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brickol

Boris Johnson and Matt Hancock in self-isolation with coronavirus | World news | The Guardian - 0 views

www.theguardian.com/...tests-positive-for-coronavirus

COVID-19

shared by brickol on 27 Mar 20 - No Cached
  • Boris Johnson and health secretary Matt Hancock have both tested positive for coronavirus and will have to work leading the government’s efforts to tackle the pandemic in isolation.
  • Johnson posted a video on Friday morning on Twitter saying he had a temperature and a persistent cough. “I am working from home, I’m self-isolating, and that’s entirely the right thing to do,” he said.
  • The World Health Organization has said there is no evidence that pregnant women are at higher risk of severe illness than the general population if they contract Covid-19.
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  • “Fortunately for me the symptoms so far have been very mild so I’ve been able to carry on with the work driving forward the UK response,” he said. “I’ll be continuing to do everything I can to get our carers the support that they need. And I’ll be doing that from here but with no less gusto.”
  • A Downing Street spokeswoman said: “After experiencing mild symptoms yesterday, the prime minister was tested for coronavirus on the personal advice of England’s chief medical officer, Prof Chris Whitty. The test was carried out in No 10 by NHS staff and the result of the test was positive.
  • Earlier in the week it was announced that the Prince of Wales had “mild symptoms” of the disease. The Labour MP Angela Rayner, the favourite to become the party’s deputy leader, announced on Twitter that she was self-isolating after displaying symptoms.
  • Ian Blackford, the Scottish National party’s leader in the House of Commons, said the news showed no one was immune.
  • Johnson posted a video on Friday morning on Twitter saying he had a temperature and a persistent cough. “I am working from home, I’m self-isolating, and that’s entirely the right thing to do,” he said.
  • After the prime minister, who is 55, said he had mild symptoms and would self-isolate in Downing Street, Hancock posted a Twitter video saying that he too had mild symptoms and he would be able to continue.
  • Boris Johnson and health secretary Matt Hancock have both tested positive for coronavirus and will have to work leading the government’s efforts to tackle the pandemic in isolation.
  • “Fortunately for me the symptoms so far have been very mild so I’ve been able to carry on with the work driving forward the UK response,” he said. “I’ll be continuing to do everything I can to get our carers the support that they need. And I’ll be doing that from here but with no less gusto.”
  • The World Health Organization has said there is no evidence that pregnant women are at higher risk of severe illness than the general population if they contract Covid-19.
  • Earlier in the week it was announced that the Prince of Wales had “mild symptoms” of the disease. The Labour MP Angela Rayner, the favourite to become the party’s deputy leader, announced on Twitter that she was self-isolating after displaying symptoms.
  • journalism that is rooted in empirical data and science matters. It may even save lives. This administration has cleared out science and scientists across all departments. Donald Trump's daily coronavirus press briefings have become political rallies. He frequently spreads, at best, misinformation and, at worst, lies.
Javier E

The Coronavirus Can Be Stopped, but Only With Harsh Steps, Experts Say - The New York Times - 0 views

www.nytimes.com/...ronavirus-restrictions-us.html

pandemic response strategy WHO

shared by Javier E on 23 Mar 20 - No Cached
  • Terrifying though the coronavirus may be, it can be turned back. China, South Korea, Singapore and Taiwan have demonstrated that, with furious efforts, the contagion can be brought to heel.
  • for the United States to repeat their successes will take extraordinary levels of coordination and money from the country’s leaders, and extraordinary levels of trust and cooperation from citizens. It will also require international partnerships in an interconnected world.
  • This contagion has a weakness.
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  • the coronavirus more often infects clusters of family members, friends and work colleagues,
  • “You can contain clusters,” Dr. Heymann said. “You need to identify and stop discrete outbreaks, and then do rigorous contact tracing.”
  • The microphone should not even be at the White House, scientists said, so that briefings of historic importance do not dissolve into angry, politically charged exchanges with the press corps, as happened again on Friday.
  • Americans must be persuaded to stay home, they said, and a system put in place to isolate the infected and care for them outside the home
  • Travel restrictions should be extended, they said; productions of masks and ventilators must be accelerated, and testing problems must be resolved.
  • It was not at all clear that a nation so fundamentally committed to individual liberty and distrustful of government could learn to adapt to many of these measures, especially those that smack of state compulsion.
  • What follows are the recommendations offered by the experts interviewed by The Times.
  • they were united in the opinion that politicians must step aside and let scientists both lead the effort to contain the virus and explain to Americans what must be done.
  • medical experts should be at the microphone now to explain complex ideas like epidemic curves, social distancing and off-label use of drugs.
  • doing so takes intelligent, rapidly adaptive work by health officials, and near-total cooperation from the populace. Containment becomes realistic only when Americans realize that working together is the only way to protect themselves and their loved ones.
  • Above all, the experts said, briefings should focus on saving lives and making sure that average wage earners survive the coming hard times — not on the stock market, the tourism industry or the president’s health.
  • “At this point in the emergency, there’s little merit in spending time on what we should have done or who’s at fault,”
  • The next priority, experts said, is extreme social distancing.If it were possible to wave a magic wand and make all Americans freeze in place for 14 days while sitting six feet apart, epidemiologists say, the whole epidemic would sputter to a halt.
  • The virus would die out on every contaminated surface and, because almost everyone shows symptoms within two weeks, it would be evident who was infected. If we had enough tests for every American, even the completely asymptomatic cases could be found and isolated.
  • The crisis would be over.
  • Obviously, there is no magic wand, and no 300 million tests. But the goal of lockdowns and social distancing is to approximate such a total freeze.
  • In contrast to the halting steps taken here, China shut down Wuhan — the epicenter of the nation’s outbreak — and restricted movement in much of the country on Jan. 23, when the country had a mere 500 cases and 17 deaths.Its rapid action had an important effect: With the virus mostly isolated in one province, the rest of China was able to save Wuhan.
  • Even as many cities fought their own smaller outbreaks, they sent 40,000 medical workers into Wuhan, roughly doubling its medical force.
  • Stop transmission within cities
  • the weaker the freeze, the more people die in overburdened hospitals — and the longer it ultimately takes for the economy to restart.
  • People in lockdown adapt. In Wuhan, apartment complexes submit group orders for food, medicine, diapers and other essentials. Shipments are assembled at grocery warehouses or government pantries and dropped off. In Italy, trapped neighbors serenade one another.
  • Each day’s delay in stopping human contact, experts said, creates more hot spots, none of which can be identified until about a week later, when the people infected there start falling ill.
  • South Korea avoided locking down any city, but only by moving early and with extraordinary speed. In January, the country had four companies making tests, and as of March 9 had tested 210,000 citizens — the equivalent of testing 2.3 million Americans.
  • As of the same date, fewer than 9,000 Americans had been tested.
  • Fix the testing mess
  • Testing must be done in a coordinated and safe way, experts said. The seriously ill must go first, and the testers must be protected.In China, those seeking a test must describe their symptoms on a telemedicine website. If a nurse decides a test is warranted, they are directed to one of dozens of “fever clinics” set up far from all other patients.
  • Isolate the infected
  • As soon as possible, experts said, the United States must develop an alternative to the practice of isolating infected people at home, as it endangers families. In China, 75 to 80 percent of all transmission occurred in family clusters.
  • Cellphone videos from China show police officers knocking on doors and taking temperatures. In some, people who resist are dragged away by force. The city of Ningbo offered bounties of $1,400 to anyone who turned in a coronavirus sufferer.
  • In China, said Dr. Bruce Aylward, leader of the World Health Organization’s observer team there, people originally resisted leaving home or seeing their children go into isolation centers with no visiting rights — just as Americans no doubt would.
  • In China, they came to accept it.“They realized they were keeping their families safe,” he said. “Also, isolation is really lonely. It’s psychologically difficult. Here, they were all together with other people in the same boat. They supported each other.”
  • Find the fevers
  • Make masks ubiquitous
  • In China, having a fever means a mandatory trip to a fever clinic to check for coronavirus. In the Wuhan area, different cities took different approaches.
  • In most cities in affected Asian countries, it is commonplace before entering any bus, train or subway station, office building, theater or even a restaurant to get a temperature check. Washing your hands in chlorinated water is often also required.
  • The city of Qianjiang, by contrast, offered the same amount of money to any resident who came in voluntarily and tested positive
  • Voluntary approaches, like explaining to patients that they will be keeping family and friends safe, are more likely to work in the West, she added.
  • Trace the contacts
  • Finding and testing all the contacts of every positive case is essential, experts said. At the peak of its epidemic, Wuhan had 18,000 people tracking down individuals who had come in contact with the infected.
  • Dr. Borio suggested that young Americans could use their social networks to “do their own contact tracing.” Social media also is used in Asia, but in different ways
  • When he lectured at a Singapore university, Dr. Heymann said, dozens of students were in the room. But just before he began class, they were photographed to record where everyone sat.
  • Instead of a policy that advises the infected to remain at home, as the Centers for Disease and Prevention now does, experts said cities should establish facilities where the mildly and moderately ill can recuperate under the care and observation of nurses.
  • There is very little data showing that flat surgical masks protect healthy individuals from disease. Nonetheless, Asian countries generally make it mandatory that people wear them.
  • The Asian approach is less about data than it is about crowd psychology, experts explained.All experts agree that the sick must wear masks to keep in their coughs. But if a mask indicates that the wearer is sick, many people will be reluctant to wear one. If everyone is required to wear masks, the sick automatically have one on and there is no stigma attached.
  • Also, experts emphasized, Americans should be taught to take seriously admonitions to stop shaking hands and hugging
  • Preserve vital services
  • Only the federal government can enforce interstate commerce laws to ensure that food, water, electricity, gas, phone lines and other basic needs keep flowing across state lines to cities and suburbs
  • “I sense that most people — and certainly those in business — get it. They would prefer to take the bitter medicine at once and contain outbreaks as they start rather than gamble with uncertainty.”
  • Produce ventilators and oxygen
  • The manufacturers, including a dozen in the United States, say there is no easy way to ramp up production quickly. But it is possible other manufacturers, including aerospace and automobile companies, could be enlisted to do so.
  • Canadian nurses are disseminating a 2006 paper describing how one ventilator can be modified to treat four patients simultaneously. Inventors have proposed combining C-PAP machines, which many apnea sufferers own, and oxygen tanks to improvise a ventilator.
  • One of the lessons of China, he noted, was that many Covid-19 patients who would normally have been intubated and on ventilators managed to survive with oxygen alone.
  • Retrofit hospitals
  • In Wuhan, the Chinese government famously built two new hospitals in two weeks. All other hospitals were divided: 48 were designated to handle 10,000 serious or critical coronavirus patients, while others were restricted to handling emergencies like heart attacks and births.
  • Wherever that was impractical, hospitals were divided into “clean” and “dirty” zones, and the medical teams did not cross over. Walls to isolate whole wards were built
  • Decide when to close schools
  • Recruit volunteers
  • China’s effort succeeded, experts said, in part because of hundreds of thousands of volunteers. The government declared a “people’s war” and rolled out a “Fight On, Wuhan! Fight On, China!” campaign.
  • Many people idled by the lockdowns stepped up to act as fever checkers, contact tracers, hospital construction workers, food deliverers, even babysitters for the children of first responders, or as crematory workers.
  • “In my experience, success is dependent on how much the public is informed and participates,” Admiral Ziemer said. “This truly is an ‘all hands on deck’ situation.”
  • Prioritize the treatments
  • Clinicians in China, Italy and France have thrown virtually everything they had in hospital pharmacies into the fight, and at least two possibilities have emerged that might save patients: the anti-malaria drugs chloroquine and hydroxychloroquine, and the antiviral remdesivir, which has no licensed use.
  • An alternative is to harvest protective antibodies from the blood of people who have survived the illness,
  • The purified blood serum — called immunoglobulin — could possibly be used in small amounts to protect emergency medical workers, too.
  • “Unfortunately, the first wave won’t benefit from this,” Dr. Hotez said. “We need to wait until we have enough survivors.”Find a vaccine
  • testing those candidate vaccines for safety and effectiveness takes time.
  • The roadblock, vaccine experts explained, is not bureaucratic. It is that the human immune system takes weeks to produce antibodies, and some dangerous side effects can take weeks to appear.
  • After extensive animal testing, vaccines are normally given to about 50 healthy human volunteers to see if they cause any unexpected side effects and to measure what dose produces enough antibodies to be considered protective.
  • If that goes well, the trial enrolls hundreds or thousands of volunteers in an area where the virus is circulating. Half get the vaccine, the rest do not — and the investigators wait. If the vaccinated half do not get the disease, the green light for production is finally given.
  • In the past, some experimental vaccines have produced serious side effects, like Guillain-Barre syndrome, which can paralyze and kill. A greater danger, experts said, is that some experimental vaccines, paradoxically, cause “immune enhancement,” meaning they make it more likely, not less, that recipients will get a disease. That would be a disaster.
  • One candidate coronavirus vaccine Dr. Hotez invented 10 years ago in the wake of SARS, he said, had to be abandoned when it appeared to make mice more likely to die from pneumonia when they were experimentally infected with the virus.
  • Reach out to other nations
Javier E

Nine Days in Wuhan, the Ground Zero of the Coronavirus Pandemic | The New Yorker - 0 views

www.newyorker.com/...ro-of-the-coronavirus-pandemic

china pandemic politics policy censorship origins

shared by Javier E on 10 Oct 20 - No Cached
  • By now, with worldwide infections at thirty-five million and counting, and with near-total silence on the part of the Chinese government, the market has become a kind of petri dish for the imagination.
  • One common Chinese conspiracy theory claims that the U.S. Army deliberately seeded the virus during the 2019 Military World Games, which were held in Wuhan that October. On the other side of the world, a number of Americans believe that the virus was released, whether accidentally or otherwise, from the Wuhan Institute of Virology, whose research includes work on coronaviruses.
  • There’s no evidence to support these theories, and even the prevalent animal-market connection is unclear. There weren’t many wildlife dealers in the market—about a dozen stalls, according to most published reports—and Wuhan natives have little appetite for exotic animals.
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  • There are three hundred and twenty-one testing locations in the city, and the system is so extensive that in June, when Beijing suffered an outbreak, Wuhan hospitals sent seventy-two staffers to the capital to help with tests.
  • When Wuhan was sealed, the strategy of isolation was replicated throughout the city. Housing compounds were closed and monitored by neighborhood committees, with residents going out only for necessities.
  • Toward the end of the first month, the guidelines were tightened further, until virtually all goods were delivered. On February 17th, Fang Fang wrote, “Everyone is now required to remain inside their homes at all times.”
  • Meanwhile, approximately ten thousand contact tracers were working in the city, in order to cut off chains of infection, and hospitals were developing large-scale testing systems. But isolation remained crucial: patients were isolated; suspected exposures were isolated; medical workers were isolated.
  • Zhang said the experience of working through the pandemic had left him calmer and more patient. He drove more carefully now; he wasn’t in such a rush.
  • I often asked Wuhan residents how they had been personally changed by the spring, and there was no standard response. Some expressed less trust in government information; others said they had increased faith in the national leadership.
  • Wuhan had most recently reported a locally transmitted symptomatic case on May 18th. It’s the most thoroughly tested city in China: at the end of May, in part to boost confidence, the government tried to test every resident, a total of eleven million.
  • I never met a cabdriver who had been swab-tested less than twice, and a couple had been tested five times. Most of the cabbies had no relatives or friends who had been infected; swabbing was simply required by the city and by their cab companies.
  • “I tend to take a charitable view of countries that are at the beginning stage of epidemics,” Jennifer Nuzzo, an epidemiologist at the Johns Hopkins Center for Health Security, told me, in a phone conversation. According to her, it’s unrealistic to expect that any country could have stopped this particular virus at its source. “I’ve always believed that this thing was going to spread,” she said
  • The physician who handled testing told me that, on average, his hospital still recorded one positive for every forty thousand exams. Most of these positives were repeat patients: after having been infected during the initial run of the virus, they recovered fully, and then for some reason, months later, showed evidence of the virus again. So far, most of the positives had been asymptomatic, and the physician saw no indication that the virus was spreading in the city.
  • In town, there were few propaganda signs about the epidemic, and Wuhan newspapers ran upbeat headlines every morning (Yangtze Daily, August 29th, front page: “STUDENTS DO NOT HAVE TO WEAR MASKS IN SCHOOLS”). Movie theatres were open; restaurants and bars had no seating restrictions. At the Hanyang Renxinghui Mall, I saw barefaced kids playing in what may have been one of the last fully functioning ball pits on earth, a sight that seemed worthy of other headlines (“CHILDREN DO NOT HAVE TO WEAR MASKS IN WUHAN BALL PITS”).
  • Across town, colleges and universities were in the process of bringing back more than a million students. Wuhan has the second-highest number of students of any city in China, after Guangzhou.
  • Wuhan memories remained fresh, and the materials of documentation were also close at hand. People sometimes handed over manuscripts, and they took out their phones and pulled up photographs and messages from January and February. But I wondered how much of this material would dissipate over time.
  • In town, I met two Chinese journalists in their twenties who were visiting from out of town. They had been posted during the period of the sealed city: back then, anybody sent to cover events in Wuhan had to stay for the long haul.
  • One was a director of streaming media whom I’ll call Han, and he had found that government-run outlets generally wanted footage that emphasized the victory over the disease, not the suffering of Wuhan residents. Han hoped that eventually he’d find other ways to use the material. “It will be in the hard drive,” he said, tapping his camera.
  • After that, Yin reported on a number of issues that couldn’t be published or completed, and she often talked with scientists and officials who didn’t want to say too much. “One person said, ‘Ten years later, if the climate has changed, I’ll tell you my story,’ ” Yin told me. “He knew that he would be judged by history.” She continued, “These people are inside the system, but they also know that they are inside history.”
  • Such fare is much more popular in Guangdong, in the far south. It’s possible that the disease arrived from somewhere else and then spread in the wet, cool conditions of the fish stalls. A few Wuhan residents told me that a considerable amount of their seafood comes from Guangdong, and they suggested that perhaps a southerner had unwittingly imported the disease,
  • When I spoke with scientists outside China, they weren’t focussed on the government’s early missteps
  • In time, we will learn more, but the delay is important to the Communist Party. It handles history the same way that it handles the pandemic—a period of isolation is crucial. Throughout the Communist era, there have been many moments of quarantined history: the Great Leap Forward, the Cultural Revolution, the massacre around Tiananmen Square. In every case, an initial silencing has been followed by sporadic outbreaks of leaked information. Wuhan will eventually follow the same pattern, but for the time being many memories will remain in the sealed city.
  • Wafaa El-Sadr, the director of ICAP, a global-health center at Columbia University, pointed out that Chinese scientists had quickly sequenced the virus’s genome, which was made available to researchers worldwide on January 11th. “I honestly think that they had a horrific situation in Wuhan and they were able to contain it,” she said. “There were mistakes early on, but they did act, and they shared fast.”
  • For much of El-Sadr’s career, she has worked on issues related to AIDS in the United States, Africa, and elsewhere. After years of research, scientists eventually came to the consensus that H.I.V. most likely started through the bushmeat trade—the first human was probably infected after coming into contact with a primate or primate meat.
  • El-Sadr views the coronavirus as another inevitable outcome of people’s encroachment on the natural world. “We are now living through two concomitant massive pandemics that are the result of spillover from animal to human hosts, the H.I.V. and the COVID pandemics,” she wrote to me, in an e-mail. “Never in history has humanity experienced something along this scale and scope.”
  • There’s a tendency to believe that we would know the source of the coronavirus if the Chinese had been more forthcoming, or if they hadn’t cleaned out the Huanan market before stalls and animals could be studied properly.
  • Yiwu He, the chief innovation officer at the University of Hong Kong, told me that the C.N.B.G. vaccine has already been given to a number of Chinese government officials, under an emergency-use approval granted by the authorities. “I know a few government officials personally, and they told me that they took the vaccine,” he said, in a phone conversation. He thought that the total number was probably around a hundred. “It’s middle-level officials,” he said. “Vice-ministers, mayors, vice-mayors.”
  • Daszak believes the virus probably circulated for weeks before the Wuhan outbreak, and he doubts that the city was the source. “There are bats in Wuhan, but it was the wrong time of year,” he told me. “It was winter, and bats are not out as much.”
  • His research has indicated that, across Southeast Asia, more than a million people each year are infected by bat coronaviruses. Some individuals trap, deal, or raise animals that might serve as intermediary hosts. “But generally it’s people who live near bat caves,”
  • Daszak said that he had always thought that such an outbreak was most likely to occur in Kunming or Guangzhou, southern cities that are close to many bat caves and that also have an intensive wildlife trade.
  • He thinks that Chinese scientists are probably now searching hospital freezers for lab samples of people who died of pneumonia shortly before the outbreak. “You would take those samples and look for the virus,” he said. “They’ll find something eventually. These things just don’t happen overnight; it requires a lot of work. We’ve seen this repeatedly with every disease. It turns out that it was already trickling through the population.”
  • Daszak is the president of EcoHealth Alliance, a nonprofit research organization based in New York. EcoHealth has become the target of conspiracy theorists, including some who claim that the virus was man-made. Daszak and many prominent virologists say that anything created in a lab would show clear signs of manipulation.
  • There’s also speculation that the outbreak started when researchers accidentally released a coronavirus they were studying at the Wuhan Institute of Virology. But there’s no evidence of a leak, or even that the institute has ever studied a virus that could cause a COVID-19 outbreak.
  • “Scientists in China are under incredible pressure to publish,” Daszak said. “It really drives openness and transparency.”
  • He has spent a good deal of time in Wuhan, and co-authored more than a dozen papers with Chinese colleagues. “If we had found a virus that infected human cells and spread within a cell culture, we would have put the information out there,” he said. “In sixteen years, I’ve never come across the slightest hint of subterfuge. They’ve never hidden data. I’ve never had a situation where one lab person tells me one thing and the other says something else. If you were doing things that you didn’t want people to know about, why would you invite foreigners into the lab?”
  • In April, President Trump told reporters that the U.S. should stop funding research connected to the Wuhan Institute of Virology. Shortly after Trump’s comments, the National Institutes of Health cancelled a $3.7-million grant to EcoHealth, which had been studying how bat coronaviruses are transmitted to people.
  • I asked Daszak why, if he has such faith in the openness of his Wuhan colleagues, the Chinese government has been so closed about other aspects of the outbreak. He said that science is one thing, and politics something else; he thinks that officials were embarrassed about the early mistakes, and in response they simply shut down all information.
  • At the beginning of July, China National Biotec Group, a subsidiary of a state-owned pharmaceutical company called Sinopharm, completed construction of a vaccine-manufacturing plant in Wuhan. The project began while the city was still sealed. “That’s the politically correct thing to do,” a Shanghai-based biotech entrepreneur told me. “To show the world that the heroic people of Wuhan have come back.”
  • But Peter Daszak, a British disease ecologist who has collaborated with the Wuhan Institute of Virology for sixteen years on research on bat coronaviruses, told me that it’s typical to fail to gather good data from the site of an initial outbreak. Once people get sick, local authorities inevitably focus on the public-health emergency. “You send in the human doctors, not the veterinarians,” he said, in a phone conversation. “And the doctors’ response is to clean out the market. They want to stop the infections.”
  • Pharmaceutical executives have also been expected to lead the way, like the construction manager who donned P.P.E. in order to escort his workers into the patient ward. “Every senior executive at Sinopharm and C.N.B.G. has been vaccinated,” He said. “Including the C.E.O. of Sinopharm, the chairman of the board, every vice-president—everyone.” The Chinese press has reported that vaccinations have also been administered to hundreds of thousands of citizens in high-risk areas around the world.
  • In the West, China’s image has been badly damaged by the pandemic and by other recent events. The country has tightened political crackdowns in Hong Kong and Xinjiang, and, in May, after Australia called for an investigation into the origins of the virus, China responded furiously, placing new tariffs and restrictions on Australian goods ranging from barley to beef.
  • But He believes that the situation is fluid. “All of these feelings can turn around quickly,” he told me. “I think that once China has a vaccine, and if they can help other countries, it can make a huge difference.”
  • There’s also a competitive element. “China wants to beat America,” He said. He believes that the C.N.B.G. vaccine will receive some level of approval for public use by the end of October. “Chinese officials are thinking that Donald Trump might approve a U.S. vaccine before the election,” he said. “So their goal is to have a vaccine approved before that.”
  • No matter how quickly the Chinese develop a vaccine, or how effectively they have handled the pandemic since January, it’s unlikely to make Westerners forget the mistakes and misinformation during the pandemic’s earliest phase.
  • Some of this is due to a cultural difference—the Chinese response to errors is often to look forward, not back. On January 31st, Fang Fang commented in her diary, “The Chinese people have never been fond of admitting their own mistakes, nor do they have a very strong sense of repentance.” It’s often hard for them to understand why this quality is so frustrating for Westerners. In this regard, the pandemic is truly a mirror—it doesn’t allow the Chinese to look out and see themselves through the eyes of others.
  • The pandemic illuminates both the weaknesses and the strengths of the Chinese system, as well as the relationship between the government and the people. They know each other well: officials never felt the need to tell citizens exactly what happened in Wuhan, but they understood that American-level casualties would have been shocking—given China’s population, the tally would have been more than a million and counting.
  • In order to avoid death on that scale, the government also knew that people would be willing to accept strict lockdowns and contribute their own efforts toward fighting the virus.
  • In turn, citizens were skilled at reading their government. People often held two apparently contradictory ideas: that the Party lied about some things but gave good guidance about others. More often than not, citizens could discern the difference. During the pandemic, it was striking that, when the Chinese indulged in conspiracy theories, these ideas rarely resulted in personally risky behavior, as they often did in the U.S.
  • Perhaps the Chinese have been inoculated by decades of censorship and misinformation: in such an environment, people develop strong instincts for self-preservation, and they don’t seem as disoriented by social media as many Americans are.
  • Early in the year, I corresponded by WeChat with a Wuhan pharmacist who worked in a hospital where many were infected. On February 26th, he expressed anger about the early coverup. “My personal opinion is that the government has always been careless and suppressed dissent,” he wrote. “Because of this, they lost a golden opportunity to control the virus.”
  • In Wuhan, we met a few times, and during one of our conversations I showed him what he had written in February. I asked what he would do now if he found himself in Li Wenliang’s position, aware of an outbreak of some unknown disease. Would he post a warning online? Contact a health official? Alert a journalist?The pharmacist thought for a moment. “I would tell my close friends in person,” he said. “But I wouldn’t put anything online. Nothing in writing.”
  • I asked if such an event would turn out differently now.“It would be the same,” he said. “It’s a problem with the system.”
  • He explained that, with an authoritarian government, local officials are afraid of alarming superiors, which makes them inclined to cover things up. But, once higher-level leaders finally grasp the truth, they can act quickly and effectively.
Javier E

Which States Have Coronavirus Travel Restrictions? - The Atlantic - 0 views

www.theatlantic.com/...617321

quarantine

shared by Javier E on 10 Dec 20 - No Cached
  • Hawaii has one of the strictest quarantine laws in the country.
  • The state’s geographic isolation has helped and hurt its efforts to control the virus. On one hand, the state would be completely unequipped to deal with a coronavirus surge. There are no states nearby from which to borrow doctors or ICU capacity. The island of Kauai has just 15 ventilators. On the other hand, everyone enters Hawaii through its airports, which makes enforcing a quarantine easier there than in almost every other state.
  • There’s no national database of quarantine noncompliance, but in U.S. states other than Hawaii, quarantine violations rarely result in fines or jail time—or, really, any consequences at all,
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  • Yet quarantine compliance is essential for the combination of testing, contact tracing, and isolation of sick people to work. Simply telling people they’ve been exposed and letting them loose on the nation’s Outback Steakhouses is not sufficient
  • Public-health departments are reluctant to seem like bad cops—or cops at all.
  • Hawaii created its quarantine law as a travel quarantine, stopping everyone at the airport. These types of quarantines are logistically easier to implement—they don’t require contact tracers—than medical quarantines, in which the state orders a certain individual to stay in isolation
  • Some other countries have imposed much tougher travel restrictions and quarantine policies. At one point, Greeks were required to text authorities to explain why they needed to go out. Norway quarantined its own citizens under threat of a fine or imprisonment. Most foreigners still can’t fly to Vietnam.
  • Keen believes that Hawaii residents are on such high alert because of long-ago pandemics that came to the islands and killed large percentages of the population
  • “Generations of stories you hear, from great-grandparents, grandparents, parents, that the pandemics nearly killed off Native Hawaiians,” she told me. “So there is a great fear here of outsiders coming in and bringing it with them.”
  • On the mainland, states cite a combination of COVID-19 denial, logistical hurdles, and funding and personnel shortages to explain why they haven’t been willing or able to enforce quarantines.
  • scofflaws: Some people stay inside for three or four days, then decide, “I’m bored with staying home,”
  • Even if a North Dakotan wants to do the right thing, she might not be able to without going hungry or losing her job. Grocery delivery isn’t available in parts of the large and rural state
  • Some states can’t quarantine people, because they have too many cases to trace
  • In fact, many COVID-exposed Americans who want to stay home and quarantine have an intractable problem: Their bosses won’t let them
  • The Families First Coronavirus Response Act granted paid leave to recover from COVID-19 to many Americans. But the law doesn’t cover everyone: Large companies aren’t included, and small companies can claim an exemption. Because of these exemptions, only 47 percent of private-sector workers have guaranteed access to coronavirus-related sick leave,
  • The U.S. is the only country out of 193 nations to exclude workers from sick-leave benefits based on the size of the company they work for, according to a recent UCLA study.
  • “We don’t really pay people to stay at home to quarantine,” Polly Price, a global-health professor at Emory University, says. But that’s exactly the problem: In a study in Israel, people were more likely to quarantine after exposure to COVID-19 if they were paid during their isolation.
  • Months into the pandemic, half of Americans didn’t know they might have the right to stay home with pay if they contracted the coronavirus.
  • even if they did, employers might have pressured them to come to work if they were no longer showing symptoms,
  • “After testing positive, employees are being scheduled and expected to work as long as they don’t show symptoms and [are] not placed in quarantine,” a worker at a Georgia taco restaurant complained in July. OSHA has formally inspected just 11 of the employers in these incidents. “Under the Trump administration, OSHA decided to do almost no enforcement,”
  • America’s laissez-faire federal pandemic response has, in effect, treated each state like its own country
  • When it comes time to isolate sick people, though, it becomes painfully clear that states aren’t countries. Wisconsin can’t stop Iowans from driving into it. North Dakota doesn’t have enough health workers to trace all of its infected citizens. The governor can’t help you when your employer is—legally—dragging you back into the office.
  • the reason Hawaii has been so ruthlessly effective at quarantine is that it in some ways still acts as its own country with its own border controls.
  • The state consistently has some of the lowest case numbers in the nation. As with so many other pandemic rules, Americans might not like quarantine, but it works.
Javier E

What Hannah Arendt's Work Tells Us About Ukraine - The Atlantic - 0 views

www.theatlantic.com/...627081

authoritarian isolation human rights citizenship autocracy Arendt

shared by Javier E on 19 Mar 22 - No Cached
  • The toxic nationalism and open racism of Nazi Germany, only recently defeated; the Soviet Union’s ongoing, cynical attacks on liberal values and what it called “bourgeois democracy”; the division of the world into warring camps; the large influx of refugees; the rise of new forms of broadcast media capable of pumping out disinformation and propaganda on a mass scale; the emergence of an uninterested, apathetic majority, easily placated with simple bromides and outright lies; and above all the phenomenon of totalitarianism, which she described as an “entirely new form of government”—all of these things led Arendt to believe that a darker era was about to begin.
  • Once again, we are living in a world that Arendt would recognize, a world in which it seems “as though mankind had divided itself between those who believe in human omnipotence (who think that everything is possible if one knows how to organize masses for it) and those for whom powerlessness has become the major experience of their lives”
  • In the totalitarian world, trust has dissolved. The masses “believe everything and nothing, think that everything was possible and that nothing was true.”
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  • because Arendt feared for the future, much of The Origins of Totalitarianism was in fact focused on an excavation of the past.
  • the principle that led her down this path remains important: To grapple with a broad social trend, look at its history, try to find its origins, try to understand what happened when it last appeared, in another country or another century
  • To explain Nazi anti-Semitism, Arendt reached back not only to the history of the Jews in Germany but also to the history of European racism and imperialism, and to the evolution of the notion of the “rights of man”—which we now more commonly speak of as “human rights.” To have such rights, she observed, you must not only live in a state that can guarantee them; you must also qualify as one of that state’s citizens.
  • the questions Arendt asks remain absolutely relevant today. She was fascinated by the passivity of so many people in the face of dictatorship, by the widespread willingness, even eagerness, to believe lies and propaganda
  • it offers us a kind of dual methodology, two different ways of thinking about the phenomenon of autocracy.
  • To explain this phenomenon, Arendt zeroes in on human psychology, especially the intersection between terror and loneliness. By destroying civic institutions, whether sports clubs or small businesses, totalitarian regimes kept people away from one another and prevented them from sharing creative or productive projects.
  • when each person felt himself isolated from the rest, resistance became impossible. Politics in the broadest sense became impossible too: “Terror can rule absolutely only over men who are isolated against each other … Isolation may be the beginning of terror; it certainly is its most fertile ground; it always is its result.”
  • it is impossible not to wonder whether the nature of modern work and information, the shift from “real life” to virtual life and the domination of public debate by algorithms that increase emotion, anger, and division, hasn’t created some of the same results
  • In a world where everyone is supposedly “connected,” loneliness and isolation once again are smothering activism, optimism, and the desire to participate in public life.
  • he 20th-century totalitarian model has not been banished; it can be brought back, at any place and at any time.
  • The Origins of Totalitarianism does not contain a set of policy prescriptions, or directions on how to fix things. Instead it offers proposals, experiments, different ways to think about the lure of autocracy and the seductive appeal of its proponents as we grapple with them in our own time
jlessner

Racial Isolation in Public Schools - NYTimes.com - 0 views

www.nytimes.com/...olation-in-public-schools.html

schools isolation US education

shared by jlessner on 10 Jan 15 - No Cached
  • New York’s schools are the most segregated in the nation, and the state needs remedies right away.
  • Minority children are disproportionately trapped in schools that lack the teaching talent, course offerings and resources needed to prepare them for college and success in the new economy.
  • It has a moral obligation to ensure that as many children as possible escape failing schools for ones that give them a fighting chance. And history has shown that districts can dramatically improve educational opportunities for minority children — and reduce racial isolation — with voluntary transfer plans and especially with high-quality magnet schools that attract middle-class families.
  • ...1 more annotation...
  • Today nearly half the city’s public schools either have low graduation rates or rank in the bottom 5 percent of state schools in math and English.
nrashkind

Quarantine: How to prepare to isolate due to possible coronavirus infection - CNN - 0 views

www.cnn.com/...index.html

shared by nrashkind on 29 Mar 20 - No Cached
  • It's a scenario all too many of us are facing -- or will soon face.
  • You or a loved one has a mild fever, body aches, the start of a nagging, dry cough. Food doesn't taste good nor smell as it once did. Maybe you have shortness of breath or struggle to breath deeply.
  • The rest of us with symptoms but no additional known risk factors will also certainly be told to stay home, rest and drink plenty of fluids, all while keeping a close eye on how we feel.
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  • Preparation is the key to a good plan.
  • Hopefully, you've been following standard hygiene practices. These are behaviors we should be doing daily, automatically, to protect ourselves from germs, colds and flu:
  • Avoid touching your eyes, nose and mouth with unwashed hands; cough and sneeze into elbows or tissues that you immediately throw away, and regularly wash, wash, wash those hands with warm water and lots of soapy bubbles.
  • Parents and guardians should plan well in advance by setting up a structure in which all kids and potential caregivers know their roles and expectations, said pediatrician Dr. Tanya Altmann, Editor-in-Chief of the American Academy of Pediatrics' book "Caring for Your Baby and Young Child: Birth to Age 5 and The Wonder Years."
  • A working thermometer to monitor fever, which is considered to be 100 degrees Fahrenheit (37.7 degrees Celsius), and a method to clean it, such as Isopropyl alcohol.
  • Fever reducing medications, such as acetaminophen.
  • Regular soap and 70% alcohol-based hand sanitizer (antibacterial soap isn't necessary if you wash properly, and that way you won't will contribute to the world's growing antibiotic-resistant superbugs).
  • Tissues to cover sneezes and coughs. But there's really no need to hoard toilet paper -- this is a respiratory disease.
  • Regular cleaning supplies, kitchen cleaning gloves and trash can liners.
  • Disinfectant cleaning supplies -- the CDC suggests picking from a list that meets the virus-fighting standards of the US Environmental Protection Agency, but says you can also make your own version by using 1/3 cup unexpired bleach per gallon of water or 4 teaspoons bleach per quart of water. Never mix bleach with ammonia or any other cleanser -- it produces toxic gases.
  • If you live alone, that's not difficult. Your challenge is to monitor your symptoms and care for yourself when you're not feeling well. Be sure to have a plan in place to deliver food and medications, and find someone who can be responsible for virtually checking in on you on a regular basis.
  • The rest of the family should practice isolation as well, Radesky added.
  • If you are running short on face masks, or don't have any because of hoarding, try to protect the caregiver as best you can, the CDC says.
  • Altmann stresses maximizing isolation and protective actions.
  • "You can have a healthy person leave the sick one food and drinks at the door, and then go wash their hands," Altmann explained. "Wear gloves to pick up the empty plates, take them back to the kitchen and wash them in hot water with soap, or preferably with a dishwasher, and wash your hands again."
  • One last, very important thing: Call 911 immediately if you or your loved ones have any of these symptoms: increased or sudden difficulty breathing or shortness of breath; a persistent pain or pressure in the chest; and any sign of oxygen deprivation, such as new confusion, bluish lips or face, or you can't arouse the sick person.
  • To be clear: Everyone in the house needs to isolate themselves from the outside world as much as possible.
Javier E

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

www.theatlantic.com/...608719

strategies effects pandemic culture politics history crisis

shared by Javier E on 25 Mar 20 - No Cached
  • 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

How local officials scrambled to protect themselves against the coronavirus - The Washington Post - 0 views

www.washingtonpost.com/...virus-local-officials-response

officials local pandemic crisis trump policy

shared by Javier E on 30 Mar 20 - No Cached
  • Across the country, state and local officials, frustrated by what they described as a lack of leadership in the White House and an absence of consistent guidance from federal agencies, took steps on their own to prepare for the pandemic and protect their communities. In some cases, these actions preceded federal directives by days or even weeks as local officials sifted through news reports and other sources of information to educate themselves about the risks posed by the coronavirus.
  • With scant information about the virus and no warnings against large gatherings, cities such as New Orleans moved ahead in February with massive celebrations that may have turned them into hotspots for the virus.
  • “The leader in global pandemics and protecting the United States starts at the federal level,” said Nick Crossley, the director of emergency management in Hamilton County, Ohio, and past president of the U.S. Council of International Association of Emergency Managers.
  • ...47 more annotations...
  • He praised Republican Gov. Mike DeWine for taking bold steps early, including declaring a state of emergency when there were only three reported cases on March 9, four days before the federal government followed suit. Thirty states had declared a state of emergency by the time Trump declared a national emergency on March 13.
  • “They didn’t move fast enough,” said Crossley, of the federal government. “And what you’ve seen is more local and state officials sounding the alarm. “We needed a national response to this event.”
  • With seven reported infections in the United States by the end of the day, Health and Human Services Secretary Alex Azar declared a public health emergency on Jan. 31, and Trump announced strict travel restrictions, barring most foreign visitors coming from China. He also imposed the nation’s first mandatory quarantine in 50 years.
  • Officials spent three hours war-gaming how they would respond. The drill prompted the state to send 300 employees home early to test their remote work capability. That unmasked a serious problem: A quarter of the team could not perform their jobs at home because they needed access to secure computer systems.
  • Then he heard the news: The United States had identified its first case of person-to-person transmission involving someone who had not traveled overseas. Also, the World Health Organization classified the coronavirus as a public health emergency of international concern.
  • Chicago Jan. 31: 9,927 cases worldwide, seven cases in the United States
  • Tallahassee Jan. 30: 8,234 cases worldwide, five cases in the United States
  • “We are concerned about our public health system’s capacity to implement these measures, recognizing they may inadvertently distract us from our ongoing tried-and-true efforts to isolate confirmed cases and closely monitor their contacts,” according to a previously unreported Feb. 6 letter. “We also worry about the potential to again overwhelm laboratory capacity, recognizing that national capacity has not been adequate to quickly test our highest-risk individuals.”
  • “In the first few sets of conversations, we were not hearing answers to those questions,” Lightfoot, a Democrat, said of her talks with federal officials. “It was kind of like, either silence, or ‘Do the best you can,’ which was obviously not acceptable.”
  • she drafted a letter to Trump on behalf of the mayors from Detroit, Los Angeles, New York, San Francisco and Seattle. They insisted on clear, written directions from the federal government, according to the letter, and worried about diverting health-care resources during flu season, when hospitals were already stretched.
  • Americans who had visited China’s Hubei province would be forced to quarantine for 14 days, and those who visited other parts of China would be screened for symptoms and asked to isolate themselves for two weeks. Chicago Mayor Lori Lightfoot was caught off guard. The directive came with little guidance. Where were local governments supposed to quarantine the travelers? What would they do if someone refused to quarantine? Who was going to pay for the resources needed to quarantine people?
  • Mount Kisco, N.Y. Feb. 9: 40,150 cases worldwide, 11 cases in the United States
  • Weeks earlier, Amler had started fitting employees for personal protective equipment and training them on how to use the gear. In January, she watched what was happening in Wuhan with growing concern: “It seemed impossible that it wouldn’t eventually spill out of China into the rest of the world.”
  • San Francisco Feb. 24: 79,561 cases worldwide, 51 cases in the United States
  • Trump continued to reassure the public that there was little to worry about. On Feb. 24, he tweeted, “The Coronavirus is very much under control in the USA.”
  • But Colfax and his public health staff in San Francisco were seeing something else when they studied the “curves” of the pandemic — graphs showing how many cases were reported in other regions over time.
  • Wuhan’s curve was climbing exponentially, and other countries, such as Italy, were seeing soaring infection rates as well. Colfax noticed that in every infected region, officials were more and more aggressive about restricting their populations
  • “It became apparent that no jurisdiction that was where the virus was being introduced, was sort of, in retrospect, thinking, ‘Oh, we overreacted,’ ” Colfax said.
  • On Feb. 24, Colfax and other health officials assembled their research and met with Mayor London Breed. They made an urgent request: Declare a state of emergency
  • by the end of the meeting, Breed was convinced. They needed to declare a state of emergency so that they could tap into state and federal funds and supplies, and redeploy city employees. The next day, San Francisco became one of the first major cities in the United States to do so, after Santa Clara and San Diego counties did earlier in the month.
  • It would take another 17 days, as the virus infected people in nearly every state, before Trump declared a national emergency.
  • In New Orleans, officials moved ahead with Mardi Gras festivities in late February that packed people into the streets. It was a decision the mayor would later defend as coronavirus cases traced to the celebration piled up.
  • On Feb. 27, at a White House reception, Trump predicted that the coronavirus would disappear. “Like a miracle,” he said.
  • “No red flags were given,” by the federal government, New Orleans Mayor LaToya Cantrell, a Democrat, later said in a CNN interview. “If we were given clear direction, we would not have had Mardi Gras, and I would’ve been the leader to cancel it.
  • San Antonio Feb. 29: 86,011 cases worldwide, 68 cases in the United States
  • The last day of February marked a major turning point for the coronavirus in the United States: The first American who had been diagnosed with the illness died
  • In a Saturday news conference, Trump described the patient from the Seattle area as a “medically high-risk” person who had died overnight. A CDC official said that the man, who was in his 50s, had not traveled recently — another sign that the virus was snaking through local communities.
  • During the announcement, Trump asked the media to avoid inciting panic as there was “no reason to panic at all.”
  • “We’re doing really well,” he said. “Our country is prepared for any circumstance. We hope it’s not going to be a major circumstance, it’ll be a smaller circumstance. But whatever the circumstance is, we’re prepared.”
  • That same afternoon in San Antonio, the CDC mistakenly released a woman from quarantine who was infected. The woman was one of dozens of evacuees from Wuhan whom the federal government had brought to a nearby military base and then isolated at the Texas Center for Infectious Disease.
  • the woman had been dropped off at a Holiday Inn near the San Antonio airport and headed to a mall where she shopped at Dillard’s, Talbots and Swarovski and ate in the food court.
  • As local officials learned details about the infected woman’s movements and how she had been transported at 2 a.m. back to the Texas Center for Infectious Disease, they waited for the CDC to issue a statement. Hours passed, but they heard nothing. “They were like quiet little mouses,” Wolff said. “They were all scared to talk because I think they felt they were going to get in trouble with the president of the United States because he was saying there was not a problem.”
  • The next day, San Antonio officials declared a public health emergency and filed a lawsuit to prevent the CDC from releasing the 120 people in quarantine until they were confirmed negative for the virus or completed a 28-day quarantine. A judge denied the motion, but the CDC agreed that evacuees must have two consecutive negative tests that are 24 hours apart and that no one with a pending test can be released.
  • In Oklahoma City, the coronavirus became a reality for Mayor David Holt, a Republican, when the NBA abruptly canceled a Thunder basketball game after a Utah Jazz player tested positive on March 11. Until then, Holt said, the coronavirus felt “distant on many levels.”
  • Mount Kisco, N.Y. March 3: 92,840 cases worldwide, 118 cases in the United States
  • Within days, state authorities set up an emergency operations center in New Rochelle and created a one-mile containment zone. Inside the perimeter, schools and community centers shuttered and large gatherings were prohibited.
  • Through it all, local officials faced backlash from some community leaders who thought they were overreacting.
  • San Francisco March 5: 97,886 cases worldwide, 217 cases in the United States
  • Days after San Francisco’s emergency declaration, Breed stood in front of news cameras to announce the city’s first two cases of the coronavirus.
  • They were not related, had not traveled to any coronavirus-affected areas and had no contact with known coronavirus patients: It was spreading in the community.
  • By then, Miami Mayor Francis X. Suarez, a Republican, had announced the cancellation of the Ultra Music festival, a three-day celebration that draws about 50,000 people. Miami was the first city to call off a major music festival, and Suarez faced tremendous backlash
  • When he tried to order more masks, none were immediately available. By then the entire country was scrambling for protective gear.
  • Days later, Holt huddled on the phone with other leaders from the United States Conference of Mayors. For about 20 minutes, Seattle Mayor Jenny Durkan, a Democrat, detailed the crisis seizing her city
  • “She sounded like the main character in a Stephen King novel,” Holt recalled. “She had hundreds of cases, she had dozens of deaths.”
  • “Any struggles that we’re having, whether it be testing or other issues, or even just convincing our public of the seriousness of the matter, there are some roots back to the time period in January and February, when not all national leadership was expressing how serious this was,” Holt said.
  • While the mayors held their conference call on March 13, Trump declared a national emergency to combat the coronavirus.
  • By then, Suarez had tested positive for the coronavirus and was in quarantine. As of Sunday, he remained in isolation, leading the city by phone calls and video chats. He wanted to stop flights into Miami and the governor to order residents to shelter in place as California and other states had already done.
Javier E

We could stop the pandemic by July 4 if the government took these steps - The Washington Post - 0 views

www.washingtonpost.com/...a-9f5e-56d8239bf9ad_story.html

pandemic government testing strategies

shared by Javier E on 18 May 20 - No Cached
  • We, too, favor markets and share the president’s eagerness to stop economically ruinous shutdowns.
  • the choice between saving lives and saving the economy, the latter of which Trump has endorsed implicitly, is a false one.
  • In fact, framing the issue that way could kill many Americans and kill the economy.
  • ...21 more annotations...
  • in a pandemic, encouraging the sick to haul themselves into work can be disastrous. The plan backfired. Hundreds of Smithfield employees were infected, forcing the plant to shut down for more than three weeks. If we stay the current course, we risk repeating the same mistake across the whole economy.
  • The economy consists of people who have hopes and fears. As long as they are afraid of a lethal virus, they will avoid restaurants, travel and workplaces.
  • The only way to restore the economy is to earn the confidence of both vulnerable industries and vulnerable people through testing, contact tracing and isolation.
  • To pull off this balancing act, the country should be divided into red, yellow and green zones. The goal is to be a green zone, where fewer than one resident per 36,000 is infected.
  • Here, large gatherings are allowed, and masks aren’t required for those who don’t interact with the elderly or other vulnerable populations.
  • Two weeks ago, a modest 1,900 tests a day could have kept 19 million Americans safely in green zones. Today, there are no green zones in the United States.
  • Most Americans — about 298 million — live in yellow zones, where disease prevalence is between .002 percent and 1 percent
  • even in yellow zones, the economy could safely reopen with aggressive testing and tracing, coupled with safety measures including mandatory masks.
  • Today, 30 million Americans live in such hot spots — which include Detroit, New Jersey, New Orleans and New York City.
  • A disease prevalence greater than 1 percent defines red zones.
  • In addition to the yellow-zone interventions, these places require stay-at-home orders.
  • by strictly following guidelines for testing and tracing, red zones could turn yellow within four weeks, moving steadfastly from lockdown to liberty.
  • Getting to green nationwide is possible by the end of the summer, but it requires ramping up testing radically. The United States now administers more than 300,000 tests a day, but according to our guidelines, 5 million a day are needed (for two to three months)
  • Researchers estimate that the current system has a latent capacity to produce 2 million tests a day, and a surge in federal funding would spur companies to increase capacity. The key is to do it now, before manageable yellow zones deteriorate to economically ruinous red zones.
  • States can administer these “test, trace and supported isolation” programs — but Congress would need to fund them. The total cost, we estimate, is $74 billion, to be spent over 12 to 18 months
  • That amount is a lot, but not compared to the cost of a crippled economy. In Congress’s latest relief package, $75 billion went to struggling hospitals alone, $380 billion to help small businesses and $25 billion toward testing.
  • Economists talk about “multipliers” — an injection of spending that causes even larger increases in gross domestic product. Spending on testing, tracing and paid isolation would produce an indisputable and massive multiplier effect.
  • Nations that have invested the most in disease control have suffered the least economic hardship: Taiwan grew 1.5 percent in the first quarter, whereas the United States’ gross domestic product contracted by 4.8 percent
  • Looking forward, we will see stark economic contrasts across states, depending on their investment in disease control.
  • When local and state governments become accountable for adopting strategies that work, we can expect more innovation.
  • How do we know that testing, tracing and supported isolation would work? It already has worked in New Zealand, South Korea and Taiwan
katherineharron

Fact checking the outlandish claim that millions of Trump votes were deleted - CNNPolitics - 0 views

www.cnn.com/...index.html

election

shared by katherineharron on 13 Nov 20 - No Cached
  • A human error that briefly led to incorrect election results in a Michigan county has spiraled into a sprawling, baseless conspiracy theory suggesting that glitches in widely-used voting software led to millions of miscast ballots.
  • Conservative media figures, social media users, and President Donald Trump have spread rumors about problems with Dominion Voting Systems
  • They've claimed that isolated reports about Election Night glitches raise concerns about election results in states around the country.
  • ...16 more annotations...
  • "DOMINION DELETED 2.7 MILLION TRUMP VOTES NATIONWIDE," Trump tweeted on Thursday, citing a report from the right-wing One America News Network. Without showing any evidence, he claimed that states using the company's technology had "SWITCHED 435,000 VOTES FROM TRUMP TO BIDEN."
  • Trump's tweet is completely without evidence.
  • "No credible reports or evidence of any software issues exist," the company wrote. "While no election is without isolated issues, Dominion Voting Systems are reliably and accurately counting ballots. State and local election authorities have publicly confirmed the integrity of the process."
  • the network claims to have proof of widespread voter fraud but is choosing to sit on that proof for more than a week.
  • Giuliani has claimed to have received an affidavit from someone "inside" Dominion who alleges that batches of "phony" pro-Biden ballots were counted. Giuliani hasn't released any evidence.
  • Dominion, a Canadian company founded in 2002 with US headquarters in Denver, is the second-largest provider of voting technology in the US, according to a 2017 report from the University of Pennsylvania's Wharton Public Policy Initiative. In 2016, Dominion's technology was used in 1,635 jurisdictions in more than two dozen states, the report found
  • Further undermining Trump's claims was the fact that hours after his tweet, federal government agencies released a statement declaring that "the November 3rd election was the most secure in American history."
  • The county's initial results showed Joe Biden leading, and election officials quickly realized on election night that something was wrong with their results, the local clerk told the Detroit Free Press last week.
  • The county uses Dominion's technology to tally ballots, but the mistake was due to human error and not the company's systems, according to the Michigan Secretary of State.
  • "This was an isolated error, there is no evidence this user error occurred elsewhere in the state, and if it did it would be caught during county canvasses, which are conducted by bipartisan boards of county canvassers," the secretary of state's office said in its statement.
  • Other rumors pointed to Oakland County, Michigan, a suburb of Detroit, where initial results mistakenly double-counted votes from the city of Rochester Hills, according to the secretary of state's office. But that was due to human error, not a software issue, the local clerk said.
  • "As a Republican, I am disturbed that this is intentionally being mischaracterized to undermine the election process," Tina Barton, the clerk of Rochester Hills, Michigan, said
  • But online, right-wing voices -- including Giuliani, Eric Trump, conservative Arizona Rep. Paul Gosar and Breitbart News -- have seized on those isolated issues as purported evidence of wider "glitches" with Dominion's software.
  • "It really does feel like people believe what they want to believe," he said. "I don't think I've ever seen it quite like this before."
  • Social media posts have also baselessly alleged ties between Dominion and Democratic leaders, misinformation that was first noted and debunked by The Associated Press.
  • Several Twitter posts that have been retweeted thousands of times have claimed that the company is involved with the Clinton Foundation. But while Dominion did agree to donate its technology to "emerging democracies" as part of a program run by the Clinton Foundation in 2014, according to the foundation's website, Dominion said in its statement that it has "no company ownership relationships" with the foundation.
peterconnelly

Two maps show NATO's growth and Russia's isolation since 1990 - 0 views

www.cnbc.com/...wing-isolation-since-1990.html

maps russia isolation nato

shared by peterconnelly on 04 Jun 22 - No Cached
  • Russia has become increasingly isolated from the rest of Europe over the last 30 years, and maps of the continent illustrate just how drastic the change has been.
  • Russia first attacked Ukraine in 2014, after a civilian uprising ejected a pro-Russia leader from the country. Ukraine sought military training and assistance from Western countries afterward but had not been admitted to NATO.
  • Countries in NATO are bound by treaty to defend each other. Like Ukraine, Finland shares a long border with Russia.
  • ...4 more annotations...
  • Though Sweden and Finland want to join their Nordic
  • neighbors in NATO,
  • admission
  • could take many months or be blocked entirely.
Javier E

Life Is Worse for Older People Now - The Atlantic - 0 views

www.theatlantic.com/...673507

agism age health culture crisis policy history pandemic

shared by Javier E on 25 Mar 23 - No Cached
  • A major reason older people are still at risk is that vaccines can’t entirely compensate for their immune systems. A study recently published in the journal Vaccines showed that for vaccinated adults ages 60 and over, the risk of dying from COVID versus other natural causes jumped from 11 percent to 34 percent within a year of completing their primary shot series
  • A booster dose brings the risk back down, but other research shows that it wears off too. A booster is a basic precaution, but “not one that everyone is taking,”
  • Unlike younger people, most of whom fully recover from a bout with COVID, a return to baseline health is less guaranteed for older adults. In one study, 32 percent of adults over 65 were diagnosed with symptoms that lasted well beyond their COVID infection
  • ...11 more annotations...
  • For every COVID death, many more older people develop serious illness. Risk increases with age, and people older than 70 “have a substantially higher rate of hospitalizations” than those ages 60 to 69,
  • Where America has landed is hardly a new way of life but rather one that is simply more onerous. “One way to think about it is that this is a new risk that’s out there” alongside other natural causes of death, such as diabetes and heart failure,
  • The antiviral Paxlovid was supposed to help blunt the wave of old people falling sick and ending up in the hospital—and it can reduce severe disease by 50 to 90 percent. But unfortunately, it is not widely used; as of July, just a third of Americans 80 or older took Paxlovid.
  • The reality is that as long as the virus continues to be prevalent, older Americans will face these potential outcomes every time they leave their home. That doesn’t mean they will barricade themselves indoors, or that they even should. Still, “every decision that we make now is weighing that balance between risk and socialization,”
  • Persistent coughs, aches, and joint pain can linger long after serious illness, together with indirect impacts such as loss of muscle strength and flexibility, which can affect older people’s ability to be independent, Rivers said. Older COVID survivors may also have a higher risk of cognitive decline. In some cases, these ailments could be part of long COVID, which may be more prevalent in older people.
  • Before the pandemic, the association between loneliness and higher mortality rates, increased cardiovascular risks, and dementia among older adults was already well established. Increased isolation during COVID amplified this association.
  • Even older adults who have weathered the direct and indirect effects of the pandemic still face other challenges that COVID has exacerbated. Many have long relied on personal caregivers or the staff at nursing facilities. These workers, already scarce before the pandemic, are even more so now because many quit or were affected by COVID themselves
  • “Long-term care has been in a crisis situation for a long time, but it’s even worse now,” Muramatsu said, noting that many home care workers are older adults themselves
  • Older people won’t have one single approach to contending with this sad reality. “Everybody is trying to figure out what is the best way to function, to try to have some level of everyday life and activity, but also keep your risk of getting sick as low as possible,”
  • Again, many of these people did not have it great before the pandemic, even if the rest of the country wasn’t paying attention. “We often don’t provide the basic social support that older people need,” Kenneth Covinsky, a clinician-researcher at the UCSF Division of Geriatrics, said. Rather, ageism, the willful ignorance or indifference to the needs of older people, is baked into American life.
  • It is perhaps the main reason older adults were so badly affected by the pandemic in the first place, as illustrated by the delayed introduction of safety precautions in nursing homes and the blithe acceptance of COVID deaths among older adults. If Americans couldn’t bring themselves to care at any point over the past three years, will they ever?
cjlee29

Warning of ISIS Plots Against West, U.S. Plans Assault on Raqqa - The New York Times - 0 views

www.nytimes.com/...raqqa-syria-islamic-state.html

shared by cjlee29 on 27 Oct 16 - No Cached
  • The fight to retake Raqqa, the Syrian city that serves as the capital of the Islamic State, must begin soon — within weeks — to disrupt planning believed to be underway there to stage terrorist attacks on the West
  • “sense of urgency.
  • isolate the city begin soon to prevent attacks on the West that could be launched or planned from the militants’ capital.
  • ...14 more annotations...
  • American officials are sweeping aside objections from Turkey and moving forward with plans to rely on a ground fighting force that includes Kurdish militia fighters in Syria.
  • Kurdish militia fighters will be a part of the ground force used to isolate Raqqa.
  • An American military official said the Raqqa operation would take place in roughly three phases.
  • Kurdish militia will make up the bulk of the operation, General Townsend said many of the more than 300 American Special Operations forces now in Syria would help recruit, train and equip local forces in and around Raqqa who are predominantly Syrian Arabs.
  • neither the Turks nor the Syrian Kurds view the recapture of Raqqa as one of their top priorities — unlike Washington.
  • American military officials say the Y.P.G. personnel are the best fighters they have.
  • begin within weeks.
  • Phase one, he said, is what the American-led coalition fighting the Islamic State has been doing for months:
  • Phase two, to begin in the coming weeks, will be to isolate Raqqa with the available forces
  • Phase three will be the fight for Raqqa itself, which American officials say they hope will be conducted mostly by Syrian Arabs, given that the city is majority Sunni Arab.
  • Manbij was the last stop on the route out of Syria for Islamic State militants headed to Europe.
  • Coming out of Manbij, we found links to individuals and plot streams to France, the United States, other European countries,” he said.
  • The Raqqa fight will take place even as the fight for Mosul, next door in
  • Iraq, is continuing, American military planners say.
Grace Gannon

How North Korea Became So Isolated - 0 views

www.huffingtonpost.com/...story-isolation_n_5991000.html

North Korea isolation international relations war

shared by Grace Gannon on 23 Oct 14 - No Cached
  • Grace Gannon on 23 Oct 14
     
    As one of the most isolated countries in the world, this article looks into the many factors that have contributed to this title. Citizens of North Korea are incredibly restricted in their abilities to interact with the outside world; this traces back to the Choson dynasty's decision to keep NK separate from the rest of the world. Additionally, ensuing wars have only added to the reclusion of the country. With a history of isolationism, it is unlikely that North Korea will be welcomed back into the international playground.
sarahbalick

Osama bin Laden: In final days, he was isolated - CNN.com - 0 views

www.cnn.com/...index.html

osama days

shared by sarahbalick on 03 Mar 16 - No Cached
  • An isolated Osama bin Laden struggled to keep his bodyguards
  • In the last months of his life, an isolated Osama bin Laden was in a serious dispute with the two brothers who had been pretty much his only connection to the outside world for the previous eight years.
  • Worried about the CIA hunting for him, bin Laden was confined to one building inside the large compound in Abbottabad, which the brothers had moved him to in 2005.
  • ...5 more annotations...
  • Crucially, it was one of the brothers who was the courier who delivered messages to and from al Qaeda's leader to senior members of al Qaeda living in other parts of Pakistan.
  • According to letters released Tuesday by the U.S. Office of the Director of National Intelligence that were recovered during the SEAL raid, by early 2011 the brothers were fed up with all the pressure that came from protecting and serving the world's most wanted man.
  • Bin Laden confided to one of his wives that the brothers who protected him were "exhausted" by all the pressures on them and were planning to quit.
  • In the letter bin Laden said the brothers had been so "irritated" in a recent meeting with him that he was resorting to writing them a letter to clarify matters. He asked the brothers to give him adequate time to find substitute protectors
  • But the new documents underline the fact that if the CIA had learned of the compound in Abbottabad later than it did, or if President Obama had not ordered the SEAL raid when he did, it's quite possible that bin Laden could have left for another location and the trail that led the CIA to his Abbottabad compound might have gone cold.
brookegoodman

Millions to need food aid in days as virus exposes UK supply | World news | The Guardian - 0 views

www.theguardian.com/...ays-as-virus-exposes-uk-supply

crisis

shared by brookegoodman on 27 Mar 20 - No Cached
  • Millions of people in the UK will need food aid in the coming days, food charities are warning, as the coronavirus outbreak threatens to quickly spiral into a crisis of hunger unless the government acts immediately to reinvent the way we feed ourselves.
  • Supermarket distribution systems, based on “just in time” supply chains, are struggling to cope with a sudden surge in demand since Covid-19 took hold. The most pressing concern is finding a way to feed the country’s most vulnerable and isolated people.
  • Anna Taylor, the Food Foundation’s director, said that between 4 million and 7 million people in lower risk categories are also affected by severe food insecurity or loneliness, so having to self-isolate could tip them into crisis.
  • ...9 more annotations...
  • Tim Lang, professor of food policy at City University, London, and a former government adviser, said ministers have worked on the assumption that feeding Britain can be left to the market and big retailers. While ministers have been in discussion with supermarket chief executives during the pandemic, Lang argues they are failing to grasp the structural weaknesses in the food system and the scale of food poverty.
  • Lang added: “Borders are closing, lorries are being slowed down and checked. We only produce 53% of our own food in the UK. It’s a failure of government to plan.”
  • “Some £1bn extra food and groceries were bought by households in the last two to three weeks. That’s like Christmas but worse because it’s gone on for three times as long,” said Andrew Opie, director of food at the British Retail Consortium, the supermarket trade association.
  • Supermarkets have built supply chains of immense complexity and sophistication over the last four decades, affording customers a choice of more than 40,000 lines from around the world – from dozens of different kinds of pasta to a permanent global summertime of fresh fruits and vegetables.
  • The consequences of a disrupted supply chain will be most acute for the millions in households whose incomes are so low that they have depended on food banks or free meals at school or in daycare centres, which have now closed.
  • She added: “We may need the army to oversee biosecurity as caterers, for example in school kitchens, supply hubs and to enforce social distancing as people collect food from them.”
  • The government has also been working on a scheme for parents of the 1.6 million children who had been on free school meals, with vouchers which can be redeemed in supermarkets. Campaigners, however, argue the vouchers should be usable for nutritionally-balanced meals from school kitchens, which could be kept open.
  • The industry can see other threats on the near horizon. The British food system is largely built on a cheap and highly flexible labour force, which can be turned on and off like a tap. Now that is drying up as Brexit, travel restrictions and fear of illness are keeping away the migrants who have typically done that work.
  • It is creating around eight new hubs from which children in low-income families and isolated adults can have food delivered to their doors. “We have the data to identify people who are likely to be struggling and have mobilised staff,” said its director of public health, Jason Strelitz, but the council was still waiting for government to commit money.
Javier E

This pro-Trump coastal community in Florida, hit early by virus, sits at emotional nexus of national debate over reopening economy amid health crisis - The Washington Post - 0 views

www.washingtonpost.com/...a-85cb-8670579b863d_story.html

economy health community florida virus debate politicization pandemic

shared by Javier E on 30 Mar 20 - No Cached
  • Lee Health, the hospital system that serves most of the county and has been modeling the crisis for policymakers, estimates that 35 to 40 percent of the community was isolated last week. To avoid overwhelming hospitals, according to Therese Everly, the vice chair of Lee Health’s board, the city needs to be 60 percent isolated. To bridge the gap will probably take a drastic step Fort Myers area leaders have been steadily moving toward: government-enforced social isolation.
  • Although city and county leaders insisted that they were not trying to inject partisan politics into a crisis of this magnitude, the same fissures that inhabit everyday life nibbled around the edges of the community’s arguments: personal responsibility to stay home versus a government mandate, and arguments about how much the strong should sacrifice to safeguard the most vulnerable.
  • In Lee County, 42 percent of registered voters are Republican. The mayor is Republican, and running for a congressional seat. The Florida House majority leader, who is a Republican from Fort Myers, is also seeking a congressional seat. In interviews, many political and civic leaders stressed that everyone was working hard to keep partisanship out of the debate — but also peppered in praise for the Republican president and Florida’s Republican governor.
  • ...3 more annotations...
  • “On one side, the voices are saying what’s wrong with you guys are you not paying attention. What’s a human life worth? Saving life is more important than saving a business. You must be corrupt,” he said. “There are other people that argue . . . they have all these employees and have to make payrolls.”
  • The compromise area leaders settled on has been to strongly encourage people to stay home — but not to mandate it with the threat of fines and the force of law.
  • Opponents of a stay-at-home order point to signs that people are taking personal responsibility: Traffic counts are down 80 percent, public transit ridership has dropped 45 percent, people are, for the most part, obeying the glowing orange signs that say the beaches are closed
Javier E

We scientists said lock down. But UK politicians refused to listen | Helen Ward | Opinion | The Guardian - 0 views

www.theguardian.com/...coronavirus-science-who-advice

politicians scientist advice response pandemic uk

shared by Javier E on 15 Apr 20 - No Cached
  • It’s now clear that so many people have died, and so many more are desperately ill, simply because our politicians refused to listen to and act on advice. Scientists like us said lock down earlier; we said test, trace, isolate. But they decided they knew better.
  • it is the role of policymakers to act on the best available evidence. In the context of a rapidly growing threat, that means listening to experts with experience of responding to previous epidemics.
  • When I say that politicians “refused to listen”, I am referring to the advice and recommendations coming from the World Health Organization, from China and from Italy. The WHO advice, based on decades of experience and widely accepted by public health leaders and scientists around the world was clear – use every possible tool to suppress transmission. That meant testing and isolating cases, tracing and quarantining contacts, and ramping up hygiene efforts
  • ...9 more annotations...
  • Neither the advice nor the science were followed that week. My colleagues, led by Neil Ferguson, published a report on 16 March estimating that without strong suppression, 250,000 people could die in the UK. The government responded that day with a recommendation for social distancing, avoiding pubs and working from home if possible. But there was still no enforcement, and it was left up to individuals and employers to decide what to do. Many people were willing but unable to comply as we showed in a report on 20 March. It was only on 23 March that a more stringent lockdown and economic support was announced.
  • etween 12 and 23 March, tens, if not hundreds of thousands, of people will have been infected.
  • The current best estimate is that around 1% of those infected will die.
  • So where to now? Once again, public health experience, including modelling, leads to some very clear recommendations. First, find cases in the community as well as hospitals and care homes; isolate them, and trace their contacts using a combination of local public health teams and digital tools.
  • Second, know your epidemic. Track the epidemic nationally and locally using NHS, public health and digital surveillance to see where cases are continuing to spread
  • Build community resilience by providing local support for vulnerable people affected by the virus and the negative impact of the control measures.
  • Third, ensure transmission is suppressed in hospitals, care homes and workplaces through the right protective equipment, testing, distancing and hygiene
  • Fourth, ensure that the most vulnerable, socially and medically, are fully protected through simple access to a basic income, rights for migrants, and safety for those affected by domestic violence.
  • I am not looking to blame – but for scrutiny so that lessons can be learned to guide our response. We need to avoid further mistakes, and ensure that the government is hearing, and acting on, the best advice.
Javier E

The Coronavirus in America: The Year Ahead - The New York Times - 0 views

www.nytimes.com/...oronavirus-america-future.html

pandemic response strategies US

shared by Javier E on 19 Apr 20 - No Cached
  • More than 20 experts in public health, medicine, epidemiology and history shared their thoughts on the future during in-depth interviews. When can we emerge from our homes? How long, realistically, before we have a treatment or vaccine? How will we keep the virus at bay
  • The path forward depends on factors that are certainly difficult but doable, they said: a carefully staggered approach to reopening, widespread testing and surveillance, a treatment that works, adequate resources for health care providers — and eventually an effective vaccine.
  • The scenario that Mr. Trump has been unrolling at his daily press briefings — that the lockdowns will end soon, that a protective pill is almost at hand, that football stadiums and restaurants will soon be full — is a fantasy, most experts said.
  • ...76 more annotations...
  • They worried that a vaccine would initially elude scientists, that weary citizens would abandon restrictions despite the risks, that the virus would be with us from now on.
  • Most experts believed that once the crisis was over, the nation and its economy would revive quickly. But there would be no escaping a period of intense pain.
  • Exactly how the pandemic will end depends in part on medical advances still to come. It will also depend on how individual Americans behave in the interim. If we scrupulously protect ourselves and our loved ones, more of us will live. If we underestimate the virus, it will find us.
  • More Americans may die than the White House admits.
  • The epidemiological model often cited by the White House, which was produced by the University of Washington’s Institute for Health Metrics and Evaluation, originally predicted 100,000 to 240,000 deaths by midsummer. Now that figure is 60,000.
  • The institute’s projection runs through Aug. 4, describing only the first wave of this epidemic. Without a vaccine, the virus is expected to circulate for years, and the death tally will rise over time.
  • Fatality rates depend heavily on how overwhelmed hospitals get and what percentage of cases are tested. China’s estimated death rate was 17 percent in the first week of January, when Wuhan was in chaos, according to a Center for Evidence-Based Medicine report, but only 0.7 percent by late February.
  • Various experts consulted by the Centers for Disease Control and Prevention in March predicted that the virus eventually could reach 48 percent to 65 percent of all Americans, with a fatality rate just under 1 percent, and would kill up to 1.7 million of them if nothing were done to stop the spread.
  • A model by researchers at Imperial College London cited by the president on March 30 predicted 2.2 million deaths in the United States by September under the same circumstances.
  • China has officially reported about 83,000 cases and 4,632 deaths, which is a fatality rate of over 5 percent. The Trump administration has questioned the figures but has not produced more accurate ones.
  • The tighter the restrictions, experts say, the fewer the deaths and the longer the periods between lockdowns. Most models assume states will eventually do widespread temperature checks, rapid testing and contact tracing, as is routine in Asia.
  • In this country, hospitals in several cities, including New York, came to the brink of chaos.
  • Only when tens of thousands of antibody tests are done will we know how many silent carriers there may be in the United States. The C.D.C. has suggested it might be 25 percent of those who test positive. Researchers in Iceland said it might be double that.
  • China is also revising its own estimates. In February, a major study concluded that only 1 percent of cases in Wuhan were asymptomatic. New research says perhaps 60 percent were.
  • The virus may also be mutating to cause fewer symptoms. In the movies, viruses become more deadly. In reality, they usually become less so, because asymptomatic strains reach more hosts. Even the 1918 Spanish flu virus eventually faded into the seasonal H1N1 flu.
  • The lockdowns will end, but haltingly.
  • it is likely a safe bet that at least 300 million of us are still vulnerable.
  • Until a vaccine or another protective measure emerges, there is no scenario, epidemiologists agreed, in which it is safe for that many people to suddenly come out of hiding. If Americans pour back out in force, all will appear quiet for perhaps three weeks.
  • The gains to date were achieved only by shutting down the country, a situation that cannot continue indefinitely. The White House’s “phased” plan for reopening will surely raise the death toll no matter how carefully it is executed.
  • Every epidemiological model envisions something like the dance
  • On the models, the curves of rising and falling deaths resemble a row of shark teeth.
  • Surges are inevitable, the models predict, even when stadiums, churches, theaters, bars and restaurants remain closed, all travelers from abroad are quarantined for 14 days, and domestic travel is tightly restricted to prevent high-intensity areas from reinfecting low-intensity ones.
  • In his wildly popular March 19 article in Medium, “Coronavirus: The Hammer and the Dance,” Tomas Pueyo correctly predicted the national lockdown, which he called the hammer, and said it would lead to a new phase, which he called the dance, in which essential parts of the economy could reopen, including some schools and some factories with skeleton crews.
  • Even the “Opening Up America Again” guidelines Mr. Trump issued on Thursday have three levels of social distancing, and recommend that vulnerable Americans stay hidden. The plan endorses testing, isolation and contact tracing — but does not specify how these measures will be paid for, or how long it will take to put them in place.
  • On Friday, none of that stopped the president from contradicting his own message by sending out tweets encouraging protesters in Michigan, Minnesota and Virginia to fight their states’ shutdowns.
  • China did not allow Wuhan, Nanjing or other cities to reopen until intensive surveillance found zero new cases for 14 straight days, the virus’s incubation period.
  • Compared with China or Italy, the United States is still a playground.Americans can take domestic flights, drive where they want, and roam streets and parks. Despite restrictions, everyone seems to know someone discreetly arranging play dates for children, holding backyard barbecues or meeting people on dating apps.
  • Even with rigorous measures, Asian countries have had trouble keeping the virus under control
  • But if too many people get infected at once, new lockdowns will become inevitable. To avoid that, widespread testing will be imperative.
  • Reopening requires declining cases for 14 days, the tracing of 90 percent of contacts, an end to health care worker infections, recuperation places for mild cases and many other hard-to-reach goals.
  • Immunity will become a societal advantage.
  • Imagine an America divided into two classes: those who have recovered from infection with the coronavirus and presumably have some immunity to it; and those who are still vulnerable.
  • “It will be a frightening schism,” Dr. David Nabarro, a World Health Organization special envoy on Covid-19, predicted. “Those with antibodies will be able to travel and work, and the rest will be discriminated against.”
  • Soon the government will have to invent a way to certify who is truly immune. A test for IgG antibodies, which are produced once immunity is established, would make sense
  • Dr. Fauci has said the White House was discussing certificates like those proposed in Germany. China uses cellphone QR codes linked to the owner’s personal details so others cannot borrow them.
  • As Americans stuck in lockdown see their immune neighbors resuming their lives and perhaps even taking the jobs they lost, it is not hard to imagine the enormous temptation to join them through self-infection
  • My daughter, who is a Harvard economist, keeps telling me her age group needs to have Covid-19 parties to develop immunity and keep the economy going,”
  • It would be a gamble for American youth, too. The obese and immunocompromised are clearly at risk, but even slim, healthy young Americans have died of Covid-19.
  • The virus can be kept in check, but only with expanded resources.
  • Resolve to Save Lives, a public health advocacy group run by Dr. Thomas R. Frieden, the former director of the C.D.C., has published detailed and strict criteria for when the economy can reopen and when it must be closed.
  • once a national baseline of hundreds of thousands of daily tests is established across the nation, any viral spread can be spotted when the percentage of positive results rises.
  • To keep the virus in check, several experts insisted, the country also must start isolating all the ill — including mild cases.
  • “If I was forced to select only one intervention, it would be the rapid isolation of all cases,”
  • In China, anyone testing positive, no matter how mild their symptoms, was required to immediately enter an infirmary-style hospital — often set up in a gymnasium or community center outfitted with oxygen tanks and CT scanners.
  • There, they recuperated under the eyes of nurses. That reduced the risk to families, and being with other victims relieved some patients’ fears.
  • Still, experts were divided on the idea of such wards
  • Ultimately, suppressing a virus requires testing all the contacts of every known case. But the United States is far short of that goal.
  • In China’s Sichuan Province, for example, each known case had an average of 45 contacts.
  • The C.D.C. has about 600 contact tracers and, until recently, state and local health departments employed about 1,600, mostly for tracing syphilis and tuberculosis cases.
  • China hired and trained 9,000 in Wuhan alone. Dr. Frieden recently estimated that the United States will need at least 300,000.
  • There will not be a vaccine soon.
  • any effort to make a vaccine will take at least a year to 18 months.
  • the record is four years, for the mumps vaccine.
  • for unclear reasons, some previous vaccine candidates against coronaviruses like SARS have triggered “antibody-dependent enhancement,” which makes recipients more susceptible to infection, rather than less. In the past, vaccines against H.I.V. and dengue have unexpectedly done the same.
  • A new vaccine is usually first tested in fewer than 100 young, healthy volunteers. If it appears safe and produces antibodies, thousands more volunteers — in this case, probably front-line workers at the highest risk — will get either it or a placebo in what is called a Phase 3 trial.
  • It is possible to speed up that process with “challenge trials.” Scientists vaccinate small numbers of volunteers, wait until they develop antibodies, and then “challenge” them with a deliberate infection to see if the vaccine protects them.
  • Normally, it is ethically unthinkable to challenge subjects with a disease with no cure, such as Covid-19.
  • “Fewer get harmed if you do a challenge trial in a few people than if you do a Phase 3 trial in thousands,” said Dr. Lipsitch, who recently published a paper advocating challenge trials in the Journal of Infectious Diseases. Almost immediately, he said, he heard from volunteers.
  • The hidden danger of challenge trials, vaccinologists explained, is that they recruit too few volunteers to show whether a vaccine creates enhancement, since it may be a rare but dangerous problem.
  • if a vaccine is invented, the United States could need 300 million doses — or 600 million if two shots are required. And just as many syringes.
  • “People have to start thinking big,” Dr. Douglas said. “With that volume, you’ve got to start cranking it out pretty soon.”
  • Treatments are likely to arrive first.
  • The modern alternative is monoclonal antibodies. These treatment regimens, which recently came very close to conquering the Ebola epidemic in eastern Congo, are the most likely short-term game changer, experts said.
  • as with vaccines, growing and purifying monoclonal antibodies takes time. In theory, with enough production, they could be used not just to save lives but to protect front-line workers.
  • Having a daily preventive pill would be an even better solution, because pills can be synthesized in factories far faster than vaccines or antibodies can be grown and purified.
  • Goodbye, ‘America First.’
  • A public health crisis of this magnitude requires international cooperation on a scale not seen in decades. Yet Mr. Trump is moving to defund the W.H.O., the only organization capable of coordinating such a response.
  • And he spent most of this year antagonizing China, which now has the world’s most powerful functioning economy and may become the dominant supplier of drugs and vaccines. China has used the pandemic to extend its global influence, and says it has sent medical gear and equipment to nearly 120 countries.
  • This is not a world in which “America First” is a viable strategy, several experts noted.
  • “If President Trump cares about stepping up the public health efforts here, he should look for avenues to collaborate with China and stop the insults,”
  • If we alienate the Chinese with our rhetoric, I think it will come back to bite us,” he said.“What if they come up with the first vaccine? They have a choice about who they sell it to. Are we top of the list? Why would we be?”
  • Once the pandemic has passed, the national recovery may be swift. The economy rebounded after both world wars, Dr. Mulder noted.
  • In one of the most provocative analyses in his follow-up article, “Coronavirus: Out of Many, One,” Mr. Pueyo analyzed Medicare and census data on age and obesity in states that recently resisted shutdowns and counties that voted Republican in 2016.
  • He calculated that those voters could be 30 percent more likely to die of the virus.
  • In the periods after both wars, Dr. Mulder noted, society and incomes became more equal. Funds created for veterans’ and widows’ pensions led to social safety nets, measures like the G.I. Bill and V.A. home loans were adopted, unions grew stronger, and tax benefits for the wealthy withered.
  • If a vaccine saves lives, many Americans may become less suspicious of conventional medicine and more accepting of science in general — including climate change
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