Rural Miscellan: 27th May 2020

“When I tell the truth, it is not for the sake of convincing those who do not know it, but for the sake of defending those that do.”

“To see a world in a grain of sand and heaven in a wild flower Hold infinity in the palm of your hand and eternity in an hour.”

“It is easier to forgive an enemy than to forgive a friend.”

William Blake

We return to one of my favourite poets, William Blake. He was a 18th Century English poet, writer, artist and mystic. He was largely unrecognised in his own lifetime but is now considered as a genius and champion of the Romantic Age. He and his works remain somewhat enigmatic even to this day. He was deeply religious with a strong social conscious. He was particularly moved by the French Revolution and yearned to see similar upheavals in England. This of course aroused considerable suspicion among a ruling class fearful of revolutionary contagion at home. His work was seen as subversive and he was lucky to escape arrest and imprisonment.

Blake stands out as a unique figure in British art and literature. He pioneered new and exciting printing techniques and has a huge and loyal following today

“The Tyger” is one of Blake’s most quoted and famous poems. Written in 1794 and published in his collection The Songs of Experience. The tiger is the epitome of fire and fear. It compliments an earlier poem “The Lamb” (included below) when he asks “Did he who made the Lamb make thee?”. Like so much of Blake’s works, he is guided by his strong religious faith

The Tyger

Tyger Tyger, burning bright,
In the forests of the night;
What immortal hand or eye,
Could frame thy fearful symmetry?

In what distant deeps or skies.
Burnt the fire of thine eyes?
On what wings dare he aspire?
What the hand, dare seize the fire?

And what shoulder, & what art,
Could twist the sinews of thy heart?
And when thy heart began to beat,
What dread hand? & what dread feet?

What the hammer? what the chain,
In what furnace was thy brain?
What the anvil? what dread grasp,
Dare its deadly terrors clasp!

When the stars threw down their spears
And water’d heaven with their tears:
Did he smile his work to see?
Did he who made the Lamb make thee?

Tyger Tyger burning bright,
In the forests of the night:
What immortal hand or eye,
Dare frame thy fearful symmetry?

The Tyger – William Blake (Powerful Life Poetry)

<a href=”https://www.youtube.com/watch?v=8tkPDCK5e4s”>https://www.youtube.com/watch?v=8tkPDCK5e4s</a>

The Lamb was published earlier in his collection “Songs of Innocence”. Again this strong religious theme but the lamb can also be interpreted as a child and the an innocent.

The Lamb

Little Lamb who made thee
Dost thou know who made thee
Gave thee life & bid thee feed.
By the stream & o’er the mead;
Gave thee clothing of delight,
Softest clothing wooly bright;
Gave thee such a tender voice,
Making all the vales rejoice!
Little Lamb who made thee?
Dost thou know who made thee?

Little Lamb I’ll tell thee!
He is called by thy name,
For he calls himself a Lamb:
He is meek & he is mild,
He became a little child:
I a child & thou a lamb,
We are called by his name.
Little Lamb God bless thee.
Little Lamb God bless thee.

<h1>The Lamb by William Blake – Read by Sir Ralph Richardson</h1>
<h1><a href=”https://www.youtube.com/watch?v=izZWdqvEoKA”>https://www.youtube.com/watch?v=izZWdqvEoKA</a></h1>

The hymn called ‘Jerusalem’ is surrounded by misconceptions and legend. Blake wrote the words which the composer Hubert Parry later set to music, but Blake didn’t call his poem ‘Jerusalem’, and instead the famous words that form the lyrics of the hymn are merely one part of a longer poem, a poem which Blake called Milton. The poem has been read as a satire of the rampant jingoism and Christian feeling running through England during the Napoleonic Wars, and has even been described as anti-patriotic, despite the patriotic nature of the hymn it inspired. It is a rousing hymn which has become England’s unofficial national anthem

Jerusalem

And did those feet in ancient time
Walk upon Englands mountains green:
And was the holy Lamb of God,
On Englands pleasant pastures seen!

And did the Countenance Divine,
Shine forth upon our clouded hills?
And was Jerusalem builded here,
Among these dark Satanic Mills?

Bring me my Bow of burning gold:
Bring me my arrows of desire:
Bring me my Spear: O clouds unfold!
Bring me my Chariot of fire!

I will not cease from Mental Fight,
Nor shall my sword sleep in my hand:
Till we have built Jerusalem,
In Englands green & pleasant Land.

<h1>Jerusalem by William Blake (read by Tom O’Bedlam)</h1>
<a href=”https://www.youtube.com/watch?v=qneUVc5LYDE”>https://www.youtube.com/watch?v=qneUVc5LYDE</a>

In the poem “London”, Blake describes what he sees as he walks the streets of London. He is shocked by the misery and poverty that he encounters. He describes the hopelessness and oppression that people experience. It is believed that he wrote this as a response to the French Revolution which he hoped could change lives of the common people

London

I wander thro’ each charter’d street,
Near where the charter’d Thames does flow.
And mark in every face I meet
Marks of weakness, marks of woe.

In every cry of every Man,
In every Infants cry of fear,
In every voice: in every ban,
The mind-forg’d manacles I hear

How the Chimney-sweepers cry
Every blackning Church appalls,
And the hapless Soldiers sigh
Runs in blood down Palace walls

But most thro’ midnight streets I hear
How the youthful Harlots curse
Blasts the new-born Infants tear
And blights with plagues the Marriage hearse

<h1>Idris Elba Reading ‘London’ By William Blake</h1>
<a href=”https://www.youtube.com/watch?v=AcmWSKqcJro”>https://www.youtube.com/watch?v=AcmWSKqcJro</a>

On the face of it, “The Sick Rose” appears quite straightforward but what is the invisible worm and does the “…bed of crimson joy” signify a more sensuous meaning?

The Sick Rose

O Rose thou art sick.
The invisible worm,
That flies in the night
In the howling storm:

Has found out thy bed
Of crimson joy:
And his dark secret love
Does thy life destroy.

<h1>”The Sick Rose”, William Blake</h1>
<a href=”https://www.youtube.com/watch?v=J3LKPF3gyC8″>https://www.youtube.com/watch?v=J3LKPF3gyC8</a>

In the “Poison Tree” describes how hatred grows and eats away at you with disastrous consequences

A Poison Tree

I was angry with my friend:
I told my wrath, my wrath did end.
I was angry with my foe:
I told it not, my wrath did grow.

And I watered it in fears.
Night and morning with my tears:
And I sunned it with smiles.
And with soft deceitful wiles.

And it grew both day and night.
Till it bore an apple bright.
And my foe beheld it shine.
And he knew that it was mine.

And into my garden stole.
When the night had veild the pole;
In the morning glad I see;
My foe outstretchd beneath the tree.

<h1>”A Poison Tree” William Blake</h1>
<a href=”https://www.youtube.com/watch?v=QqB43x6qP1c”>https://www.youtube.com/watch?v=QqB43x6qP1c</a>

Today’s Post

<ol>
<li> India: Scroll.in: Stronger health system could have averted 500,000 non-Covid deaths in India in early lockdown period</li>
</ol>
Managing the coronavirus pandemic should not result in restricted access to other services.

As India is focused largely on responding to the threat from Covid-19, it has been forced to turn a blind eye to deaths due to other causes as a result of highly restricted access to healthcare during the lockdown. These deaths have been caused often from causes that are preventable. They reflect the weakness of the Indian health care system. This is also a huge challenge when fighting the coronavirus itself.

A crisis is not created only by the incriminating agent or event. As novelist Michael Crichton wrote in <a href=”https://www.goodreads.com/work/quotes/997271″>The Andromeda Strain</a>, which inspired the film that has an uncanny resemblance to the events that are now unfolding, “A crisis is the sum of intuition and blind spots [of men], a blend of facts noted and facts ignored.”

The sad fact ignored in midst of the crisis is that lakhs of people are dying in India due to causes other than coronavirus, and many more will do so if we do not immediately take measures to redeem this.

Between January 30, when the first case of Covid-19 was reported in the country, and May 3, the last day of the second extension of the lockdown, we estimate that about 24 lakh people have died in India. We also review evidence that the prolonged nationwide lockdown and resultant huge decreases in healthcare utilisation across rural India will lead to lakhs of additional deaths due to causes such as tuberculosis, HIV and cancers.

<a href=”https://scroll.in/article/962147/stronger-health-system-could-have-averted-500000-non-covid-deaths-in-india-in-early-lockdown-period?fbclid=IwAR1Jti60G-e_YB9cmbD8nRmMugH26c5wCDiErS9fwKKoyqUbSE8PEHICi_4″>https://scroll.in/article/962147/stronger-health-system-could-have-averted-500000-non-covid-deaths-in-india-in-early-lockdown-period?fbclid=IwAR1Jti60G-e_YB9cmbD8nRmMugH26c5wCDiErS9fwKKoyqUbSE8PEHICi_4</a>

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<ol start=”2″>
<li> Indonesia: Indonesian Rural and Remote Doctors Association IRRDA: Coronavirus Resource Page</li>
</ol>
<a href=”http://www.irrda.org/”>http://www.irrda.org</a>

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<ol start=”3″>
<li> India: The Indian Feed: Video: Artist captured the dark and contrasting sides of Lockdown</li>
</ol>
In the video which has gone viral across platforms, Debjyoti Saha, the illustrator addresses our class privilege and shows how lockdown is not the same for some people.
“We sure have got used to this in the past four months. Being stuck at home, working without fixed hours, we are all getting used to this ‘new normal’. some even claim to have been losing their sanity with power cuts and terrible internet connections. On the flip side I’m sure many have found their inner calling of being a chef, an expert at yoga, catch up on their sleep and the importance of staying home with family. However, the concept of ‘home’ is different to different people. For some, it is a place, a thousand miles away where they desperately want to reach, at any cost, without a penny in the pocket, a vehicle to get on or even a pair of slippers for their bleeding soles, with the hope of being at peace. While we hoard more ‘essentials’ for our family and sip on our Dalgona, they share a roti among three. While we miss the social gatherings with friends a video call away, they cry on the streets unable to reach their loved ones. While we crib about running out of things to do in the comfort of our homes, they walk barefoot for miles and days to reach theirs. The list is never ending. History is witnessing one of the worst migrant crises in the country and smirking at our hypocrisy. Storms always hit the lowest of the low. Understand and acknowledge the privilege you reek of. Do what you can to ease their load. Not a funny episode, right? Nope.”, the accompanying caption reads.

<a href=”https://www.facebook.com/theindianfeed/videos/vb.888354911226557/451594745688345/?type=2&theater”>https://www.facebook.com/theindianfeed/videos/vb.888354911226557/451594745688345/?type=2&theater</a>

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<ol start=”4″>
<li> Ghana: Care International: How Ghanaians are Counteracting Myths about COVID-19</li>
</ol>
Amid the COVID-19 outbreak, a network of volunteers has emerged in Ghana to translate health messages into local languages so residents can access accurate information.

As COVID-19 started spreading in Ghana earlier this spring, Elisabeth Efua Sutherland’s colleagues began forwarding audio messages claiming that if she drank apple cider vinegar or bathed using a certain “miracle medicine,” she wouldn’t contract the virus.

Myths such as these, with no scientific evidence or medical backing, have been circulating widely on social media in Ghana and elsewhere. A recent survey indicated that <a href=”https://www.ghanaweb.com/GhanaHomePage/NewsArchive/50-of-what-Ghanaians-know-about-coronavirus-is-misinformation-Report-908254″>50% of what Ghanaians know about the coronavirus is misinformation</a>, with the leading myths being that spraying alcohol on one’s body can kill the virus and that eating garlic helps prevent infection.

Misinformation can be dangerous, even deadly, during outbreaks. In the fight against Ebola in the Democratic Republic of Congo, for instance, many don’t believe the disease exists or associate its spread with healthcare workers and avoid seeking treatment. “It is as much a crisis of communication as it is a health crisis,” <a href=”http://news.care.org/article/its-a-race-to-save-lives/”>said David Bisimwa, humanitarian coordinator for CARE in the DRC, last year</a>.

<a href=”http://news.care.org/article/how-ghanaians-are-counteracting-myths-about-covid-19/”>http://news.care.org/article/how-ghanaians-are-counteracting-myths-about-covid-19/</a>

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<ol start=”5″>
<li> Nature: How coronavirus lockdowns stopped flu in its tracks</li>
</ol>
Reported rates of influenza and other infections have fallen sharply, but some communicable diseases may see a rise. Lockdowns and social-distancing measures aimed at slowing the spread of coronavirus seem to have shortened the influenza season in the northern hemisphere by about six weeks.

Globally, an estimated 290,000–650,000 people typically die from seasonal flu, so a shorter flu season could mean tens of thousands of lives are spared. But the net impacts on global health will be hard to unpick against the large number of deaths from COVID-19 as well as other causes in 2020 and beyond. Tracking influenza and other infectious diseases can help to reveal the effectiveness of public-health policies aimed at stopping the coronavirus pandemic.

<a href=”https://www.nature.com/articles/d41586-020-01538-8?utm_source=Nature+Briefing&utm_campaign=1adfc8e604-briefing-dy-20200522&utm_medium=email&utm_term=0_c9dfd39373-1adfc8e604-45238390″>https://www.nature.com/articles/d41586-020-01538-8?utm_source=Nature+Briefing&utm_campaign=1adfc8e604-briefing-dy-20200522&utm_medium=email&utm_term=0_c9dfd39373-1adfc8e604-45238390</a>

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<ol start=”6″>
<li> USA: The Guardian: US national park reopenings raise fears of coronavirus outbreaks</li>
</ol>
Rural towns on the edge of parks split between fear of infection and imperative to revive tourism-dependent economies

On Wednesday, Zion national park in Utah, one of the most popular natural attractions in the US, received its first visitors in more than a month as the Trump administration continued its push to reopen the nation’s outdoors as well as it cities and businesses.

More than 4,000 people poured into the beauty spot from numerous states.

Yet the <a href=”https://www.nps.gov/index.htm”>phased reopening</a> of America’s national parks has raised concerns about exacerbating the spread of Covid-19 and endangering the residents of rural towns located near parks

<a href=”https://www.theguardian.com/environment/2020/may/15/us-national-park-reopenings-coronavirus”>https://www.theguardian.com/environment/2020/may/15/us-national-park-reopenings-coronavirus</a>

<ol start=”7″>
<li> USA: National Health law Program: The COVID-19 Pandemic Will Cause Deep Cuts to Rural America</li>
</ol>
Most major media outlets to date have focused their attention on the spread of COVID-19 in metropolitan areas like New York City, where the devastating impact of this pandemic is undeniably overwhelming. Nearly a <a href=”https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html”>quarter</a> of all recorded U.S. COVID-19 deaths have been in New York City yet, a growing and less noticeable crisis is surfacing in the heart of rural America.

Rural communities play a vital role in the health of the nation

<a href=”https://www.census.gov/library/stories/2017/08/rural-america.html”>One in five</a> Americans live in rural areas. Rural areas are a crucial source of water, food, energy, and natural resources. At a time when <a href=”https://www.brookings.edu/blog/up-front/2020/05/06/the-covid-19-crisis-has-already-left-too-many-children-hungry-in-america/”>1 in 5</a> families are experiencing food insecurity, we need to remember that farms supply safe food to America’s grocery stores and food pantries. Despite the importance of rural communities to the nation’s overall health, the health of rural Americans is often overlooked in federal policy. Even when it is discussed, it’s viewed through a homogeneous lens. Glaringly absent from the dominant narrative about rural America, and rural health research, is the experiences of black, Native American and Latinx populations, as well as immigrants, LGBTQ individuals and people with disabilities.

<a href=”https://healthlaw.org/the-covid-19-pandemic-will-cause-deep-cuts-to-rural-america/”>https://healthlaw.org/the-covid-19-pandemic-will-cause-deep-cuts-to-rural-america/</a>

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<ol start=”8″>
<li> India: Indian Express: The foot soldiers of Kerala’s Covid-19 battle, 26,000 women who won’t overlook any detail</li>
</ol>
The Accredited Social Health Activists (ASHAs) scouring for people with infections and keeping a stern vigil on their quarantine, on the side helping others and sustaining their community connect

KOCHI: “We are like the drones that the Kerala Police use these days for surveillance. Our eyes are everywhere,” laughs Latha Raju.

The 47-year-old is an Accredited Social Health Activist (ASHA) responsible for nearly 500 households in the Thattazham ward within Kochi Corporation limits. On normal days, she can be found combing through her ward, going from house to house scribbling notes and numbers in her little diary about pregnant women and the medicines they need, newborn children who require immediate vaccination and the elderly suffering from crippling lifestyle diseases. A small bag slung over her shoulder doubles up as an essential medicine kit, with everything from paracetamol to ORS sachets.

“You never know what comes handy when,” she says.

On other days, she can be found in the local corporation hall taking nutritional classes for expecting mothers or lecturing on family planning among newly-weds.

But these are not normal days. Over the past three months, during the course of which a frightening <a href=”https://indianexpress.com/article/explained/pandemic-explained-who-novel-coronavirus-covid19-what-is-a-pandemic-6309727/”>pandemic</a> has gripped Kerala and the rest of the world, Latha and nearly 26,000 ASHAs across the state have taken on braver, far more challenging roles. They have become the eyes and ears of the government on the ground, constantly flitting through their jurisdictional areas like a detective, scouring for people with infections and keeping a stern vigil on their quarantine. If someone coughs or sneezes, hers is the phone that rings first. If someone entered the ward after travelling from another district, she would be the first to know.

<a href=”https://indianexpress.com/article/facebook-stories-of-strength-2020/governing-the-crisis/the-foot-soldiers-of-keralas-covid-19-battle-25000-women-who-wont-overlook-any-detail-6394687/”>https://indianexpress.com/article/facebook-stories-of-strength-2020/governing-the-crisis/the-foot-soldiers-of-keralas-covid-19-battle-25000-women-who-wont-overlook-any-detail-6394687/</a>

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<ol start=”9″>
<li> Africa: Interesting Engineering: New Drones Fly to Ghana and Rwanda in 15 Minutes for Rapid COVID-19 Supply Delivery</li>
</ol>
The autonomous drones can travel hundreds of kilometers in a matter of minutes.

Some companies, organizations, and people are finding novel methods to deliver critical COVID-19 supplies to rural health centers and hospitals.

In the U.S. <a href=”https://interestingengineering.com/16-year-old-pilot-flies-much-needed-medical-supplies-to-rural-hospitals-amid-pandemic”>a young teen flies his own plane</a> between hospitals, and in Africa, the tech company <a href=”https://flyzipline.com/how-it-works/”>Zipline</a> delivers supplies via autonomous drones to rural health centers in Ghana and Rwanda.

Zipline has engineered its drones to carry much-needed supplies over hundreds of kilometers in <a href=”https://www.businessinsider.com/zipline-drone-coronavirus-supplies-africa-rwanda-ghana-2020-5?r=DE&IR=T”>mere minutes</a> to and from these hospitals.

<a href=”https://www.businessinsider.com/zipline-drone-coronavirus-supplies-africa-rwanda-ghana-2020-5?r=DE&IR=T”>Zipline’s</a> drones are carrying vital supplies to COVID-19-stricken rural hospitals in Ghana and Rwanda. Flying these supplies instead of bringing them by car or truck over rough terrain that takes hours to drive through shortens the trip to just 15 or so minutes, and very importantly, minimizes direct human interaction.

<a href=”https://interestingengineering.com/new-drones-fly-to-ghana-and-rwanda-in-15-minutes-for-rapid-covid-19-supply-delivery”>https://interestingengineering.com/new-drones-fly-to-ghana-and-rwanda-in-15-minutes-for-rapid-covid-19-supply-delivery</a>

<ol start=”10″>
<li> USA: New York Times: Lockdown Delays Cost at Least 36,000 Lives, Data Show</li>
</ol>
Even small differences in timing would have prevented the worst exponential growth, which by April had subsumed New York City, New Orleans and other major cities, researchers found. If the United States had begun imposing social distancing measures one week earlier than it did in March, about 36,000 fewer people would have died in the coronavirus outbreak, according to <a href=”https://www.medrxiv.org/content/10.1101/2020.05.15.20103655v1″>new estimates</a> from Columbia University disease modelers.

And if the country had begun locking down cities and limiting social contact on March 1, two weeks earlier than most people started staying home, the vast majority of the nation’s deaths — about 83 percent — would have been avoided, the researchers estimated.

<a href=”https://www.nytimes.com/2020/05/20/us/coronavirus-distancing-deaths.html”>https://www.nytimes.com/2020/05/20/us/coronavirus-distancing-deaths.html</a>

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<ol start=”11″>
<li> South Africa: News 24: Grim Covid-19 projections for SA: 40 000 deaths, 1 million infections and a dire shortage of ICU beds</li>
</ol>
More than 40 000 people are expected to die from the coronavirus in South Africa by November, one million people will be infected and the country is unlikely to have enough ICU beds at the peak of the pandemic.

This according to a presentation by a group of scientists advising the government on projections and modelling to inform policy and regulations.

<a href=”https://m.news24.com/SouthAfrica/News/grim-covid-19-projections-for-sa-40-000-deaths-1-million-infections-and-a-dire-shortage-of-icu-beds-20200519″>https://m.news24.com/SouthAfrica/News/grim-covid-19-projections-for-sa-40-000-deaths-1-million-infections-and-a-dire-shortage-of-icu-beds-20200519</a>

<ol start=”12″>
<li> France: ABC News: 70 cases of COVID-19 at French schools days after re-opening</li>
</ol>
Just one week after a third of French schoolchildren went back to school in an easing of the <a href=”https://abcnews.go.com/alerts/Coronavirus”>coronavirus</a> lockdown, there has been a worrying flareup of about 70 COVID-19 cases linked to schools, the government said Monday.

Some lower grades in schools were opened last week and a further 150,000 junior high students went back to the classroom Monday as further restrictions were loosened by the government. The move initially spelled relief: the end of homeschooling for hundreds of thousands of exhausted French parents, many of whom were also working from home.

But French Education minister Jean-Michel Blanquer sounded the alarm Monday, telling French radio RTL that the return has put some children in new danger of infection. He said the affected schools are being closed immediately. French media reported that seven schools in northern <a href=”https://abcnews.go.com/alerts/France”>France</a> were closed.

<a href=”https://abcnews.go.com/Health/wireStory/70-cases-covid-19-french-schools-days-opening-70740749″>https://abcnews.go.com/Health/wireStory/70-cases-covid-19-french-schools-days-opening-70740749</a>

<ol start=”13″>
<li> USA: Interesting Engineering: Inside of Luxury Boeing 777 Jet That Is Now Flying COVID-19 Cargo Instead of VIP Passengers</li>
</ol>
Joining the efforts of other airline carriers, Crystal Cruises will help deliver crucial COVID-19 supplies around the world.

Some airline companies and individuals are offering their flying services to help deliver and transport essential COVID-19 medical supplies around the world. For instance, a young teen in the U.S. is <a href=”https://interestingengineering.com/16-year-old-pilot-flies-much-needed-medical-supplies-to-rural-hospitals-amid-pandemic”>flying medical goods to rural hospitals</a>, the world’s largest cargo plane the <a href=”https://interestingengineering.com/biggest-plane-in-the-world-soars-into-the-covid-19-struggle”>Antonov</a> is moving essential supplies across the globe, and even the American football team the <a href=”https://interestingengineering.com/latest-updates-on-the-coronavirus-disease”>New England Patriots’ private jet</a>has been lent for the occasion.

As <a href=”https://interestingengineering.com/video/covid-19-has-left-the-aviation-industry-fighting-for-survival”>the travel industry is taking a huge hit</a>, airlines have more capacity to help by transporting cargo instead.

Now, luxury private jet lines are joining the fight too, one such company is <a href=”http://mediacenter.crystalcruises.com/”>Crystal Cruises</a> who is offering up its <a href=”https://www.businessinsider.nl/crystal-cruises-boeing-777-crystal-skye-flying-cargo-charter-flights-2020-4/”>Boeing 777 jet</a> that usually transports VIP passengers to instead transport COVID-19 goods.

<a href=”https://interestingengineering.com/inside-of-luxury-boeing-777-jet-that-is-now-flying-covid-19-cargo-instead-of-vip-passengers”>https://interestingengineering.com/inside-of-luxury-boeing-777-jet-that-is-now-flying-covid-19-cargo-instead-of-vip-passengers</a>

<ol start=”14″>
<li>Europe: ECHAlliance: Video: Tales from Canada, Italy, Wales, Spain, Northern Ireland, Manchester and Greece on how COVID-19 has impacted and changed home and social care
We had the pleasure of hosting a very busy Pop-Up Ecosystem today focusing on the challenges in Home and Social Care with the COVID-19 Emergency. We have fantastic input from our Ecosystems in Italy, Wales, Greece, Northern Ireland and North West England and for the first time our soon to launch ecosystem in Montreal – Canada</li>
</ol>
Our members, also took part and we had great input from Connected Health, Elemental and Tunstall in Spain showcasing the needs and solutions that they have created to meet the demands of COVID-19.

<a href=”https://echalliance.com/tales-from-canada-italy-walesspain-northern-ireland-manchester-and-greece-on-how-covid-19-has-impacted-and-changed-home-and-social-care/”>https://echalliance.com/tales-from-canada-italy-walesspain-northern-ireland-manchester-and-greece-on-how-covid-19-has-impacted-and-changed-home-and-social-care/</a>

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<ol start=”15″>
<li> Tanzania: New York Times: Tanzania Leader Says Virus Cases Down Despite U.S. Warning</li>
</ol>
Tanzanian President John Magufuli has said prayers have succeeded in reducing the number of COVID-19 cases in the country, despite the American embassy recently warning that “all evidence points to exponential growth of the epidemic” in the country’s largest city.

Magufuli said during a church service Sunday that if the trend of declining cases of the disease caused by the coronavirus continues this week he will open schools, universities and sports events.

The Tanzanian government has not released any data on COVID-19 cases for more than two weeks, so there are no current figures on the number of people diagnosed with the disease, the U.S. embassy said in a health advisory released last week.

Many hospitals in Dar es Salaam, Tanzania’s largest city, have been overwhelmed with COVID-19 cases in recent weeks, said the strongly worded health advisory issued by the U.S. embassy on Friday.

Magufuli said charter flights fully booked with tourists were lining up to come to Tanzania because its safe. He said he had ordered the minister for wildlife and tourism not to put the tourists in quarantine and to let them in the country if their temperature is found to be normal.

<a href=”https://www.nytimes.com/aponline/2020/05/17/world/africa/ap-af-virus-outbreak-tanzania.html”>https://www.nytimes.com/aponline/2020/05/17/world/africa/ap-af-virus-outbreak-tanzania.html</a>

<ol start=”16″>
<li> Tanzania: New York Times: Tanzania’s Magufuli Plans to Lift Coronavirus Restrictions</li>
</ol>
Tanzania’s President John Magufuli said on Sunday he plans to re-open universities and allow the resumption of sports and international flights if the decline in new coronavirus infections continues.

The Tanzanian government closed schools, stopped international flights and banned large gatherings but much of the regular economic activity has continued and religious services have been allowed to continue unlike neighbors like Rwanda and Uganda which imposed total lockdowns.

Magufuli, who has questioned the quality of COVID-19 test kits and at one time asked citizens to pray away the virus, said activities could resume in the coming days.

“If the trend I am seeing continues in the coming week, I plan to open up universities so students can continue with their education,” Magufuli said while speaking at a church service in northwest Tanzania.

<a href=”https://www.nytimes.com/reuters/2020/05/17/world/africa/17reuters-health-coronavirus-tanzania.html”>https://www.nytimes.com/reuters/2020/05/17/world/africa/17reuters-health-coronavirus-tanzania.html</a>

<ol start=”17″>
<li>Nature: Coronavirus vaccine trials have delivered their first results — but their promise is still unclear</li>
</ol>
Scientists urge caution over hints of success emerging from small human and animal studies.

As coronavirus vaccines hurtle through development, scientists are getting their first look at data that hint at how well <a href=”https://www.nature.com/articles/d41586-020-01221-y”>different vaccines are likely to work</a>. The picture, so far, is murky.

On 18 May, US biotech firm Moderna revealed the first data from a human trial: its COVID-19 vaccine triggered an immune response in people, and protected mice from lung infections with the coronavirus SARS-CoV-2. The results — which the company, based in Cambridge, Massachusetts, announced in a <a href=”https://investors.modernatx.com/news-releases/news-release-details/moderna-announces-positive-interim-phase-1-data-its-mrna-vaccine”>press release</a> — were widely interpreted as positive and sent stock prices surging. But some scientists say that because the data haven’t been published, they lack the details needed to properly evaluate those claims.

<a href=”https://www.nature.com/articles/d41586-020-01092-3?utm_source=Nature+Briefing&utm_campaign=0f2156291a-briefing-dy-20200520&utm_medium=email&utm_term=0_c9dfd39373-0f2156291a-45238390″>https://www.nature.com/articles/d41586-020-01092-3?utm_source=Nature+Briefing&utm_campaign=0f2156291a-briefing-dy-20200520&utm_medium=email&utm_term=0_c9dfd39373-0f2156291a-45238390</a>

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<ol start=”18″>
<li> USA: AAAS: Science Mag: Why do some COVID-19 patients infect many others, whereas most don’t spread the virus at all?</li>
</ol>
When 61 people met for a choir practice in a church in Mount Vernon, Washington, on 10 March, everything seemed normal. For 2.5 hours the chorists sang, snacked on cookies and oranges, and sang some more. But one of them had been suffering for 3 days from what felt like a cold—and turned out to be COVID-19. In the following weeks, 53 choir members got sick, three were hospitalized, and two died, according to a <a href=”https://www.cdc.gov/mmwr/volumes/69/wr/mm6919e6.htm”>12 May report by the U.S. Centers for Disease Control and Prevention</a> (CDC) that meticulously reconstructed the tragedy.

Many similar “superspreading events” have occurred in the COVID-19 pandemic. A <a href=”https://wellcomeopenresearch.org/articles/5-83″>database by Gwenan Knight</a> and colleagues at the London School of Hygiene & Tropical Medicine (LSHTM) lists an outbreak in a dormitory for migrant workers in Singapore linked to almost 800 cases; 80 infections tied to live music venues in Osaka, Japan; and a cluster of 65 cases resulting from Zumba classes in South Korea. Clusters have also occurred aboard ships and at nursing homes, meatpacking plants, ski resorts, churches, restaurants, hospitals, and prisons. Sometimes a single person infects dozens of people, whereas other clusters unfold across several generations of spread, in multiple venues.

<a href=”https://www.sciencemag.org/news/2020/05/why-do-some-covid-19-patients-infect-many-others-whereas-most-don-t-spread-virus-all?utm_source=Nature+Briefing&utm_campaign=0f2156291a-briefing-dy-20200520&utm_medium=email&utm_term=0_c9dfd39373-0f2156291a-45238390″>https://www.sciencemag.org/news/2020/05/why-do-some-covid-19-patients-infect-many-others-whereas-most-don-t-spread-virus-all?utm_source=Nature+Briefing&utm_campaign=0f2156291a-briefing-dy-20200520&utm_medium=email&utm_term=0_c9dfd39373-0f2156291a-45238390</a>

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<ol start=”19″>
<li> USA: CNN: US asks for abortion references to be removed from UN pandemic response plan</li>
</ol>
The Trump administration is urging the United Nations secretary general to remove any references to reproductive health, including abortions, from the UN’s humanitarian response plan to the coronavirus pandemic to “avoid creating controversy.”

“The United States stands with nations that have pledged to protect the unborn,” acting Administrator of USAID John Barsa wrote <a href=”https://www.usaid.gov/news-information/press-releases/may-18-2020-acting-administrator-john-barsa-un-secretary-general-antonio-guterres”>in a letter</a> to UN Secretary General António Guterres on Monday. “To achieve global unity toward this goal, it is essential that the UN’s response to the pandemic avoid creating controversy. Therefore, I ask that you remove references to ‘sexual and reproductive health,’ and its derivatives from the Global HRP, and drop the provision of abortion as an essential component of the UN’s priorities to respond to the COVID-19 pandemic.”

Though the <a href=”https://edition.cnn.com/2020/05/09/politics/us-rejects-un-coronavirus-resolution-china-who/”>US blocked</a> a UN Security Council resolution that called for a global ceasefire aimed at collectively addressing the coronavirus pandemic ravaging the globe earlier this month, Barsa said the references risked undermining a united response to the crisis.

“Now is not the time to add unnecessary discord to the Covid-19 response,” Barsa wrote.

<a href=”https://edition.cnn.com/2020/05/19/politics/us-abortion-un-pandemic-response/index.html”>https://edition.cnn.com/2020/05/19/politics/us-abortion-un-pandemic-response/index.html</a>

<ol start=”20″>
<li> USA: Harvard Center for Primary Care: Experiencing Rural Family Medicine During the COVID-19 Pandemic</li>
</ol>
I arrived in Valdez, Alaska in mid-February as a visiting third year medical student and was quickly immersed in full-scope Family Medicine. I was learning in a myriad of settings: seeing patients in clinic for routine primary care, evaluating a trauma in the emergency room, assisting with vaginal and cesarean deliveries, and rounding on inpatients in the 11-bed critical access hospital. Six Family Medicine physicians provide comprehensive care here in a town of 4,000 residents, more than 300 road miles from the next hospital, in a census area where the population density is 0.3 persons per square mile. Throughout my experience I was struck by these doctors’ comfort in such a wide range of situations and the versatility of their skills.

<a href=”http://info.primarycare.hms.harvard.edu/blog/rural-family-medicine-covid”>http://info.primarycare.hms.harvard.edu/blog/rural-family-medicine-covid</a>

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<ol start=”21″>
<li> USA: Washington Post: Top White House economic adviser expresses uncertainty about recovery despite Trump’s confidence</li>
</ol>
In Washington Post event, Larry Kudlow says he sees some glimmers of hope but acknowledges that labor market weakness could drag on for months

The White House’s top economic official expressed uncertainty on Thursday that America’s economy would swiftly rebound from the downturn caused by the <a href=”https://www.washingtonpost.com/health/2020/02/28/what-you-need-know-about-coronavirus/?itid=lk_inline_manual_2″>coronavirus</a> pandemic, striking a more cautious tone about the recovery than President Trump has in recent days.

Larry Kudlow, director of the White House National Economic Council, said there are some “small glimmers of hope” and voiced optimism about a dramatic improvement this summer. But he emphasized the coronavirus still poses a unique and unpredictable threat to the nation’s economy and that the overall picture appears bleak.

<a href=”https://www.washingtonpost.com/business/2020/05/21/kudlow-post-live-economy-coronavirus/?pwapi_token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJjb29raWVuYW1lIjoid3BfY3J0aWQiLCJpc3MiOiJDYXJ0YSIsImNvb2tpZXZhbHVlIjoiNWU4YWMxZTY5YmJjMGYwYTJlNzk3ODE3IiwidGFnIjoiNWVjODNlMDlmZTFmZjY1NGMyZTNmM2FmIiwidXJsIjoiaHR0cHM6Ly93d3cud2FzaGluZ3RvbnBvc3QuY29tL2J1c2luZXNzLzIwMjAvMDUvMjEva3VkbG93LXBvc3QtbGl2ZS1lY29ub215LWNvcm9uYXZpcnVzLz91dG1fY2FtcGFpZ249d3BfdG9feW91cl9oZWFsdGgmdXRtX21lZGl1bT1lbWFpbCZ1dG1fc291cmNlPW5ld3NsZXR0ZXImd3Bpc3JjPW5sX3R5aCZ3cG1rPTEifQ.dzIkAH250F3aO4Jpqs-OzJEaa54MMsGMKFJslmVjjqA&utm_campaign=wp_to_your_health&utm_medium=email&utm_source=newsletter&wpisrc=nl_tyh&wpmk=1″>https://www.washingtonpost.com/business/2020/05/21/kudlow-post-live-economy-coronavirus/?pwapi_token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJjb29raWVuYW1lIjoid3BfY3J0aWQiLCJpc3MiOiJDYXJ0YSIsImNvb2tpZXZhbHVlIjoiNWU4YWMxZTY5YmJjMGYwYTJlNzk3ODE3IiwidGFnIjoiNWVjODNlMDlmZTFmZjY1NGMyZTNmM2FmIiwidXJsIjoiaHR0cHM6Ly93d3cud2FzaGluZ3RvbnBvc3QuY29tL2J1c2luZXNzLzIwMjAvMDUvMjEva3VkbG93LXBvc3QtbGl2ZS1lY29ub215LWNvcm9uYXZpcnVzLz91dG1fY2FtcGFpZ249d3BfdG9feW91cl9oZWFsdGgmdXRtX21lZGl1bT1lbWFpbCZ1dG1fc291cmNlPW5ld3NsZXR0ZXImd3Bpc3JjPW5sX3R5aCZ3cG1rPTEifQ.dzIkAH250F3aO4Jpqs-OzJEaa54MMsGMKFJslmVjjqA&utm_campaign=wp_to_your_health&utm_medium=email&utm_source=newsletter&wpisrc=nl_tyh&wpmk=1</a>

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<ol start=”22″>
<li> New Zealand: Stuff: Coronavirus: Telehealth technology advancements put patient in driver’s seat</li>
</ol>
It has been the best of times and the worst of times for our health system. Combatting the Covid-19 pandemic has exposed not only the hard-working heroes on the frontline of our national healthcare set-up but also many of the problems at its core.

These include a lack of leadership and co-ordination within the district health boards, chronic underfunding and antiquated systems that undermine efficiency and ease of access.

But we have also had a glimpse of the ways in which new technology and thinking might change national health, and maybe for the better.

Changes that are likely to put the patient in the driver’s seat.

Virtual consultations, by video or by phone, became the new normal as physical interactions with clinicians and GPs were reduced over concerns about virus transmission.

<a href=”https://www.stuff.co.nz/national/health/121485132/coronavirus-telehealth-technology-advancements-put-patient-in-drivers-seat”>https://www.stuff.co.nz/national/health/121485132/coronavirus-telehealth-technology-advancements-put-patient-in-drivers-seat</a>

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<ol start=”23″>
<li> USA: Washington Post: Elderly covid-19 patients on ventilators usually do not survive, New York hospitals report</li>
</ol>
Most elderly covid-19 patients put on ventilators at two New York hospitals did not survive, according to a sweeping study published Tuesday that captured the <a href=”https://www.washingtonpost.com/health/antibody-tests-support-whats-been-obvious-covid-19-is-much-more-lethal-than-flu/2020/04/28/2fc215d8-87f7-11ea-ac8a-fe9b8088e101_story.html?tid=lk_inline_manual_2&itid=lk_inline_manual_2″>brutal nature </a>of this new disease and the many ways it attacks the body.

The study, <a href=”http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31189-2/fulltext”>published in the Lancet</a>, is broadly consistent with clinical findings from China and Europe, and confirmed that advanced age is the greatest risk factor for a severe outcome, particularly if accompanied by <a href=”https://www.washingtonpost.com/health/why-older-and-chronically-ill-americans-are-at-greater-risk-from-coronavirus/2020/03/10/d7e4cc04-622e-11ea-acca-80c22bbee96f_story.html?tid=lk_inline_manual_3&itid=lk_inline_manual_3″>chronic underlying diseases</a>, such as hypertension, diabetes, heart disease and obesity.

<a href=”https://www.washingtonpost.com/health/elderly-covid-19-patients-on-ventilators-usually-do-not-survive-new-york-hospitals-report/2020/05/19/ba20e822-99f8-11ea-89fd-28fb313d1886_story.html?pwapi_token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.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.cMgzR_1-JyEPeMLyYUXJTjKz6P3jmqT1ZLlj0HbQXls&utm_campaign=wp_to_your_health&utm_medium=email&utm_source=newsletter&wpisrc=nl_tyh&wpmk=1″>https://www.washingtonpost.com/health/elderly-covid-19-patients-on-ventilators-usually-do-not-survive-new-york-hospitals-report/2020/05/19/ba20e822-99f8-11ea-89fd-28fb313d1886_story.html?pwapi_token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJjb29raWVuYW1lIjoid3BfY3J0aWQiLCJpc3MiOiJDYXJ0YSIsImNvb2tpZXZhbHVlIjoiNWU4YWMxZTY5YmJjMGYwYTJlNzk3ODE3IiwidGFnIjoiNWVjNTkyYmVmZTFmZjY1NGMyZTI1Yzc1IiwidXJsIjoiaHR0cHM6Ly93d3cud2FzaGluZ3RvbnBvc3QuY29tL2hlYWx0aC9lbGRlcmx5LWNvdmlkLTE5LXBhdGllbnRzLW9uLXZlbnRpbGF0b3JzLXVzdWFsbHktZG8tbm90LXN1cnZpdmUtbmV3LXlvcmstaG9zcGl0YWxzLXJlcG9ydC8yMDIwLzA1LzE5L2JhMjBlODIyLTk5ZjgtMTFlYS04OWZkLTI4ZmIzMTNkMTg4Nl9zdG9yeS5odG1sP3V0bV9jYW1wYWlnbj13cF90b195b3VyX2hlYWx0aCZ1dG1fbWVkaXVtPWVtYWlsJnV0bV9zb3VyY2U9bmV3c2xldHRlciZ3cGlzcmM9bmxfdHloJndwbWs9MSJ9.cMgzR_1-JyEPeMLyYUXJTjKz6P3jmqT1ZLlj0HbQXls&utm_campaign=wp_to_your_health&utm_medium=email&utm_source=newsletter&wpisrc=nl_tyh&wpmk=1</a>

<ol start=”24″>
<li> WHO: Cleaning and disinfection of environmental surfaces in the context of COVID-19</li>
</ol>
The purpose of this document is to provide guidance on the cleaning and disinfection of environmental surfaces in the context of COVID-19. This guidance is intended for health care professionals, public health professionals and health authorities that are developing and implementing policies and standard operating procedures (SOP) on the cleaning and disinfection of environmental surfaces in the context of COVID-19.

<a href=”https://www.who.int/publications-detail/cleaning-and-disinfection-of-environmental-surfaces-inthe-context-of-covid-19″>https://www.who.int/publications-detail/cleaning-and-disinfection-of-environmental-surfaces-inthe-context-of-covid-19</a>

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<ol start=”25″>
<li> Lancet: Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study</li>
</ol>
Over 40 000 patients with COVID-19 have been hospitalised in New York City (NY, USA) as of April 28, 2020. Data on the epidemiology, clinical course, and outcomes of critically ill patients with COVID-19 in this setting are needed.

<a href=”https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31189-2/fulltext”>https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31189-2/fulltext</a>

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<ol start=”26″>
<li> UK: HSJ: Only a fraction of patients are accessing GPs through video systems, despite a huge shift to remote consultations.</li>
</ol>
Patients shun video in favour of telephone and messaging. Data shared with HSJ by primary care IT suppliers shows face-to-face consultations have dwindled as patients are either staying away from health services or accessing care remotely.

However, the majority accessing care remotely are using telephones or online requests, rather than video consultations.

The NHS has urged GPs to obtain video consultation systems and has celebrated that more than 90 per cent of practices are now offering video appointments.

Primary care fundamentally transformed at the start of the coronavirus pandemic, from a service largely focused on face-to-face provision to one largely conducted remotely.

<a href=”https://www.hsj.co.uk/service-design/patients-shun-video-in-favour-of-telephone-and-messaging/7027680.article?mkt_tok=eyJpIjoiTWprNE1tVTROVFUxWXpBNCIsInQiOiJid1YyRW5scFNXdTFwdlc2Z1dzUEN5bmxScmxpdUhsMjRESmU2dzlwQTlQVW5zUjV3bW5UK0NRenVCd0RQQkhpeVhcL0krMm9KQ3FSWXBQRUlqUWRCS0ltcXpTNnMzbUxtSFd0aEhKOW5nMktXcjQ0b2pyaXM5VDdyKzhiV2ZLS24ifQ%3D%3D”>https://www.hsj.co.uk/service-design/patients-shun-video-in-favour-of-telephone-and-messaging/7027680.article?mkt_tok=eyJpIjoiTWprNE1tVTROVFUxWXpBNCIsInQiOiJid1YyRW5scFNXdTFwdlc2Z1dzUEN5bmxScmxpdUhsMjRESmU2dzlwQTlQVW5zUjV3bW5UK0NRenVCd0RQQkhpeVhcL0krMm9KQ3FSWXBQRUlqUWRCS0ltcXpTNnMzbUxtSFd0aEhKOW5nMktXcjQ0b2pyaXM5VDdyKzhiV2ZLS24ifQ%3D%3D</a>

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<ol start=”27″>
<li> Australia: ACRRM: World Family Doctor Day – an opportunity to recognise doctors supporting rural and remote Australia</li>
</ol>
On the eve of World Family Doctor Day, the Australian College of Rural and Remote Medicine (ACRRM) says it’s a timely opportunity to highlight the role Rural Generalists (RGs) are playing in providing excellent health care to families in rural and remote communities.

The 2020 theme for World Family Doctor Day on Tuesday 19 May is ‘family doctors on the front line’, emphasising that doctors are key to the management of the COVID-19 pandemic outbreak.

<a href=”https://www.acrrm.org.au/about-us/news-events/media-releases/article/2020/05/18/world-family-doctor-day—an-opportunity-to-recognise-doctors-supporting-rural-and-remote-australia?utm_source=country%20watch&utm_medium=email&utm_campaign=21%20may%2020″>https://www.acrrm.org.au/about-us/news-events/media-releases/article/2020/05/18/world-family-doctor-day—an-opportunity-to-recognise-doctors-supporting-rural-and-remote-australia?utm_source=country%20watch&utm_medium=email&utm_campaign=21%20may%2020</a>

ACRRM President Dr Ewen McPhee got in front of the camera to recognise the important role members have in meeting the needs of rural and remote communities

<a href=”https://www.youtube.com/watch?v=N3kdtnYB5HY&feature=youtu.be&utm_source=country+watch&utm_medium=email&utm_campaign=21+may+20″>https://www.youtube.com/watch?v=N3kdtnYB5HY&feature=youtu.be&utm_source=country+watch&utm_medium=email&utm_campaign=21+may+20</a>

The critical role general practice plays in the health of the community has been highlighted during the nation-wide response to COVID-19 and, together with the Rural Doctors Association of Australia (RDAA), we are calling for the inclusion of general practice in all disaster response planning.

<a href=”https://www.acrrm.org.au/about-us/news-events/media-releases/article/2020/05/19/joint-release-covid-19-shows-gps-essential-in-disaster-response?utm_source=country%20watch&utm_medium=email&utm_campaign=21%20may%2020″>https://www.acrrm.org.au/about-us/news-events/media-releases/article/2020/05/19/joint-release-covid-19-shows-gps-essential-in-disaster-response?utm_source=country%20watch&utm_medium=email&utm_campaign=21%20may%2020</a>

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<ol start=”28″>
<li> BMJ: Family Medicine and Community Health: Challenges and responsibilities of family doctors in the new global coronavirus outbreak</li>
</ol>
The world is again facing the threat of a deadly infection. After the Ebola outbreaks in Africa, the WHO has declared the novel coronavirus, spreading from Wuhan city in China since December, another public health emergency of international concern. At the time I was writing this commentary, the virus continues to infect more people and land on more cities. While the healthcare systems are put to a tough test, it is also a critical moment that the roles and responsibilities of family doctors are assessed and recognised.

<a href=”https://fmch.bmj.com/content/8/1/e000333″>https://fmch.bmj.com/content/8/1/e000333</a>

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<ol start=”29″>
<li> Latin America: Care International: A Perfect Storm: Domestic violence, economic hardship and COVID-19 in Latin America</li>
</ol>
The forecast for Latin America and the Caribbean (LAC) resembles a perfect storm of risk factors that include social, economic and humanitarian crises, now compounded by the consequences of COVID-19. The pandemic has tipped the region, already experiencing an economic recession and two unfolding humanitarian crises in Venezuela and Haiti, into a situation where Brazil now sits among the top ten most infected by COVID-19 around the world, with Peru and Ecuador also experiencing heavy infection rates.

<a href=”https://medium.com/@CAREGlobal/a-perfect-storm-domestic-violence-economic-hardship-and-covid-19-in-ecuador-db97d12bd9be”>https://medium.com/@CAREGlobal/a-perfect-storm-domestic-violence-economic-hardship-and-covid-19-in-ecuador-db97d12bd9be</a>

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<ol start=”30″>
<li> International: Tortoisemedia: Video: ‘The world should be in revolt’</li>
</ol>
Dr David Nabarro, a Special Envoy of the World Health Organisation on Covid-19, makes an impassioned plea for better collaboration between global leaders

We just have a complete fracture in global leadership right now. To the point where a UN Security Council resolution on Covid was not approved because the World Health Organisation was mentioned in the resolution. The people of the world actually should be going completely crazy with anger. There should be a petition of 500 million people to the world leaders saying, “What on earth are you doing? What on earth are you playing at?”

We have the biggest crisis of all time in many of our livelihoods and you’re squabbling. You’re squabbling over whether the World Health Organisation should be killed or kept alive, when the world needs the WHO more than ever. Because it’s the only organisation that pulls the stuff together; it’s the only organisation that’s supporting countries with PPE; together with the World Food Programme and Unicef, it’s running the only airline that’s bringing supplies into Africa, bringing tests in. We’re dealing with the market failures.

<a href=”https://members.tortoisemedia.com/2020/05/13/david-nabarro-on-global-leadership/content.html?sig=OLNaXnBELKTPesge8iYiybqtn1XD9zU4jXFDb1v1GwY”>https://members.tortoisemedia.com/2020/05/13/david-nabarro-on-global-leadership/content.html?sig=OLNaXnBELKTPesge8iYiybqtn1XD9zU4jXFDb1v1GwY</a>

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<ol start=”31″>
<li> USA: The Atlantic: Quarantine Fatigue Is Real</li>
</ol>
Instead of an all-or-nothing approach to risk prevention, Americans need a manual on how to have a life in a pandemic.

In the earliest years of the HIV epidemic, confusion and fear reigned. AIDS was still known as the “gay plague.” To the extent that gay men received any health advice at all, it was to avoid sex. In 1983, the activists Richard Berkowitz and Michael Callen, with guidance from the virologist Joseph Sonnabend, published a foundational document for their community, called “How to Have Sex in an Epidemic.” Recognizing the need for pleasure in people’s lives, the pamphlet rejected abstinence as the sole approach and provided some of the earliest guidance on safer sex for gay men, including recommendations about condoms and which sex acts had a lower or higher risk for disease transmission.

<a href=”https://www.theatlantic.com/ideas/archive/2020/05/quarantine-fatigue-real-and-shaming-people-wont-help/611482/”>https://www.theatlantic.com/ideas/archive/2020/05/quarantine-fatigue-real-and-shaming-people-wont-help/611482/</a>

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<ol start=”32″>
<li> Drexel: University: Dornsife School of Public Health: How Many Lives Have Stay-at-Home Orders Saved?</li>
</ol>
The Dornsife School of Public Health, through its <a href=”https://drexel.edu/uhc/”>Urban Health Collaborative</a> (UHC), is working with the Big Cities Health Coalition (BCHC) to support the Coalition’s vision of healthy, more equitable cities through big city innovation and leadership. For the UHC, the partnership is an opportunity to advance its commitment to research, training, and policy translation in urban health locally and globally, leveraging the School’s historic expertise in public health practice in urban settings.

Shortly after this partnership began, cities around the world were faced with the COVID-19 pandemic. Stay-at-home orders were issued for almost all large cities and residents are facing the loss of not only life but livelihoods as well. However, stay-at-home orders are extremely crucial in slowing the spread of COVID-19.

<a href=”https://drexel.edu/dornsife/news/latest-news/2020/May/how-many-lives-have-stay-at-home-orders-saved/”>https://drexel.edu/dornsife/news/latest-news/2020/May/how-many-lives-have-stay-at-home-orders-saved/</a>

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<ol start=”33″>
<li> Australia: The Guardian: Child abuse predator ‘handbook’ lists ways to target children during coronavirus lockdown</li>
</ol>
Exclusive: Australian authorities warn of significant rise in reports of child sexual abuse material under Covid-19 restrictions

Child abusers have created and shared an online grooming manual describing ways to manipulate and exploit the increased number of children at home and online during Covid-19, Australia’s e-safety commissioner has said.

Covid-19 restrictions have coincided with a significant increase in reports to the eSafety Office about child sexual abuse material, Julie Inman Grant told Guardian Australia. She said investigators had seen a jump in searches by predators on the dark web seeking information on how to abuse children.

<a href=”https://www.theguardian.com/society/2020/may/14/child-abuse-predator-handbook-lists-ways-to-target-children-during-coronavirus-lockdown”>https://www.theguardian.com/society/2020/may/14/child-abuse-predator-handbook-lists-ways-to-target-children-during-coronavirus-lockdown</a>

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<ol start=”34″>
<li> UK: The Guardian: Cambridge University moves all lectures online until summer 2021:</li>
</ol>
Institution first to announce virtual teaching for next academic year

Cambridge has become the first university to set out measures for the full 2020-21 academic year, announcing that it will move all “face-to-face lectures” online for the duration. The institution added that it was “likely” social distancing would continue to be required.

The university said lectures would continue virtually until summer 2021, while it may be possible for smaller teaching groups to take place in person if it “conforms to social-distancing requirements”.

<a href=”https://www.theguardian.com/uk-news/2020/may/19/cambridge-university-moves-all-lectures-online-until-summer-2021″>https://www.theguardian.com/uk-news/2020/may/19/cambridge-university-moves-all-lectures-online-until-summer-2021</a>

<ol start=”35″>
<li> The Philippines: ABS CBN News: Doctors groups in PH warn vs. COVID-19 rapid tests to screen returning workers</li>
</ol>
Several doctors associations on Tuesday said they do not recommend the use of rapid antibody tests for COVID-19 to screen employees returning to work.

“The sensitivity or the yield of a positive test (of an antibody test) is very low (at) about 20%. And among that 20%, 2/3 will be false positive,” said Dr. Issa Alejandria of the Philippine Society of Microbiology and Infectious Diseases (PSMID) during a virtual briefing with media on Tuesday noon.

<a href=”https://news.abs-cbn.com/news/05/19/20/doctors-groups-in-ph-warn-vs-covid-19-rapid-tests-to-screen-returning-workers”>https://news.abs-cbn.com/news/05/19/20/doctors-groups-in-ph-warn-vs-covid-19-rapid-tests-to-screen-returning-workers</a>

<ol start=”36″>
<li> UK: BBC: Coronavirus: Security flaws found in NHS contact-tracing app</li>
</ol>
Wide-ranging security flaws have been flagged in the Covid-19 contact-tracing app being piloted in the Isle of Wight.

The <a href=”https://www.stateofit.com/UKContactTracing/”>security researchers involved have warned the problems</a> pose risks to users’ privacy and could be abused to prevent contagion alerts being sent.

GCHQ’s National Cyber Security Centre (NCSC) told the BBC it was already aware of most of the issues raised and is in the process of addressing them.

But the researchers suggest a more fundamental rethink is required.

Specifically, they call for new legal protections to prevent officials using the data for purposes other than identifying those at risk of being infected or holding on to it indefinitely.

In addition, they suggest the NHS considers shifting from its current “centralised” model – where contact-matching happens on a computer server – to a “decentralised” version – where the matching instead happens on people’s phones.

<a href=”https://www.bbc.co.uk/news/technology-52725810″>https://www.bbc.co.uk/news/technology-52725810</a>

37.BMJ: Blog: Family Medicine and community Health: “This is the time for solidarity”

Chinese GPs` experience sharing on Covid-19 control and prevention

Since March 2020, the Covid-19 outbreak has become a multi-centre global pandemic, and its epicentre has moved to Europe. Currently, the confirmed cases have surpassed over 200,000 worldwide. The strong negative impact it has on people’s health, on the society, from personal to a national level according to the Engel Model is significant. In addition, the recent cross-regional and cross-continent migration of residents of different countries in attempts to find a safe haven demonstrates this epidemic is truly becoming a worldwide threat.: China’s national intervention strategy is a positive case that demonstrates the successful containment and development of the outbreak. However, some details of this intervention need to be illustrated clearly, such as:

as the key intermediary link between public health policy and individual prevention, how was the community-level control and prevention implemented in China during the past two months? What role have Chinese GPs played in fighting against the outbreak?

Even though there may be varying context in different countries and regions, sharing the Chinese GPs` experience will provide a valuable reference for primary care researchers, practitioners and policy-makers worldwide in their fight against the outbreak.

<a href=”https://blogs.bmj.com/fmch/2020/03/25/this-is-the-time-for-solidarity：chinese-gps-experience-sharing-on-covid-19-control-and-prevention/”>https://blogs.bmj.com/fmch/2020/03/25/this-is-the-time-for-solidarity：chinese-gps-experience-sharing-on-covid-19-control-and-prevention/</a>

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<ol start=”38″>
<li> USA: Heart.org: Stroke rates among COVID-19 patients are low, but cases are more severe; overall stroke hospital admissions are down globally</li>
</ol>
The rate of strokes in COVID-19 patients appears relatively low, but a higher proportion of those strokes are presenting in younger people and are often more severe compared to strokes in people who do not have the novel coronavirus, while globally rates for stroke hospitalizations and treatments are significantly lower than for the first part of 2019, according to four separate research papers published this week in Stroke, a journal of the American Stroke Association, a division of the American Heart Association.

In “<a href=”https://www.ahajournals.org/doi/abs/10.1161/STROKEAHA.120.030335″>SARS2-CoV-2 and Stroke in a New York Healthcare System</a>,” researchers reported key demographic and clinical characteristics of patients who developed ischemic stroke associated with the COVID-19 infection and received care within one hospital system serving all 5 boroughs of New York City.

During the study period of March 15 through April 19, 2020, out of 3,556 hospitalized patients with diagnosis of COVID-19 infection, 32 patients (0.9%) had imaging-proven ischemic stroke. They compared those 32 patients admitted with stroke and COVID-19 to those admitted only with stroke (46 patients) and found that the patients with COVID-19:
<ul>
<li>tended to be younger, average age of 63 years vs. 70 years for non-COVID stroke patients;</li>
<li>had more severe strokes, average score of 19 vs. 8 on the National Institutes of Health Stroke Scale;</li>
<li>had higher D-dimer levels, 10,000 vs. 525, which can indicate significant blood clotting;</li>
<li>were more likely to be treated with blood thinners, 75% vs. 23.9%;</li>
<li>were more likely to have a cryptogenic stroke in which the cause is unknown, 65.6% vs. 30.4%; and</li>
<li>were more likely to be dead at hospital discharge, 63.6% vs. 9.3%</li>
</ul>
<a href=”https://newsroom.heart.org/news/stroke-rates-among-covid-19-patients-are-low-but-cases-are-more-severe-overall-stroke-hospital-admissions-are-down-globally”>https://newsroom.heart.org/news/stroke-rates-among-covid-19-patients-are-low-but-cases-are-more-severe-overall-stroke-hospital-admissions-are-down-globally</a>

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Journal of Rural and Remote Health

<a href=”https://www.rrh.org.au/journal/article/6000″>6000 – Australasia – Adapting to a new reality: COVID-19 coronavirus and online education in the health professions</a>

The current novel coronavirus, COVID-19, has effected a significant change in the way industry based and tertiary health professions education (HPE) can occur. This is the first paper in a series that addresses the risks and opportunities in the current transition to online HPE, and provides practical solutions for educators who are now unable to embrace more traditional face-to-face HPE delivery methods and activities.

Thoughts as before are with you all as always, especially those of you working on the front line.

Please feel free to feedback and ask for help

Best wishes

John Wynn-Jones

Rural Miscellan: 27th May 2020

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