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Coronavirus And The Sun: A Lesson From The 1918 Influenza Pandemic

Fresh air, sunlight and improvised face masks seemed to work a century ago; and they might help us now.

Influenza-patients-getting-sunlight-at-the-Camp-Brooks-emergency-open-air-hospital-in-Boston.-Medical-staff-were-not-supposed-to-remove-their-masks
Influenza patients getting sunlight at the Camp Brooks emergency open-air hospital in Boston. Medical staff were not supposed to remove their masks. (National Archives)

When new, virulent diseases emerge, such SARS and Covid-19, the race begins to find new vaccines and treatments for those affected.

As the current crisis unfolds, governments are enforcing quarantine and isolation, and public gatherings are being discouraged.

Health officials took the same approach 100 years ago, when influenza was spreading around the world.

The results were mixed. But records from the 1918 pandemic suggest one technique for dealing with influenza — little-known today — was effective.

Some hard-won experience from the greatest pandemic in recorded history could help us in the weeks and months ahead.

 

Put simply, medics found that severely ill flu patients nursed outdoors recovered better than those treated indoors.

A combination of fresh air and sunlight seems to have prevented deaths among patients; and infections among medical staff.[1]

There is scientific support for this. Research shows that outdoor air is a natural disinfectant. Fresh air can kill the flu virus and other harmful germs.

Equally, sunlight is germicidal and there is now evidence it can kill the flu virus.

`Open-Air’ Treatment in 1918

During the great pandemic, two of the worst places to be were military barracks and troop-ships. Overcrowding and bad ventilation put soldiers and sailors at high risk of catching influenza and the other infections that often followed it.[2,3]

As with the current Covid-19 outbreak, most of the victims of so-called `Spanish flu’ did not die from influenza: they died of pneumonia and other complications.

When the influenza pandemic reached the East coast of the United States in 1918, the city of Boston was particularly badly hit. So the State Guard set up an emergency hospital.

They took in the worst cases among sailors on ships in Boston harbour. The hospital’s medical officer had noticed the most seriously ill sailors had been in badly-ventilated spaces.

So he gave them as much fresh air as possible by putting them in tents. And in good weather they were taken out of their tents and put in the sun.

At this time, it was common practice to put sick soldiers outdoors. Open-air therapy, as it was known, was widely used on casualties from the Western Front.

And it became the treatment of choice for another common and often deadly respiratory infection of the time; tuberculosis.

Patients were put outside in their beds to breathe fresh outdoor air. Or they were nursed in cross-ventilated wards with the windows open day and night. The open-air regimen remained popular until antibiotics replaced it in the 1950s.

Doctors who had first-hand experience of open-air therapy at the hospital in Boston were convinced the regimen was effective. It was adopted elsewhere.

If one report is correct, it reduced deaths among hospital patients from 40 per cent to about 13 per cent.[4]

According to the Surgeon General of the Massachusetts State Guard:

`The efficacy of open air treatment has been absolutely proven, and one has only to try it to discover its value.’

Fresh Air is a Disinfectant

Patients treated outdoors were less likely to be exposed to the infectious germs that are often present in conventional hospital wards.

They were breathing clean air in what must have been a largely sterile environment. We know this because, in the 1960s, Ministry of Defence scientists proved that fresh air is a natural disinfectant.[5]

Something in it, which they called the Open Air Factor, is far more harmful to airborne bacteria — and the influenza virus — than indoor air.

They couldn’t identify exactly what the Open Air Factor is. But they found it was effective both at night and during the daytime.

Their research also revealed that the Open Air Factor’s disinfecting powers can be preserved in enclosures — if ventilation rates are kept high enough.

Significantly, the rates they identified are the same ones that cross-ventilated hospital wards, with high ceilings and big windows, were designed for.[6]

But by the time the scientists made their discoveries, antibiotic therapy had replaced open-air treatment. Since then the germicidal effects of fresh air have not featured in infection control, or hospital design. Yet harmful bacteria have become increasingly resistant to antibiotics.

Sunlight and Influenza Infection

Putting infected patients out in the sun may have helped because it inactivates the influenza virus.[7] It also kills bacteria that cause lung and other infections in hospitals.[8] During the First World War, military surgeons routinely used sunlight to heal infected wounds.[9]

They knew it was a disinfectant. What they didn’t know is that one advantage of placing patients outside in the sun is they can synthesise vitamin D in their skin if sunlight is strong enough.

This was not discovered until the 1920s. Low vitamin D levels are now linked to respiratory infections and may increase susceptibility to influenza.[10]

Also, our body’s biological rhythms appear to influence how we resist infections.[11] New research suggests they can alter our inflammatory response to the flu virus.[12]

As with vitamin D, at the time of the 1918 pandemic, the important part played by sunlight in synchronizing these rhythms was not known.

Face Masks Coronavirus and Flu

Surgical masks are currently in short supply in China and elsewhere. They were worn 100 years ago, during the great pandemic, to try and stop the influenza virus spreading.

While surgical masks may offer some protection from infection they do not seal around the face.

So they don’t filter out small airborne particles. In 1918, anyone at the emergency hospital in Boston who had contact with patients had to wear an improvised face mask. This comprised five layers of gauze fitted to a wire frame which covered the nose and mouth.

The frame was shaped to fit the face of the wearer and prevent the gauze filter touching the mouth and nostrils. The masks were replaced every two hours; properly sterilized and with fresh gauze put on.

They were a forerunner of the N95 respirators in use in hospitals today to protect medical staff against airborne infection.

Temporary Hospitals

Staff at the hospital kept up high standards of personal and environmental hygiene. No doubt this played a big part in the relatively low rates of infection and deaths reported there.

The speed with which their hospital and other temporary open-air facilities were erected to cope with the surge in pneumonia patients was another factor.

Today, many countries are not prepared for a severe influenza pandemic.[13]

Their health services will be overwhelmed if there is one. Vaccines and antiviral drugs might help. Antibiotics may be effective for pneumonia and other complications. But much of the world’s population will not have access to them.

If another 1918 comes, or the Covid-19 crisis gets worse, history suggests it might be prudent to have tents and pre-fabricated wards ready to deal with large numbers of seriously ill cases. Plenty of fresh air and a little sunlight might help too.

Dr. Richard Hobday is an independent researcher working in the fields of infection control, public health and building design. He is the author of `The Healing Sun’.

References:

  1. Hobday RA and Cason JW. The open-air treatment of pandemic influenza. Am J Public Health 2009;99 Suppl 2:S236–42. doi:10.2105/AJPH.2008.134627.
  2. Aligne CA. Overcrowding and mortality during the influenza pandemic of 1918. Am J Public Health 2016 Apr;106(4):642–4. doi:10.2105/AJPH.2015.303018.
  3. Summers JA, Wilson N, Baker MG, Shanks GD. Mortality risk factors for pandemic influenza on New Zealand troop ship, 1918. Emerg Infect Dis 2010 Dec;16(12):1931–7. doi:10.3201/eid1612.100429.
  4. Anon. Weapons against influenza. Am J Public Health 1918 Oct;8(10):787–8. doi: 10.2105/ajph.8.10.787.
  5. May KP, Druett HA. A micro-thread technique for studying the viability of microbes in a simulated airborne state. J Gen Micro-biol 1968;51:353e66. Doi: 10.1099/00221287–51–3–353.
  6. Hobday RA. The open-air factor and infection control. J Hosp Infect 2019;103:e23-e24 doi.org/10.1016/j.jhin.2019.04.003.
  7. Schuit M, Gardner S, Wood S et al. The influence of simulated sunlight on the inactivation of influenza virus in aerosols. J Infect Dis 2020 Jan 14;221(3):372–378. doi: 10.1093/infdis/jiz582.
  8. Hobday RA, Dancer SJ. Roles of sunlight and natural ventilation for controlling infection: historical and current perspectives. J Hosp Infect 2013;84:271–282. doi: 10.1016/j.jhin.2013.04.011.
  9. Hobday RA. Sunlight therapy and solar architecture. Med Hist 1997 Oct;41(4):455–72. doi:10.1017/s0025727300063043.
  10. Gruber-Bzura BM. Vitamin D and influenza-prevention or therapy? Int J Mol Sci 2018 Aug 16;19(8). pii: E2419. doi: 10.3390/ijms19082419.
  11. Costantini C, Renga G, Sellitto F, et al. Microbes in the era of circadian medicine. Front Cell Infect Microbiol. 2020 Feb 5;10:30. doi: 10.3389/fcimb.2020.00030.
  12. Sengupta S, Tang SY, Devine JC et al. Circadian control of lung inflammation in influenza infection. Nat Commun 2019 Sep 11;10(1):4107. doi: 10.1038/s41467–019–11400–9.
  13. Jester BJ, Uyeki TM, Patel A, Koonin L, Jernigan DB. 100 Years of medical countermeasures and pandemic influenza preparedness. Am J Public Health. 2018 Nov;108(11):1469–1472. doi: 10.2105/AJPH.2018.304586.

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As the coronavirus spreads, a drug that once raised the world’s hopes is given a second shot

remdesivir-coronavirus
Gilead Science's Remdesivir is now being investigated for it's potential as Covid-19 treatment. (iStock/Getty Images)

A decade ago, a group of chemists cooked up a compound they simply called 3a and that, in lab experiments, fought off a number of different viruses. One was a type of coronavirus.

Now, the descendant of that molecule — Gilead Sciences’ remdesivir — is being rushed to patients with infections from the novel coronavirus in hopes that it can reduce the intensity and duration of Covid-19 and ease the burden of the pandemic on health systems.

Remdesivir, in the spotlight as scientists and governments scramble to find a treatment for the disease, took a circuitous route to center stage. Born as a general antiviral candidate, researchers threw it at an array of viruses and saw where it stuck. It bounced along from Gilead’s labs to academic centers, nudged by both federal taxpayer dollars and support from the company. It kept turning up whiffs of potential in cells and animals infected by other coronaviruses like SARS and MERS, but these bugs weren’t causing sustained global crises. For years, Gilead was primarily focused on ushering remdesivir into trials and toward approval for a different kind of infection: Ebola.

But there’s nothing like a pandemic to break the emergency glass on all possible options.

Remdesivir is now being tested in five Covid-19 clinical trials that have been set up at breakneck speed. It’s been delivered through a compassionate use program to some patients, including the first case in the United States. The first trial results are expected next month, though some analysts have already raised concerns about the prospects based on the drips of data emerging from a small number of patients.

Others’ hopes are high for the drug. As of now, there are no approved therapies for any coronavirus infection, and remdesivir is the farthest along in the development process of any candidate.

“There’s only one drug right now that we think may have real efficacy,” Bruce Aylward of the World Health Organization said last month. “And that’s remdesivir.”

Remdesivir’s odyssey illuminates the complicated trajectory drugs can take as they are forged, refined, scrutinized, and moved into human studies. But its long, meandering path also underscores why drugs need to demonstrate their efficacy in these studies. The drug similarly had lofty expectations as an Ebola treatment, and strong data from animal studies to boot. But in a landmark trial that compared four experimental therapies and was published last year, two other treatments were shown to dramatically reduce deaths from the infection, while remdesivir faltered, producing less impressive survival benefits.

“Drug discovery and development is usually a very long and tedious process and you could have many failures on the path to an approved product,” Tomas Cihlar, Gilead’s vice president of virology, said in an interview with STAT.

As for remdesivir’s chances in Covid-19, Cihlar said:  “It would be wonderful if it works. But it needs to be proven.”

When the patient with the first known U.S. case of Covid-19 was admitted to Providence Regional Medical Center in Everett, Wash., on Jan. 20, he wasn’t all that sick.

The 35-year-old man had the respiratory infection’s most common symptoms of fever and cough, but had no trouble breathing and no evidence of pneumonia — inflammation of the lungs’ air sacs. But around that time, his doctors saw a report from China that detailed that some patients there developed more severe symptoms several days into their illnesses.

“That perked our ears to the worsening of this disease,” said George Diaz, the infectious disease section chief at the hospital.

Within a few days, the man — who had visited family in Wuhan, China, where the outbreak is believed to have started, and returned home to Washington Jan. 15 — started experiencing shortness of breath and requiring oxygen. An X-ray revealed pneumonia.

Diaz informed officials at the Centers for Disease Control and Prevention, with whom he had been conferring daily, that the patient was taking a turn for the worse. The CDC suggested trying an experimental drug, and mentioned Gilead’s remdesivir.

Hospital officials got in touch with Gilead about providing the drug, and then got the approval from the Food and Drug Administration to treat the patient through a compassionate use program, which allows unapproved drugs to be given under select circumstances outside of clinical trials. Gilead overnighted the drug to the hospital.

“Treatment with intravenous remdesivir was initiated on the evening of day 7, and no adverse events were observed,” the medical team wrote in a case report in the New England Journal of Medicine. The man started feeling better the following day.

“We were aware that he was the first patient on the planet getting the drug for this infection, so we were super interested to see, hopefully, if he would improve,” Diaz recalled.

The apparent success in one patient does not prove the drug is effective. That is where the large trials that will compare remdesivir to placebos come in.

Remdesivir has been able to advance into clinical studies so quickly for two key reasons. For one, thanks to its use in Ebola, it was known to be generally safe in humans. And two, it had a large body of preclinical evidence — that is, data from studies in cells in lab experiments and in infected animals — that indicated it could temper coronavirus infections. One study published just last month by researchers from Gilead and the National Institute of Allergy and Infectious Diseases showed remdesivir inhibited the replication of MERS, a related coronavirus, in infected monkeys.

Much of this preclinical research has been conducted through collaboration among the National Institutes of Health, academic labs, and Gilead, steered by the Antiviral Drug Discovery and Development Center, or AD3C. The center is an NIH-funded program run out of the University of Alabama at Birmingham that, since 2014, has been on the hunt for new treatments for emerging viruses.

Since drug screens revealed that remdesivir had potential as a coronavirus fighter, it was routed into the arm of AD3C focused on this family, a project led by Mark Denison at Vanderbilt University and Ralph Baric at University of North Carolina. Starting in about 2015 and with the backing of Gilead, they and scientists in their labs have pulled back the curtain on how exactly remdesivir curtails coronaviruses and demonstrated that it can block the viruses from multiplying in infected animals.


With the coronavirus, drug that once raised global hopes gets another shot
Bottles of remdesivir in a hospital for Covid-19 patients in Wuhan, China. FeatureChina via AP

The researchers got an additional NIH grant to ready remdesivir for clinical trials, and thought the target could be MERS, which has caused 858 deaths and nearly 2,500 cases, mostly in Saudi Arabia, since it started infecting people in 2012. But even with that focus, they were also thinking about how the drugs they were studying could be used for the next spillover — when a virus jumps from animals to people.

“We’ve always thought that coronaviruses were a family on the move,” said Tim Sheahan, a UNC coronavirus expert.

Even with that expectation, though, the researchers who have toiled away for years on these projects without much fanfare find themselves caught off guard now.

“People like me, people doing basic science, oftentimes the work that we’re doing has no obvious direct translation to improving human health,” Sheahan said. “It’s hard to imagine that the work we’ve done in a lab in North Carolina could be saving people’s lives around the world. It’s incredibly gratifying, but it’s surprising and unusual for someone like me to experience this.”

But if remdesivir had hopes as an Ebola treatment, how can it also work against coronaviruses? Their viral families are so different, “it’s like saying a giraffe versus an elephant,” said Gene Olinger, a former U.S. Army Ebola researcher, who is now the scientific advisor at MRI Global, a nonprofit research organization.

The trick is that remdesivir does not go after the virus directly. Instead, it targets the system the virus uses to replicate itself, hijacking it like you would your office’s copy machine as part of a company-wide prank.

These viruses have a genome that consists of a strand of RNA. To make copies of themselves, they rely on a molecule called a polymerase to string together the individual building blocks of the viral genome. These are like the “letters” that we think of composing DNA.

Remdesivir is an “analog,” designed to mimic the appearance of one of the RNA letters, adenosine. It looks so similar that the polymerase can unknowingly pick it up instead of the real adenosine and insert it into the strand of viral genome that’s being constructed, like bringing home the wrong twin from summer camp. Once in place, the analog acts as a cap, preventing any additional pieces from being strung on. This leaves the strand short of the full genome. The virus can’t go on to replicate or infect other cells.

“The polymerase grabs it almost accidentally and uses it in place of adenosine,” said Maria Agostini, a postdoctoral researcher in Denison’s Vanderbilt lab. “The polymerase can kind of get it mixed up sometimes.”

The drug can inhibit coronaviruses as well as Ebola because their polymerases are similar enough that its cloak-and-dagger operation fools them all. (Remdesivir does not appear to work on other viruses with more unrelated forms of polymerase.)

Like a bad song clears out a dance floor, remdesivir can clear the viral levels in a person, as long as it can interrupt enough replication. The key, researchers say, is that it has to be delivered somewhat early in an infection, as the virus is still proliferating. In patients who develop severe disease, it’s not the virus that’s always the main problem. The body’s own immune system can react by heading into overdrive and causing secondary complications like organ damage. An antiviral can’t head that off once it’s begun.

“If you wait to treat someone until they’re in the ICU on a ventilator, it’s too late, you’re not going to do a darn thing,” said Richard Whitley, an infectious disease expert at UAB who coordinates the antiviral consortium.

When remdesivir stumbled in the Ebola trials last year, it was a disappointment, Gilead’s Cihlar acknowledged. But he argued it refocused the company’s attention to other targets for the drug.

They didn’t have to wait long.

In December, reports popped up from Wuhan of mysterious pneumonia cases. In early January, word came of a new coronavirus. “At that point, we started getting ready,” Cihlar said.

And when Chinese scientists published the virus’ genome, Gilead zeroed in on the portion that contained the recipe for the replication machinery — the polymerase. They saw it was nearly identical to the version in SARS — evidence that remdesivir might work against this virus as well. “That was a really strong signal for us,” he said.

There are now five clinical trials of remdesivir in Covid-19: two run by Chinese scientists, one looking at severe infections, and one at mild and moderate infections; one sponsored by NIAID; and two sponsored by Gilead in countries around the world with a large number of cases, looking at different disease severities and dosing regimens.

If the drug is successful in trials, most antiviral experts think the drug should primarily be used for patients with more severe symptoms and those who are hospitalized — some 15% to 20% of cases. But observers have also raised a number of points that could potentially trip up the trials. For one, the process moved so quickly that analysts have wondered if the best doses were chosen. They have also pointed to the fact that one of the Chinese trials includes patients whose symptoms started up to 12 days prior. There are concerns that might be too late.

“The overall trial might not be as spectacular as people think,” Umer Raffat, an analyst at Evercore ISI, said in a presentation last week. But, Raffat added, results from patients who start treatment early might show the drug has efficacy if given soon after symptoms arise.

Another detail that will be scrutinized: Can the drug, which is given intravenously into the bloodstream, reach the cells it needs to clear the respiratory infection?

“We don’t know if the amount of remdesivir that’s going to get into the lungs is enough to get the virus down,” said Andre Kalil, an infectious disease specialist at University of Nebraska Medical Center and an investigator in the NIAID-sponsored trial. “This is part of the reason we’re doing the study.”

Remdesivir may have had a head start, but other efforts are underway to come up with Covid-19 treatments. (These are separate from vaccine projects.) Virologists said they were keeping an eye on a candidate pursued by researchers at Vanderbilt, UNC, and Emory University that, in its various forms, has been identified as NHC, EIDD-2801, and EIDD-1931. The drug company Regeneron, which steered its Ebola antiviral to success in the same trial in which remdesivir stumbled, is working on a treatment, as are other biopharma companies. Some experts have proposed using antibody-containing blood from survivors of Covid-19 as a therapy.

If remdesivir does succeed in clinical trials, Gilead will only face a new round of questions.

The company has run into a buzzsaw of public and governmental criticism in the past over the cost of its HIV and hepatitis C antivirals, and any drug approved to treat Covid-19 will certainly face pricing scrutiny. A Gilead spokesperson said the company was not discussing pricing yet.

Health authorities are already stressing the importance of access to therapeutics that do make it to market.

“We cannot have a situation where people who need the drug don’t get it and people who don’t need the drug do,” Mike Ryan, who leads the WHO’s emergency program, said at a briefing this month when asked about the ongoing clinical trials. “We must find ways to ensure we can scale up production of any drugs that prove effective and we can ensure that those drugs are distributed on the basis of need and the basis of benefit.”

 

That points to another challenge Gilead could face with an approval for remdesivir: supply. Even if it was recommended only for people with severe infections who are hospitalized, that could still amount to thousands of patients needing doses, and needing them soon.

On a call with analysts this month, Gilead CEO Daniel O’Day said the company was “engaging our manufacturing and supply chain in the event of success” and said that it was already talking with partners about increasing production of remdesivir. But given that the drug is still in trials, he said, “right now the demand is really unknown.”

That same day, O’Day appeared at the White House with other drug and vaccine makers.

“We’re moving as fast as we can,” O’Day told President Trump as he described remdesivir. “I think everybody around the table is moving as fast as we can.”

Trump had a simple message for O’Day: “Get it done, Daniel. Don’t disappoint us, Daniel.”

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The Netherlands: Medical research teams are the first to discover COVID-19 antibody

The Netherlands Medical research teams are the first to discover COVID-19 antibody
The Netherlands Medical research teams are the first to discover COVID-19 antibody. (iStock/Getty Images)

Researchers at the Erasmus Medical Center in Rotterdam and at Utrecht University have reported that they have discovered an antibody which combats COVID-19 infection.

If their discovery is confirmed, the antibody could form the basis of the first COVID-19 vaccine, as reported by Free West Media, or possibly even a medicine, which could be developed more quickly than a vaccine.

It may still take some time before an antidote is made available to the public, however. The discovery needs to be verified through the peer review process and it would need to be tested on human subjects before it could be produced for mass distribution.

 
 

Free West Media described it as “a monoclonal antibody, capable of recognizing the protein” that can infect humans. “The antibody has the ability to bind to the aforementioned protein and, consequently, is able to prevent the virus from connecting to the respiratory cells.”

If verified, the discovery could lead to the development of a test for infection that people could use themselves at home, in addition to an antidote. The researchers also believe that the antibody could be effective in treating other viruses which might develop out of the same strain in the future.

“If you were to take this as a patient, it is expected . . . that the infection will be stopped,” Grosveld explained. “And so it can give the patient an opportunity to recover.”

Many European countries are taking extreme measures in order to try to slow the spread of the virus. Angela Merkel said that it is anticipated that 70% of Germans will eventually be infected with the disease, as reported by Voice of Europe.

Berlin acts to stop US poaching German coronavirus vaccine company

Concern that Washington may seek monopoly on any breakthrough in fight against disease

 
Berlin acts to stop US poaching German coronavirus vaccine company
There are fears in Berlin that countries could take an 'every man for himself' approach to combating coronavirus © Adrienne Surpreant/Bloomberg

Berlin is seeking to stop a German company trying to come up with a vaccine against coronavirus from moving its research to the US, amid fears Washington may seek a monopoly on any breakthrough in the fight against the disease. A German government source said that ministers were looking at ways to keep the company in question, biopharma group CureVac, in Germany. On Sunday the German newspaper Die Welt am Sonntag reported that Donald Trump was trying to lure CureVac to the US with generous offers of money. Welt quoted unnamed German officials as saying the president was doing everything in his power to acquire a vaccine for the US — “but only for the US”. The report has reinforced fears in Berlin that countries could take an “every man for himself” approach to fighting coronavirus, rather than pooling resources and sharing potential scientific breakthroughs that would help to stop the disease. A German government spokesman declined to comment on the Welt story. But the health ministry issued a statement saying the government had “a great interest in ensuring that vaccines and compounds against the new type coronavirus are also developed in Germany and in Europe”. “With this in mind, the government is in an intensive exchange with the firm CureVac,” the ministry added. German officials have pointed to Berlin’s law on foreign trade, under which the government can scrutinise bids from non-EU countries “if national or European security interests are at stake”. A US official said the Welt story was “wildly overplayed”. He said the US government had spoken with more than 25 companies that claim they can help with a vaccine, and most of them had already received seed funding from US investors.

“We will continue to talk to any company that claims to be able to help,” he said. “And any solution found would be shared with the world.” This month, CureVac reported on its website that its chief executive Daniel Menichella had been invited to the White House to discuss “strategies and opportunities for the rapid development and production of a coronavirus vaccine” with Mr Trump and members of his coronavirus task force. In the press release, Mr Menichella was quoted as saying that the company was “very confident that we will be able to develop a potent vaccine candidate within a few months”. It said it hoped to start clinical trials early this summer. A few days after the meeting, Mr Menichella left the company, which is based in the south-western town of Tübingen. He was replaced as chief by Ingmar Hoerr, CureVac’s founder.

The Welt report kicked up a political storm in Germany. “The exclusive sale of a potential vaccine to the US must be prevented using all available means,” said Karl Lauterbach, health policy spokesman for the Social Democrats, the junior partner in Angela Merkel’s grand coalition government. “Capitalism has limits,” he tweeted. “We can’t continue to be reliant on medicine from China and the US. Our policy on research needs to change.” “It’s an ethical, not an economic or national issue,” said Bärbel Bas, deputy head of the SPD’s parliamentary group. “If there’s a vaccine, it must be available for everyone. Anything else would be a scandal. “In a pandemic, it’s about everyone, not ‘America First’,” she added.

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Coronavirus: Facts vs. Panic

Separating facts from irrational fear in the global virus pandemic.

Coronavirus Facts vs Panic
A hospital sign in Switzerland urges patients to consider working from home. FABRICE COFFRINI/AFP via Getty Images

Coronavirus is nothing to sneeze at. But so far, widespread panic may not be justified.

You should know:

  • Almost all of the reported coronavirus deaths in the U.S. happened in long-term care facilities in Washington State. And almost all of those occurred at the same facility.
  • Most people who get coronavirus have mild or no symptoms.
  • No young or middle-age people have died of coronavirus in the U.S. 
  • Most around the world diagnosed from January-March 1 have already recovered.

Obviously, this is a fast-moving news target. For the latest information from the government, you can visit the Centers for Disease Control (CDC) coronavirus page at CDC.gov. The following information is accurate as of Thursday.

Q: What is the average American’s risk of getting coronavirus?

A: Low. CDC reports: “For the majority of people, the immediate risk of being exposed to the virus that causes COVID-19 is thought to be low.”

Q: What’s the likelihood that coronavirus is in my community?

A: Low. CDC reports: “There is not widespread circulation in most communities in the United States.”

Q: How many coronavirus deaths have there been in the U.S.?

A: So far, not many. CDC reports 36 deaths. Adding various news reports, the number could be about 40 and growing. Although one death is too many, the reported deaths are among 43 states (including the District of Columbia) reporting outbreaks since January in a population of more than 327 million people.

Q: How many young people have died of coronavirus in the U.S.?

A: So far, there are no reports of deaths among young people in the U.S. The U.S. Surgeon General reports the average age of people who have died from coronavirus in the U.S. is 80. Additionally, he says those who are most impacted have chronic, serious health problems such as heart disease, diabetes, and lung disease.

Q: Who has died so far?

A. These were compiled using CDC reports plus news and local health department reports: 

  • 31 Washington State elderly. That includes 27 in King County, (22 at the same elderly nursing facility in Kirkland), three in Snohomish county, and one in Grant County, a patient in their 80s.
  • Four California elderly: A woman in assisted living in her 90s, a hospitalized woman Santa Clara in her 60s, an “elderly man” in assisted living, and a 71-year-old man with underlying health conditions who’d been on a Grand Princess cruise ship. 
  • Two Florida residents in their 70s who had traveled overseas. 
  • One New Jersey diabetic man, 69, who suffered two cardiac arrests. 
  • One South Dakota man aged 60-69, with “underlying medical conditions”
  • One Georgia man, 67, with “underlying medical conditions”

Q: How many people have recovered?

A: News reports say that in China alone, out of 80,000 diagnosed, nearly 60,000 have already recovered. However, the true number of recovered is likely far higher since most of those who get the virus have mild or no symptoms, and so are not diagnosed at all.

Q: Why have there been so many coronavirus deaths in Italy?

A: Italy has reported 827 coronavirus deaths. Experts say the high number is partly because Italy has more residents in the vulnerable age category. Italy has the oldest population in Europe and more elderly per capita than the U.S. Most of the Italian deaths are in patients in their 80s and 90s. In addition, Italy has a great number of direct China contacts. Italy was the first to join China’s “silk road” economic partnership project. The coronavirus is believed to have originated in China. Italy’s 827 deaths are out of a population of 60 million people. Even though one death is too many, it is still a small relative number.

Q: Why am I hearing so many different fatality rates?

A: Experts say all coronavirus death rates are nothing more than estimates at the moment. That’s because it is impossible to know how many people have or had the virus. And that total number is needed to calculate an accurate rate. What makes it more difficult is the fact that most people have few or no symptoms, and so it is impossible to count them.

Some current death rates that sound high are being calculated in a particular age group. The rate will be highest among the elderly and, in the U.S., there have been zero deaths among people age 50 and under. Some death rates are being calculated as deaths among the sickest patients, those are diagnosed and treated, which will produce a much higher number than a more accurate death rate that takes into consideration those patients who are infected but do not become ill at all.

via – Just The News | SourceJust The News | Search  》coronavirus facts symptoms

Protect Your Mind as Much as You Protect Your Body

In a new epoch of Global Pandemic. Author Patrick Allan at LifeHacker pens some Stoic Wisdom for the ages.

Protect Your Mind as Much as You Protect Your Body
Stoic Wisdom in stone. Protect Your Mind as Much as You Protect Your Body. Photo by Paul VanDerWerf.

Epictetus in Enchiridion (28). asks why we don’t value our mind’s protection the same as our body’s:

“If a person gave your body to any stranger he met on his way, you would certainly be angry. And do you feel no shame in handing over your own mind to be confused and mystified by anyone who happens to verbally attack you?”

 

Here’s another version:

“If a person gave away your body to some passerby, you’d be furious. Yet you hand over your mind to anyone who comes along, so they may abuse you, leaving it disturbed and troubled—have you no shame in that?”

What It Means

This question that Epictetus asks is in the form of a mini thought experiment. If you were walking along and somebody took your body and did whatever they liked with it, you’d be angry, right? So you do your best to keep people from touching, grabbing, or moving your body unless you authorize it.

But for some reason we don’t usually exercise such stalwart defenses when it comes to our minds. We hand our minds over to anyone and anything that comes along, be it an advertisement, a politician, a social media post, the news, or just a stranger who wants to put us down and disrupt our day. Doesn’t that bother you?

What to Take From It

There are so many things out there that distract us, confuse us, make us doubt ourselves, get us angry, and push us in directions we never intended to go. This is because we let it happen. We choose to let those things in and affect us, and this is the unshakeable basis of stoicism itself.

Granted, it’s not easy to just block everything out. We have to battle against our own instincts and biology to do that. Still, we can all stand to defend our minds a bit more. Every day, think about ways you can guard your inner self from the never-ending onslaught of persuasion. Learn to recognize what an attack on your mind looks like—from something as small as a superfluous distraction to something bigger like a villainous acquaintance—and, once a day, say to yourself, “No, I’m not letting this in.” The same way you’d slap away an unwanted hand trying to grab your body, slap away an incursion on your mind.

Your body and mind are the only two things you’ll always own as long as you’re alive and coherent. No matter what, you always need them both as they are your two most valuable possessions. Why not defend them equally?

You can read all of Enchiridion for free here.

via – Lifehacker | SourceLifehacker | Search  》stoic wisdom

Coronavirus Symptoms: WHO Reveals Common Signs Based On Analysis Of Confirmed Cases

World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus
World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus attends a daily press briefing on COVID-19 at the WHO headquaters on March 6, 2020 in Geneva. (Photo by FABRICE COFFRINI / AFP)

The World Health Organization declared the COVID-19 outbreak a pandemic on Wednesday. Over 118,000 cases and 4,000 deaths have been reported so far. The WHO’s new analysis has revealed the most common symptoms ever since the outbreak in China in 2019.

Here is a gist of the most common symptoms, according to the report that analyzed over 55,900 confirmed cases:

  1. COVID-19 symptoms are non-specific and the disease presentation can range from asymptomatic to fatal ones such as severe pneumonia or death
  2. Typical signs and their prevalence: Fever: 87.9%, Dry Cough: 67.7%, Fatigue: 38.1%, Sputum production: 33.4%, Shortness of breath: 18.6%, Sore throat: 12.9%, Headache: 13.6%, Myalgia/Arthralgia: 14.8%, Chills: 11.4%, Nausea/Vomiting: 5%, Nasal Congestion: 4.8%, Diarrhea: 3.7%, Hemoptysis: 0.9%, and Conjunctival congestion: 0.8%.
  3. The symptoms generally develop about 5-6 days after infection and the mean incubation period ranges from 1-14 days
  4. About 80% of individuals who testes positive for COVID-19, exhibited mild symptoms and recovered
  5. 13.8% have severe symptoms including dyspnea, respiratory failure, septic shock and/or multiple organ failure
  6. While there were cases reported of asymptomatic infection, a majority of them went on to develop symptoms.
  7. Individuals at the highest risk of severe symptoms and fever: Older adults over 60, those with underlying health conditions such as diabetes, hypertension, cardiovascular disease, chronic respiratory disease and cancer
  8. COVID-19 in children appears to be relatively rare, with mild symptoms and only 2.4% of the total reported cases were under 19.
  9. The crude fatality ratio (CFR) varies by location as well as the intensity of transmission. In China, the CFR which was higher in the early stages of the outbreak has reduced over time
  10. Mortality rates increases with age and the highest mortality rates are seen among older adults over 80 and higher among men compared to women.

“We have never before seen a pandemic sparked by a coronavirus. And we have never before seen a pandemic that can be controlled at the same time,” CNN Health quoted WHO Director-General Tedros Adhanom Ghebreyesus. “Describing the situation as a pandemic does not change WHO’s assessment of the threat posed by this coronavirus. It doesn’t change what WHO is doing, and it doesn’t change what countries should do,” he added.

coronavirus-france-gel
Employees of a laboratory work on the production of hydroalcoholic solution according to WHO recommendations for hygienic hand disinfection in Paris, France, March 13, 2020. Photo: REUTERS/Benoit

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How to Prevent Loneliness in a Time of Social Distancing

Here’s advice for preserving your mental health while avoiding physical proximity

How to Prevent Loneliness in a Time of Social Distancing
Human beings are social creatures. Necessary social isolation during the Coronavirus pandemic is a challenge for our social & mental wellbeing. (Credit: Richard Bailey Getty Images)

With increasing numbers of people isolated because of quarantine and social distancing, COVID-19 is not the only public health threat we should be worried about—loneliness is one as well.

While scientists are rushing to understand how the coronavirus works, researchers have long understood the toll that social isolation and loneliness take on the body. People who do not feel connected to others are more likely to catch a cold, experience depression, develop heart disease, have lower cognitive function and live a shorter life. In fact, the long-term harm caused by loneliness is similar to smoking or obesity.

In January, a national survey found that 79 percent of Gen Zers, 71 percent of millennials and 50 percent of baby boomers feel lonely. Similarly, the proportion of people who belong to any kind of community group, such as a hobby club, sports league or volunteer group, fell from 75 to 57 percent over the past decade. Even without the coronavirus keeping us apart, it seems the majority of the population suffers from poor social health.

Although isolation is the right response to the coronavirus pandemic, we need the exact opposite in response to the loneliness epidemic. So how can you cultivate your social well-being while avoiding infection?

An obvious answer is the device you are reading this article on. People often blame technology for the prevalence of loneliness, pointing out that we spend too much time scrolling through social media and not enough of it interacting IRL. Yet recent research by my colleagues at the Harvard T. H. Chan School of Public Health paints a more nuanced picture: how you use such platforms seems to matter more than how much you do so. We can all benefit from developing digital habits that support meaningful human connections—especially now that it may be our only option until the outbreak calms.

Whether you are quarantined, working remotely or just being cautious, now is the perfect time to practice using technology in socially healthy ways. Here are a few suggestions for how to connect without contact.

Face-to-face from afar: The next best thing to in-person interaction is video chat, because facial cues, body language and other nonverbal forms of communication are important for bonding. When possible, opt for video over messaging or calling and play around with doing what you would normally do with others. For example, try having a digital dinner with someone you met on a dating app, a virtual happy hour with friends or a remote book club meeting.

One-minute kindness: Getting lots of likes on a social media post may give you a fleeting hit of dopamine, but receiving a direct message or e-mail with a genuine compliment or expression of gratitude is more personal and longer lasting—without taking much more time. When you find yourself scrolling through people’s posts, stop and send one of them a few kind words. After all, we need a little extra kindness to counter the stress and uncertainty of the coronavirus.

Cultivate your community: The basis of connection is having something in common. Whatever your niche interest is, there is an online community of people who share your passion and can’t wait to nerd out with you about it. There are also digital support groups, such as for new parents or patients with a rare disease. Use these networks to engage around what matters most to you.

Deepen or broaden: Fundamentally, there are two ways to overcome loneliness: nurture your existing relationships or form new ones. Reflect on your current state of social health and then take one digital action to deepen it—such as getting in touch with a friend or family member you haven’t spoken with in a while—or to broaden it—such as reaching out to someone you’d like to get to know.

Use a tool: Increasingly, apps and social platforms are being designed to help us optimize our online interactions with loved ones, including Ikaria, Cocoon, Monaru and Squad. If you do well with structure, these resources may be a useful option for you. Or you can consider using conversation prompts, such as TableTopics or The And, to spark interesting dialogue during a video call.The coronavirus pandemic has reminded us that human connection can spread illness. But human connection also promotes wellness. Let’s take this opportunity to recognize the importance of relationships for our health and to practice leveraging technology for social well-being.

State of Alaska is exploring options for housing people quarantined for coronavirus

The remotest state of the union is doing some blue-sky thinking when it comes to Coronavirus quarantine housing plans.

alaska-coronavirus-quarantine-plans
Alaska may be planning to house much-needed Coronavirus quarantine patients. (iStock/Getty Images)

The State of Alaska put out a request this week “seeking information from interested parties for providing housing units that are quarantined to allow for monitoring for COVID-19.”

“The State wishes to identify companies that are capable of providing the housing units and gain an understanding of the potential project cost for budgeting purposes,” the request said.

The state is seeking “motel rooms, apartments, trailers, or other suitable dwellings,” the request said. The units must be located so the general public can avoid interaction with those being quarantined, it said. Apartments or hotels may not be suitable if there is a common hallway, for example.

Outside of Alaska, many communities with a large number of patients in quarantine have repurposed buildings to provide temporary space. King County in Washington, which is a center of the West Coast coronavirus outbreak, for example, is in the process of purchasing an EconoLodge in the suburban community of Kent to house patients, a move that has been controversial with some of its neighbors.

The state’s Chief Medical Officer Anne Zink said that the housing wouldn’t necessarily be in one place, but there may be a variety of options that it could be used for including people who are homeless, people who need to disembark from cruise ships, people who can’t be isolated in their homes or people traveling through the state for some other reason.

“We want to make sure we are nimble,” she said.

Gov. Mike Dunleavy said the state is assessing all potential resources.

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How long can the new coronavirus last on surfaces?

A new study suggests the virus can live on surfaces for up to 3 days.

How long can the new coronavirus last on surfaces
The new SARS-CoV-2 remains a mystery. (Image: © NIAID-RML)

As the coronavirus outbreak continues to accelerate in the U.S., cleaning supplies are disappearing off the shelves and people are worried about every subway rail, deli counter and toilet seat they touch. 

But how long can the new coronavirus linger on surfaces, anyway? The short answer is, we don’t know. A new analysis found that the virus can remain viable in the air for up to 3 hours, on copper for up to 4 hours, on cardboard up to 24 hours and on plastic and stainless steel up to 2 to 3 days. However, this study, which was published in the preprint database medRxiv on Wednesday (March 11),  has not yet yet been peer-reviewed.

Another study published in February in The Journal of Hospital Infection analyzed several dozen previously published papers on human coronaviruses (other than the new coronavirus) to get a better idea of how long they can survive outside of the body. 

They concluded that if this new coronavirus resembles other human coronaviruses, such as its “cousins” that cause SARS and MERS, it can stay on surfaces —  such as metal, glass or plastic — for as long as nine days (In comparison, flu viruses can last on surfaces for only about 48 hours.)

But some of them don’t remain active for as long at temperatures higher than 86 degrees Fahrenheit (30 degrees Celsius). The authors also found that these coronaviruses can be effectively wiped away by household disinfectants. 

For example, disinfectants with 62-71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite (bleach) can “efficiently” inactivate coronaviruses within a minute, according to the study. “We expect a similar effect against the 2019-nCoV,” the researchers wrote, referring to the new coronavirus. But even though the new coronavirus is a similar strain to the SARS coronavirus, it’s not clear if it will behave the same.

It’s also not clear how frequently hands become contaminated with coronaviruses after touching a sick patient or contaminated surface, according to the study. The World Health Organization recommends washing hands or using alcohol-based hand rubs for decontamination of the hands, the authors wrote.

It’s possible that a person can be infected with the virus by touching a contaminated surface or object, “then touching their own mouth, nose, or possibly their eyes,” according to the Centers for Disease Control and Prevention (CDC). “But this is not thought to be the main way the virus spreads.” Though the virus remains viable in the air, the new study can’t say whether people can become infected by breathing it in from the air,  according to the Associated Press

The virus is most likely to spread from person to person through close contact and respiratory droplets from coughs and sneezes that can land on a nearby person’s mouth or nose, according to the CDC.

via – Livescience | SourceLivescience | Search  》coronavirus