“The blues tells a story. Every line of the blues has a meaning.”
John Lee Hooker

“Everything comes out in blues music: joy, pain, struggle. Blues is affirmation with absolute elegance”
Wynton Marsalis

“Blues is easy to play, but hard to feel”.
Jimi Hendrix

“The blues was bleeding the same blood as me”.
B. B. King

“There’s no way in the world I can feel the same blues the way I used to. When I play in Chicago, I’m playing up-to-date, not the blues I was born with. People should hear the pure blues – the blues we used to have when we had no money.”
Muddy Waters

“When you ain’t got no money, you’ve got the Blues. When you ain’t got no money to pay your house rent, you’ve still got the Blues. A lot of people holler ‘I don’t like no Blues’, but when you ain’t got no money, and you can’t pay your house rent, and can’t buy no food, you damn sure got the Blues!”
Howlin’ Wolf

“When Robert Johnson started singing, he seemed like a guy who could have sprung from the head of Zeus in full armour.”
Bob Dylan

“Every bad situation is a blues song waiting to happen”.
Amy Whinehouse

Blues Music

Mississippi John Hurt

Mahalia Jackson, the great blues and gospel singer said that “Blues are the songs of despair” while Willie Dixon, the Chicago Bluesman said that “The Blues are the true facts of life expressed in words and song, inspiration, feeling, and understanding”.
We don’t entirely know where the Blues came from. Certainly, much came from the roots of the countless, nameless people who were torn out of their native Africa and delivered into slavery. There is probably also a strong influence of European traditional music especially Irish and Scottish songs and ballads. Whatever, out of this mix came Blues, Jazz and Zydeco and other musical forms.
The traditional cradle of the blues was the Mississippi Delta, a low lying, marshy area north of New Orleans which was mainly cleared of its trees after the civil war and became ideal for growing cotton. African Americans might have been freed after the civil war, but they were certainly not liberated, and they lived in severe poverty, suffering appalling discrimination and inequality. It is this environment that nurtured the Blues. Mississippi is not the only home of the blues but it is certainly the most prominent.
Early Mississippi Delta bluesmen included Charlie Patton, Son House, Skip James, Freddie Spruell, Mississippi John Hurt and many more.
One of the most enduring stories is that of Robert Johnson whose music influenced so many 60s and 70s musicians such as Eric Clapton, Jimi Hendrix, Robert Plant, Ry Cooder, Keith Richards, Peter Green etc… So, the legend goes and according to his contemporary, bluesman Son House, he was a decent harmonica player but a terrible guitarist until he disappeared for a few weeks. Legend has it that Johnson took his guitar to the crossroads of Highway 61 and Route 49 in Clarksdale, Mississippi where the devil retuned his instrument in exchange for his soul. He returned with a formidable technique and a mastery of the blues. Whatever the truth, this Faustian tale and the description of his music as the devil’s music has had lasting resonance.
Robert Johnson died in 1938, aged only 27, after a troubled life and an itinerant career. His only recordings, made a year before his death, still have a spooky quality even 80 years on. Legend has it that he was poisoned by the jealous husband of one of his many lovers

Here are some of Robert Johnson’s haunting recordings


Sweet Home Chicago

Love in Vain

Watch Eric Clapton play Love in Vain

I have collected together some blues poetry, some written at the time that blues was emerging as a distinctive music form and some more contemporary.
Finally, I would like to finish by introducing you to my favourite bluesman and hero, Mississippi John Hurt. I have included links to him performing his own songs, so please take a little time to listen to him. It’s well worth it

James Mercer Langston Hughes (1902 –1967)
James Mercer Langston Hughes was an American poet, social activist, novelist, playwright, and columnist from Joplin, Missouri. He was one of the earliest innovators of the then-new literary art form called jazz poetry. Hughes is best known as a leader of the Harlem Renaissance.
He was born in Joplin Missouri. He was the great-great-grandson of Charles Henry Langston, whose brother John Mercer Langston was the first Black American to be elected to public office. His parents divorced while he was still a small child and his mother took him to Lawrence, Kansas, where she’d grown up, while his father moved to Cuba and then Mexico. Langston and his mother start living in a state of poverty at the home of her mother, Mary Langston.
In the frequent absence of his mother, who was constantly moving around looking for work, he was raised by his grandmother until he was thirteen, when he moved to Lincoln, Illinois, to live with his mother and her new husband. It was in Lincoln that he started to write poetry. After graduation from Cleveland’s Central High School, he spent a year in Mexico with his father and a year at Columbia University. After a while he dropped out of the degree course but continued to write poetry.
Langston Hughes’s first published poem, ‘The Negro Speaks of Rivers’, was in a 1921 issue of The Crisis Magazine. This was to become one of his most famous poems, later appearing in Brownie’s Book and he included it in his first book of poetry, The Weary Blues in 1926.

The Negro Speaks of Rivers

I’ve known rivers:

I’ve known rivers ancient as the world and older than the
flow of human blood in human veins.

My soul has grown deep like the rivers.

I bathed in the Euphrates when dawns were young.
I danced in the Nile when I was old
I built my hut near the Congo and it lulled me to sleep.
I looked upon the Nile and raised the pyramids above it.
I heard the singing of the Mississippi when Abe Lincoln
went down to New Orleans, and I’ve seen it’s muddy
bosom turn all golden in the sunset.
I’ve known rivers:
Ancient, dusky rivers.
My soul has grown deep like the rivers.

Sterling A Brown 1901-1989
Sterling Brown was born in Washington, D.C., on May 1, 1901. He was educated at Dunbar High School and received a bachelor’s degree from Williams College. In 1923, he earned a master’s degree from Harvard University and was employed as a teacher at the Virginia Seminary and College in Lynchburg until 1926. Three years later, Brown began teaching at Howard University and in 1932 his first book, Southern Road, was published.
His poetry was influenced by jazz, the blues, work songs and spirituals and, like other black poets of the period, his writing expresses his concerns about race in America. Southern Road was well received by critics and Brown became part of the artistic tradition of the Harlem Renaissance, but with the arrival of the Depression, Brown could not find a publisher for his second book of verse. He turned to writing essays and focused on his career as a teacher at Howard, where he taught until his retirement in 1969. He finally published his second book of poetry, The Last Ride of Wild Bill, in 1975. Brown is known for his frank, unsentimental portraits of black people and their experiences, and the incorporation of African American folklore and contemporary idiom into his verse. He died in 1989 in Takoma Park, Maryland.

Riverbank Blues

A man git his feet set in a sticky mudbank,
A man git dis yellow water in his blood,
No need for hopin’, no need for doin’,
Muddy streams keep him fixed for good.

Little Muddy, Big Muddy, Moreau and Osage,
Little Mary’s, Big Mary’s, Cedar Creek,
Flood deir muddy water roundabout a man’s roots,
Keep him soaked and stranded and git him weak.

Lazy sun shinin’ on a little cabin,
Lazy moon glistenin’ over river trees;
Ole river whisperin’, lappin’ ‘gainst de long roots:
“Plenty of rest and peace in these . . .”

Big mules, black loam, apple and peach trees,
But seems lak de river washes us down
Past de rich farms, away from de fat lands,
Dumps us in some ornery riverbank town.

Went down to the river, sot me down an’ listened,
Heard de water talkin’ quiet, quiet lak an’ slow:
“Ain’ no need fo’ hurry, take yo’ time, take yo’
time . . .” Heard it sayin’—”Baby, hyeahs de way life go . . .”

Dat is what it tole me as I watched it slowly rollin’,
But somp’n way inside me rared up an’ say,
“Better be movin’ . . . better be travelin’ . . .
Riverbank’ll git you ef you stay . . .”

Towns are sinkin’ deeper, deeper in de riverbank,
Takin’ on de ways of deir sulky Ole Man—
Takin’ on his creepy ways, takin’ on his evil ways,
“Bes’ git way, a long way . . . whiles you can. Man got his
sea too lak de Mississippi Ain’t got so long for a whole lot longer way,
Man better move some, better not git rooted Muddy water fool you, ef you stay . . .”

Michael James O’Neill
Michael James O’Neill has worked in the world of education as a teacher, as a consultant and as a principal. He lives part of the year in the beautiful Beauce region of Québec, Canada, and the other part in the heart of South America: Cochabamba, Bolivia. He has written textbooks and materials for students of English as a second language elementary and high school levels. His fiction has been published in Foliate Oak and The Legendary.

Blues Man

Man of the blues,
Sing me a song
Plead, moan and holler those blues.

Of love and passion
And joy and sadness;
Of being alone
and being together;
Of payback to enemies,
And payback to society;
Of prisons of concrete,
And prisons of the mind;
Sing of politics for the oppressed,
And politics that oppress;
You can deal with the drudging reality of life,
You can talk of fading utopian dreams.

They say you play the Devil’s music,
That you harbor a weakness
For whiskey and wild women.
Damn them all.
It’s nobody’s business what you do.

Oh troubadour of the troubled,
Sing of the bad and the glad,
Sing of great times to be had,
Tonight, you can be my muse
And sing me out of these blues

Play your black shiny guitar
Cajole that axe, make it wail
With a dissonance that aches
Like a tormented soul.

Sing to us
Of woman and man,
Of lovers and cheaters.
Sing for the droners and loners.
You can warm chilled hearts
And can save the doomed.

Sing to me
Of the promise of new love,
Of love that mingles joy and some pain.
Serenade my sadness away,
Soothe my soul.
Release my rage,
Caress my broken heart.

Ah bard of the blue,
Sing of the bad and the glad,
Sing of great times to be had.
Tonight, be my muse
And get me out of these blues.

Michael Miller
A native of Fullerton, California, Michael Miller is the cofounder of Moon Tide Press and the author of College Town (Tebot Bach, 2010), The First Thing Mastered (Tebot Bach, 2013) and Angels in Seven (Moon Tide Press, 2016). A longtime journalist, he has written for the Los Angeles Times and other publications and won a 2014 Orange County Press Club award for his story on poets Lee Mallory and Charles Bukowski. He earned a BA from the University of California, Irvine and an MA in creative writing from the University of East Anglia. He teaches English and runs the creative writing club at Our Lady of Lourdes School in Los Angeles.

Blues Man

One century (which time let go)
lives on stubbornly in this room.
The speakers hum with tales
of Sunday gospel, police dogs on the shoals,
bootleg whiskey at the back of a bus
in Chicago after the war.
Thirty chairs and a light turned low
give shelter from the cold outside
where the word ‘legend’ is scrawled in black
by the photograph on the window.
Hoarse, white-haired, he squints at the figures
who watch him back from the crooked tables,
his fingers conjuring the notes from childhood,
his foot on the case tapping rhymes.

You’re healed now, say the thin girl’s eyes.
I’m out of change, says the man with the jar.
A couple sways in the dark by the counter;
the boys sit up front, eager, taking notes down.

Their pens sustain him. At ten, alone,
he walks by the ghosts of a college town,
the bootleggers painted solemn on
the gallery walls, Chicago beamed
into the multiplex, the gnash of police dogs
pantomimed through a flickering reel,
the bus stopping by the curb to take him
to his next one-night stand, the headlights gold
as the waitress shuts out the light,
and heads for the dead of home.

Dave Alan Walker
All I could find out about Dave Alan Walker was this personal comment
‘I write true poems, real people poems, justice poems and everything in between. My blues poems can be seen on www.earlyblues.com”


He’s just
Any old man
In any old bar
With a guitar
Then a drunk
Comes up and say’s
Play us a barre
Every line on his face
Is a hook
For a book
Every crease in his neck
Is for the pain
He had to take
So he didn’t care
About some young drunk
He just pulled up a chair
He started to play
People could do nothing but stare
At the sweet sound
Of misery and despair
As the bluesman played
The drunk fell to his knees
Tears of respect
Rolled down his face
As he felt the bluesmans fears
He took him to places he’d never been
He took him back
With the sweet sound of home
He took him
To where he had grown
His name
Was bluesman Jack

Mississippi John Hurt (1893-1966)
John Smith Hurt, better known as Mississippi John Hurt, was an American country blues singer and guitarist. Raised in Avalon, Mississippi, Hurt taught himself to play the guitar around the age of nine and within a few years he was performing at parties, doing a ragtime repertory rather than blues. As a farm hand, he lived in relative isolation, and it was only in 1916, when he went to work briefly for the railroad, that he got to broaden his horizons and his repertory beyond Avalon. In the early ’20s, he teamed up with white fiddle player Willie Narmour, playing square dances.
He was spotted by a scout for Okeh Records who passed through Avalon in 1927 and was signed to record after a quick audition. Of the eight sides that he recorded in Memphis in February of 1928, only two were ever released, but he was still asked to record in New York late in 1928.
His period of fame lasted only a short time when the depression hit and he disappeared into obscurity like so many other performers. However, with the folk revival in the 50s and 60s he was by chance, rediscovered and recorded. We now have a significant body of his work as a lasting legacy. His music is gentle, playing traditional blues and ballads. He is often referred to as a “Songster” like other musicians such as Mance Lipscomb. He plays a versatile finger picking style.
I was fortunate to visit Avalon in 2010. I met people who knew him, visited his shack and found his grave. He is buried in a wood with his wife and daughter in absolute seclusion.
Just looking at him, hearing him sing and listening to local people in Avalon, John must have been a really nice man.
I include 3 of his songs with video links to hear him perform them.

Candy Man Blues

Well all you ladies gather ’round
That good sweet candy man’s in town
It’s the candy man
It’s the candy man
He likes a stick of candy just nine inch long
He sells as fast a hog can chew his corn
It’s the candy man

All heard what sister Johnson said
She always takes a candy stick to bed
Don’t stand close to the candy man
He’ll leave a big candy stick in your hand
He sold some candy to sister Bad
The very next day she took all he had
If you try his candy, good friend of mine
You sure will want it for a long long time
His stick candy don’t melt away
It just gets better, so the ladies say

Mississippi John Hurt Candyman Live At Newport Folk Festival

Mississippi John Hurt – Candyman Blues (Live)

Coffee Blues

This is the ‘Coffee Blues’. I likes a certain brand:
Maxwell’s House, it’s good till the last drop
Just like it says on the can, I used to have a girl
Cookin’ a good Maxwell House, she moved away
Some said to Memphis and some said to Leland

But I found her, I wanted her to cook me
Some good Maxwell’s House. I understand
If I can get me just a spoonful of Maxwell’s House,
(it’ll) Do me much good as two or three cups this other coffee

(begins singing:)
I’ve got to go to Memphis, bring her back to Leland
I wanna see my baby ’bout a lovin’ spoonful, my lovin’ spoonful
Well, I’m just got to have my lovin’…

[Lyrics from: https:/lyrics.az/mississippi-john-hurt/avalon-blues-library-of-congress-sessions/coffee-blues.html]
(spoken:) I found her.

Good mornin’, baby, how you do this mornin’?
Well, please, ma’am, just a lovin’ spoon, just a lovin’ spoonful
I declare, I got to have my lovin’ spoonful
My baby packed her suitcase and she went away
I couldn’t let her stay for my lovin’, my lovin’ spoonful
Well, I’m just got to have my lovin’…

Good mornin’, baby, how you do this mornin’?
Well, please, ma’am, just a lovin’ spoon, just a lovin’ spoonful
I declare, I got to have my lovin’ spoonful

Well, the preacher in the pulpit, jumpin’ up and down
He laid his Bible down for his lovin’…
Ain’t Maxwell House all right?
Well, I’m just got to have my lovin’…

Mississipi John Hurt – Coffee Blues (acoustic blues 1928)

Casey Jones

Casey Jones was a brave engineer
He told his fireman to not to fear
Says, “All I want, my water and my coal
Look out the window, see me drive wheel roll”

Early one mornin’ came a shower of rain
‘Round the curve I seen a pa**enger train
In the cabin was Casey Jones
He’s a noble engineer, man but he’s dead and gone

Casey’s wife, she got the news
She was sittin’ on the bedside, she was lacin’ up her shoes
Said, “Go away, children and hold your breath
You’re gonna draw a pension after your daddy’s dead”

“Children, children, get your hat”
“Mama, Mama, what you mean by that?”
[Lyrics from: https:/lyrics.az/mississippi-john-hurt/avalon-blues-1963/casey-jones.html]
“Get your hat, put it on your head
Go down in town, see if your daddy’s dead”

“Mama, mama, oh, how can it be?
My daddy got k**ed on the old I.C.”
“Hush your mouth I said and hold your breath
You’re gonna draw a pension after daddy’s dead”

Casey said, before he died
Fixed the blinds so the boys can’t ride
If they ride, let ’em ride the rod
Trust they lives in the hands of God

Casey Jones was a brave engineer
He told his fireman to not to fear
Says, “All I want, my water and my coal
Look out the window, see me drive wheel roll”

Mississippi John Hurt – Casey Jones

Today’s Posts
1. The Lancet: 2·5 million more child marriages due to Covid-19 Pandemic
The COVID-19 pandemic’s damage to education and the economy could reverse decades of progress on child marriage and pregnancy. Sophie Cousins reports.
Up to 2·5 million more girls around the world are at risk of marriage in the next 5 years because of the COVID-19 pandemic, Save the Children has warned.
In its Global Girlhood Report 2020, the charity warned of 2020 being a year of “irreversible setbacks and lost progress” for girls, predicting that 500 000 more girls are at risk of being forced into child marriage this year alone and 1 million more are expected to become pregnant. This increase will bring the total number of child marriages to around 12·5 million in 2020.
Gabrielle Szabo, senior gender policy adviser at Save the Children UK and author of the report, told The Lancet that the pandemic threatened to reverse 25 years of progress on child marriage, fuelled by school closures and economic destitution.

2. UK: BBC: ‘Long Covid’: Why are some people not recovering?
For most people, Covid-19 is a brief and mild disease but some are left struggling with symptoms including lasting fatigue, persistent pain and breathlessness for months. The condition known as “long Covid” is having a debilitating effect on people’s lives, and stories of being left exhausted after even a short walk are now common.
So far, the focus has been on saving lives during the pandemic, but there is now a growing recognition that people are facing long-term consequences of a Covid infection. Yet even basic questions – such as why people get long Covid or whether everyone will fully recover – are riddled with uncertainty.
What is long Covid?: There is no medical definition or list of symptoms shared by all patients – two people with long Covid can have very different experiences. However, the most common feature is crippling fatigue.

3. UK: BBC: Coronavirus: Specialist ‘long Covid’ clinics to be set up in England
People with “long Covid” symptoms will be offered specialist help at clinics across England, the head of NHS England has announced.
Sir Simon Stevens said there were “tens of thousands, probably hundreds of thousands” of patients affected.
People with relatively mild coronavirus infections as well as those who have been treated in intensive care can have persistent health problems for months.
The most common symptom of long Covid is crippling fatigue.
But breathlessness, joint pain, anxiety, brain fog and many other symptoms have also been reported.
And some estimates suggest one in 10 of those infected with the virus could be affected.

4. NEJM: Clinical Practice: Severe Covid-19
This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors’ clinical recommendations.
A 50-year-old, previously healthy man presents to the emergency department with 2 days of worsening dyspnea. He had fever, cough, and fatigue during the week before presentation. He appears acutely ill. The body temperature is 39.5°C (103°F), heart rate 110 beats per minute, respiratory rate 24 breaths per minute, and blood pressure 130/60 mm Hg. The oxygen saturation is 87% while the patient is breathing ambient air. The white-cell count is 7300 per microliter with lymphopenia. Chest radiography shows patchy bilateral opacities in the lung parenchyma. A reverse-transcriptase–polymerase-chain-reaction assay detects the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in a nasopharyngeal swab. How would you evaluate and manage this case?

5. The Lancet: Food for thought during school closures
Since March, 2020, countries around the world have imposed nationwide school closures in an attempt to help reduce the burden of COVID-19. Ensuring that children safely return to the classroom at the start of the new school year has been a top priority for many nations in the northern hemisphere. Unfortunately, school attendance has been patchy, with schools in areas with high infection rates remaining closed. In other places, entire year groups have been asked to self-isolate for 14 days if a positive case is found in the same year group or contact bubble.
The true cost of keeping schools closed for long periods of time is difficult to evaluate because the effect goes well beyond the obvious disruption to learning and social development. One of the less apparent consequences of school closure is the double impact on childrens’ nutrition. On one hand, there is concern that rates of overweight and obesity will increase owing to the lack of opportunities for children to be physically active and the skipping of regular healthy meals, which might instead get replaced by all-day snacking. On the other hand, children who depend on free or reduced-price school meals might no longer have adequately nutritious diets. In one study in the USA, researchers estimated that between March 9 and May 1, students who receive free and reduced-price meals missed more than 1·15 billion school breakfasts and lunches because of school closures. In the UK, a voucher system was announced in March to provide support to low-income families whose children were eligible for free school meals, but the programme did not run as smoothly as hoped.

6. The Lancet Global Health: Effect of the COVID-19 pandemic response on intrapartum care, stillbirth, and neonatal mortality outcomes in Nepal: a prospective observational study
The COVID-19 pandemic response is affecting maternal and neonatal health services all over the world. We aimed to assess the number of institutional births, their outcomes (institutional stillbirth and neonatal mortality rate), and quality of intrapartum care before and during the national COVID-19 lockdown in Nepal.
Institutional childbirth reduced by more than half during lockdown, with increases in institutional stillbirth rate and neonatal mortality, and decreases in quality of care. Some behaviours improved, notably hand hygiene and keeping the baby skin-to-skin with their mother. An urgent need exists to protect access to high quality intrapartum care and prevent excess deaths for the most vulnerable health system users during this pandemic period.

7. The Lancet: Mental health: time to invest in quality
The theme of this year’s World Mental Health Day, on Oct 10, is increased investment in mental health. Why invest, and why now? The answer is simple. At the best of times, good mental health is needed for a society to thrive. During a pandemic, good mental health is more important than ever. Without a focus on mental health, any response to COVID-19 will be deficient, reducing individual and societal resilience, and impeding social, economic, and cultural recovery.
2020 has been a difficult year for mental health. The threat of infection, repeated lockdowns, social isolation, and economic uncertainty have created widespread fear and anxiety. A Rapid Review published in The Lancet showed the negative psychological effects of enforced quarantines. Many people who previously thought themselves unaffected by mental health issues have discovered that they, too, are vulnerable. Those with pre-existing mental health conditions have often found their difficulties increased. The precise neurological and psychiatric consequences of infection, meanwhile, remain unknown but demand careful monitoring. What investment is needed from governments and non-governmental organisations to mitigate the mental health impact of COVID-19 and, more importantly, to improve mental health globally?
S ED Mental

8. NEJM: Clinical Practice: Mild or Moderate Covid-19
This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors’ clinical recommendations.
A 73-year-old man with hypertension and chronic obstructive pulmonary disease calls to report that he has had a fever (maximal temperature, 38.3°C) and a dry cough for the past 2 days. He notes that his shortness of breath has worsened. His medications include losartan and inhaled glucocorticoids. He lives alone. How should he be evaluated? If he has coronavirus disease 2019 (Covid-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), then how should he be treated?

9. International: NPR: 10% Of Global Population May Have Contracted The Coronavirus, WHO Says
About 10% of the global population may have been infected by the coronavirus, according to a senior World Health Organization official.
It’s an estimate that’s far higher than the total of global confirmed cases reported by governments. At the same time, it would mean that most of the world’s population is still vulnerable to getting infected and this pandemic is far from over, the WHO’s head of emergencies Dr. Michael Ryan said Monday.
“This varies by country, it varies urban to rural, it varies by different groups,” Ryan said. “But what it does mean is that the vast majority of the world remains at risk.”
The WHO’s executive board is meeting in a special session Monday and Tuesday to review the WHO’s handling of the coronavirus pandemic.
The meeting at the WHO’s headquarters in Geneva and online comes as the world has officially tallied more than 35 million coronavirus cases and more than 1 million fatalities. The WHO’s Director-General, Tedros Adhanom Ghebreyesus, said the actual number of deaths from COVID-19 is certainly higher. “Numbers can blind us to the reality that every single life lost is someone who loved and was loved by others – someone’s mother, father, sister, brother, daughter or son,” Tedros said through a mask as he opened the meeting.

10. International: UN News: 70 per cent of COVID cases located in just 10 countries, WHO reports
Globally, there were more than 35 million cases of COVID-19 as of Monday, and more than one million deaths. Dr. Michael Ryan, WHO Emergencies Director, reported that the pandemic continues to evolve, with a surge in Southeast Asia, an “upward trajectory” in the northern hemisphere, and an increase in cases and deaths in Europe and the Eastern Mediterranean. Meanwhile, the situation “is currently rather more positive” in Africa and the Western Pacific. “Our current best estimates tell us that about 10 per cent of the global population may have been infected by this virus. This varies depending on country; it varies from urban to rural; it varies between different groups. But what it does mean is that the vast majority of the world remains at risk”, said Dr. Ryan. “We know the pandemic will continue to evolve. But we also know we have the tools that work to suppress transmission and save lives right now, and they are at our disposal. The future depends on the choices we collectively make about how we use those tools; develop, scale-up and distribute others.”
Tedros outlined four scenarios countries are facing during the crisis.
Some nations took quick and decisive action against the pandemic, thus avoiding large outbreaks. And while some countries suffered large outbreaks, they were able to bring them under control and suppress the virus.
“Third, while some countries brought the virus under control, as economies and societies have eased restrictions, there has been an increase in cases”, he continued. And fourth, there are still some countries in the “intense phase of transmission.” Tedros stressed that “every situation can be turned around”, underlining the importance of strong leadership, clear and comprehensive strategies, consistent communication, as well as engaging the population.

11. The Lancet: COVID-19 and clean air: an opportunity for radical change
The COVID-19 pandemic has caused more than 30 million infections and 960 000 deaths, causing disease in almost every country worldwide. Like all pandemics, it has laid bare and exploited social inequalities, and caused disproportionate damage to low-income families, people with poor health, and minority and marginalised groups. A further consequence of this pandemic has been economic havoc of a magnitude not seen since 1932. This downturn is projected to wipe out 200 million jobs worldwide. The previously unimaginable prospect of a second Great Depression seems possible. Yet, among all this suffering, two events have unfolded that suggest that this time of crisis could also be a time of fundamental, even revolutionary, change.
The first has been the global rise of the Black Lives Matter movement. In the aftermath of the killings of Ahmaud Arbery and George Floyd, millions of people in countries across the globe have risen together as one to denounce hatred and racism and to call for an end to the social and economic inequalities—the structural violence—that underlie the disproportionate effects of COVID-19 on people of low-income and racial minority backgrounds.
The second has been a remarkable worldwide reduction in ambient air pollution. These decreases are so great that they can be seen from outer space In northern India, air pollution is at a 20-year low and concentrations of fine particulate matter (PM2·5) in New Delhi have fallen by more than 50%. In Europe, nitrogen dioxide concentrations have fallen by 40% and PM2·5 concentrations by 10%. In New York and Los Angeles, PM2·5 concentrations are 25–30% lower than concentrations from the same month a year ago.

12. The Lancet: Health and climate change: policy responses to protect public health
The 2015 Lancet Commission on Health and Climate Change has been formed to map out the impacts of climate change, and the necessary policy responses, in order to ensure the highest attainable standards of health for populations worldwide. This Commission is multidisciplinary and international in nature, with strong collaboration between academic centres in Europe and China.

13. NEJM: Perspective: Seizing the Teachable Moment — Lessons from Eisenhower’s Heart Attack
One reason to study history is to avoid repeating past mistakes; another is to understand what went right. For both reasons, it is worth stepping back from the flood of information surrounding the hospitalization of President Donald Trump for Covid-19 and recalling the events surrounding the heart attack of President Dwight Eisenhower in 1955 — including the crucial role played by cardiologist Paul Dudley White.
The news of Eisenhower’s heart attack was as dramatic for Americans as the revelation that Trump had Covid-19. “Two events in my lifetime shook me severely,” wrote Dr. Leonard Scheele, the U.S. surgeon general at the time. “One was the announcement of the president’s coronary thrombosis, and the other was the announcement of the Japanese raid on Pearl Harbor.”
Eisenhower’s myocardial infarction began on Friday, September 23, 1955, while he was playing golf in Denver. At first, he attributed his discomfort to the hamburger he’d had for lunch. He went back to the house where he was a guest, continued to have what he thought was intermittent “indigestion,” then awoke around 2 a.m. with severe chest pain. His wife, Mamie, called Eisenhower’s personal physician, who arrived about 3 a.m.

14. Mali: AP News: UN chief: COVID-19 compounds dire situation in Mali, Sahel
U.N. Secretary-General Antonio Guterres said the coronavirus pandemic has compounded the “dire humanitarian and security situations” in Mali and Africa’s Sahel region.
The U.N. chief said in a report to the Security Council obtained Thursday by The Associated Press that the deteriorating security situation “remains of grave concern with terrorist groups allied with al-Qaida and Islamic State competing for control over areas of influence.”
Guterres said terrorist attacks against civilians, Malian and international forces are continuing in northern and central Mali, posing the most significant security threat in the north. He said clashes between al-Qaida and the Islamic State group have also been reported.

15. The Lancet: The intersection of COVID-19 and mental health
On Oct 6, 2020, WHO published the results of a survey of the impact of COVID-19 on mental, neurological, and substance use (MNS) services in 130 WHO Member States, ahead of World Mental Health Day on Oct 10. The survey revealed that most countries are experiencing some disruption to MNS services, with the greatest impact on community-based and prevention and promotion services. Reasons for disruption included an insufficient number or redeployment of health workers to the COVID-19 response (in 30% of countries), use of mental health facilities as COVID-19 quarantine or treatment facilities (in 19% of countries), and insufficient supply of personal protective equipment (in 28% of countries). Although 116 (89%) countries reported that mental health and psychological support was part of their national COVID-19 response plans, only 17% said they had committed additional funding for this. This report comes on the back of mounting evidence that the COVID-19 pandemic is having monumental effects on the mental health and wellbeing of populations worldwide. With seemingly low capacity to respond, it is unclear how the world will deal with this looming mental health crisis.
Historical examples show the detrimental impact events such as a pandemic can have on the mental health of affected populations. For example, research from communities affected by outbreaks of Ebola virus disease (EVD) revealed widespread panic and anxiety, depression resulting from the sudden deaths of friends, relatives, and colleagues, and stigmatisation and social exclusion of survivors. A meta-analysis found that depressed mood, anxiety, impaired memory, and insomnia were present in 33–42% of patients admitted to hospital for severe acute respiratory syndrome or Middle East respiratory syndrome, and that in some cases these effects continued beyond recovery.
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16. UK: RCGP Learning: Long COVID-19
COVID-19 is a new disease and we are increasingly presented with patients who suffer from persistent and cyclical symptoms after their initial infection, independent of its severity. People have started calling this phenomenon ‘Long COVID” and those struggling with persistent symptoms are calling themselves ‘long haulers’. In conjunction with the course Recovery from COVID , this module will summarise what we know so far about sequelae of COVID-19 and reflect on on how we can support our patients in times of uncertain evidence. We will focus on the psychological sequelae after the previous coronavirus outbreaks, such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).
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17. NEJM: Perspective: Covid-19, Ebola, and HIV — Leveraging Lessons to Maximize Impact
As researchers who have long experience with HIV/AIDS prevention, vaccines, and therapies, some of whom also have experience with Ebola, we believe it is critical to build the response to the Covid-19 pandemic on lessons from the HIV pandemic and recent Ebola outbreaks.
First and foremost, those epidemics have taught us that interventions must be based on sound science. As in the early days of AIDS, we face many uncertainties about the epidemiology, clinical presentation, and natural history of a new virus. SARS-CoV-2 science is therefore evolving quickly, which adds to the complexity of decision making, communication, and development and sustainability of public trust. Yet Covid-19 presents an important opportunity for smart deployment of our hard-won knowledge.
HIV/AIDS has taught us the value and imperative of involving affected communities in planning and implementation of research and care. And both HIV and Ebola have shown that accurate and timely local information are required to enable and guide tailored interventions; public health and medical experts should heed the slogan “Know your epidemic” and target interventions accordingly.

18. Nature: Face masks: what the data say: The science supports that face coverings are saving lives during the coronavirus pandemic, and yet the debate trundles on. How much evidence is enough?
When her Danish colleagues first suggested distributing protective cloth face masks to people in Guinea-Bissau to stem the spread of the coronavirus, Christine Benn wasn’t so sure.
“I said, ‘Yeah, that might be good, but there’s limited data on whether face masks are actually effective,’” says Benn, a global-health researcher at the University of Southern Denmark in Copenhagen, who for decades has co-led public-health campaigns in the West African country, one of the world’s poorest.
That was in March. But by July, Benn and her team had worked out how to possibly provide some needed data on masks, and hopefully help people in Guinea-Bissau. They distributed thousands of locally produced cloth face coverings to people as part of a randomized controlled trial that might be the world’s largest test of masks’ effectiveness against the spread of COVID-19.
Face masks are the ubiquitous symbol of a pandemic that has sickened 35 million people and killed more than 1 million. In hospitals and other health-care facilities, the use of medical-grade masks clearly cuts down transmission of the SARS-CoV-2 virus. But for the variety of masks in use by the public, the data are messy, disparate and often hastily assembled. Add to that a divisive political discourse that included a US president disparaging their use, just days before being diagnosed with COVID-19 himself. “People looking at the evidence are understanding it differently,” says Baruch Fischhoff, a psychologist at Carnegie Mellon University in Pittsburgh, Pennsylvania, who specializes in public policy. “It’s legitimately confusing.”

19. South America: Washington Post: ‘There are no words’: As coronavirus kills Indigenous elders, endangered languages face extinction
The old man knew he was dying. The disease he’d been warning of for weeks had taken hold, and it wouldn’t be long now. He looked to his son, who would soon be the leader of what remained of their people.
The old man was fluent in five languages, but the one he chose to speak now was one that virtually no one else in the world could understand. “Awiri nuhã,” Aritana Yawalapiti, 71, said in the language of the Yawalapiti, an Indigenous tribe in the Amazon rainforest. “Take care of the people. Take care of the land. Take care of the forest.” With Aritana’s death, his son Tapi became the new leader of a people beset by disease and illegal loggers. And the number of people who speak their language fluently dropped from three to two, both of whom are well into their 70s.

20. NEJM: Dying in a Leadership Vacuum
Covid-19 has created a crisis throughout the world. This crisis has produced a test of leadership. With no good options to combat a novel pathogen, countries were forced to make hard choices about how to respond. Here in the United States, our leaders have failed that test. They have taken a crisis and turned it into a tragedy.
The magnitude of this failure is astonishing. According to the Johns Hopkins Center for Systems Science and Engineering,1 the United States leads the world in Covid-19 cases and in deaths due to the disease, far exceeding the numbers in much larger countries, such as China. The death rate in this country is more than double that of Canada, exceeds that of Japan, a country with a vulnerable and elderly population, by a factor of almost 50, and even dwarfs the rates in lower-middle-income countries, such as Vietnam, by a factor of almost 2000. Covid-19 is an overwhelming challenge, and many factors contribute to its severity. But the one we can control is how we behave. And in the United States we have consistently behaved poorly.
We know that we could have done better. China, faced with the first outbreak, chose strict quarantine and isolation after an initial delay. These measures were severe but effective, essentially eliminating transmission at the point where the outbreak began and reducing the death rate to a reported 3 per million, as compared with more than 500 per million in the United States. Countries that had far more exchange with China, such as Singapore and South Korea, began intensive testing early, along with aggressive contact tracing and appropriate isolation, and have had relatively small outbreaks. And New Zealand has used these same measures, together with its geographic advantages, to come close to eliminating the disease, something that has allowed that country to limit the time of closure and to largely reopen society to a prepandemic level. In general, not only have many democracies done better than the United States, but they have also outperformed us by orders of magnitude.

21. Zambia: NPR: Who Do People Trust For Coronavirus Info? In Zambia, It’s Nuns On The Radio
A nun in headphones is on the radio — offering expectant families advice for stimulating fetal development. “Tell the husband to pat [your] tummy,” she laughs. “And speak to the [baby]!” When Sister Astridah Banda, a Catholic nun and social worker in Zambia, first went on the air, she recalls that people were jolted by her manner. “People are always surprised to see sisters can joke,” she says. “They think you’re always serious and praying – and in such instances, I look at myself and say ‘Madame, you and I are one and the same.”
And now she’s branching out in her subject matter with a show she started in March — the “COVID-19 Awareness Programme.”
The many languages of her homeland are what inspired the 36-year-old to start the program.
COVID-19 struck the nation in March, and the case mark passed the 1,000 in late May, with 7 recorded deaths to date – though some researchers say those figures are likely undercounts.
Much of the vital health information surrounding the disease was being shared English, says Banda, who lives in the capital city of Lusaka.
While English is Zambia’s official language, many citizens speak a dialect from the Bantu family. And there are over 70 languages spoken across the nation.

22. UK: RCGP Learning: Coronavirus – Top 10 tips on what to do in primary care
Consider your balance between remote and face to face care – have you got it right and how might it need to change in the months to come?
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23. International: New York Times: Contact Tracing, Key to Reining In the Virus, Falls Flat in the West
Tracing is seen as a vital tool to avoid lockdowns and open economies, but that requires a robust system, widespread rapid testing and public trust. All are lacking in the West. As the coronavirus stampeded across Europe and the United States this spring, governments made their depleted citizens a tantalizing promise: Soon, legions of disease detectives would hunt down anyone exposed to the virus, confining them to their homes and letting everyone else get on with their lives.
Nearly eight months on, as a web of new infections spreads across Europe and the United States, that promise has nearly evaporated.
Despite repeated vows by Western nations to develop “world-beating” testing and tracing operations, those systems have been undone by a failure of governments to support citizens through onerous quarantines or to draw out intimate details of their whereabouts. That has shattered the hope of pinpoint measures replacing lockdowns and undermined flagging confidence in governments.
Beholden to privacy rules, Western officials largely trusted people to hand over names to contact tracers. But that trust was not repaid, in large part because governments neglected services that were crucial to winning people’s cooperation: a fast and accurate testing system, and guarantees that people would be housed, fed and paid while they isolated.

24. USA: Washington Post: White House signals stronger coronavirus precautions, but Trump continues to resist
The White House offered an informal nod to coronavirus best practices Tuesday, with mask-wearing prevalent after months of flouting public health recommendations and new internal guidelines for interacting with President Trump, who tested positive for the virus late last week.
But the biggest source of resistance appeared to be Trump himself, who, despite having just come home from a three-night hospitalization, was defiant — lobbying to return immediately to work in the Oval Office, discussing an address to the nation as early as Tuesday evening and clamoring to get back on the campaign trail in the coming days. At least nine White House employees have now tested positive for the virus, including senior adviser Stephen Miller, who got his result late Tuesday, a senior administration official said. Trump’s aides, allies and advisers find themselves grappling with how to implement more safety measures and precautions without displeasing their boss, who continues to say — as he did in a tweet Monday — “Don’t be afraid of Covid. Don’t let it dominate your life.”

25. Africa: Washington Post: Africa has defied the covid-19 nightmare scenarios. We shouldn’t be surprised.
After the novel coronavirus first appeared in Africa in late February, Ghana’s government decided it would take no chances. Ghanaian citizens were soon put under lockdown, and travel between major cities was banned. Then President Nana Akufo-Addo announced the closure of the country’s land and sea borders.
At the time, my dad was in Ghana visiting family, and he faced the prospect of being stuck until commercial flights resumed. As experts predicted how the pandemic would be a unique and devastating disaster in Africa, my siblings and I scrambled to get my father a spot on a State Department repatriation flight for U.S. citizens. We rushed to get him out because we thought he would be better off in the United States.
But after he got back to Texas, the number of cases there started to rise, and I joked with him that he would have been safer in Ghana. “Ghana is doing much better with this than America,” he had said after I picked him up from the airport, amused that I sprayed down the entire car with disinfectant before making him sit in the back seat, away from me.

26. South Asia: The Conversation: South Asia: how to ensure progress on reducing poverty isn’t reversed by coronavirus
South Asia accounted for nearly two-fifths of the world’s poor, nearly half of the world’s malnourished children and was home to the largest number of stunted children in 2015. Despite this, the region had made significant progress in lifting people out of poverty – and between 1990 and 2015 its poverty rate sharply declined from 52% to 17%. Sustaining such progress in the region is key to achieving the global targets of the UN’s Sustainable Development Goals (SDGs) before 2030. But this trend could be reversed due to COVID-19. Globally, as many as 400 million people could be pushed into poverty by the pandemic. Restoring the pre-pandemic trend in poverty reduction in South Asia will be challenging, but not impossible. During the era of the Millennium Development Goals (MDGs) between 1990 and 2015, South Asia’s achievements in reducing poverty and improving human development masked an uneven pattern of progress. There were significant differences in child mortality and income poverty reduction across the region – for example Bangladesh experienced exceptional improvements, while progress was limited in Pakistan and India. Yet there are important lessons from this era that can help accelerate future progress in post-pandemic South Asia.

27. International: IPS News: Will COVID-19 Change the Global Balance of Power?
Lockdowns, social distancing, face-masks and other restrictions on personal and social behaviour have helped slow the progress of the COVID-19 virus. Enough to allow health systems to start catching their breath, for doctors to work out treatment protocols, and for work to start on a vaccine. There is now a need to take stock of the many other impacts the pandemic is likely to have, particularly at the economic and political level.
In terms of short to medium term impacts, the developed countries have been the hardest hit in terms of mortality, and their economies are projected by the IMF to shrink by 8% over 2020. More critically, the economic contraction will disproportionately impact the poor in these countries and accentuate the inequality that has been rising over the last 30 years. The US stock market has regained all losses despite the fact that millions are jobless. The tech giants continue to post immense profits. Jeff Bezos, founder and major shareholder of Amazon, is now the richest man on earth with a net worth of over US$200 billion – this means that if he were to live another 40 years, and wanted to use all his money before dying, he would need to spend almost US$14 million a day! This, at a time when a growing number of people cannot afford decent housing, adequate clothing and proper nutrition.
It has become clear that widespread disease and death, helplessly watching one’s loved ones die, and being turned away from hospitals, are not things that happen only in poor countries. In contrast to what is happening in the advanced economies, many developing countries – particularly in Africa and Asia – have experienced lower mortality rates. This differential impact could be due to demographics – with the younger population in these countries proving more resilient. Or it could be due to their more frequent exposure to other viruses which have built up their immunity levels. In some countries such as China, Viet Nam and South Korea it was clearly due to the Governments’ containment measures and the high levels of conformity to government guidelines.

28. UK: The Guardian: Manchester students organising ‘Covid Positive’ parties
Infection incidence rate in 17-21 age group is six times higher than the rest of the city
Dress codes are nothing new to students going out in Manchester – no trainers, no football shirts and, increasingly, no man bags. But one student party this weekend had a special entry requirement: Covid.
According to one fresher at the University of Manchester, the “Covid Positive” party in the university’s Fallowfield campus halls of residence was broken up by security on Saturday. It is just one of the increasing instances of students’ risky behaviour during lockdown restrictions.
“There was a flat party a few days ago which had a policy that you could only get in if you were positive. It was like their health-and-safety measure,” the 18-year-old physics student said.
Had security not arrived it could have been a big party. According to David Regan, Manchester’s director of public health, the incidence rate in the city’s 17-21 undergraduate age group is now 2,935 for every 100,000 people – almost six times higher than the rest of Manchester, which itself now has the highest rate in the UK.
By Sunday, 1,041 University of Manchester students had tested positive, most of them living in halls, plunging thousands of others into isolation. A smaller outbreak at nearby Manchester Metropolitan University in late September was deemed serious enough to force 1,700 students into a two-week quarantine, with 531 positive cases in the first two weeks of term.

29. Nature Editorial: Why Nature needs to cover politics now more than ever
Science and politics are inseparable — and Nature will be publishing more politics news, comment and primary research in the coming weeks and months.
Since Nature’s earliest issues, we have been publishing news, commentary and primary research on science and politics. But why does a journal of science need to cover politics? It’s an important question that readers often ask.
This week, Nature reporters outline what the impact on science might be if Joe Biden wins the US presidential election on 3 November, and chronicle President Donald Trump’s troubled legacy for science. We plan to increase politics coverage from around the world, and to publish more primary research in political science and related fields.
Science and politics have always depended on each other. The decisions and actions of politicians affect research funding and research-policy priorities. At the same time, science and research inform and shape a spectrum of public policies, from environmental protection to data ethics. The actions of politicians affect the higher-education environment, too. They can ensure that academic freedom is upheld, and commit institutions to work harder to protect equality, diversity and inclusion, and to give more space to voices from previously marginalized communities. However, politicians also have the power to pass laws that do the opposite.

30. USA: Nature: How Trump damaged science — and why it could take decades to recover
The US president’s actions have exacerbated the pandemic that has killed more than 200,000 people in the United States, rolled back environmental and public-health regulations and undermined science and scientific institutions. Some of the harm could be permanent.
People packed in by the thousands, many dressed in red, white and blue and carrying signs reading “Four more years” and “Make America Great Again”. They came out during a global pandemic to make a statement, and that’s precisely why they assembled shoulder-to-shoulder without masks in a windowless warehouse, creating an ideal environment for the coronavirus to spread.
US President Donald Trump’s rally in Henderson, Nevada, on 13 September contravened state health rules, which limit public gatherings to 50 people and require proper social distancing. Trump knew it, and later flaunted the fact that the state authorities failed to stop him. Since the beginning of the pandemic, the president has behaved the same way and refused to follow basic health guidelines at the White House, which is now at the centre of an ongoing outbreak. The president spent 3 days in a hospital after testing positive for COVID-19 and was released on 5 October.
Trump’s actions — and those of his staff and supporters — should come as no surprise. Over the past eight months, the president of the United States has lied about the dangers posed by the coronavirus and undermined efforts to contain it; he even admitted in an interview to purposefully misrepresenting the viral threat early in the pandemic. Trump has belittled masks and social-distancing requirements while encouraging people to protest against lockdown rules aimed at stopping disease transmission. His administration has undermined, suppressed and censored government scientists working to study the virus and reduce its harm. And his appointees have made political tools out of the US Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA), ordering the agencies to put out inaccurate information, issue ill-advised health guidance, and tout unproven and potentially harmful treatments for COVID-19.

Africa: Nature: COVID-19 vaccines: how to ensure Africa has access
History must not repeat itself — global and continental cooperation are essential.
Last month, a grand experiment was launched. Its aim? To speed up the development of COVID 19 vaccines and make sure they are distributed equitably among higher- and lower-income countries.
This welcome endeavour is called the COVID-19 Vaccine Global Access (COVAX) initiative. It is co-led by the World Health Organization (WHO), the Coalition for Epidemic Preparedness Innovations (CEPI) and Gavi, the Vaccine Alliance. As of 1 October, 167 countries have signed up, covering nearly two-thirds of the global population. More have expressed interest, according to Gavi.
The initiative covers several vaccines currently in testing. It aims to ensure access to whichever ones prove to be effective. Under this scheme, even poor nations should have enough vaccines to protect health-care workers and the most vulnerable 20% of their populations. Still, Africa has reasons to worry. Already, several high-income countries have signed their own contracts with individual companies to buy selected vaccines. The United States, for example, has made deals worth upwards of US$6 billion with several firms. An analysis by the international charity Oxfam finds that, even if all five of the most-advanced vaccine candidates succeed, there will not be enough vaccine for most of the world’s people until 2022.

31. USA: Bloomberg: Prognosis: Early Covid Treatments Could Be a ‘Bridge’ to Vaccine
Monoclonal antibodies that stop the coronavirus from spreading in the body are among promising strategies for averting severe illness from Covid-19 before vaccines arrive, said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Antibody-based medications, other blood products from recovered patients and antivirals are being investigated as early treatments, Fauci said. The aim is to prevent patients from developing the serious lung damage for which Gilead Sciences Inc.’s remdesivir and the anti-inflammatory drug dexamethasone are administered.
“We are focusing very heavily now on treatment of early infection and, or prevention of infection,” Fauci told the Journal of the American Medical Association in an interview Friday. “And that’s the bridge to the vaccine.”

32. USA: Washington Post: Some covid-19 rule-breakers could be narcissists, experts say. Here’s how to approach them.
Susan Whitbourne was shopping recently in her neighborhood Whole Foods in Framingham, Mass., when another patron caught her eye. The man, who was chatting on his cellphone as he meandered around the store, had pulled his face covering down — a violation of Massachusetts’s statewide mask mandate.
Summoning her courage, Whitbourne, a professor emerita of psychological and brain sciences at the University of Massachusetts at Amherst, approached the unmasked shopper and reminded him of the rules. He replied, “Well, I’m talking on the phone,” she recalled.
Whitbourne believes that “teeny, tiny slice of behavior” may have been a sign of an unwholesome personality trait that could explain some of the resistance to masks in America: narcissism. Several recent studies have similarly concluded that narcissistic behavior may be contributing to noncompliance with public health guidelines during the coronaviruspandemic.

33. International: UN News: COVID-19 disrupting critical mental health services, WHO warns
Announcing the findings on Monday, the UN health agency also said that the pandemic has increased the need for the vital services.
“COVID-19 has interrupted essential mental health services around the world just when they’re needed most,” said Tedros Adhanom Ghebreyesus, WHO Director-General, calling on world leaders to “move fast and decisively to invest more in life-saving mental health programmes – during the pandemic and beyond.”
“Good mental health is absolutely fundamental to overall health and well-being,” he added.
Bereavement, isolation, loss of income and fear are triggering mental health conditions or exacerbating existing ones. Many people may be facing increased levels of alcohol and drug use, insomnia, and anxiety, according to WHO.
COVID-19 itself can lead to neurological and mental complications, such as delirium, agitation, and stroke. People with pre-existing mental, neurological or substance use disorders are also more vulnerable to SARS-CoV-2 infection – they may stand a higher risk of severe outcomes and even death.
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34. USA: Washington Post: ‘Unjustifiable hysteria’: Republican recalcitrance about the virus persists even as GOP faces growing turmoil
(Note: GOP is the Republican Party)
Widespread Republican recalcitrance about federal health guidelines showed few signs of waning on Monday, even as the party faces growing turmoil following President Trump’s hospitalization and as more White House aides test positive for the novel coronavirus.
White House press secretary Kayleigh McEnany and at least two of her deputies have now contracted the virus, further derailing the functioning of a West Wing plunged into crisis and adding to a long list of top Republicans who have been infected.
But many Republicans continue to dismiss calls for alarm about the virus’s spread — and for changes to the party’s message on the pandemic.
Sen. Ron Johnson (R-Wis.), who tested positive last week, said in an interview with a conservative talk-show host that there is “a level of unjustifiable hysteria” about a virus that has killed nearly 210,000 Americans and asked, “Why do we think we actually can stop the progression of a contagious disease?”

35. CDC: Washington Post: CDC says airborne transmission plays a role in coronavirus spread in a long-awaited update after a website error last month
The agency updated its website to warn that tiny viral particles can sometimes travel farther than six feet and linger in the air for hours.
The Centers for Disease Control and Prevention acknowledged Monday that people can sometimes become infected with the novel coronavirus through airborne transmission, especially in enclosed spaces with inadequate ventilation.
The long-awaited update to the agency Web page explaining how the virus spreads represents an official acknowledgment of growing evidence that under certain conditions, people farther than six feet apart can become infected by tiny droplets and particles that float in the air for minutes and hours, and that they play a role in the pandemic.
The update follows an embarrassing incident last month when the agency removed a draft that had not gone through proper review and was posted in error. The draft’s wording included a reference to aerosols — tiny droplets that can stay in the air, potentially traveling a significant distance. Officials said the draft was removed because they feared the language could be misinterpreted as suggesting that airborne transmission is the main way the virus spreads.

36. Japan: CBS News: Why Japanese researchers say there’s “no reason” to keep doing painful COVID nasal swab tests
Researchers in Japan announced “game changing” research this week that found simple saliva tests for COVID-19 are just as reliable as the widely used, but more complicated and uncomfortable, swab tests. The study involved testing almost 2,000 people who were showing no symptoms of the coronavirus using both saliva and the familiar nasal swab.
The results have already upended conventional wisdom about mass screening in Japan.
“Now it’s clear by our data that sensitivity and specificity are the same” for saliva and swab tests, research team leader Takanori Teshima of Hokkaido University told CBS News. Given the importance public health experts put on mass-screening for asymptomatic carriers of the virus, Teshima said the strong evidence that simple, non-invasive saliva tests are just as effective as the far more common “PCR” tests is “game changing.”

37. International: BBC: Coronavirus: How to tell which countries are coping best with Covid
As the Covid crisis has unfolded, infection rates have fluctuated and restrictions have proliferated. But it has always felt that there was one idea to cling to: that by working out which countries were doing well – and which were not – there was something to be learned. After all, historians will surely puzzle over how the countries of Western Europe, with broadly similar economies, produced such drastically different outcomes. So far, at least. We use international comparisons all the time, of course – they’re a way of measuring how our own governments are doing. But even comparing the simplest data can be complex. There can be differences in how and when death is reported, how co-morbidities are reflected on death certificates, and for how long after a positive test a death is considered to be Covid-related. All will influence how a country’s performance at any given moment is measured. For the moment, the gaps in performance appear to be startling.

38. Bangladesh: Population Health: Telepsychiatry as a mental health intervention for garment workers in Bangladesh: A ‘Need of Hour’ during COVID-19?
The global effects on the world economy of the COVID-19 pandemic has caused clothing brands and retailers to reduce their orders. This has put millions of garment workers in Bangladesh at risk of losing their job. Bangladesh Garments Manufacturers and Exporters Association (BGMEA) reported recent order cancellations worth of 3.18 billion US$ from 1150 garment factories, resulting in 2.28 million workers remaining unpaid and 1 million losing their jobs1. These workers, primarily women and often the only breadwinner of their family, will subsequently suffer from acute poverty and food insecurity, resulting in an increased number of human rights abuses such as domestic violence. A past UK-funded study found 60% of female workers faced physical and/or verbal abuse2. Poor workplace conditions, low wages and few benefits within the employment facilities predispose garment workers to serious mental illness. In addition to global lockdowns and unprecedented job losses, garment workers’ fear of contracting COVID-19, amidst this humanitarian crisis, will likely cause greater emotional and mental turmoil. The same UK-funded study also reported that 40% of female garment workers suffer from depressive symptomatology, and their analysis revealed intimate-partner violence, work- related stress, poor general health, low self-esteem and low life satisfaction, likely contributing to their symptoms2. The degree of vulnerability to mental health problems indicates the need for increased mental health care for this vulnerable group of workers.
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39. UK The Guardian: Covid: how Excel may have caused loss of 16,000 test results in England
Public Health England data error blamed on limitations of Microsoft spreadsheet
A million-row limit on Microsoft’s Excel spreadsheet software may have led to Public Health England misplacing nearly 16,000 Covid test results, it is understood.
The data error, which led to 15,841 positive tests being left off the official daily figures, means than 50,000 potentially infectious people may have been missed by contact tracers and not told to self-isolate.
PHE was responsible for collating the test results from public and private labs, and publishing the daily updates on case count and tests performed.
But the rapid development of the testing programme has meant that much of the work is still done manually, with individual labs sending PHE spreadsheets containing their results. Although the system has improved from the early days of the pandemic, when some of the work was performed with phone calls, pens and paper, it is still far from automated.
In this case, the Guardian understands, one lab had sent its daily test report to PHE in the form of a CSV file – the simplest possible database format, just a list of values separated by commas. That report was then loaded into Microsoft Excel, and the new tests at the bottom were added to the main database.

40. International: Society of Bedside Manner: Telemedicine 5 Minute Moments
Examinations of Knee, Shoulder, Back and URTI
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41. UK: Nursing Notes: Healthcare workers ‘terrified’ of the emerging second peak
The findings come after daily cases in the UK soared to more than 3,500 on Friday.
Healthcare workers believe a second peak is very likely in the next six months.
The second peak of COVID-19 is the number one concern among the medical profession, according to a survey by the British Medical Association (BMA).
Around 7,000 doctors and medical students said that a second peak was likely or very likely in the next six months.
The findings come after daily cases in the UK soared to more than 3,500 on Friday. With the R number rising for the first time since March case numbers and ultimately deaths will rise further. Doctors say the failure of the test and trace system, a lack of monitoring and adherence to infection control measures in public places, and mixed messages to the public are the key reasons for a second rise.
Sarah, a frontline nurse from London, told NursingNotes; “The thought of a second peak is terrifying – I am worried about my whole team. I saw how emotionally and physically draining it was the first time. I’m not sure they would be able to cope… We must do everything we can to avoid a second wave.”

42. UK: Barnardo’s: 7 things you need to know about grief
Grief can be overwhelming after you’ve been through trauma, but with the right support recovery can begin. We’ve put together seven facts about grief to help explain the process, for you and your children. Loss and grief are part of life. Throughout our life, we all experience the death of loved ones, and grieve for them. It is painful and sad, working out what life looks like without the loved one can be difficult, and coping with the loss once it happens can be a struggle. It is important to remember when grieving that everyone goes through it, and there are people who want to help you through it. That can be friends, family, your GP, a therapist or counsellor, someone within your faith community, a charity or a helpline.
S ED Mental

43. USA: FiveThirtyEight: Why Coming Up With Effective Interventions To Address COVID-19 Is So Hard
It has been hard to measure the effects of the novel coronavirus. Not only is COVID-19 far-reaching — it’s touched nearly every corner of the globe at this point — but its toll on society has also been devastating. It is responsible for the deaths of over 905,000 people around the world, and more than 190,000 people in the United States alone. The associated economic fallout has been crippling. In the U.S., more people lost their jobs in the first three months of the pandemic than in the first two years of the Great Recession. Yes, there are some signs the economy might be recovering, but the truth is, we’re just beginning to understand the pandemic’s full impact, and we don’t yet know what the virus has in store for us.
This is all complicated by the fact that we’re still figuring out how best to combat the pandemic. Without a vaccine readily available, it has been challenging to get people to engage in enough of the behaviors that can help slow the virus. Some policy makers have turned to social and behavioral scientists for guidance, which is encouraging because this doesn’t always happen. We’ve seen many universities ignore the warnings of behavioral scientists and reopen their campuses, only to have to quickly shut them back down.
But this has also meant that there are a lot of new studies to wade through. In the field of psychology alone, between Feb. 10 and Aug. 30, 541 papers about COVID-19 were uploaded to the field’s primary preprint server, PsyArXiv. With so much research to wade through, it’s hard to know what to trust — and I say that as someone who makes a living researching what types of interventions motivate people to change their behaviors.

44. India: The Telegraph: Public health experts call for caution as daily Covid-19 cases drop in India
Public health experts warn it is too early to conclude India’s Covid-19 epidemic is slowing, despite recording its lowest number of new daily cases for six weeks.
On Tuesday India reported around 61,000 infections and has had an average of 64,000 new daily cases this month, a significant drop from around 87,000 every day in September.
Maharashtra, the Indian state with the largest number of infections, also reported its lowest number of daily cases since August 17.
It is too early to conclude this is a downward trend, despite an increase in daily tests from 70,000 in August to over one million in October, said Dr Jyoti Joshi, the head of South Asia at the Center for Disease Dynamics, Economics and Policy.
The increase in seasonal illnesses with symptoms that present like Covid-19 means more Indians are getting tested and then returning a negative result.
Meanwhile, many of those who may unknowingly have the virus are self-medicating as they presume what they have is common influenza.

45. UK: HSJ: Health is made at home, hospitals are for repair
Lessons for NHS to learn from health creators that use a holistic approach to health and wellbeing, creating conducive environment for people to flourish, by Nigel Crisp
I spent several months recently meeting with people outside the formal health and caring services who are creating health in their communities, businesses and schools.
I spent time with the policeman in Cornwall who was fed up with chasing local teenagers for petty crimes and started to work constructively with them, the unemployed men in Salford using their time and skills to improve the community, the woman who set up a community sewing business in Skelmersdale to support lonely people, the people working with children excluded from school in Berkshire, the women in Yorkshire who started growing vegetables in public spaces and have sparked a countrywide movement, the bankers and lawyers who have been improving mental health in the city of London and many, many more.
They all have their own specific goals whether they were reducing crime, combatting loneliness or improving the workplace. And they all, at the same time, are improving health and wellbeing in measurable ways.
Some had received help from the NHS, other hadn’t and some had found it impossible to work with the NHS. More importantly perhaps, the groups were all self-motivated, in control of what they were doing. This certainly wasn’t about professionals empowering people, “asset based healthcare” or social prescribing. And, I began to realise, most of what they were doing wasn’t about healthcare or even about the prevention of disease.

Best Wishes to you all and stay safe
John Wynn-Jones