Emergence of a Deadly Coronavirus

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I've heard that the V4 countries (Hungary,Poland,Slovakia and the Czech Republic) were the best cooperating countries.

second wave of the coronavirus is on the way. When it arrives, we will lack the will to deal with it. Despite all the sacrifices of the past months, the virus is likely to win—or perhaps it would be more accurate to say that it already has.

In absolute terms, the United States has been hit harder than any other country. About a quarter of worldwide deaths have been recorded on these shores. And while the virus is no longer growing at an exponential rate, the threat it poses remains significant: According to a forecasting model by Morgan Stanley, the number of American cases will, if current trends hold, roughly double over the next two months.

But neither the impact of mass protests over police brutality nor the effect of the recent reopening of much of the country—including the casinos in Las Vegas—is reflected in the latest numbers. It can take at least 10 days for people to develop symptoms and seek out a test, and for the results to be aggregated and disseminated by public-health authorities.

Even so, the disease is slowly starting to recede from the public’s attention. After months of dominating media coverage, COVID-19 has largely disappeared from the front pages of most national newspapers. In recent polls, the number of people who favor “reopening the economy as soon as possible” over “staying home as long as necessary” has increased. And so it is perhaps no surprise that even states where the number of new infections stands at an all-time high are pressing ahead with plans to lift many restrictions on businesses and mass gatherings.

When the first wave of COVID-19 was threatening to overwhelm the medical system, back in March, the public’s fear and uncertainty were far more intense than they are now. So was the reason to hope that some magic bullet might rescue us from the worst ravages of the disease.

At this point, such hopes look unrealistic. After months of intense research, an effective treatment for COVID-19 still does not exist. A vaccine is, even if we get lucky, many months away from deployment. Because the virus is spreading especially rapidly in parts of the Southern Hemisphere, from Latin America to Africa, heat is clearly no impediment to its dissemination.

Perhaps most important, it is now difficult to imagine that anybody could muster the political will to impose a full-scale lockdown for a second time. As one poll in Pennsylvania found, nearly nine out of 10 Republicans trusted “the information you hear about coronavirus from medical experts” back in April. Now just about one in three does. With public opinion more polarized than it was a few months ago, and the presidential election looming, any attempt to deal with a resurgence of the virus is likely to be even more haphazard, contentious, and ineffective than it was the first time around.

In the fullness of time, many books will be written about why a country as rich, powerful, and scientifically advanced as the United States failed quite so badly at coping with a public-health emergency that experts had predicted for many years. As is always the case, competing explanations will quickly emerge. Some will focus on the incompetence of the Trump administration, while others will draw attention to the country’s loss of state capacity; some will argue that the United States is an outlier, while others will put its failure in the context of other countries, such as Brazil and Russia, that are also faring poorly.

I do not intend to offer a first draft of history. We are too close to the events to judge, with a cool head, which factors are most responsible for putting us in our current tragic situation. But I would like to offer a partial list of individuals and institutions who, however central or peripheral their contribution to the ultimate outcome, have helped to get us into this mess:

If the virus wins, it is because the World Health Organization downplayed the threat for far too long.

If the virus wins, it is because Donald Trump was more interested in hushing up bad news that might hurt the economy than in saving American lives.

If the virus wins, it is because the Centers for Disease Control and Prevention, created to deal with just this kind of emergency, has proved to be too bureaucratic and incompetent to do its job.

If the virus wins, it is because the White House did not even attempt to put a test-and-trace regime into place at the federal level.

Although we do not yet know the effect of more recent events on the course of the pandemic, or what exactly will happen in the coming weeks and months, the list of culprits will likely be even longer than that.

If the virus wins, it may also be because Derek Chauvin kept his knee on George Floyd’s neck for eight minutes and 46 seconds as Floyd was pleading for his life, setting off protests that—as righteous as they are—could well result in mass infections.

If the virus wins, it may also be because 1,200 public-health experts obfuscated the mortal risk that these mass protests would pose to the most vulnerable among us by declaring not only (as would be reasonable) that they supported them as citizens, but also (which is highly implausible) that they had determined, as scientists, that they would actively serve “the national public health.

If the virus wins, it may also be because so many states moved to reopen before getting the pace of infections under control.

If the virus wins, it may also be because the right-wing-media echo chamber is starting to downplay the risk that a second wave poses to Americans.

If the virus does win, then, it is because American elites, experts, and institutions have fallen short—and continue to fall short—of the grave responsibility with which they are entrusted in ways too innumerable to list.

bout a month ago, I started to write a very different article. “Is it possible,” I wondered, “that with the benefit of hindsight, this cruel period will seem rather more heroic than is obvious to its contemporaries? One thing is clear: If we had let the virus rip through the population unchecked, the consequences would have been unspeakable. But if—a big if—we manage to contain the pandemic, and avert millions of deaths, it would constitute one of the greatest achievements in human history.”

Hoping to publish the article in The Atlantic, I kept waiting for the situation in the United States to recover sufficiently to justify my guarded optimism. But that moment never arrived. Now it feels more remote than ever.

We were on the brink of doing something incredible. And much of the credit for that would have gone to the many ordinary citizens who lived up to their moral responsibility in an extraordinary moment.

Scientists have desperately searched for a vaccine. Despite the real risks to their health, doctors, nurses, cooks, cleaners, and clerical staff have reported for duty in their hospitals. Suddenly declared “essential,” workers who have long enjoyed little respect and low wages helped to keep society afloat.

For the rest of us, the order of the day was simply to stay at home and slow the spread. It was a modest task, which made it all the more galling that some people fell short. But this nitpick obscures how many people did do what they could to get us all through the crisis: They checked in with their relatives and cooked for the elderly. They took to their balconies to thank health-care workers or sang songs to cheer up the neighbors. By and large, they stayed at home and slowed the spread.

Thanks to the effort of millions of people, we were close to a great success story. But because of the failures of Trump and Chauvin, of the CDC and the WHO, of public-health experts and Fox News hosts, we are, instead, likely to give up—and tolerate that hundreds of thousands of our fellow citizens will die needless deaths.

Pandemics reveal the true state of a society. Ours has come up badly wanting.

In the trial, led by a team from Oxford University, about 2,000 hospital patients were given dexamethasone and compared with more than 4,000 who were not.

For patients on ventilators, it cut the risk of death from 40% to 28%.

For patients needing oxygen, it cut the risk of death from 25% to 20%.

Chief investigator Prof Peter Horby said: "This is the only drug so far that has been shown to reduce mortality - and it reduces it significantly. It's a major breakthrough."

Lead researcher Prof Martin Landray said the findings suggested one life could be saved for:

every eight patients on a ventilator
every 20-25 treated with oxygen

"There is a clear, clear benefit," he said.

"The treatment is up to 10 days of dexamethasone and it costs about £5 per patient.

"So essentially it costs £35 to save a life.

"This is a drug that is globally available."

When appropriate, hospital patients should now be given it without delay, Prof Landray said.

But people should not go out and buy it to take at home.

Dexamethasone does not appear to help people with milder symptoms of coronavirus who do not need help with their breathing.

Good news:
Cheap, readily available steroid can save (some) lives of serious COVID patients
https://www.bbc.com/news/health-53061281

Good news:
Cheap, readily available steroid can save (some) lives of serious COVID patients

https://www.bbc.com/news/health-53061281

Authorities in Beijing have imposed a soft lockdown on the entire city, after the Chinese capital reported more than 100 new locally transmitted coronavirus cases in the past five days.

The city raised its alert level from Level 3 to Level 2 -- the highest alert being Level 1 -- the Beijing government's Deputy Secretary Chen Bei announced in a press conference Tuesday night.

The move comes as the city's latest coronavirus outbreak continued to spread Tuesday, with at least 106 new infections since Thursday following an outbreak at Xinfadi, the city's largest wholesale food market.

Officials had earlier locked down more residential compounds, ordered more than 30,000 restaurants to be disinfected and tightened outbound travel.

All residents living communities deemed medium or high risk, as well as people connected to the Xinfadi market, are banned from leaving the city.

The sprawling, bustling market in Beijing's southwestern Fengtai district occupies 277 acres and has more than 2,000 stalls, selling mainly fruit and vegetables as well as meat and seafood. It supplies about 70% of the city's vegetables and 10% of its pork, according to officials.

The market has been shut down since Saturday, but its sheer size and the amount of people who work or visit there from in and outside of Beijing have heightened the risk of the outbreak spreading.

For the rest of the city's more than 20 million residents, non-essential travel out of town is strongly discouraged, according to the government announcement. Those who must travel need to present a negative result from tests conducted within seven days of departure.

The city is reintroducing strict access rules in and out of all local residential communities, and shutting down all schools and recreational venues. Sporting events will also be canceled.

Via door-to-door visits and calls, authorities have tracked down nearly 200,000 people who had been to the market during the two weeks prior to its closure. They have been told to stay at home for medical observation and are being tested for the coronavirus, a city official told a news conference on Monday.

Residential lockdown
Two other Beijing food markets have been shut down due to confirmed cases linked to Xinfadi, leading to strict residential lockdowns in their vicinity.

On Tuesday, Xicheng district -- which neighbors Fengtai -- announced that seven residential communities around the Tiantao Honglian market will be locked down following the discovery of a coronavirus case on Sunday.

This follows similar lockdowns on residential compounds near Xinfadi and the Yuquandong market in Haidian district. In total, 29 residential communities have been locked down across the city.

The residential lockdown measures are similar to the ones imposed earlier in the city of Wuhan, the original epicenter of the coronavirus outbreak.

Wang Du, who lives in one of the communities under lockdown near Yuquandong market, said residents couldn't leave the compound to buy groceries, and had to order food online or buy from a truck that came to the compound once a day with potatoes, fresh vegetables and eggs

China's new coronavirus outbreak sees Beijing adopt 'wartime' measures as capital races to contain spread
China's new coronavirus outbreak sees Beijing adopt 'wartime' measures as capital races to contain spread
She said all residents in her community had nucleic acid tests for the coronavirus yesterday.

"To be honest, I'm not too worried," she said. "I think we have a lot of experience in containment measures, and we're able to react very swiftly (to the new outbreak)."

As of Tuesday morning, 276 agricultural produce markets and 33,173 restaurants across the city had also been disinfected, officials said.

Outbound travel restricted
The outbreak has also spread beyond Beijing, with the nearby provinces of Liaoning and Hubei reporting a total of eight coronavirus cases linked to the capital clusters.

On Tuesday, Sichuan province in the country's southwest also reported a confirmed case -- a woman who returned from Beijing on June 9. She was infected while visiting her husband, who worked at Xinfadi market.

Unlike Wuhan, the epicenter of China's original outbreak, Beijing has not completely cut off travel. However outbound taxi and car-hailing services, and some long-distance bus routes between Beijing and neighboring provinces have been suspended, according to the state-run Beijing Daily.

Municipal authorities also banned high-risk groups, such as close contacts of confirmed cases, from leaving the city, officials said Monday.

On Tuesday, Shanghai announced that travelers from areas with medium-to-high coronavirus risk would be required to be quarantined for 14 days. Beijing had one neighborhood designated as high-risk and 22 as medium-risk as of Monday.

Texans under the age of 30 are testing positive for the new coronavirus at a higher rate than previously seen since the pandemic began, contributing to a recent surge in the number of cases in the state, Gov. Greg Abbott said during a press conference Tuesday.

Data from several counties and health experts confirms the trend in younger people testing positive across Texas.

"There are certain counties where a majority of the people who are tested positive in that county are under the age of 30, and this typically results from people going to bars," Abbott said during the conference. "That is the case in Lubbock County, Bexar County, Cameron County."

Abbott said that it’s unclear why more young people are contracting the virus, but he speculated that it could be from increased activity over Memorial Day weekend, visits to bars or other types of social gatherings.

This comes as Texas businesses have begun to reopen with relaxed restrictions under Abbott’s executive orders. As of last Friday, restaurants can operate at 75% capacity, while almost all other businesses can operate at 50%. Texas water parks and amusement parks have been allowed to reopen as well. In recent weeks, thousands of Texans have also flooded the streets of some of the largest cities to protest police brutality in the wake of George Floyd’s death.

One of the areas of concern Abbott mentioned was Hays County, where 476 of the 938 confirmed cases are people ages 20 to 29. People in their 20s accounted for 50.7% of all the cases in Hays County as of Monday, an increase from Friday, when the age group made up 42% of total cases.

Last week, epidemiologist Eric Schneider warned that those numbers are "staggering" for Hays County.

San Antonio Mayor Ron Nirenberg also expressed concern Monday about more young people getting sick.

“What’s most concerning is that we’ve seen the largest increase in infection among 20-year-olds,” Nirenberg said in a televised interview with ABC, adding that city officials are seeing younger patients in the hospitals as well. “While they may survive an illness, younger people are going to be stuck with a pretty hefty medical bill at the end of it.”

In Travis County and the city of Austin, the median age of all positive cases has ticked downward to 38 years old this week, from 39 years old last week. Twenty- to 29-year-olds make up 24% of all cases in the area and 8.3% of the hospitalizations.

As for Dallas County, the trend is reflected in hospitalizations rather than new cases. Almost a month ago, on May 19, 18% of all people hospitalized were between the ages of 18 and 40, the age range used by local officials to designate young adults. On Tuesday, that age group made up 21% of hospitalizations.

Dr. David Persse, public health authority for the Houston Health Department, said the same trend is materializing in Harris County. Overall, 17.5% of all people impacted in that area are people in their 20s.

"It is my current theory that elder persons have become more vigilant in taking precautions," Persse said.

Angela Clendenin, an epidemiologist and biostatistician at Texas A&M University, said young people may be acting less cautious than older Texans because they're careless or more confident in their ability to fight off the virus, she said.

"It boils down to behaviors," she said. "Younger people, because they're asymptomatic or mildly symptomatic, going about business as usual, still wanting to hang out with each other. ... They feel perfectly comfortable that they're fine and they will be fine."

Some have suggested the surge in cases could be due to increased testing access.

But for Galveston County, the increase in cases affecting young people is not a result of more testing, said Dr. Philip Keiser, the local health authority.

“Fewer people are getting tested, but more people are becoming positive. Of those becoming positive, they are overrepresented by young people,” he said.

Keiser estimated that last week, about half of the new cases in that county were in their 20s, which he says could be due to “COVID fatigue” and more people are going out than before.

During the press conference, Abbott blamed lax adherence to social distancing at bars for part of the problem. He reiterated the Texas Alcoholic Beverage Commission’s recent warning to bars and restaurants that serve alcohol that if they do not follow COVID-19 guidelines, their licenses could be suspended for 30 or 60 days.

“There have been pictures that I have seen and others have seen about these bar-type settings where clearly the standards are not being followed,” Abbott said. “Enforcements from the TABC should bring these types of settings more and align to being safer standards.”

Abbott’s comments come as the number of people hospitalized for the virus in Texas reached record highs eight of the last nine days.

There were more than 2,500 confirmed COVID-19 patients in Texas hospitals Tuesday, nearly 200 more than the day before, according to state data. That number — a gauge for the severity of the disease and the amount of available hospital beds — has risen almost every day since the beginning of June. There are still about 15,000 hospital beds open in the state, as well as 1,700 ICU beds.

“Even though there are more people hospitalized, we still remain at the lowest threat level to our hospital capacity,” Abbott said Tuesday. The number of new reported cases has also increased. Abbott attributed recent and sometimes dramatic upswings to targeted testing that has been done in hard-hit facilities like meatpacking plants and nursing homes.

Another metric to evaluate the situation is the length of stay in hospitals. Dr. Mark Escott, the interim health authority for Austin and Travis County, said that about half of the people hospitalized go out in four days or less.

“But we still have some which are prolonged for 30, 60 days, sometimes longer,” he warned.

A genetic analysis of COVID-19 patients suggests that blood type might influence whether someone develops severe disease.

Scientists who compared the genes of thousands of patients in Europe found that those who had Type A blood were more likely to have severe disease while those with Type O were less likely.

Wednesday's report in the New England Journal of Medicine doesn't prove a blood type connection, but it does confirm a previous report from China of such a link.

Most of us discounted it because it was a very crude study," Dr. Parameswar Hari, a blood specialist at the Medical College of Wisconsin, said of the report from China. With the new work, "Now I believe it," he said. "It could be very important."

Other scientists urged caution.

The evidence of a role for blood type is "tentative ... it isn't enough of a signal to be sure," said Dr. Eric Topol, head of the Scripps Research Translational Institute in San Diego.

The study, involving scientists in Italy, Spain, Denmark, Germany and other countries, compared about 2,000 patients with severe COVID-19 to several thousand other people who were healthy or who had only mild or no symptoms. Researchers tied variations in six genes to the likelihood of severe disease, including some that could have a role in how vulnerable people are to the virus. They also tied blood groups to possible risk.

Most genetic studies like this are much larger, so it would be important to see if other scientists can look at other groups of patients to see if they find the same links, Topol said.

Many researchers have been hunting for clues as to why some people infected with the coronavirus get very ill and others, less so. Being older or male seems to increase risk, and scientists have been looking at genes as another possible "host factor" that influences disease severity.

There are four main blood types - A, B, AB and O - and "it's determined by proteins on the surface of your red blood cells," said Dr. Mary Horowitz, scientific chief at the Center for International Blood and Marrow Transplant Research.

People with Type O are better able to recognize certain proteins as foreign, and that may extend to proteins on virus surfaces, Hari explained.

During the SARS outbreak, which was caused by a genetic cousin of the coronavirus causing the current pandemic, "it was noted that people with O blood type were less likely to get severe disease," he said.

Blood type also has been tied to susceptibility to some other infectious diseases, including cholera, recurrent urinary tract infections from E. coli, and a bug called H. pylori that can cause ulcers and stomach cancer, said Dr. David Valle, director of the Institute of Genetic Medicine at Johns Hopkins University.

Bottom line: "It's a provocative study. It's in my view well worth publishing and getting out there," but it needs verification in more patients, Valle said.

While loss of taste or smell has been a known symptom of COVID-19, some parents are now saying that their children are losing those senses weeks or even months after recovering from the virus. NBC New York’s Melissa Russo reports.

Prince Charles has still not fully regained his sense of smell and taste after having coronavirus in March, he revealed on a visit to NHS staff.

The prince discussed his personal experience with the virus as he met workers at the Gloucestershire Royal Hospital - at a 2m distance.

Prince Charles greeted some of those he met with a "namaste" - clasping his hands together - instead of a handshake.

Jeff Mills, 47, a healthcare assistant from Cheltenham General Hospital, said: "He did speak of his personal experience, so first-hand experience for him.

"He also spoke about his loss of smell and taste and, sort of, still felt he's still got it now."