“Family is the most important thing in the world”
Princess Diana

“I sustain myself with the love of family.”
Maya Angelou

“All happy families are alike; each unhappy family is unhappy in its own way.”
Leo Tolstoy

“Happiness is having a large, loving, caring, close-knit family in another city.”
George Burns

“All parents damage their children. It cannot be helped. Youth, like pristine glass, absorbs the prints of its handlers. Some parents smudge, others crack, a few shatter childhoods completely into jagged little pieces, beyond repair.”
Mitch Albom

“After a good dinner one can forgive anybody, even one’s own relations.”
Oscar Wilde

“Show me a family of readers, and I will show you the people who move the world.”
Napoleon Bonaparte

“If you cannot get rid of the family skeleton, you may as well make it dance.”
George Bernard Shaw

“I grew up with six brothers. That’s how I learned to dance -waiting for the bathroom”
Bob Hope


If I asked you what family meant to you, I suspect that I would get as many answers as the number of people reading this post. It’s at stressful and special times that we think more about families. We have just had Diwali and so many Hindu families were unable to meet up as they normally do. Christmas is coming in the Christian calendar and we are already beginning to lament the fact that families may not be able to meet up and reaffirm their family bonds in these dark times.
The poems that I have chosen echo the diversity with which we think of our families. For many, it is our family that sustains us, while for others, families are millstones around their necks, riven by arguments and sibling rivalry. In our modern world the strong bonds that once bound extended families together have weakened. So many families have been poisoned by long standing feuds often about issues that they have long forgotten about.
You can either take the cynical view of family described to us by Oscar Wilde and Ogden Nash or perhaps we should try to see our families as described by Maya Angelou who wrote “I sustain myself with the love of family.”
I give you a view of families across the world, across time and for better and for worse!

Anne Bradstreet (1612-72)
Anne Bradstreet was the most prominent of the early English poets of North America and the first writer in England’s North American colonies to be published. She is the first Puritan figure in American Literature and notable for her large body of poetry, as well as personal writings published posthumously.
Life was hard in the early colonies with illhealth such as fevers appearing regularly in her poems. Her poems demonstrate considerable tenderness about members of her family. In this poem, she thanks God for delivering her daughter Hannah from a fever.

Upon my daughter Hannah Wiggin her recouery from a dangerous feaver

Bles’t bee thy Name, who did’st restore
To health my Daughter dear
When death did seem ev’n to approach,
And life was ended near.
Gravnt shee remember what thov’st done,
And celebrate thy Praise;
And let her Conversation say,
Shee loues thee all thy Dayes.

I can’t find a reading of this poem but I enclose a link to another of her poems
“To My Dear and Loving Husband” by Anne Bradstreet

Edgar Guest (1881-1959)
Edgar Guest was born in Birmingham in England. He however made his name when he moved to America where he earned the title of the ‘People’s Poet’. In this poem, Guest argues that the families that stick together and remember that blood is thicker than water are the best kinds of families, and the happiest. He tells us that there’s nothing quite as valuable as the family for those lucky enough to have one. The Stick-Together Families was published in 1917 in the book “Just Folks”. Guest wrote a poem a day, seven days a week for thirty years as a columnist for the Detroit Free Press. As the People’s Poet, he was recognised for championing the traditional values of the typical American family of the first half of the 20th century.

The Stick-Together Families

The stick-together families are happier by far
Than the brothers and the sisters who take separate highways are.
The gladdest people living are the wholesome folks who make
A circle at the fireside that no power but death can break.
And the finest of conventions ever held beneath the sun
Are the little family gatherings when the busy day is done.

There are rich folk, there are poor folk, who imagine they are wise,
And they’re very quick to shatter all the little family ties.
Each goes searching after pleasure in his own selected way,
Each with strangers likes to wander, and with strangers likes to play.
But it’s bitterness they harvest, and it’s empty joy they find,
For the children that are wisest are the stick-together kind.

There are some who seem to fancy that for gladness they must roam,
That for smiles that are the brightest they must wander far from home.
That the strange friend is the true friend, and they travel far astray
they waste their lives in striving for a joy that’s far away,
But the gladdest sort of people, when the busy day is done,
Are the brothers and the sisters who together share their fun.

It’s the stick-together family that wins the joys of earth,
That hears the sweetest music and that finds the finest mirth;
It’s the old home roof that shelters all the charm that life can give;
There you find the gladdest play-ground, there the happiest spot to live.
And, O weary, wandering brother, if contentment you would win,
Come you back unto the fireside and be comrade with your kin.

The Stick Together Families

Langston Hughes (1902-1967)
We have come across Langston Hughes on a few occasions before. James Mercer Langston Hughes was an American poet, social activist, novelist, playwright, and columnist from Joplin, Missouri. 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.
“Mother to Son” is a poem that describes the difficulties that black people face in a racist society, alluding to the many obstacles and dangers that racism throws in their way—obstacles and dangers that white people don’t have to face. Langston Hughes uses the metaphor of a staircase to depict the difficulties and dangers one will face in life. The poem contains a mother’s warning to her son about the stairs one is forced to climb throughout life.

Mother to Son

Well, son, I’ll tell you:
Life for me ain’t been no crystal stair.
It’s had tacks in it,
And splinters,
And boards torn up,
And places with no carpet on the floor-
But all the time
I’se been a-climbin’ on,
And reachin’ landin’s,
And turnin’ corners,
And sometimes goin’ in the dark
Where there ain’t been no light.
So, boy, don’t you turn back.
Don’t you set down on the steps.
‘Cause you finds it’s kinder hard.
Don’t you fall now-
For I’se still goin’, honey,
I’se still climbin’,
And life for me ain’t been no crystal stair.

Mother to Son by Langston Hughes – Narration by Viola Davis

Ogden Nash (1902-1971)
Frederic Ogden Nash was an American poet well known for his light verse, of which he wrote over 500 pieces. With his unconventional rhyming schemes, he was declared the country’s best-known producer of humorous poetry. A concise, precise and much more cynical take on families from master of amusing and comical poetry

Family Court

One would be in less danger
From the wiles of a stranger
If one’s own kin and kith
Were more fun to be with.

Family Court, by Ogden Nash

Maya Angelou (1928-2014)
Maya Angelou needs no further introduction. She was an American poet, memoirist, and civil rights activist. She published seven autobiographies, three books of essays, several books of poetry, and is credited with a list of plays, movies, and television shows spanning over 50 years. She received dozens of awards and more than 50 honorary degrees.
Maya Angelou’s poem echoes many others that I found, reminding us that we are part of a much bigger family and we need to knuckle down and value our fellow human beings.

Human Family

I note the obvious differences
in the human family.
Some of us are serious,
some thrive on comedy.

Some declare their lives are lived
as true profundity,
and others claim they really live
the real reality.

The variety of our skin tones
can confuse, bemuse, delight,
brown and pink and beige and purple,
tan and blue and white.

I’ve sailed upon the seven seas
and stopped in every land,
I’ve seen the wonders of the world
not yet one common man.

I know ten thousand women
called Jane and Mary Jane,
but I’ve not seen any two
who really were the same.

Mirror twins are different
although their features jibe,
and lovers think quite different thoughts
while lying side by side.

We love and lose in China,
we weep on England’s moors,
and laugh and moan in Guinea,
and thrive on Spanish shores.

We seek success in Finland,
are born and die in Maine.
In minor ways we differ,
in major we’re the same.

I note the obvious differences
between each sort and type,
but we are more alike, my friends,
than we are unalike.

We are more alike, my friends,
than we are unalike.

We are more alike, my friends,
than we are unalike.

Maya Angelou reads Human Family poem

Rabindranath Tagore (1861-1941)
Rabindranath Tagore, also known by his pen name Bhanu Singha Thakur (Bhonita), was a polymath, poet, musician, and artist from the Indian subcontinent. He reshaped Bengali literature and music, as well as Indian art in the late 19th and early 20th centuries. Author of the “profoundly sensitive, fresh and beautiful verse” of Gitanjali, he became in 1913 the first non-European to win the Nobel Prize in Literature. Tagore’s poetic songs were viewed as spiritual and mercurial; however, his “elegant prose and magical poetry” remain largely unknown outside Bengal. He is sometimes referred to as “the Bard of Bengal”.
How many of us will recognise what Tagore is saying to us here? Our mothers are giants in our lives, but we sometimes struggle to remember things about her until a memory is triggered by something ordinary and the memory floods back so strongly.

I cannot remember my mother

I cannot remember my mother
only sometimes in the midst of my play
a tune seems to hover over my playthings,
the tune of some song that she used to
hum while rocking my cradle.

I cannot remember my mother
but when in the early autumn morning
the smell of the shiuli flowers floats in the air
the scent of the morning service in the temple
comes to me as the scent of my mother.

I cannot remember my mother
only when from my bedroom window I send
my eyes into the blue of the distant sky,
I feel that the stillness of
my mother’s gaze on my face
has spread all over the sky.

Kelly Roper
I don’t know much about Kelly Roper. She lives in Toledo, Ohio and works as an editorial assistant, writer and blogger. Hers is a rather optimistic and somewhat sentimental view of family life.

The Thing About Family…

The thing about family is,
You may not always like them,
But you’re always going to love them.
It just might take a little while sometimes
To remember that.

Family Means Everything

Family members
Are the people who
Make life worth living.
In good times and bad,
Love them first and last because
Your family means everything.

Philip Larkin (1922-1985)
Most of you will recognise this poem and I think that it’s the 3rd time that I have included it. I could not post poetry on the theme of families without this irreverent take on the family from Philip Larkin. Such a change from to the poem that precedes it.
Philip Larkin was an English poet, novelist, and librarian. He was one of post-war England’s most famous poets and was commonly referred to as “England’s other Poet Laureate” until his death in 1985. When the position of laureate became vacant in 1984, many poets and critics favoured Larkin’s appointment, but Larkin preferred to avoid the limelight.
Larkin achieved acclaim on the strength of an extremely small body of work—just over one hundred pages of poetry in four slender volumes that appeared at almost decade-long intervals.

This be the verse

They fuck you up, your mum and dad.
They may not mean to, but they do.
They fill you with the faults they had
And add some extra, just for you.

But they were fucked up in their turn
By fools in old-style hats and coats,
Who half the time were soppy-stern
And half at one another’s throats.

Man hands on misery to man.
It deepens like a coastal shelf.
Get out as early as you can,
And don’t have any kids yourself.

Philip Larkin reads “This be the verse”

Michael J. Burt (1985)
Michael J. Burt is an American poet and author who was born in Washington, DC. He was raised in Prince George’s County, Maryland, where he currently resides. Burt studies psychology at Frostburg State University in Western Maryland. Burt’s first volume of poetry entitled “Experience Is Impossible Without a Chance: A Collection of Poems” was published in 2005.
This wonderful poem celebrates the diversity of mankind and reaffirms that we are in the end one big family.

We are Family

we are family,
although we do not resemble
although i am black and you are white
although you are rich and i am poor

we are family,
even though i am democrat, and you are republican
even though your ancestors are from Iraq, and mine are from Africa
even though you teach the class i’m enrolled in

we are family,
although i’m a poet and you are a singer
although you are old and i am young
although i’m a gentleman and you a lady

we are family,
even though you praise Allah and I praise Jesus Christ
even though i love football and you play soccer
even though you are a Sagittarius and i’m a Cancer

we are family,
although i prefer rhythm and blues and you love blue grass
even though you have a car and i have a bus…to ride
although i have love and you are alone
even though you dress one way, and i dress the other
although my family loves me and yours does not know of you

we are family,
you and i are family,
me and you are family,
no matter what the difference is
family we are, forever
because we are here, and here is earth
and earth is our home
so here, we will live,
we are family.

We Are Family – Poem by Michael J. Burt


Sister Sledge – We Are Family

Dolly Parton “Family”

Eric Clapton – My Father’s Eyes

Sly & The Family Stone ~ Family Affair

A new book has just been published from renowned consultant gynecologist Prof. Shaughn O’Brien and women’s health expert Dr. Paula Briggs suggesting that men should take an active role in opening up dialogue around menopause, PMS/PMDD and other female hormone related issues.

In his own words Shaughn writes:
“Within the last year, thanks to the likes of celebrities such as Meg Matthews and Jenny Éclair and journalists Caitlin Moran, Sam Baker and Alison Pearson all speaking out about their experiences with the menopause and peri-menopause the subject has started to lose some of its hushed tones.”
Hormone changes throughout reproductive life and through the menstrual cycle and menopause are normal, but in some women, they can give rise to life transforming disorders with devastating consequences for both lives and relationships. But these are treatable conditions and the more we, as a society, talk about them and understand them, the more we can do to help. As such, HerHormones is the first book of its kind specifically written with a male audience in mind.
The book outlines several hormonal disorders including heavy menstrual bleeding, PMS/PMDD, menopause, polycystic ovary syndrome, endometriosis and their treatments so that men will understand the hormonal problems women face on a day to day basis and then hopefully they will understand, empathise and sympathise with their female partner.
Over the course of our careers and many thousands of patients, we saw so many lives and relationships which suffered from the impacts of hormonal changes. We realised that whilst more women are now talking about the menopause and PMS/PMDD, men – whose closest relationships are often affected by them – are still clueless. We wanted to write something which made the world of women’s hormones accessible to men so they could support their partners through what can often be an extremely difficult time of life.”
About the authors:
Professor Shaughn O’Brien was Consultant Obstetrician and Gynaecologist at the University Hospital of North Staffordshire and is Emeritus Professor of Obstetrics and Gynaecology at Keele University School of Medicine. He was Chairman of the International Society for Premenstrual Disorders and past Chairman of the British Society for Psychosomatic Obstetrics and Gynaecology. Since his retirement in 2019 he has become a sculptor almost full time and one of his pieces is currently being exhibited at the Royal Academy’s Summer Exhibition.
Dr. Paula Briggs forfeited a place at the Royal Ballet School to pursue medicine. She was a GP before transferring to a career in sexual and reproductive health. She is an honorary senior lecturer at the University of Liverpool, where she is currently undertaking an MD. Paula has co-edited 4 books for Cambridge University Press.
HerHormones: A Book for Men by Shaughn O’Brien and Paula Briggs is published By Clink Street Publishing on the 26th November RRP £7.99 is available to buy online from retailers including Amazon (including Kindle) and can be ordered from all good bookstores.

Today’s Post

1. International: BBC: Moderna: Covid vaccine shows nearly 95% protection
A new vaccine that protects against Covid-19 is nearly 95% effective, early data from US company Moderna shows. The results come hot on the heels of similar results from Pfizer, and add to growing confidence that vaccines can help end the pandemic.
Both companies used a highly innovative and experimental approach to designing their vaccines. Moderna says it is a “great day” and they plan to apply for approval to use the vaccine in the next few weeks. However, this is still early data and key questions remain unanswered.
The trial involved 30,000 people in the US with half being given two doses of the vaccine, four weeks apart. The rest had dummy injections. The analysis was based on the first 95 to develop Covid-19 symptoms. Only five of the Covid cases were in people given the vaccine, 90 were in those given the dummy treatment. The company says the vaccine is protecting 94.5% of people. The data also shows there were 11 cases of severe Covid in the trial, but none happened in people who were immunised.
“The overall effectiveness has been remarkable… it’s a great day,” Tal Zaks, the chief medical officer at Moderna, told BBC News. Dr Stephen Hoge, the company’s president, said he “grinned ear to ear for a minute” when the results came in.
He told BBC News: “I don’t think any of us really hoped that the vaccine would be 94% effective at preventing Covid-19 disease, that was really a stunning realisation.”

2. Italy: Tumori Journal: Unexpected detection of SARS-CoV-2 antibodies in the prepandemic period in Italy
There are no robust data on the real onset of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and spread in the prepandemic period worldwide. We investigated the presence of SARS-CoV-2 receptor-binding domain (RBD)–specific antibodies in blood samples of 959 asymptomatic individuals enrolled in a prospective lung cancer screening trial between September 2019 and March 2020 to track the date of onset, frequency, and temporal and geographic variations across the Italian regions. SARS-CoV-2 RBD-specific antibodies were detected in 111 of 959 (11.6%) individuals, starting from September 2019 (14%), with a cluster of positive cases (>30%) in the second week of February 2020 and the highest number (53.2%) in Lombardy. This study shows an unexpected very early circulation of SARS-CoV-2 among asymptomatic individuals in Italy several months before the first patient was identified, and clarifies the onset and spread of the coronavirus disease 2019 (COVID-19) pandemic. Finding SARS-CoV-2 antibodies in asymptomatic people before the COVID-19 outbreak in Italy may reshape the history of pandemic.

3. UK: RCGP Learning: COVID-19 Vaccine
On the 9th November 2020 NHS England released a set of letters to general practice setting out the plans to deploy a COVID-19 vaccine based upon the methods that are used to deliver the seasonal influenza vaccination programme. This module will cover an outline of the proposal and suggest how practices and primary care networks might deliver the COVID-19 vaccination programme. We will update the course as more information becomes available. This module applies to England only. Updates for Northern Ireland, Wales, and Scotland will follow.
S Education

4. USA: BBC: Video: Covid in North Dakota: One day inside a rural US hospital’s fight
Health workers at a 14-bed hospital in North Dakota are struggling to keep friends’ family members alive, as rates of new Covid-19 infections soar in the US heartland’s tight-knit communities. Small towns like Grafton – with a population of around 4,000 – are especially vulnerable to a surge in critically ill patients, as local hospitals have limited space and staff. Watch a day in the life of Unity Medical Center – told by the very people who work there.
N Video

5. UK: RCGP: Identification of COVID-19 from symptoms
This paper looks at the nature and range of acute COVID-19 symptoms in adults. As we increase our understanding of this disease over time, the familiar triad of cardinal symptoms needs to be revisited.
The current UK case definition of COVID-19 in the community requires the following symptoms (referred to as ‘cardinal symptoms’ in this paper)
• a new continuous cough
• high temperature of 37.8 or above
• a loss of, or change in, normal sense of taste or smell (anosmia)
However a range of symptoms related to COVID-19 have now been published, together with the frequency of these symptoms. Several studies demonstrate a difference in symptoms between genders and there are also marked differences in reported symptoms in different countries. A number of authors point out that different symptoms appear at different stages of the illness eg loss of smell and taste appears to be an early symptom (and associated with milder disease) and shortness of breath is a later symptom, often appearing around days 8-10 and is not surprisingly associated with more severe disease. As with other acute illnesses, older people may present non-specifically with COVID, such as being reported as being ‘off their legs’. Additionally, a number of studies flag up that delirium is a common symptom in the frail old.

6. Nepal: Nepal Times: Unique hospital handover in Dolakha
The transfer of Charikot Hospital management to muncipality can be a model for other local governments In one of the few arrangements of its kind in Nepal, a public-private partnership initiative has handed over to the local government the management of Charikot Hospital which had been run by a private non-profit organisation ever since the earthquake five years ago. Bhimeswar Municipality took over the hospital from the group Nyaya Health Nepal on 30 October in an innovative and successful DBOT (Design, Build, Operate, Transition) model which is significant in Nepal’s new federal structure where local governments take on more responsibility for grassroots healthcare delivery. This is especially remarkable considering that improving public sector healthcare, especially in rural areas, has been a challenge in Nepal. The country’s already under-resourced healthcare is also under strain because of the Covid-19 pandemic. Nyaya Health signed an agreement with the Ministry of Health in 2015 to rebuild the damaged healthcare facilities in Dolakha and upgrade the primary healthcare centre in Charikot into a full-fledged hospital. The organisation was building on its experience in Achham where it manages Bayalpata Hospital under a similar partnership model since 2009.

7. USA: The Conversation: How the US health-care system works — and how its failures are worsening the pandemic
The United States does not have a health system — it has multiple systems, with no coherence. If you are an armed services veteran, you have access to a comprehensive, centrally coordinated, government-run health service. If you are over 65, you are covered by Medicare, a federally funded, quite generous insurance-based system. If you are poor, the partly federally funded but state-run Medicaid system is your option. The extent of your eligibility will vary depending on the state you live in, but the system is generally pretty mean in terms of income thresholds for eligibility.
If you are employed, your employment package may include health insurance coverage and you generally get to choose — from a panel selected by your employer — which insurer will cover you in the forthcoming year.
The types of insurers on offer normally include those operating a fee-for-service model like Australian private health insurance, and those offering a whole-of-care experience where the insurer is also the provider, or is closely linked to the provider, and covers all care for a fixed sum each year.
The “Obamacare” reforms added an option, for those without other coverage, of insuring through federal and state “marketplaces”. These marketplaces enabled people to avoid the very high premiums that was the norm for individually-negotiated private insurance, by sharing risks across the insured in a bulk-buy arrangement.

8. Nature: What the data say about asymptomatic COVID infections: People without symptoms can pass on the virus, but estimating their contribution to outbreaks is challenging.
How many people don’t experience any symptoms after becoming infected with SARS-CoV-2? And what is their role in spreading COVID-19? These have been key questions since the beginning of the pandemic. Now, evidence suggests that about one in five infected people will experience no symptoms, and they will transmit the virus to significantly fewer people than someone with symptoms. But researchers are divided about whether asymptomatic infections are acting as a ‘silent driver’ of the pandemic. Although there is a growing understanding of asymptomatic infections, researchers say that people should continue to use measures to reduce viral spread, including social distancing and wearing masks, regardless of whether they have symptoms. The issue with putting a reliable figure on the rate of asymptomatic COVID-19 is distinguishing between people who are asymptomatic and pre-symptomatic, says Krutika Kuppalli, an infectious-disease researcher at Stanford University School of Medicine in California. “Asymptomatic is someone who never developed symptoms ever throughout the course of their disease, and pre-symptomatic is somebody who has mild symptoms before they do go on to develop symptoms,” Kuppalli says. There is also no standardized accepted definition of that, she says.

9. USA: Washington Post: South Dakota nurse says many patients deny the coronavirus exists — right up until death
Jodi Doering, an emergency room nurse in South Dakota, was overwhelmed Saturday night. Her patients were dying of covid-19, yet were still in denial about the pandemic’s existence.It’s like a “horror movie that never ends,” Doering wrote on Twitter. Her anxiety and despair are shared by many health-care workers who are facing a dramatic surge in covid-19 patients. But some front-line workers, like Doering, also face the emotional toll of treating patients who, despite being severely ill, are reluctant to acknowledge that they have been infected with a virus that President Trump has said will simply disappear.
Doering said she has covid-19 patients who need 100-percent-oxygen breathing assistance and who will also swear they don’t have the illness that has ended the lives of nearly a quarter-million people in the United States since February.

10. UK: BBC: Covid: Oxford vaccine shows ‘encouraging’ immune response in older adults
The Oxford coronavirus vaccine shows a strong immune response in adults in their 60s and 70s, raising hopes that it can protect age groups most at risk from the virus.
Researchers say the Lancet phase two findings, based on 560 healthy adult volunteers, are “encouraging”.They are also testing whether the vaccine stops people developing Covid-19 in larger, phase three trials.Early results from this crucial stage are expected in the coming weeks.Three vaccines – Pfizer-BioNTech, Sputnik and Moderna – have already reported good preliminary data from phase three trials, with one suggesting 94% of over-65s could be protected from Covid-19. The UK has already ordered 100 million doses of the Oxford vaccine, manufactured by AstraZeneca, 40 million doses of the Pfizer-BioNTech vaccine and five million of the Moderna vaccine. The challenge with developing a Covid vaccine is to trigger the body to fight back against the virus no matter how old someone is.

11. Kenya: BBC: Coronavirus: Kenya doctors’ fury over Covid-19 deaths
The doctors’ union in Kenya has accused the government of not protecting healthcare workers who are treating Covid-19 patients, after the deaths of four medical practitioners last week. They all died in a 24-hour period, although it is unclear if they had contact with coronavirus patients. The union, which is threatening strike action, wants all health workers to get PPE and comprehensive medical cover.
Kenya has reported 1,239 Covid-19 deaths since its first case in March.
Thirty healthcare workers, including 10 specialist doctors, have so far died from Covid-19, according to the Kenya Medical Practitioners, Pharmacists and Doctors Union. “Our members have worked in extremely difficult, draining, hazardous and injurious working environments,” it said in a statement which issued a 21-day strike notice to the government.

12. UK: HSJ: Exclusive: NHS setting up dozens of mass covid vaccination centres and seeking 40,000 staff
• NHS England preparing contracts for 42 health systems to have at least one mass vaccination centre
• Plans would require up to 40,000 staff, with recruitment campaigns due to launch Sites would be run by “lead providers”, mostly NHS trusts providing community health services
• The health service is setting up more than 40 mass vaccination centres, and working on recruiting tens of thousands of staff for the huge covid-19 vaccination effort, HSJ has learned.
NHS England has told local leaders that each of the 42 health and care systems in England should have at least one mass vaccination site, with two expected for some larger systems, according to several senior sources.
They will typically be run by “lead providers”, which will be contracted by NHSE to cover each part of England — mostly expected to be NHS trusts which provide community services. They are likely to be in conference centres and similar venues; there have been discussions about co-locating them with covid test centres.
These will be in addition to smaller GP-run vaccine centres, for which locations are due to be confirmed early next week, starting with one in each of around 1,000 primary care networks. It is expected the mass centres will start work a little later than the GP practices, and are more likely to vaccinate groups which are not at the top of the nationally-set priority list.
NHSE has not yet made clear whether, next year when wider groups are eligible for vaccination, people will be able to self-book and/or choose where to receive their vaccine.
Meanwhile work is beginning on recruiting large numbers of staff for the huge covid-19 vaccination effort. HSJ understands it is estimated that 6,000 staff will be needed in the South East region and 5,000 in London — suggesting around 30,000 to 40,000 across England.

13. Europe: Nature: Europe must think more globally in crafting its pandemic response
The EU has struggled to find a unified voice in the pandemic. A new plan is a strong start, but needs to be more outward-looking. How is it that countries with some of the world’s highest levels of health-care spending have also seen some of the highest mortality from COVID-19? This is one of the great mysteries of the coronavirus pandemic. Almost one year into the crisis, five of Europe’s biggest economies — Germany, France, the United Kingdom, Italy and Spain — have recorded a total of almost 200,000 deaths. At the same time, the 27-country European Union has failed to produce much in the way of a unified response. In the pandemic’s early months, some EU nations stopped exports of personal protective equipment, even to fellow member states. EU nations have so far allocated nearly €6 billion (US$7.1 billion) to support the pandemic response, but individual countries do not have a common benchmark on which to base interventions, so have differed on crucial issues such as what is meant by social distancing, when to lock down, and the rules of quarantine. The incoherence of the EU’s pandemic response is surprising for a group of nations that has so successfully acted and spoken with one voice on other cross-border issues, most notably climate change.
Fortunately, the European Commission and its ethics and research advisers have been working to get a firmer grip on the situation. On 11 November, the commission published a lengthy list of actions for the European Parliament and the governments of EU nations to consider. These include upgrading the European Centre for Disease Prevention and Control to improve its disease surveillance and its capacity to help countries to prepare for — and respond to — epidemics.

14. UK: Huffington Post: Long Covid Isn’t Just Leaving People Sick – It’s Taking Everything They’ve Got
Four people with long-term symptoms of the virus tell HuffPost UK how it’s left them out of work – and out of money. People suffering with long-term symptoms of Covid-19 have revealed how the virus has impacted their ability to work – and in some cases, left them in financial ruin. One in ten people are reporting a longer tail of symptoms, which exceeds the suggested two-week recovery time from the virus. The issue has been dubbed ‘long Covid’, as people struggle with extreme fatigue, breathlessness and problems with concentration and memory for months.
Many are unable to return to work because of these extended symptoms – and even those who do feel ready to work aren’t necessarily able to perform at the same capacity they once did. One woman told HuffPost UK she was made redundant over the summer and has just £3,000 in savings. She doesn’t feel well enough to leave the house, let alone look for another job. She’s applied for benefits, but worries how she’ll pay her mortgage and bills going forward.

15. USA: Washington Post: At least 246,000 people have died from coronavirus in the U.S.
The number of coronavirus cases in the United States passed 11 million on Sunday. It took 100 days for the nation to log its first 1 million cases; it took just six days to get from 10 million to 11 million. The number of people being hospitalized with covid-19 is also higher. Fearing that the worsening crisis will lead to even more preventable deaths, the governors of several states implemented new restrictions to help slow the spread. The residents of North Dakota are now required to wear masks. Colleges, high schools, workplaces and in-person dining are closing for three weeks in Michigan. Indoor social gatherings with people outside one’s household are now prohibited in Washington, along with indoor dining at restaurants and bars.
As health officials long predicted, autumn brought soaring case counts, strained hospital capacity and increased deaths nationwide, as the virus is not only popping up in new places but also circling back to areas that once appeared to have it contained. Nearly all metrics in most of the country are trending in the wrong direction.
During an April peak, the seven-day-average U.S. death toll hit more than 2,000 per day, but cases were concentrated largely in the Northeast. During a July lull, average deaths sank to a low of 463 per day, although cases surged in the Sun Belt.
By early November, however, the country was recording more new cases than ever — well over 100,000 per day — and many states reported record-high caseloads and hospitalizations. The average U.S. deaths per day again shot past 1,000, despite improvements in treatment that make survival more likely.

16. Nature: What if tropical diseases had as much attention as COVID?
As the COVID-19 pandemic threatens to erode huge gains against much more devastating infections, I look for silver linings.
All year, COVID-19 has commandeered the world’s attention. It is as if no other disease has ever been more important, more contagious or more deadly.
I founded a non-profit research institute in 2008; we established the first molecular-biology laboratory in the Republic of Congo, at the country’s only public university. We monitor pathogens such as those that cause gastrointestinal diseases, malaria, HIV, tuberculosis (TB) and chikungunya — which together infect more than 250 million people each year globally, and kill more than 2.5 million. To keep treatments effective, we assess the development of resistance to antimalarial, antiretroviral and antibiotic drugs. Our research programmes were already in place, so we could quickly pivot to diagnostic testing and blood-based epidemiological studies to understand how COVID-19 was spreading in Congo and how to keep health-care workers safe. Since March, three-quarters of our time has been spent on COVID-19.
That means I am neglecting my work on other diseases — which are not going away. And it’s not only my lab. In October, the World Health Organization (WHO) reported that progress against TB might stall: in the countries with the highest rates of the disease, the number of people diagnosed and directed to care dropped by one-quarter compared with last year’s figure. Because many countries have implemented lockdowns, hospitals and health centres have seen a significant drop in the number of people coming for treatment.

17. Finland: Frontiers in Microbiology: Urbanization Reduces Transfer of Diverse Environmental Microbiota Indoors
Expanding urbanization is a major factor behind rapidly declining biodiversity. It has been proposed that in urbanized societies, the rarity of contact with diverse environmental microbiota negatively impacts immune function and ultimately increases the risk for allergies and other immune-mediated disorders. Surprisingly, the basic assumption that urbanization reduces exposure to environmental microbiota and its transfer indoors has rarely been examined. We investigated if the land use type around Finnish homes affects the diversity, richness, and abundance of bacterial communities indoors. Debris deposited on standardized doormats was collected in 30 rural and 26 urban households in and near the city of Lahti, Finland, in August 2015. Debris was weighed, bacterial community composition determined by high throughput sequencing of bacterial 16S ribosomal RNA (rRNA) gene on the Illumina MiSeq platform, and the percentage of four different land use types (i.e., built area, forest, transitional, and open area) within 200 m and 2000 m radiuses from each household was characterized. The quantity of doormat debris was inversely correlated with coverage of built area. The diversity of total bacterial, Proteobacterial, Actinobacterial, Bacteroidetes, and Firmicutes communities decreased as the percentage of built area increased. Their richness followed the same pattern except for Firmicutes for which no association was observed. The relative abundance of Proteobacteria and particularly Gammaproteobacteria increased, whereas that of Actinobacteria decreased with increasing built area. Neither Phylum Firmicutes nor Bacteroidetes varied with coverage of built area. Additionally, the relative abundance of potentially pathogenic bacterial families and genera increased as the percentage of built area increased. Interestingly, having domestic animals (including pets) only altered the association between the richness of Gammaproteobacteria and diversity of Firmicutes with the built area coverage suggesting that animal ownership minimally affects transfer of environmental microbiota indoors from the living environment. These results support the hypothesis that people living in densely built areas are less exposed to diverse environmental microbiota than people living in more sparsely built areas.

18. Sweden: Thompson Reuters Foundation: Sweden limits public gatherings as pandemic second wave swells
The Swedish government on Monday moved to cut the size of public gatherings sharply as it sought to come to grips with a second wave of the pandemic that has seen record daily numbers of new cases and growing pressure on hospitals.
Swedes are not sticking to coronavirus recommendations as well as in the spring and public gatherings will now be limited to eight people, Prime Minister Stefan Lofven said, down from a previous upper limit of 300. “This is the new norm for the entire society,” Lofven told a news conference. “Don’t go to gyms, don’t go to libraries, don’t host dinners. Cancel.” The resurgence of the disease hit Sweden weeks later than much of continental Europe, but the number of new infections has picked up speed since the turn of the month, with rising admissions to intensive care units and general Covid-19 wards. The daily death toll from the disease has also climbed after having slowed to single digits during an extended summer lull, when many Swedes gradually began to live their lives more normally. Interior Minister Mikael Damberg said the new limit on gatherings – far lower the 50 allowed during the spring outbreak – would be in place for four weeks but could be extended to run over the Christmas and New Year holidays. Sweden has gained international attention for its unorthodox response to the pandemic, shunning lockdowns and widespread use of face masks and instead relying on mainly voluntary measures even as the pandemic hit the country increasingly hard. More than 6,000 people with COVID-19 have died in Sweden since the pandemic began, a death rate per capita several times higher than that of its Nordic neighbours, if somewhat lower than some larger European countries such as Spain.

19. USA: Washington Post: More than 3 million people in U.S. estimated to be contagious with the coronavirus
More than 3 million people in the United States have active coronavirus infections and are potentially contagious, according to a new estimate from infectious-disease experts tracking the pandemic. That number is significantly larger than the official case count, which is based solely on those who have tested positive for the virus.
The vast — and rapidly growing — pool of coronavirus-infected people poses a daunting challenge to the governors and mayors in hard-hit communities who are trying to arrest the surge in cases. Traditional efforts such as testing, isolation of the sick and contact tracing can be overwhelmed when a virus spreads at an exponential rate, especially when large numbers of asymptomatic people may be walking around without even knowing they are infectious. To put the 3 million-plusfigure in perspective: It is close to 1 percent of the population. It is about equal to the number of public school teachers in the entire country, or the number of truck drivers. If the University of Michigan’s football stadium were packed with a random selection of Americans, about a thousand of them would be contagious right now.

20. USA: The Atlantic: ‘No One Is Listening to Us’: More people than ever are hospitalized with COVID-19: Health-care workers can’t go on like this.
On Saturday morning, Megan Ranney was about to put on her scrubs when she heard that Joe Biden had won the presidential election. That day, she treated people with COVID-19 while street parties erupted around the country. She was still in the ER in the late evening when Biden and Vice President–elect Kamala Harris made their victory speeches. These days, her shifts at Rhode Island Hospital are long, and they “are not going to change in the next 73 days,” before Biden becomes president, she told me on Monday. Every time Ranney returns to the hospital, there are more COVID-19 patients.
In the months since March, many Americans have habituated to the horrors of the pandemic. They process the election’s ramifications. They plan for the holidays. But health-care workers do not have the luxury of looking away: They’re facing a third pandemic surge that is bigger and broader than the previous two. In the U.S., states now report more people in the hospital with COVID-19 than at any other point this year—and 40 percent more than just two weeks ago.
Emergency rooms are starting to fill again with COVID-19 patients. Utah, where Nathan Hatton is a pulmonary specialist at the University of Utah Hospital, is currently reporting 2,500 confirmed cases a day, roughly four times its summer peak. Hatton says that his intensive-care unit is housing twice as many patients as it normally does. His shifts usually last 12 to 24 hours but can stretch to 36. “There are times I’ll come in in the morning, see patients, work that night, work all the next day, and then go home,” he told me. I asked him how many such shifts he has had to do. “Too many,” he said.

21. Africa: African Journal of Primary Care & Family Medicine PHCFM: Editorial: Covid-19 special collection
It is a well-known story. Disease epidemics by their nature sweep through countries, exposing underlying weaknesses and vulnerabilities, and, in the process, eventually revealing inequalities in access to healthcare and means of protection. Our challenge in African countries with the Coronavirus disease 2019 (Covid-19) pandemic is how to change these threats into opportunities so that we could be better prepared to manage our response to this pandemic, and also to prepare for the next and possibly worse infectious disease pandemic. A colleague with experience from the 2014–2015 Ebola epidemic in West Africa advised us to make the most of the calm before the storm, the period between the early cases and widespread community transmission, to get health staff informed and skilled, to run drills and practical training, to organise health facilities to improve patient flow, to explore strategic approaches that describe clear roles, tasks and communications, and to develop ways of supporting each other when things get worse (Johnson O, 2020, personal communication, 04 April 2020).
The epidemic has evolved from those who could afford to travel and brought the infection from distant lands to local transmission through social, work and other networks. It will initially spread through urban areas and to areas of high population density, and will impact the poor and less privileged the most. The purpose of publishing special reports in the African Journal of Primary Health Care and Family Medicine is to share examples of preparedness and lessons already learnt from the Covid-19 pandemic. We would like to know how we can become better in coping with the crisis. Having stopped to take a breath, how can we re-frame the future so that it is more compassionate, more respectful of diversity and inclusive of all sectors of societies?

22. Los Angeles Times: Some in L.A. are getting COVID-19 tests so they can party, socialize. Officials call this a disaster
Desperately seeking to find a seemingly responsible way to hold dinner parties, some people have started to get tests for the coronavirus as a way to clear themselves to attend dinner parties without needing to wear masks or keep their distance.
That’s absolutely the wrong thing to do, according to Barbara Ferrer, Los Angeles County’s director of public health. Ferrer said on Monday that she has heard of groups of young adults going to get tested for the coronavirus on a Thursday in hopes of getting the negative results by Saturday morning, and then having a dinner party on Saturday night. But such tests provide a false sense of security — and engaging in this practice can still result in the dinner party becoming a super-spreading event that can transmit the highly contagious virus widely. “That’s actually a false sense of security. It’s a false narrative,” Ferrer said.
“Your test result that you got Saturday morning was from Thursday when you got tested, and it said, ‘On Thursday, you were negative,’” Ferrer said. “It says nothing about whether you’re still negative on Saturday.

23. South Africa: PHCFM: The Cape Town International Convention Centre from the inside: The family physicians’ view of the ‛Hospital of Hope’
This short report captures the week-by-week reflections of a group of family physicians who joined the clinical and operational management teams tasked with providing the in-patient service of an 862-bed COVID-19 field hospital. The ‘Hospital of Hope’ at the Cape Town International Convention Centre (CTICC) was established as an intermediate care facility specifically to cope with the effects of the COVID-19 pandemic in Cape Town metropole. In an extraordinary feat of engineering, the conference centre floor was transformed within a matter of weeks into wards with piped oxygen at each bed. Whilst the emergency medicine specialists took the lead in designing and commissioning the facility, the medical management and staff were drawn mostly from family physicians. This report is a short reflection on the experience of the first 4 weeks of managing patients in this repurposed space. Our insights evolved during various formal and informal learning conversations as the in-patient service became more organised over time. We hope that these insights, as well as the process of reaching them, will assist other colleagues in serving their communities during this difficult moment in history; moreover, it may reflect a renewed appreciation for team-based interdisciplinary efforts in achieving person-centred care.

24. South Africa: PHCFM: Implementing a video call visit system in a coronavirus disease 2019 unit
The lockdown and physical distancing strategies imposed to combat COVID-19 have caused seismic shifts at all levels of society. Hospitals have been particularly affected. Healthcare workers (HCW’s) wore PPE during all patient interactions and visitors were prohibited. Life for a patient became lonelier and for those with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) measures were even more severe. HCW’s must treat patients following a biopsychosocial approach and promote communication between patients and loved ones. We implemented a low cost Video Call Visit system at Tygerberg Hospital, Cape Town. In this article we discuss the elements of a successful implementation and potential pitfalls in the context of a pandemic, notably cross-infection and privacy. Rapid but responsible innovation using 21st century tools was required to address the many challenges of the pandemic, including improving the lived experience for patients and families. These should be intended to last after the pandemic has passed.

25. Japan: Washington Post: Vaccine development, test events make IOC ‘very confident’ Japan’s Olympics will go ahead with fans
The International Olympic Committee is “very confident” the Olympics can take place in Tokyo next summer with a reasonable number of spectators, thanks to the development of vaccines and rapid coronavirus testing, IOC President Thomas Bach said Monday. If vaccines are approved, the IOC also wants to “convince” foreign athletes and spectators to be vaccinated before coming to ¬Japan, he said, but it can’t make immunization obligatory. “In order to protect the Japanese people and out of respect for the Japanese people, the IOC will undertake great effort so that as many as possible — Olympic participants and visitors — will arrive here vaccinated, if by then a ¬vaccine is available,” Bach said. “This makes us all very confident that we can have spectators in the Olympics stadium next year and that spectators will enjoy a safe environment.”

26. USA: American Institute of Economic Research: Even a Military-Enforced Quarantine Can’t Stop the Virus, Study Reveals
The New England Journal of Medicine has published a study that goes to the heart of the issue of lockdowns. The question has always been whether and to what extent a lockdown, however extreme, is capable of suppressing the virus. If so, you can make an argument that at least lockdowns, despite their astronomical social and economic costs, achieve something. If not, nations of the world have embarked on a catastrophic experiment that has destroyed billions of lives, and all expectation of human rights and liberties, with no payoff at all.
[The earliest version of this article misstated the conditions of the control group. They were equally locked down with those who participated in the study. The difference between the two concerned testing frequency and the isolation response. This does not affect this article’s conclusion; indeed it strengthens it: even under extreme measures, the virus spread, and more so with the extra measure intended to control the virus. Nearly all infections were without symptoms.]
AIER has long highlighted studies that show no gain in virus management from lockdowns. Even as early as April, a major data scientist said that this virus becomes endemic in 70 days after the first round of infection, regardless of policies. The largest global study of lockdowns compared with deaths as published in The Lancet found no association between coercive stringencies and deaths per million.

27. Canada: Washington Post: Canadian coronavirus cases grow and spread as once-effective unity frays
For the Canadian prime minister, it was a reversal of sorts. Justin Trudeau had said he was not in the business of judging whether some provinces had mismanaged the coronavirus pandemic. Now he was suggesting otherwise.
“I would hope that no leader in our country is easing public health vigilance because they feel pressure not to shut down businesses or slow down our economy,” Trudeau told reporters last week. “I urge premiers and mayors to do the right thing: Act now to protect public health.” Which ones were doing the wrong thing? He wouldn’t name names. Canada’s spring wave battered Ontario and Quebec, the two most populous provinces. Now, a spiraling resurgence is buffeting provinces once heralded as success stories, as cracks emerge in the “Team Canada” approach.
The seven-day average for new cases in Canada climbed to approximately 4,300 on Friday, up about 22 percent from the previous week and almost 45 percent from the end of October. Indicators in much of the country are blinking red. Several provinces in western Canada are setting hospitalization records.

28. Zimbabwe: PHCFM: Coronavirus-19 and malaria: The great mimics
The use of SARS-CoV-2 rapid diagnostic test (RDT) kits by some African countries for screening has raised serious concerns over their role in malaria areas. Coupled with a lack of adequate personal protective equipment and the scarcity of knowledge on the possible interaction between malaria and COVID-19 both in terms of presentations and shared symptoms, this has left many frontline health workers with fears and anxieties. Several anecdotal reports have already raised questions pertaining to possible false-positive COVID-19 results in proven malaria cases by use of SARS-CoV-2 RDT kits with huge costs to already constrained budgets. The report raises concerns on the use of SARS-CoV-2 kits in malaria areas in terms of cost, to prompt research, allay fears and guide policy during this pandemic and beyond.

29. UK: British Heart Foundation: How to reduce your risk of dying from coronavirus
There are many factors that can put you at higher risk from coronavirus. Some of them can’t be changed, but there are four key things you can do to reduce your risk of becoming seriously unwell if you do get coronavirus.
• Manage your heart health
• Manage your weight
• Quit smoking
• Get moving
• When to get medical help

30. USA: LA Times: Super-spreading wedding party demonstrates COVID-19 risk posed by holiday gatherings
If you want to know why public health officials are so nervous about how much worse the COVID-19 pandemic will get as the holiday season unfolds, consider what happened after a single, smallish wedding reception that took place this summer in rural Maine.
Only 55 people attended the Aug. 7 reception at the Big Moose Inn in Millinocket. But one of those guests arrived with a coronavirus infection. Over the next 38 days, the virus spread to 176 other people. Seven of them died.
None of the victims who lost their lives had attended the party.
In a new report, investigators from the Maine Center for Disease Control and Prevention explain how a well-meaning celebration with family and friends wound up causing so much suffering and death throughout the state in such a short period of time. Although the pandemic was 5 months old at the time of the wedding, few of those who found themselves in the virus’ path were taking the kinds of precautions that could have reduced their risk of infection. That indifference to public health guidelines appears to have played a key role in making the reception a super-spreading event, according to the report.

31. BMJ Leader: Speaking truth to power: why leaders cannot hear what they need to hear
‘Forty years ago, when I was a junior doctor, I decided to speak up about a consultant’s malpractice. I went into a senior clinician’s office, explained what I had seen and was then told in no uncertain terms ‘young man, if you value your future career, you will desist immediately with these claims’. So, I did. And it still haunts me today.’
This story is among thousands we have heard in the National Health Service (NHS). Unfortunately, this kind of situation is not relegated to the past—among stories of real promise and heroic action, the NHS is still grappling with issues of bullying, harassment, exclusion and malpractice. Crucially and similar to the numerous organisations we have examined globally and across every industry sector, leaders are still falling into a critical trap that thwarts their ability to improve the situation.
That is, they are focusing their attention and efforts predominantly on those who feel silenced, urging them to ‘be brave’, ‘speak up’ and have the ‘courageous conversations’ that are required. While this is undoubtedly an important initiative, we need to tackle the cultural context1 that means that such bravery and courage is required in the first place.
We need to stop trying to ‘fix the silenced’ and rather ‘fix the system’. This requires us to focus more time and resources on enabling those who are in perceived positions of power to skilfully invite those silenced to speak and then in turn to listen up themselves. It requires us to question and disrupt the very way we socially construct power at work.
In this article, we seek to explore the imperative to speak up and the reasons for silence, the perceptions of speaking and listening up in the NHS, the inevitable blind spots leaders have and what can be done. We draw on our research—a 5-year global, cross-sector, multimethods inquiry into speaking and listening up at work.

32. Russia: Reuters: The Secrets of Star City: The woman who fell from the sky
Within weeks of Russia’s first confirmed case, the coronavirus penetrated Star City, the secretive home of the country’s space programme. It spread through the town during a period of international attention and national pride, and a few inches of glass might have been all that prevented it from traveling to space in a cosmonaut. Reuters investigates how Natalya Lebedeva, a doctor who headed the town’s ambulance service, took her own life in the midst of suspicion, fear and blame. When the pandemic potentially came within a thin sheet of glass to astronauts about to lift off into space, Star City, the secretive home of Russia’s space program, became a place of suspicion, fear and blame. One doctor, the leader of the town’s ambulance service, found herself in a desperate situation. The Star City Closed Administrative Territorial Unit is barely an hour’s drive northeast of the Kremlin, but for decades the town never appeared on any maps. Only after the Soviet Union fell apart was its location revealed. Even now, it is shrouded by forests, and behind its tall concrete walls lies the somber infrastructure of Russia’s legendary space program, and the Soviet-era apartment blocks that its cosmonauts and scientists call home.
Star City’s medical clinic stands in a wooded area just past a monument to Yuri Gagarin, who became the first man in space in 1961, and a soaring symbol of Cold War-era glory. To this day, flowers are often placed at his feet. For around a decade, physician Natalya Lebedeva worked out of the Star City clinic as a paramedic. One autumn, she and another doctor were called out to the 12th-floor apartment of a young musician.

33. Africa: PHCFM: COVID-19: Pandemic burden in Sub-Saharan Africa and the right to health – The need for advocacy in the face of growing privatisation
For Africa, the backdrop against which COVID-19 emerged is a stark one. Although sub-Saharan Africa accounts for 11% of the world’s population, it bears 24% of the global disease burden. The continent is home to 60% of the people with human immunodeficiency virus (HIV), and over 90% of malarial patients. In this region, infectious diseases such as malaria and HIV cause 69% of deaths. As states respond to COVID-19, we need to keep our eyes open to what effective responses are notifying us about our healthcare systems, so that we can craft sustainable interventions as a result and uphold the right to health. This is especially true in the light of the ongoing nature of pandemics on the continent, making urgent the need to maximise the value of our health system and its resources, as we seek lasting transformation.

34. Canada: The Guardian: Margaret Atwood: ‘If you’re going to speak truth to power, make sure it’s the truth’
A polarising US election, a global pandemic, the rise of cancel culture: what does the queen of dystopian fiction make of 2020 so far?
Margaret Atwood is smiling, waving a green copy of her book The Testaments at me, while I wave a black one back at her. High-cheekboned, pale-skinned, her curly grey hair like a corona, she’s wearing a jewel-green blouse that makes her eyes glitter. Behind her stretches her large, comfy, slightly darkened sitting room in Toronto, with books and wall hangings and a whirring fan. Atwood gleams out of my screen, bright in all senses.
She is talking about being a grouch. She tells me she turns down a lot of interview requests, “and then I get a reputation as being very grumpy and hard to deal with. But who cares?” Grumpy seems wrong to me. I had been warned that Atwood was scary – super-sharp and impatient – but she’s not like that either. She is unsentimental, clear, sure of her facts and opinions, but she also has a light, mischievous quality. She says my name as though constantly on the verge of teasing me. And she’s not grand, though she has every right to be, as one of the most successful writers in the world. Now 80, she has written 17 novels, 17 books of poetry, 10 books of non-fiction, eight collections of short stories, eight children’s books and three graphic novels. Her green copy of The Testaments is the paperback version of her slightly more cheerful sequel to The Handmaid’s Tale: the black hardback sold more than 250,000 copies in its first month in the UK alone. Atwood could be forgiven for resting on her laurels – or resting, full stop – but she likes to be hands on: she runs her own Twitter and Instagram accounts, where she posts books she likes, links to campaigns and festivals, sometimes funny little clips (there is a great short film of her riding an electric scooter in New Zealand in February). She writes articles, and puts her name to open letters for causes she supports: Greta Thunberg’s environmentalism, free speech, LGBTQ+ rights, women’s rights, birdwatching. She has a lot going on.
S ED Humanities

35. USA: BBC: Video: How the sanctuary movement in the US is advocating for immigration reform
How the sanctuary movement in the US is advocating for immigration reform Close
Across the US, a number of Lutheran churches have formed a sanctuary movement to support undocumented migrants – and their work has doubled due to Covid.
In California, Pastor Nelson Rabel Gonzalez has been visiting his city’s mainly Mexican migrant population that work in the grape and cherry fields. He says that lots of them have not been provided with masks and hand sanitiser, but need to continue to work as they are essential workers – and that those who have been let go because of the pandemic are struggling to pay rent.
And in Ohio, Pastor Sally Padgett has been looking after Miriam, a mother from Honduras who is at risk of deportation. When they both caught Covid, they were terrified that if Miriam’s health deteriorated that they may have to go to hospital – meaning Miriam would have to leave the safety of the church and risk being captured by Immigration and Customs Enforcement Officers.
N Video

36. USA: New York Times: My Patients Can’t Take Trump’s Advice
He urged Americans to not let the virus “dominate” their lives, but the people who come to my hospital seeking care are genuinely afraid.
Imagine wanting, needing, to take a gulp of air and finding that you can’t. On Monday, a patient walked into the emergency room where I work. He struggled to breathe as he explained his symptoms to me. When the test result came back positive for the coronavirus, his eyes brimmed, and he spoke quietly: “Will I be OK?”
I see some version of this story every day at my hospital in rural west Michigan. It’s some 700 miles away from the White House, and feels even farther as I watch President Trump whisked to the hospital and back in helicopters, and flanked by men in white lab coats, ready to serve him. And yet he tweets, “Don’t be afraid of Covid.”
My patients are genuinely afraid. That fear didn’t come from CNN or “fake news.” Nor did it come from Dr. Anthony Fauci. My patients’ fears come from the fact that they can’t breathe. The people who come to my hospital seeking care are largely underserved with underlying conditions. As they struggled and wheezed, they may have thought of their own mortality in the context of the more than 211,000 lives cut short — too many in their prime, healthy one day, dead a week or two later.

37. UK: The Cost of Keeping Coronavirus Out of Your Care Home; Coronavirus is here to stay.
So far, 29 million people have caught it. Any chance we had to contain it has passed and the scientific consensus is that this virus is too widespread and too easily transmissible. It is never going away.
In August, the first case of a person being reinfected with Covid-19 was reported and at the time of writing this post, cases are increasing rapidly and restrictions to our movements are being re-introduced.
Even when we hopefully have a working vaccine by the end of next year, breakouts will occur. Eventually, we will have to learn to live with it as we do with the flu virus.
Keeping Coronavirus out of your care home is proving to be a challenging exercise and right now, cases are increasing once more. One of the biggest challenges is the actual cost of trying to keep Coronavirus out of your care home and keeping your residents safe.
But do you know how much this is costing you? The cost of PPE is only one factor and not even the largest.
On a weekly basis the cost of keeping your residents Covid-19 free could be the equivalent of several bed fees.
You need to know how much your efforts to keep your residents safe is costing you because only by knowing something can you have any hope of doing something about it. In this post I’ll take you through the key task you should be carrying out and talk about what you should be doing now to manage the extra cost that this virus has laid at your door.

38. USA: Medical News Today: COVID-19: Cell phone data reveals ‘superspreader’ venues
A model of SARS-CoV-2 transmission suggests that a small number of venue types, such as restaurants, hotels, and religious venues, account for the majority of infections. The model also helps explain why infections disproportionately affect people living in deprived areas.
Almost a year since the start of the COVID-19 pandemic in Wuhan, China, there remains considerable uncertainty about the safest ways to restore economic and social life to something resembling normality. According to the creators of the new model at Stanford University, CA, and Northwestern University in Chicago, IL, the model provides a tool for identifying high risk venues and testing alternative paths out of lockdown. Computer scientists and medical researchers collaborated on the model, which used anonymized location data from cell phone networks to reveal the movements of 98 million people in the United States between March 1 and May 2, 2020. The team modeled the number of infections occurring hour by hour at around 553,000 venues, which they grouped into 20 categories according to use. They also factored in the floor space of each venue. Their simulations accurately predicted daily confirmed infections in 10 of the largest metropolitan areas, including Chicago, New York City, and San Francisco. The model suggests that reopening gyms, full-service restaurants, cafes, hotels, and religious venues leads to the largest surge in infections, due to the high densities of people and their long lengths of stay.
A relatively small number of these “superspreader” venues account for the majority of new infections, according to the model. For example, the model found that 10% of all the venues in the Chicago metropolitan area accounted for 85% of all infections.

39. UK: The Guardian: Chocolate sales soar as UK shoppers comfort eat at home amid Covid
Annual spend up £50m driven by multipacks and ‘sharing bars’, but smaller bars decline. Spending on chocolate has soared by £50m year on year, powered by sales of chocolate bars bought in supermarkets to eat at home. The increase in sales of multipacks and large “sharing bars” has offset a dip in sales of single bars, often impulse buys to eat on the go, from newsagents and other outlets.
While the £50m sales increase is only 3% up on the total value of chocolate sales, the amount of chocolate eaten is likely to have risen by two or three times that level because the kind of chocolate bought in supermarkets is so much cheaper.
Sales of multipacks of chocolate bars in supermarkets are up by more than a fifth, according to analysts at research group Kantar. But the biggest increase has come from large chocolate blocks, sales of which are up nearly 46% in supermarket outlets.
Waitrose said its sales of big sharing bars of brands such as Cadbury Dairy Milk were up by 37% as shoppers turned to comfort eating during the lockdown.
However, demand for the supermarket’s premium own-label bars was also up by a fifth as people indulged in what the grocer described as “self-treating at home”.
Sales of small single bars and gift boxes for family and friends have declined after travel and visits to other households were curtailed by government restrictions.

40. France: CNRS News: Tracking Covid-19 in wastewater
Testing sewage for Covid-19 could help predict future outbreaks. The Obépine project, which analyses wastewater, could use the concentration of the virus in human faeces to develop an early alert system in France.
On 5 March 2020, only ten Covid-19 cases had been detected in Paris. And yet, the new coronavirus was already present in the city’s sewers. If someone had analysed the wastewater back then, they would have known the low number of positive cases was misleading and that Paris was already in the midst of a crisis, with hospital admissions soon going to soar.
That month, with health services near breaking point, the concentration of the virus in the city’s wastewater had multiplied by more than a hundred until, in early April, the number of cases fizzled out and began to decline rapidly. In the matter of weeks, it dropped to a thousand times lower than during the peak. The drastic confinement measures imposed by the authorities had successfully stopped the spread of the epidemic.

41. Australia: University of Melbourne: KEEPING AGED CARE RESIDENTS CONNECTED
As COVID-19 increasingly impacts on our day-to-day lives, people in aged care homes are already isolated. But new technologies can play a role keeping residents connected The COVID-19 crisis has left some of our most vulnerable citizens – people in residential aged care – cut off from the outside world.
Not only has COVID-19 shutout friends and family from visiting their loved ones in aged care homes, it has also reduced the social programs on offer, leaving those living in aged care at risk of social isolation and disengagement.
In these strange times of enforced social isolation, can technology help aged care residents feel connected to the wider world?
Our research explores how some of the new technologies on offer are used in aged care to provide social and emotional enrichment for residents.
These technologies range from relatively simple solutions, like videoconferencing to connect with family, to more sophisticated programs, like using immersive virtual reality that let people ‘travel’ the world. Recently, as the social distancing measures to combat COVID-19 became more strict, one Australian not-for-profit aged care and community health provider developed an online ‘Virtual Hug’ tool. It allows families and carers to share to share messages of hope and love. Social technologies like this are being used in creative ways to provide people in aged care with a sense of connection to the world. But introducing and using these new technologies in care homes isn’t easy.
Ongoing work is needed to ensure staff and residents are well supported with access to appropriate tools, as well as training and time to make effective use of them.
S ED Telemedicine

42. Australia: University of Melbourne: PROTECTING OUR AGEING POPULATION FROM COVID-19
While Australia works to prevent the spread of COVID-19, there are extra health considerations when it comes to older Australians and our ageing society
COVID-19 is a new virus, causing respiratory illness with flu-like symptoms such as dry cough, fever and aches and pains.
But, unlike flu symptoms, which progress relatively quickly, the symptoms for COVID-19 may progress more slowly taking several days to get worse.
Although there’s still a lot of research being done, COVID-19 also appears to be more infectious and have a higher mortality rate than the flu.
But what does that mean for older Australians? Firstly, you need to consider the immune response of individuals. We know from the flu that an older person’s immune response is not as robust as a younger one.
The immune cells in an older person’s immune system already have a lot of history. And each immune cell within the immune system can act only once to one virus or bacterium. Once a cell has reacted to either a virus or bacterium they are ‘primed’ to resist that infectious agent. As a result, cells are able to create a ‘memory’ of that infectious agent, meaning that in future the immune system will be able to react to that virus or bacterium very quickly and provide an immune response to defend your body against it. The cells that have not previously come into contact with a virus or bacterium are known as ‘naïve’ cells.
So, if you are older and you come in contact with COVID-19, there are a couple of important things to consider.

43. USA: Washington Post: ‘How do you sleep at night?’: CNN’s Anderson Cooper thrashes MyPillow CEO over dubious coronavirus drug
Even by the somewhat raucous standards of cable news, CNN anchor Anderson Cooper’s interview with pillow company executive Mike Lindell on Tuesday afternoon was particularly tense.
During the segment, which launched an avalanche of commentary on social media, Cooper challenged the MyPillow founder on his support of a plant extract, oleandrin, which he has been lobbying the Trump administration to approve as a possible therapeutic for the novel coronavirus.
Cooper likened Lindell to a “snake oil salesman” and asked, “How do you sleep at night?” Watch below:

44. USA: CDC: Characteristics and Maternal and Birth Outcomes of Hospitalized Pregnant Women with Laboratory-Confirmed COVID-19 — COVID-NET, 13 States, March 1–August 22, 2020
What is already known about this topic? Information on the clinical characteristics and birth outcomes of hospitalized U.S. pregnant women with COVID-19 is limited.
What is added by this report? Among 598 hospitalized pregnant women with COVID-19, 55% were asymptomatic at admission. Severe illness occurred among symptomatic pregnant women, including intensive care unit admissions (16%), mechanical ventilation (8%), and death (1%). Pregnancy losses occurred for 2% of pregnancies completed during COVID-19-associated hospitalizations and were experienced by both symptomatic and asymptomatic women.
What are the implications for public health practice? Pregnant women and health care providers should be aware of potential risks for severe COVID-19, including adverse pregnancy outcomes. Identifying COVID-19 during birth hospitalizations is important to guide preventive measures to protect pregnant women, parents, newborns, other patients, and hospital personnel.

45. Australia: The Guardian: The megafires and pandemic expose the lies that frustrate action on climate change
If there was a moment of true emergency in the fight to preserve our climate, it is now
This is part of a series of essays by Australian writers responding to the challenges of 2020: Tim Flannery
I was in Melbourne in late January, watching as more and more people donned face masks to protect themselves against the bushfire smoke that had thickened the air for weeks and that was causing hundreds of deaths. Turning on the news, I was surprised to see footage of crowds in China similarly masked, but for a very different reason. Hundreds were then dying in Wuhan, Hubei province, from a novel virus.
When I asked Australia’s chief medical officer about the virus that same week, I could see the concern in his eyes. But my attention was largely on the fires. They were unlike anything experienced on the continent previously, and climate scientists were beginning to piece together the link with climate change. What few knew back then was that three catastrophes would strike Australia in quick succession: the unprecedented, climate-fuelled megafires that were extinguished in February by damaging, climate-influenced floods. Then, in March, the Covid-19 pandemic that began to spread across Australia.
These three catastrophes are proof that things that travel invisibly through the great aerial ocean that is our atmosphere are a particular danger to our complex, global civilisation. The carbon dioxide molecule that accumulates imperceptibly as we burn fossil fuels causes an increase in average global temperature, which triggered the profoundly disruptive droughts, floods and fires that plagued Australia over the past year. But the coronavirus also travels unseen through the great aerial ocean, insinuating itself in lung after lung, killing person after person, until it threatens our health system, economy and society.

Once more, look after yourselves and stay safe
John Wynn-Jones