Complemento mis reportes diarios vespertinos con las noticias relevantes del mes de mayo, sobre la pandemia de COVID-19. Me limitaré, como en el mes anterior, a compartir aquellas que me lleguen provenientes de fuentes de reconocido prestigio internacional, que ofrezcan información actualizada y objetivamente verificable. Por lo tanto, no encontrarán en esta entrega ninguna clase de “meme”, ni las mentiras que abundan en nuestra redes sociales sobre el COVID-19. Mantendré los títulos en el idioma original de los artículos, seguido de un brevísimo resumen, también el idioma original.
Adicionalmente los invito a visitar los informes de situación que publico diariamente. Allí encontrarán gráficas actualizadas y explicativas del Informe de Situación de la OMS y del MINSA, correspondiente al día que se trate.
Noticias relevantes del mes de mayo
As the world grapples with how to safely reopen society in the midst of the coronavirus pandemic, scientists have been racing to understand whether COVID-19 infection confers immunity—and how long such immunity might last. A lot of hangs in the balance: A strong immune response could mean people who have already been infected would be able to safely return to work. And it would also bode well for vaccine development efforts.
With a little luck and a lot of science, the world might in the not-too-distant future get vaccines against Covid-19. But those vaccines won’t necessarily prevent all or even most infections. In the public imagination, vaccines are often seen effectively as cure-alls, like inoculations against measles. Rather than those vaccines, however, the Covid-19 vaccines in development may be more like those that protect against influenza — reducing the risk of contracting the disease, and of experiencing severe symptoms should infection occur, a number of experts told STAT.
Here’s a guide to some of the most talked-about efforts to treat or prevent coronavirus infection, with details on the science, history, and timeline for each endeavor (and we will update the tracker with any new developments). We’re looking at novel medicines, not repurposed drugs. (For more on some of the efforts to repurpose drugs, read this.) The below therapies and vaccines are sorted in order of how close they could be to approval, starting with a treatment in Phase 3 trials, followed by others in Phase 1 studies and then preclinical development. Approval, of course, would only come if they are proven safe and effective.
Con la pandemia del coronavirus amenazando vidas y el bienestar, la mayoría de los gobiernos en América Latina y el Caribe han impuesto límites estrictos a las interacciones sociales para manejar mejor el contagio. Sin embargo, tras dos meses de confinamiento, el costo para las economías de la región es evidente. Cerca de la mitad de los hogares han reportado pérdidas de empleos, y la mayoría de las empresas han cerrado o recortado drásticamente sus operaciones. A medida que el riesgo de infección disminuye en las semanas y meses venideros, el levantamiento gradual de las restricciones ofrece la esperanza de poner a la región en la vía hacia la recuperación económica.
Six months into the global coronavirus pandemic, and more than two months into the widespread lockdowns of American public life, we have lots and lots of data. But what have we learned? The hard data we have today remains flawed, and it can tell us a lot more about the “where” of the pandemic than the “why.” One of the chief lessons we can take is the difficulty of comparing very different regions of the world. America isn’t South Korea or New Zealand, and never could have been. Another is quite how uniquely bad the situation in the New York metro area has been. For today, let’s focus on a single metric: deaths per capita. It is the ultimate bottom line: How many of your people have you lost?
Since china locked down the city of Wuhan on January 23rd, over a third of the world’s population has at one time or another been shut away at home. It is hard to think of any policy ever having been imposed so widely with such little preparation or debate. But then closing down society was not a thought-out response, so much as a desperate measure for a desperate time. It has slowed the pandemic, but at a terrible price. As they seek to put lockdowns behind them, governments are not thinking hard enough about the costs and benefits of what comes next.
Since early April, a growing number of businesses and governments around the world have begun to reopen, ushering in a new—if tenuous—phase of the coronavirus situation. Likewise, the results from our latest McKinsey Global Survey on the economy (conducted from May 4 to May 8, 2020) point to an improving outlook.1 Executives are much likelier now than in April or March to expect improving conditions and increased growth rates in the months ahead.
There’s nothing like a worldwide pandemic and its incessant media coverage to get you ruminating on the fragility of life. And those thoughts of death triggered by the coronavirus amplify the best and worst in people. The results of this psychological phenomenon are all around: people hoarding toilet paper and hand sanitizer, hurling ethnic slurs and attacking Asian Americans, heaping praise or scorn on President Trump, hailing new political and health care heroes. Sheltering at home has drawn some families closer together but is a crucible of domestic violence for others. For many, social distancing has increased feelings of isolation, boredom, anxiety and despair. What’s behind these attitudinal and behavioral shifts?
While coronavirus disease 2019 (COVID-19) continues to spread across the globe, many countries have decided to close schools as part of a physical distancing policy to slow transmission and ease the burden on health systems. The UN Educational, Scientific and Cultural Organization estimates that 138 countries have closed schools nationwide, and several other countries have implemented regional or local closures. These school closures are affecting the education of 80% of children worldwide. Although scientific debate is ongoing with regard to the effectiveness of school closures on virus transmission, the fact that schools are closed for a long period of time could have detrimental social and health consequences for children living in poverty, and are likely to exacerbate existing inequalities. We discuss two mechanisms through which school closures will affect poor children in the USA and Europe.
Un nuevo informe del Programa las Naciones Unidas para el Desarrollo advierte del deterioro de las condiciones a nivel sanitario, educativo y de calidad de vida. La pandemia del COVID-19 está, además, ampliando la desigualdad. Solo la implementación de medidas coordinadas basadas en la igualdad podría limitar los efectos de la crisis.
Current guidance by the U.S. Centers for Disease Control and Prevention recommends patients who test positive isolate themselves until the following three criteria are fulfilled: 10 days have passed since symptoms first appeared, the patient has had three full days with no fever, and other symptoms like cough or shortness of breath are also improving. For close contacts who have been exposed, the CDC recommends a 14-day quarantine after the last date of exposure. (“Isolation” is the term used for confirmed positive patients, “quarantine” is used for exposed contacts; practically speaking, what you need to do is the same — stay away from others.)
States across the country are scrambling to hire tens of thousands of contact tracers, who will play a key role in keeping the coronavirus contained. Many experts I interviewed said that a high school diploma should be sufficient for a basic contact tracing job, though teams should be led by an experienced public health worker. Indeed, this could be an opportunity for the U.S. to provide employment for thousands of people who have recently lost their jobs.
La Organización Mundial de la Salud (OMS) recibió hoy un claro apoyo de los países para seguir liderando la respuesta global a la pandemia, mientras que una primera evaluación independiente aprueba su actuación y señala que los países no pueden pretender transferirle sus propias responsabilidades. “La respuesta de la Secretaría de la OMS al covid-19 fue más rápida que frente a las epidemias del SARS y del MERS (dos coronavirus anteriores que circularon entre humanos), pero esto no provocó una acción rápida por parte de todos los Estados miembros”, concluye en su primer informe el Comité Independiente de Supervisión de la organización. El documento, publicado coincidiendo con el primer día de la asamblea mundial de la OMS, la instancia de control recomienda que los países revisen el Reglamento Sanitario Internacional, que guía las acciones de la OMS en tiempos de crisis sanitarias, por el desfase que parece haber entre lo que son sus obligaciones y las expectativas de los países.
Moderna, the Massachusetts biotechnology company behind a leading effort to create a coronavirus vaccine, announced promising early results from its first human safety tests Monday. The company plans to launch a large clinical trial in July aimed at showing whether the vaccine works. The company reported that in eight patients who had been followed for a month and a half, the vaccine at low and medium doses triggered blood levels of virus-fighting antibodies that were similar or greater than those found in patients who recovered. That would suggest, but doesn’t prove, that it triggers some level of immunity. The antibody-rich blood plasma donated by patients who have recovered is separately being tested to determine whether it is an effective therapy or preventive measure for covid-19.
Coronavirus: cuánto debe preocuparnos que aparezcan nuevos brotes de covid-19 en los países que levantan la cuarentena
En momentos en que gran parte del mundo sigue confinado por la pandemia de SARS-CoV-2, los ojos están puestos en las ciudades y países que han empezado a levantar algunas de sus restricciones para regresar, paulatinamente, a un estado de relativa normalidad.
The airborne lifetime of small speech droplets and their potential importance in SARS-CoV-2 transmission
Speech droplets generated by asymptomatic carriers of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are increasingly considered to be a likely mode of disease transmission. Highly sensitive laser light scattering observations have revealed that loud speech can emit thousands of oral fluid droplets per second. In a closed, stagnant air environment, they disappear from the window of view with time constants in the range of 8 to 14 min, which corresponds to droplet nuclei of ca. 4 μm diameter, or 12- to 21-μm droplets prior to dehydration. These observations confirm that there is a substantial probability that normal speaking causes airborne virus transmission in confined environments.
El libro publicado por la Librería Editora Vaticana recoge ocho intervenciones del Papa en los primeros meses del año marcados la pandemia de coronavirus. Aquí se recogen ocho significativos textos, pronunciados o escritos desde el 27 de marzo al 22 de abril. ¿A quién se dirige el Papa, y cómo? ¿Qué dice y por qué? La lectura es guiada por el prefacio del cardenal Michael Czerny, subsecretario de la Sección de Migrantes del Dicasterio para el Servicio del Desarrollo Humano Integral, que ilustra el pensamiento unitario del Pontífice, su visión del futuro de la humanidad, lleno de amor y esperanza.
It seems many people are breathing some relief, and I’m not sure why. An epidemic curve has a relatively predictable upslope and once the peak is reached, the back slope can also be predicted. We have robust data from the outbreaks in China and Italy, that shows the backside of the mortality curve declines slowly, with deaths persisting for months. Assuming we have just crested in deaths at 70k, it is possible that we lose another 70,000 people over the next 6 weeks as we come off that peak. That’s what’s going to happen with a lockdown. As states reopen, and we give the virus more fuel, all bets are off. I understand the reasons for reopening the economy, but I’ve said before, if you don’t solve the biology, the economy won’t recover.
A daily chart that helps explain a changing world—during the pandemic and beyond. In case you missed them, this week featured a closer look at: European jobs at risk; The effects of school closures on working parents; Africa’s fiscal stimulus; Whether COVID-19 is claiming more lives than we think; How national economies can think about reopening
On the menu today: We could all dunk on people who were wrong in their early assessments of this pandemic, but the more pressing question is who is not learning from getting things wrong during this outbreak; one mainstream publication notices that the conventional wisdom on Florida was far from the truth; why the media’s reflexive partisan sympathies are leading Americans to not understand the virus and what policies work best to mitigate it; and a funny and brutally honest assessment of what’s coming to higher education.
Even before the pandemic, globalization was in trouble. The open system of trade that had dominated the world economy for decades had been damaged by the financial crash and the Sino-American trade war. Now it is reeling from its third body-blow in a dozen years as lockdowns have sealed borders and disrupted commerce (see Briefing). The number of passengers at Heathrow has dropped by 97% year-on-year; Mexican car exports fell by 90% in April; 21% of transpacific container-sailings in May have been cancelled. As economies reopen, activity will recover, but don’t expect a quick return to a carefree world of unfettered movement and free trade. The pandemic will politicize travel and migration and entrench a bias towards self-reliance. This inward-looking lurch will enfeeble the recovery, leave the economy vulnerable and spread geopolitical instability.
As of early May 2020, approximately 65 000 people in the US had died of coronavirus disease 2019 (COVID-19),1 the disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This number appears to be similar to the estimated number of seasonal influenza deaths reported annually by the Centers for Disease Control and Prevention (CDC). This apparent equivalence of deaths from COVID-19 and seasonal influenza does not match frontline clinical conditions, especially in some hot zones of the pandemic where ventilators have been in short supply and many hospitals have been stretched beyond their limits. The demand on hospital resources during the COVID-19 crisis has not occurred before in the US, even during the worst of influenza seasons. Yet public officials continue to draw comparisons between seasonal influenza and SARS-CoV-2 mortality, often in an attempt to minimize the effects of the unfolding pandemic.
More than 140 world leaders and experts, including the President of South Africa and Chair of the African Union, Cyril Ramaphosa, the Prime Minister of Pakistan, Imran Khan, the President of the Republic of Senegal, Macky Sall and the President of the Republic of Ghana, Nana Addo Dankwa Akufo-Addo have signed an open letter calling on all governments to unite behind a people’s vaccine against COVID-19. The call was made just days before health ministers meet virtually for the World Health Assembly on 18 May. The letter, which marks the most ambitious position yet set out by world leaders on a COVID-19 vaccine, demands that all vaccines, treatments and tests be patent-free, mass produced, distributed fairly and made available to all people, in all countries, free of charge.
Many governments hope salvation can come sooner, with contact-tracing apps on smartphones—even as a row brews over Apple’s and Google’s grip on the technology. These apps can be used to automate the difficult process of tracking down people who have been in contact with those diagnosed with covid-19, which is vital for keeping tabs on the virus. Countries from Bahrain and Bulgaria to Indonesia and Iceland have developed such apps. They are an attractive idea. Yet contact-tracing apps are also an untested medical invention that will be introduced without the sort of safeguards that new drugs are subjected to. Inaccurate information can mislead health officials and citizens in ways that can be as harmful as any failed drug. Governments should proceed with care.
We see numerous advantages to using GS-441524 rather than remdesivir as an anti-Covid-19 therapy. GS-441524 is easier to synthesize and dissolves in water, which can speed manufacturing and enable higher dosing. It is a smaller molecule than remdesivir, which would make it easier to produce an aerosolized formulation for inhalable therapeutic and prophylactic treatment — this would be particularly attractive for achieving a high concentration of the drug in lung cells while minimizing systemic toxicity or side effects. And it is also less toxic than remdesivir. For these reasons, we do not see the point of making a significantly more complex drug like remdesivir when what actually reaches infected lungs is GS-441524.
After eight weeks of confinement, France was supposed to resume work this week. Permission forms to leave home locally have been binned. Public transport was running at 75% of normal in Paris, with masks compulsory. Hairdressers, clothes shops, bookstores and all other commerce—except restaurants and cafés—were allowed to reopen. Some primary-school pupils returned to class. It was “essential” for the economy to get going again, said Bruno Le Maire, the finance minister. Much of the complexity of organizing this is not unique to France. The sourcing of masks, the spacing of seats on public transport or in classrooms, the distribution of hand gel in shops and offices: these problems are shared by all countries exiting lockdown. Yet, as the court decision against Renault shows, France also faces some quite specific difficulties.
Only eight weeks ago, we published “Safeguarding our lives and our livelihoods: The imperative of our time.” Back then, we worried about the supply of ventilators and critical-care capacity, the world’s ability to suppress the coronavirus, and how governments would respond to the pandemic’s economic fallout. So what has the world learned since?
World Health Assembly negotiators have agreed on a draft resolution that ensures countries can navigate patent rights for Covid-19 medical products, a victory for those supporting wider access to drugs, diagnostics, and vaccines. Although the language could still change, the document mentions a voluntary pool, which would collect patent rights, regulatory test data, and other information that could be shared for developing medical products. The European Union last month asked the assembly, which is the governing body of the World Health Organization, to adopt the idea, and WHO Director-General Tedros Adhanom Ghebreyesus has already voiced support.
After several weeks of lockdowns and strict social distancing, some countries are starting to open for business. This relaxation of lockdowns and other crisis measures does not mark a return to business as usual, but rather the transition to a “new normal.” This is a first stage toward recovery. With variations likely across contexts, economic activity will gradually return but will still be far different for workers and firms. After all, the impacts of rising unemployment and underemployment will not disappear, and labor market conditions may worsen further as emergency measures are phased out. Global working hours shrank by 4.5 percent in the first quarter of 2020 compared to the last quarter of 2019 per ILO estimates. Worldwide, three quarters of informal workers are estimated to be severely impacted by lockdowns or are working in the hardest hit sectors. What can governments do to help workers transition to this new normal?
The cost of inaction: COVID-19-related service disruptions could cause hundreds of thousands of extra deaths from HIV
“We must read this as a wake-up call to countries to identify ways to sustain all vital health services. For HIV, some countries are already taking important steps, for example ensuring that people can collect bulk packs of treatment, and other essential commodities, including self-testing kits, from drop-off points, which relieves pressure on health services and the health workforce. We must also ensure that global supplies of tests and treatments continue to flow to the countries that need them,”
ONE WAS punched in the face on a Chicago bus. Two were stoned by a mob in the Indian city of Indore. Five men doused another in the Philippines with bleach. At least 21 in Mexico have been assaulted. At a time when politicians lionise them and homebound citizens cheer them on with claps and pictures of rainbows, doctors, nurses and other health workers around the world are finding themselves under threat of violent attack, and under terrible psychological strain. From Australia to China, governments and hospitals have had to take extraordinary measures to ensure the safety of their staff, even as they battle to control the global pandemic.
Companies need a new approach to financial planning and performance management—one that informs rapid realignment of plans and actions and ensures organizational resilience.
Now that the federal government has begun distributing the experimental Covid-19 drug remdesivir, hospitals are in a bind. So far, it’s the only medication that has shown benefit for coronavirus patients in rigorous studies. But there isn’t enough for everyone who’s eligible. That leaves doctors with a wrenching ethical decision: Who gets the drug, and who doesn’t?
From hard-hit Italy, physicians report that some people who survived the coronavirus face long convalescences — which are even longer for people with lighter symptoms. “It leaves something inside you,” says 77-year-old patient. “And you never go back the way you were before.”
Moderna’s COVID-19 Vaccine Moves to Phase 2 Testing, and Gets Fast-Track Approval from the U.S. Government
On May 12, Moderna Therapeutics, based in Cambridge, Mass., received fast-track approval from the U.S. Food and Drug Administration (FDA) for its COVID-19 vaccine candidate, mRNA-1273. Days earlier, the FDA gave the company the green light to proceed to Phase 2 testing of the vaccine, which is expected to begin shortly. The company plans to launch the final stage of human testing, Phase 3, this summer, assuming the Phase 2 studies are complete, says the president of Moderna.
Para ayudar a la población más vulnerable a superar los efectos del coronavirus hace falta un ingreso mínimo
El efecto de la pandemia de COVID-19 en la economía mundial ha empezado a sentirse y será aún mayor en los próximos meses. En el caso de América Latina, como en otras regiones, la grave desaceleración del crecimiento generará un aumento de la pobreza, la pobreza extrema y la desigualdad, afirma la Comisión dedicada a la economía del subcontinente.
Los casos de COVID-19 ya sobrepasan los cuatro millones a nivel mundial y países que han levantado las medidas de confinamiento como China y Alemania están experimentando un resurgimiento de pacientes con coronavirus. Los expertos explican que esto era algo que se esperaba, y que a medida que las personas vuelvan a salir en otros países el potencial de transmisión aumentará por lo que se necesitan medidas fuertes de salud pública.
We can reopen the economy again if we do a few things right, including testing and contact tracing. We need to test all people with symptoms and their contacts, which means at most 3% of our tests should turn out positive. We need to identify as many infected as possible, and 70% to 90% of their contacts, to isolate or quarantine them. If we do all of that really fast (within a day or so), it might be enough to control the epidemic. We should hire lots of people to do that, and also use technology. The technology has some privacy tradeoffs, but they are really reasonable. Most of the Bluetooth contact tracing apps built today are amazing pieces of technology that will be useless unless they get some fundamental changes.
The length of disruption for patients continuing physical distancing remains unclear. However, most forward-looking healthcare organizations may use this time to materially scale virtual health offerings in ways that create competitive advantage.
After a rapid rise in coronavirus cases throughout Europe – particularly Italy and Spain – tough public health measures “flattened the curve.” That is, the spread of the virus slowed enough so fewer people would need treatment at the same time. Hospitals would not be overwhelmed; COVID-19 patients would do better. Now, two months after implementing some form of physical distancing, European governments are planning to reopen their economies.
The drug maker Gilead Sciences released a bombshell two weeks ago: A study conducted by a U.S. government agency had found that the company’s experimental drug, remdesivir, was the first treatment shown to have even a small effect against Covid-19. Behind that ray of hope, though, was one of the toughest quandaries in medicine: how to balance the need to rigorously test a new medicine for safety and effectiveness with the moral imperative to get patients a treatment that works as quickly as possible. At the heart of the decision about when to end the trial was a process that was — as is often in the case in clinical trials — by turns secretive and bureaucratic.
This article will explain when, and how, we will dance. Specifically, we will discover: What can we learn from the experiences of countries around the world? What measures will we need to implement during the dance, so we can get back to a new normal? At what cost? How can we make them a reality?
La ONU triplica su llamado para el plan humanitario al coronavirus y lo eleva a 6,700 millones de dólares
Las Naciones Unidas lanzan una actualización de su plan humanitario de respuesta a la COVID-19 y solicitó a la comunidad internacional de donantes 6700 millones de dólares para proteger millones de vidas y frenar la propagación del coronavirus en algunas de las naciones más vulnerables.
The pandemic of coronavirus disease 2019 (COVID-19) continues to affect much of the world. Knowledge of diagnostic tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still evolving, and a clear understanding of the nature of the tests and interpretation of their findings is important. This Viewpoint describes how to interpret 2 types of diagnostic tests commonly in use for SARS-CoV-2 infections—reverse transcriptase–polymerase chain reaction (RT-PCR) and IgM and IgG enzyme-linked immunosorbent assay (ELISA)—and how the results may vary over time.
Contact tracing is a decades-old tool for helping control the spread of infectious diseases. It has been used successfully in efforts to contain Ebola, SARS, MERS, tuberculosis, and other disease outbreaks.1 It is now a critical part of the fight against COVID-19. In practice, contact tracing begins with those who test positive for COVID-19. Those with whom they have had close contact are then identified, as they may have been infected too. These contacts are notified and supported through a period of quarantine—until they develop symptoms, pass the window of risk, or are proven not to have been exposed. Widespread testing enables optimally effective contact tracing.
WHEN COVID-19 began its march across the world, so did a desperate hunt for a treatment. Not only would finding one save lives, knowing it was available would also allow countries to relax the lockdowns that are strangling economies everywhere. Attention has focused especially on whether existing drugs—the safety of which is already known from human trials—might be repurposed for the job.
Researchers have identified a mutation in the genetic code of SARS-CoV-2 that mirrors change scientists saw in the 2003 SARS outbreak. newly discovered mutation in SARS-CoV-2 sheds some light on how the current outbreak might evolve. SARS-CoV-2 is the virus that causes the illness COVID-19. In the mutation, 81 letters in the virus’s genome had been deleted. Viral mutations are a normal part of a virus’s evolution and can alter the severity of the disease they cause. In the case of SARS-CoV-2, the finding is of interest because the nature of the mutation suggests it may have an association with a less severe form of the disease. A less virulent virus may have a selective advantage over other strains.
WHO launches checklist to support prison administrators and policy-makers for rapid and effective response to COVID-19
To support Member States in effective preparedness, prevention and control of COVID-19 in prisons and other places of detention, WHO has developed a checklist to help policymakers and prison administrators evaluate their level of preparedness for the disease. The checklist covers actions specifically designed or adapted to tackle the current COVID-19 pandemic, along with other aspects that relate to wider service planning and delivery.
Connectivity is what the world’s agro-industrial complex is all about. Four-fifths of the planet’s 8bn mouths are fed in part by imports; the $1.5trn that was paid for them last year was three times 2000’s bill. Battalions of lorries and fleets of ships connect tens of millions of farms to hundreds of millions of shops and kitchens. The sophistication of the system, and the foresight of players within it like Mr Parker, has meant that, so far, it has held up to covid-19’s impacts on both supply and demand by dexterously swapping sources and rerouting supply chains. Prices for most staples have fallen so far this year.
A las arcas del Estado no ingresaron $536 millones en Ingresos Corrientes durante el primer cuatrimestre del 2020, en relación a lo que tenía estimado o presupuestado, según datos estadísticos preliminares de la Dirección General de Ingresos (DGI) —entidad adscrita al Ministerio de Economía y Finanzas—, informó su director, Publio De Gracia Tejada. Mediante un comunicado de prensa, el MEF aclaró que con base en el presupuesto Ley 110 del 2019 habían estimado que, en el primer cuatrimestre, la recaudación de Ingresos Corrientes sería de $2,250 millones, pero solo ingresaron a $1,714 millones, lo que representa un nivel de cumplimiento del 76%.
Routine vaccination of children in the United States appeared to have declined dramatically in March and April, in the weeks after Covid-19 was declared a pandemic and the United States government declared a national emergency, a new study published Friday shows.
Changes in SARS-CoV-2 Positivity Rate in Outpatients in Seattle and Washington State, March 1-April 16, 2020
The positivity rates for SARS-CoV-2 in outpatient settings in Washington State and in emergency departments (EDs) in Seattle were analyzed to identify temporal trends that may reflect the local dynamics of the pandemic and the effect of mitigation strategies such as physical distancing.
I, like many Americans, miss the pre-pandemic world of hugging family and friends, going to work and having dinner at a restaurant. A protective vaccine for SARS-Cov2 is likely to be the most effective public health tool to get back to that world. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, cautiously estimates that a vaccine could be available in 12 to 18 months.
IF YOU LIVE in the rich world and want an example of trade and global co-operation, look no further than your dinner plate. As the lockdowns began in the West two months ago, many feared that bread, butter and beans would run short, causing a wave of stocking-up. Today, thanks to fleets of delivery lorries filling supermarket shelves, you can binge-eat as you binge-watch.
YOU MIGHT have hoped that a pandemic would bring the world together. Instead covid-19 is tearing it apart. As the disease has spread, relations between America and China have plunged into an abyss from which they will struggle to escape.
Plans are beginning to emerge for ensuring the equitable worldwide distribution of vaccines and therapeutics resulting from biomedical innovations. Absent broad agreement and buy-in on those plans, governments may prioritize their own populations, resulting in inequitable distribution of medical products both within and among countries. During the 2009 influenza A(H1N1) pandemic, wealthy nations bought virtually all vaccine supplies. Even after the WHO appealed for donations, supplies for low- and middle-income countries (LMICs) were limited. The White House may have already sought exclusive access to a COVID-19 vaccine candidate. European and Asian countries have imposed export controls on personal protective equipment and ventilators, with similar export controls likely to extend to COVID-19 vaccine and therapeutic stocks.
Mainland China and South Korea have reduced the number of reported new covid-19 cases down to around 100 a day or less; Hong Kong, Singapore and Taiwan never saw steep rises in the first place. Now they all face the same challenge: how to limit the all-but-inevitable rise in cases that will follow when they relax current controls, a rise which can already be seen in some places. To meet that challenge they are all turning to information technology.
May marks a new phase of the coronavirus pandemic in the United States. Across the country, retail stores, restaurants, and other businesses are beginning to reopen. According to the nonprofit Kaiser Family Foundation, just over half of states had eased their public-health restrictions in one way or another as of the start of this week, with more states to follow soon.
It has been less than two months since the world scrambled to go into the “Great Lockdown” to slow the spread of COVID-19. Now, many countries are considering their exit strategies. Some have already eased up. The push is largely economic. There is a lot scientists don’t yet understand about the novel coronavirus, and there is no known cure or vaccine. Many countries are still experiencing a rise in infections. But the lockdowns have played havoc with people’s livelihoods. Entire economies are in meltdown: The International Monetary Fund predicts the worst economic downturn since the Great Depression.
Many researchers are optimistic that antibodies will, relatively quickly, prove their worth as a preventive or remedy that buys the world time until a vaccine arrives—if it does. “We’ve got at least 50—and probably more we don’t know about—companies and academic labs that are all racing horses,” says immunologist Erica Ollmann Saphire of the La Jolla Institute for Immunology, who leads an effort to coordinate and evaluate these candidates. Regeneron Pharmaceuticals, which developed a cocktail of three monoclonal antibodies that worked against the Ebola virus—a notoriously difficult disease to treat—may be out of the gates first with a candidate monoclonal drug entering clinical trials as soon as next month.
The pace at which scientists are working toward a Covid-19 vaccine may be unprecedented, but it will still be months or longer before the average American benefits from these efforts. In a new story, STAT’s Helen Branswell details how, even if vaccine candidates are pushed through accelerated testing timelines to prove themselves to be effective by the fall, not everyone who wants to get one will be able to get it. Health care and other frontline workers are likely to be prioritized. “I don’t think we’re communicating very well at all with the public, because I keep having to tell these people, you know, even if we had a vaccine that showed some evidence of protection by September, we are so far from having a vaccine in people’s arms,” says infectious disease expert Michael Osterholm.
A precipitous surge in unemployment continues to shake the US workforce in the wake of COVID-19. Total claims reached 30 million in the six weeks since March 14th. And even as initial steps are underway to ease lockdowns, up to a third of all US jobs remain vulnerable.1 One of the challenges for policy makers and executives is figuring out how to get these employees back to work. The challenge is especially acute for small businesses (those with 500 or fewer employees), which account for a disproportionate share of the vulnerable jobs.2 Before COVID-19, they provided nearly half of all US private-sector jobs, yet they account for 54 percent (30 million) of the jobs most vulnerable during COVID-19. Specifically, half of jobs at firms with fewer than 100 employees are vulnerable, compared with 40 percent of those at large private-sector employers. That estimate is based on our analysis of whether jobs are typically deemed essential and whether they require close proximity to others.
Why the drug hydroxychloroquine will prove to be a life-saver for some coronavirus patients and useless or even a life-ender for others; why the country needs to “embrace the suck” and be able to accept, process, and respond to bad news; why we are likely to be forced into a reopening plan that lots of Americans will vehemently dislike; and the 2020 campaign’s forgotten man. Part of the frustration in dealing with a really bad situation is a ravenous hunger for magic bullet solutions. One reader wrote in, contending that hydroxychloroquine is effective 100 percent of the time if it’s administered early enough, so why not reopen society and give everyone a prescription for hydroxychloroquine at the first sign of the virus?
EXPONENTIAL INCREASES are a hallmark of pandemics. The spread of SARS-CoV-2 around the world has followed such a curve inexorably. But so, too, has the research effort to understand and control the virus. More than 7,000 papers on the pandemic—covering everything from virology to epidemiology—have appeared in the past three months (see chart). A fifth of them have come out in the past week alone.
For families eager for schools to throw open their doors, the tale of a 9-year-old British boy who caught COVID-19 in the French Alps in January offers a glimmer of hope. The youngster, infected by a family friend, suffered only mild symptoms; he enjoyed ski lessons and attended school before he was diagnosed. Astonishingly, he did not transmit the virus to any of 72 contacts who were tested. His two siblings didn’t become infected, even though other germs spread readily among them: in the weeks that followed, all three had influenza and a common cold virus.
Ensayos en Estados Unidos dan un “rayo de esperanza” sobre el uso del remdesivir contra el coronavirus
El medicamento ya hace parte del ensayo mundial de la OMS de tratamientos contra el COVID-19. Los expertos esperan que se logre distribuir el remdesivir de manera más amplia, a medida que se obtengan mayores datos sobre su efectividad. Además, este lunes, donantes comprometieron 7400 millones de euros para vacunas y tratamientos contra la enfermedad.
As governments in Europe announce plans to end the lockdown, a new phase in the COVID-19 pandemic is upon us. It is a time for hope but also for caution. The end of the lockdown will not spell a return to the old “normal”, nor will it be universal. The opening will take different shapes, with different countries, different regions, and different business sectors opening up in different ways and at differing speeds. The virus still lurks and the ability to contain its spread will dictate what happens next; any resurgence will likely bring about renewed restrictions. Large-scale testing and tracing, the broad availability of masks, and sufficient intensive-care capacity in hospitals will determine the pace of recovery.
The big story this morning is a study by the Johns Hopkins Bloomberg School of Public Health, used in a draft government report, that projects the United States will have 200,000 cases of coronavirus infection per day by June 1, “a staggering jump that would be accompanied by more than 3,000 deaths each day.” The White House and the Centers for Disease Control and Prevention insisted it was a draft report and not officially endorsed, even though the report has the CDC logo on it.
Afrontar los desafíos que trajo consigo la pandemia del COVID-19 puede ser abrumador. Tratar de lidiar con el confinamiento, el estrés y la ansiedad que esto provoca. Más aún, cuando en medio del caos intentas cumplir con tus responsabilidades del día a día, como es trabajar o estudiar, cuidar de tus hijos, de su educación o simplemente cuidar de las personas que dependen de ti. Estamos viviendo una especie de ‘trauma colectivo’. Es importante comprender que por más que tratemos de “normalizar la situación” está bien no estar bien, reconociendo nuestros sentimientos sin minimizarlos.
There is no denying the crucial role that health care workers are playing in the Covid-19 pandemic. Americans are acknowledging their sacrifice and hard work by sending them meals and applauding them from their houses. But while these acts are much appreciated, they are small comfort to the thousands of health care workers who have been denied adequate protection and care.
Coronavirus: los 2 grandes escenarios mundiales que plantean algunos expertos para después de la pandemia
El coronavirus es el mayor reto para el mundo desde la Segunda Guerra Mundial, según las Naciones Unidas. Y las medidas para combatirlo traerán la peor recesión económica desde la Gran Depresión, anticipó el Fondo Monetario Internacional. En este contexto, distintos expertos comenzaron a cuestionarse si el escenario mundial que resultará de todo esto será más reminiscente a la era posterior a la Primera o la Segunda Guerra Mundial.
The immune system is no wimp. When pathogens cause illness, it kicks into high gear. Cells work together to tag, kill and gobble up invaders as they fight the infection. While these cells go on the offensive, other parts of the immune system store away information and learn as much as they can about the pathogen. This process helps to build immunity, so if the bug ever comes back again, the immune system will be able to detect and destroy it, preventing the person from developing the illness again. Watch the explainer above to learn more about antibodies, immunity, and what they mean for Covid-19.
Las 4 claves del éxito de Costa Rica, el único país del continente que logró controlar el coronavirus
Tras casi dos meses de haber detectado el primer caso de COVID-19, Costa Rica aún no tiene contagio comunitario, registra la tasa de mortalidad más baja de América (0,81 %), más recuperados que casos activos y ha conseguido avances científicos en el estudio y el tratamiento del virus. A pesar de los buenos números y al descenso de la curva del virus, las autoridades insisten en la necesidad de mantener las estrictas medidas higiénicas y restrictivas. A continuación, las claves de Costa Rica para sus buenos registros, que incluyen solo 733 casos positivos y 6 muertos.
WHEN COVID-19 began its march across the world, so did a desperate hunt for a treatment. Not only would finding one save lives, the knowledge that it was available would also allow countries to relax the lockdowns which are strangling economies everywhere. Attention has focused especially on whether existing drugs—which have already gathered evidence of safety in human trials—might be repurposed for the job.
A back-of-the-envelope calculation suggests that more people are dying from covid-19 globally than from almost anything else. According to the Global Burden of Disease, an annual study by the Institute for Health Metrics and Evaluation (IHME) that tallies the lives lost to 282 illnesses and injuries across 195 countries and territories, diabetes was responsible for 20,000 deaths a week, on average, in 2017 (the latest year for which data are available). Road accidents killed 25,000 a week. Lung and tracheal cancers, 36,000. Lower respiratory infections, such as pneumonia and bronchitis, another 49,000. During one particularly deadly seven-day period in April, the coronavirus killed more than 50,000
La confianza está en altos niveles en Suecia — en su gobierno, en las instituciones y en sus compatriotas. Cuando su gobierno desafió la sabiduría convencional y se rehusó a ordenar un cierre de emergencia total para “aplanar la curva” de la epidemia de coronavirus, los funcionarios de salud pública señalaron que la confianza es una justificación central. Los suecos, dicen, que se les puede confiar en quedarse en casa, que sigan los protocolos de distancia social y que se laven las manos para desalentar la propagación del virus — sin ninguna orden obligatoria. Y, en gran medida, Suecia parece haber sido exitosa en controlar el virus como muchas otras naciones.
El coronavirus nos amenaza a todos, pero se ensaña con las personas más vulnerables. La pandemia del coronavirus ha causado un sufrimiento generalizado en los países ricos, saturando algunos de los mejores sistemas de atención médica del mundo. Con la propagación del virus a muchos países más pobres, su impacto podría ser catastrófico y afectar de manera desproporcionada a las mujeres.
High-quality antibody tests (a type of serological test) can help us understand a person’s and population’s exposure to COVID-19. A person who has been exposed to, and recovered from, COVID-19 will likely have antibodies to the SARS-CoV-2 virus in their blood. These tests may be important for guiding our next steps in the fight against this pandemic, such as by providing information on disease prevalence and the frequency of asymptomatic infection, and also by identifying potential donors of “convalescent plasma,” an approach in which blood plasma containing antibodies from a recovered individual serves as a therapy for an infected patient with severe or immediately life-threatening disease.
A majority of vaccine skeptics plan to refuse a COVID-19 vaccine, a study suggests, and that could be a big problem
The availability of a vaccine for the novel coronavirus will likely play a key role in determining when Americans can return to life as usual. Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, on April 30 announced that a vaccine could even be available by January 2021. Whether a vaccine can end this pandemic successfully, however, depends on more than its effectiveness at providing immunity against the virus, or how quickly it can be produced in mass quantities.
There are two problems with tests that are largely being overlooked. “One is that they’re only as good as the sample being collected. The technology is as close to perfect as you’re going to get in a diagnostic test. But if you don’t sample where the virus is, the test result will be a false negative. A recent scientific paper that has not yet been peer-reviewed concluded that the real-life sensitivity of tests where persons were collecting their own samples was down around 60 percent, which is pretty much unacceptable when testing for a contagious disease. It turns out, and this is no surprise, that you can’t rely on people to stick a swab far enough up their nose or down their throat to get a useful specimen.” The second problem is that the test is only a one-time snapshot, and it doesn’t mean that a person isn’t going to be contagious tomorrow, or even later today. That has serious policy implications and may be the only way to get people to understand that we can’t bring the risk down to zero.
Three potential futures for Covid-19: recurring small outbreaks, a monster wave, or a persistent crisis
As epidemiologists attempt to scope out what Covid-19 has in store for the U.S. this summer and beyond, they see several potential futures, differing by how often and how severely the no-longer-new coronavirus continues to wallop humankind. But while these scenarios diverge on key details — how much transmission will decrease over the summer, for instance, and how many people have already been infected (and possibly acquired immunity) — they almost unanimously foresee a world that, even when the current outbreak temporarily abates, looks and feels nothing like the world of just three months ago.
El Secretario General de las Naciones Unidas llama a los Gobiernos y a otras partes interesadas a garantizar que los periodistas puedan realizar su trabajo durante toda la pandemia de COVID-19 y posteriormente, en especial ante la amenaza que representa la otra “pandemia” que nos invade: la de la desinformación.
Un grupo de expertos en enfermedades infecciosas ha comparecido ante los medios para explicar sus conclusiones sobre 260 casos de personas curadas de coronavirus que dieron positivo de nuevo semanas después de superar la enfermedad. Oh Myoung-don, director del Comité Central para el Control de Enfermedades Emergentes de Corea del Sur, ha asegurado que no hay razones para creer que esos casos podrían estar provocados por reinfecciones o reactivaciones del Covid-19. Los casos de nuevas infecciones en pacientes que ya han pasado la enfermedad y los interrogantes en torno a la inmunidad han creado un importante debate científico porque complicarían los esfuerzos mundiales por detener la pandemia al no garantizarse la inmunización de los ya infectados.
When major decisions must be made amid high scientific uncertainty, as is the case with Covid-19, we can’t afford to silence or demonize professional colleagues with heterodox views. Even worse, we can’t allow questions of science, medicine, and public health to become captives of tribalized politics. Today, more than ever, we need vigorous academic debate.
Health care workers are well-trained to manage the intensity of a medical crisis. But few are equally comfortable managing its mental health aftermath, in themselves or in others. Even before the pandemic emerged, moral injury and burnout were rampant among clinicians. Coping with Covid-19 has magnified many of those challenges and added new ones with the reality of resource constraints.
For two days in a row last week, amid coronavirus-related market meltdowns, a group of stocks on China’s main exchange moved so significantly that they triggered automatic circuit-breakers designed to halt trading. But trading was suspended not because the stocks plummeted. It was because they soared. In the next month, government workers in these cities will use a smartphone application to receive at least a portion of their paychecks in the form of a digital payment, marking a milestone on the path toward the world’s first digital currency system by a major central bank. To some experts, the digital currency could represent a serious threat to an American asset that has reigned unchallenged for decades: the U.S. dollar.
Equipados con sus ropas deportivas para correr o pedalear, o con vestimenta corriente para salir a pasear, y ayudados por el tiempo casi veraniego que hoy predomina en toda España, la actividad protagoniza ciudades y poblaciones que durante cerca de dos meses estuvieron semidesiertas. Estas salidas se permiten después de que el ritmo de nuevos casos detectados se situó el viernes en un 0,55 por ciento diario, después de que en los peores momento aumentaran en un 35 por ciento.
Catalogada a menudo como “la madre de todas las pandemia”, la que pasaría a la historia como gripe española causó la muerte de entre 20 y 50 millones de personas alrededor del mundo, según cálculos de la Organización Mundial de la Salud. Se extendió entre 1918 y 1920, y los científicos creen que fue contagiada al menos un tercio de la población mundial de aquel entonces, calculada en 1.800 millones de habitantes. Mientras el mundo reacciona ante la covid-19, te proponemos mirar hacia el pasado hasta el tiempo de la última gran pandemia que puso en compás de espera al planeta. Esto fue lo que ocurrió cuando todo terminó.
China’s most frightening outbreak of covid-19 lurks in Harbin, a north-eastern city known for Russian architecture and a winter festival featuring large castles hewn from river ice. Traced to a Chinese student who flew from America in March, the outbreak has pushed the city of 10m back into semi-lockdown, weeks after a first wave of the virus was defeated in Wuhan, far to the south. China is taking a different path. Alone among large countries with many land neighbors, it wants an rt as close to zero as possible, and will endure pain to achieve that.
Governments now ask heavy sacrifices from their people, with around a third of the global population under some form of lockdown. But demonstration that governments are in fact acting to protect the public, for example, through adequately preparing the health system and giving clear advice aimed at saving lives, has been highly variable. Although international comparisons are not straightforward, there are nonetheless encouraging examples of where strong and swift action has succeeded in staving off the worst effects of the virus, be they Germany’s quick escalation of testing, New Zealand’s elimination strategy, or South Korea’s aggressive pursuit of a test-and-trace approach. By contrast, the UK, USA, and Brazil, among others, have been slow to react and haphazard when they did. The serious deficiencies in pandemic planning and response have sparked protests and condemnation and call into question commitment to the most vital interests of the public.
Those with responsibility for leading us through this emergency have called it “a once in a century global health crisis”. This statement is incorrect on two grounds. First, because we cannot know what the rest of the century will bring. It is highly probable that this current pandemic will be neither the last nor the worst global health crisis of the present century. But second, and more importantly, this global calamity is not a crisis concerning health. It is a crisis about life itself. We have been tempted in recent years to assume the omnipotence of our species. The idea of the Anthropocene places human activity as the dominant influence on the future of life on our planet. Although this newest of geological eras is supposed to underline the harm our species is doing to fragile planetary systems, paradoxically it also asserts our supremacy. But we are only one species among many, and we are certainly not a dominant influence when faced with a virus that can destroy life with such ease and facility.
Las personas mayores tienen el mismo derecho a la vida que los demás durante y después del coronavirus
En su condición de titular de la ONU, pero también de persona mayor, António Guterres lanza una iniciativa para defender los derechos de los ancianos y recuerda que “ninguna persona, joven o vieja, es prescindible”. Toda respuesta social, económica y humanitaria al COVID-19 debe tener en cuenta las necesidades y la opinión de las personas mayores.
“In this article, we suggest that in order to come back stronger, companies should reimagine their business model as they return to full speed. The moment is not to be lost those who step up their game will be better off and far more ready to confront the challenges—and opportunities—of the next normal than those who do not. There are four strategic areas to focus on: recovering revenue, rebuilding operations, rethinking the organization, and accelerating the adoption of digital solutions…”.
“As COVID-19 deaths and hospitalizations begin to plateau and decline in hard-hit areas, our collective attention has turned to returning to work and regular activities. The economic devastation and potential negative health impacts of lockdown have been acutely felt everywhere. However, the phrase “when we have adequate testing” has become the siren song within many conversations around return, namely in reopening the economy. Experts agree that testing is necessary, but our research has indicated that testing should be tiered, target, and prioritized, given the limited number and types of accurate tests we are likely to have globally in the short term”.
Gileads remdesivir has seen success against the coronavirus. Now the company has to make enough to supply the world
“A few months and the onset of one coronavirus pandemic later, demand for remdesivir is booming. A study run by the National Institute of Allergy and Infectious Diseases showed that patients with Covid-19 who were given the drug recovered faster than those who were given a placebo, the agency said this week. Regulators have not yet approved the drug — though an emergency authorization is reportedly imminent — but the company now stands in the position of having to scale up production of a drug that the whole world may want”.
“The Food and Drug Administration announced Friday that it would permit emergency use of remdesivir, the antiviral medicine from Gilead Sciences, to treat patients with Covid-19. The decision to issue an “emergency use authorization” was based on positive results from a government-conducted clinical trial, announced Wednesday, that showed remdesivir accelerated the recovery time of patients with Covid-19 compared to a placebo and from a study conducted by Gilead that studied two different treatment durations of the medicine. At the same time, the government’s top infectious disease expert cautioned that the drug was not a “knockout.””
“One measure of viral spread is the R0, the expected number of secondary infectious cases produced by a primary infectious case. This calculation is used to determine the potential for epidemic spread in a susceptible population. The effective reproduction number, Rt, determines the potential for epidemic spread at a specific time t under the control measures in place. To evaluate the effectiveness of public health interventions, the Rt should be quantified in different settings, ideally at regular and frequent intervals (eg, weekly)”.
We found and tested 47 old drugs that might treat the coronavirus: Results show promising leads and a whole new way to fight COVID-19
“The more researchers know about how the coronavirus attaches, invades and hijacks human cells, the more effective the search for drugs to fight it. That was the idea my colleagues and I hoped to be true when we began building a map of the coronavirus two months ago. The map shows all of the coronavirus proteins and all of the proteins found in the human body that those viral proteins could interact with”.