools, but with states facing mounting budget constraints that’s going to be a big challenge. A similar bill is pending in the Senate.

In our view, without federal intervention, these gaps will not meaningfully narrow.

 

By     :      Morgan Polikoff (Associate Professor of Education, University of Southern California)

                Anna Rosefsky Saavedra (Research Scientist, University of Southern California – Dornsife College of Letters, Arts and

                                                          Sciences)

                Shira Korn (PhD Student K-12 Education Policy, University of Southern California)

Date  :     May 8, 2020

Source  : The Conversation 

https://theconversation.com/not-all-kids-have-computers-and-theyre-being-left-behind-with-schools-closed-by-the-coronavirus-137359

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Counting the human cost of Covid-19: 'Numbers tell a story words can't'

 

The Guardian’s data journalists in the UK, US and Australia explain how they have shone a light on the statistical narrative behind the pandemic, and what they have helped to reveal

Mona Chalabi, data editor, Guardian US

Creating data journalism about Covid-19 has felt different. For one thing, the public aren’t thinking of the statistics as dry and abstract: they understand how critical they are. People are learning about methodologies and bell curves and logarithmic scales because they’re no longer inclined to look away from the screen when they see those words. That means there are also huge opportunities to learn and for people to change their (usually negative!) relationship with numbers.

I think we’ve always had the responsibility to inform without making people feel afraid, alone or sad. At first though, especially here in the US, it felt like not enough people were sufficiently scared. It was fear that was compelling me to stay at home – fear of making other people sick and fear of getting sick myself. So I was trying to create data visualisations that had that emotional resonance too. Illustrations that showed the numbers in a way that communicated the seriousness of this situation. I think that now the need has shifted a little where most people grasp the gravity of the situation. They need information about how to cope.

Caelainn Barr, data projects editor

Data is key in this crisis. It tells us the story of how the virus is spreading, who it affects most and, with political will, it could help pave the way out.

I am fascinated by what is left out of datasets. What we collect and omit tells us something about what we value and overlook as a society. If you don’t have data you can’t understand a problem or begin to formulate effective public policy to address it. As a journalist the gaps in datasets also give you a sense of what is not understood and should be examined in greater depth. This line of thinking has informed much of our reporting to date.

We have uncovered flaws in the government death toll, shown how the most deprived would be disproportionately affected if parks were closed, revealed BAME people are more at risk of dying from Covid-19, and explored why the poor are twice as likely to die of the virus as the rich.

Work is incredibly demanding at the moment. Very often we’re trying to make sense of new information and patchy datasets in a rapidly evolving crisis. So far data has shown us that the virus is certainly not a social leveller, rather it has found the cracks in society and blown them wide open, making long-standing inequalities painfully clear. By inquiring beyond the headline numbers, data can help us understand who the virus is affecting the most so we can forge a fairer society once this has passed.

Pamela Duncan, data journalist

Counting the human cost of the coronavirus has been one of the greatest challenges faced professionally by journalists since the onset of the pandemic: even the number of deaths is genuinely hard to provide.

Part of the problem is that data collection and reporting by the responsible agencies in the UK and elsewhere has been slow to become uniform: ordinarily deaths are collected by statistical bodies with a delay. But deaths due to Covid-19 are of obvious public interest and so the figures need to be circulated. Therefore, for data journalists like myself, much of the past two months has been spent chasing data; figuring out which deaths have and have not been included in various organisations’ figures; finding out what we can and cannot compare.

As a Guardian journalist you are always focused on reporting the truth. Never has this been more pronounced than in this crisis, where you are hyper-aware that underreporting the figures could cause complacency whereas exaggerating them could cause panic. Some have criticised journalists for not being critical enough while others wrongly, and dangerously, suggest that the figures are exaggerated. But it isn’t those people we concern ourselves with: it is getting to the truth and pointing out what we know when we know it. This means that we aren’t just putting out a BIG FIGURE and leaving it at that. Instead we are explaining why we think the BIG FIGURE isn’t the whole picture. We have faith in our audience’s ability to recognise that we may not have all the answers right now but that we are working tirelessly to get them.

Nick Evershed, data and interactives editor, Guardian Australia

Australia is now a success story in terms of its early response to Covid-19, with new cases now often below 20 a day, and far fewer deaths per million people than other countries. How this early success in flattening the curve transitions into an easing of restrictions and the prospect of a second wave remains to be seen.

When the pandemic started worsening in Australia, there were significant challenges with reporting on basic aspects of the outbreak.

Because of the difference in reporting times and methods, getting basic information correct such as the number of cases, deaths, and testing rates required staying on top of information released by nine governments.

Inspired by other projects doing similar work we started tracking these figures internally, and then decided to release the data with a licence allowing reuse. This decision paid off – the data has been used by researchers, private companies and ordinary citizens to analyse and visualise the pandemic’s impact on Australia.

Having the data openly accessible also means our figures are constantly being checked, ensuring they are as accurate as possible. This was especially helpful in the early days when significant time pressure would inevitably mean some mistakes – thankfully quickly corrected in response to reader emails.

The response has been phenomenal. The summary page has been one of the most popular pieces we have produced during the pandemic, with 5.4m page views at the time of writing. The data also is used in all our liveblogs to give readers a quick summary of the current situation.

Niko Kommenda, visual projects editor, and Pablo Gutiérrez, visual artist

We realised very early on that the story of the coronavirus crisis would benefit hugely from visually led coverage – we published our first visual explainer on the topic in early February, when the overwhelming majority of confirmed cases and deaths were still being reported in China.

From this early stage, our audience was eager to understand the details of the story. We wanted to report on it in a way that was easy to understand and offered clear conclusions. Using maps and charts, we were able to analyse the quantity and speed with which the disease multiplied each day. Our visual trackers evolved as we were able to establish comparisons between countries, put the data into historical context and shed light on different scenarios playing out in different regions.

Visual journalists around the world are coming up with ever more ingenious ways of explaining and contextualising the numbers, from case counts to reproduction numbers, to the tragic death toll of the virus.

“Flatten the curve” is perhaps the best example of a visualisation so well designed and so memorable that it has become a universally understood metaphor for a concept that would require a much lengthier explanation if one tried to convey it through words alone.

Our team is following the lively debate within the data visualisation community closely, and we’re constantly working to improve our own coronavirus trackers while experimenting with new formats to communicate the scale of the emergency. We have also experienced a growing interest from our readers in how we make our graphics, with a variety of questions reaching us each day via email and social networks.

As the global pandemic continues, we’re using visuals to drive home the dramatic change that the virus has spurred in the way we live and work – from mapping how lockdown measures have slashed global air pollution to quantifying the disastrous impact on the economy.

 

Source      :       The Guardian

https://www.theguardian.com/membership/datablog/2020/may/09/data-covid-19-numbers-story-pandemic-guardian-statistics

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Which Covid-19 Data Can You Trust?

 

The Covid-19 pandemic has created a tidal wave of data. As countries and cities struggle to grab hold of the scope and scale of the problem, tech corporations and data aggregators have stepped up, filling the gap with dashboards scoring social distancing based on location data from mobile phone apps and cell towers, contact-tracing apps using geolocation services and Bluetooth, and modeling efforts to predict epidemic burden and hospital needs. In the face of uncertainty, these data can provide comfort — tangible facts in the face of many unknowns.

In a crisis situation like the one we are in, data can be an essential tool for crafting responses, allocating resources, measuring the effectiveness of interventions, such as social distancing, and telling us when we might reopen economies. However, incomplete or incorrect data can also muddy the waters, obscuring important nuances within communities, ignoring important factors such as socioeconomic realities, and creating false senses of panic or safety, not to mention other harms such as needlessly exposing private information. Right now, bad data could produce serious missteps with consequences for millions.

Unfortunately, many of these technological solutions — however well intended — do not provide the clear picture they purport to. In many cases, there is insufficient engagement with subject-matter experts, such as epidemiologists who specialize in modeling the spread of infectious diseases or front-line clinicians who can help prioritize needs. But because technology and telecom companies have greater access to mobile device data, enormous financial resources, and larger teams of data scientists, than academic researchers do, their data products are being rolled out at a higher volume than high quality studies.

Whether you’re a CEO, a consultant, a policymaker, or just someone who is trying to make sense of what’s going on, it’s essential to be able to sort the good data from the misleading — or even misguided.

Common Pitfalls

While you may not be qualified to evaluate the particulars of every dashboard, chart, and study you see, there are common red flags to let you know data might not be reliable. Here’s what to look out for:

Data products that are too broad, too specific, or lack context. Over-aggregated data — such as national metrics of physical distancing that some of our largest data aggregators in the world are putting out — obscure important local and regional variation, are not actionable, and mean little if used for inter-nation comparisons given the massive social, demographic, and economic disparities in the world.

Conversely, overly disaggregated data can do outright harm. Public health practitioners and data privacy experts rely on proportionality — only use the data that you absolutely need for the intended purpose and no more. To some extent, all data risk breaching the privacy of individual or group identities, but publishing scorecards for specific neighborhoods risks shaming or punishing communities, while ignoring the socioeconomic realities of people’s lives that make it difficult for them to stay home. Even more granular examples, such as footfalls at identifiable business locations, risks de-identifying religious groups; patients visiting cancer hospitals, HIV clinics, or reproductive health clinics; or those seeking public assistance. The medical and public health communities long ago deemed the un-masking of such information without consent unacceptable, but companies have recently been releasing it on publicly available dashboards.

Even data at an appropriate spatial resolution must be interpreted with caution — context is key. Say you see a map that shows a 20% decrease in mobility in an American suburb and a 40% decrease in a nearby city after social distancing measures are announced. The decrease in the suburb may adequately push physical distancing to below the desired threshold, given that its residents started with a relatively low baseline to begin with. The city may still be far away from the mobility reduction required to meaningfully impact transmission rates, as its residents were very mobile before. Until we know more about how these changing movement patterns impact epidemiological aspects of the disease, we should use these data with caution. Simply presenting them, or interpreting them without a proper contextual understanding, could inadvertently lead to imposing or relaxing restrictions on lives and livelihoods, based on incomplete information.

The technologies behind the data are unvetted or have limited utility. Tech solutions such as mobile phone-based contact tracing — a solution gaining steam in many countries — have untested potential, but only as part of a broader comprehensive strategy that includes a strong underlying health system. Jason Bay, the product lead of Singapore’s successful tracing app, TraceTogether, cautions that “automated contact tracing is not a coronavirus panacea.” Yet some app-based contact-tracing efforts are being used to risk-stratify people, and these estimates are being used to make decisions on quarantine, isolation, and freedom of movement, without concomitant testing.

Both producers and consumers of outputs from these apps must understand where these can fall short. They may prove to be very useful if we experience recurrent waves in the coming months, when the outbreaks may be more localized, and our testing capacity commensurate with our technological aspirations. In the absence of a tightly coupled testing and treatment plan, however, these apps risk either providing false reassurance to communities where infectious but asymptomatic individuals can continue to spread disease, or requiring an unreasonably large number of people to quarantine. The behavioral response of the population to these apps is therefore unknown and likely to vary significantly across societies.

In some cases, the data from tracing apps requires another caveat: the methods they use are not transparent, so they cannot be fully evaluated by experts. Some contact-tracing apps follow black-box algorithms, which preclude the global community of scientists from refining them or adopting them elsewhere. These non-transparent, un-validated interventions — which are now being rolled out (or rolled back) in countries such as China, India, Israel and Vietnam — are in direct contravention to the open cross-border collaboration that scientists have adopted to address the Covid-19 pandemic. Only transparent, thoroughly vetted algorithms should be considered to augment public health interventions that affect the lives of millions.

Models are produced and presented without appropriate expertise. Well-meaning technologists and highly influential consulting firms are advising governments, and consequently businesses and general populations around the world, on strategies to combat the epidemic, including by building projection and prediction models. Epidemiological models that can help predict the burden and pattern of spread of Covid-19 rely on a number of parameters that are, as yet, wildly uncertain. We still lack many of the basic facts about this disease, including how many people have symptoms, whether people who have been infected are immune to reinfection, and — crucially — how many people have been infected so far. In the absence of reliable virological testing data, we cannot fit models accurately, or know confidently what the future of this epidemic will look like for all these reasons, and yet numbers are being presented to governments and the public with the appearance of certainty

Take a recent example: A leading global consulting firm explained their projections for an east-coast American city, by overlaying on it what they referred to as “the Wuhan curve.” The two populations and cities could not be more different in their demography and health care infrastructure. Such oversimplifications risk inaccurate projections and the untimely diversion of critical resources from places that need them the most. Corporations have the vast resources required to rapidly translate the knowledge generated from their data and technologies to governments and communities, but are crowdsourcing expertise from within their ranks. While it can be tempting to want to move with speed, a rapid “move fast and break things” approach — the hallmark of our startup culture — is inappropriate here. Coupling this enthusiasm with the right kind of subject matter expertise may go farther.

Read Carefully and Trust Cautiously

Relying on trustworthy sources is always good advice, but now it is an absolute must. Here are some buoys to help you navigate your way to the shore, whether you are a producer or consumer of data.

Transparency: Look for how the data, technology, or recommendations are presented. The more transparent the providers are about the representativeness of their data, analytic methods, or algorithms, the more confident they are of their process, and more open to public scrutiny. These are the safest knowledge partners.

Example: Singapore’s government was entirely transparent about the code, algorithm, and logic used in its TraceTogether contact app. While launching the app, they openly published a policy brief and white paper describing the rational and working of the app, and most importantly, their protocol (“BlueTrace”) and codebase (“OpenTrace”), allowing open review.

Thoughtfulness: Look for signs of hubris. Wanton disregard of privacy, civil rights, or well-established scientific facts belie overconfidence at best, and recklessness at worst. These kinds of approaches are likely to result in the most harm. Analysts that are conservative in their recommendations, share the uncertainty associated with their interpretations, and situate their findings in the appropriate local context are likely to be more useful.

Example: Telenor, the Norwegian telco giant has led the way in responsible use of aggregated mobility data from cell phone tower records. Its data have been used, in close collaboration with scientists and local practitioners, to model, predict, and respond to outbreaks around the world. Telenor has openly published its methods and provided technological guidance on how telco data can be used in public health emergencies in a responsible, anonymized format that does not risk de-identification.

Expertise: Look for the professionals. Examine the credentials of those providing and processing the data. We are facing a deluge of data and interpretation from the wrong kinds of experts, resulting in a high noise-to-signal ratio. On the most bullish of days, we wouldn’t want our bankers to be our surgeons.

Example: Imperial College, among other academic groups, has been involved in guiding decision makers in the U.K. Covid-19 response since the early days of the epidemic, through the work of the MRC Center for Global Infectious Disease Analysis. In the U.S., longstanding collaborations between state and local health departments and research groups have been augmented by new collaborative partnerships. In both countries, these efforts critically rely on sustained funding of centers that can support methods development and training during inter-epidemic periods and mobilized to respond when crises hit.

Open Platforms: Look for the collaborators. There are several data aggregators that are committed to supporting an ecosystem of communities, businesses, and research partners, by sharing data or code in safe and responsible ways. Such open ecosystem approaches, while not easy to manage, can yield high dividends.

Example: Where technology companies like Camber Systems, Cubeiq and Facebook have allowed scientists to examine their data, researchers can compare data across these novel data streams to account for representativeness and correct biases, making the data even more useful. The Covid-19 Mobility Data Network, of which we are part, comprises a voluntary collaboration of epidemiologists from around the world analyzes aggregated data from technology companies to provide daily insights to city and state officials from California to Dhaka, Bangladesh. Governments convey what information gaps exist in their planning and policy making, the scientists help identify the best analytic approaches to address those gaps, and the technology companies make available the data they have access to in a meaningful, interpretable format. All data exchange follows strict institutional ethical guidelines and is in compliance with local and international law. Daily outputs speak to the articulated needs of the collaborating government officials.

This pandemic has been studied more intensely in a shorter amount of time than any other human event. Our globalized world has rapidly generated and shared a vast amount of information about it. It is inevitable that there will be bad as well as good data in that mix. These massive, decentralized, and crowd-sourced data can reliably be converted to life-saving knowledge if tempered by expertise, transparency, rigor, and collaboration. When making your own decisions, read closely, trust carefully, and when in doubt, look to the experts.

 

By        : Satchit Balsari, Caroline Buckee and Tarun Khanna

Date    : May 08, 2020

Source:  Harvard Business Review (https://hbr.org/2020/05/which-covid-19-data-can-you-trust?ab=hero-main-text)

 

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Why are more men dying from COVID-19?

 

The novel coronavirus tends to affect men more severely than it does women. Though nobody can yet explain the oddity, researchers are hot on the case. 

It's possible that the sex hormones estrogen and testosterone play a role, according to previous research on respiratory illnesses. Or perhaps it's because the X chromosome (which women have two of, but men have only one) has a larger number of immune-related genes, giving women a more robust immune system to fight off the coronavirus, SARS-CoV-2. Or, maybe the virus is hiding in the testes, which has abundant expression of ACE2 receptors, the portal that allows SARS-CoV-2 into cells. 

Uncovering the real reason is, of course, imperative because it could help improve patient "outcomes during an active public health crisis," according to an editorial published April 10 in the Western Journal of Emergency Medicine (WJEM). 

 

What are the numbers?

Since the first known COVID-19 case was reported in China late last year, countless studies have shown that the disease tends to be more severe and deadly in men than in women. 

For instance, in an analysis of 5,700 COVID-19 patients hospitalized in New York City, just over 60% were men, according to an April 22 study published in the journal JAMA. What's more, "mortality rates were higher for male compared with female patients at every 10-year age interval older than 20 years," the researchers wrote in the study. 

Furthermore, of the 373 patients who ended up in intensive care units, 66.5% were men, the JAMA study reported.

Results are similar in other studies. When the WJEM editorial was published in early April, the authors noted that between 51% and 66.7% of hospitalized patients in Wuhan, China, were male; 58% in Italy were male; and 70% of all COVID-related deaths worldwide were male. In one large study of more than 44,600 people with COVID-19 in China, 2.8% of men died versus just 1.7% of women. 

 

Are men more susceptible?

These COVID-19 sex differences are not unexpected. Other coronavirus outbreaks, including outbreaks of SARS in 2003 and the Middle East respiratory syndrome (MERS) in 2012, had higher fatality rates in men than in women, according to the WJEM editorial. For example, a 2016 study found that men had a 40 percent higher odds of dying of MERS than women did.

Even the comically labeled "man flu" is so named because men tend to have a weaker immune response to respiratory viruses that cause flu and the common cold. As a result, men tend to get more severe symptoms from these viruses than women do, a 2017 review in BMJ found. That review pinned these results on the differences in "sex dependent hormones" in men and women. 

A mouse experiment offers clues about this hormonal mystery; when scientists infected both male and female mice of different ages with SARS, the male mice were more susceptible to the infection than females of the same age, according to a 2017 study, which was published in The Journal of Immunology. However, when the female mice had their estrogen-producing ovaries removed or were treated with an estrogen-receptor blocker, they died at higher rates than those with working ovaries and normal estrogen.

"These data indicate that sex hormones produced in female [mice] may help to defend against coronaviruses like SARS and SARS-CoV-2," Akiko Iwasaki, a professor of immunobiology at Yale University School of Medicine, who was not involved in the study, told Live Science. 

To learn more, scientists at Cedars-Sinai Medical Center in Los Angeles and the Renaissance School of Medicine at Stony Brook University in New York are testing estrogen or another sex hormone called progesterone on small groups of people who have COVID-19, Live Science previously reported.

There's another way to look at the COVID-19 sex difference; perhaps the X chromosome is protective because it has more immune-related genes than the Y chromosome does. This may also explain why women are more likely than men to have autoimmune diseases, the authors of the WJEM editorial noted. 

The second X chromosome is usually silenced in women, but almost 10% of those genes can be activated, Veena Taneja, who studies differences in male and female immune systems at the Mayo Clinic, told NPR. "Many of those genes are actually immune-response genes," she said. This could give women a "double-dose" of protection, Taneja said, although research is needed to see whether these genes factor into protection against COVID-19.

 

Hiding in the testes?

New research offers yet another idea; men seem to clear SARS-CoV-2 from their bodies more slowly than women do. To explain that possibility, researchers have suggested the virus may have found a hiding place in men: the testes. 

In the research, published on the preprint medRxiv database, 68 people confirmed to have COVID-19 in Mumbai, India, were tested with nasal swabs until they tested negative for the virus. At the end of the experiment, scientists found that women cleared the virus from their bodies in an average of 4 days, compared with men's average of 6 days. The same test in three different Mumbai households found similar results.

"Our collaborative study found that men have more difficulty clearing coronavirus following infection, which could explain their more serious problems with COVID-19 disease," study lead researcher Dr. Aditi Shastri, assistant professor of medicine at the Albert Einstein College of Medicine in New York City and a clinical oncologist at the Montefiore Einstein Center for Cancer Care, said in a statement.

Previous research has shown that SARS-CoV-2 invades certain human cells by plugging into these cells' ACE2 receptors. So, the researchers consulted a database, and found that the testes have high levels of ACE2 expression. In contrast, ACE2 could not be detected in the ovaries, the female equivalent of the testes.

However, the research did not actually look in the testes to see if SARS-CoV-2 is hanging out there, so "it does not tell us whether the virus infects testes or whether it is a reservoir of virus," said Iwasaki, who was not involved in the research. 

 

What about smoking?

Other research has suggested that smoking may play a role, as smoking is related to higher expression of ACE2 receptors. But while more men than women smoke in China, that's not true in other countries, which likely puts a kibosh on smoking to explain the sex difference. 

"What we saw in Wuhan [with the sex difference] has been replicated in every country around the world where we have accurate reporting," Sabra Klein, a researcher at the Johns Hopkins Center for Women's Health, Sex, and Gender Differences, told NPR. "In countries like Spain, where the percentages of males and females who report smoking is not significantly different, we still are seeing this profound male bias in severity of COVID-19."

Other explanations: Women are simply less likely to engage in health-related risks and are better at washing their hands, studies find, and perhaps that's behind the gender disparity

Sex differences aren't the only factor at play, however. Other groups more vulnerable to COVID-19 include the elderly and people with diabetes, high blood pressure and obesity, Live Science previously reported. 

  • 20 of the worst epidemics and pandemics in history
  • 28 Devastating Infectious Diseases 
  • 11 Surprising Facts About the Respiratory System 

 

By                  :                Laura Geggel - Associate Editor 

Date              :                April 28, 2020

Source          :                Live Science 

https://www.livescience.com/why-covid-19-more-severe-men.html 

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How the COVID-19 lockdown will take its own toll on health

NEW YORK (Reuters) - It’s the most dramatic government intervention into our lives since World War II. To fight the coronavirus outbreak, governments across the globe have closed schools, travel and businesses big and small. Many observers have fretted about the economic costs of throwing millions of people out of work and millions of students out of school.

Now, three weeks after the United States and other countries took sweeping suppression steps that could last months or more, some public health specialists are exploring a different consequence of the mass shutdown: the thousands of deaths likely to arise unrelated to the disease itself.

The longer the suppression lasts, history shows, the worse such outcomes will be. A surge of unemployment in 1982 cut the life spans of Americans by a collective two to three million years, researchers found. During the last recession, from 2007-2009, the bleak job market helped spike suicide rates in the United States and Europe, claiming the lives of 10,000 more people than prior to the downturn. This time, such effects could be even deeper in the weeks, months and years ahead if, as many business and political leaders are warning, the economy crashes and unemployment skyrockets to historic levels.

Already, there are reports that isolation measures are triggering more domestic violence in some areas. Prolonged school closings are preventing special needs children from receiving treatment and could presage a rise in dropouts and delinquency. Public health centers will lose funding, causing a decline in their services and the health of their communities. A surge in unemployment to 20% – a forecast now common in Western economies – could cause an additional 20,000 suicides in Europe and the United States among those out of work or entering a near-empty job market.

None of this is to downplay the chilling death toll COVID-19 threatens, or to suggest governments shouldn’t aggressively respond to the crisis.

A recent report by researchers from Imperial College London helped set the global lockdown in motion, contending that coronavirus could kill 2 million Americans and 500,000 people in Great Britain unless governments rapidly deployed severe social distancing measures. To truly work, the report said, the suppression effort would need to last, perhaps in an on-again, off-again fashion, for up to 18 months.

In the United States, the White House this week said the final toll could rise to 240,000 dead. States have responded to the dire warnings, and the escalating number of cases revealed each day, by extending stay-at-home shutdowns.

The medical battle against COVID-19 is developing so rapidly that no one knows how it will play out or what the final casualty count will be. But researchers say history shows that responses to a deep and long economic shock, coupled with social distancing, will trigger health impacts of their own, over the short, mid and long term.

Here is a look at some.

 

SHORT TERM CONSEQUENCES

Domestic Violence

Trapped at home with their abusers, some domestic violence victims are already experiencing more frequent and extreme violence, said Katie Ray-Jones, the chief executive officer of the National Domestic Violence Hotline.

Domestic violence programs across the country have cited increases in calls for help, news accounts reported – from Cincinnati to Nashville, Portland, Salt Lake City and statewide in Virginia and Arizona. The YWCA of Northern New Jersey, in another example, told Reuters its domestic violence calls have risen up to 24%.

“There are special populations that are going to have impacts that go way beyond COVID-19,” said Ray-Jones, citing domestic violence victims as one.

Vulnerable Students

Students, parents and teachers all face challenges adjusting to remote learning, as schools nationwide have been closed and online learning has begun.

Some experts are concerned that students at home, especially those living in unstable environments or poverty, will miss more assignments. High school students who miss at least three days a month are seven times more likely to drop out before graduating and, as a result, live nine years less than their peers, according to a Robert Wood Johnson Foundation report.

Among the most vulnerable: the more than 6 million special education students across the United States. Without rigorous schooling and therapy, these students face a lifetime of challenges.

Special needs students “benefit the most from highly structured and customized special education,” said Sharon Vaughn, executive director of the The Meadows Center for Preventing Educational Risk at the University of Texas. “This means that they are the group that are most likely to be significantly impacted by not attending school both in the short and long term.”

In New Jersey, Matawan’s Megan Gutierrez has been overwhelmed with teaching and therapy duties for her two nonverbal autistic sons, eight and 10. She’s worried the boys, who normally work with a team of therapists and teachers, will regress. “For me, keeping those communications skills is huge, because if they don’t, that can lead to behavioral issues where they get frustrated because they can’t communicate,” Gutierrez said.

 

MEDIUM TERM CONSEQUENCES

Soaring Suicides

In Europe and the United States, suicide rates rise about 1% for every one percentage point increase in unemployment, according to research published by lead author Aaron Reeves from Oxford University. During the last recession, when the unemployment in the United States peaked at 10%, the suicide rate jumped, resulting in 4,750 more deaths. If the unemployment rate increases to 20%, the toll could well rise.

“Sadly, I think there is a good chance we could see twice as many suicides over the next 24 months than we saw during the early part of the last recession,” Reeves told Reuters. That would be about 20,000 additional dead by suicide in the United States and Europe.

Less than three weeks after extreme suppression measures began in the United States, unemployment claims rose by nearly 10 million. Treasury Secretary Steven Mnuchin warned the rate could reach 20% and Federal Reserve economists predicted as high as 32%. Europe faces similarly dire forecasts.

Some researchers caution that suicide rates might not spike so high. The conventional wisdom is that more people will kill themselves amid skyrocketing unemployment, but communities could rally around a national effort to defeat COVID-19 and the rates may not rise, said Anne Case, who researches health economics at Princeton University. “Suicide is hard to predict even in the absence of a crisis of Biblical proportions,” Case said.

This week, the Air Force Academy in Colorado Springs, Colorado, relaxed its strict social isolation policies after the apparent suicides of two cadet seniors in late March, The Gazette, a Colorado Springs newspaper, reported. While juniors, sophomores and freshmen had been sent home, the college seniors were kept isolated in dorms, and some had complained of a prison-like setting. Now, the seniors will be able to leave campus for drive-thru food and congregate in small groups per state guidelines.

Public Health Crippled

Local health departments run programs that treat chronic diseases such as diabetes. They also help prevent childhood lead poisoning and stem the spread of the flu, tuberculosis and rabies. A severe loss of property and sales tax revenue following a wave of business failures will likely cripple these health departments, said Adriane Casalotti, chief of government affairs with the National Association of County and City Health Officials, a nonprofit focused on public health.

After the 2008 recession, local health departments in the U.S. lost 23,000 positions as more than half experienced budget cuts. While it’s become popular to warn against placing economic concerns over health, Casalotti said that, on the front lines of public health, the two are inexorably linked. “What are you going to do when you have no tax base to pull from?” she asked.

Carol Moehrle, director of a public health department that serves five counties in northern Idaho, said her office lost about 40 of its 90 employees amid the last recession. The department had to cut a family planning program that provided birth control to women below the poverty line and a program that tested for and treated sexually transmitted diseases. She worries a depression will cause more harm.

“I honestly don’t think we could be much leaner and still be viable, which is a scary thing to think about,” Moehrle said.

 

LONG TERM CONSEQUENCES

Job-loss Mortality

Rises in unemployment during large recessions can set in motion a domino effect of reduced income, additional stress and unhealthy lifestyles. Those setbacks in income and health often mean people die earlier, said Till von Wachter, a University of California Los Angeles professor who researches the impact of job loss. Von Wachter said his research of past surges in unemployment suggests displaced workers could lose, on average, a year and a half of lifespan. If the jobless rate rises to 20%, this could translate into 48 million years of lost human life.

Von Wachter cites measures he believes could mitigate the effects of unemployment. The Coronavirus Aid, Relief, and Economic Security Act approved by the White House last week includes emergency loans to businesses and a short-time compensation program that could encourage employers to keep employees on the payroll.

Young People Suffer

Young adults entering the job market during the coronavirus suppression may pay an especially high price over the long term.

First-time job hunters seeking work during periods of high unemployment live shorter and unhealthier lives, research shows. An extended freeze of the economy could shorten the lifespan of 6.4 million Americans entering the job market by an average of about two years, said Hannes Schwandt, a health economics researcher at Northwestern University, who conducted the study with von Wachter. This would be 12.8 million years of life lost.

Thousands of college graduates will enter a job market at a time global business is frozen. Jason Gustave, a senior at William Paterson University in New Jersey who will be the first in his family to graduate from college, had a job in physical therapy lined up. Now his licensure exam is postponed and the earliest he could start work is September.

“It all depends on where the economy goes,” he said. “Is there a position still available?”

 

WHAT COMES NEXT

In the weeks ahead, a clearer picture of the disease’s devastation will come into focus, and governments and health specialists will base their fatality estimates on a stronger factual grounding.

As they do, some public health experts say, the government should weigh the costs of the suppression measures taken and consider recalibrating, if necessary.

Dr. Jay Bhattacharya, who researches health policy at Stanford University, said he worries governments worldwide have not yet fully considered the long term health impacts of the impending economic calamity. The coronavirus can kill, he said, but a global depression will, as well. Bhattacharya is among those urging government leaders to carefully consider the complete shutdown of businesses and schools.

“Depressions are deadly for people, poor people especially,” he said.

 

 

Reporting in New York by M.B. Pell and Benjamin Lesser. Data editing by Janet Roberts. Editing by Ronnie Greene.

 

Date                         :               April 3, 2020

Source                     :               Reuters 

https://uk.reuters.com/article/uk-health-coronavirus-usa-cost-special-r/special-report-how-the-covid-19-lockdown-will-take-its-own-toll-on-health-idUKKBN21L21K

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Antarctic endeavours, primary health-care research and dark matter exploration – the coronavirus casualties you haven’t heard of

The year 2020 came with big expectations for researchers, myself included. Last year I was successful in the first round of the National Health and Medical Research Council Investigator Grants scheme. Six years since completing my PhD, I managed to launch my Healthy Primary Care research team.

We investigate how principles of wellness such as healthy eating and exercise are incorporated into health care, particularly in general practice. I spent the summer planning how to support my team for the next five years, focusing on impact and research translation into real-world settings.

Big things were in the works. It was an exciting time. But as it turns out, wellness in health care isn’t a priority during the COVID-19 crisis.

As the pandemic lingers, big players (especially pharmaceutical companies) around the world have understandably dropped everything, joining forces to give the virus their undivided attention.

A sudden loss

Many of my team’s projects relied on doctors, nurses and other health professionals to collect or provide data. With the strain placed on health care by the pandemic, continuing was no longer viable. Grant applications, domestic and international travel, conferences and meetings have all been cancelled or postponed indefinitely.

As a supervisor, the hardest part was withdrawing research students and interns I’d lined up to start projects in clinics. This pandemic has challenged the relevance, impact and productivity of our work.

This shock comes shortly after a summer of devastating bushfires which hindered research progress by forcing experts out of fire-affected regions, destroying expanses of equipment and reportedly setting some studies “back months or years”.

Stoppages across the field

Social distancing, travel bans and quarantine restrictions mean scientific fieldwork across the world has almost completely stopped.

The Australian Antarctic Program, led by the federal Department of Agriculture, Water and the Environment has been reduced to essential staff only to keep the Antarctic continent COVID-19-free. Instead of sending 500 expeditioners in the next summer season, the Australian Antarctic Division will only send about 150.

Social distancing measures are also preventing climate scientists from being able to visit their laboratories. If the pandemic continues, this could hamper important weather and climate surveillance practices. In some cases, labs have been reduced to one essential worker whose sole job is to keep laboratory animals alive for when research resumes.

Delays have also impacted one of the world’s largest efforts to investigate the nature of dark matter. The XENON experiment based in Italy is worth more than US$30 million, according to the New York Times. It faced a multitude of roadblocks when the country was forced into lockdown earlier this year.

Young research stars missing opportunities

For young researchers, social distancing and event cancellations are especially damaging to professional development. Scientific conferences and meetings foster collaboration and can also lead to employment opportunities.

This crisis has left the next generation of researchers unsupported, and have negative flow-on effects for all research areas. In health and disease prevention, research efforts apart from vaccinations are still vital, as the onset of COVID-19 hasn’t stopped the rise of chronic disease.

There are positives

Australia boasts a robust and passionate research workforce, which means we can divert resources to a united cause such as the coronavirus crisis. As the race for a vaccine continues, the value of research has never been more apparent to the non-scientific community. This may help weaken anti-science messages.

The pandemic is also providing opportunity for future university leaders to understand university management, funding and governance decisions. Never before has information been so accessible on where funding comes from.

Online conferencing and collaboration related to research has also made participation more accessible and affordable. This increases inclusively by removing barriers for people who may not be able to attend in-person gatherings, such as people living with a physical disability, full-time carers and people experiencing financial hardship. Less domestic and international travel is also helping reduce carbon footprints.

Charging forward

The health system isn’t working normally, which means my team’s research isn’t working normally. Nonetheless, we’re pivoting well in this uncertain time. We’re helping plan the first online conference for Australian primary care to improve access to relevant research across the country.

New grant opportunities are aligning COVID-19 to our research focus, such as the Royal Australian College of General Practitioners’s and the Hospitals Contribution Fund’s special call for projects on COVID-19 in general practice.

Some may think non-COVID-19 research isn’t currently necessary, but it will be once we combat this disease. And when that happens, we’ll be ready to right where we left off.

 

By                  :               Lauren Ball (Associate Professor/ Principal Research Fellow, Griffith University)

Date              :               April 21, 2020

Source          :               The Conversation

https://theconversation.com/antarctic-endeavours-primary-health-care-research-and-dark-matter-exploration-the-coronavirus-casualties-you-havent-heard-of-136390

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The Scariest Pandemic Timeline

If the flu and coronavirus hit at the same time this fall, America might have a longer, more severe lockdown.

If you held out a glimmer of hope about life returning to normal this year, that hope may have been thoroughly extinguished this week by the director of the Centers for Disease Control and Prevention, Robert Redfield.

“There’s a possibility that the assault of the virus on our nation next winter will actually be even more difficult than the one we just went through,” Redfield told The Washington Post on Tuesday. “We’re going to have the flu epidemic and the coronavirus epidemic at the same time.”

President Trump later tried to claim that Redfield had been misquoted, but Redfield clarified that he was quoted accurately. He’s also far from the only person who believes that the United States is in for a bleak winter. Numerous public-health experts are concerned that COVID-19 might make a comeback this fall (assuming that total case numbers even drop to begin with). In combination with the normal, October-through-March flu season, the disease could strain hospital capacity even more than it did this spring, when flu season was petering out. “It’s going to be a very difficult fall and winter this year coming up,” says Ashish Jha, the director of the Harvard Global Health Institute.

Scientists don’t yet know if the coronavirus will fade away during the summer before making a resurgence in colder temperatures. Some other respiratory illnesses do this: During the 2009 swine-flu outbreak, cases surged in the spring, subsided over the summer, then returned with a vengeance in the autumn. But the new coronavirus strain’s behavior is still too mysterious to predict for certain. Experts expect the virus to circulate among humans for some time, but its particular ebbs and flows aren’t yet known.

A late-in-the-year rebound would be a problem because flu season already puts hospitals close to capacity, experts told me. Though fewer people hospitalized for the flu would require ventilators than COVID-19 patients likely would, flu patients might need precious intensive-care-unit space. Already during this outbreak, reports from hospitals read like dispatches from a war zone. One 49-year-old COVID-19 patient was found “blue and dead” in an emergency-room chair while waiting for an inpatient bed. Doctors’ groups debated whether younger patients should have preferential access to ventilators. Having to contend with another round of COVID-19 patients while also taking on severe flu cases might cause hospitals to quickly run out of ventilators, beds, or even doctors.

Some people might even get infected with both the flu and COVID-19 at the same time. While health experts don’t know exactly how that would make COVID-19 worse, “I can’t imagine that would be good,” Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security, said.

Even as the seasonal flu reenters the picture, Americans likely won’t have developed herd immunity to COVID-19, and a vaccine is likely still more than a year away. The absolute safest thing to do would be for all Americans to lock themselves inside until there’s a coronavirus vaccine. However, even die-hard public-health cheerleaders say that’s simply not feasible. Millions of people have lost their jobs; non-COVID-19 medical treatments are being postponed; children are suffering from a lack of schooling and socialization.

Instead, health experts broadly concur that the best path forward will be an aggressive testing and contact-tracing regimen. It might not be possible to get asymptomatic people tested regularly. However, the rapid testing of anyone who has possible COVID-19 symptoms, along with a way to track and isolate anyone they’ve been in contact with, could keep coronavirus infections from spreading as the flu simultaneously rips through the population. While America’s testing capabilities have been increasing, we are currently not testing or contact-tracing at anywhere near the necessary level, experts say.

There are other ways to prepare for a big fall surge in flu and COVID-19 infections. Government and hospital officials could use the intervening time to staff up hospitals and increase their capacity. Large sporting events and concerts may need to be postponed until there’s more immunity in the population, Nuzzo and others say. Jha says universities should cancel sports and extracurriculars, give every student a single dorm, and stagger dining times. Vulnerable people—like the elderly or those with chronic illnesses—may have to stay home longer than others. Everyone could wear masks even after they’re no longer required to, and work from home if they’re able to.

In addition to mitigating coronavirus transmission, these types of mild social-distancing measures might help reduce the spread of the flu. “Some of these things will hopefully work their way into our more normal, day-to-day lives, and we’ll be able to do ‘social distancing light’ in a way that will help us reduce the transmission,” Stephen Kissler, an infectious-disease modeler at Harvard, told me.

Jha is hopeful that between now and this fall, biotech companies will have developed drugs that can lessen COVID-19 symptoms. Though these might not be “cures” per se, they might reduce the amount of time COVID-19 patients are in the hospital and thus ease the strain on the health-care system. If these measures don’t happen, Americans might see additional lockdowns. “If we don’t get our act together, the chances that there will be another lockdown in the fall, and that it will be a long one, are very, very high,” Jha said.

To be sure, even if no one takes unnecessary risks, and therapeutics are available, and the hospitals are well stocked, and hand-washing becomes a religion, there still might need to be a fall lockdown. This is, unfortunately, the new uncertainty with which we all now live.

If you are desperate to cling to some modicum of control, the number-one way everyday Americans can help to prevent this flu-COVID-19 Armageddon is by getting the flu shot. Employers could even make returning to work in the fall contingent on being vaccinated against the flu, Nuzzo said. The flu shot is one of the few things that are within our power, and it doesn’t rely on the vicissitudes of pathogens. There aren’t many opportunities to feel empowered these days. We might want to seize the ones we get.

 

OLGA KHAZAN is a staff writer at The Atlantic and the author of Weird: The Power of Being an Outsider in an Insider World.

 

By              :              Olga Khazan

Date          :               April 24, 2020

Source      :               The Atlantic (https://www.theatlantic.com/health/archive/2020/04/could-there-be-another-coronavirus-quarantine/610630/) 

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Open science takes on the coronavirus pandemic

 

Data sharing, open-source designs for medical equipment, and hobbyists are all being harnessed to combat COVID-19.

When reports emerged in late 2019 of an outbreak of a new coronavirus centred in Wuhan, China, researchers at the virological-analysis website Nextstrain were ready. The open-source project tracks the spread of viruses through genetic variations in the sequences that scientists find. After five years of development and operation, Nextstrain had team members on three continents who could continuously refresh the analysis, 24 hours a day.

What they didn’t know was whether researchers would share their data. “You just never know what level of detail is going to be allowed to come out,” says Emma Hodcroft, a Nextstrain developer and molecular epidemiologist at the University of Basel in Switzerland.

But since 11 January, when a team led by Zhang Yong-Zhen at the Shanghai Public Health Clinical Center, China, shared the first genome sequence of the SARS-CoV-2 virus, the volume of data has skyrocketed. By the end of March, Nextstrain was receiving anywhere from 50 to 200 sequences a day from laboratories around the world, and was running its analysis of virus evolution every few hours. “The volume that we’re getting right now, this is totally unprecedented,” says Hodcroft.

Nextstrain is just one example of how an open ethos has driven the scientific response to the COVID-19 pandemic. Academics, online data repositories and home hobbyists with 3D printers are adopting new practices of rapid data sharing and collaboration that are appropriate to the urgency of the crisis. Many hope it will change the way science is done even after the pandemic subsides.

Do it yourself

Perhaps nowhere is that open ethos clearer than in the way do-it-yourself (DIY) and ‘maker’ communities have stepped up. As soon as it became clear that health systems around the world were at risk of running out of crucial equipment to treat people with COVID-19 and protect medical workers, DIY-ers set about trying to close the gap.

Facebook groups such as Open Source COVID19 Medical Supplies, which has more than 70,000 members, have become dispatch centres, through which hospital workers seek volunteers to print or make supplies, and volunteers trade tips on what materials to use and where to source them, and on sterilization procedures.

The coronavirus crisis plays to 3D printing’s strong points — rapid prototyping and the ability to produce parts on demand anywhere in the world. Prusa Research, a manufacturer of 3D printers in Prague, has designed a frame for a face shield that is meant to be worn outside a mask or respirator to protect against infectious droplets. The company says it has the capacity to produce 800 shields per day, and tens of thousands of the devices are already protecting health-care workers in the Czech Republic. But because the company made its designs open-source, they are also being made around the world in maker spaces and homes.

Formlabs, a 3D-printer manufacturer based in Somerville, Massachusetts, leads another project that has reached production: printing nasal swabs for COVID-19 test kits. Unlike common cotton swabs, nasal swabs must have a rod that is long and flexible enough to reach deep into the nose, to the upper throat. The swabs were designed by doctors at the University of South Florida in Tampa and the Northwell Health hospital system in New York, using printers purchased from the company to produce test versions. “They are prototyping it themselves, which is crazy and really awesome,” says Formlabs’s chief product officer, Dávid Lakatos. And whereas conventional swabs feature a bushy tip coating of nylon flock, the doctors devised a tip with an intricately textured pattern that is 3D-printed.

But unlike face shields, these parts are beyond the capabilities of most printers used by hobbyists. “If someone tried to print the swabs on a hobbyist printer, they can really do harm” in a clinical setting, says Lakatos.

Under US regulations, commercial manufacturing of nasal swabs must take place in a facility that has been registered with the US Food and Drug Administration (FDA). Formlabs has its own registered lab in Millbury, Ohio, with 250 printers (each costing about US$3,500) that can print 100,000 swabs a day.

The right tool

Other 3D-printed and DIY projects seek to provide everything from protective face masks for medical workers to door handles that can be opened using an elbow — helping health-care staff to avoid contaminating their hands — and ventilators for people who are critically ill. Among the furthest along in development are the OpenLung ventilator — a collaboration between groups based in Toronto, Canada, and Dublin — and the MIT Emergency Ventilator developed at the Massachusetts Institute of Technology in Cambridge. But manufacturing of such devices is still subject to regulatory approval. The MIT team told Nature that “approval would be sought by a manufacturer that ultimately adapts and makes a device inspired by the open-source reference material”. On 17 April, the first such device, called Spiro Wave, received Emergency Use Authorization from the FDA, making it available for use during the crisis; New York City has already ordered 3,000 units.

In the United Kingdom, a collaboration between University College London (UCL), the UCL Hospital and the Mercedes Formula One racing team has reverse-engineered and optimized a ‘continuous positive airway pressure’ device. The design has been approved by UK authorities for use during the COVID-19 pandemic and made available at no cost to manufacturers and researchers. The National Health Service has ordered up to 10,000 units. And in Nigeria, Yunusa Mohammed Garba, a researcher at Gombe State University, has built a positive-pressure ventilator from hobbyist and second-hand components, for use in the northeastern Gombe state, a resource-constrained part of the country. Nigeria has a population of about 200 million, yet it might have fewer than 500 ventilators. Garba’s design is currently being optimized and tested for use at the Federal Teaching Hospital Gombe, which plans to obtain two devices. “At the moment [the ventilator] can only be used in the ambulance,” Garba says. “We are currently using funding from the government to build an upgraded version of the ventilator that can be fully utilized in the hospitals.”

Still, even proponents of 3D printing find some of the projects potentially dangerous. “It’s both inspiring and extremely scary,” says Lakatos. Formlabs, for instance, investigated face-mask designs and produced numerous prototypes before recommending against 3D printing them. “The [3D-printed] face masks that I’m seeing, those designs are absolutely not sealing anything,” says Lakatos. “And I think they may be even giving a false kind of confidence to people.”

Following discussions with clinicians, Formlabs has instead been recommending a DIY respirator design produced by Boston Children’s Hospital in Massachusetts that repurposes off-the-shelf parts, including ventilator filters and a face mask used for administering anaesthetic gas. “It seems to be a much better solution than trying to do it with 3D printing,” says Lakatos.

One of the most widespread open-source face-shield designs eschews 3D printing entirely. The project began in March with the University of Wisconsin Makerspace in Madison, which worked with Midwest Prototyping, a 3D-printing company in nearby Blue Mounds, to produce them. But after bringing in Jesse Darley at the Madison office of Delve, an engineering design firm, the group decided to change tack. Instead of 3D printing, the frames and straps of the resulting ‘Badger Shields’ (named after the university’s mascot) are made from elastic and foam that can be purchased off-the-shelf in bulk form, and cut down either by machine or by hand. Darley says such components can be made in 20 seconds, compared with several hours through 3D printing.

The Madison group has already received orders for five million shields. To meet that demand, manufacturers have stepped in to help, including Ford Motor Company, which Darley says has tweaked the design for mass production and can make around one million shields per week.

Where credit’s due

The open ethos is influencing other aspects of the pandemic response, too. More than 2,000 articles on COVID-19 have been posted in the preprint archives bioRxiv and medRxiv, according to biomed-sanity.com, a site that aggregates preprints related to the pandemic. Numerous COVID-19 data sets are available on the code-sharing site GitHub, including the data underlying Johns Hopkins University’s widely used COVID-19 case-tracking dashboard. So, too, are reviews of the COVID-19 literature by researchers at the Icahn School of Medicine at Mount Sinai in New York City, and separately by a collaborative project led by computational biologists Halie Rando and Casey Greene at the University of Pennsylvania in Philadelphia.

Yet it wasn’t a given that researchers would embrace openness early in the outbreak: data that are made public can be difficult to publish through conventional channels later. And multiple news reports have suggested that health workers and researchers in China were initially subjected to government limits on what information they could release. But when Chinese researchers uploaded the first genome sequence of the SARS-CoV-2 virus to the online repositories virological.org and GenBank, they opened the floodgates for more sequences from China and from the rest of the world, Hodcroft says. “I am very grateful for the scientists who took this risk, because I think this set the precedent for the rest of the epidemic.” Given that the outbreak was initially confined to China, had those researchers not done so, “we might have completely different pictures that might be incorrect” she says.

Hodcroft hopes that these collaborative practices will carry over to research on other viruses and seasonal outbreaks. Not all labs have the equipment and personnel to sequence a viral genome, and even for those that do, the work requires time and money. But if more take that step — even if only every couple of weeks — she says it should be possible to track outbreaks in greater detail, using mutations as markers to better understand their geographical spread.

The pandemic could also bring lasting changes in how medical equipment is developed, produced and distributed. Lakatos would like to see hospitals have their own 3D printers as an emergency back-up to produce crucial equipment such as nasal swabs. And publicly available designs for parts such as face shields could make it easier to overcome breakdowns in international supply chains, allowing for more flexible, distributed manufacturing, says Darley.

Soon after releasing the Badger Shield plans, Darley was contacted by a company in Bonner, Montana, he had worked with that makes cycle rickshaws. The firm, called Coaster Cycles, had laid off or drastically cut hours for nearly all its workers because of the pandemic, but after seeing the open-source plans, it won a contract to supply shields to health systems spanning six US states — and hired back its workforce to produce them. Chief executive Ben Morris says the company eventually hopes to sell one million face shields. “That’s the power of open source,” says Darley. “It allows a family to make a few [units], or a manufacturer to make thousands, or hundreds of thousands.”

 

By            :            Mark Zastrow

Date        :             April 24, 2020

Source    :            Nature  (https://www.nature.com/articles/d41586-020-01246-3)

Additional reporting by Abdullahi Tsanni in Abuja, Nigeria

doi: 10.1038/d41586-020-01246-3

 

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How pandemics shape society

Johns Hopkins sociologist and historian Alexandre White discusses how past pandemics, such as the 1918 Spanish flu outbreak, have reverberated long after the disease stops spreading

From the bubonic plague of the 14th century to the Spanish flu outbreak in 1918, the repercussions and effects of pandemics have changed how societies function. Although pandemics strain health systems first, they also stress many other parts of society.

The Hub reached out to Alexandre White, an assistant professor of sociology and history of medicine at Johns Hopkins University, to learn more about the societal repercussions and consequences of past pandemics. This conversation has been edited for length and clarity.

How do international responses to the COVID-19 pandemic compare with those of previous pandemics?

That's a complicated question on a couple of levels. COVID-19, in a lot of ways, is a particularly effective disease at destabilizing health systems, as well as global economic processes. The fact that it can transmit asymptomatically and produce fairly mild symptoms in many of the cases means that its capacity to spread is quite high and it is putting a real strain on health systems around the world.

Since 1851, the threat of epidemic spread from particular diseases has been a critical concern for nations and the international community. The International Sanitary Conferences, which began in 1851, aimed to prevent the spread of infectious disease without disrupting trade and traffic. From the late 19th century through World War II, the ISC [oversaw the international response to] the spread of three diseases—plague, cholera, and yellow fever—until those responsibilities were transferred to what we now know as the World Health Organization.

The response by the WHO to COVID-19 was organized quite quickly. Since 2005, WHO regulations have established protocols and criteria for national health system readiness and also for what constitutes a "public health emergency of international concern," or PHEIC. WHO declared a PHEIC for COVID-19 at the end of January, which highlighted the severity of the threat. This was intended to aggressively mobilize international responses.

What we've actually seen in response to WHO's PHEIC declaration, particularly in the U.S. and the EU, has been a limited capacity for testing potential cases, which means that aspects of our treatment capacity are weakened.

The COVID-19 pandemic is frequently compared to the 1918 Spanish flu pandemic and the 2009 H1N1 outbreak. Are these fair comparisons?

I think that, biologically, comparing COVID-19 to previous flu outbreaks is useful because the process of epidemic spread can be similar. Like COVID-19, flus are often spread through droplets. The differences arise in the populations that are most at risk. We're still learning about the profile for those most at risk for COVID-19. Also, we have more effective diagnostic tools and biomedical responses now than we did in 1918, as well as increased capacity and knowledge in the medical sector. That puts us in a better position to confront this pandemic. However, in the absence of the pharmacological intervention, the practices of social distancing and quarantine initiatives might look similar to those of 1918.

An epidemic that's largely been overlooked in comparison to this one is the most recent West African Ebola virus disease epidemic, as well as the recent Ebola epidemic in Democratic Republic of Congo. In these epidemics, aggressive, long-term social distancing measures were put in place in countries like Guinea, Liberia, and Sierra Leone. Although Ebola is biologically different in its method of contagion, we might still be able to look at the effective social distancing strategies carried out in West Africa for solutions to this current pandemic.

I hope we can recognize that social distancing measures are taken out of an abundance of care for one another, and we should be vigilant about how these practices protect the ones we love and the health workers confronting this disease.

There has been a lot of postulating on how public health measures, like social distancing, might change the nature of society. Historically, what are the lingering effects of global pandemics on societies?

In Cape Town in 1901, a plague epidemic produced a very aggressive racial segregated quarantine that, in many ways, became the precursor and blueprint for future segregated towns and communities in apartheid South Africa. It's a stark example of how racism and bigotry can drive very aggressive and oppressive responses against those most marginalized in a society.

Epidemics are crises. During crises, a lot of commonly held beliefs are questioned, and the status quo can be thrown into question, too. It's my hope that we can see how public health and socioeconomic disparities are widening as a result of the COVID-19 pandemic. Ideally, this will lead us to create better systems in the future.

Have there been any indications that the COVID-19 pandemic is exacerbating these inequalities?

Unfortunately, yes. The dangerous framing of this particular pandemic as a "Chinese virus" or the "Wuhan virus" leads to a great deal of stigma for anyone from China or of Asian descent. It leads to violence, harassment, hatred, and bigotry, as we've already seen. The ways in which this pandemic has exacerbated these particular practices of bigoted and racist ideology is not surprising during an epidemic, but it's a serious threat to effective health responses.

We've seen time and time again, in responses to HIV/AIDS in the 1980s or in responses internationally to bubonic plague from the early 1900s, that stigma and bigotry—especially when diseases become associated with certain people and communities—have the effect of creating a potentially vindictive public health response. We don't want to steer people who are sick away from the health care that they need because they're afraid they'll be persecuted or stigmatized for their illness.

The second aspect I'd want to touch on is how epidemics highlight inequality. We're starting to see it now in the high rates of unemployment that are stretching the capacities of our existing social welfare network in the United States. There have been very few national initiatives thus far for people who have been laid off from service work like employees at restaurants, in hospitality, and in recreation.

We are also seeing now how racial inequalities and existing health disparities are putting certain people at greater risk of severe symptoms and complications. These are the products of social inequality as much as epidemic dynamics. This needs to be addressed soon, and is emblematic of the declining social welfare network in the United States.

 

Date         :               April 9, 2020

By            :               Hub staff report

Source     :               https://hub.jhu.edu/2020/04/09/alexandre-white-how-pandemics-shape-society/

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Coronavirus is spreading panic. Here’s the science behind why.

From prehistoric predator encounters to frantic toilet paper runs, our anxious brains can short-circuit when faced with the scary unknown.

Since the coronavirus began spreading across the world, we’ve learned a lot about the lengths to which people will go for a roll of toilet paper, a tube of hand sanitizer or a face mask. As the number of confirmed coronavirus cases increases and states and countries lock down large gatherings or shops to promote social distancing, these uncertainties are driving the so-called “panic-buying” that’s emptying store shelves quicker than they can be restocked.

Panic-buying supplies is one way humans have coped with uncertainty over epidemics since at least 1918 during the Spanish flu—when people in Baltimore raided drug stores for anything that would prevent the flu or relieve its symptoms—all the way up to the 2003 SARS outbreak.

“When you’re seeing extreme responses. It’s because people feel like their survival is threatened and they need to do something to feel like they’re in control,” explains Karestan Koenen, professor of psychiatric epidemiology at the Harvard T.H. Chan School of Public Health.

But what exactly causes us to panic—and how can we keep our cool in a high-stress time like a pandemic? It depends on how different areas of the brain play along with each other.

The evolution of fear and panic

Human survival has depended on both fear and anxiety, requiring us to react immediately when we encountered a threat (think: the lion around the corner) as well as being able to mull over perceived threats (where are the lions tonight?)

Panic starts when a negotiation of sorts in the brain goes awry. Koenen explains that the amygdala, the emotional center of the brain, wants us to get out of harm’s way immediately—and it doesn’t care how we avoid the lion.

But the frontal cortex, which handles your behavioral responses, insists that we think the lion situation through first. When might we run into a lion again, and what to do about it?

Sometimes anxiety can get in the way. Rather than talking directly to the parts of our brains that are good at planning and making decisions, the frontal cortex gets confused by all the cross-talk between other parts of the brain that are determined to play out all the possible scenarios for how we might become a lion’s dinner.

Panic happens when the whole thing short-circuits.

While our frontal cortex wants to think about where the lions may be tomorrow night, our amygdalas are in overdrive.

“Panic happens when that more rational part of your brain [the frontal cortex] gets overrun by emotion,” Koenen says. Your fear is so acute that the amygdala takes over and adrenaline kicks in.

In certain scenarios, panic can be life-saving. When we’re in immediate danger of being mauled by a lion or run over by a car, the most rational response may be flight, fight, or freeze. We don’t want our brains to spend too much time debating that.

But listening just to the amygdala can come with serious drawbacks. In his 1954 work, “The Nature and Conditions of Panic,” Enrico Quarantelli, a sociologist who conducted ground-breaking research on how humans behave during disasters, told the story of a woman who heard an explosion and fled her house, thinking a bomb had hit it. It was only when she realized the explosion had occurred across the street that she remembered she had left her baby behind.

“Panic, rather than being antisocial, is a nonsocial behavior,” Quarantelli wrote. “This disintegration of social norms… sometimes results in the shattering of the strongest primary group ties.”

Panic doesn’t help much with long-term threats either. That’s when it’s essential for the frontal cortex to remain in control, alerting you to the possibility of a threat while also taking the time to assess the risk and make a plan to act.

How uncertainty can drive panic

But if we’re deluged with information and messaging during this pandemic, why are some people hoarding toilet paper and hand sanitizer during this pandemic while others are dismissing the risks and packing into bars?

Humans are notoriously bad at assessing risk in the face of uncertainty—and we’re often bad at it in different ways that cause us to overestimate or underestimate our personal risks.

Sonia Bishop, an associate professor of psychology at the University of California Berkeley who researches how anxiety affects decision-making, says that’s particularly true now during the coronavirus pandemic. Inconsistent messaging from governments, the media, and public health authorities—such as all the varied recommendations on social distancing—fuels anxiety.

“We’re not used to living in situations where we have rapidly changing probabilities,” Bishop says.

Panic and our psychological biases

Ideally, Bishop says, we should be taking an approach called model-free learning to assess our risk in the face of uncertainty. This approach is essentially trial and error: we rely on our personal experiences and gradually update our estimates of how likely something is to happen, how bad it would be if it does happen, and how much effort we need to put in to prevent it.

When we don’t have a model for how to handle a threat, Bishop says, many people turn to model-based learning, a framework in which we either try to recall examples from the past or simulate future possibilities.

And that’s where “availability bias” creeps in. When we’ve heard or read about something a lot—for instance, a plane crash covered extensively in the news—it becomes so easy to imagine oneself in a plane that’s crashing that one may overestimate the risk of flying. “It’s that ease of simulating that scenario that then overwhelms our judgements of the probability,” Bishop says.

Similarly, some people have biases toward optimism or pessimism. While pessimists can’t stop anxiously imagining all the potential doomsday scenarios, optimists tend to believe that nothing bad is going to happen. Even if they fall into one of the vulnerable groups, they find a way to reconcile that with their worldview by assuring themselves that they are too healthy to die from the coronavirus. “It gives you back some [sense of] control,” Bishop says.

Is there ever a good time to panic?

While there certainly are people behaving on either side of these extremes, most people are experiencing something else: acute anxiety.

Some amount of anxiety can be good in the face of disaster. Fear can be a motivator, raising our alertness and energy levels. It reminds us to wash our hands, pay attention to the news—and, yes, even stock up on essentials at grocery stores.

Jennifer Horney, founding director of epidemiology at the University of Delaware and a public health preparedness expert, points out that a little more panic could be particularly helpful in a place like the U.S., whose population historically has not as good as other countries’ when it comes to following public health interventions such as isolation and quarantine.

“In that sense maybe a little more panic might be productive in terms of understanding that our behavior does impact others,” she says.

On the other hand, anxiety is a terrible thing to suffer from over the long term. For one thing, as we become more anxious, it’s also harder for our brains to keep from spiraling into panic mode. Studies have indicated that chronic stress can actually shrink the parts of our brains that help us reason, which can further fuel panic.

Bishop points out that our bodies really aren’t made to live with acute stress and anxiety for weeks and months. Though they may give us a short term energy burst, it ultimately leaves us exhausted and depressed. This can ultimately have serious implications for society’s response if people get so burned out on social distancing that they start going out again before the pandemic has hit its peak.

Panic and pandemic interventions

Horney, who trained rapid response teams during the 2009 H1N1 (“Swine Flu”) pandemic, says reducing uncertainty is key to ensuring that our interventions do work.

Coronavirus is not a complete unknown, she notes. Public health officials also know a lot about coronaviruses from dealing with SARS and MERS.

“A lot of the things that are happening are the typical public health measures that we take to control outbreaks; it’s just happening on a much larger scale,” Horney says.

“We quarantine cruise ships all the time because of outbreaks, but it’s usually norovirus or seasonal influenza.”

 

Date                         :               March 17,  2020

By                            :               Amy Mckeever

Source                     :               https://www.nationalgeographic.com/history/reference/modern-history/why-we-evolved-to-feel-panic-anxiety/

 

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Social distancing prevents infections, but it can have unintended consequences

 

In response to the coronavirus pandemic, public health officials are asking us to do something that does not come naturally to our very social species: Stay away from each other. Such social distancing—avoiding large gatherings and close contact with others—is crucial for slowing the spread of the virus and preventing our health care system from getting overwhelmed. But it won’t be easy.

“The coronavirus spreading around the world is calling on us to suppress our profoundly human and evolutionarily hard-wired impulses for connection: seeing our friends, getting together in groups, or touching each other,” says Nicholas Christakis, a social scientist and physician at Yale University.

And social distancing also tests the human capacity for cooperation, he adds. “Pandemics are an especially demanding test … because we are not just trying to protect people we know, but also people we do not know or even, possibly, care about.”

The effects of short-term social distancing haven’t been well studied, but several researchers—most of them scrambling to deal with disruptions to their own lives because of the coronavirus—recently took time to share some thoughts with ScienceInsider on the potential social and psychological impacts, and how to mitigate them. Here’s what they said:

What’s known about the effects of social interaction on mental and physical health?

Over long periods of time, social isolation can increase the risk of a variety of health problems, including heart disease, depression, dementia, and even death. A 2015 meta-analysis of the scientific literature by Julianne Holt-Lunstad, a research psychologist at Brigham Young University, and colleagues determined that chronic social isolation increases the risk of mortality by 29%.

That may be because social contacts can buffer the negative effects of stress. Lab studies by Holt-Lunstad and others have found that having a friend present can reduce a person’s cardiovascular response to a stressful task. There’s even a correlation between perceived social connectedness and stress responses. “Just knowing that you have someone you can count on if needed is enough to dampen some of those responses even if [that person is] not physically present,” Holt-Lunstad says.

What effects, if any, might be caused by social distancing in response to the coronavirus is an open question. “I have a couple competing hypotheses,” Holt-Lunstad says. “On the one hand, I am concerned that this will not only exacerbate things for those who are already isolated and lonely, but also might be a triggering point for others to now get into habits of connecting less.”

A more optimistic possibility, she says, is that heightened awareness of these issues will prompt people to stay connected and take positive action. “We’d love to be collecting data on that,” she says.

Are certain people or populations more likely to be affected?

People of all ages are susceptible to the ill effects of social isolation and loneliness, Holt-Lunstad says. But a recent report from the National Academy of Sciences (of which she was a co-author) highlights some reasons older people may be more susceptible, including the loss of family or friends, chronic illness, and sensory impairments like hearing loss that can make it harder to interact.

There’s enormous individual variation in people’s ability to handle social isolation and stress, adds Chris Segrin, a behavioral scientist at the University of Arizona. It’s important to remember that not everyone is going into this with the same level of mental health, he says. “Someone who is already having problems with, say, social anxiety, depression, loneliness, substance abuse, or other health problems is going to be particularly vulnerable.”

Overall, though, people are remarkably resilient. And many have endured far worse situations. Segrin points to case studies of U.S. prisoners during the Vietnam War who were confined in tiny cells called “tiger cages,” sometimes in water up to their chin. One trait that predicted their long-term psychological health was optimism: Prisoners who believed that, no matter how bad things were, they would survive and the war would eventually be won had better mental health later on in life.

Can technology help compensate for some of the downsides of social distancing?

Texting, email, and apps like Skype and FaceTime can definitely help people stay in touch. “We are fortunate to live in an era where technology will allow us to see and hear our friends and family, even from a distance,” Christakis says.

Even so, those modes of communication don’t entirely replace face-to-face interactions, Segrin says. “When we interact with other people, a lot of the meaning conveyed between two people is actually not conveyed in the actual words, but in nonverbal behavior,” he says. A lot of those subtleties of body language, facial expressions, and gestures can get lost with electronic media. “They’re not as good as face to face interactions, but they’re infinitely better than no interaction,” Segrin says.

What will we miss by not being able to go to things like concerts and sporting events?

One hundred years ago, French sociologist Émile Durkheim used the phrase “collective effervescence” to describe the shared emotional excitement people experience during religious ceremonies. The same concept applies to sporting events where spectators simultaneously experience the rise and fall of emotions during the course of a game, says Mario Small, a sociologist at Harvard University. “It dramatically magnifies the sensation for you while also reinforcing the idea that you’re something larger than yourself,” Small says.

Such events help build cohesiveness, he says, and although no one expects society to fall apart just because NBA and other sports leagues have suspended their seasons, for many sports fans (and music fans and festival goers) the growing list of canceled events represents another coping mechanism they’ll have to temporarily get by without.

What else can we do?

“Any one of us can pick up a phone and call to see how people are doing and what they might need,” Holt-Lunstad says. She notes that research on altruism has found that giving support can be even more beneficial than receiving it. “Not only will helping others potentially help them, but it can help us to still feel connected as well.”

There’s also the inspiration of people under lockdown in Italy singing and playing music through open windows to keep spirits up. “That’s the kind of thing we need!” says Robin Dunbar, an evolutionary psychologist at the University of Oxford. “But maybe only the Italians would have the flair to do that without being embarrassed,” he adds. The rest of us, it seems, will have plenty of time to work up the nerve.

 

Date                         :               March 16, 2020

By                            :               Greg Miller

Source                     :               https://www.sciencemag.org/news/2020/03/we-are-social-species-how-will-social-distancing-affect-us#

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Using sociology to make sense of the coronavirus pandemic

'We must begin with the kind of mind that links our personal circumstances with the public experience'

 

It is apparent that the coronavirus pandemic is trouble for every individual. But there is a caveat to this.

Sociologist C. Wright Mills proposes that our personal troubles should be understood in light of public issues. More often than not, we do not link our personal troubles with the issues of society as a whole. We might think that our personal troubles – in this case, safety from the virus – can be solved through our individual coping mechanisms alone. But one thing is certain: the coronavirus is a public issue.

But the mere recognition of the issue as a public concern is just the beginning. Making sense of this phenomenon is another task. German sociologist Ulrich Beck’s notion of “risk society” will be helpful here.

He describes the contemporary world as one where people, governments, and corporations are increasingly mindful of the experience of risk in different aspect of our lives, including health. He says that in the event of any world catastrophe, the impact would be damaging and difficult to contain. We see this social reality in the increasing number of deaths worldwide and in the different measures, rules, and regulations imposed by different states.

How, then, should we deal with the phenomenon of the coronavirus as a public issue and a global risk?

 

Date                         :               March 26, 2020

By                            :               Prince Kennex R. Aldama

Source                     :               https://www.rappler.com/views/imho/255954-opinion-using-sociology-make-sense-coronavirus-pandemic

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Sociologist explains how coronavirus might change the world around us

 

In his role as a medical sociologist, Richard M. Carpiano studies population health issues, analyzing how a variety of social factors influence both the physical and mental health of people around the world.

Carpiano is a professor of public policy and sociology at the University of California, Riverside. Most recently, his research has focused on vaccine hesitancy, or the reasons underlying whether parents might choose not to vaccinate their children or to delay vaccine coverage.

A pandemic like COVID-19 is especially interesting to sociologists because "it forces conversations by radically rearranging our social routines," Carpiano said. Below, he shares some insights about how the coronavirus could have far-reaching impacts on our social structures and routines.

As a sociologist, can you give us a bird's-eye view of how you approach a pandemic like COVID-19? What do you look at first?

For me, an event like this is especially notable because of its ability to reveal limitations in social policy. As a society, we can plan for so many human elements, but then here's a virus that comes along and shows all the weak links we have when it comes to things like family leave policy, unemployment policy, and public health policy.

What we often don't discuss when we talk about health care in the U.S. is our public health system. This situation is really bringing forward how important having a well-funded, well-organized public health system is in this country at the county, state, and national levels, and how important it is to have coordination between agencies. It's a sector that's been underinvested in for a long time, especially at the federal level, but as we're seeing, you really do get what you pay for.

In your research, you study how social conditions—and social inequities—influence health outcomes. How are you applying that lens to looking at the coronavirus?

Well, a pandemic like this doesn't hit everyone equally. Of course, with COVID-19 we see differences in risk based on age, and we can already see certain groups being more marginalized when it comes to being able to access resources such as testing and medical care. But in particular, this pandemic has highlighted the vulnerabilities of people in different types of occupations, many of whom belong to traditionally lower income brackets. It's revealed how closely our benefits are tied to our work, what happens when that work goes away, and ultimately how many Americans are in precarious work situations.

What about health impacts we might see as a result of people being isolated and having to dramatically change their usual routines?

There's been talk that we might see a coronavirus birth cohort as people are spending more time quarantined at home—it's certainly a time for intimacy, but a time for more conflict, too, as people are living on top of one another for long stretches. But we also might see a number of collateral health impacts from this pandemic, such as people being more sedentary, eating more out of boredom, and generally being less active. We might see alcohol consumption go up and substance abuse become more prevalent. I would imagine most people right now have less access to their doctors or are becoming less likely than usual to have their medications refilled. All of these things could lead to additional health consequences down the line.

Do you see any unexpected silver linings that could result from this situation?

I've been trying very hard, as a coping mechanism, to think of some positive things that could come out of this, and one thing I think might be a silver lining is that this event has really highlighted the importance of state government. People have a lot of criticisms about how the federal government has been handling this situation, and many of those are legitimate, but we're also seeing state officials really rise to the challenge and demonstrate leadership at a time when trust in government isn't exactly the highest. It's been an opportunity for a new wave of political leaders to step forward—people showing that it's not just about politics or partisanship, but really about being a public servant.

The reality is there are very few people who are anti-government in times of crisis. People look to government for direction on what to do. As a result of this, I think we might see more trust in state government, in particular.

Are there any historical events you view as similarly disruptive to society or are looking to in comparison?

It might be because I was in New York when 9/11 happened, but that's what my mind goes to. That was another situation where the U.S. was taken off guard and had its governmental limitations exposed very suddenly—major limitations in operation, planning, and problem-solving. But in the wake of 9/11, we saw a real public push to figure out how this happened and how we could prevent it from happening ever again. We saw the formation of the 9/11 Commission and a lot of other significant changes made in the realms of foreign policy and national security. I'm hoping a similar trend might take hold after this, but in relation to public health and promoting new conversations about what we can do to prevent something similar from happening again by strengthening our public health system.

You also study vaccine hesitancy, or the reasoning behind why some parents might not choose to have their children vaccinated. Do you think this situation could have any bearing on changing public perception of vaccines to help skeptics view them more favorably?

Vaccines are not a bread-and-butter issue for the average American; most people in this country support them. If anything, I think, this situation could help raise support for elected officials to enact stricter measures to ensure the population's vaccination coverage is as high as it can be. But when we look at the very small minority of vocal, dyed-in-the-wool groups who are anti-vaccines and actively lobby against them, I'm unfortunately not very optimistic that this event will change their minds much. We're already seeing a lot of conspiracy theorizing surrounding this situation from them, and they tend to equate vaccine requirements with "government overreach" no matter what. But one thing I think we might see is their usual tactics not working as well when it comes to getting the ears of elected officials.

 

Date                         :               April 2, 2020

By                            :               Tess Eyrich, University of California – Riverside

Source                     :               https://phys.org/news/2020-04-sociologist-coronavirus-world.html

 

 

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Poor city dwellers run greatest coronavirus risk

 

BARCELONA, April 9 (Thomson Reuters Foundation) - In working-class Roquetes, life looks good: the Mediterranean glitters on the horizon and sun dapples the green hills behind. But in the coronavirus crisis, this modest Barcelona neighbourhood faces grave risk.

Residents are seven times more likely to get COVID-19 than people in wealthier districts of Spain’s second city, according to an interactive map published by regional authorities.

The rate of infection in Roquetes, among the Nou Barris - or ‘New Districts’ - of Barcelona, is 533 per 100,000 inhabitants, according to the map, which tracked COVID-19 across Catalonia.

About 6 km away, in the upmarket area of Sant Gervasi, the rate of infection is just 77.

Spain is among the worst hit nations in the global crisis, with some 150,000 cases and its big cities suffering most.

Nor is the Roquetes district an inner-city exception.

In El Prat de Llobregat and Sant Quirze del Vallès – working-class satellite towns just outside Barcelona – the rate of infection is even higher, at 604 and 701 per 100,000 inhabitants respectively.

These stark urban inequalities are mirrored in busy cities across the world, showing just what money can buy.

Health experts hope the Barcelona map, along with a slew of others tracking the spread of the new coronavirus, helps the world to recalibrate in COVID-19’s aftermath and better protect those city dwellers most at risk from disease.

Socio-economic status is the biggest factor in determining whether someone in Barcelona will contract the virus or not, said Mark Nieuwenhuijsen, a professor of environmental epidemiology at the Barcelona Institute for Global Health.

“In places like Nou Barris, where you see the highest risk, there is less education around, people are probably less aware of these kinds of things but also need to travel more for jobs,” he told the Thomson Reuters Foundation by phone.

“Poorer people often do jobs that mean they have to get around - like working in shops or running public transport systems,” he said, while the wealthy can often work from home and so are less likely to come into contact with the virus.

POVERTY

Urban health experts say busy western hubs share many similarities with Asian cities, whose crowded neighbourhoods and slums are particularly vulnerable to disease outbreaks.

“Refugee and minority populations live in poor quality, densely occupied accommodation with insecure working conditions,” said Carolyn Stephens, a professor of global health at University College London.

Aside from the ease of contagion in dense neighbourhoods, a poor standard of living carries wider risks, said Herbert Gans, a sociology professor at Columbia University.

“Poverty has an almost endless number of bad effects, beginning with poor health, a weak immunity system and low resistance, insufficient medical care, unhealthy housing, and so on,” Gans told the Thomson Reuters Foundation.

In New York, for instance, the rate of people who have tested positive in Queens and the Bronx far outstrips that of people living in the wealthier borough of Manhattan, according to data released by New York City’s Health Department.

“Urban density may play a role, as with this you tend to have more human contact, but I don’t think it’s the determining factor,” Nieuwenhuijsen concurred.

 

Date                         :               April 9, 2020

By                            :               Sophie Davies, Thomson Reuters Foundation

Source                     :               https://www.reuters.com/article/health-coronavirus-innercity/feature-poor-city-dwellers-run-greatest-coronavirus-risk-idUSL8N2BV2HD

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