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ngq, you sexy beast! Here is a sanity check for that clean meta. ;)
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                    [post_date] => 2020-04-12 10:05:11
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April 9 marks the 100th day since the WHO was notified of the first case of “pneumonia of unknown cause” in Wuhan, China.


As of April 12 at 10am EST, the total worldwide deaths from COVID-19 has surpassed 110,000, as confirmed cases approach 1.8 million. The actual number of dead and infected worldwide are believed to be much higher, but testing shortages, different counting practices and concealment by some governments limit detection and reporting.


The U.S. is the current global epicentre with over 530,000 confirmed cases and over 20,000 deaths, while the five worst affected countries (U.S., Spain, Italy, Germany, France) account for over 60% of all cases and almost 80% of deaths globally.


Community transmission is spreading, and the rapid increase of cases across low- and middle-income countries has become a critical global issue, as over 20 developing countries are reporting more than 1,000 cases. The number of African cases increased approximately by 40% over the past week, with all 55 countries reporting cases and 8 African countries seeing exponential rise. South Africa’s border controls and lockdown over the past two weeks have significantly reduced the number of new cases.


The economic fallout from the global pandemic could push 500 million people into poverty (8% of global population), according to a UN University report. This would be the first time that poverty has increased globally in over thirty years. The World Bank and IMF have scaled up and accelerated efforts to provide emergency funding to countries, while the UN Office for the Coordination for Humanitarian Affairs (OCHA) issued a US$2 billion appeal for a Coordinated Global Humanitarian Response Plan, which as of April 8, is only 20% funded.


As governments confront the dual challenge of containing the viral pandemic and economic crisis, public health experts warn countries that premature re-opening could lead to a second wave of outbreaks, echoed as well by modelling projections in a recent Lancet paper. Oxfam has urged world leaders to contribute to the $2.5 trillion economic rescue plan set out by the UN to “keep poor countries and poor communities afloat.” Mounting job losses and disruptions to global supply chains are also expected to result in chronic food shortages, as countries are urged to keep trade open and to protect farmers.


                    [post_title] => Global Snapshot
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The number of confirmed cases and reported deaths have consistently increased by 10-20% per day over the past week, surpassing 7,300 and 250, respectively, across 23 locations with humanitarian responses. This does not include countries like Iran where UN humanitarian agencies do not operate, and where the number of reported cases is 71,686, including 4,474 COVID-related deaths.


The COVID-19 Global Humanitarian Response Plan by OCHA will be implemented by UN agencies, with international NGOs and consortiums playing a direct role in the response, but remains about 20% funded as of 8 April.


The FAO published a framework for Addressing the Impacts of COVID-19 in Food Crises, including an appeal for US$110 million to maintain the provision of critical assistance where there are already high levels of need. The WFP estimates that 100-120 million people across 80 countries will require urgent support and food supplies.


The UN High Commissioner for Human Rights issued renewed guidance on protection of human rights, calling for urgent and coordinated action by countries to prevent “wider inequalities and extensive suffering.” This is in light of reports by the IOM of increased restrictions at points of entry, limiting mobility and delivery of essential goods. Humanitarian organizations, including the ICRC and MSF have urged countries to protect vulnerable populations, including IDPs and asylum seekers.


The combination of economic and social stresses, along with restrictive control measures, have led to a dramatic increase in the numbers of women and girls facing domestic abuse, as the UN Secretary General called for urgent measures to address the “horrifying global surge in domestic violence.”


                    [post_title] => Situation Summary: Humanitarian Response Locations
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                    [post_content] => 
WHO lists two COVID-19 tests for emergency use


7 April 2020


https://www.who.int/news-room/detail/07-04-2020-who-lists-two-covid-19-tests-for-emergency-use


WHO listed the first two COVID-19 diagnostic tests under the Emergency Use Listing Procedure. The move should help increase access to quality-assured, accurate tests that can now be supplied by the UN and other procurement agencies supporting the COVID-19 response. The two in vitro diagnostics include: (1) genesig Real-Time PCR Coronavirus (Primerdesign, U.K.), an open system suitable for laboratories with moderate sample testing capacity, and (2) cobas SARS-CoV-2 Qualitative assay (Roche, U.S.) is a closed system assay for larger laboratories using the cobas 6800/8800 Systems.


The FDA-approved Drug Ivermectin inhibits the replication of SARS-CoV-2 in vitro


Caly et al, Antiviral Research, 3 April 2020


https://www.sciencedirect.com/science/article/pii/S0166354220302011?via%3Dihub


Findings


Ivermectin is a widely available and used treatment for parasite infections in humans and animals, and it has an established safety profile for human use. It is also FDA-approved and appears on the WHO Model List of Essential Medicines. A single treatment of Ivermectin resulted in a 5,000-fold reduction in the SARS-Cov-2 virus at 48h in cell culture.


Interpretation


Ivermectin shows the potential to inhibit the causative virus in vitro. Further studies are needed to evaluate whether ivermectin has human clinical impact in limiting the viral load, preventing severe disease progression, and limiting person-person transmission.


An overview of the rapid test situation for COVID-19 diagnosis in the EU/EEA


European Centers for Disease Control, 1 April 2020


https://www.ecdc.europa.eu/sites/default/files/documents/Overview-rapid-test-situation-for-COVID-19-diagnosis-EU-EEA.pdf


Timely and accurate laboratory testing is an essential part of the management of COVID-19 to slow transmission, support decisions on infection control strategies, and detect asymptomatic cases that could spread the virus further. At present, clinical public health guidelines (including by the WHO) recommend COVID-19 diagnosis by molecular testing which detect the virus RNA. However, these tests require well-equipped laboratory facilities, skilled technicians and expensive reagents. Infrastructure limitations and supply shortages are currently limiting testing capacity below the growing demand for COVID- 19 diagnostics. This report surveys the range of rapid diagnostic tests that are currently available – including rapid antigen testing – in order to alleviate the pressure on laboratories and expand testing capacity to meet the most urgent medical and public health needs.


                    [post_title] => Research: Diagnostic Testing and Treatment
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                    [post_date] => 2020-04-12 10:02:11
                    [post_date_gmt] => 2020-04-12 14:02:11
                    [post_content] => 
Preliminary estimates of the prevalence of selected underlying health conditions among patients with COVID-19 — United States, February 12–March 28, 2020


US CDC, WMWR Early Release, 3 April 2020


https://www.cdc.gov/mmwr/volumes/69/wr/mm6913e2.htm?s_cid=mm6913e2_w


Findings


Of the 7,162 patients with reported data on underlying factors, 37.6% had at least one underlying condition or risk factor, including diabetes mellitus (11%), chronic lung disease (9%), cardiovascular disease (9%). Underlying conditions and risk factors were significantly higher among ICU admissions (78%), while at least one underlying condition was reported in 94% of patients that died.


Interpretation


Preliminary estimates suggest that underlying risk factors and co-morbidities can play a significant role, particularly among severe cases that require ICU admission. It remains unknown, however, whether severity or level of control of underlying health conditions affects the risk for severe disease with COVID-19.


Loss of smell and taste in combination with other symptoms is a strong predictor of COVID-19 infection


Menni et al, 7 April 2020, NOT YET PEER REVIEWED


https://www.medrxiv.org/content/10.1101/2020.04.05.20048421v1


Findings


This paper in pre-press shows preliminary evidence that anosmia (loss of smell) and ageusia (loss of taste) may be early symptoms of COVID-19. The study suggests that loss of taste and smell is a strong predictor of having been infected by the COVID-19 virus. Also, the combination of symptoms that could be used to identify and isolate individuals includes anosmia, fever, persistent cough, diarrhoea, fatigue, abdominal pain and loss of appetite. This is particularly relevant to healthcare and other key workers in constant contact with the public who have not yet been tested for COVID-19.


                    [post_title] => Research: Clinical Public Health and Diagnosis
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                    [post_date] => 2020-04-12 10:01:11
                    [post_date_gmt] => 2020-04-12 14:01:11
                    [post_content] => 
High Contagiousness and Rapid Spread of Severe Acute Respiratory Syndrome Coronavirus 2


Sanche et al, Emerging Infectious Disease EARLY RELEASE, 7 April 2020


https://wwwnc.cdc.gov/eid/article/26/7/20-0282_article


Findings


Initial estimates of the early dynamics of the outbreak in Wuhan suggest a doubling time of 2.3–3.3 days, which is less than half the time of prior estimates (6-7 days). Assuming a serial interval of 6–9 days, the authors also calculate a median basic reproductive number (R0) of 5.7 (95% CI 3.8–8.9) in the early stages of the pandemic, which is more than double existing estimates for R0 (2.2-2.7). Based on modelling of high-resolution domestic travel and infection data, the paper also shows that active surveillance, contact tracing, quarantine, and early strong social distancing efforts can slow transmission.


Interpretation


Dynamics of transmission for COVID-19 is not uniform and can be significantly higher in the early stages than previously thought.


Facemasks and similar barriers to prevent respiratory illness such as COVID-19: A rapid systematic review


Brainard et al, 6 April 2020, NOT YET PEER REVIEWED


https://www.medrxiv.org/content/10.1101/2020.04.01.20049528v1


Findings


Based on a review of 31 studies (including 12 RCTs), the authors conclude that wearing face masks can be slightly protective against primary infection from casual community contact, and modestly protective against household infections when both infected and uninfected members wear face masks. Randomized Control Trials often suffered from poor compliance and controls using face masks, resulting in under-estimation of the protective effect, while observational studies exaggerated their efficacy.


Interpretation


The authors conclude that while the evidence is insufficient to support widespread use of face masks as a protective measure against COVID-19, there is enough evidence to support their use for short periods, especially vulnerable individuals and in transient high-risk environments.


Respiratory virus shedding in exhaled breath and efficacy of face masks


Leung et al, Nature Medicine, 3 April 2020


https://www.nature.com/articles/s41591-020-0843-2


Findings


Surgical face masks have been shown to effectively block the spread of seasonal coronaviruses in respiratory droplets, suggesting that masks can prevent transmission of COVID-19, which has been detected in both ‘coarse’ droplets and finer ‘aerosol’ droplets emitted by volunteers not wearing masks. Larger ‘coarse’ particles are carried by sneezes and coughs, whereas exhaled breath can spread ‘aerosol’ droplets, which have a diameter of five micrometres or less. Masks reduced detection of viral RNA in both types of droplets.


Interpretation


Face masks could prevent transmission of the novel coronaviruses and influenza viruses from symptomatic individuals.


                    [post_title] => Research on Transmission Dynamics and Efficacy of Face Masks
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                    [post_date] => 2020-04-12 10:00:11
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                    [post_content] => 
Short-term forecasts of COVID-19 deaths in multiple countries


Imperial College London, 8 April 2020


https://sangeetabhatia03.github.io/covid19-short-term-forecasts/index.html


This weekly report by Imperial College London presents forecasts of transmission and mortality estimates over the coming week for 42 countries with active transmission, accounting for the impact of control measures. The caveat with these forecasts is that accuracy varies with the quality of surveillance and reporting, i.e. presenting likely underestimates for countries with poor reporting. That said, based on transmissibility estimates, the COVID-19 epidemic is expected to demonstrate:


    

  • Stabilizing patterns in 14 countries (including Italy, Iran, Iraq, South Korea);
    • 

  • Slow-growth transmission (1<Rt<2) in Spain and Netherlands; and
    • 

  • Rapidly growing transmission (Rt>2) across 26 countries (including Algeria, Brazil, Canada, China, Egypt, France, Germany, India, Japan, Peru, Turkey, U.K. and U.S.).
    • 



Based on central forecasting trends, reported deaths in the coming week are expected to be:


    

  • Relatively small (<100) and large (100-1000) in 29 countries;
    • 

  • Large (1,000-5,000) in 8 countries (including Algeria, Brazil, Germany, Iran, and Turkey); and
    • 

  • Very large (5,000+) in 5 countries (France, Italy, Spain, U.K. and U.S).
    • 



New COVID-19 forecasts for Europe: Italy & Spain have passed the peak of their epidemics; UK, early in its epidemic, faces a fast-mounting death toll


Institute for Health Metrics and Evaluation, 7 April 2020


http://www.healthdata.org/news-release/new-covid-19-forecasts-europe-italy-spain-have-passed-peak-their-epidemics-uk-early-its


New COVID-19 forecast from IHME found that among European nations, the peak daily death rate from the pandemic will occur during the third week of April, with the pandemic spreading from Southern Europe. According to current trajectories, 151,680 COVID-19 deaths could occur during the “first wave” of the pandemic in Europe, while the U.S. is expected to face 81,766 deaths. Declines in deaths are now occurring in Italy and Spain as most regions in the two countries have passed their peaks in the number of deaths, while other nations are approaching their peaks and still others facing peak mortality later in April. The death toll in many countries is compounded by demand for hospital resources well in excess of what is available. Predicted peaks in daily COVID-19 deaths appear to be highly variable among EEA countries, likely reflecting the equally variable ways that the novel coronavirus initially spread and then continued to affect Europe.


Projecting hospital utilization during the COVID-19 outbreaks in the United States


Moghadas et al, National Academy of Sciences, 3 April 2020


https://www.pnas.org/content/117/16/9122


Findings


Without isolation and with R0 = 2.5, treatment of critically ill patients at the outbreak peak would require 3.8x more ICU beds than exist in the U.S. (or 2x if R0 = 2). With self-isolation by 20% of cases within 24 hours of symptom onset, the outbreak trajectory would delay and flatten, and the number of ICU beds needed at the peak would reduce by 48.4% (or 73.5% if R0 = 2).


Interpretation


Hand washing and self-isolation is shown to significantly contribute to reducing the rate of spread of COVID-19, and therefore reducing the number of ICU beds needed at any one time. This could facilitate emergency mobilization to expand mobilization of critical care capacity to handle the burgeoning outbreak.


                    [post_title] => Research on Forecasting Peak Transmission and Health System Utilization
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                    [post_date] => 2020-04-12 09:59:11
                    [post_date_gmt] => 2020-04-12 13:59:11
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COVID-19 pandemic in west Africa (Martinez-Alvarez et al, Lancet Global Health, 1 April 2020).


Whether warmer temperatures will slow the spread of the COVID-19 virus has been a point of much speculation. This hypothesis has led some European countries to adopt initial policies that rely on decreased transmission rates during the summer months, and the belief that African countries will face smaller epidemics than their European counterparts. No strong evidence base exists for such claims, however. The authors argue that COVID-19 has likely arrived later in west Africa than in Europe, and plot and present data that shows a similar rapid rate of community transmission in West African countries to rates of community transmission in European countries, once a case of COVID-19 has been confirmed. Nine of the25 poorest countries are in the west African region and  have poorly resourced health systems, rendering them unable to quickly scale up an epidemic response. The authors furthermore argue that the impact of a similar COVID-19 epidemic as currently seen in Europe would be devastating in west Africa.


                    [post_title] => Research: COVID-19 pandemic in west Africa
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                    [post_date] => 2020-04-12 09:58:11
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                    [post_content] => 
Some say there is a trade-off: save lives or save jobs – this is a false dilemma (Heads of the IMF & WHO, Telegraph, 3 April 2020)


Commentary by the IMF Managing Director and the WHO Director General about the false dichotomy of save lives or save livelihoods. The argue that getting the virus under control is a prerequisite to saving livelihoods. Their joint appeal to policymakers, particularly in low- and middle-income countries, is to recognize that “protecting public health and putting people back to work go hand-in-hand.” In addition to the WHO, which is actively providing technical assistance to its Member States, at least 85 countries have requested emergency financing from the IMF. As financing reaches the countries in need, the authors furthermore extend a joint plea “to place health expenditures at the top of the priority list,” including paying salaries to healthcare workers, supporting hospitals, establishing field clinics, investing in medical and protective equipment, as well as carrying out public awareness campaigns such as hand washing.”


                    [post_title] => Some say there is a trade-off: save lives or save jobs – this is a false dilemma
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                    [post_date] => 2020-04-12 09:57:11
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                    [post_content] => 
Amy Maxmen, Nature News, 1 April 2020


https://www.nature.com/articles/d41586-020-00983-9


The threat of a COVID-19 explosion across developing countries continues to grow. While the first dozen cases in Africa were detected in March, the virus likely arrived weeks or months before. Despite the rising incidence of test positive cases, limited testing and contact tracing capacity, political leadership and resource mobilization from donor nations has been lacking, despite calls from the WHO and the UN Secretary General. Many countries face underfunded healthcare systems, unreliable stocks of essential medicines, precarious access to health facilities, and frequent power outages. The Ebola outbreaks also showed that when health systems are overwhelmed by one infectious disease, many often die from a lack of care for malaria, pneumonia and other preventable diseases, as well as care during pregnancy and childbirth. At the same time, case reports from the peak of the epidemic in Wuhan, China suggest that an estimated 2.6 ICU beds were required per 10,000 adults. Italy has less than half that capacity and is overwhelmed. Many low-income countries, including those in sub-Saharan Africa, have less than one ICU bed per million people. Given the lack of well-funded health systems, countries in Africa are focusing on mitigation strategies to prevent COVID-19 from spreading as soon as they confirm their first cases. This includes shutting down most activities with the threat of arrest, rolling out tests to detect genetic sequences from the virus and a willingness to deploy rapid, easy-to-use tests(even if they are not as accurate as PCR tests that require lab capacity), and sequencing the genome of SARS-Cov-2 sampled from Nigeria.


                    [post_title] => How poorer countries are scrambling to prevent a coronavirus disaster
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                    [post_content] => 
Reflections by Dr. Andrew Nevin, Price Waterhouse Cooper Nigeria, 5 April 2020


The Dahdaleh Institute invited Dr. Andrew Nevin, a Partner and Chief Economist at PWC Nigeria, to offer his views on core structural imperatives in dealing with COVID-19 in Africa beyond healthcare responses.


In the absence of a climate effect, Dr. Nevin warns African countries are headed for a humanitarian crisis in part due to weak healthcare systems, vulnerable populations, limited risk messaging, overcrowded housing and other difficulties with socially distancing. He anticipates the impacts in Africa could include:


    

  • Significant reduction in daily wages;
    • 

  • Breakdown of food supply chains;
    • 

  • Inability of the public sector to function virtually;
    • 

  • Strong private sector response in managing their businesses;
    • 

  • Confusion about who is in charge, and
    • 

  • Lack of information.
    • 



Based on these anticipated impacts, Dr. Nevin identified the following non-health system related priorities for African countries for COVID-19:


    

  1. Direct transfers to the bottom of the pyramid to replace purchasing power;
    2. 

  2. Ensuring that food supply chains keep working;
    3. 

  3. Getting organized private sector to support the public sector (e.g. national emergency committees as decision-making bodies with government and industry partners);
    4. 

  4. Rapid and coordinated economic support and debt relief by international finance institutions; and
    5. 

  5. Reflect on possible structural change (e.g. economic decentralization) following response
    6. 



                    [post_title] => Commentary: Action Imperatives for COVID-19 in Africa
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                    [post_date] => 2020-04-03 12:42:50
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                    [post_content] => 
Substantial undocumented infection facilitates the rapid dissemination of COVID-19 (Li et al, Science)


Findings


Using a model-inference framework, the authors estimates the contagiousness and proportion of undocumented infections of COVID-19 in 375 cities in China before (Jan 10-23) and after (Jan 24-Feb 8) implementation of control measures in Wuhan (including: travel restrictions self-quarantine and contact precautions, access to rapid testing and PPE). The effective reproduction number (Re), i.e. number of secondary infections per index infection, was 2.4. The authors estimate that before control measures, 86% of all infections were undocumented, estimated to be about half (55%) as contagious as reported infections. After Control Measures, the proportion of undocumented infections fell to 31-35%, while the Re decreased to 0.99-1.4.


Interpretation


Although inference results should be interpreted with caution, the study suggests that control measures in Wuhan as of Jan 23 altered the epidemiological characteristics of the outbreak.


                    [post_title] => Research: Substantial undocumented infection facilitates the rapid dissemination of COVID-19 
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                    [post_modified] => 2020-08-13 22:42:39
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                    [post_content] => 
Identifying Locations with Possible Undetected Imported Severe Acute Respiratory Syndrome Coronavirus 2 Cases by Using Importation Predictions (De Salazar et al, CDC Early Release)


Findings


The aim was to identify locations with likely undetected or under-detected imported cases of COVID-19. The results suggest that locations above the 95% PI of imported-and-reported cases could have higher case-detection capacity. Locations below the 95% PI might have undetected cases because of expected imported-and-reported case counts under high surveillance. Under-detection of cases could increase the international spread of the outbreak because the transmission chain could be lost, reducing opportunities to deploy case-based control strategies.


Interpretation


They recommend rapid strengthening of outbreak surveillance and control efforts in locations below the 95% PI lower bound to curb potential local transmission. Early detection of cases and implantation of appropriate control measures can reduce the risk for self-sustained transmission in all locations


                    [post_title] => Research: Identifying Locations with Possible Undetected Imported Severe Acute Respiratory Syndrome Coronavirus 2 Cases by Using Importation Predictions
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            [post_date] => 2020-04-12 10:05:11
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April 9 marks the 100th day since the WHO was notified of the first case of “pneumonia of unknown cause” in Wuhan, China.


As of April 12 at 10am EST, the total worldwide deaths from COVID-19 has surpassed 110,000, as confirmed cases approach 1.8 million. The actual number of dead and infected worldwide are believed to be much higher, but testing shortages, different counting practices and concealment by some governments limit detection and reporting.


The U.S. is the current global epicentre with over 530,000 confirmed cases and over 20,000 deaths, while the five worst affected countries (U.S., Spain, Italy, Germany, France) account for over 60% of all cases and almost 80% of deaths globally.


Community transmission is spreading, and the rapid increase of cases across low- and middle-income countries has become a critical global issue, as over 20 developing countries are reporting more than 1,000 cases. The number of African cases increased approximately by 40% over the past week, with all 55 countries reporting cases and 8 African countries seeing exponential rise. South Africa’s border controls and lockdown over the past two weeks have significantly reduced the number of new cases.


The economic fallout from the global pandemic could push 500 million people into poverty (8% of global population), according to a UN University report. This would be the first time that poverty has increased globally in over thirty years. The World Bank and IMF have scaled up and accelerated efforts to provide emergency funding to countries, while the UN Office for the Coordination for Humanitarian Affairs (OCHA) issued a US$2 billion appeal for a Coordinated Global Humanitarian Response Plan, which as of April 8, is only 20% funded.


As governments confront the dual challenge of containing the viral pandemic and economic crisis, public health experts warn countries that premature re-opening could lead to a second wave of outbreaks, echoed as well by modelling projections in a recent Lancet paper. Oxfam has urged world leaders to contribute to the $2.5 trillion economic rescue plan set out by the UN to “keep poor countries and poor communities afloat.” Mounting job losses and disruptions to global supply chains are also expected to result in chronic food shortages, as countries are urged to keep trade open and to protect farmers.


            [post_title] => Global Snapshot
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