Coronavirus: we separate myths from facts and give advice

[Anthea]

Erbil imposes limited lockdown

A week-long "limited lockdown" including the shutdown of public places at night and closure of government offices is to begin on Friday, June 26, the governor of Erbil province has announced, as the rise in coronavirus cases shows little sign of slowing

"Public places" - including shops, food and drink establishments, parks, places of worship, recreational spaces - are to be shut from 8 pm to 5 am for one week starting June 26, deputy governor Hemin Qadir announced earlier on Thursday. Government offices will be shut at all times for the week.

Deputy governor Qadir told Rudaw later on Thursday that non-essential traffic will also be banned in Erbil from 8 pm to 5 am.

"We made this decision because we are currently in an extremely dangerous situation, as the coronavirus is everywhere," governor Firsat Sofi told reporters on Thursday.

The decision to impose only a partial lockdown was made as a compromise "between the life of the public and the health situation," Sofi said.

Erbil has seen a total of 1,061 COVID-19 cases, 443 of which remain active. Twenty people in the province have died after contracting the virus.

Sulaimani has been the Kurdistan Region province worst-hit by the coronavirus pandemic, recording over two-thirds of the Region's total cases. It has also recorded the vast majority of coronavirus-related deaths - 113 of 133, according to an interactive dashboard from the Kurdistan Regional Government (KRG) last updated on Wednesday night.

The province saw 12 coronavirus-related deaths on Thursday alone, local health authorities have said.

The KRG interior ministry on Wednesday placed decisions on the extent of lockdown in the hands of provincial authorities.

Sulaimani officials decided to apply a ban on traffic in the city's downtown and bazaar, to apply until July 1.

The ministry last week announced fines for people and institutions that do not follow health measures, especially the wearing of face masks in public. The fines range from 5,000 to 150,000 Iraqi dinars ($4.10-$125).

https://www.rudaw.net/english/kurdistan/250620202

[Anthea]

23% of US counties have
uncontrollable COVID growth

Twenty three percent of counties across the United States are now seeing an uncontrollable growth in new COVID-19 infections, according to a data map - as model projections show Phoenix could see 28,000 new cases a day by July 18

A color-coded data map, compiled by spatial analytics company Esri, shows how the US is faring in terms of infections by tracking the number of new COVID-19 cases on a county level.



Updated data from Thursday shows that large parts of the South and Southwest are showing an 'epidemic trend' or 'spreading trend' for new coronavirus infections.

The epidemic trend is described as an uncontrolled spread, while spreading indicates an outbreak that could still be controlled if preventative steps are taken.

Of the 3,141 counties across the country, 745 are currently experiencing an epidemic outbreak and 1,232 are seeing spreading trends, according to the data map.

Nearly 670 counties are currently seeing a controlled trend in new coronavirus cases.

According to the map, the entire state of Arizona is seeing either epidemic or spreading trends.

A color-coded data map, compiled by spatial analytics company Esri, shows that 23 percent of counties across the US are now seeing an uncontrollable growth in new COVID-19 infections. According to the map, the entire state of Arizona is seeing either epidemic or spreading trends

The majority of counties in states like Florida, California, Georgia, the Carolinas, Alabama, Louisiana and Mississippi are seeing similar trends.

About half the counties in Texas are currently seeing epidemic and spreading trends in new infections.

Infections across the US have been surging for more than a week after trending down for over six weeks. Currently, the US has recorded more than 2.3 million coronavirus cases and more than 121,000 Americans have died from the virus.

New cases and hospitalizations have been spiking to record levels in states like Arizona, Texas, California and Florida. Los Angeles County now has the most cases of all US counties with more than 85,000 confirmed infections.

As cases continue to rise, forecast models from the PolicyLab at Children's Hospital of Philadelphia predict infections in Phoenix will rise to a staggering 28,000 new cases a day by July 18.

That forecast is far worst than the daily cases epicenter New York City saw in mid-April.

In Houston, daily infections are forecast to increase to more than 4,500 in the same time frame. Miami could see cases surge to more than 2,800 in the next three weeks.

Researchers from the PolicyLab have warned that there is a risk Montgomery, Alabama; Little Rock, Arkansas; Tulsa, Oklahoma; Las Vegas, Nevada; and South Carolina could risk a similar resurgence.

Data shows that the current levels in those cities is similar to where parts of Arizona, Texas and Florida were just a few weeks ago.

PHOENIX FORECAST: As cases continue to rise, forecast models from the PolicyLab at Children's Hospital of Philadelphia predict infections in Phoenix (above) will rise to a staggering 28,000 new cases a day by July 18

HOUSTON FORECAST: In Houston, daily infections are forecast to increase to more than 4,500 in the same time frame

MIAMI FORECAST: Miami could see cases surge to more than 2,800 in the next three weeks

The forecasts, however, show that many counties across the country are starting to see stabilizing cases. States like Oregon, Louisiana, North Carolina and California are showing improving four-week forecasts, according to researchers.

It is not yet clear how much of this stabilization in risk for resurgence is related to masking policies or increased personal vigilance in distancing and hygiene practices as people have observed what is happening in other parts of the country, the researchers say.

David Rubin, the director of the PolicyLab, said the current forecasts may be an indication some states need to halt or scale back their reopenings.

'We've reached a point in communities throughout Arizona, Texas and Florida where the epidemic is accelerating at an alarming pace and may quickly overwhelm local health care systems -signaling a need to pause reopening plans,' Rubin said.

'For those other areas of rising concern in our model that have forecasts similar to those of Arizona just a few weeks ago, we would encourage local leaders to view our projections as an early warning system and enact swift response measures to prevent further widespread community transmission.'

The current coronavirus surge has sent infections to dire new levels across the South and West with hospital administrators and health experts warning on Wednesday that politicians and a tired-of-being-cooped-up public are letting a disaster unfold.

While newly confirmed infections have been declining steadily in early hot spots like New York and New Jersey, several other states set single-day records this week, including Arizona, California, Mississippi, Nevada, Texas and Oklahoma.

Some of them also broke hospitalization records, as did North Carolina and South Carolina.

CALIFORNIA: In California, cases have surged nearly 70 percent in just two days. The state reported over 7,100 new cases on Wednesday, up from 4,230 on Sunday

CALIFORNIA HOSPITALS: Hospitalizations have also reached record highs across the state in the past week

TEXAS CASES: Rapidly worsening coronavirus numbers in Texas continue to reach bleak new milestones with the state recording more than 5,550 new cases in a single day

TEXAS HOSPITAL: In Texas, which began lifting its shutdowns on May 1, hospitalizations have doubled and new cases have tripled in two weeks

TEXAS DEATHS: The state recorded an additional 29 deaths on Wednesday compared to the record 58 on May 15

In California, cases have surged nearly 70 percent in just two days. The state reported over 7,100 new cases on Wednesday, up from 4,230 on Sunday.

Hospitalizations have also reached record highs across the state with about 1,500 suspected or confirmed patients requiring intensive care.

While Governor Gavin Newsom said part of the rise was due to testing, much is the result of people failing to engage in safe practices when gathering with friends and family, or visiting newly reopened businesses.

Los Angeles County now has the most cases of all US counties with more than 85,000 confirmed infections. Los Angeles Mayor Eric Garcetti on Wednesday urged residents to stay home and wear masks while out in public.

More than 20 members of a single Los Angeles family have tested positive for COVID-19 that resulted in the 60-year-old patriarch dying. The family insist they didn't attend or host any large gatherings and believe it spread due to one or two family members visiting the home.

Florida's single-day count surged to 5,500 on Wednesday - a 25 percent jump from the record of 4,049 on June 20.

In Texas, which began lifting its shutdowns on May 1, hospitalizations have doubled and new cases have tripled in two weeks.

Rapidly worsening coronavirus numbers in Texas continue to reach bleak new milestones with the state recording more than 5,550 new cases in a single day.

Hospitalizations in Texas have again hit record numbers, leading the largest pediatric hospital in the US to begin treating adult patients in Houston.

In Arizona, emergency rooms are seeing about 1,200 suspected COVID-19 patients a day, compared with around 500 a month ago. If the trends continue, hospitals will probably exceed capacity within the next several weeks,according to Dr Joseph Gerald, a University of Arizona public health policy professor.

'We are in deep trouble,' Gerald said as he urged the state to impose new restrictions on businesses, which Governor Doug Ducey has refused to do.

Dr Peter Hotez, an infectious-disease expert at the Baylor College of Medicine in Texas, said he worries that states will squander what time they have to head off a much larger crisis.

'We're still talking about subtlety, still arguing whether or not we should wear masks, and still not understanding that a vaccine is not going to rescue us,' he said.

FLORIDA: Florida recorded a record high 5,508 new cases (left) on Wednesday, up from the previous record of 4,049 on June 20. Forty four new deaths (right)were recorded across the state on Wednesday

ARIZONA CASES: Arizona reported 1,795 new cases on Tuesday, down from the record 3,591 new infections a day earlier

ARIZONA HOSPITALS: The number of people admitted to Arizona hospitals with COVID-19 or suspected of having coronavirus on Tuesday was at 2,200

ARIZONA DEATHS: Arizona recorded 79 new deaths on Tuesday - compared to the 67 deaths recorded on May 8

The Texas governor initially barred local officials from fining or penalizing anyone for not wearing a mask as the state reopened. After cases began spiking, Abbott said last week that cities and counties could allow businesses to require masks.

More than a dozen US states and some major cities have face-covering rules. California Governor Gavin Newsom last week told residents to wear masks at nearly all times outside the home. Newsom has said he will withhold pandemic-related funding from local governments that brush off state requirements on masks and other anti-virus measures in response to the soaring numbers.

Washington Governor Jay Inslee on Tuesday ordered residents to wear face masks in public and Nevada's Governor Steve Sisolak said residents will have to wear masks or face coverings out in public beginning Friday.

It comes as health officials warn coronavirus cases are climbing rapidly among young adults in a number of states where bars, stores and restaurants have reopened - a disturbing generational shift that not only puts them in greater peril than many realize but poses an even bigger danger to older people who cross their paths.

In states like Florida, Texas and Arizona, young people have started going out again, many without masks, in what health experts see as irresponsible behavior.

'The virus hasn't changed. We have changed our behaviors,' said Ali Mokdad, professor of health metrics sciences at the University of Washington in Seattle. 'Younger people are more likely to be out and taking a risk.'

Figures from the Centers for Disease Control and Prevention show that almost as soon as states began reopening people 18 to 49 years old quickly became the age bracket most likely to be diagnosed with new cases.

Although every age group saw an increase in cases during the first week in June, the numbers shot up fastest among 18- to 49-year-olds. For the week ending June 7, there were 43 new cases per 100,000 people in that age bracket, compared with 28 cases per 100,000 people over 65.

In Florida, young people ages 15 to 34 now make up 31 percent of all cases, up from 25 percent in early June. Last week, more than 8,000 new cases were reported in that age group, compared with about 2,000 among people 55 to 64 years old.

Just over 820 Americans died from coronavirus on Tuesday, bringing the total death toll to more than 121,000. It is the highest number of daily deaths recorded in the past week after fatality rates started declining nationwide

New cases in the US have been surging for more than a week after trending down for over six weeks. Nearly 35,000 new cases were reported on Tuesday, which is down from the record 36,000 infections that were logged on April 24

Link to Article - Graphs:

https://www.dailymail.co.uk/news/articl ... rowth.html

[Anthea]

Covid-19 causes human
cells to sprout TENTACLES

The coronavirus zombifies human cells and causes them to sprout tentacles in order to spread around the body, scientists have discovered





A study led by the University of California saw researchers take microscopic images of this process, which they have described as 'so sinister'.

Images show infected cells growing tentacle-like spikes, known as filopodia, which appear to be littered with viral particles.

The researchers believe the disease uses the tentacles to 'surf' to healthy cells, where it injects its viral venom into them and creates more zombie cells.

Until now, researchers believed Covid infected like most other viruses - by latching onto healthy cells and turning them into copying machines.

But, in people with healthy immune systems, the body can fight off the majority of the virus and prevent it from replicating in high amounts in the body.

The latest discovery appears to show that Covid has, at some point in its evolution, developed a back-up plan to get round the immune system.

The finding has been described as an 'amazing leap' in the fight against coronavirus and may open the door to a host of new treatment options.

The coronavirus 'zombifies' human cells and causes them to sprout tentacles to spread around the body, scientists have discovered. A study led by the University of California saw researchers take microscopic images of this process

Covid-19 appears to litter these tentacles with viral particles which 'surf' to healthy cells and inject their viral venom into them, creating more zombie cells

Nevan Krogan, a professor in cellular and molecular pharmacology at the University of California and lead researcher, told the LA Times: 'It’s just so sinister that the virus uses other mechanisms to infect other cells before it kills the cell.'

Other viruses — including HIV and vaccinia, a member of the virus family that causes smallpox — also use filopodia as way to spread infection through the body.

But Professor Krogan said the way Covid-19 can grow the tentacles so rapidly is highly unusual.

Britain's top vaccine scientists say Covid-19 has lots of 'tricks' to deceive the immune system

The coronavirus has lots of 'immunological tricks up its sleeve' that make it hyper-infectious, according to one of Britain's top vaccine scientists.

Peter Openshaw, professor of experimental medicine at Imperial College London, said the virus is 'surprisingly' good at ducking the human immune system — despite only jumping from animals six months ago.

He said normally it takes years of co-existing with humans for any virus to evolve these traits.

Professor Openshaw told the House of Lords Science and Technology Committee last week: 'In terms of durability, viruses often have a way of modulating the host's immune response.

'It's the way they've evolved to tune down the immune response that's generated by the virus. That would usually be particularly strong in virus that's had long time to co-evolve with human host.

'What surprises us about this novel virus that's only recently jumped from bats to humans, is already seems to have a lot of immunological tricks up its sleeve and is able to interfere with the immune response and in a way disseminate in a way that you wouldn't really expect a virus that has only just moved into the human population.

'We wonder why that is. We wouldn't have thought that a virus could behave in such a complex way when its only just been introduced into a new species.'

He added: 'So maybe there are tricks it has learned while evolving in another species that have cross over effect.'

Professor Openshaw shot down theories that the virus had already infected humans before.

He also ruled out the possibility that had been manufactured or interefered with in a laboratory in China, as has been heavily insinuated by US President Donald Trump.

Professor Openshaw told the committee that he thought it was 'just chance' that the virus has learnt to trick the immune system.

He also said their shape - protruding out of the cell towards other cells like branches on a tree - was also strange.

Columbia University microbiologist Professor Stephen Goff admitted the finding was 'intriguing' but said it did not necessarily mean the tentacles were behaving as a seond mode of spreading.

He told the LA Times: 'It’s intriguing and a really cool observation. But we don’t yet know what stage [of infection] is affected. It will be great fun to find out.'

Scientists behind the study - published in the journal Cell - believe the discovery could open the door to new treatments.

They have now identified seven existing cancer drugs that block the growth of filopodia.

Among the seven drugs are gilteritinib, sold as Xospata, which is used to treat acute myeloid leukemia and Silmitasertib, an unproven drug being trialled as a treatment for bile duct cancer and a form of childhood brain cancer.

Reacting to the findings, Professor Andrew Mehle, a microbiologist at the University of Wisconsin-Madison, told SFist: 'This paper shows just how completely the virus is able to rewire all of the signals going on inside the cell. That's really remarkable and it's something that occurs very rapidly (as soon as two hours after cells are infected).'

Lynne Cassimeris, a professor of biological sciences at Lehigh University, said the discovery was an 'amazing leap'.

The study included scientists from Mount Sinai in New York, Rocky Mountain Labs in Montana, the Pasteur Institute in Paris and the University of Freiburg in Germany.

It was launched in February to rapidly identify existing drugs that had the potential to treat the then-brand new disease.

They monitored how the virus responded to drugs under laboratory settings in test tube experiments.

One of Britain's leading experts said last week that the coronavirus has lots of 'immunological tricks up its sleeve' that make it hyper-infectiou.

Peter Openshaw, professor of experimental medicine at Imperial College London, said the virus is 'surprisingly' good at ducking the human immune system — despite only jumping from animals six months ago.

He said normally it takes years of co-existing with humans for any virus to evolve these traits.

Professor Openshaw told the House of Lords Science and Technology Committee last week: 'In terms of durability, viruses often have a way of modulating the host's immune response.

'It's the way they've evolved to tune down the immune response that's generated by the virus. That would usually be particularly strong in virus that's had long time to co-evolve with human host.

'What surprises us about this novel virus that's only recently jumped from bats to humans, is already seems to have a lot of immunological tricks up its sleeve and is able to interfere with the immune response and in a way disseminate in a way that you wouldn't really expect a virus that has only just moved into the human population.

'We wonder why that is. We wouldn't have thought that a virus could behave in such a complex way when its only just been introduced into a new species.'

He added: 'So maybe there are tricks it has learned while evolving in another species that have cross over effect.'

Professor Openshaw shot down theories that the virus had already infected humans before. He also ruled out the possibility that had been manufactured or interefered with in a laboratory in China, as has been heavily insinuated by US President Donald Trump.

Professor Openshaw told the committee that he thought it was 'just chance' that the virus has learnt to trick the immune system.
Is this the mutation that made coronavirus spread like wildfire in NYC, Italy and the UK? D614G strain has four-times as many 'spikes' that latch onto human cells

A mutated strain of coronavirus that has decimated the US, UK and Italy is nearly 10 times more infectious than the original virus that emerged from China, a study suggests.

The potent version of SARS-CoV-2 - called D614G - has four to five times more 'spikes' that protrude from the viral surface allow it to latch onto human cells.

Not only does this trait make it more infectious, but it also makes the virus more stable and resilient.

Scientists have been puzzled about why coronavirus has seemed to hit some states and countries harder than others.

Previous research had highlighted that the potent D614G strain was circulating in high numbers in Italy, the UK and New York City - where infection and death rates are among the worst in the world.

Now, a study by scientists at Scripps Research has confirmed that the mutated coronavirus latches onto receptors more easily than other strains.

Although the research only looked at D614G in tightly controlled laboratory settings, experts told DailyMail.com it's 'plausible' the strain's viral structure makes it more infectious in people.

Professor Ian Jones, a virologist at the University of Reading in England, said: 'Yes it is plausible. The work is good quality and it would mean that the virus could successfully infect at a lower dose and so spread more widely.'

Coronavirus's 'spike' protein (pictured) has two components (shown in purple and green). Being comprised of two parts makes it 'unstable' and fragile, but a new mutation makes it more stable by making the whole spike more 'flexible' and infectious, a Scripps Research study says

Researchers there isolated various strains of coronavirus that have been identified by their genetic signatures around the world.

They then put each into a sort microscopic cage match, testing how aggressively the respective strains attacked human cells in petri dishes.

One strain was the clear winner - the iteration of the virus with the mutated gene that gave it more 'spike' proteins.

'Viruses with this mutation were much more infectious than those without the mutation in the cell culture system we used,' said virologist Dr Hyeryun Choe, PhD, senior author of the study.

The 'spike' is a protein on the surface of the coronavirus - known as SARS-CoV-2 - that allows it to latch onto receptors on human cells' surfaces.

Specifically, it binds to ACE2 receptors, which are prevalent on the surface of lung cells as well as blood vessels - making these systems prime targets for coronavirus.

The more spikes it has, the more opportunities the virus has to stick to a human cell, and hijack its machinery to make more of itself.

And the mutant strain that's spread in the US, Italy and Britain has them in spades.

The potent strain of coronavirus also hit Europe, taking a particularly strong hold in Italy, before spreading to the US (light blue)

'The number - or density - of functional spikes on the virus is 4 or 5 times greater due to this mutation,' said Dr Choe.

Not only did it have more spikes, it had particularly well-adapted ones.

Its protein spike was flexible rather than rigid. That gives it the same advantage that modern suspensions bridges have. Swaying and jostling might bend it - but it won't break.

And the longer and more stabley it can hang onto receptors, the better the opportunity for viral particles to march into the human cell and take it over, without the virus falling to pieces.

'Our data are very clear, the virus becomes much more stable with the mutation,' Dr Choe said.

That mutation belongs to a strain of coronavirus known as D614G.

Researchers at Los Alamos National Laboratory in New Mexico said in March that the mutant strain started spreading in early February in Europe.

It has since made its way to the US, where it became the most common - and aggressive - strain on the East Coast by March, and the scientists there said it's now the world-dominating strain.

https://www.dailymail.co.uk/news/articl ... ACLES.html

[Anthea]

Erbil governorate announces
new total lockdown

Erbil province will be put under total lockdown for nearly five days, announced the ministry of interior late Sunday

Firsat Sofi, governor of Erbil, informed Rudaw that the provincial lockdown will begin on Tuesday, rather than on Monday as previously noted in a statement

The order will now be put in place between Tuesday, June 30, at 6:00 am and 11:59 pm on Saturday, July 4.

All civilian movement will be prohibited, including vehicle traffic.

Residents will be allowed to purchase essentials at their local bakeries, supermarkets, groceries, and pharmacies, which will remain open during the lockdown, according to the issued order. No hours of operation have been specified for the essential businesses.

Military, humanitarian, diplomatic mission, oil and gas company, and medical vehicles are allowed to move freely during the lockdown, as well as fire department and public sanitation company vehicles.

All non-commercial transportation between Erbil and other Kurdistan Region provinces remains prohibited.

Journalists are allowed to move within the province for their work commitments, but will not be allowed to enter Erbil province until 11:59 pm July 4.

On Sunday, the KRG health ministry recorded 139 new cases of the virus, as well as six coronavirus-related deaths - two in Erbil province, two in Sulaimani province, one in Raparin, and one in Halabja province.

So far, the Region has recorded 5,672 cases of the virus. Of this figure, 1,675 people have recovered and 186 have died after contracting the virus.

https://www.rudaw.net/english/kurdistan/280620201

[Anthea]

Leicester faces lock-down extension

Pubs and restaurants in Leicester may stay closed for two more weeks due to a surge in coronavirus cases, the city's mayor has said

Sir Peter told the Today programme the city could "remain restricted for two weeks longer than the rest of the country".

There have been 2,987 positive cases in Leicester since the pandemic began, with 866 of those - 29% - reported in the two weeks to 23 June.

Coronavirus restrictions across England are due to be eased from 4 July, with pubs, restaurants, hairdressers and hotels allowed to reopen.

But Sir Peter said he had received an email from the government overnight and "it seems they're suggesting we continue the present level of restriction for a further two weeks beyond 4 July".

He criticised the analysis as "superficial" and said "it does not provide us with the information we need if we are to remain restricted for two weeks longer than the rest of the country".

Sir Peter added it was unclear whether the government had the power to impose an extension on the city if council officials concluded it was not necessary.

Local and government officials are due to meet later.

On Sunday's Andrew Marr Show, Home Secretary Priti Patel said: "With local flare-ups, it is right we have a local solution."

Prime Minister Boris Johnson said: "We are concerned about Leicester, we are concerned about any local outbreak. I want to stress to people that we are not out of the woods yet."

He said a local "whack-a-mole" strategy used to deal with outbreaks in Weston-super-Mare and around GP surgeries in London would be "brought to bear in Leicester as well".

We should get used to these local flare-ups - they are going to become a way of life over the coming months.

The virus, while at low levels, is still here.

There are around 1,000 positive tests every day across the UK on average - and then there are the unknown number of silent spreaders, those who do not show symptoms and hence do not get tested.

What's important is that these clusters are brought under control quickly and don't spread.

The fact a local outbreak has been identified in one part of Leicester suggests the system is working to some extent - although it's fair to ask whether it could have been spotted more quickly given cases have been growing for a number of weeks.

With extra testing facilities parachuted in officials will be desperately trying to get a clear idea of just how far it has spread so delaying the further easing of restrictions is the logical step.

If more cases keep emerging a local lockdown will be on the cards.

Should it be like this? Some argue we should have suppressed the virus further before easing - essentially going for elimination like New Zealand.

But for a country like the UK where the virus had spread further before lockdown and with its size of population and packed cities that is somewhat harder.

Ivan Browne, Leicester's director of public health, said detailed data on local cases suggested they were "very much around the younger working-age population and predominately towards the east part of our city".

"I don't think at the moment we're seeing a single cause or single smoking gun on this...it's likely to be a combination of factors," he added.

Leicester East MP Claudia Webbe has called for a lockdown due to a "perfect storm" of poverty, positive tests and higher ethnic diversity.

About 28% of Leicester's population is of Indian heritage, and a further 21% are from black or Asian backgrounds.

Dr Manish Pareek, a consultant at Leicester Royal Infirmary, said many recent cases were from "inner-city areas...which have high levels of ethnic diversity, pockets of deprivation but also quite crowded housing with inter-generational and multi-occupancy households".

These factors "are almost like a perfect storm for a virus to be spread within", he added.

What the data does and doesn't tell us

The figure for confirmed cases in Leicester is more than double that published by the government.

This is because the government's published data for local cases only cover tests carried out in hospitals and for health workers - known as Pillar 1.

Tests outside of hospitals, known as Pillar 2, are not broken down by local authority but Public Health England has started publishing a weekly round-up by region.

In the week of 18 to 24 June the East Midlands went from 18,516 confirmed cases to 19,861, equivalent to 28 new confirmed cases for every 100,000 people.

In its weekly report Public Health England said case detections were highest in the north of England and there had been increases outside of hospital testing in Yorkshire and the Humber over the previous two weeks.

"At a local authority level, activity was highest in parts of West Yorkshire, Greater Manchester and in Leicester," it added.
Presentational grey line

A Department of Health and Social Care spokesperson said: "We are working alongside Public Health England to support the council and local partners in Leicester to help prevent further transmission of the virus.

"Based on the latest data, there are now four mobile testing units deployed and thousands of home testing kits available, to ensure anyone in the area who needs a test can get one."

Do you live in Leicester? What do you think about a local lockdown extension? Share your experiences by emailing haveyoursay@bbc.co.uk.

https://www.bbc.co.uk/news/uk-england-l ... e-53217095

[Anthea]

UK: Majority of public braced
for return to full lockdown

The majority of the public think pubs and restaurants have been reopened too soon and are braced for a return to full lockdown before a vaccine is found

The first pints have been poured at pubs in England which can now reopen following months of closure as lockdown restrictions are lifted.

Couples can get married and hairdressers have been allowed to welcome customers, alongside restaurants, bars and cinemas on so-called Super Saturday, which has seen the biggest relaxation of rules yet.

However, 52% of voters believe the hospitality sector is going back into business early, according to a survey by pollster Opinium.

The snapshot survey shows that 73% expect a second outbreak of Covid-19 this year

It states the Government’s disapproval rating is at 49% – with just 30% approving of its performance.

The survey also finds that 53% of people think the easing of the lockdown is happening too fast.

More than half of voters, 55%, are also braced to go back into full lockdown before a vaccine becomes available.

Similarly, 52% of people think the Government has under-reacted to the situation, while 30% believe it has reacted proportionately.

Boris Johnson has a knife-edge lead over who is considered best prime minister, with a 34% rating compared to Labour leader Sir Keir Starmer’s 33% tally.

Sir Keir’s approval rating also dipped from 46% to 43%, according to the survey.

Adam Drummond, head of political polling at Opinium, said: “While the Government may be keen to reopen, the public are looking ahead and with trepidation and aren’t expecting this release to be anything but temporary.

“An overwhelming majority expect a second wave of coronavirus to hit the UK, and a smaller majority expect a further lockdown will be needed before a vaccine eventually releases us from this virus.”

Four people were arrested and several pubs decided to close after alcohol related anti-social behaviour in north Nottinghamshire.

Nottinghamshire Police said three pubs in Mansfield and Sutton in Ashfield, plus two in Arnold and Newark closed.

Inspector Craig Berry said: “Officers were quickly on the scene to deal with a number of alcohol related anti-social behaviour reports including a smashed window and minor assault. As a result four arrests were made by officers and we supported licensees who chose to close their own premises.

“No pubs have been closed by the police.

“We’d like to thank the majority of the public who have acted responsibly throughout Saturday, especially whilst watching the much-anticipated Derby v Forest match.”

Meanwhile, the city of Leicester for the most part remains closed amid its own local lockdown.

Restaurants, cafes, bars and pubs in the city must remain closed, but can be open for takeaways.

People are also banned from staying overnight at another household, and those in the restricted area can no longer visit people in private gardens or indoors, and could face fines if they flout rules.

The East Midlands city was placed under harsher restrictions by Health Secretary Matt Hancock following the rapid rise of coronavirus cases.

As well as the city of Leicester, the lockdown area includes parts of Leicestershire that touch on the city’s boundaries, including parts of Blaby District and Charnwood in the county.

https://www.standard.co.uk/news/uk/supe ... 89021.html

[Anthea]

WHO: Coronavirus pandemic
accelerating' and 'getting worse

Dr Tedros Adhanom Ghebreyesus, director general of the WHO, warned the pandemic has still not reached its peak and the virus is not under control "in most of the world”

His message comes as quarantine rules for people returning to or visiting the UK from certain countries are relaxed from Friday.

The UK Government has published a list of 76 countries and territories from which people arriving into England will no longer need to self-isolate for 14 days.

But Dr Ghebreyesus said the total number of cases of coronavirus worldwide has doubled in the last six weeks.

The WHO issued the message as quarantine measures are lifted in England

Speaking at the member state briefing on the Covid-19 pandemic evaluation, he said: "The virus has upended health systems in some of the world’s wealthiest nations, while some countries that have mounted a successful response have been of modest means.

"We know that when countries take a comprehensive approach based on fundamental public health measures – such as find, isolate, test and treat cases, and trace and quarantine contacts – the outbreak can be brought under control.

In most of the world the virus is not under control

He added: "More than 11.8 million cases of Covid-19 have now been reported to WHO. More than 544,000 lives have been lost.

"And the pandemic is still accelerating. The total number of cases has doubled in the last six weeks."

The relaxation of the quarantine rules has largely been welcomed by political figures and the tourism industry, although Labour has criticised the Government for failing to set up so-called air bridges to other countries.

Shadow transport secretary Jim McMahon said that workers and holidaymakers were paying the price of the Government’s failure to act.

"The fact they have been unable to negotiate air bridges is an indictment of their failure to tackle the crisis at home," he said.

Meanwhile, for people choosing to shun holidays to stay at home in England, swimming pools, gyms and outdoor arts performances were given the green light to reopen in the latest easing of the lockdown.

Culture Secretary Oliver Dowden said outdoor pools will be able to reopen from Saturday to be followed by indoor pools, gyms and other sports facilities from July 25.

Shops reopen during Coronavirus lockdown ease

Theatres, opera, dance and music will also be able to resume outdoors from the weekend although audience numbers will be restricted and will be subject to social-distancing rules.

Following the opening for hairdressers last week, beauticians, tattooists, spas, tanning salons and other close contact services will be able to welcome back customers from Monday.

In Scotland, Nicola Sturgeon announced a relaxation of the rules allowing people to mix indoors and confirming plans for bars, restaurants and hairdressers to reopen.

The First Minister said it is “undoubtedly a time for cautious hope and optimism” as she moved the country to phase three of its four-phase easing plan.

https://www.standard.co.uk/news/world/c ... 94226.html

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Face masks in UK shops?

Making face coverings mandatory in shops in England is being considered by the government to slow the spread of coronavirus, senior sources have said

Speaking in a Facebook Q&A video, Boris Johnson hinted at the change saying: "We are looking at ways of making sure that people really do have face coverings in shops."

Face coverings have been compulsory in shops in Scotland since 10 July.

Mr Johnson also said "people should be going back to work if they can now."

Responding to a question about extending the furlough scheme the prime minister said: "I think everybody has sort of taken the 'stay at home if you can' - I think we should now say, well, 'go back to work if you can'.

"I think it's very important that people should try to lead their lives more normally."

The UK government was initially hesitant about advising people to wear face coverings, arguing that evidence that they reduce transmission was "weak".

However, rules compelling people to wear face masks on public transport in England were introduced on 15 June.

And speaking on Friday Mr Johnson said "the balance of scientific opinion seems to have shifted more in favour of them than it was, and we're very keen to follow that".

"I don't think we are going to get to a world where we say everyone has to wear face coverings the whole time everywhere," he said, but added "We need to be stricter in insisting that people wear face coverings in confined spaces where they are meeting people they don't usually meet.

"The future for the country has got to be a world where we are managing the virus so effectively with local lockdowns, test and trace that we don't need ultimately to have some of these social distancing measures."
line

The messaging on face masks has evolved, to put it mildly. And Labour's calling on the government to offer some speedy clarity on the matter.

Of course some will suggest that the position has evolved as the science has evolved. But perhaps something to consider here too; the economy.

Today Boris Johnson urged people to go back to work. He also hinted at a stricter policy on face masks.

Lo and behold he was pictured, out and about at a shop and takeaway, wearing a face mask. It doesn't take a detective to spot an overarching theme.

Ministers want people to start embracing the new normal; leaving their homes, spending money and helping businesses get back on their feet - but yes with mitigation measures, like masks, in place.

Those mitigations are of course there to help suppress transmission but can also play their part in in helping people feel confident.

Because public confidence is important; you can urge someone to do something but they may well resist unless they feel safe.

Currently people in England are advised to wear a face covering if possible in enclosed public spaces where social distancing is not possible.

Those exempt from wearing face coverings include children under 11, people with disabilities, those with breathing difficulties and anyone travelling with someone who relies on lip reading.

The rules on face covering vary across the nations. In Scotland face coverings are mandatory in shops and on public transport.

People in Wales are being asked to wear non-medical face coverings where social distancing is not possible - including on public transport - but the government in Cardiff stopped short of making their use mandatory.

While in Northern Ireland, plans to make wearing face coverings on public transport compulsory have been put on hold, pending legal clarification.

Is the science on face coverings changing?

Right from the early weeks of the crisis there's been concern about "silent spreaders" - people who don't realise they're infected passing the virus to others.

It was that fear that led the US government and many others, back in April, to recommend that people cover their faces when in crowded indoor spaces.

And since then the evidence has become stronger that in the 24-48 hours before symptoms show, people can be at their most infectious. Many others may never show symptoms at all, as I reported back in May.

So as lockdowns are eased, and there's more mingling on public transport and in shops, the logic is that a barrier over the mouth and nose - even one that's homemade - can trap much of the virus that an infected person may release.

According to Prof Sir Venki Ramakrishnan, president of the Royal Society, the UK's leading science academy, masks help to reopen economies because they make it easier for people to go about their normal lives and "they're a very small price to pay".

Way behind

The World Health Organization says non-medical face coverings should be worn where social distancing is not possible.

Homemade cloth face coverings can help reduce the spread of coronavirus from people who are contagious but have no symptoms or are yet to develop symptoms.

Prof Sir Venki Ramakrishnan expressed concern that the UK is "way behind" other countries in terms of face mask usage.

He said the government's guidelines had been inconsistent adding: "What we would like for the government is to be a bit stronger and clearer about the messaging and require it whenever you are in crowded public spaces where you cannot get more than 2m away from the next person.

London Mayor Sadiq Khan has written to Mr Johnson urging him to make face coverings mandatory in public places where it is not possible to keep a safe distance from others.

Labour's shadow health secretary Jonathan Ashworth said: "We urge ministers to conclude this review rapidly to provide the strong and clear guidance needed."

https://www.bbc.co.uk/news/uk-politics-53365062

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UK how local lockdowns work?

The UK's first local lockdown has been introduced in Leicester, following a spike in coronavirus cases

Who decides when a local lockdown is needed?

A single premises with a coronavirus cluster is likely to be closed temporarily by the local director of public health and the Health and Safety Executive, and must legally remain shut.

These powers have been used previously to deal with salmonella or Legionnaires' disease outbreaks.

If there is evidence of a bigger coronavirus outbreak in a town, city or region, several organisations decide the response.

Click to enlarge:


England's chief medical officer can advise a minister to use existing emergency powers to control it. This could mean introducing legislation which doesn't need voting on in Parliament.

Local authorities will for the first time be given access to postcode-level data about the number of people testing positive for coronavirus in their areas.

An agreement, signed individually with councils over the past week, gives them access to a digital dashboard which shows extremely localised test results.

What could a local lockdown involve?

In Leicester, it will be similar to going back to the UK-wide lockdown introduced at the end of March.

Residents will have to stay at home as much as they can, while people in other parts of England will have more freedom.

Non-essential shops have to shut again

Hotels and places of worship must also close, although ceremonies can be broadcast and funerals may take place

Local Covid-19 testing will be stepped up

The reopening of pubs and restaurants for consumption on the premises

The relaxation of social distancing across England on 4 July to "one metre plus", will not apply

Non-essential travel to, from and within Leicester should also be avoided.

People or businesses that repeatedly flout the new law could receive fines of up to £3,200.

But a future lockdown in another place might not be so tough. It will depend on the nature of the coronavirus spike.

"It might be closing schools again if the increase is only seen in children and teachers," says Dr Nathalie McDermott, clinical lecturer in infectious diseases at King's College London.

"Or it might be not opening restaurants and bars because you're concerned about the direction the trend is going in."

Why are Leicester and its suburbs in lockdown?

Mr Hancock told the Commons on Monday the city had "10% of all positive cases in the country over the past week".

Click to enlarge:


Leicester's seven-day infection rate of 135 cases per 100,000 people was "three times higher than the next highest city". Admissions to hospital were between six and 10 per day - compared to about one a day elsewhere.

Its local lockdown will be officially reviewed in two weeks although the Health Secretary Matt Hancock can end it at any time.

Could offices, factories or schools be closed instead?

The city-wide lockdown was brought in because "targeted action" had not worked, Mr Hancock said.

When many Covid-19 cases are found in one place like a hospital, factory or school, this is called a cluster. They can be dealt with by local directors of public health, often by closing the premises.

There have already been clusters in several parts of the UK:

At Weston-super-Mare hospital, North Somerset

At two GP surgeries in Enfield, North London

At three meat factories in Cleckheaton West Yorkshire, and Anglesey and Wrexham in North Wales

When different clusters are found to be linked, this is defined as an outbreak.

Can police enforce the lockdown?

Police have powers to enforce the local lockdown, for example, if they believe that somebody is staying overnight somewhere other than where they live they can tell them to return home.

Police can also fine people for breaking the rules, with fines starting at £100, as before.

And they may also issue a "prohibition notice" directing somebody not to do something.

Have other countries tried local lockdowns?

In Germany, local authorities have the power to vary the level of restrictions in individual states, and a number of small lockdowns have been imposed recently.

One has also been enforced in parts of China's capital, Beijing after a recent outbreak.

What has been said about the rest of the UK?

Public Health Wales said that a local lockdown was under consideration after the recent outbreak in Anglesey. However, First Minister Mark Drakeford said that any decision would be not be taken lightly.

The Scottish government - for which public health teams work for the NHS, rather than councils - says it is developing a "responsive system of community surveillance" at a national, regional and local level to identify outbreaks quickly.

In Northern Ireland, the government says that any potential clusters or outbreaks will be handled using "appropriate infection control" in line with its normal guidelines for handling an outbreak of a disease.

https://www.bbc.co.uk/news/uk-england-52934822

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Summary of World Cases:

More than 230,000 cases were recorded on Sunday, the WHO says

Most new cases were in the Americas, followed by South East Asia

Coronavirus immunity may only last for months, according to a study by King's College London

Mexico now has the fourth-most virus deaths, passing Italy

In England, nail bars, beauty salons, spas, and tattoo parlours can reopen today

The Palestinian Authority imposes a curfew on the West Bank

Bolivia's economy minister tests positive, days after the interim president did

Globally there have been 12.9m confirmed cases since the outbreak began, with 568,000 deaths

[Anthea]

Coronavirus deaths are
up 46% across the US

Deaths related to COVID-19 have increased across the United States by 46 percent in the past week with Texas, Arizona and Mississippi reporting the biggest weekly spikes

More than 5,000 people died from COVID-19 between July 6 and July 12, which is an increase of 46 percent compared to the previous week, according to a Reuters analysis of data from The COVID Tracking Project.

About a dozen states have reported increases in deaths for at least two straight weeks, including California, Florida and Texas.

In Texas, news deaths surged by 127 percent last week when it added 555 new deaths, bringing the total to just over 3,100.

Arizona's deaths increased by 94 percent after adding 428 deaths. The hardhit state's death toll was at 2,237 the week ending July 12.

Mississippi's deaths spike by 92 percent last week compared to the previous week. The state added 138 deaths, bringing the total to just over 1,200.

In California and Florida - two of the other hot spot states - deaths surged by more than 60 percent last week.

Florida recorded 514 deaths in the week ending July 12, bringing total to over 4,300; and California reported 686 deaths, bringing the total to 7,000. Florida on Monday added a record 132 fatalities to its death toll.

Forty-six states reported more new cases of COVID-19 last week compared to the previous week, the analysis found

New cases also continue to rise with the US reporting over 400,000 infections for the week ending July 12, which was up 21 percent from the previous seven days.

Nationally, new COVID-19 cases have risen every week for six straight weeks.

Forty-six states reported more new cases of COVID-19 last week compared to the previous week, the analysis found.

Cases are only falling on a weekly basis in New York, Tennessee, New Jersey and Delaware.

While Southern and Western states are seeing the biggest increase in cases, infections are also rising in the Midwest with Minnesota cases up 60 percent, Missouri up 40 percent and Iowa up 30 percent.

Currently, more than 135,000 Americans have died from coronavirus and there have been more than 3.3 million infections.

Until now, the number of deaths per day from COVID-19 had been falling for months even as hot spots states like Florida, Texas and Arizona saw explosions in cases and hospitalizations.

Daily infections across the US have broken records several times in recent days.

Health officials have been warning for weeks that deaths would surge again because the fatality rate lags several weeks behind infections.

A coronavirus death, when it occurs, typically comes several weeks after a person is first infected.

Experts had predicted states that saw spikes in cases and hospitalizations would, at some point, see deaths rise too.

Florida COVID rates rocket as Fauci suggests US reopening too soon

The impact of the new surge in deaths has been felt by the healthcare workers grappling in overstretched hospitals with Texas and Arizona requesting refrigerated trucks as morgues reach capacity.

In Arizona, capacity within intensive care units had surged to 90 percent. Hospitalizations in Texas continue to spike to record highs with more than 10,000 people being treated on Monday.

Researchers expect deaths to rise for at least several weeks but some think the count probably will not go up as dramatically as it did in the spring.

A forecast model from the University of Washington's Institute for Health Metrics is predicting the death toll to rise to 208,255 by November 1.

Experts say the death toll may not be as bad as when the pandemic first hit because testing was extremely limited early on and that many people's health behaviors have now changed with mask-wearing becoming more common in some places.

Testing for COVID-19 rose by 7.4 percent in the United States last week and set a new record high on July 10, with over 823,000 tests performed, according to the Reuters analysis.

Nationally, 8.8 percent of tests came back positive for coronavirus, up from 7.5 percent the prior week and 5 percent three weeks ago.

The World Health Organization considers a positivity rate above 5 percent to be a cause for concern because it suggests there are more cases in the community that have not yet been uncovered.

TEXAS CASES: The number of infections have also been increasing in recent days in Texas. Just over 5,600 new cases were reported on Monday

ARIZONA CASES: Arizona recorded 1,357 new infections on Monday as capacity within the state's intensive care units surged to 90 percent

California Governor Newsom announces statewide indoor closures

Thirty-one states had positivity test rates above 5 percent, according to the analysis, including Arizona at 27 percent, South Carolina at 19 percent and Florida at 19 percent.

The surge in new cases has prompted many states to temporarily halt the reopening of their economies or order some businesses to close for a second time.

California's Gov Gavin Newsom has once again closed bars, inside dining and, for much of the state, gyms, indoor church services and hair and nail salons in an effort to prevent COVID-19 cases from swamping hospitals.

The Gov issued the sweeping set of closures on Monday as the state recorded more than 329,000 cases and deaths topped 7,000. Hospitalizations have surged by 28 percent in the past two weeks, including a 20 percent increase in patients requiring intensive care.

'COVID-19 is not going away anytime soon, until there is a vaccine and or an effective therapy,' Newsom said.

The affected counties include Los Angeles and virtually all of Southern California.

In Los Angeles, Mayor Eric Garcetti immediately implemented the shutdowns and warned that the city was 'on the verge' of raising its COVID-19 threat level from orange to red — the highest level — and resorting to shutting down all but essential businesses.

Garcetti noted that Los Angeles County now has more virus cases than Canada.

'We have never had as many people infected, or infectious,' he said. 'We've never had as many people in the hospital as there are tonight.'

CALIFORNIA: California's cases surged to just over 8,300 and daily deaths increased by 23 on Monday

FLORIDA: Florida added a record 132 fatalities to its death toll on Monday, bringing the statewide total to 4,409. The number of cases in the state increased by 9,194, bringing the total to 291,629

https://www.dailymail.co.uk/news/articl ... nt-US.html

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Who should be shielding in UK?

About 2.5 million people most at risk of needing hospital treatment if they catch coronavirus are being asked to stay at home

This "shielding" is to protect lives.

Why do it?

While everyone is being advised to keep their distance from other people to help stop the spread of coronavirus, some people with underlying health conditions need to take even more precautions to protect themselves.

The virus poses a high risk if someone who is shielding is exposed to it.

Coming out of lockdown

The guidance on shielding is being kept under review.

Infection levels in the community are now falling so the risk of exposure is significantly less than it has been.

People who are shielding in England and Northern Ireland are able to spend some time outdoors, as long as they continue to follow social distancing rules. They can also gather in groups of up to six people outdoors, including individuals outside of their household, and form a "support bubble" with one other household.

People shielding in Scotland and Wales have been told they can also now spend time outdoors for exercise, either on their own, with their family or with people from another household.

Single adults or single parents who are shielding will be able to bubble with any household, and households with a shielded person in it can also bubble with any single person (or single adult with children).

In England and Northern Ireland, the shielding advice is set to be paused from 31 July. After that date people will no longer need to shield but should take particular care when outside and strictly maintain social distancing.

Who should shield?

Those most at risk, who include:

Solid organ transplant recipients

Some people with cancer who are undergoing treatments such as chemotherapy and radiotherapy

People on immunosuppression drugs

Women who are pregnant and have heart disease

People with severe respiratory conditions - cystic fibrosis, severe asthma and COPD

Some people with rare diseases such as severe combined immunodeficiency

Anyone in this highest-risk category who has not yet received a letter from the NHS or been contacted by their doctor should get in touch with their GP or hospital doctor by phone or online.

This does not include all elderly people, although they are strongly advised to practise social distancing.

What about children?

In England, the vast majority of children considered extremely vulnerable to Covid-19 will no longer need to shield from the end of the July.

New guidance from the Royal College of Paediatrics and Child Health says that most youngsters with conditions such as asthma, diabetes, epilepsy, and kidney disease do not need to continue to shield and could, for example, go back to school.

Just over 90,000 people shielding are under 18. However, children will only be removed from the shielding list by their GP or specialist doctor after discussions with the child and their family.

Is it compulsory?

Experts strongly advise people with serious underlying health conditions to follow the advice. If this applies to you, shielding is for your personal protection - it is your choice to decide whether to follow the recommendations.

You could call your doctor to discuss this.

What does it entail?

It means staying at home and following the guidelines. You should not go out to work, to shop or visit friends in their homes.

You should avoid any face-to-face contact, so that means no visitors.

Visits from people who provide you with essential healthcare and personal support are fine. Carers and care workers should stay away if they have any of the symptoms of coronavirus, and anyone coming into your home should keep their hands clean by washing them with soap and water.

Coronavirus: What you need to know graphic featuring three key points: wash your hands for 20 seconds; use a tissue for coughs; avoid touching your face

What about any people I live with?

They do not need to shield themselves but must make sure they follow recommendations to shield you.

They should also stringently follow the guidance on social distancing.

They should also keep some physical distance (2m when possible) from you and keep to a minimum the time spent in shared spaces such as the kitchen, bathroom and lounge. Shared spaces should be kept well ventilated - open a window.

If you can, use a separate bathroom and bedroom from the rest of the household, and also make sure you use separate towels.

Cutlery

If you share a toilet and bathroom, make sure they are cleaned after every use. Consider drawing up a rota for bathing, with you using the facilities first.

Use the kitchen when others are not in there and take your meals back to your room to eat. Coronavirus is spread through droplets (from coughs and sneezes), so do not share cutlery or crockery unless it is clean. Use a dishwasher if you have one. Soap or washing-up liquid and water gets rid of the virus too.

Keep surfaces that are frequently touched - door handles, taps and handrails - clean.
What about my medicine and food?

People in England can register to get essential food and medicine supplies if friends or family cannot help.

Similar support is available in Scotland, Wales and Northern Ireland.

People will retain their priority for supermarket delivery slots, and still be able to access help with shopping, medication, phone calls and transport to medical appointments when shielding is eased in England and Northern Ireland on 1 August.

How long will shielding last?

In England, people have been asked to shield until 31 July

In Wales people have been asked to shield until 16 August

In Scotland people have been asked to shield until 31 July

In Northern Ireland people have been advised to shield until 31 July

The ultimate ambition is to be able to control the virus enough so that people can move out of shielding. A vaccine could help enable this.

What should I do if I get a cough or fever?

These are symptoms of coronavirus. It does not mean that you definitely have it, but you should contact the NHS 111 online coronavirus service, or call NHS 111 or your doctor. Do this as soon as you get symptoms. Do not visit the GP, pharmacy, urgent care centre or hospital.

In an emergency, call 999 if you are seriously ill.
Other tips to stay safe and well

Good hygiene can stop the virus spreading:
NHS advice

Keep physically active

Look after your mental wellbeing. Stay in touch with friends on the phone, by post or online.

Prepare a hospital bag just in case. This should include your emergency contact, a list of medicines you take and any information on your planned care appointments, as well as things you would need for an overnight stay, such as a toothbrush and pyjamas.

https://www.bbc.co.uk/news/health-51997151

[Anthea]

US counties seeing epidemic spread

Forty five percent of counties across the United States are currently battling uncontrollable COVID-19 outbreaks, a data map shows - as the latest models predict the number of deaths will surge by at least 20,000 in the next four weeks

The data map, compiled by spatial analytics company Esri, shows that an 'epidemic trend', or uncontrollable spread, of coronavirus cases is occurring across the Sun Belt states and parts of the Midwest.

Of the 3,141 counties across the US, 1,415 are currently experiencing an epidemic outbreak and 1,103 are seeing spreading trends, which is an outbreak that could still be controlled if preventative measures are taken, the data shows.

Only a handful of states - including Arizona, Louisiana, Alabama, Florida and South Carolina - are experiencing epidemic or spreading trends.

Mississippi, Arkansas, Georgie, North Carolina and Tennessee are the states where only one or two counties are not currently seeing an uncontrollable spread.

Texas and California - two hot spot states - have a handful of counties that have controlled the spread, according to the data map.

Forty five percent of counties across the United States are currently battling uncontrollable, or 'epidemic' COVID-19 outbreaks, a data map compiled by spatial analytics company Esri shows

Currently, the number of infections across the US has surpassed 3.4 million and more than 137,000 Americans have died from the virus.

The latest modeling projects the number of COVID-19 deaths in the US to increase further - even as one research team suggests the near-universal use of masks could save 40,000 lives between now and November.

The country should hit 151,000 by August 1 and 157,000 by August 8, according to an average of models of 23 US and international research groups.

The figures, which were published by the University of Massachusetts Amherst's Reich lab, are among the forecasts relied on by the Centers for Disease Control and Prevention.

A week ago, this average predicted 147,000 deaths on August 1.

California, Florida and Texas, which are the three most populous states in the country, will see 1,000 more deaths over the next four weeks compared to the previous four, according to the model.

Meanwhile, a newly revised model from the University of Washington's Institute for Health Metrics and Evaluation projects the death toll will climb to just above 224,000 by November 1 - up 16,000 from a prior forecast - due to rising infections and hospitalizations in many states.

The latest forecast predicts the death toll could be reduced by 40,000 if nearly all Americans wore masks in public.

The latest modeling projects the number of COVID-19 deaths should hit 151,000 by August 1 and 157,000 by August 8, according to an average of models of 23 US and international research groups

A newly revised model from the University of Washington's Institute for Health Metrics and Evaluation projects the death toll will climb to just above 224,000 by November 1 - up 16,000 from a prior forecast. The model predicts the death toll could be reduced by 40,000 if nearly all Americans wore masks in public

'Use of masks is up, but not as high as it should be. If 95 percent of Americans wore masks each time they left their homes, infection rates would drop, hospitalizations would drop, and forecast deaths would drop,' IHME researchers said.

The IHME's new forecast came after Alabama, Florida and North Carolina on Tuesday reported record daily increases in deaths from COVID-19 - marking grim new milestones of a second wave of infections surging across much of the country.

The new IHME forecast - 224,089 American lives lost by November 1 - was revised upward from the 208,254 deaths projected on July 7.

The IHME's projections have been cited in the past by the White House and are watched closely by public health officials.

It comes as the United States set yet another record for new coronavirus cases after hitting a single-day spike of 67,400 with almost half of those infections coming from Texas, Florida and California.

Daily cases have been spiking in hot spot states in recent weeks and the US is now averaging about 60,000 infections per day.

Forty six states reported more new cases of COVID-19 last week compared to the previous week, according to a Reuters analysis of data from The COVID Tracking Project.

Nationally, new COVID-19 cases have risen every week for six straight weeks. Cases are only falling on a weekly basis in New York, Tennessee, New Jersey and Delaware.

With the virus is spreading quickly in the southern and western states, one of the country’s top public health officials offered conflicting theories about what is driving the outbreak.

Trump says he and Dr Fauci are 'on the same team' with COVID

https://www.dailymail.co.uk/news/articl ... ID-19.html

[Anthea]

Record single-day rise in
global coronavirus cases

The number of new cases of coronavirus rose by almost 260,000 in 24 hours - the largest single-day increase since the pandemic began, the World Health Organization (WHO) said on Saturday

According to WHO, this is the first time the number of new daily infections has surpassed a quarter of a million.

The biggest increases were in:

US
Brazil
India
South Africa

The global death toll from coronavirus also rose by 7,360 - the largest daily increase since 10 May.

The previous record rise in new confirmed cases was recorded by WHO just one day earlier.

The total number of confirmed cases of coronavirus passed 14 million on Saturday, according to the tally kept by US-based Johns Hopkins University.

What is happening in the US?

Cases are surging in several US states, particularly in southern states that were initially reluctant to enforce lockdowns or mandate the wearing of masks. Florida, Texas and Arizona have seen particularly high surges.

Florida is currently the epicentre of the US epidemic. The state recorded more than 10,000 new infections and 90 more deaths on Saturday, bringing its total number of cases to more than 337,000 and its death toll to more than 5,000.

In recent weeks, hospitals across the state had also warned that their ICUs were at capacity and that they were unable to accept any new patients.

Measures to stem the spread of the virus, including wearing masks, have become highly politicised in the US.

Click to enlarge:

Map of rising cases in the US

Click to enlarge:

Chart showing rise in cases by continent

The US's top infectious disease expert Dr Anthony Fauci urged state and local leaders on Friday to be "forceful" in making sure people wore masks, although President Donald Trump later said he would not mandate mask-wearing on a national level.

Which other countries are seeing surges?

In Brazil, where the coronavirus and measures to contain it have been highly politicised, cases continue to surge - although WHO announced earlier this week that cases were no longer increasing exponentially.

Scientists have also warned that India could still be months away from the peak of its outbreak - despite the country already having the third-highest number of confirmed cases. Hospitals in the worst-hit cities, including Mumbai and Bangalore, have been overwhelmed with patients.

India recorded another 34,884 infections in a 24-hour period on Saturday, and another 671 deaths linked to coronavirus.

And South Africa, which saw one of the largest single-day rises in cases, has the highest number of confirmed infections on the African continent.

What's happening in Europe?

Western European countries, which have managed to largely contain the spread of the virus, are now beginning to reopen their borders and businesses.

However, there are localised surges across Spain - the worst being in the country's north-eastern Catalonia region.

The region has again recorded a daily increase in confirmed cases of more than 1,000, and about four million people in ​​Barcelona, ​​La Noguera and El Segrià have been ordered to stay at home for 15 days.

Among the measures imposed are a ban on public or private meetings of more than 10 people, a ban on visits to nursing homes, and the closure of gyms and nightclubs.

Spain only ended its tough national lockdown about four weeks ago and was hoping to kick-start the economy, particularly with tourism numbers.

Neighbouring France is now considering closing borders with Spain in response to the surge.

When asked whether a closure of borders could be possible, new Prime Minister Jean Castex said: "We are monitoring this very closely, here in particular, because it is a real issue that we also need to discuss with the Spanish authorities."

The French border was only reopened to general citizens on 21 June.

How are the EU's plans for coronavirus relief going?

On Saturday, discussions in Brussels over a huge post-coronavirus economic recovery plan ground on.

The second day of talks received mixed reviews. Italian Prime Minister Giuseppe Conte said talks were deadlocked but Austrian Chancellor Sebastian Kurz said he thought they were going in the right direction.

Some "frugal" northern nations like the Netherlands and Sweden have balked at the €750bn ($857bn; £680bn) package, arguing it should be loans not grants.

A revised plan would tone down the level of grants but there appears to be a long way to go.

The talks are now going into a third day on Sunday.

https://www.bbc.co.uk/news/world-53454558

[Anthea]

Why eased lockdown not caused second wave

We’ve witnessed street protests, packed beaches and Soho streets awash with drunken revellers but still the virus has been kept at bay. Surely then, it is the scientists who have got things wrong?



But the fault may sit with our ability to judge probabilities. In a room of just 23 people there’s a 50-50 chance of at least two having the same birthday. In a room of 75 the probability jumps to 99.9 per cent. Occasionally meeting someone who shares the same birthday should therefore be no surprise at all.

The pandemic has turned us all into armchair epidemiologists who think we know how the virus spreads, but experts warn against complacency and easy answers.

Adam Kucharski, a mathematical epidemiologist at the London School of Hygiene and Tropical Medicine, suggests three concepts that may help: superspreading events (80 per cent of cases are driven by 10 per cent of infections); Japan's 'Three Cs'; and what he has dubbed on Twitter as "transmission budgets".

"When we’re looking at things like superspreading events, typically they occur in quite close-knit settings – offices, restaurants, parties, gatherings. Casual interactions outside don’t seem to be driving transmission," he told the Daily Telegraph in May.

In Britain, and much of the rest of the west, keeping a safe distance from others is the principle which guides infection control. But in Japan and other parts of Asia the messaging is more sophisticated.

Japan’s “Three Cs’ warn people to avoid Closed spaces (with poor ventilation); Crowded places (with many people nearby); and Close-contact settings (such as close conversations). Then, crucially, it adds: "The risk of clusters is particularly high when the 'Three Cs' overlap."

In the UK, the eye-catching crowds made so much of in the media have really only fallen into one of these categories – crowded outdoor places.

"[These events] weren’t enough to push the R value above one," says Paul Hunter, professor in medicine at the University of East Anglia.

"But if you look at the UK transmission data in terms of the trend it's quite noticeable that there was a decrease in the rate of decline towards the end of June."

Throughout May, when the lockdown was solid, the rate of new infections was dropping by 20 to 25 per cent each week. But by July, as a series of crowds gathered, this rate of decline slowed to roughly 10 per cent week on week.

Now the trend is flat and may even have reversed. In the seven days to Friday July 17, there were a total of 4,264 new cases reported, compared to 3,857 the previous week – an increase of almost 11 per cent, says Prof Hunter.

"It's 'sensor lag'," adds one commentator. "We don't see the effects until the situation slips too far back into the danger zone."

Certainly that has been the case for several countries which initially did well in suppressing the virus but are now witnessing a resurgence.

Israel, Australia and Spain are prime examples. And the US is perhaps the clearest instance where policymakers, despite the disaster of New York, failed to judge the probability of the virus surging elsewhere. Even in Japan – equipped with the Three Cs – cases are now rising again.

For the moment, the reproductive rate in the UK as a whole remains below one, the point at which cases will start to grow exponentially.

But the national estimate for R, which now sits between 0.7 and 0.9, is an average. The figure hides hotspots – including Leicester, Bradford, Blackburn and Herefordshire – where case numbers have jumped again.

Dr Kucharski suggests the concept of "transmission budgets", where the value of R is broken down into its constituent parts, is a useful one for policymakers looking forward.

"Countries essentially have a 'transmission budget' when it comes to Covid-19," he Tweeted as the Prime Minister pondered a further relaxation of lockdown this week.

"Global patterns suggest there are only so many things that can go back to normal before flare-ups start happening".

One problem in the UK is that we don't know with any precision how different measures, such as school or office reopenings, contribute to the overall budget.

However, there is some evidence from overseas. A study conducted in Hong Kong when schools were closed and track and trace was operating was able to isolate and measure the effect of other interventions as they were introduced and then relaxed.

"One of the most consequential physical distancing measures appears to be the work at home policy for civil servants, which was mirrored by many other institutions and private employers", say the authors.

"We estimated that the effectiveness of implementation of civil servants working from home was 67 per cent and the effectiveness of implementation of additional physical distancing measures including closure of high-risk places/facilities [such as bars and restaurants] was 58 per cent."

A separate study looked at nine interventions in 41 countries between January and April 2020 and found eight of them to be effective.

Closing schools reduced R by an average of 50 per cent. Other things that worked included: closing non-essential businesses (34 per cent); closing high-risk businesses (26 per cent); limiting gatherings to 10 people or less (28 per cent); and issuing stay-at-home orders (14 per cent).

The "surprisingly large role for schools" the study found will worry policymakers and underlines how tight the UK's transmission budget is. It may partly explain why the Prime Minister did not order a full return to office work this week.

"Working out these budgets is incredibly difficult," says Prof Hunter, who like many other experts urges caution in the absence of firm evidence. "We don't know with certainty what the real numbers are for each activity in the UK."

Preventing a resurgence in Covid cases is one thing, stopping a separate winter wave another perhaps. Five out of 10 of the last big respiratory outbreaks have featured significant subsequent waves, four of them after a summer trough.

Already there is evidence that winter in the southern hemisphere is having an effect, the cold weather forcing people inside and the Three Cs starting to overlap. The strong second peak of cases in Victoria, Australia provides the strongest hint of possible trouble to come in the UK once winter sets in.

"As soon as the bad weather comes and we start living indoors again, that’s likely to be a big boost to the R value," says Prof Hunter.

"I suspect that unless by then we have an effective test, track and trace system in place – which to be honest isn't looking promising at the moment – then we, almost certainly, will go into a second wave."

The "reasonable worst case scenario" for the UK winter was laid out in a Government commissioned report by the Academy of Medical Sciences last week.

The modelling suggested a further 120,000 hospital patients would die in a peak occurring early in the new year if R rose to 1.7 in the UK over winter.

A less severe second wave might lead to 1,300 or 75,000 deaths between September 2020 and June 2021 if the R value rises to 1.1 or 1.5 respectively, it said.

https://www.telegraph.co.uk/global-heal ... obal-en-GB