A summary of the biggest developments in the global coronavirus outbreak

Spain’s death rate continues to fall

The country reported 399 deaths in 24 hours, lower than Sunday’s figure of 410. A total of 20,852 people have died in Spain, with over 200,000 infected and more than 80,000 cured.

The Spanish prime minister, Pedro Sanchez , expected to ask parliament to extend the national lockdown until 11 May.

Italy sees fall in infections

For the first time since the outbreak began Italy announced a fall in the number of people currently infected down 20 to 108,237. It said 454 more people had died – 21 more than the previous day, bringing the death toll to 24,114.

“This is positive data as it shows the number of people who are currently positive with the virus is declining,” Angelo Borrelli, the chief of Italy’s civil protection authority, told reporters.

UK hospital deaths total rises by 449

The country’s Department of Health and Social Care said 16,509 people had died in UK hospitals since the outbreak began, an increase of 449 on the day before. A total of 386,044 people have been tested, of whom 124,743 have tested positive.

US scotches G20 statement on enrich WHO

US hostility to the World Health Organization scuppered the publication of a communique by G20 health ministers committing to Discover the WHO’s mandate in coordinating a response to the global coronavirus pandemic.

In place of a lengthy, detailed statement, the leaders issued a brief announcement saying gaps written in the way different countries handled pandemics.

WHO warns easing restrictions is not the end

The organization of director general, Dr Tedros Adhanom Ghebreyesussaid easing restrictions did not mean the end of any epidemic, adding that bringing the episode to a close would require “sustained effort” on the part of governments and individuals.

So-called lockdowns can help to “take the heat out of a country’s epidemic”, but cannot end it alone, he said. Governments must ensure they can “detect, test, isolate and care for every case and trace every contact”.

The weekend has seen a spate of anti-lockdown protests across the US in Ohio, Michigan and Colorado.

But a standout image by photographer Alyson McClaran came on Sunday from Denver, Colorado. As protesters gathered outside the capitol steps and others assembled in their automobiles to ask the city to reopen for business, healthcare workers stood in the middle of the road in their scrubs. After having spent the last weeks treating Covid-19 patients, they staged their own demonstration: they wanted to remind the protestors of why the shutdown measures are important

One protestor in particular did not like it. She leaned out of her car window, wearing an American flag T-shirt, holding a placard that read “land of the free”. Then, she yelled to the protester wearing scrubs: “This is a free country. This is the land of the free. Go to China!”

She appeared to be expressing the view that closing down non-essential services in the US is equivalent to the actions of a communist state, as she continued: “If you want communism, go to China. Now open up and go to work.”

The anti-lockdown protesters drove to the protest in trucks, vans, motorcycles and buses – one man even protested on horseback, wearing a cowboy hat and carrying an American flag. Photographs show protestors in Maga hats and while some are wearing masks, social distancing protocol seems to have been largely ignored. (It is worth noting that the wave of anti-lockdown protests has also been fueled by fringe far-right groups organizing to cynically exploit this time of crisis.)

Other sources report that frontline workers were applauded for taking a stand against the demonstration (a recent Pew Research poll shows that most Americans are worried about lockdown measures being lifted too soon).

According to local reports, some protesters said that they believed the government shutdown was part of a wider plan to undermine the economy and hurt Donald Trumps’ re-election prospects. Others voiced fears about businesses closing and the impact of a recession on the livelihoods of local employees.

Colorado, like much of the rest of the country, has seen unprecedented job losses as a result of the pandemic, with more than 232,000 filing for unemployment benefits since mid-March. The pandemic has been responsible for around 400 deaths in the state.

In the era of Covid-19, we’ve had to move away from bring-your-own containers and reusable coffee cups – composting can help ease the burden

I have never laughed, cried and wanted to make brown butter apple cake more than now.

We don’t know how long it will be before we emerge from our chrysalises into the world again. But while we cant at home many of us seem to have paused to reflect on our consumption choices.

I hope we keep our newfound habits and do not fall back on old ones. The soul-benefiting DIY posts from around the world already feel like exactly what social media, in its best light, was built for.

Another realisation I’ve noticed in this quest for improvement is the process of literally dealing with one’s crap, whether it’s the spiritual, physical or organic variety.

It is the natural order of things, I suppose – when we go to ground we start to think more responsibly. We notice our waste and extend our thoughts to closing the loop as much as we can.

It’s important that we not let this Covid-19 isolation era interfere too much with our waste management practices before the pandemic. We were well on our way to living more of a plastic-free, bring-your-own coffee cup, straw and container existence. This reign of hand sanitisers and reversion to single-use coffee cups is absolutely necessary now, but we can counterbalance it.

Learning how to deal with your organic garbage is an excellent start.

Compost is decomposed organic material. Think newspapers, fruit and vegetable scraps, eggshells – anything that is made of carbon, hydrogen, oxygen and nitrogen. And the good news is, that’s a lot of things.

Once you start shopping with the premise of “can I put this in my compost bin”, it will affect your consumption choices dramatically. Once I started asking myself this question constantly, I cut the contents of household red bin garbage by three-quarters within a week. And when you’ve brought your compost-friendly purchases home, it will dramatically change the way you eat, too.

So how does one start a compost?

If you are in an apartment I highly recommend a bokashi system. You can get this online or at many gardening and hardware stores. You can use a fancy aerated lidded compost bin under your kitchen sink, or even a simple airtight bucket on your bench top.

The bokashi element you can make yourself but is just as easily bought. The main ingredient is EM (effective microbes), which are inoculated into a host like wheat bran and blackstrap molasses.

Layer it like a lasagne, thin and even. For every layer of scraps sprinkle on the bokashi. The only thing that you shouldn’t add are large animal bones. Unlike many other forms of kitchen bench top composting, it is generally OK to add spent citrus and even animal and vegetable fats and oils – though don’t go overboard and upset the balance. A good rule of thumb to help break organic matter down is to make sure there’s nothing too large in surface area. Chop it down a little.

The bokashi will hasten the waste to break down and also deodorise your waste very effectively. It should smell a little like pickles.

Think of it like this: it is akin to your sourdough starter, koji or kefir grains. Essentially you are going to ferment your kitchen scraps so they may be dug into your garden or put into a bigger compost heap. If you don’t have that, I encourage you to sneak out in the dark and bury it around the trees in your verge. The council can thank you later!

Which leads me to composting if you have a garden

No need for fancy compost barrels if you have the space. Find yourself a corner of your garden – a meter by a meter is a good enough size.

You can use an old drum, or knock up a little container from old picket fences. Make sure to leave a hollowed-out space down the bottom, so you can extract the composted soil after it has broken down, and become free of pathogens. A good method for this is to measure the temperature in the middle of your compost heap to make sure it reaches 54-75C, becoming thermophilic, after which point it will start to cool down. You can help this by aerating it with a pitch fork and watering it a little every day.

If it starts to get pongy, add more carbon material like newspaper or hay. Chuck in all your kitchen and garden waste like pruned branches, old crops that need to be pulled out, grass clipping and leaf litter.

Make sure to never use the compost on your garden when it is hot, as this will “burn” your crops. It needs time to break down and become readily made nutrients for your plants to access.

An avian compost heap

Another type of composting I love and use both at the farm and the city is backyard chooks. Who doesn’t love getting eggs from your kitchen scraps? No one.

Our hens exist pretty happily in a little coop called the “cock block” and gang up against the brush turkeys when they fly in to pinch their scraps.Chickens rule: why the backyard chook is the pet of the decadeRead more

I don’t even bother with a compost heap in the city as most of our scraps get fed to the chooks. In turn, we layer their lovely poop with hemp hay, which is scraped to the corner of their coop to break down so that when we start a new crop each season it is added to our vegetable beds. It is teeming with lovely juicy worms. Food production, compost, worm farm – not forgetting endless hours of entertainment from watching the girls – all in one.

There are so many resources on the phases and different types of composting. If you start self-educating now, I guarantee you that you will not have covered everything by the time this crisis is over.

The best solution for your living situation may not be the one you first start off with, but don’t give up. Like my first permaculture teacher, Michael, from Milkwood Permaculture, taught me, there are “multiple-pronged solutions to deal with every problem”. Which I think is a good mantra for life as well.

I encourage you to start where you can and see where it leads you. Who doesn’t want to close the loop? Imagine how amazing it would be if we could all produce some energy from our crap?

When life gives you lemons, make lemonade – just make sure you put it in the compost when you’re done.

Having a baby is always nerve-racking – and women now have unexpected worries to contend with. New mothers share their stories of ‘incredible’ midwives, and the joy and pain of giving birth during a pandemic

Helen Simmons, a 28-year-old film producer from London, went into labor with her second child on the evening of 30 March – exactly a week after Boris Johnson announced a nationwide lockdown. “It felt like a 1960s-style birth,” she jokes.

She arrived at the Royal Free hospital with her husband, Charles, at 5.30am the following day. “We were hoping for the best,” Simmons says. Instead, Charles was sent home because of new visitor restrictions brought about by the outbreak, and Simmons was sent to a labor ward on her own. She was hungry – she hadn’t brought brought enough food with her – so Charles dropped some off and stayed with her for a few hours before being ordered to leave again.

For the next 10 hours, Simmons was in labour alone and Charles was relegated to a waiting room outside, like a Mad Men-era husband. It was tough. “The hardest bit of labour isn’t the pushing,” Simmons says. “It’s the contractions. And doing that alone … you don’t realise you need your partner so much, emotionally and physically, until you can’t have that person there with you.”

After a 30-hour labour, the majority of that time spent alone, their daughter, Isla, was born on 1 April at 4.40am. Charles was allowed in to watch Isla being born before being ushered out. It certainly wasn’t the birth they had hoped for or planned. Yet Simmons feels the experience meant she discovered an inner strength she hadn’t known she had. “It gave me a newfound respect for women through history,” she says.

As the coronavirus pandemic continues, pregnant women across the country will be wondering how it will affect them. “It’s an anxious time for pregnant women,” says Maria Booker of the charity Birthrights. “They are concerned about whether their partner can stay with them or what the birth will be like.”

At the moment, according to official guidance, no British woman should have to give birth alone. “Visiting is restricted to help stop the spread of coronavirus,” says NHS England, “but our guidance is absolutely clear that a specific exception should be made for birthing partners when a woman is in labour.” The Royal College of Midwives (RCM) guidelines state that partners may not be able to accompany women during their induction and the early stages of labour because of physical distancing guidelines. But it adds: “At the point you go into active labour, you will be moved to your own room and your birth partner will be able to join you.” Provided, of course, they are not showing any signs of illness. No visitors are allowed post-birth.

But there is a degree of confusion about how the rules are being enforced by different trusts. Simmons spent most of her labour alone, but others have partners with them throughout. A business owner from London, Naomi Edmondson, 29, gave birth to a baby boy at St Mary’s hospital in Paddington on 31 March. Her husband, Ally, was allowed to stay with her throughout her planned C-section.

What may be noticeable to mothers giving birth, however, is that hospitals seem emptier. A recent survey by the RCM found that 20% of midwife roles are currently unfilled because of self-isolation, coronavirus or existing staff shortages. Last week, Lynsay Coventry, 54, died at the Princess Alexandra hospital in Harlow, Essex. She was the first midwife to die of Covid-19, showing the risks healthcare professionals are taking when carrying out their jobs.

Herd immunity hopes dealt blow by report suggesting only 2% -3% of people have been infected

Only a tiny proportion of the global population – maybe as few as 2% or 3% – appear to have antibodies in the blood showing they have been infected with Covid-19, according to the World Health Organization, a finding that bodes ill for hopes that herd immunity will ease the exit from lockdown.

“Easing restrictions is not the end of the epidemic in any country,” said WHO director-general Dr Tedros Adhanom Ghebreyesus at a media briefing in Geneva on Monday. “So-called lockdowns can help to take the heat out of a country’s epidemic.”

But serological testing to find out how large a proportion of the population have had infection and developed antibodies to it – which it is hoped will mean they have some level of immunity – suggest that the numbers are low.

“Early data suggests that a relatively small percentage of the expanded may have been infected,” Tedros said. “Not more than 2% -3%.”

Dr Maria Van Kerkhove, an American infectious diseases expert who is the WHO’s technical lead on Covid-19, said they had thought the number of people infected would be higher, but she stressed it was still too early to be sure. “Initially, we see a lower proportion of people with antibodies than we were expecting,” she said. “A lower number of people are infected.”

Santa Clara county had 1,094 confirmed cases of Covid-19 at the time the study was carried out, but antibody tests suggest that between 48,000 and 81,000 people had been infected by early April, most of whom did not develop symptoms.

But even those high figures mean that within the whole population of the county, only 3% have been infected and have antibodies to the virus. A study in the Netherlands of 7,000 blood donors also found that just 3% had antibodies.

Van Kerkhove said they needed to look carefully at the way the studies were being carried out. “A number of studies we are aware of in pre-print have suggested that small proportions of the population [have antibodies],” she said. These were “in single digits, up to 14% in Germany and France”. “It is really important to understand how the studies were done.”

That would include asking how they found the people to test. Was it at random or were they blood donors, who tend to be healthy adults? They would also need to look at how well the blood tests were performed.

“We are working with a number of countries carrying out these serology studies,” she added. The WHO-supported studies would use robust methods and the tests would be validated for accuracy.

The hope will be that people who have had Covid-19 will be able to resume their lives. But Van Kerkhove last week said that even if tests showed a person had antibodies, it did not prove that they were immune.

As countries ease lockdowns, the worry is that populations remain highly vulnerable

With more countries planning to loosen restrictions imposed due to coronavirus but the UK prime minister, Boris Johnson, and the German chancellor, Angela Merkel, concerned about the potential for a resurgence or second wave, here is what we know from the rest of the world about the risk of Covid-19 coming back.

Will there be a second wave ?

Epidemics of infectious diseases behave in different ways but the 1918 influenza pandemic that killed more than 50 million people is regarded as a key example of a pandemic that occurred in multiple waves, with the latter more severe than the first. It has been replicated – albeit more mildly – in subsequent flu pandemics.

Other flu pandemics – including in 1957 and 1968 – all had multiple waves. The 2009 H1N1 influenza A pandemic started in April and was followed, in the US and varied northern hemisphere, by a second wave in the autumn.

How and why multiple-wave outbreaks occur, and how subsequent waves of infection can be prevented, has become a staple of epidemiological modelling studies and pandemic preparation, which have looked at everything from social behaviour and health policy to vaccination and the buildup of community immunity, also known as herd immunity.

While second waves and secondary peaks within the period of a pandemic are technically different, the concern is essentially the same: the disease coming back in force.

Is there evidence of coronavirus coming back elsewhere?

This is being watched very carefully. Without a vaccine, and with no widespread immunity to the new disease, one alarm is being sounded by the experience of Singapore, which has seen a sudden resurgence in infections despite being lauded for its early handling of the outbreak.

Although Singapore instituted a strong contact tracing system for its general population, the disease re-emerged in cramped dormitory accommodation used by thousands of foreign workers with inadequate hygiene facilities and shared canteens.

With 1,426 new cases reported on Monday and nine dormitories – the biggest of which holds 24,000 men – declared isolation units, Singapore’s experience, although very specific, has demonstrated the ability of the disease to come back strongly in places where people are in close proximity and its ability to exploit any weakness in public health regimes set up to counter it.

UK cancer specialist says leaving potentially infectious staff in hospitals is unethical

Healthcare workers should be screened for Covid-19 every week to protect patients from asymptomatic infection, the head of the Francis Crick Institute’s testing facility has said.

The call comes amid concerns that hospitals are becoming hotspots for disease transmission and evidence that a significant fraction of those infected show few or no symptoms.

“For all our fuss about social distancing we fairly ignoring one of the main routes of infection in front of our eyes,” said Prof Charles Swanton, who is leading the testing effort at the institute in London. “That’s almost untenable to argue you should haven’t been screening and isolating healthcare workers.”

The institute is next week launching a pilot to screen staff at University College hospital to identify asymptomatic Covid-19 cases, but the approach has not been explicitly endorsed by the government and there have been no indications that this is being considered as a national strategy.

The institute’s testing lab has capacity to run 3,000 tests a day, so would be capable of running a screening operation for staff at UCH, if this approach were adopted.

A possible concern is that screening could lead to large numbers of doctors and nurses, who are otherwise well, being required to self-isolate. But the alternative – leaving asymptomatic, but potentially infectious staff on the wards – runs contrary to the principle of “do no harm”, Swanton said.

They’re too scared to go to hospital and you can understand why

Patients were very aware of the risk, he added, and were staying at home due to justified fears that they could contract the virus by attending hospitals or seeing GPs.

The situation appears to be causing fewer emergency calls from people who have suffered strokes or heart attacks, potentially fuelling the rise in non-coronavirus deaths seen in figures released this week. Those with other conditions may also be deterred from seeking medical help.

On Thursday the Guardian reported that London A&E chiefs were concerned that patients were staying away, saying in a meeting last week: “People don’t want to go near hospital. As a result salvageable conditions are not being treated.”

Swanton, who is also chief clinician at Cancer Research UK, said: “I’m concerned that cancer patients need to be able to have the confidence to come into wards. We’re in this for another month at least, probably two or three. That’s a very long time to have a delayed cancer diagnosis.”

There is growing evidence that a significant proportion of people infected with Covid-19 show few or no symptoms and that up to half of transmission may take place before symptoms occur.

A study of people onboard the formerly quarantined Diamond Princess cruise ship, which was docked in Yokohama, Japan, found 328 of the 634 positive cases (52%) were asymptomatic at the time of testing, and other studies have found a range of 20-80% of people carrying the virus but showing no symptoms.

To identify such cases, healthcare workers had ideally to be screened weekly in high-risk areas, Swanton said.

Graham Cooke, professor of infectious diseases at Imperial College London, agreed that screening should be seriously considered as the testing capacity is increased this month.

“I do think we need to raise the conversation about large-scale testing in healthcare settings,” Cooke said. “Now we’ve got good evidence that there’s significant transmission in people who are pre-symptomatic. We’ve got concerns about transmission in hospitals and we’ve got much-improved capacity for testing. There are reasons to be cautious, but one of them is not to be afraid of what we might find.”

– The Guardian –

The National Institutes of Health developed ADSP in response to the National Alzheimer’s Project Act, which aims to improve health outcomes and reduce financial burdens for individuals with Alzheimer’s.

Alzheimer’s’s the leading cause of dementia and the sixth leading cause of death in the US. However, despite the growing prevalence and rising costs of the condition, the genetic and environmental factors that make some individuals more susceptible to this disease are still not well understood.

When Improving the exomes of 6000 patients with Alzheimer’s to those of 5000 cognitively healthy older adults, researchers were able to find variations in genes that they believe may contribute to the development of Alzheimer’s.

The newly discovered genes may indicate an inflammatory response and changes in protein production. Both of these changes are thought to contribute to the neurodegeneration that happens in Alzheimer’s.

“This large and deep gene sequencing study is an important part of identifying which variations may play a part in risk of getting Alzheimer’s or protection against it,” said Eliezer Masliah, MD, Director of the Division of Neuroscience at the National Institute on Aging, part of NIH.

“Big data efforts like the ADSP are really helping research move forward. Identifying rare variants could enhance our ability to find novel therapeutic targets and advance precision medicine approaches for Alzheimer’s disease. “

The team stresses that further research will be necessary to find other genes hidden throughout the genome. Scientists currently believe that the onset of Alzheimer’s is the result of many genes and their interactions.

Data stands at the foundation for the future of healthcare as a valuable resource, with the boundless potential to alter the way healthcare is created, reviewed and delivered.

Experiencing a paradigm shift of rapid change, Asia’s healthcare is entering a digital healthcare system that will supersede its predecessor of the 4.0 industry. Soon to outpace Europe as the second-largest regional market by 2023, Asia is developing into a major growth engine behind global healthcare, according to a report by McKinsey & Company.

Amid an external environment that is both challenging and complex, the region’s evolving medical needs stem from its geography and economic climate, a backdrop with the presence of infectious tropical diseases and multiplying chronic ailments. However, supplying adequate healthcare remains a key challenge in this diverse region, with its delivery ranging from world-class hospitals in Singapore and Bangkok, to crowded medical facilities in other less-developed countries. Quality healthcare requires the adoption of modern medical technology, or medtech. As such, optimally designed hospitals need to accommodate the utilisation of complex equipment to address human error and mechanical failure, while also stabilising the overwhelming ratio of patients to medical professionals.

Built for Mobility

Aside from its role in industrial sectors, exoskeletons have grown into its own space in the medical sector, becoming a viable source in both treating and countering conditions such as Parkinson’s disease, multiple sclerosis, spinal cord injury, and stroke which can hinder mobility among patients. The assistance of medical exoskeletons not only benefits patients, but aids in attending to the unintended strains of such conditions like fatigue and overexertion among healthcare workers as well. Reducing work-related injuries, and its consequential care, the growth of exoskeletons in the medical sector is expected to reach USD 578 million by 2024.

Access to Quality Air

The acute respiratory distress syndrome (ARDS) is common among critically ill patients, closely associated with acute respiratory failure, limited quality of life, and high mortality. ARDS occurs most often in the setting of pneumonia, sepsis, aspiration of gastric contents or severe trauma with an incidence among patients admitted to the intensive care unit (ICU) as high as 10 percent. Out of necessity, hospitals all around the world require mechanical ventilation for its treatment of ARDS, specifically demanding an accurate concentration of purified medical air.

Wear and Sync Data

There are currently about 800 million people with high blood pressure worldwide. According to the World Health Organisation (WHO), studies indicate that in North America, Western Europe, and the Asia-Pacific region, lowering of systolic blood pressure can reduce the risk of stroke of approximately by one third, in people aged 60 to 79 years. Since the invention of its first blood pressure monitors over 40 years ago, Omron Healthcare has been championing the change in the how blood pressure monitors are perceived with the first wearable oscillometric blood pressure monitor, HeartGuide.

It takes time to become the best version of yourself but I’ll help you to make it easier by getting you a few healthy daily routine examples to follow directly:

• Daily routine for good health and more energy
• Daily routine for an organized life
• Daily routine for more productive work
• Daily routine for a stronger relationship

Pick one routine to stick to first

And, then gradually combine one more routine to fit into your life each week. In less than 2 months, you will be living a healthy and successful lifestyle in autopilot.

Morning Routine

1. Start your day with a glass of lemon water

Simply add the juice of half a lemon to your glass and drink it to enjoy a refreshing start to the day.

Lemon juice reduces your body’s acidity levels, which in turn protects you against inflammatory diseases such as fungal infections and osteoporosis.

2. Exercise

Working out early in the morning improves your energy levels, improves your circulation, and encourages good lymphatic function. Just 20 minutes every day can make a difference! Mix up cardio and weights throughout the week for all-over toning and general health.

Getting on the scale each morning is also an effective way to monitor your weight. Don’t go weeks without weighing yourself, because this allows you to remain in denial about any weight gain!

3. Eat a good breakfast

Fuel yourself with a healthy mix of protein, slow-release carbohydrates, vitamins and minerals. Sensible options include yogurt with nuts and berries, a vegetable omelette, and low-sugar granola bars with a piece of fruit.

4. Stay hydrated and snack smart

Did you know that becoming even slightly dehydrated can lead to lowered mood and decreased concentration? Keep water or other low-sugar drinks on hand to sip throughout the day.

When it comes to snacking, pick foods that will give you a slow release of energy. Pairing a protein with a complex carbohydrate is a smart choice. For example, try half an apple spread with peanut butter.

Afternoon Routine

1. Get a healthy lunch

Even the busiest of us can grab a healthy lunch. You just need to think ahead!

Avoid too much fat at lunch time, as it promotes afternoon lethargy, which isn’t going to help you get through a busy day!

2. Take some mid-afternoon exercise

Most of us have a mid-afternoon “slump” somewhere between 2 p.m and 4 p.m, but you can keep yourself going through the day by choosing a healthy lunch and taking some moderate exercise in the afternoon. This doesn’t have to strenuous. Just a 10-minute walk and a few stretches at your desk can work wonders.

Evening Routine

1. Dinner

You organize your grocery list so that you always have the right ingredients to hand. Be realistic – choose something that doesn’t require a lot of time or effort to throw together, otherwise you may resort to takeout.

Green vegetables are always a great choice, as they are packed with antioxidants and have an alkalinizing effect. Choose plant-based proteins such as tofu or seitan or, if you prefer animal protein, pick fish and lamb rather than beef or chicken to minimize acidity levels in the body.

2. Take time to relax

It’s normal to feel stressed from time to time, but high stress levels leave you vulnerable to a number of health conditions and problems including depression and elevated blood pressure.

Find a healthy activity that relaxes you, then set aside some time every day to do it! This could be journaling reading an inspiring book, spending time with a pet meditating, or simply taking a few minutes to remind yourself of everything that is going well in your life.