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Javier E

Opinion | The Pandemic Probably Started in a Lab. These 5 Key Points Explain Why. - The... - 0 views

  • a growing volume of evidence — gleaned from public records released under the Freedom of Information Act, digital sleuthing through online databases, scientific papers analyzing the virus and its spread, and leaks from within the U.S. government — suggests that the pandemic most likely occurred because a virus escaped from a research lab in Wuhan, China.
  • If so, it would be the most costly accident in the history of science.
  • The SARS-like virus that caused the pandemic emerged in Wuhan, the city where the world’s foremost research lab for SARS-like viruses is located.
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  • Dr. Shi’s group was fascinated by how coronaviruses jump from species to species. To find viruses, they took samples from bats and other animals, as well as from sick people living near animals carrying these viruses or associated with the wildlife trade. Much of this work was conducted in partnership with the EcoHealth Alliance, a U.S.-based scientific organization that, since 2002, has been awarded over $80 million in federal funding to research the risks of emerging infectious diseases.
  • Their research showed that the viruses most similar to SARS‑CoV‑2, the virus that caused the pandemic, circulate in bats that live roughly 1,000 miles away from Wuhan. Scientists from Dr. Shi’s team traveled repeatedly to Yunnan province to collect these viruses and had expanded their search to Southeast Asia. Bats in other parts of China have not been found to carry viruses that are as closely related to SARS-CoV-2.
  • When the Covid-19 outbreak was detected, Dr. Shi initially wondered if the novel coronavirus had come from her laboratory, saying she had never expected such an outbreak to occur in Wuhan.
  • The SARS‑CoV‑2 virus is exceptionally contagious and can jump from species to species like wildfire. Yet it left no known trace of infection at its source or anywhere along what would have been a thousand-mile journey before emerging in Wuhan.
  • The year before the outbreak, the Wuhan institute, working with U.S. partners, had proposed creating viruses with SARS‑CoV‑2’s defining feature
  • The laboratory pursued risky research that resulted in viruses becoming more infectious: Coronaviruses were grown from samples from infected animals and genetically reconstructed and recombined to create new viruses unknown in nature. These new viruses were passed through cells from bats, pigs, primates and humans and were used to infect civets and humanized mice (mice modified with human genes). In essence, this process forced these viruses to adapt to new host species, and the viruses with mutations that allowed them to thrive emerged as victors.
  • Worse still, as the pandemic raged, their American collaborators failed to publicly reveal the existence of the Defuse proposal. The president of EcoHealth, Peter Daszak, recently admitted to Congress that he doesn’t know about virus samples collected by the Wuhan institute after 2015 and never asked the lab’s scientists if they had started the work described in Defuse.
  • By 2019, Dr. Shi’s group had published a database describing more than 22,000 collected wildlife samples. But external access was shut off in the fall of 2019, and the database was not shared with American collaborators even after the pandemic started, when such a rich virus collection would have been most useful in tracking the origin of SARS‑CoV‑2. It remains unclear whether the Wuhan institute possessed a precursor of the pandemic virus.
  • In 2021, The Intercept published a leaked 2018 grant proposal for a research project named Defuse, which had been written as a collaboration between EcoHealth, the Wuhan institute and Ralph Baric at the University of North Carolina, who had been on the cutting edge of coronavirus research for years. The proposal described plans to create viruses strikingly similar to SARS‑CoV‑2.
  • Coronaviruses bear their name because their surface is studded with protein spikes, like a spiky crown, which they use to enter animal cells. The Defuse project proposed to search for and create SARS-like viruses carrying spikes with a unique feature: a furin cleavage site — the same feature that enhances SARS‑CoV‑2’s infectiousness in humans, making it capable of causing a pandemic. Defuse was never funded by the United States.
  • owever, in his testimony on Monday, Dr. Fauci explained that the Wuhan institute would not need to rely on U.S. funding to pursue research independently.
  • While it’s possible that the furin cleavage site could have evolved naturally (as seen in some distantly related coronaviruses), out of the hundreds of SARS-like viruses cataloged by scientists, SARS‑CoV‑2 is the only one known to possess a furin cleavage site in its spike. And the genetic data suggest that the virus had only recently gained the furin cleavage site before it started the pandemic.
  • Ultimately, a never-before-seen SARS-like virus with a newly introduced furin cleavage site, matching the description in the Wuhan institute’s Defuse proposal, caused an outbreak in Wuhan less than two years after the proposal was drafted.
  • When the Wuhan scientists published their seminal paper about Covid-19 as the pandemic roared to life in 2020, they did not mention the virus’s furin cleavage site — a feature they should have been on the lookout for, according to their own grant proposal, and a feature quickly recognized by other scientists.
  • At the Wuhan Institute of Virology, a team of scientists had been hunting for SARS-like viruses for over a decade, led by Shi Zhengl
  • In May, citing failures in EcoHealth’s monitoring of risky experiments conducted at the Wuhan lab, the Biden administration suspended all federal funding for the organization and Dr. Daszak, and initiated proceedings to bar them from receiving future grants. In his testimony on Monday, Dr. Fauci said that he supported the decision to suspend and bar EcoHealth.
  • Separately, Dr. Baric described the competitive dynamic between his research group and the institute when he told Congress that the Wuhan scientists would probably not have shared their most interesting newly discovered viruses with him. Documents and email correspondence between the institute and Dr. Baric are still being withheld from the public while their release is fiercely contested in litigation.
  • In the end, American partners very likely knew of only a fraction of the research done in Wuhan. According to U.S. intelligence sources, some of the institute’s virus research was classified or conducted with or on behalf of the Chinese military.
  • In the congressional hearing on Monday, Dr. Fauci repeatedly acknowledged the lack of visibility into experiments conducted at the Wuhan institute, saying, “None of us can know everything that’s going on in China, or in Wuhan, or what have you. And that’s the reason why — I say today, and I’ve said at the T.I.,” referring to his transcribed interview with the subcommittee, “I keep an open mind as to what the origin is.”
  • The Wuhan lab pursued this type of work under low biosafety conditions that could not have contained an airborne virus as infectious as SARS‑CoV‑2.
  • Labs working with live viruses generally operate at one of four biosafety levels (known in ascending order of stringency as BSL-1, 2, 3 and 4) that describe the work practices that are considered sufficiently safe depending on the characteristics of each pathogen. The Wuhan institute’s scientists worked with SARS-like viruses under inappropriately low biosafety conditions.
  • ​​Biosafety levels are not internationally standardized, and some countries use more permissive protocols than others.
  • In one experiment, Dr. Shi’s group genetically engineered an unexpectedly deadly SARS-like virus (not closely related to SARS‑CoV‑2) that exhibited a 10,000-fold increase in the quantity of virus in the lungs and brains of humanized mice. Wuhan institute scientists handled these live viruses at low biosafety levels, including BSL-2.
  • Even the much more stringent containment at BSL-3 cannot fully prevent SARS‑CoV‑2 from escaping. Two years into the pandemic, the virus infected a scientist in a BSL-3 laboratory in Taiwan, which was, at the time, a zero-Covid country. The scientist had been vaccinated and was tested only after losing the sense of smell. By then, more than 100 close contacts had been exposed. Human error is a source of exposure even at the highest biosafety levels, and the risks are much greater for scientists working with infectious pathogens at low biosafety.
  • An early draft of the Defuse proposal stated that the Wuhan lab would do their virus work at BSL-2 to make it “highly cost-effective.” Dr. Baric added a note to the draft highlighting the importance of using BSL-3 to contain SARS-like viruses that could infect human cells, writing that “U.S. researchers will likely freak out.”
  • Years later, after SARS‑CoV‑2 had killed millions, Dr. Baric wrote to Dr. Daszak: “I have no doubt that they followed state determined rules and did the work under BSL-2. Yes China has the right to set their own policy. You believe this was appropriate containment if you want but don’t expect me to believe it. Moreover, don’t insult my intelligence by trying to feed me this load of BS.”
  • SARS‑CoV‑2 is a stealthy virus that transmits effectively through the air, causes a range of symptoms similar to those of other common respiratory diseases and can be spread by infected people before symptoms even appear. If the virus had escaped from a BSL-2 laboratory in 2019, the leak most likely would have gone undetected until too late.
  • One alarming detail — leaked to The Wall Street Journal and confirmed by current and former U.S. government officials — is that scientists on Dr. Shi’s team fell ill with Covid-like symptoms in the fall of 2019. One of the scientists had been named in the Defuse proposal as the person in charge of virus discovery work. The scientists denied having been sick.
  • The hypothesis that Covid-19 came from an animal at the Huanan Seafood Market in Wuhan is not supported by strong evidence.
  • In December 2019, Chinese investigators assumed the outbreak had started at a centrally located market frequented by thousands of visitors daily. This bias in their search for early cases meant that cases unlinked to or located far away from the market would very likely have been missed
  • To make things worse, the Chinese authorities blocked the reporting of early cases not linked to the market and, claiming biosafety precautions, ordered the destruction of patient samples on January 3, 2020, making it nearly impossible to see the complete picture of the earliest Covid-19 cases. Information about dozens of early cases from November and December 2019 remains inaccessible.
  • A pair of papers published in Science in 2022 made the best case for SARS‑CoV‑2 having emerged naturally from human-animal contact at the Wuhan market by focusing on a map of the early cases and asserting that the virus had jumped from animals into humans twice at the market in 2019
  • More recently, the two papers have been countered by other virologists and scientists who convincingly demonstrate that the available market evidence does not distinguish between a human superspreader event and a natural spillover at the market.
  • Furthermore, the existing genetic and early case data show that all known Covid-19 cases probably stem from a single introduction of SARS‑CoV‑2 into people, and the outbreak at the Wuhan market probably happened after the virus had already been circulating in humans.
  • Not a single infected animal has ever been confirmed at the market or in its supply chain. Without good evidence that the pandemic started at the Huanan Seafood Market, the fact that the virus emerged in Wuhan points squarely at its unique SARS-like virus laboratory.
  • With today’s technology, scientists can detect how respiratory viruses — including SARS, MERS and the flu — circulate in animals while making repeated attempts to jump across species. Thankfully, these variants usually fail to transmit well after crossing over to a new species and tend to die off after a small number of infections
  • investigators have not reported finding any animals infected with SARS‑CoV‑2 that had not been infected by humans. Yet, infected animal sources and other connective pieces of evidence were found for the earlier SARS and MERS outbreaks as quickly as within a few days, despite the less advanced viral forensic technologies of two decades ago.
  • Even though Wuhan is the home base of virus hunters with world-leading expertise in tracking novel SARS-like viruses, investigators have either failed to collect or report key evidence that would be expected if Covid-19 emerged from the wildlife trade. For example, investigators have not determined that the earliest known cases had exposure to intermediate host animals before falling ill.
  • No antibody evidence shows that animal traders in Wuhan are regularly exposed to SARS-like viruses, as would be expected in such situations.
  • In previous outbreaks of coronaviruses, scientists were able to demonstrate natural origin by collecting multiple pieces of evidence linking infected humans to infected animals
  • In contrast, virologists and other scientists agree that SARS‑CoV‑2 required little to no adaptation to spread rapidly in humans and other animals. The virus appears to have succeeded in causing a pandemic upon its only detected jump into humans.
  • it was a SARS-like coronavirus with a unique furin cleavage site that emerged in Wuhan, less than two years after scientists, sometimes working under inadequate biosafety conditions, proposed collecting and creating viruses of that same design.
  • a laboratory accident is the most parsimonious explanation of how the pandemic began.
  • Given what we now know, investigators should follow their strongest leads and subpoena all exchanges between the Wuhan scientists and their international partners, including unpublished research proposals, manuscripts, data and commercial orders. In particular, exchanges from 2018 and 2019 — the critical two years before the emergence of Covid-19 — are very likely to be illuminating (and require no cooperation from the Chinese government to acquire), yet they remain beyond the public’s view more than four years after the pandemic began.
  • it is undeniable that U.S. federal funding helped to build an unprecedented collection of SARS-like viruses at the Wuhan institute, as well as contributing to research that enhanced them.
  • Advocates and funders of the institute’s research, including Dr. Fauci, should cooperate with the investigation to help identify and close the loopholes that allowed such dangerous work to occur. The world must not continue to bear the intolerable risks of research with the potential to cause pandemics.
  • A successful investigation of the pandemic’s root cause would have the power to break a decades-long scientific impasse on pathogen research safety, determining how governments will spend billions of dollars to prevent future pandemics. A credible investigation would also deter future acts of negligence and deceit by demonstrating that it is indeed possible to be held accountable for causing a viral pandemic
  • Last but not least, people of all nations need to see their leaders — and especially, their scientists — heading the charge to find out what caused this world-shaking event. Restoring public trust in science and government leadership requires it.
Javier E

Scientists Predicted the Coronavirus Pandemic - The Atlantic - 0 views

  • The now-prophetic words could be found at the end of a research paper published in the journal Clinical Microbiology Reviews in October of 2007: “The presence of a large reservoir of SARS-CoV-like viruses in horseshoe bats, together with the culture of eating exotic mammals in southern China, is a time bomb.”
  • The warning—made nearly 13 years ago and more than four years after the worrying first wave of severe acute respiratory syndrome, or SARS, killed nearly 800 people globally—was among the earliest to predict the emergence of something like SARS-CoV-2, the virus behind the current COVID-19 pandemic.
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  • Dogged by skepticism and inconsistent funding, these coronavirus researchers were stymied from developing treatments and vaccines for SARS—many of which could have been helpful in the current crisis.
  • Another similarly affected researcher was Brenda Hogue, a virologist at Arizona State University in Tempe. Hogue had devoted her career to studying coronaviruses, focusing on the protein machinery that drives their assembly. After SARS, she and her colleagues turned part of their attention toward developing a vaccine. But when the funding dropped off in 2008, she said, the vaccine went into limbo “and we put our efforts into other directions.”
  • to some experts whose business it is to hunt potential pathogens before they spill over into human populations, the many years spent not girding for a serious coronavirus outbreak were tragically—and unnecessarily—wasted.
  • “We were out there on the ground after SARS, working on coronaviruses with Chinese colleagues in collaboration,” said Peter Daszak, president of the EcoHealth Alliance, a New York–based nonprofit group that took part in a large federally funded effort, called Predict, to hunt for new pandemic viruses in wildlife in 31 countries, including China. That program was famously defunded last fall, just before the SARS-CoV-2 outbreak began.
  • “But we were the only group of western scientists,” Daszak added. “How can we be the only people looking for these viruses when there was such a clear and present danger?”
  • when SARS emerged in late 2002, there was initially “general disbelief among medical people that a coronavirus could be the basis of such a huge outbreak.”
  • As that epidemic spread, an influx of new researchers crowded the field. More grants were awarded, and funding started to climb. “Everyone wanted to know where the virus had come from,” said Ralph Baric, a microbiologist at the University of North Carolina’s Gillings School of Global Public Health. Initial findings pointed to wild civets and raccoon dogs sold for meat and pelts, respectively, in Chinese markets. Later evidence began to implicate horseshoe bats as the original source of the infections. Some researchers whose pre-SARS careers had been grounded in basic coronavirus biology began working on therapies and vaccines—and they made steady progress for several years.
  • funding declines hobbled individual investigators who weren’t part of these larger consortia. Pharmaceutical companies that develop vaccines and therapies scaled back on coronavirus research, too. Within a few years after the SARS outbreak, public health funding agencies both in the United States and abroad “no longer regarded coronaviruses as a high public health threat compared to other diseases,” Saif wrote in an email.
  • Then on May 12, The Wall Street Journal reported that the Chinese government was responding in kind, “by stalling international efforts to find the source of the [SARS-CoV-2] virus amid an escalating U.S. push to blame China for the pandemic.”
  • To demonstrate that a particular virus is actually harmful to people, scientists need to isolate and culture the microbe and show it infects human cells in the lab
  • Led by virologist Zheng-Li Shi, the Wuhan team reported in 2013 that this particular virus, called WIV1, binds with ACE2 in civet and human cells, and then replicates efficiently inside them. “That was the red flag,” Saif said. Earlier evidence suggested that direct contact with these bats could lead to viral spillover in humans. “Now there was proof of that.”
  • hen cases of those diseases fell off, public-health responders shifted to other viral emergencies such as Ebola and Zika, and coronavirus research funding dropped sharply.
  • They created a hybrid microbe by attaching the spike protein from SHC014 to the genetic backbone of a SARS-like virus that was previously adapted to grow in mice. Called a chimera—an organism containing cells with more than one genotype—this lab-made microbe had no problem binding with ACE2 and infecting human cells. Baric’s research team concluded that like WIV1, any SARS-like viruses outfitted with the SHC014 spike could pose cross-species threats to people.
  • Baric acknowledged the risky nature of the research but emphasized the safety protocols. “In general, we don’t know the transmissibility or virulence potential of any bat viruses or chimeras,” Baric said in an email message. “Hence it’s best to keep and work with them under biosafety level 3 laboratory conditions to maximize safety.”
  • Baric also pointed out that a chimera would display a genetic signature “that says what it is.” The adjoining parts of a chimera segregate discreetly in a logical pattern.
  • A genetic analysis of the chimera produced in his lab, for instance, “would come out to be mouse-adapted SARS everywhere but the spike, which is SHC014.” Similar logical patterns are absent in SARS-CoV-2, indicating that the virus that causes COVID-19 evolved naturally.
  • ven as Baric and others were generating lab evidence that more SARS-like viruses were poised for human emergence, another outbreak—in pigs, not people—provided another strong and recent signal: Some 25,000 piglets were killed by a coronavirus in the Guangdong province of China, starting in 2016. That virus, too, was found in horseshoe bats, and Buchmeier described the outbreak as both a major cross-species spillover and a warning shot that was never really picked up by the broader public-health community.
  • The EcoHealth Alliance, which had been part of the Predict effort, maintained its own collaboration with the Wuhan Institute of Virology using funds supplied by the National Institutes of Health. But on April 24, the Trump administration—which is investigating whether SARS-CoV-2 escaped accidentally from the Wuhan Institute, an allegation that’s been broadly discredited—directed the NIH to cut off that support.
  • The bats had been trapped in a cave in Kunming, the capital of the Yunnan province. At least seven other SARS-like strains were present in that same colony, leading the researchers to speculate that bat coronaviruses remained “a substantial global threat to public health.”
  • To disease experts, the bickering is a worrying—perhaps even astonishing—indicator that at least some global leaders still aren’t hearing what they have to say about the threat of coronaviruses, and Baric asserted that the ongoing pandemic exposes the need for better communication between countries, not less. “That is absolutely key,” he said. “Critical information needs to be passed as quickly as possible.”
  • Many other warnings would follow.Indeed, evidence of a looming and more deadly coronavirus pandemic had been building for years. Yet experts who specialize in coronaviruses—a large family of pathogens, found especially in birds and mammals, that can cross over to humans from other mammals and cause varying degrees of illness—struggled to convince a broader audience of the risk
  • the number of coronavirus-research grants funded by the National Institutes of Health—which had increased from a low of 28 in 2002 to a peak of 103 in 2008—went into a tailspin.
  • Though support for coronavirus research spiked a bit with the MERS outbreak in 2012, the increase was short-lived. Since that outbreak was quickly contained, the disease didn’t raise wider concerns and grant opportunities declined further.
  • Ironically, just as funding for drugs and vaccines was drying up, evidence that other coronavirus threats lurked in wildlife was only getting stronger
  • Ten years would pass, however, before researchers could show there were other SARS-like viruses in nature that also bind with ACE2. The evidence came from a team based at the Wuhan Institute of Virology
Javier E

Opinion | Who Is Immune to the Coronavirus? - The New York Times - 0 views

  • No such human-challenge experiments have been conducted to study immunity to SARS and MERS. But measurements of antibodies in the blood of people who have survived those infections suggest that these defenses persist for some time: two years for SARS, according to one study, and almost three years for MERS, according to another one. However, the neutralizing ability of these antibodies — a measure of how well they inhibit virus replication — was already declining during the study periods.
  • These studies form the basis for an educated guess at what might happen with Covid-19 patients. After being infected with SARS-CoV-2, most individuals will have an immune response, some better than others. That response, it may be assumed, will offer some protection over the medium term — at least a year — and then its effectiveness might decline.
  • One concern has to do with the possibility of reinfection. South Korea’s Centers for Disease Control and Prevention recently reported that 91 patients who had been infected with SARS-CoV-2 and then tested negative for the virus later tested positive again. If some of these cases were indeed reinfections, they would cast doubt on the strength of the immunity the patients had developed.
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  • Several of my colleagues and students and I have statistically analyzed thousands of seasonal coronavirus cases in the United States and used a mathematical model to infer that immunity over a year or so is likely for the two seasonal coronaviruses most closely related to SARS-CoV-2 — an indication perhaps of how immunity to SARS-CoV-2 itself might also behave.
  • Mild illness, in other words, might not always build up protection. Similarly, it will be important to study the immune responses of people with asymptomatic cases of SARS-CoV-2 infection to determine whether symptoms, and their severity, predict whether a person becomes immune.
  • the issue might be resolved by comparing the viral genome sequence from the first and the second periods of infection.
  • it is reasonable to assume that only a minority of the world’s population is immune to SARS-CoV-2, even in hard-hit areas. How could this tentative picture evolve as better data come in? Early hints suggest that it could change in either direction.
  • One recent study (not yet peer-reviewed) suggests that rather than, say, 10 times the number of detected cases, the United States may really have more like 100, or even 1,000, times the official number
  • if this one is correct, then herd immunity to SARS-CoV-2 could be building faster than the commonly reported figures suggest.
  • another recent study (also not yet peer-reviewed) suggests that not every case of infection may be contributing to herd immunity. Of 175 Chinese patients with mild symptoms of Covid-19, 70 percent developed strong antibody responses, but about 25 percent developed a low response and about 5 percent developed no detectable response at all
  • An alternative possibility, which many scientists think is more likely, is that these patients had a false negative test in the middle of an ongoing infection, or that the infection had temporarily subsided and then re-emerged
  • The balance between these uncertainties will become clearer when more serologic surveys, or blood tests for antibodies, are conducted on large numbers of people. Such studies are beginning and should show results soon. Of course, much will depend on how sensitive and specific the various tests are: how well they spot SARS-CoV-2 antibodies when those are present and if they can avoid spurious signals from antibodies to related viruses.
  • Based on the volunteer experiments with seasonal coronaviruses and the antibody-persistence studies for SARS and MERS, one might expect a strong immune response to SARS-CoV-2 to protect completely against reinfection and a weaker one to protect against severe infection and so still slow the virus’s spread.
  • But designing valid epidemiologic studies to figure all of this out is not easy — many scientists, including several teams of which I’m a part — are working on the issue right now.
  • getting a handle on this fast is extremely important: not only to estimate the extent of herd immunity, but also to figure out whether some people can re-enter society safely, without becoming infected again or serving as a vector, and spreading the virus to others. Central to this effort will be figuring out how long protection lasts.
  • Experimental and statistical evidence suggests that infection with one coronavirus can offer some degree of immunity against distinct but related coronaviruses.
  • then there is the question of immune enhancement: Through a variety of mechanisms, immunity to a coronavirus can in some instances exacerbate an infection rather than prevent or mitigate it.
  • administering a vaccine against dengue fever, a flavivirus infection, can sometimes make the disease worse.
  • concern that they might be at play is one of the obstacles that have slowed the development of experimental vaccines against SARS and MERS.
  • The good news is that research on SARS and MERS has begun to clarify how enhancement works, suggesting ways around it, and an extraordinary range of efforts is underway to find a vaccine for Covid-19, using multiple approaches.
Javier E

How Will the Coronavirus End? - The Atlantic - 0 views

  • A global pandemic of this scale was inevitable. In recent years, hundreds of health experts have written books, white papers, and op-eds warning of the possibility. Bill Gates has been telling anyone who would listen, including the 18 million viewers of his TED Talk.
  • We realized that her child might be one of the first of a new cohort who are born into a society profoundly altered by COVID-19. We decided to call them Generation C.
  • “No matter what, a virus [like SARS-CoV-2] was going to test the resilience of even the most well-equipped health systems,”
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  • To contain such a pathogen, nations must develop a test and use it to identify infected people, isolate them, and trace those they’ve had contact with. That is what South Korea, Singapore, and Hong Kong did to tremendous effect. It is what the United States did not.
  • That a biomedical powerhouse like the U.S. should so thoroughly fail to create a very simple diagnostic test was, quite literally, unimaginable. “I’m not aware of any simulations that I or others have run where we [considered] a failure of testing,”
  • The testing fiasco was the original sin of America’s pandemic failure, the single flaw that undermined every other countermeasure. If the country could have accurately tracked the spread of the virus, hospitals could have executed their pandemic plans, girding themselves by allocating treatment rooms, ordering extra supplies, tagging in personnel, or assigning specific facilities to deal with COVID-19 cases.
  • None of that happened. Instead, a health-care system that already runs close to full capacity, and that was already challenged by a severe flu season, was suddenly faced with a virus that had been left to spread, untracked, through communities around the country.
  • With little room to surge during a crisis, America’s health-care system operates on the assumption that unaffected states can help beleaguered ones in an emergency.
  • That ethic works for localized disasters such as hurricanes or wildfires, but not for a pandemic that is now in all 50 states. Cooperation has given way to competition
  • Partly, that’s because the White House is a ghost town of scientific expertise. A pandemic-preparedness office that was part of the National Security Council was dissolved in 2018. On January 28, Luciana Borio, who was part of that team, urged the government to “act now to prevent an American epidemic,” and specifically to work with the private sector to develop fast, easy diagnostic tests. But with the office shuttered, those warnings were published in The Wall Street Journal, rather than spoken into the president’s ear.
  • Rudderless, blindsided, lethargic, and uncoordinated, America has mishandled the COVID-19 crisis to a substantially worse degree than what every health expert I’ve spoken with had feared. “Much worse,”
  • “Beyond any expectations we had,” said Lauren Sauer, who works on disaster preparedness at Johns Hopkins Medicine. “As an American, I’m horrified,” said Seth Berkley, who heads Gavi, the Vaccine Alliance. “The U.S. may end up with the worst outbreak in the industrialized world.”
  • it will be difficult—but not impossible—for the United States to catch up. To an extent, the near-term future is set because COVID-19 is a slow and long illness. People who were infected several days ago will only start showing symptoms now, even if they isolated themselves in the meantime. Some of those people will enter intensive-care units in early April
  • A “massive logistics and supply-chain operation [is] now needed across the country,” says Thomas Inglesby of Johns Hopkins Bloomberg School of Public Health. That can’t be managed by small and inexperienced teams scattered throughout the White House. The solution, he says, is to tag in the Defense Logistics Agency—a 26,000-person group that prepares the U.S. military for overseas operations and that has assisted in past public-health crises, including the 2014 Ebola outbreak.
  • The first and most important is to rapidly produce masks, gloves, and other personal protective equipment
  • it would also come at a terrible cost: SARS-CoV-2 is more transmissible and fatal than the flu, and it would likely leave behind many millions of corpses and a trail of devastated health systems.
  • This agency can also coordinate the second pressing need: a massive rollout of COVID-19 tests.
  • These measures will take time, during which the pandemic will either accelerate beyond the capacity of the health system or slow to containable levels. Its course—and the nation’s fate—now depends on the third need, which is social distancing.
  • There are now only two groups of Americans. Group A includes everyone involved in the medical response, whether that’s treating patients, running tests, or manufacturing supplies. Group B includes everyone else, and their job is to buy Group A more time. Group B must now “flatten the curve” by physically isolating themselves from other people to cut off chains of transmission.
  • Given the slow fuse of COVID-19, to forestall the future collapse of the health-care system, these seemingly drastic steps must be taken immediately, before they feel proportionate, and they must continue for several weeks.
  • Persuading a country to voluntarily stay at home is not easy, and without clear guidelines from the White House, mayors, governors, and business owners have been forced to take their own steps.
  • when the good of all hinges on the sacrifices of many, clear coordination matters—the fourth urgent need
  • Pundits and business leaders have used similar rhetoric, arguing that high-risk people, such as the elderly, could be protected while lower-risk people are allowed to go back to work. Such thinking is seductive, but flawed. It overestimates our ability to assess a person’s risk, and to somehow wall off the ‘high-risk’ people from the rest of society. It underestimates how badly the virus can hit ‘low-risk’ groups, and how thoroughly hospitals will be overwhelmed if even just younger demographics are falling sick.
  • A recent analysis from the University of Pennsylvania estimated that even if social-distancing measures can reduce infection rates by 95 percent, 960,000 Americans will still need intensive care.
  • There are only about 180,000 ventilators in the U.S. and, more pertinently, only enough respiratory therapists and critical-care staff to safely look after 100,000 ventilated patients. Abandoning social distancing would be foolish. Abandoning it now, when tests and protective equipment are still scarce, would be catastrophic.
  • If Trump stays the course, if Americans adhere to social distancing, if testing can be rolled out, and if enough masks can be produced, there is a chance that the country can still avert the worst predictions about COVID-19, and at least temporarily bring the pandemic under control. No one knows how long that will take, but it won’t be quick. “It could be anywhere from four to six weeks to up to three months,” Fauci said, “but I don’t have great confidence in that range.”
  • there are three possible endgames: one that’s very unlikely, one that’s very dangerous, and one that’s very long.
  • The first is that every nation manages to simultaneously bring the virus to heel, as with the original SARS in 2003. Given how widespread the coronavirus pandemic is, and how badly many countries are faring, the odds of worldwide synchronous control seem vanishingly small.
  • The second is that the virus does what past flu pandemics have done: It burns through the world and leaves behind enough immune survivors that it eventually struggles to find viable hosts. This “herd immunity” scenario would be quick, and thus tempting
  • The U.S. has fewer hospital beds per capita than Italy. A study released by a team at Imperial College London concluded that if the pandemic is left unchecked, those beds will all be full by late April. By the end of June, for every available critical-care bed, there will be roughly 15 COVID-19 patients in need of one.  By the end of the summer, the pandemic will have directly killed 2.2 million Americans,
  • The third scenario is that the world plays a protracted game of whack-a-mole with the virus, stamping out outbreaks here and there until a vaccine can be produced. This is the best option, but also the longest and most complicated.
  • there are no existing vaccines for coronaviruses—until now, these viruses seemed to cause diseases that were mild or rare—so researchers must start from scratch.
  • The first steps have been impressively quick. Last Monday, a possible vaccine created by Moderna and the National Institutes of Health went into early clinical testing. That marks a 63-day gap between scientists sequencing the virus’s genes for the first time and doctors injecting a vaccine candidate into a person’s arm. “It’s overwhelmingly the world record,” Fauci said.
  • The initial trial will simply tell researchers if the vaccine seems safe, and if it can actually mobilize the immune system. Researchers will then need to check that it actually prevents infection from SARS-CoV-2. They’ll need to do animal tests and large-scale trials to ensure that the vaccine doesn’t cause severe side effects. They’ll need to work out what dose is required, how many shots people need, if the vaccine works in elderly people, and if it requires other chemicals to boost its effectiveness.
  • No matter which strategy is faster, Berkley and others estimate that it will take 12 to 18 months to develop a proven vaccine, and then longer still to make it, ship it, and inject it into people’s arms.
  • as the status quo returns, so too will the virus. This doesn’t mean that society must be on continuous lockdown until 2022. But “we need to be prepared to do multiple periods of social distancing,” says Stephen Kissler of Harvard.
  • First: seasonality. Coronaviruses tend to be winter infections that wane or disappear in the summer. That may also be true for SARS-CoV-2, but seasonal variations might not sufficiently slow the virus when it has so many immunologically naive hosts to infect.
  • Second: duration of immunity. When people are infected by the milder human coronaviruses that cause cold-like symptoms, they remain immune for less than a year. By contrast, the few who were infected by the original SARS virus, which was far more severe, stayed immune for much longer.
  • scientists will need to develop accurate serological tests, which look for the antibodies that confer immunity. They’ll also need to confirm that such antibodies actually stop people from catching or spreading the virus. If so, immune citizens can return to work, care for the vulnerable, and anchor the economy during bouts of social distancing.
  • Aspects of America’s identity may need rethinking after COVID-19. Many of the country’s values have seemed to work against it during the pandemic. Its individualism, exceptionalism, and tendency to equate doing whatever you want with an act of resistance meant that when it came time to save lives and stay indoors, some people flocked to bars and clubs.
  • “We can keep schools and businesses open as much as possible, closing them quickly when suppression fails, then opening them back up again once the infected are identified and isolated. Instead of playing defense, we could play more offense.”
  • The vaccine may need to be updated as the virus changes, and people may need to get revaccinated on a regular basis, as they currently do for the flu. Models suggest that the virus might simmer around the world, triggering epidemics every few years or so. “But my hope and expectation is that the severity would decline, and there would be less societal upheaval,”
  • After infections begin ebbing, a secondary pandemic of mental-health problems will follow.
  • But “there is also the potential for a much better world after we get through this trauma,”
  • Testing kits can be widely distributed to catch the virus’s return as quickly as possible. There’s no reason that the U.S. should let SARS-CoV-2 catch it unawares again, and thus no reason that social-distancing measures need to be deployed as broadly and heavy-handedly as they now must be.
  • Pandemics can also catalyze social change. People, businesses, and institutions have been remarkably quick to adopt or call for practices that they might once have dragged their heels on, including working from home, conference-calling to accommodate people with disabilities, proper sick leave, and flexible child-care arrangements.
  • Perhaps the nation will learn that preparedness isn’t just about masks, vaccines, and tests, but also about fair labor policies and a stable and equal health-care system. Perhaps it will appreciate that health-care workers and public-health specialists compose America’s social immune system, and that this system has been suppressed.
  • Attitudes to health may also change for the better. The rise of HIV and AIDS “completely changed sexual behavior among young people who were coming into sexual maturity at the height of the epidemic,”
  • Years of isolationist rhetoric had consequences too.
  • “People believed the rhetoric that containment would work,” says Wendy Parmet, who studies law and public health at Northeastern University. “We keep them out, and we’ll be okay. When you have a body politic that buys into these ideas of isolationism and ethnonationalism, you’re especially vulnerable when a pandemic hits.”
  • Pandemics are democratizing experiences. People whose privilege and power would normally shield them from a crisis are facing quarantines, testing positive, and losing loved ones. Senators are falling sick. The consequences of defunding public-health agencies, losing expertise, and stretching hospitals are no longer manifesting as angry opinion pieces, but as faltering lungs.
  • After COVID-19, attention may shift to public health. Expect to see a spike in funding for virology and vaccinology, a surge in students applying to public-health programs, and more domestic production of medical supplies.
  • The lessons that America draws from this experience are hard to predict, especially at a time when online algorithms and partisan broadcasters only serve news that aligns with their audience’s preconceptions.
  • “The transitions after World War II or 9/11 were not about a bunch of new ideas,” he says. “The ideas are out there, but the debates will be more acute over the next few months because of the fluidity of the moment and willingness of the American public to accept big, massive changes.”
  • One could easily conceive of a world in which most of the nation believes that America defeated COVID-19. Despite his many lapses, Trump’s approval rating has surged. Imagine that he succeeds in diverting blame for the crisis to China, casting it as the villain and America as the resilient hero.
  • One could also envisage a future in which America learns a different lesson. A communal spirit, ironically born through social distancing, causes people to turn outward, to neighbors both foreign and domestic. The election of November 2020 becomes a repudiation of “America first” politics. The nation pivots, as it did after World War II, from isolationism to international cooperation
  • The U.S. leads a new global partnership focused on solving challenges like pandemics and climate change.
  • In 2030, SARS-CoV-3 emerges from nowhere, and is brought to heel within a month.
  • On the Global Health Security Index, a report card that grades every country on its pandemic preparedness, the United States has a score of 83.5—the world’s highest. Rich, strong, developed, America is supposed to be the readiest of nations. That illusion has been shattered. Despite months of advance warning as the virus spread in other countries, when America was finally tested by COVID-19, it failed.
Javier E

Opinion | Yes, the Coronavirus Is in the Air - The New York Times - 0 views

  • The World Health Organization has now formally recognized that SARS-CoV-2, the virus that causes Covid-19, is airborne and that it can be carried by tiny aerosols.
  • until earlier this month, the W.H.O. — like the U.S. Centers for Disease Control and Prevention or Public Health England — had warned mostly about the transmission of the new coronavirus through direct contact and droplets released at close range.
  • After several months of pressure from scientists, on July 9, the W.H.O. changed its position — going from denial to grudging partial acceptance: “Further studies are needed to determine whether it is possible to detect viable SARS-CoV-2 in air samples from settings where no procedures that generate aerosols are performed and what role aerosols might play in transmission.”
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  • A month later, I believe that the transmission of SARS-CoV-2 via aerosols matters much more than has been officially acknowledged to date.
  • This confirms the results of a study from late May (not peer-reviewed) in which Covid-19 patients were found to release SARS-CoV-2 simply by exhaling — without coughing or even talking. The authors of that study said the finding implied that airborne transmission “plays a major role” in spreading the virus.
  • Accepting these conclusions wouldn’t much change what is currently being recommended as best behavior. The strongest protection against SARS-CoV-2, whether the virus is mostly contained in droplets or in aerosols, essentially remains the same: Keep your distance and wear masks.
  • Rather, the recent findings are an important reminder to also be vigilant about opening windows and improving airflow indoors. And they are further evidence that the quality of masks and their fit matter, too.
  • here is no neat and no meaningful cutoff point — at 5 microns or any other size — between droplets and aerosols: All are tiny specks of liquid, their size ranging along a spectrum that goes from very small to really microscopic.
  • Yes, droplets tend to fly through the air like mini cannonballs and they fall to the ground rather quickly, while aerosols can float around for many hours.
  • The practical implications are plain:Social distancing really is important. It keeps us out of the most concentrated parts of other people’s respiratory plumes. So stay away from one another by one or two meters at least — though farther is safer.
  • “The smaller the exhaled droplets, the more important the short-range airborne route.”
  • Can you walk into an empty room and contract the virus if an infected person, now gone, was there before you? Perhaps, but probably only if the room is small and stuffy.
  • Can the virus waft up and down buildings via air ducts or pipes? Maybe, though that hasn’t been established.
  • another, recent, preprint (not peer reviewed) about the Diamond Princess concluded that “aerosol inhalation was likely the dominant contributor to Covid-19 transmission” among the ship’s passengers.
  • It might seem logical, or make intuitive sense, that larger droplets would contain more virus than do smaller aerosols — but they don’t.
  • The Lancet Respiratory Medicine that analyzed the aerosols produced by the coughs and exhaled breaths of patients with various respiratory infections found “a predominance of pathogens in small particles” (under 5 microns). “There is no evidence,” the study also concluded, “that some pathogens are carried only in large droplets.”
  • I believe that, taken together, much of the evidence gathered to date suggests that close-range transmission by aerosols is significant — possibly very significant, and certainly more significant than direct droplet spray.
  • But basic physics also says that a 5-micron droplet takes about a half-hour to drop to the floor from the mouth of an adult of average height — and during that time, the droplet can travel many meters on an air current. Droplets expelled in coughs or sneezes also travel much farther than one meter.
  • Wear a mask. Masks help block aerosols released by the wearer. Scientific evidence is also building that masks protect the wearer from breathing in aerosols around them.
  • When it comes to masks, size does matter.
  • My lab has been testing cloth masks on a mannequin, sucking in air through its mouth at a realistic rate. We found that even a bandanna loosely tied over its mouth and nose blocked half or more of aerosols larger than 2 microns from entering the mannequin.
  • Ventilation counts. Open windows and doors. Adjust dampers in air-conditioning and heating systems. Upgrade the filters in those systems. Add portable air cleaners, or install germicidal ultraviolet technologies to remove or kill virus particles in the air.
  • Avoid crowds. The more people around you, the more likely someone among them will be infected. Especially avoid crowds indoors, where aerosols can accumulate.
  • We also found that especially with very small aerosols — smaller than 1 micron — it is more effective to use a softer fabric (which is easier to fit tightly over the face) than a stiffer fabric (which, even if it is a better filter, tends to sit more awkwardly, creating gaps).
  • One study from 2013 found that surgical masks reduced exposure to flu viruses by between 10 percent and 98 percent (depending on the mask’s design).A recent paper found that surgical masks can completely block seasonal coronaviruses from getting into the air.To my knowledge, no similar study has been conducted for SARS-CoV-2 yet, but these findings might apply to this virus as well since it is similar to seasonal coronaviruses in size and structure.
  • What about the outbreak on the Diamond Princess cruise ship off Japan early this year? Some 712 of the 3,711 people on board became infected.
  • Consider the case of a restaurant in Guangzhou, southern China, at the beginning of the year, in which one diner infected with SARS-CoV-2 at one table spread the virus to a total of nine people seated at their table and two other tables.Yuguo Li, a professor of engineering at the University of Hong Kong, and colleagues analyzed video footage from the restaurant and in a preprint (not peer reviewed) published in April found no evidence of close contact between the diners.Droplets can’t account for transmission in this case, at least not among the people at the tables other than the infected person’s: The droplets would have fallen to the floor before reaching those tables.But the three tables were in a poorly ventilated section of the restaurant, and an air conditioning unit pushed air across them. Notably, too, no staff member and none of the other diners in the restaurant — including at two tables just beyond the air conditioner’s airstream — became infected.
Javier E

You Are Going to Get COVID Again … And Again … And Again - The Atlantic - 0 views

  • You’re not just likely to get the coronavirus. You’re likely to get it again and again and again.
  • “I personally know several individuals who have had COVID in almost every wave,” says Salim Abdool Karim, a clinical infectious-diseases epidemiologist and the director of the Center for the AIDS Program of Research in South Africa, which has experienced five meticulously tracked surges, and where just one-third of the population is vaccinated.
  • er best guess for the future has the virus infiltrating each of us, on average, every three years or so. “Barring some intervention that really changes the landscape,” she said, “we will all get SARS-CoV-2 multiple times in our life.”
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  • that would be on par with what we experience with flu viruses, which scientists estimate hit us about every two to five years, less often in adulthood. It also matches up well with the documented cadence of the four other coronaviruses that seasonally trouble humans, and cause common colds.
  • For now, every infection, and every subsequent reinfection, remains a toss of the dice. “Really, it’s a gamble,” says Ziyad Al-Aly, a clinical epidemiologist and long-COVID researcher at Washington University in St. Louis. Vaccination and infection-induced immunity may load the dice against landing on severe disease, but that danger will never go away completely, and scientists don’t yet know what happens to people who contract “mild” COVID over and over again
  • Or maybe not. This virus seems capable of tangling into just about every tissue in the body, affecting organs such as the heart, brain, liver, kidneys, and gut; it has already claimed the lives of millions, while saddling countless others with symptoms that can linger for months or years.
  • considering our current baseline, “less dangerous” could still be terrible—and it’s not clear exactly where we’re headed. When it comes to reinfection, we “just don’t know enough,”
  • Perhaps, as several experts have posited since the pandemic’s early days, SARS-CoV-2 will just become the fifth cold-causing coronavirus.
  • A third or fourth bout might be more muted still; the burden of individual diseases may be headed toward an asymptote of mildness that holds for many years
  • Future versions of SARS-CoV-2 could continue to shape-shift out of existing antibodies’ reach, as coronaviruses often do. But the body is flush with other fighters that are much tougher to bamboozle—among them, B cells and T cells that can quash a growing infection before it spirals out of control
  • Those protections tend to build iteratively, as people see pathogens or vaccines more often. People vaccinated three times over, for instance, seem especially well equipped to duke it out with all sorts of SARS-CoV-2 variants, including Omicron and its offshoots.
  • promising patterns: Second infections and post-vaccination infections “are significantly less severe,” she told me, sometimes to the point where people don’t notice them at all
  • Bodies, wised up to the virus’s quirks, can now react more quickly, clobbering it with sharper and speedier strikes.
  • “There are still very good reasons” to keep exposures few and far between, Landon, of the University of Chicago, told me. Putting off reinfection creates fewer opportunities for harm: The dice are less likely to land on severe disease (or chronic illness) when they’re rolled less often overall. It also buys us time to enhance our understanding of the virus, and improve our tools to fight it.
  • Immunity, though, is neither binary nor permanent. Even if SARS-CoV-2’s assaults are blunted over time, there are no guarantees about the degree to which that happens, or how long it lasts.
  • A slew of factors could end up weighting the dice toward severe disease—among them, a person’s genetics, age, underlying medical conditions, health-care access, and frequency or magnitude of exposure to the virus.
  • for everyone else, no amount of viral dampening can totally eliminate the chance, however small it may be, of getting very sick.
  • Long COVID, too, might remain a possibility with every discrete bout of illness. Or maybe the effects of a slow-but-steady trickle of minor, fast-resolving infections would sum together, and bring about the condition.
  • Every time the body’s defenses are engaged, it “takes a lot of energy, and causes tissue damage,” Thomas told me. Should that become a near-constant barrage, “that’s probably not great for you.”
  • Bodies are resilient, especially when they’re offered time to rest, and she doubts that reinfection with a typically ephemeral virus such as SARS-CoV-2 would cause mounting damage. “The cumulative effect is more likely to be protective than detrimental,” she said, because of the immunity that’s laid down each time.
  • people who have caught the virus twice or thrice may be more likely to become long-haulers than those who have had it just once.
  • Some other microbes, when they reinvade us, can fire up the immune system in unhelpful ways, driving bad bouts of inflammation that burn through the body, or duping certain defensive molecules into aiding, rather than blocking, the virus’s siege. Researchers don’t think SARS-CoV-2 will do the same. But this pathogen is “much more formidable than even someone working on coronaviruses would have expected,
  • Seasonal encounters with pathogens other than SARS-CoV-2 don’t often worry us—but perhaps that’s because we’re still working to understand their toll. “Have we been underestimating long-term consequences from other repeat infections?” Thomas said. “The answer is probably, almost certainly, yes.”
  • the rhythm of reinfection isn’t just about the durability of immunity or the pace of viral evolution. It’s also about our actions and policies, and whether they allow the pathogen to transmit and evolve. Strategies to avoid infection—to make it as infrequent as possible, for as many people as possible—remain options, in the form of vaccination, masking, ventilation, paid sick leave, and more.
  • Gordon and Swartz are both hopeful that the slow accumulation of immunity will also slash people’s chances of developing long COVID.
  • The outlooks of the experts I spoke with spanned the range from optimism to pessimism, though all agreed that uncertainty loomed. Until we know more, none were keen to gamble with the virus—or with their own health. Any reinfection will likely still pose a threat, “even if it’s not the worst-case scenario,” Abdool Karim told me. “I wouldn’t want to put myself in that position.”
Javier E

Opinion | American exceptionalism has become a hazard to our health - The Washington Post - 0 views

  • Taiwan gets the gold medal for its coronavirus strategy. It has close ties with mainland China, where the disease originated, receiving almost 3 million visitors from there in a typical year. It is a densely populated land, and Taipei, the capital city, has crowded public transit. And yet, with a population of nearly 24 million, Taiwan has had just seven deaths. New York state, with a smaller population, has had 33,000.
  • SARS also came out of China, where authorities bungled the initial response and withheld information from the outside world. The Taiwanese were caught unprepared and made several mistakes. In the aftermath, they totally overhauled their pandemic preparedness procedures. They ensured they had adequate supplies of equipment on hand. They made plans to act early, smartly and aggressively.
  • Many Asia-Pacific countries have succeeded against covid-19 — South Korea, Vietnam, Singapore, New Zealand, Australia. All were hit by SARS or witnessed its economic damage, and they learned from the experience. The only non-Asian country with a SARS outbreak was Canada, and it, too, changed its procedures after 2003 and took precautions.
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  • SARS doesn’t explain the success of every country that has handled covid-19 well, but it reveals an important aspect of the story.
  • Consider, on the other hand, countries that have handled covid-19 badly. Anthropologist Martha Lincoln, writing in Nature, points out that several of these countries tend to think of themselves as exceptional in some way. She notes that the United States, Britain, Brazil and Chile all have strong national narratives that see themselves as separate, distinct and better than others.
  • That sense of being special makes a country unlikely to adopt the standard attitude of any business when confronting a challenge — to look for best practices.
  • Bill Gates recently wrote that he has always approached problem-solving by starting with two fundamental questions: “Who has dealt with this problem well? And what can we learn from them?
  • And yet the United States is remarkably uninterested in how other countries approach similar challenges.
  • Dozens of advanced countries have health-care systems that deliver better results at half the cost of America’s. Most have a fraction of our homicide rates. Many much poorer countries have better infrastructure, which they build at far lower cost. They ensure that money does not dominate their elections. Not only do we not learn from them, we barely bother to look.
  • In an essay in Foreign Affairs, Jeremy Konyndyk argues that “American exceptionalism — the notion that the United States is unique among nations and that the American way is invariably the best — has blinded the country’s leaders (and many of its citizens) to potentially lifesaving lessons from other countries.
  • He quotes the eminent U.S. historian Eric Foner, who once explained that American exceptionalism translates into “hubris and closed-mindedness, and . . . ignorance about the rest of the world. Since the United States is so exceptional, there is no point in learning about other societies.” Konyndyk concludes: “That mentality is now costing American lives.”
hannahcarter11

Opinion | Chimamanda Ngozi Adichie: Nigeria Is Murdering Its Citizens - The New York Times - 0 views

  • SARS, which stood for Special Anti-Robbery Squad, was supposed to be the elite Nigerian police unit dedicated to fighting crime, but it was really a moneymaking terror squad with no accountability.
  • SARS officers would raid bars or stop buses on the road and arbitrarily arrest young men for such crimes as wearing their hair in dreadlocks, having tattoos, holding a nice phone or a laptop, driving a nice car. Then they would demand large amounts of money as “bail.”
  • In 2012 Mr. Iloanya was 20 when SARS officers arrested him at a child dedication ceremony in Anambra State. He had committed no crime
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  • There are so many families like the Iloanyas who are caught between pain and hope, because their sons and brothers were arrested by SARS and they fear the worst, knowing the reputation of SARS, but still they dare to hope in the desperate way we humans do for those we love.
  • the protesters insisted on not having a central leadership, it was social rather than traditional media that documented the protests, and, in a country with firm class divisions, the protests cut across class
  • The protests were peaceful, insistently peaceful, consistently peaceful.
  • But the Nigerian government tried to disrupt their fund-raising.
  • Twelve hours after soldiers shot peaceful protesters, Mr. Buhari still had not addressed the nation.
  • The Lagos State government accused protesters of violence, but it defied common sense that a protest so consistently committed to peaceful means would suddenly turn around and become violent.
  • At about noon on Oct. 20, 2020, about two weeks into the protests, the Lagos State governor suddenly announced a curfew that would begin at 4 p.m., which gave people in a famously traffic-clogged state only a few hours to get home and hunker down.
  • Government officials reportedly cut the security cameras, then cut off the bright floodlights, leaving only a darkness heavy with foreboding. The protesters were holding Nigerian flags, sitting on the ground, some kneeling, some singing the national anthem, peaceful and determined.
  • A blurry video of what happened next has gone viral — soldiers walk toward the protesters with a terrifyingly casual calm, the kind of calm you cannot have if you are under attack, and they shoot, not up in the air, which anyway would still be an atrocity when dealing with peaceful protesters, but with their guns at arm level, shooting into a crowd of people, shooting to kill.
  • The Nigerian state has turned on its people. The only reason to shoot into a crowd of peaceful citizens is to terrorize: to kill some and make the others back down.
  • From the capital city of Abuja to the small town of Ogbomosho, state agents attacked and beat up protesters
  • In the first week of the protests, the president sent out a tweet and then gave a flaccid speech about ending SARS
Javier E

A Deadly Coronavirus Was Inevitable. Why Was No One Ready? - WSJ - 0 views

  • When Disease X actually arrived, as Covid-19, governments, businesses, public-health officials and citizens soon found themselves in a state of chaos, battling an invisible enemy with few resources and little understanding—despite years of work that outlined almost exactly what the virus would look like and how to mitigate its impact.
  • Governments had ignored clear warnings and underfunded pandemic preparedness. They mostly reacted to outbreaks, instead of viewing new infectious diseases as major threats to national security. And they never developed a strong international system for managing epidemics, even though researchers said the nature of travel and trade would spread infection across borders.
  • Underlying it all was a failure that stretches back decades. Most everyone knew such an outcome was possible. And yet no one was prepared.
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  • Last year, a Chinese scientist he worked with published a specific forecast: “It is highly likely that future SARS- or MERS-like coronavirus outbreaks will originate from bats, and there is an increased probability that this will occur in China.”
  • Humans today are exposed to more deadly new pathogens than ever. They typically come from animals, as global travel, trade and economic development, such as meat production and deforestation, push people, livestock and wildlife closer together
  • Scientists knew infectious disease outbreaks were becoming more common, with 2010 having more than six times the outbreaks of pathogens from animal origins than in 1980, according to data in a study by Brown University researchers.
  • Yet plenty was left undone, in areas including funding, early-warning systems, the role of the WHO and coordination with China. A big chunk of U.S. funding went toward protecting Americans against a bioterror attack. Government funding for pandemics has come largely in emergency, one-time packages to stop an ongoing outbreak.
  • She said a better solution would be to fund public health more like national defense, with much more guaranteed money, year in, year out.
  • “Will there be another human influenza pandemic?” Dr. Webster asked in a paper presented at an NIH meeting in 1995. “The certainty is that there will be.”
  • Experts including Dr. Webster were particularly concerned about the potential for spillover in southern China, where large, densely populated cities were expanding rapidly into forests and agricultural lands, bringing people into closer contact with animals. Two of the three influenza pandemics of the 20th century are thought to have originated in China.
  • Dr. Webster and others warned it could re-emerge or mutate into something more contagious. With U.S. funding, he set up an animal influenza surveillance center in Hong Kong. The WHO, which hadn’t planned for pandemics before, started compiling protocols for a large-scale outbreak, including contingency plans for vaccines.
  • At a dinner back in the U.S., he remembers one guest saying, “Oh, you really needed to have someone in the U.S. to be impacted to really galvanize the government.”
  • That “drove home the reality in my own mind of globalization,” said Dr. Fukuda. SARS showed that viruses can crisscross the globe by plane in hours, making a local epidemic much more dangerous.
  • The WHO’s director-general, Gro Harlem Brundtland, publicly criticized China. The government under new leaders reversed course. It implemented draconian quarantines and sanitized cities, including a reported 80 million people enlisted to clean streets in Guangdong.
  • By May 2003, the number of new SARS cases was dwindling. It infected around 8,000 people world-wide, killing nearly 10%.
  • After SARS, China expanded epidemiologist training and increased budgets for new laboratories. It started working more closely in public health with the U.S., the world’s leader. The U.S. CDC opened an office in Beijing to share expertise and make sure coverups never happened again. U.S. CDC officials visiting a new China CDC campus planted a friendship tree.
  • In Washington in 2005, a powerful player started driving U.S. efforts to become more prepared. President George W. Bush had read author John M. Barry’s “The Great Influenza,” a history of the 1918 flu pandemic
  • Mr. Bush leaned toward the group of 10 or so officials and said, “I want to see a plan,” according to Dr. Venkayya. “He had been asking questions and not getting answers,” recalled Dr. Venkayya, now president of Takeda Pharmaceutical Co. ’s global vaccine business unit. “He wanted people to see this as a national threat.”
  • Mr. Bush launched the strategy in November, and Congress approved $6.1 billion in one-time funding.
  • The CDC began exercises enacting pandemic scenarios and expanded research. The government created the Biomedical Advanced Research and Development Authority to fund companies to develop diagnostics, drugs and vaccines.
  • A team of researchers also dug into archives of the 1918 pandemic to develop guidelines for mitigating the spread when vaccines aren’t available. The tactics included social distancing, canceling large public gatherings and closing schools—steps adopted this year when Covid-19 struck, though at the time they didn’t include wide-scale lockdowns.
  • A year after the plan was released, a progress report called for more real-time disease surveillance and preparations for a medical surge to care for large numbers of patients, and stressed strong, coordinated federal planning.
  • A European vaccine makers’ association said its members had spent around $4 billion on pandemic vaccine research and manufacturing adjustments by 2008.
  • The $6.1 billion Congress appropriated for Mr. Bush’s pandemic plan was spent mostly to make and stockpile medicines and flu vaccines and to train public-health department staff. The money wasn’t renewed. “The reality is that for any leader it’s really hard to maintain a focus on low-probability high-consequence events, particularly in the health arena,” Dr. Venkayya said.
  • In the U.S., President Barack Obama’s administration put Mr. Bush’s new plan into action for the first time. By mid-June, swine flu, as it was dubbed, had jumped to 74 countries. The WHO officially labeled it a pandemic, despite some evidence suggesting the sickness was pretty mild in most people.
  • That put in motion a host of measures, including some “sleeping” contracts with pharmaceutical companies to begin vaccine manufacturing—contracts that countries like the United Kingdom had negotiated ahead of time so they wouldn’t have to scramble during an outbreak.
  • In August, a panel of scientific advisers to Mr. Obama published a scenario in which as many as 120 million Americans, 40% of the population, could be infected that year, and up to 90,000 people could die.
  • H1N1 turned out to be much milder. Although it eventually infected more than 60 million Americans, it killed less than 13,000. In Europe, fewer than 5,000 deaths were reported.
  • The WHO came under fire for labeling the outbreak a pandemic too soon. European lawmakers, health professionals and others suggested the organization may have been pressured by the pharmaceutical industry.
  • France ordered 94 million doses, but had logged only 1,334 serious cases and 312 deaths as of April 2010. It managed to cancel 50 million doses and sell some to other countries, but it was still stuck with a €365 million tab, or about $520 million at the time, and 25 million extra doses.
  • The WHO had raised scares for SARS, mad-cow disease, bird flu and now swine flu, and it had been wrong each time, said Paul Flynn, a member of the Council of Europe’s Parliamentary Assembly and a British lawmaker, at a 2010 health committee hearing in Strasbourg.
  • Ultimately, an investigation by the council’s committee accused the WHO and public-health officials of jumping the gun, wasting money, provoking “unjustified fear” among Europeans and creating risks through vaccines and medications that might not have been sufficiently tested.
  • “I thought you might have uttered a word of regret or an apology,” Mr. Flynn told Dr. Fukuda, who as a representative of the WHO had been called to testify.
  • Back in Washington, scientist Dennis Carroll, at the U.S. Agency for International Development, was also convinced that flu wasn’t the only major pandemic threat. In early 2008, Dr. Carroll was intrigued by Dr. Daszak’s newly published research that said viruses from wildlife were a growing threat, and would emerge most frequently where development was bringing people closer to animals.
  • If most of these viruses spilled over to humans in just a few places, including southern China, USAID could more easily fund an early warning system.
  • “You didn’t have to look everywhere,” he said he realized. “You could target certain places.” He launched a new USAID effort focused on emerging pandemic threats. One program called Predict had funding of about $20 million a year to identify pathogens in wildlife that have the potential to infect people.
  • Drs. Daszak, Shi and Wang, supported by funds from Predict, the NIH and China, shifted their focus to Yunnan, a relatively wild and mountainous province that borders Myanmar, Laos and Vietnam.
  • One key discovery: a coronavirus resembling SARS that lab tests showed could infect human cells. It was the first proof that SARS-like coronaviruses circulating in southern China could hop from bats to people. The scientists warned of their findings in a study published in the journal Nature in 2013.
  • Evidence grew that showed people in the area were being exposed to coronaviruses. One survey turned up hundreds of villagers who said they recently showed symptoms such as trouble breathing and a fever, suggesting a possible viral infection.
  • Over the next several years, governments in the U.S. and elsewhere found themselves constantly on the defensive from global viral outbreaks. Time and again, preparedness plans proved insufficient. One, which started sickening people in Saudi Arabia and nearby
  • On a weekend morning in January 2013, more than a dozen senior Obama administration officials met in a basement family room in the suburban home of a senior National Security Council official. They were brainstorming how to help other countries upgrade their epidemic response capabilities, fueled by bagels and coffee. Emerging disease threats were growing, yet more than 80% of the world’s countries hadn’t met a 2012 International Health Regulations deadline to be able to detect and respond to epidemics.
  • The session led to the Global Health Security Agenda, launched by the U.S., the WHO and about 30 partners in early 2014, to help nations improve their capabilities within five years.
  • Money was tight. The U.S. was recovering from the 2008-09 financial crisis, and federal funding to help U.S. states and cities prepare and train for health emergencies was declining. Public-health departments had cut thousands of jobs, and outdated data systems weren’t replaced.
  • “It was a Hail Mary pass,” said Tom Frieden, who was director of the CDC from 2009 to 2017 and a force behind the creation of the GHSA. “We didn’t have any money.”
  • At the WHO, Dr. Fukuda was in charge of health security. When the Ebola outbreak was found in March 2014, he and his colleagues were already stretched, after budget cuts and amid other crises.
  • The United Nations created a special Ebola response mission that assumed the role normally played by the WHO. Mr. Obama sent the U.S. military to Liberia, underscoring the inability of international organizations to fully handle the problem.
  • It took the WHO until August to raise an international alarm about Ebola. By then, the epidemic was raging. It would become the largest Ebola epidemic in history, with at least 28,600 people infected, and more than 11,300 dead in 10 countries. The largest outbreak before that, in Uganda, had involved 425 cases.
  • Congress passed a $5.4 billion package in supplemental funds over five years, with about $1 billion going to the GHSA. The flood of money, along with aggressive contact tracing and other steps, helped bring the epidemic to a halt, though it took until mid-2016.
  • Global health experts and authorities called for changes at the WHO to strengthen epidemic response, and it created an emergencies program. The National Security Council warned that globalization and population growth “will lead to more pandemics,” and called for the U.S. to do more.
  • r. Carroll of USAID, who had visited West Africa during the crisis, and saw some health workers wrap themselves in garbage bags for protection, started conceiving of a Global Virome Project, to detect and sequence all the unknown viral species in mammals and avian populations on the planet.
  • Billionaire Bill Gates warned in a TED talk that an infectious disease pandemic posed a greater threat to the world than nuclear war, and urged world leaders to invest more in preparing for one. The Bill & Melinda Gates Foundation helped form a new initiative to finance vaccines for emerging infections, the Coalition for Epidemic Preparedness Innovations.
  • Congress established a permanent Infectious Diseases Rapid Response Fund for the CDC in fiscal 2019, with $50 million for that year and $85 million in fiscal 2020.
  • In May 2018, John Bolton, then President Trump’s national security adviser, dismantled an NSC unit that had focused on global health security and biodefense, with staff going to other units. The senior director of the unit left.
  • It pushed emerging disease threats down one level in the NSC hierarchy, making pandemics compete for attention with issues such as North Korea, said Beth Cameron, a previous senior director of the unit. She is now vice president for global biological policy and programs at the Nuclear Threat Initiative.
  • Deteriorating relations with China reduced Washington’s activities there just as researchers were becoming more certain of the threat from coronaviruses.
  • Dr. Carroll had earlier been ordered to suspend his emerging pandemic threats program in China.
  • Dr. Carroll pitched to USAID his Global Virome Project. USAID wasn’t interested, he said. He left USAID last year. A meeting that Dr. Carroll planned for last August with the Chinese CDC and Chinese Academy of Sciences to form a Chinese National Virome Project was postponed due to a bureaucratic hang-up. Plans to meet are now on hold, due to Covid-19.
martinelligi

Despite Covid-19 Success, Taiwan Still Struggles for International Legitimacy > Articles | - 0 views

  • No one understands the CCP better than Taipei. Simply put, Taiwan operates on the premise that its cross-strait counterparts are inherently untrustworthy. This was a key factor in the rapidity and comprehensiveness with which Taiwan President Tsai Ing-wen’s administration responded to reports of a strange new virus in late December.
  • The system of integrated rapid-response agencies behind Taiwan’s successful handling of Covid-19 emerged — at least partly — in response to Bejing’s attempts to prevent Taiwan attaining observer status at the WHO’s annual World Health Assembly (WHA), beginning in the late 1990s.
  • “The Chen administration, in order to improve its prospects of re-election in 2004, deliberately utilized the threat posed by the SARS pandemic to appeal to Taiwanese identity,” writes Björn Alexander Lindemann in a 2014 case study of Taiwan’s WHO bid. “The mobilization of the Taiwanese population during the SARS crisis indeed benefitted the DPP government in the 2004 elections [as] public discourse shifted... to the consequences of SARS and the threat that China posed to Taiwan’s security in the run-up to the presidential elections. People were left with the impression that the island had been left on its own and were thus susceptible to the government’s efforts to appeal to Taiwanese identity and nationalist sentiments.”1
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  • “doctors in the hospital did not identify the first SARS case immediately, because not all the criteria for the identification of SARS that had been defined by the WHO had been made available to Taiwan: unaware that the WHO was going to revise these particular criteria very soon, the medical personnel did not classify the patient as a SARS case and thus did not institute sufficient measures to prevent the spread of the virus right from the beginning.” Lindemann adds that, although it was not the only reason for Taiwan’s inadequate reaction to the SARS outbreak, government officials claimed that the lack of WHO assistance “made a bad situation worse.”
martinelligi

Why Protests in Nigeria Are Aimed at SARS, a Notorious Police Unit - The New York Times - 0 views

  • Africa’s most populous country and biggest oil producer has been convulsed by protests that started with anger over police brutality and have now broadened, drawing worldwide attention.
  • Tens of thousands of Nigerians have been demonstrating for weeks against a notoriously brutal and corrupt police agency, the Special Anti-Robbery Squad — a show of popular anger, fueled by longstanding grievances over corruption and lack of accountability, that posed the biggest challenge to the government in years.
  • Commonly known as SARS, the Special Anti-Robbery Squad was created in 1984 in response to an epidemic of violent crime including robberies, carjackings and kidnappings. While it was credited with having reduced brazen lawlessness in its initial years, the police unit was later accused of evolving into the same problem it had been designed to stop: a criminal enterprise that acts with impunity.
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  • soldiers fired on crowds of protesters, inflaming Nigerians who were already concerned about police use of violence against the demonstrators.
  • The catalyst seemed to be an Oct. 3 video that appeared to show the unprovoked killing of a man by black-clad SARS officers in Ughelli, a town in southern Delta state. Nigerian officials said the video, which was widely shared over social media, was fake and arrested the person who took it — inciting even more anger.Demonstrations erupted in Lagos, the nation’s biggest city, and elsewhere around the country, driven by calls from people — many of them young — demanding that the government dismantle SARS.
  • President Muhammadu Buhari, seeing that the protests were serious and spreading, agreed on Oct. 12 to disband SARS, calling his decision “only the first step in our commitment to extensive police reform in order to ensure that the primary duty of the police and other law enforcement agencies remains the protection of lives and livelihood of our people.”
  • The anger of the protesters seems to have only increased — especially after the deadly suppression of a peaceful demonstration in Lagos on Tuesday, compounded by a 24-hour curfew decree and the deployment of Nigeria’s military forces to quell further demonstrations.
  • The movement bears striking similarities to demonstrations in the United States this year amid the outcry over police brutality after the killing of George Floyd in Minneapolis. But Mr. Devermont said an important difference is that the Nigerian protesters are not demanding a defunding of the police — if anything, he said, they want more resources devoted to helping improve policing in their country.
dytonka

#EndSARS and the History of Nigeria's Failed Police Reform | Time - 0 views

  • the police unit known as SARS, which has been linked to torture, unlawful imprisonment, extortion and murder.
  • By 1992, when SARS was founded, the precedent of controlling Nigerian people through excessive force had long been the norm:
  • Jide Babalola, a journalist who currently works as a legislative aide for the office of the Deputy Senate President, says there’s a reason why every promise of reform has ended in disappointment: officials have lacked the funding and organizational structure to see the changes through, and rampant corruption often leaves local precincts and individual officers severely underfunded and underpaid. “Only a tiny fraction of what is budgeted for the Nigerian police force ever gets to them,” he says. “How are they going to do anything serious?” Until that underlying situation changes, Babalola says, there’s little hope of stopping the SARS problem.
  •  
    What is Sars? Why are Nigerians Protesting?
Javier E

COVID-19 Changed Science Forever - The Atlantic - 0 views

  • New diagnostic tests can detect the virus within minutes. Massive open data sets of viral genomes and COVID‑19 cases have produced the most detailed picture yet of a new disease’s evolution. Vaccines are being developed with record-breaking speed. SARS‑CoV‑2 will be one of the most thoroughly characterized of all pathogens, and the secrets it yields will deepen our understanding of other viruses, leaving the world better prepared to face the next pandemic.
  • But the COVID‑19 pivot has also revealed the all-too-human frailties of the scientific enterprise. Flawed research made the pandemic more confusing, influencing misguided policies. Clinicians wasted millions of dollars on trials that were so sloppy as to be pointless. Overconfident poseurs published misleading work on topics in which they had no expertise. Racial and gender inequalities in the scientific field widened.
  • At its best, science is a self-correcting march toward greater knowledge for the betterment of humanity. At its worst, it is a self-interested pursuit of greater prestige at the cost of truth and rigor
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  • Traditionally, a scientist submits her paper to a journal, which sends it to a (surprisingly small) group of peers for (several rounds of usually anonymous) comments; if the paper passes this (typically months-long) peer-review gantlet, it is published (often behind an expensive paywall). Languid and opaque, this system is ill-suited to a fast-moving outbreak. But biomedical scientists can now upload preliminary versions of their papers, or “preprints,” to freely accessible websites, allowing others to immediately dissect and build upon their results. This practice had been slowly gaining popularity before 2020, but proved so vital for sharing information about COVID‑19 that it will likely become a mainstay of modern biomedical research. Preprints accelerate science, and the pandemic accelerated the use of preprints. At the start of the year, one repository, medRxiv (pronounced “med archive”), held about 1,000 preprints. By the end of October, it had more than 12,000.
  • The U.S. is now catching up. In April, the NIH launched a partnership called ACTIV, in which academic and industry scientists prioritized the most promising drugs and coordinated trial plans across the country. Since August, several such trials have started.
  • Researchers have begun to uncover how SARS‑CoV‑2 compares with other coronaviruses in wild bats, the likely reservoir; how it infiltrates and co-opts our cells; how the immune system overreacts to it, creating the symptoms of COVID‑19. “We’re learning about this virus faster than we’ve ever learned about any virus in history,” Sabeti said.
  • Similar triumphs occurred last year—in other countries. In March, taking advantage of the United Kingdom’s nationalized health system, British researchers launched a nationwide study called Recovery, which has since enrolled more than 17,600 COVID‑19 patients across 176 institutions. Recovery offered conclusive answers about dexamethasone and hydroxychloroquine and is set to weigh in on several other treatments. No other study has done more to shape the treatment of COVID‑19.
  • SARS‑CoV‑2’s genome was decoded and shared by Chinese scientists just 10 days after the first cases were reported. By November, more than 197,000 SARS‑CoV‑2 genomes had been sequenced. About 90 years ago, no one had even seen an individual virus; today, scientists have reconstructed the shape of SARS‑CoV‑2 down to the position of individual atoms
  • Respiratory viruses, though extremely common, are often neglected. Respiratory syncytial virus, parainfluenza viruses, rhinoviruses, adenoviruses, bocaviruses, a quartet of other human coronaviruses—they mostly cause mild coldlike illnesses, but those can be severe. How often? Why? It’s hard to say, because, influenza aside, such viruses attract little funding or interest.
  • COVID‑19 has developed a terrifying mystique because it seems to behave in unusual ways. It causes mild symptoms in some but critical illness in others. It is a respiratory virus and yet seems to attack the heart, brain, kidneys, and other organs. It has reinfected a small number of people who had recently recovered. But many other viruses share similar abilities; they just don’t infect millions of people in a matter of months or grab the attention of the entire scientific community
  • Thanks to COVID‑19, more researchers are looking for these rarer sides of viral infections, and spotting them.
  • These factors pull researchers toward speed, short-termism, and hype at the expense of rigor—and the pandemic intensified that pull. With an anxious world crying out for information, any new paper could immediately draw international press coverage—and hundreds of citations.
  • “There’s a perception that they’re just colds and there’s nothing much to learn,” says Emily Martin of the University of Michigan, who has long struggled to get funding to study them. Such reasoning is shortsighted folly. Respiratory viruses are the pathogens most likely to cause pandemics, and those outbreaks could potentially be far worse than COVID‑19’s.
  • Their movements through the air have been poorly studied, too. “There’s this very entrenched idea,” says Linsey Marr at Virginia Tech, that viruses mostly spread through droplets (short-range globs of snot and spit) rather than aerosols (smaller, dustlike flecks that travel farther). That idea dates back to the 1930s, when scientists were upending outdated notions that disease was caused by “bad air,” or miasma. But the evidence that SARS‑CoV‑2 can spread through aerosols “is now overwhelming,”
  • Another pandemic is inevitable, but it will find a very different community of scientists than COVID‑19 did. They will immediately work to determine whether the pathogen—most likely another respiratory virus—moves through aerosols, and whether it spreads from infected people before causing symptoms. They might call for masks and better ventilation from the earliest moments, not after months of debate
  • They will anticipate the possibility of an imminent wave of long-haul symptoms, and hopefully discover ways of preventing them. They might set up research groups to prioritize the most promising drugs and coordinate large clinical trials. They might take vaccine platforms that worked best against COVID‑19, slot in the genetic material of the new pathogen, and have a vaccine ready within months
  • the single-minded focus on COVID‑19 will also leave a slew of negative legacies. Science is mostly a zero-sum game, and when one topic monopolizes attention and money, others lose out.
  • Long-term studies that monitored bird migrations or the changing climate will forever have holes in their data because field research had to be canceled.
  • negligence has left COVID‑19 long-haulers with few answers or options, and they initially endured the same dismissal as the larger ME community. But their sheer numbers have forced a degree of recognition. They started researching, cataloging their own symptoms. They gained audiences with the NIH and the World Health Organization. Patients who are themselves experts in infectious disease or public health published their stories in top journals. “Long COVID” is being taken seriously, and Brea hopes it might drag all post-infection illnesses into the spotlight. ME never experienced a pivot. COVID‑19 might inadvertently create one
  • Other epistemic trespassers spent their time reinventing the wheel. One new study, published in NEJM, used lasers to show that when people speak, they release aerosols. But as the authors themselves note, the same result—sans lasers—was published in 1946, Marr says. I asked her whether any papers from the 2020 batch had taught her something new. After an uncomfortably long pause, she mentioned just one.
  • The incentives to trespass are substantial. Academia is a pyramid scheme: Each biomedical professor trains an average of six doctoral students across her career, but only 16 percent of the students get tenure-track positions. Competition is ferocious, and success hinges on getting published
  • Conservationists who worked to protect monkeys and apes kept their distance for fear of passing COVID‑19 to already endangered species.
  • Among scientists, as in other fields, women do more child care, domestic work, and teaching than men, and are more often asked for emotional support by their students. These burdens increased as the pandemic took hold, leaving women scientists “less able to commit their time to learning about a new area of study, and less able to start a whole new research project,
  • published COVID‑19 papers had 19 percent fewer women as first authors compared with papers from the same journals in the previous year. Men led more than 80 percent of national COVID‑19 task forces in 87 countries. Male scientists were quoted four times as frequently as female scientists in American news stories about the pandemic.
  • American scientists of color also found it harder to pivot than their white peers, because of unique challenges that sapped their time and energy.
  • Science suffers from the so-called Matthew effect, whereby small successes snowball into ever greater advantages, irrespective of merit. Similarly, early hindrances linger. Young researchers who could not pivot because they were too busy caring or grieving for others might suffer lasting consequences from an unproductive year. COVID‑19 “has really put the clock back in terms of closing the gap for women and underrepresented minorities,”
  • In 1848, the Prussian government sent a young physician named Rudolf Virchow to investigate a typhus epidemic in Upper Silesia. Virchow didn’t know what caused the devastating disease, but he realized its spread was possible because of malnutrition, hazardous working conditions, crowded housing, poor sanitation, and the inattention of civil servants and aristocrats—problems that require social and political reforms. “Medicine is a social science,” Virchow said, “and politics is nothing but medicine in larger scale.”
  • entists discovered the microbes responsible for tuberculosis, plague, cholera, dysentery, and syphilis, most fixated on these newly identified nemeses. Societal factors were seen as overly political distractions for researchers who sought to “be as ‘objective’ as possible,” says Elaine Hernandez, a medical sociologist at Indiana University. In the U.S., medicine fractured.
  • New departments of sociology and cultural anthropology kept their eye on the societal side of health, while the nation’s first schools of public health focused instead on fights between germs and individuals. This rift widened as improvements in hygiene, living standards, nutrition, and sanitation lengthened life spans: The more social conditions improved, the more readily they could be ignored.
  • The ideological pivot away from social medicine began to reverse in the second half of the 20th century.
  • Politicians initially described COVID‑19 as a “great equalizer,” but when states began releasing demographic data, it was immediately clear that the disease was disproportionately infecting and killing people of color.
  • These disparities aren’t biological. They stem from decades of discrimination and segregation that left minority communities in poorer neighborhoods with low-paying jobs, more health problems, and less access to health care—the same kind of problems that Virchow identified more than 170 years ago.
  • In March, when the U.S. started shutting down, one of the biggest questions on the mind of Whitney Robinson of UNC at Chapel Hill was: Are our kids going to be out of school for two years? While biomedical scientists tend to focus on sickness and recovery, social epidemiologists like her “think about critical periods that can affect the trajectory of your life,” she told me. Disrupting a child’s schooling at the wrong time can affect their entire career, so scientists should have prioritized research to figure out whether and how schools could reopen safely. But most studies on the spread of COVID‑19 in schools were neither large in scope nor well-designed enough to be conclusive. No federal agency funded a large, nationwide study, even though the federal government had months to do so. The NIH received billions for COVID‑19 research, but the National Institute of Child Health and Human Development—one of its 27 constituent institutes and centers—got nothing.
  • The horrors that Rudolf Virchow saw in Upper Silesia radicalized him, pushing the future “father of modern pathology” to advocate for social reforms. The current pandemic has affected scientists in the same way
  • COVID‑19 could be the catalyst that fully reunifies the social and biological sides of medicine, bridging disciplines that have been separated for too long.
  • “To study COVID‑19 is not only to study the disease itself as a biological entity,” says Alondra Nelson, the president of the Social Science Research Council. “What looks like a single problem is actually all things, all at once. So what we’re actually studying is literally everything in society, at every scale, from supply chains to individual relationships.”
brookegoodman

Coronavirus vaccine: when will it be ready? | World news | The Guardian - 0 views

  • Even at their most effective – and draconian – containment strategies have only slowed the spread of the respiratory disease Covid-19. With the World Health Organization finally declaring a pandemic, all eyes have turned to the prospect of a vaccine, because only a vaccine can prevent people from getting sick.
  • This unprecedented speed is thanks in large part to early Chinese efforts to sequence the genetic material of Sars-CoV-2, the virus that causes Covid-19. China shared that sequence in early January, allowing research groups around the world to grow the live virus and study how it invades human cells and makes people sick.
  • Coronaviruses have caused two other recent epidemics – severe acute respiratory syndrome (Sars) in China in 2002-04, and Middle East respiratory syndrome (Mers), which started in Saudi Arabia in 2012. In both cases, work began on vaccines that were later shelved when the outbreaks were contained. One company, Maryland-based Novavax, has now repurposed those vaccines for Sars-CoV-2, and says it has several candidates ready to enter human trials this spring. Moderna, meanwhile, built on earlier work on the Mers virus conducted at the US National Institute of Allergy and Infectious Diseases in Bethesda, Maryland.
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  • All vaccines work according to the same basic principle. They present part or all of the pathogen to the human immune system, usually in the form of an injection and at a low dose, to prompt the system to produce antibodies to the pathogen. Antibodies are a kind of immune memory which, having been elicited once, can be quickly mobilised again if the person is exposed to the virus in its natural form.
  • Cepi’s original portfolio of four funded Covid-19 vaccine projects was heavily skewed towards these more innovative technologies, and last week it announced $4.4m (£3.4m) of partnership funding with Novavax and with a University of Oxford vectored vaccine project. “Our experience with vaccine development is that you can’t anticipate where you’re going to stumble,” says Hatchett, meaning that diversity is key. And the stage where any approach is most likely to stumble is clinical or human trials, which, for some of the candidates, are about to get under way.
  • An illustration of that is a vaccine that was produced in the 1960s against respiratory syncytial virus, a common virus that causes cold-like symptoms in children. In clinical trials, this vaccine was found to aggravate those symptoms in infants who went on to catch the virus. A similar effect was observed in animals given an early experimental Sars vaccine. It was later modified to eliminate that problem but, now that it has been repurposed for Sars-CoV-2, it will need to be put through especially stringent safety testing to rule out the risk of enhanced disease.
  • Once a Covid-19 vaccine has been approved, a further set of challenges will present itself. “Getting a vaccine that’s proven to be safe and effective in humans takes one at best about a third of the way to what’s needed for a global immunisation programme,” says global health expert Jonathan Quick of Duke University in North Carolina, author of The End of Epidemics (2018). “Virus biology and vaccines technology could be the limiting factors, but politics and economics are far more likely to be the barrier to immunisation.”
  • Because pandemics tend to hit hardest those countries that have the most fragile and underfunded healthcare systems, there is an inherent imbalance between need and purchasing power when it comes to vaccines. During the 2009 H1N1 flu pandemic, for example, vaccine supplies were snapped up by nations that could afford them, leaving poorer ones short. But you could also imagine a scenario where, say, India – a major supplier of vaccines to the developing world – not unreasonably decides to use its vaccine production to protect its own 1.3 billion-strong population first, before exporting any.
  • • This article was amended on 19 March 2020. An earlier version incorrectly stated that the Sabin Vaccine Institute was collaborating with the Coalition for Epidemic Preparedness Innovations (Cepi) on a Covid-19 vaccine.
Javier E

How U.S. can defeat coronavirus: Heed Asia?s lessons from epidemics past - The Washingt... - 0 views

  • in wealthy places on China's periphery — Hong Kong, Taiwan and South Korea — a rapid response swung into action.One reason was that they had learned from the past.
  • “We were all burned very badly with SARS, but actually it turned out to be a blessing for us.”
  • Political will, dedicated resources, sophisticated tracking and a responsible population have kept coronavirus infections and deaths in Taiwan, Hong Kong and Singapore relatively low. South Korea, with more deaths, has led the way in widespread testing.
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  • In Taiwan, officials boarded planes arriving from Wuhan and assessed passengers for symptoms before allowing anyone to disembark. Within days, Singapore, South Korea and other Asian states had implemented similar steps.
  • A year after SARS, Taiwan established a National Health Command Center that brought together all levels and branches of government, preparing for the possibility of another disease outbreak. Its interventions over the past two months have been decisive in keeping Taiwan ahead of the curve
  • They didn’t hesitate, they didn’t want to die,” Wang said. “The mortality rate was so high [during SARS] and they didn’t know how bad this one was going to be. Nobody thought it was like the flu.”
  • As early as Jan. 5, Taiwan was tracing people who had been in Wuhan in the previous 14 days. Those with symptoms of respiratory infections were quarantined.
  • In subsequent weeks, authorities used data and technology to identify and track cases, communicated effectively to reassure the public, offered relief to businesses and allocated medical resources where they were needed most — rationing face masks and dramatically increasing their production.
  • On Jan. 27, Taiwan combined the databases of its National Health Insurance Administration and National Immigration Agency, allowing it to track everyone who had been in Wuhan in the recent past and alert doctors to patients’ travel histories
  • Now, Taiwan is hoping to keep its infection numbers down and has asked residents not to travel abroad after its biggest single-day jump of cases — 23 — on Wednesday. It is also barring most noncitizens from entering.
  • South Korea, meanwhile, has become the poster child for testing. Its success is rooted in a previous failure: The limited availability of test kits was seen as having aggravated the 2015 MERS outbreak, when the country suffered the second-highest caseload after Saudi Arabia.
  • Whereas the United States and Japan keep testing tightly controlled by a central authority, South Korea opened the process to the private sector, introducing a path to grant “emergency usage approval” to tests for pathogens of pandemic potential.
  • More than 260,000 people in South Korea have been tested for the virus, the highest per capita anywhere, with testing and treatment fees covered by the government and drive-through centers capturing global attention
  • Singapore, too, benefited from its own capabilities to test, as did Hong Kong and Japan. All developed their own diagnostic tests when the covid-19 genome sequence was published.
  • Outside mainland China, the territory had been the biggest casualty of the Communist Party’s coverup of the SARS outbreak, with some 300 deaths and little clarity on what was unfolding until it was too late.
  • This time, though, and without needing to be told much, Hong Kong residents took matters into their own hands. The city’s financial district was reduced to a ghost town in early February as companies closed offices. Bakeries known for hour-long weekend lines were abandoned.
  • Parties, weddings and family gatherings were canceled — without any government order. Almost everyone rushed to ­procure masks; a recent study ­estimated that 74 percent to 98 percent of residents wore them when leaving their homes. Voluntary social distancing was hailed as a key reason for the lower rate of infections.
  • From electronic wristbands to smartphone trackers, Asian jurisdictions have pulled out all the stops to ensure that suspected patients comply with quarantine and isolation orders, monitoring that is backed by laws that were tightened post-SARS.
  • Singapore used its FBI equivalent, the Criminal Investigation Department, to effectively interrogate every confirmed case with stunning granularity — even using patients’ digital wallets to trace their footsteps. Those caught lying face fines and jail time.
  • In South Korea, information on the movements of infected people before they were tested is collected and relayed over smartphones, creating a real-time ma
  • Taiwan tracks infected people’s whereabouts via smartphones
  • In Hong Kong, everyone subject to a compulsory quarantine must activate real-time location-sharing on their phone or wear an electronic wristband.
  • These measures have been backed by local populations that lived through previous epidemics and have largely shed concerns about privacy and tracking.
  • Americans should not focus “only on the kind of high-profile displays of state power that have made headlines from China” but also look at countries such as South Korea that are “balancing Democratic openness with rapid, concerted public-health action.”
  • Experts agree, though, that Western governments must be prepared to limit their citizens’ movements, mandate isolation for positive cases and track contacts regardless of privacy concerns.
Javier E

The 1918 Pandemic and Coronavirus | The New York Review of Books | Daily - 0 views

  • As Bill Gates pointed out in a recent commentary in The New England Journal of Medicine:
  • Global health experts have been saying for years that another pandemic whose speed and severity rivaled those of the 1918 influenza epidemic was a matter not of if but of when… Covid-19 has started behaving a lot like the once-in-a-century pathogen we’ve been worried about.
  • the SARS-CoV-2 coronavirus is a very different pathogen to influenza. Although both spread via respiratory droplets in coughs and sneezes, coronaviruses do not transmit very efficiently as aerosols, as flu does
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  • SARS-CoV-2 is not thought to present a risk at distances further than six feet. Instead, the virus’s principal mode of spread appears to be through prolonged social contact, such as occurs in family groupings.
  • SARS-CoV-2 is principally a risk to the elderly, those sixty and over, and people with underlying medical conditions.
  • There is also no firm evidence, as yet, that children are a significant vector of infection
  • On the debit side, there is mounting evidence that people who are symptom-free but infected may be capable of transmitting the virus
  • the average reproduction rate of SARS-CoV-2—that is, the number of people who will be infected by one infected person—is running at 2.2, which is markedly higher than the rate for Spanish flu, which was 1.8. 
  • in 1918 almost everyone had been exposed to some type of influenza before, meaning most people could count on a degree of immunity. The result was that the Spanish flu infected only a third of the world’s population. By contrast, no one has any immunity to the new coronavirus—hence the estimates that as much as 80 percent of the world’s population could have been infected by the time the pandemic will have run its course. 
  • The greatest reason for concern, though, is that so far, SARS-CoV-2 appears to kill about 2 percent of confirmed cases. That is a very similar mortality rate to the Spanish flu.
  • even that should not be a cause for panic or despair.
  • One of the chief lessons of the 1918 pandemic is that cities such as St. Louis that acted early and decisively to contain the virus by banning large public gatherings, closing schools, and isolating ill or suspected case, fared notably better than cities such as Philadelphia that failed to take timely measures or did not sustain them.
aleija

Opinion | We Dared to Assemble. For That, We Were Killed. - The New York Times - 1 views

  • LAGOS, Nigeria — The High Court of Justice is on fire. Behind my home, it has been ablaze since noon. But in reality, the justice system the court claims to represent has been burning for nearly 60 years.
  • “We the people,” begins the Constitution of the Federal Republic of Nigeria. Section 40 guarantees us the right to freedom of assembly. By Section 41, “we the people,” are guaranteed the right to free movement. So, we assembled. And we moved. For that, we have been killed.
  • In Nigeria, the accepted experience with almost all officialdom is aggressive: the civilian officers in full military garb who slap women trying to enter the passport office; the ordinary policeman who pulls his gun on unarmed civilians because they dared to talk back. Violence defines the predictable. It takes an unpredictable, extraordinary level of brutality to cause a storm.
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  • On Oct. 3, a video surfaced online that appeared to show the point-blank killing of a Nigerian citizen by officers of the Federal Special Anti-Robbery Squad, commonly known as SARS. In the days since the video’s emergence, people across the country, young and some old, have taken to the streets to protest police brutality and call for SARS’s disbandment.
  • SARS was founded in 1992 to deal with violent crimes like kidnappings and armed robbery, common at the time. In the years since, SARS has come to resemble the armed thugs it supposedly combats. Often in plain clothes, SARS officers became synonymous with torture, illegal detention and extortion. Violent crime might have fallen, but it was not because criminals knew that they would face the full force of the law, but rather that they would be extrajudicially murdered.
  • When unlawfully arrested protesters need legal aid, they simply ask and networks organized online call volunteer lawyers, who drop what they are doing and proceed to the police station. When protesters need food, water or mobile phone data, they ask and food, water and money from an ever-growing fund of global donations is sent. And when they need ambulances or security guards to protect them from hired thugs, from the state itself, they ask, and private ambulance and security services are sent their way.
  • SARS would be disbanded and investigations opened, but the police were largely a force of hardworking officers not to be tarnished by “the few bad eggs.”
  • For two weeks, protesters dared to speak truth to power, and for two weeks the army had been looking for an excuse to make it clear that in Nigeria, violence — their violence — always reigns. They found it.
  • Most in the Nigerian government want us to see them as figures of authority. But recent events have confirmed they would be nothing without their fists. They have confirmed it is they who are afraid — afraid that their children, regardless of age, ethnicity or gender should, one day, be free in a country where honor and respect are not the result of force. It is they who are afraid that, unleashed from their shallow power, this country might no longer be a testament to unnecessary suffering and violence.
brickol

Coronavirus vaccine: when will it be ready? | World news | The Guardian - 0 views

  • Even at their most effective – and draconian – containment strategies have only slowed the spread of the respiratory disease Covid-19. With the World Health Organization finally declaring a pandemic, all eyes have turned to the prospect of a vaccine, because only a vaccine can prevent people from getting sick.
  • About 35 companies and academic institutions are racing to create such a vaccine, at least four of which already have candidates they have been testing in animals. The first of these – produced by Boston-based biotech firm Moderna – will enter human trials imminently.
  • This unprecedented speed is thanks in large part to early Chinese efforts to sequence the genetic material of Sars-CoV-2, the virus that causes Covid-19
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  • Sars-CoV-2 shares between 80% and 90% of its genetic material with the virus that caused Sars – hence its name. Both consist of a strip of ribonucleic acid (RNA) inside a spherical protein capsule that is covered in spikes. The spikes lock on to receptors on the surface of cells lining the human lung – the same type of receptor in both cases – allowing the virus to break into the cell. Once inside, it hijacks the cell’s reproductive machinery to produce more copies of itself, before breaking out of the cell again and killing it in the process.
  • Coronaviruses have caused two other recent epidemics – severe acute respiratory syndrome (Sars) in China in 2002-04, and Middle East respiratory syndrome (Mers), which started in Saudi Arabia in 2012. In both cases, work began on vaccines that were later shelved when the outbreaks were contained.
  • Though nobody could have predicted that the next infectious disease to threaten the globe would be caused by a coronavirus – flu is generally considered to pose the greatest pandemic risk – vaccinologists had hedged their bets by working on “prototype” pathogens.
  • All vaccines work according to the same basic principle. They present part or all of the pathogen to the human immune system, usually in the form of an injection and at a low dose, to prompt the system to produce antibodies to the pathogen. Antibodies are a kind of immune memory which, having been elicited once, can be quickly mobilised again if the person is exposed to the virus in its natural form.
  • Some of the Covid-19 vaccine projects are using these tried-and-tested approaches, but others are using newer technology.
  • Cepi’s original portfolio of four funded Covid-19 vaccine projects was heavily skewed towards these more innovative technologies, and last week it announced $4.4m (£3.4m) of partnership funding with Novavax and with a University of Oxford vectored vaccine project.
  • Clinical trials, an essential precursor to regulatory approval, usually take place in three phases. The first, involving a few dozen healthy volunteers, tests the vaccine for safety, monitoring for adverse effects. The second, involving several hundred people, usually in a part of the world affected by the disease, looks at how effective the vaccine is, and the third does the same in several thousand people. But there’s a high level of attrition as experimental vaccines pass through these phases.
  • There are good reasons for that. Either the candidates are unsafe, or they’re ineffective, or both. Screening out duds is essential, which is why clinical trials can’t be skipped or hurried. Approval can be accelerated if regulators have approved similar products before.
  • No vaccine made from genetic material – RNA or DNA – has been approved to date, for example. So the Covid-19 vaccine candidates have to be treated as brand new vaccines, and as Gellin says: “While there is a push to do things as fast as possible, it’s really important not to take shortcuts.”
  • It’s for these reasons that taking a vaccine candidate all the way to regulatory approval typically takes a decade or more, and why President Trump sowed confusion when, at a meeting at the White House on 2 March, he pressed for a vaccine to be ready by the US elections in November – an impossible deadline.
  • In the meantime, there is another potential problem. As soon as a vaccine is approved, it’s going to be needed in vast quantities – and many of the organisations in the Covid-19 vaccine race simply don’t have the necessary production capacity. Vaccine development is already a risky affair, in business terms, because so few candidates get anywhere near the clinic. Production facilities tend to be tailored to specific vaccines, and scaling these up when you don’t yet know if your product will succeed is not commercially feasible. Cepi and similar organisations exist to shoulder some of the risk, keeping companies incentivised to develop much-needed vaccines. Cepi plans to invest in developing a Covid-19 vaccine and boosting manufacturing capacity in parallel, and earlier this month it put out a call for $2bn to allow it to do so.
  • The problem is making sure the vaccine gets to all those who need it. This is a challenge even within countries, and some have worked out guidelines. In the scenario of a flu pandemic, for example, the UK would prioritise vaccinating healthcare and social care workers, along with those considered at highest medical risk – including children and pregnant women – with the overall goal of keeping sickness and death rates as low as possible. But in a pandemic, countries also have to compete with each other for medicines.
  • Because pandemics tend to hit hardest those countries that have the most fragile and underfunded healthcare systems, there is an inherent imbalance between need and purchasing power when it comes to vaccines.
  • Outside of pandemics, the WHO brings governments, charitable foundations and vaccine-makers together to agree an equitable global distribution strategy, and organisations like Gavi, the vaccine alliance, have come up with innovative funding mechanisms to raise money on the markets for ensuring supply to poorer countries. But each pandemic is different, and no country is bound by any arrangement the WHO proposes – leaving many unknowns.
Javier E

The U.K.'s Coronavirus 'Herd Immunity' Debacle - The Atlantic - 0 views

  • Herd immunity is typically generated through vaccination, and while it could arise through widespread infection, “you don’t rely on the very deadly infectious agent to create an immune population,” says Akiko Iwasaki, a virologist at the Yale School of Medicine. And that seemed like the goal.
  • Vallance and others certainly made it sound like the government was deliberately aiming for 60 percent of the populace to fall ill. Keep calm and carry on … and get COVID-19.
  • He says that the actual goal is the same as that of other countries: flatten the curve by staggering the onset of infections. As a consequence, the nation may achieve herd immunity; it’s a side effect, not an aim.
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  • “The messaging has been really confusing, and I think that was really unfortunate,” says Petra Klepac, who is also an infectious-disease modeler at the London School of Hygiene and Tropical Medicine. “It’s been a case of how not to communicate during an outbreak,”
  • critics of the U.K. strategy argue that swift, decisive action matters more than future hypotheticals do. The country’s current caseload puts it only a few weeks behind Italy, where more than 24,000 cases have so overburdened hospitals that doctors must now make awful decisions about whom to treat.
  • First, we don’t know how long immunity against the new coronavirus, SARS-CoV-2, lasts. When people are infected with OC43 and HKU1—two other coronaviruses that regularly circulate among humans and cause common colds—they stay immune for less than a year. By contrast, immunity against the first SARS virus (from 2003) holds for much longer. No one knows whether SARS-CoV-2 will hew to either of these extremes, and according to one recent study, its behavior could mean anything from annual outbreaks to a decades-long quiet spell.
  • making a decent long-term strategy is hard when there are still two big unknowns that substantially affect how the pandemic will progress
  • a more granular analysis across Chinese provinces showed that the virus can still easily spread in humid areas, and a third modeling study concluded that “SARS-CoV-2 can proliferate at any time of year.” The bottom line: There’s a very wide range of possible futures.
  • South Korea, by contrast, seems to have brought COVID-19 to heel through a combination of social-distancing measures and extensive testing. Hong Kong, Singapore, and Taiwan have been similarly successful.
  • In a similar letter, more than 500 behavioral scientists called on the government to disclose the evidence behind its contention that the public will experience “behavioral fatigue” if restrictions are put in place too early.
  • Without strong guidance, British institutions and citizens have begun making their own decisions, going well over what the government recommends. Universities haven’t been told to close, but many have, sending students home, moving classes and exams online, and postponing graduations. Many care homes will not be admitting visitors. Soccer leagues have been suspended. The Queen has canceled public engagements. The Scottish government is planning to close schools and expand testing.
  • “We really need people to engage and to sustain individual control measures, like social distancing, for months at a time,” Klepac adds. “We’re in this for the long term and we need everyone to do their part. It is a very big ask.
Javier E

Hoping Llamas Will Become Coronavirus Heroes - The New York Times - 0 views

  • Winter is a 4-year-old chocolate-colored llama with spindly legs
  • Winter was simply the lucky llama chosen by researchers in Belgium, where she lives, to participate in a series of virus studies involving both SARS and MERS. Finding that her antibodies staved off those infections, the scientists posited that those same antibodies could also neutralize the new virus that causes Covid-19. They were right, and published their results Tuesday in the journal Cell.
  • Scientists have long turned to llamas for antibody research. In the last decade, for example, scientists have used llamas’ antibodies in H.I.V. and influenza research, finding promising therapies for both viruses.
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  • This more diminutive antibody can access tinier pockets and crevices on spike proteins — the proteins that allow viruses like the novel coronavirus to break into host cells and infect us — that human antibodies cannot. That can make it more effective in neutralizing viruses.
  • The llama’s antibody still forms a Y, but its arms are much shorter because it doesn’t have any light-chain proteins.
  • Humans produce only one kind of antibody, made of two types of protein chains — heavy and light — that together form a Y shape. Heavy-chain proteins span the entire Y, while light-chain proteins touch only the Y’s arms. Llamas, on the other hand, produce two types of antibodies
  • Llamas’ antibodies are also easily manipulated
  • They can be linked or fused with other antibodies, including human antibodies, and remain stable despite those manipulations.
  • researchers looked to llamas — and, specifically, Winter — to find a smaller llama antibody “that could broadly neutralize many different types of coronavirus,” Dr. McLellan said.
  • They injected Winter with spike proteins from the virus that caused the 2002-03 SARS epidemic as well as MERS, then tested a sample of her blood. And while they couldn’t isolate a single llama antibody that worked against both viruses, they found two potent antibodies that each fought separately against MERS and SARS.
  • They immediately realized that the smaller llama antibodies “that could neutralize SARS would very likely also recognize the Covid-19 virus,” Dr. Saelens said.
  • It did, the researchers found, effectively inhibiting the coronavirus in cell cultures.
  • While the treatment’s protection would be immediate, its effects wouldn’t be permanent, lasting only a month or two without additional injections.
  • This proactive approach is at least several months away, but the researchers are moving toward clinical trials. Additional studies may also be needed to verify the safety of injecting a llama’s antibodies into human patients.
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