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The common challenge of covid-19 has produced very different outcomes around the world, leading to many questions about the determinants of national performance and shortcomings in global performance. Problems of reporting and standards do not make precise comparisons easy, but few would disagree that the roughly 1400 deaths reported by South Korea, Thailand, and Vietnam together represent far better results than the roughly 700 000 deaths reported by Brazil, the United Kingdom, and the United States.1 Adjusting these figures for population-the first group has about a third of the citizens of the second group-does not explain why covid-19 mortality differs by a factor of nearly 500. Neither typical proxy measures such as gross national income per capita nor national rankings on the 2019 Global Health Security Index have any meaningful association with performance on covid-19.2

Some have taken a stab at putting the pandemic in historical context. At the start of the Covid-19 pandemic, the Washington Post visualized the devastating plagues of history, with Covid-19 by comparison a tiny dot. (By today, tragically, it'd be a much bigger dot.) This vivid graphic ranks Covid-19 the ninth deadliest in history

Aerosol transmission of viruses must be acknowledged as a key factor leading to the spread of infectious respiratory diseases. Evidence suggests that SARS-CoV-2 is silently spreading in aerosols exhaled by highly contagious infected individuals with no symptoms. Owing to their smaller size, aerosols may lead to higher severity of COVID-19 because virus-containing aerosols penetrate more deeply into the lungs (10). It is essential that control measures be introduced to reduce aerosol transmission. A multidisciplinary approach is needed to address a wide range of factors that lead to the production and airborne transmission of respiratory viruses, including the minimum virus titer required to cause COVID-19; viral load emitted as a function of droplet size before, during, and after infection; viability of the virus indoors and outdoors; mechanisms of transmission; airborne concentrations; and spatial patterns. More studies of the filtering efficiency of different types of masks are also needed. COVID-19 has inspired research that is already leading to a better understanding of the importance of airborne transmission of respiratory disease.

Great powers rise and fall, shaping each transitional period of global power shift and its geographic concentration. Currently, the world is witnessing a profound transformation in the geopolitical arena of international affairs. For the past years, the pundits have been propagating the emergence of an Asian multipolar century, with a shift from the Atlantic to the Pacific realm. However, following the COVID-19 virus outbreak, this year marks the obvious manifestation of an Indo-Pacific decade, with the US, China, and potentially India being the main protagonists in an emerging competition. This time, it is the unfolding of regional centres of power, which create the delusive impression of multipolarity, while in fact a new systemic bipolarity between the US and China comes to light. In the post-COVID-19 global context, the virus has become a catalyst of multiple systemic changes, inducing ad hoc constellations of regional actors-shaped by their geopolitical and geoeconomic interests-in a changing global order with eroding multilateral structures.

BY NOW THERE'S little doubt about hydroxychloroquine: It doesn't work for treating Covid-19. But there's a bigger, more important lesson hidden in the story of its failure-a rarely-mentioned, but altogether crucial, error baked into the early research. The scientists who ran the first, promising laboratory experiments on the drug had used the wrong kind of cells: Instead of testing its effects on human lung cells, they relied on a supply of mass-produced, standardized cells made from a monkey's kidney. In the end, that poor decision made their findings more or less irrelevant to human health. Worse, it's possible that further research into novel Covid-19 cures will end up being compromised by the same mistake.

If a COVID-19 vaccine went on the market before Election Day, Kamala Harris said she's not sure she'd take it. And she's not alone. In a recent poll, a majority of Americans - 62 percent - said they were worried that the Trump administration would pressure the Food and Drug Administration to release a vaccine before it's ready, and 54 percent said they simply wouldn't take that hypothetical vaccine at all, even if it were free.

Athena Akrami's neuroscience lab reopened last month without her. Life for the 38-year-old is a pale shadow of what it was before 17 March, the day she first experienced symptoms of the novel coronavirus. At University College London (UCL), Akrami's students probe how the brain organizes memories to support learning, but at home, she struggles to think clearly and battles joint and muscle pain. "I used to go to the gym three times a week," Akrami says. Now, "My physical activity is bed to couch, maybe couch to kitchen." Her early symptoms were textbook for COVID-19: a fever and cough, followed by shortness of breath, chest pain, and extreme fatigue. For weeks, she struggled to heal at home. But rather than ebb with time, Akrami's symptoms waxed and waned without ever going away. She's had just 3 weeks since March when her body temperature was normal.

COVID-19 is a wicked problem for policy makers internationally as the complexity of the pandemic transcends health, environment, social and economic boundaries. Many countries are focusing on two key responses, namely virus containment and financial measures, but fail to recognise other aspects. The systems approach, however, enables policy makers to design the most effective strategies and reduce the unintended consequences. To achieve fundamental change, it is imperative to firstly identify the "right" interventions (leverage points) and implement additional measures to reduce negative consequences. To do so, a preliminary causal loop diagram of the COVID-19 pandemic was designed to explore its influence on socio-economic systems. In order to transcend the "wait and see" approach, and create an adaptive and resilient system, governments need to consider "deep" leverage points that can be realistically maintained over the long-term and cause a fundamental change, rather than focusing on "shallow" leverage points that are relatively easy to implement but do not result in significant systemic change

In December 2019, the Coronavirus disease 2019 (COVID-19), caused by a novel coronavirus SARS-CoV-2, emerged in Wuhan, Hubei province, China1 and soon spread across the world. In this ongoing pandemic, public health concerns and the urgent need for effective therapeutic measures require a deep understanding of its epidemiology, transmissibility and pathogenesis. Here we analyzed the clinical, molecular and immunological data from 326 confirmed cases of COVID-19 in Shanghai. Genomic sequences of SARS-CoV-2 assembled from 112 quality samples together with sequences in the Global Initiative on Sharing All Influenza Data (GISAID) showed a stable evolution and suggested two major lineages with differential exposure history during the early phase of the outbreak in Wuhan. Nevertheless, they exhibited similar virulence and clinical outcomes. Lymphocytopenia, especially the reduced CD4+ and CD8+ T cell counts upon admission, was predictive of disease progression. High levels of IL-6 and IL-8 during treatment were observed in patients with severe or critical disease and correlated with decreased lymphocyte count. The determinants of disease severity seemed to stem mostly from host factors such as age, lymphocytopenia, and its associated cytokine storm, whereas viral genetic variation did not significantly affect the outcomes.

A new machine-learning framework uses reported test results and death rates to calculate estimates of the actual number of current COVID-19 infections within all 50 U.S. states and 50 countries. Jungsik Noh and Gaudenz Danuser of the University of Texas Southwestern Medical Center present these findings in the open-access journal PLOS ONE on February 8,

More than a year after COVID-19 emerged, many mysteries persist about the disease: why do some people get so much sicker than others? Why does lung damage sometimes continue to worsen well after the body seems to have cleared the SARS-CoV-2 virus? And what is behind the extended, multi-organ illness that lasts for months in people with 'long COVID'? A growing number of studies suggest that some of these questions might be explained by the immune system mistakenly turning against the body - a phenomenon known as autoimmunity.

In December, Antarctica lost its status as the last continent free of COVID-19 when 36 people at the Chilean Bernardo O'Higgins research station tested positive. The station's isolation from other bases and fewer researchers in the continent means the outbreak is now likely contained.

Among the many uncertainties that remain about Covid-19 is how the human immune system responds to infection and what that means for the spread of the disease. Immunity after any infection can range from lifelong and complete to nearly nonexistent. So far, however, only the first glimmers of data are available about immunity to SARS-CoV-2, the coronavirus that causes Covid-19.

Bart Haagmans (Erasmus MC) concludes: "The observations made in this study provide definite proof that SARS-CoV-2 can multiply in cells of the gastrointestinal tract. However, we don't yet know whether SARS-CoV-2, present in the intestines of COVID-19 patients, plays a significant role in transmission. Our findings indicate that we should look into this possibility more closely." The current study is in line with other recent studies that identified gastrointestinal symptoms in a large fraction of COVID-19 patients and virus in the stool of patients free of respiratory symptoms. Special attention may be needed for those patients with gastrointestinal symptoms. More extensive testing using not only nose and throat swabs, but also rectal swabs or stool samples may thus be needed.

Actions taken to mitigate the threats of coronavirus disease 2019 (COVID-19) to human life and welfare have inadvertently resulted in a natural experiment offering unanticipated insight into how human behavior affects animal behavior (1). Worldwide, elective quarantine and stay-at-home orders have reduced use of public spaces and transportation networks, especially in cities. Anecdotal media accounts suggest that restricted movement has elicited rarely observed behaviors in commensal and peri-urban animals (2). Though not all of the reports have proven to be accurate (3), widely publicized observations like coyotes crossing the normally heavily trafficked Golden Gate Bridge in the San Francisco (SF) Bay Area (California, USA) have provoked widespread fascination with the prospect that animals rapidly move back into landscapes recently vacated by humans.

Rethinking University Finance in age of Covid-19

Doyne Farmer - a physicist who has studied the economic impact of the COVID-19 pandemic - talks to Benjamin Skuse about lockdown easing and the prospects of financial recovery

Yves here. So now it's clear: some companies and their law firm enablers see their right to profit, even in the face of the Covid-19 pandemic, as more important than human lives. This has been an underlying theme of investor-state dispute settlement suits (which we've written about extensively), but it's never been as crass as here. On top of everything else, these actions will deplete government coffers, adding to public distress. The only upside is this sort of thing should kill incorporating meaningful investor-state dispute settlement provisions into future trade deals.

When they are strict and prolonged, the public health and social measures to contain Covid-19 have proven difficult to respect. This column gives evidence of the different outcomes, as of 23 May, across a sample of 20 tourist-dependent island states with populations of between 100,000 and 10 million. If tourist-dependent islands have been hit hard by the shock, most have fared well, particularly those - like Mauritius - that acted early and imposed a strict lockdown.