“A man growing old becomes a child again”

“I live in that solitude, which is painful in youth, but delicious in the years of maturity.”
Albert Einstein

“The more sand that has escaped from the hourglass of our life, the clearer we should see through it.”
Jean-Paul Sartre

“I have left orders to be awakened at any time during national emergency, even if I’m in a cabinet meeting.”
Ronald Reagan

“Some guy said to me: Don’t you think you’re too old to sing rock n’ roll?
I said: You’d better check with Mick Jagger.”

Growing Old

Having posted a series of poems on the theme of childhood, I felt obliged to collect some poems on growing old. Shakespeare writes much about aging. In Sonnet 73: ‘That time of year thou mayst in me behold’ he paints somewhat depressing autumnal picture of getting older with “When yellow leaves, or none, or few, do hang upon those boughs which shake the cold”. Other writers see aging as an optimistic opportunity to see life in a different way.
Unfortunately, age comes to us all and there is a plethora of poetry out there on the subject to warn us. Much of it is sadly disheartening but I have started with a poem by the Greek Lyric Poet Anacreon which will make you smile. I also finish with a collection of humorous but respectful poems by the English poet Paul Curtis.

Anacreon (582-485 BC)
Anacreon was a Greek lyric poet, notable for his drinking songs and erotic poems. Anacreon wrote all of his poetry in the ancient Ionic dialect. Like all early lyric poetry, it was composed to be sung or recited to the accompaniment of music, usually the lyre. Anacreon’s poetry touched on universal themes of love, infatuation, disappointment, revelry, parties, festivals and the observations of everyday people and life.
Poems about old age can be really depressing but this is uplifting and joyful

Youth and Age

When I see the young men play,
Young methinks I am as they;
And my aged thoughts laid by,
To the dance with joy I fly:
Come, a flowery chaplet lend me;
Youth and mirthful thoughts attend me:
Age be gone, we’ll dance among
Those that young are, and be young:
Bring some wine, boy, fill about;
You shall see the old man’s stout;
Who can laugh and tipple too,
And be mad as well as you.

Bai Juyi (772-846)
Bai Juyi, courtesy name Letian, was a renowned Chinese poet and Tang dynasty government official. Many of his poems concern his career or observations made about everyday life, including as governor of three different provinces. Bai was also influential in the historical development of Japanese literature.

The Chrysanthemums in the Eastern Garden (AD 812)

The days of my youth left me long ago;
And now in their turn dwindle my years of prime.
With what thoughts of sadness and loneliness
I walk again in this cold, deserted place!
In the midst of the garden long I stand alone;
The sunshine, faint; the wind and dew chill.
The autumn lettuce is tangled and turned to seed;
The fair trees are blighted and withered away.
All that is left are a few chrysanthemum-flowers
That have newly opened beneath the wattled fence.
I had brought wine and meant to fill my cup,
When the sight of these made me stay my hand.
I remember, when I was young,
How easily my mood changed from sad to gay.
If I saw wine, no matter what season,
Before I drank it, my heart was already glad.
But now that age comes,
A moment of joy is harder and harder to get.
And always I fear that when I am quite old
The strongest liquor will leave me comfortless.
Therefore I ask you, late chrysanthemum-flower
At this sad season why do you bloom alone?
Though well I know that it was not for my sake,
Taught by you, for a while I will open my face.

Translated by Arthur Waley

William Shakespeare (1564-1616)
Shakespeare’s sonnets are poems that William Shakespeare wrote on a variety of themes. Hew wrote 154 sonnets that were first published all together in a quarto in 1609.
‘That time of year thou mayst in me behold’ is one of the most widely anthologised sonnets by William Shakespeare, and is often praised as one of the most successfully constructed, and most moving, of all the 154 Sonnets.
It focuses on the theme of old age. The sonnet addresses the Fair Youth. Each of the three quatrains contains a metaphor: Autumn, the passing of a day, and the dying out of a fire. Each metaphor proposes a way the young man may see the poet

Sonnet 73: ‘That time of year thou mayst in me behold’

That time of year thou mayst in me behold
When yellow leaves, or none, or few, do hang
Upon those boughs which shake against the cold,
Bare ruined choirs, where late the sweet birds sang.
In me thou see’st the twilight of such day
As after sunset fadeth in the west;
Which by and by black night doth take away,
Death’s second self, that seals up all in rest.
In me thou see’st the glowing of such fire,
That on the ashes of his youth doth lie,
As the death-bed, whereon it must expire,
Consumed with that which it was nourish’d by.
This thou perceiv’st, which makes thy love more strong,
To love that well, which thou must leave ere long.

Sonnet 73: That time of year thou mayst in me behold

Anne Bradstreet (1612-1672)
Anne Bradstreet was the most prominent of early English poets of North America and 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 corpus of poetry, as well as personal writings published posthumously
In “Of the Four Ages of Man”, there are four acts on the stage: the first is born of Phlegm, the second is born of blood and air, the third is from fire and choler, and the fourth comes out of earth and sorrow. Childhood wears white and a garland upon his head; he is always in danger of toppling over. Youth wears beautiful attire and appears to be filled with pride; his face is flushed as he twirls about, also in danger of falling into death. Middle Age is graver, wearing a sword, and his eyes are filled with choler. He has not used the sword yet. The last act, Old Age, holds a sheaf of wheat and a glass. His hair is gray and his aspect is grave. Everyone prepares to listen to Old Age, but he says he will give precedence to Childhood, because everyone was young once. Everyone will speak about themselves, both the good and the bad.

Of the Four Ages of Man

Lo, now four other act upon the stage,
Childhood and Youth, the Many and Old age:
The first son unto phlegm, grandchild to water,
Unstable, supple, cold and moist’s his nature
The second, frolic, claims his pedigree
From blood and air, for hot and moist is he.
The third of fire and choler is compos’d,
Vindicative and quarrelsome dispos’d.
The last of earth and heavy melancholy,
Solid, hating all lightness and all folly.
Childhood was cloth’d in white and green to show
His spring was intermixed with some snow:
Upon his head nature a garland set
Of Primrose, Daisy and the Violet.
Such cold mean flowers the spring puts forth betime,
Before the sun hath thoroughly heat the clime.
His hobby striding did not ride but run,
And in his hand an hour-glass new begun,
In danger every moment of a fall,
And when ‘t is broke then ends his life and all:
But if he hold till it have run its last,
Then may he live out threescore years or past.
Next Youth came up in gorgeous attire
(As that fond age doth most of all desire),
His suit of crimson and his scarf of green,
His pride in’s countenance was quickly seen;
Garland of roses, pinks and gillyflowers
Seemed on’s head to grow bedew’d with showers.
His face as fresh as is Aurora fair,
When blushing she first ‘gins to light the air.
No wooden horse, but one of mettle tried,
He seems to fly or swim, and not to ride.
Then prancing on the stage, about he wheels,
But as he went death waited at his heels,
The next came up in a much graver sort,
As one that cared for a good report,
His sword by’s side, and choler in his eyes,
But neither us’d as yet, for he was wise;
Of Autumn’s fruits a basket on his arm,
His golden god in’s purse, which was his charm.
And last of all to act upon this stage
Leaning upon his staff came up Old Age,
Under his arm a sheaf of wheat he bore,
An harvest of the best, what needs he more?
In’s other hand a glass ev’n almost run,
Thus writ about: “This out, then am I done.”

The Four Ages of Man – Anne Bradstreet poem reading | Jordan Harling Reads

Mathew Arnold (1822-1888)
Matthew Arnold was an English poet and cultural critic who worked as an inspector of schools. He was the son of Thomas Arnold, the celebrated headmaster of Rugby School, and brother to both Tom Arnold, literary professor, and William Delafield Arnold, novelist and colonial administrator.
“Growing Old” muses on getting old, and old age. It is about the misfortune of old age, which is to forget what it was like to be young. Arnold says that when someone gets old he seems as though he is losing glories and fading away from his life from shines of youth. This is a cynical poem as he says that aging leaves no room for brightness or optimism. He tells us that old age is different to how you imagine it in ones youth. Aging according to Arnold can be depressing but if met with some joyful or optimistic expectations it can be a fulfilling experience.

Growing Old

What is it to grow old?
Is it to lose the glory of the form,
The lustre of the eye?
Is it for beauty to forgo her wreath?
—Yes, but not this alone.
Is it to feel our strength—
Not our bloom only, but our strength—decay?
Is it to feel each limb
Grow stiffer, every function less exact,
Each nerve more loosely strung?
Yes, this, and more; but not
Ah, ’tis not what in youth we dreamed ’twould be!
’Tis not to have our life
Mellowed and softened as with sunset glow,
A golden day’s decline.
’Tis not to see the world
As from a height, with rapt prophetic eyes,
And heart profoundly stirred;
And weep, and feel the fullness of the past,
The years that are no more.
It is to spend long days
And not once feel that we were ever young;
It is to add, immured
In the hot prison of the present, month
To month with weary pain.
It is to suffer this,
And feel but half, and feebly, what we feel.
Deep in our hidden heart
Festers the dull remembrance of a change,
But no emotion—none.
It is—last stage of all—
When we are frozen up within, and quite
The phantom of ourselves,
To hear the world applaud the hollow ghost
Which blamed the living man.

“Growing Old” by Matthew Arnold (read by Tom O’Bedlam)

William Butler Yates (1865-1939)
William Butler Yeats was an Irish poet and Nobel Prize Winner. Hw is one of the foremost figures of 20th-century literature. A pillar of the Irish literary establishment and in his later years served two terms as a Senator of the Irish Free State.
In the poem, when you are old, the speaker asks someone to think ahead to old age, strongly suggesting that the addressee will eventually regret being unwilling to return the speaker’s love. Most critics agree that the poem is about Yeats’s relationship with Maud Gonne, an Irish actress and nationalist. Though the poem is one of the best-loved of Yeats’s works, many people don’t realize that it is based on a much earlier sonnet by Pierre de Ronsard, a 16th century French Renaissance poet.
The speaker tells the addressee to pick up this book when they’re falling asleep by the fire, and to read from it, while dreaming of the soft and shadowed look the addressee’s own eyes used to have.
The addressee should also think of how many people loved the addressee’s gracefulness and beauty, whether or not these people were sincere in their love. But there was one man who genuinely loved the addressee’s emotional and spiritual restlessness. This man also loved the sadness that showed on the addressee’s face as it changed over the years.
The speaker imagines the addressee bending down to tend to a fire and muttering sadly about how love ran away to walk restlessly in the mountains and hide among the stars of the night.

When You Are Old

When you are old and grey and full of sleep,
And nodding by the fire, take down this book,
And slowly read, and dream of the soft look
Your eyes had once, and of their shadows deep;

How many loved your moments of glad grace,
And loved your beauty with love false or true,
But one man loved the pilgrim soul in you,
And loved the sorrows of your changing face;

And bending down beside the glowing bars,
Murmur, a little sadly, how Love fled
And paced upon the mountains overhead
And hid his face amid a crowd of stars.

“When You Are Old” by W. B. Yeats (read by Tom O’Bedlam)

Maya Angelou (1928-2014)
Maya Angelou was an American poet, memoirist, and civil rights activist.
I found this rather touching commentary on this poem by Courtney Cade. It says it all!
“Reading this poem was very heartfelt and personal. Maya Angelou has always been my favorite author of all times, but reading this particular poem reminds me of my grandmother who I was lucky enough to have been raised by. Losing my grandfather recently, I saw big changes in my grandmother, who was once full of life and love, but since his passing she just always sits and stares off into deep thought. The family tries to keep her busy and visit often so that she doesn’t feel alone, but to me, alone isn’t alone; it’s a quiet, peaceful time to gather your thoughts and reflect on your memories, which can sometimes bring you as much joy as being around a crowd. I never told her, but I totally understand and can read straight through, but being silent, she never expresses exactly how she feels, which can sometimes get misunderstood.”

On Aging

When you see me sitting quietly,
Like a sack left on the shelf,
Don’t think I need your chattering.
I’m listening to myself.
Hold! Stop! Don’t pity me!
Hold! Stop your sympathy!
Understanding if you got it,
Otherwise I’ll do without it!
When my bones are stiff and aching,
And my feet won’t climb the stair,
I will only ask one favor:
Don’t bring me no rocking chair.
When you see me walking, stumbling,
Don’t study and get it wrong.
‘Cause tired don’t mean lazy
And every goodbye ain’t gone.
I’m the same person I was back then,
A little less hair, a little less chin,
A lot less lungs and much less wind.
But ain’t I lucky I can still breathe in.

Listen to Maya Angelou reading the poem to music (Great!)

Another version:

Listen to Maya Angelou talking about aging

Funny Poems About Old Age: “And Now for Something Compleartly Different”

A collection of funny poems about old age by Paul Curtis, which focus on the physical and mental deterioration associated with the twilight years.
Born in Surrey, England in 1956. Almost all of his working life has been spent in warehousing and distribution, or what is now fashionably referred to as Logistics. After 22 years in his last position. He was made redundant and is now work as a custody assistant for the Surrey police force. He says “I have also discovered amongst the non-poets that there is a popular misconception that poets are a bunch of high brows who are typically angst ridden, corduroyed and sandal clad who believe that poetry must be deeply meaningful and full of literary significance and/or unintelligible. In my case I believe in the simple premise that if the poems meaning is not obvious to the reader then I have written it badly. I think Poetry can be relevant or not but it doesn’t need to be deep and it can be funny in fact humour is a great tool to get a message across and above all it can rhyme”.
The poems are intended to be gently humorous and warmly affectionate, not disrespectful or hurtful. Enjoy!

Don’t Throw Me On The Scrap Heap

Don’t throw me on the scrap heap
Just because I’m old
I still have talent and skills to offer
If I may be so bold
My talent is called multi tasking
Or so I’ve been led to believe
And I can simultaneously wet myself
And laugh, cough, fart and sneeze

The Absent Minded Octogenarian

An octogenarian visited his doctor
‘I think I’m getting senile” he said
The doctor replied “I don’t think you are senile
Let’s look for a different diagnosis instead”
“But I keep forgetting to do up my fly”
The old man said “After I’ve been for a pee”
The doctor smiled and then replied
“Not opening your fly before you start, that’s senility”

Ask A Stupid Question

A local reporter
Asks an old lady at her leisure
“What part of being 104
Gives you most pleasure?”
She simply replied to him
“No peer pressure”

A Timely Reflection

I am feeling my age
Now I’m of the silver haired class
But on the bright side
I’m still on the right side of the grass

Today’s Posts

1. India: London School of Hygine and Tropical Medicine: Alumni Blog: COVID-19 Alumni Stories: Sanjana Mohan
Sanjana Brahmawar Mohan (MSc Epidemiology, 2012) works with Basic Healthcare Services, a not-for-profit organisation which runs primary healthcare clinics (called AMRIT clinics) in remote, tribal communities in southern Rajasthan, India. Here, she describes how her work has been affected by the COVID-19 pandemic and lockdown.
“Tribal communities in southern Rajasthan in India have amongst the highest burden of malnutrition in the state as well as the country, and a huge burden of morbidities as well as preventable mortality. In areas where they exist, AMRIT clinics are the only facilities run by qualified health providers, with the next facility located at least 15-20 km away. When the pandemic and lockdown began, a major challenge was continuing health services, and also ensuring the safety of our health workforce of physicians, nurses and health workers. The other health facilities were shutting down the regular outdoor services and focusing on COVID-19 alone. As we were practically the only providers in the area, cutting down on their work even in the face of the pandemic was not an option.
“Faced with resource and space constraints, our response included using masks (multilayered, reusable ones), social distancing, and rigorous hand hygiene. We also shifted the consultation area into the open to further reduce transmission risk. The sense of fear everywhere also affected our nurses and health workers, who were under constant pressure from their families to return home. Speaking to them regularly, clearing their doubts as well as fears with scientific knowledge as it became known, was and still is an important part of our work. These discussions, carried out through online sessions as well as in person, have clearly boosted their confidence.
“Halting of all public transport and marked restrictions on travel made it very difficult for patients with chronic conditions, most commonly tuberculosis, diabetes and hypertension to visit the clinics. We listed out these patients and our nurses and health workers made home visits to deliver their medicines. Being close to the communities, we were also able to identify their urgent needs. Very soon after the lockdown began, there was a severe shortage of food. Our field teams identified the most vulnerable families for whom we, together with the government, mobilised food rations quickly. In the early days of the pandemic, there were also a lot of rumours circulating in the communities that created a panic like situation. We trained our health workers, who conducted telephonic counselling of community members, responded to their questions, and allayed their fears.

2. India: The Lancet: COVID-19 in India: the dangers of false optimism
Despite a strong response at the outset of the pandemic, as of Sept 22, India has the world’s fastest growing outbreak of COVID-19 in absolute numbers according to WHO, reporting more than 5·6 million infections. Restrictions began to be lifted in June, and this relaxation has continued in the face of a continuing dramatic increase in case numbers nationally. Beneath these alarming national figures, the pattern of spread in India is nuanced and complex, with marked differences between states, and between rural and urban areas. For example, cities like Kolkata and rural areas in the north of India were relatively spared the outbreak initially, whereas Delhi, with strong international connections, was at the forefront of the first wave. Even so, India is clearly facing a dangerous period.
The country has responded well in many regards, especially for such a large and diverse nation. India instigated a national lockdown in March, which was praised by WHO. During the lockdown period, tertiary care provision was increased, including access to specialist equipment such as ventilators. Testing numbers also increased quickly, with India being among the first to roll out innovations like pooled testing. India has also been at the forefront of efforts to develop and manufacture a vaccine, both through domestic vaccine candidates and manufacturers such as the Serum Institute of India preparing production capacity for internationally developed vaccine candidates.

3. International: The Lily: Women worldwide are nearly 3 times more likely than men to report mental health impact from covid-19
A new study surveyed more than 6,200 women and 4,000 men in 38 countries
Like so many other women, Carrine Annette Bidzogo has struggled with her mental health during the coronavirus.
“The stress of contracting the disease prevented me from visiting family. So I stayed at home, cloistered. … The course of life changed overnight,” said Bidzogo, who lives in Cameroon. Her remarks were revealed Tuesday in a report released by CARE, a global anti-poverty organization that focuses on social justice.
The study polled more than 6,200 women and 4,000 men in 38 countries — about how the novel coronavirus has affected their lives and priorities. It is billed as the first comprehensive report to focus on women around the world and their experiences during the pandemic.
Bidzogo’s experience navigating the pandemic in central Africa resonates with women all around the world, the analysis shows.
The common threads across the globe, despite geography, race and socioeconomic status, were striking in their similarity, said Emily Janoch, CARE’s director of knowledge management and the author of the report.
S ED Mental

Filling the Data Gap to Build Back Equal
As pandemic-driven health, social, economic, and hunger crises deepen across the globe, it is increasingly clear that COVID-19 is widening systemic inequalities that have long affected women, girls, and other people who face discrimination because of race and migration status. These dynamics threaten decades of progress in realizing the rights and equalities that all people should enjoy, and that women have fought hard to claim. CARE has warned from the beginning that the pandemic would have a disproportionate impact on women and girls. But foresight is only as good as the action it enables. The efficacy of CARE’s and others’ COVID-19 responses depends on understanding how marginalized people are affected, in all their diversity, across contexts, and over time. Women’s needs are routinely overlooked without deliberate efforts to fill persistent gender data gaps. So we sought the advice of experts: women themselves.
S ED Mental

5. International: Care: CARE report identifies that COVID-19 policy and planning must consider severe gender, race and class disparities
Today, CARE has released a report calling for amplifying the voices of community-centered organizations and more gender-balanced and inclusive decision-making for COVID-19 policy and planning to address gaps within Black, Indigenous and People of Color (BIPOC) communities.
Rapid Gender Analysis: COVID-19 in the United States focuses specifically on highlighting the historical and institutional systems of oppression, gender bias, and racism targeting Black, Indigenous, and people of color (BIPOC). The findings of the report indicate that structural realities and biases put BIPOC communities, particularly women in those communities, at higher exposure to infection and a higher risk of death, exacerbated by existing disparities, including poverty, lack of access to healthcare, food, clean water, education, housing and plumbing.
“Women of Color, particularly Black and Indigenous women, are dying from COVID-19 because they are trying to survive in a system that not only ignores their needs but has also benefitted from their oppression,” said CARE Chief Operating Officer Tjada D’Oyen McKenna. “In order to identify, pinpoint and address existing gaps, states and territories must be more consistent and transparent in the collection and publishing of data. Agencies that perform federal tracking of COVID-19, like the CDC, should ensure the availability of systematic data disaggregated by sex, class, race, and age to measure the direct and indirect effects of COVID-19.”

6. Africa: BBC: Coronavirus: Health chief hails Africa’s fight against Covid-19
The head of the Africa Centres for Disease Control (CDC) has praised African states for managing to curb the spread of coronavirus.
Africa has seen about 1.4 million cases and 34,000 deaths since February.
These figures are far lower than those in Europe, Asia or the Americas, with reported cases continuing to decline.
Early interventions played a crucial role in curbing the virus’ spread, Africa CDC head John Nkengasong told the BBC’s Newsday programme.
Africa CDC is the health agency of the 55-member African Union (AU).
The continent of more than one billion people accounts for just under 5% of cases globally and 3.6% of deaths.
Dr Nkengasong described as “false” suggestions that cases and deaths in Africa were significantly under-reported.
“We may not have been picking up all the cases, just like in other parts of the world… but we are not seeing people around the continent falling dead on the streets or mass burials going on,” Dr Nkengasong said.

7. The Lancet: Risk of COVID-19-related death among patients with chronic obstructive pulmonary disease or asthma prescribed inhaled corticosteroids: an observational cohort study using the OpenSAFELY platform
Early descriptions of patients admitted to hospital during the COVID-19 pandemic showed a lower prevalence of asthma and chronic obstructive pulmonary disease (COPD) than would be expected for an acute respiratory disease like COVID-19, leading to speculation that inhaled corticosteroids (ICSs) might protect against infection with severe acute respiratory syndrome coronavirus 2 or the development of serious sequelae. We assessed the association between ICS and COVID-19-related death among people with COPD or asthma using linked electronic health records (EHRs) in England, UK.
Our results do not support a major role for regular ICS use in protecting against COVID-19-related death among people with asthma or COPD. Observed increased risks of COVID-19-related death can be plausibly explained by unmeasured confounding due to disease severity.

8. International: Politico: 25 years wiped out in 25 weeks: Pandemic sets the world back decades
Progress on global health and the worldwide economy has regressed, Gates Foundation report finds.
In only half a year, the coronavirus pandemic has wiped out decades of global development in everything from health to the economy.
Progress has not only stopped, but has regressed in areas like getting people out of poverty and improving conditions for women and children around the world, the Bill and Melinda Gates Foundation finds in its 2020 Goalkeepers report published Monday.
Vaccination coverage, seen as a good indicator for how health systems are functioning, is dropping to levels last seen in the 1990s, it says.
“In other words, we’ve been set back about 25 years in about 25 weeks,” the report says. “What the world does in the next months matters a great deal.”
Global action to stop the pandemic would prevent illness and deaths caused by Covid-19, but there’s more at stake: The crisis sets back strides made in global poverty, HIV transmission, malnutrition, gender equality, education and many more areas. Even if the world manages to get the coronavirus under control soon, it could take years to claw back lost progress.

9. USA: New York Times: Advice on Airborne Virus Transmission Vanishes From C.D.C. Website
The new guidance, published only on Friday, had acknowledged that fine particles floating in air may spread the virus.
Just days after publishing significant new guidance on airborne transmission of the coronavirus, the Centers for Disease Control and Prevention on Monday withdrew the advice, saying only that it had been “posted in error” on the agency’s website.
The rapid reversal prompted consternation among scientists and again called into question the credibility of the world’s premier health agency, even as President Trump and his senior health officials have sought to undermine C.D.C. scientists.
The president faces an election whose outcome may turn on public perception of his handling of the coronavirus pandemic.
The turnabout arrived as the number of virus-related deaths in the United States approached the 200,000 mark. Tens of thousands of new infections are reported every day, and experts fear a resurgence as cooler weather approaches and people spend more time indoors.

10. USA: Washington Post: Massive genetic study shows coronavirus mutating and potentially evolving amid rapid U.S. spread
The largest U.S. genetic study of the virus, conducted in Houston, shows one viral strain outdistancing all of its competitors, and many potentially important mutations.
Scientists in Houston on Wednesday released a study of more than 5,000 genetic sequences of the coronavirus that reveals the virus’s continual accumulation of mutations, one of which may have made it more contagious.
The new report, however, did not find that these mutations have made the virus deadlier or changed clinical outcomes. All viruses accumulate genetic mutations, and most are insignificant, scientists say.
[The Code: How genetic science helped expose a secret coronavirus outbreak]
Coronaviruses such as SARS-CoV-2 are relatively stable as viruses go, because they have a proofreading mechanism as they replicate. But every mutation is a roll of the dice, and with transmission so widespread in the United States — which continues to see tens of thousands of new, confirmed infections daily — the virus has had abundant opportunities to change, potentially with troublesome consequences, said study author James Musser of Houston Methodist Hospital.

11. Brazil: MedRxiv: COVID-19 herd immunity in the Brazilian Amazon
The herd immunity threshold is the proportion of a population that must be immune to an infectious disease, either by natural infection or vaccination such that, in the absence of additional preventative measures, new cases decline and the effective reproduction number falls below unity. This fundamental epidemiological parameter is still unknown for the recently-emerged COVID-19, and mathematical models have predicted very divergent results. Population studies using antibody testing to infer total cumulative infections can provide empirical evidence of the level of population immunity in severely affected areas. Here we show that the transmission of SARS-CoV-2 in Manaus, located in the Brazilian Amazon, increased quickly during March and April and declined more slowly from May to September. In June, one month following the epidemic peak, 44% of the population was seropositive for SARS-CoV-2, equating to a cumulative incidence of 52%, after correcting for the false-negative rate of the antibody test. The seroprevalence fell in July and August due to antibody waning. After correcting for this, we estimate a final epidemic size of 66%. Although non-pharmaceutical interventions, plus a change in population behavior, may have helped to limit SARS-CoV-2 transmission in Manaus, the unusually high infection rate suggests that herd immunity played a significant role in determining the size of the epidemic.

12. Brazil: MIT Technology Review: A city in Brazil where covid-19 ran amok may be a ‘sentinel’ for the rest of the world
So many people have gotten sick in Manaus that researchers say the virus is running out of people to infect.
What happens when a major city allows the coronavirus to rage unchecked?
If the Brazilian city of Manaus is any answer, it means about two-thirds of the population could get infected and one person in 500 could die before the epidemic winds down.
During May, as the virus spread rapidly in Manaus, the equatorial capital of the state of Amazonas, dire reports described overwhelmed hospitals and freshly dug graves. Demand for coffins ran at four to five times figures for the previous year. But since hitting a peak four months ago, new coronavirus cases and deaths in the city of 1.8 million have undergone a rapid and unexplained decline.
Now a group of researchers from Brazil and the United Kingdom say they know why—so many people got infected that the virus is running out of hosts.
In a report posted to the preprint server medRxiv, a group led by Ester Sabino, of the Institute of Tropical Medicine at the University of São Paulo, says it tested banked blood for antibodies to the virus and estimates that between 44 and 66% of the population of Manaus has been infected since the city detected its first case in March.
“From what we learned this is probably the highest prevalence in the world,” Sabino said in a phone interview. “Deaths have dropped very rapidly, and what we’re saying is that it’s related.”

13. International: Wired: Covid-19 Vaccines Could End Up With Bias Built Right In Some of the leading candidates might work better for the richest people in the world, simply on account of how they’re made.
RICH COUNTRIES HAVE often pressed for an advantage in procuring vaccines, and that pattern of behavior is playing out again today. Recently, the US stepped back from a global effort to ensure equitable access to Covid-19 immunization; while well-off nations such as Britain, France, and Canada (to name a few) have put in preorders for vaccines to secure access for their residents. Even if these machinations could be stopped, the inequities might still play out in an unexpected way. It turns out that a couple of the leading vaccine candidates have potential bias baked right into their biological designs, such that they might be most effective at preventing illness when administered to the wealthiest populations in the world.
The design of two vaccines, in particular, raise this concern: One, called Sputnik V, has already been made available by the Russian government; another, from China’s CanSino Biologics, is now in late-stage clinical trials. The potential issue comes from how they’re made: Each is a viral vector vaccine, which means it uses an engineered version of another, milder virus—here it’s one that causes common colds—as a delivery system. But some people who could end up getting these vaccines will have immunity to the vector. If that’s the case—if their bodies have fought off the relevant cold virus in the past—then their preexisting antibodies may end up hampering (or even neutralizing) the new vaccines. More concerning, this potential problem isn’t evenly spread across global populations: It’s much more common in the developing world.

14. China: Journal of General Internal Medicine: Review of the Clinical Characteristics of Coronavirus Disease 2019 (COVID-19)
In late December 2019, a cluster of cases with 2019 Novel Coronavirus pneumonia (SARS-CoV-2) in Wuhan, China, aroused worldwide concern. Previous studies have reported epidemiological and clinical characteristics of coronavirus disease 2019 (COVID-19). The purpose of this brief review is to summarize those published studies as of late February 2020 on the clinical features, symptoms, complications, and treatments of COVID-19 and help provide guidance for frontline medical staff in the clinical management of this outbreak.

15. USA: Journal of General Internal Medicine: Associations Between Primary Care Provider Shortage Areas and County-Level COVID-19 Infection and Mortality Rates in the USA
As COVID-19 disproportionately impacts certain regions across the USA, there have been speculations on various factors that may contribute to this disparity.1 Primary care Health Professional Shortage Areas (HPSAs) are regions with a lack of primary care providers based on need for care. These areas have been associated with greater poverty, larger proportions of racial minorities,2 low-wage essential workers, and congregate settings, including homeless shelters and prisons, all of whom could be at increased risk of contracting the virus.1 Shortage areas may also have limited availability of testing and treatment, which may contribute to higher COVID-19 mortality.1 However, it is not known whether shortage areas are associated with higher COVID-19 infection or mortality rates. This study investigates the hypothesis that primary care HPSAs are associated with higher rates of COVID-19 infection and mortality.

16. USA: Washington Post: Feared coronavirus outbreaks in schools yet to arrive, early data shows
Thousands of students and teachers have become sick with the coronavirus since schools began opening last month, but public health experts have found little evidence that the virus is spreading inside buildings, and the rates of infection are far below what is found in the surrounding communities.
This early evidence, experts say, suggests that opening schools may not be as risky as many have feared and could guide administrators as they chart the rest of what is already an unprecedented school year.
“Everyone had a fear there would be explosive outbreaks of transmission in the schools. In colleges, there have been. We have to say that, to date, we have not seen those in the younger kids, and that is a really important observation,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

17. International: Gates Foundation: 2020 GOALKEEPERS REPORT: COVID-19: A GLOBAL PERSPECTIVE
As we write, Covid-19 has killed more than 850,000 people. It has plunged the world into a recession that is likely to get worse. And many countries are bracing for another surge in cases.
In past editions of the Goalkeepers Report—almost every time we have opened our mouths or put pen to paper, in fact—we have celebrated decades of historic progress in fighting poverty and disease.
But we have to confront the current reality with candor: This progress has now stopped. In this report, we track 18 indicators included in the United Nations’ Sustainable Development Goals (SDGs). In recent years, the world has improved on every single one. This year, on the vast majority, we’ve regressed.
And so this essay has two goals. First, we analyze the damage the pandemic has done and is still doing—to health, to economies, and to virtually everything else. Second, we argue for a collaborative response. There is no such thing as a national solution to a global crisis. All countries must work together to end the pandemic and begin rebuilding economies. The longer it takes us to realize that, the longer it will take (and the more it will cost) to get back on our feet.

18. Saudi Arabia: BBC: Coronavirus: Saudi Arabia to gradually resume Umra pilgrimage
Saudi Arabia is to gradually resume a Muslim pilgrimage which has been suspended for seven months because of the coronavirus pandemic.
From 4 October, up to 6,000 Saudi citizens and residents will be allowed to undertake the Umra each day.
Pilgrims from countries deemed safe will be permitted from 1 November, when the daily capacity will rise to 20,000.
The Umra is an extra, optional pilgrimage that can be undertaken any time of the year.
Although it includes some of the rituals of the most important pilgrimage, the Hajj, they are shortened and there are fewer of them.

19. Afghanistan: Norweigian Refugee Council: “If the virus doesn’t kill us, hunger will”
She lives in a settlement for displaced people outside Kabul, Afghanistan’s capital city. Fifteen people share her makeshift two-room home, including Shayista’s daughter and her children.
Tipping many into hunger: More than three quarters of displaced and conflict-affected people surveyed by the Norwegian Refugee Council (NRC) for a new report told us that they had lost income since the start of the Covid-19 pandemic. The devastating economic impact is tipping many into hunger, homelessness and a deepening education crisis.
“The world’s most vulnerable communities are in a dangerous downward spiral. Already forced from their homes by violence, often with limited rights to work and access to government services, they are being pushed towards catastrophe by the economic impact of the pandemic,” says Jan Egeland, Secretary General of NRC.
The new report, Downward Spiral, is based on detailed research and needs assessments in 14 countries, and includes a survey of 1,400 people affected by conflict and displacement in Afghanistan, Colombia, Iraq, Kenya, Libya, Mali, Uganda and Venezuela. Here are the main findings.
Five ways that Covid-19 is affecting displaced people financially

20. South America: BBC: Coronavirus: What are the numbers out of Latin America?
Coronavirus cases have been going up sharply in Latin America, although there are signs that the numbers of new cases may be beginning to drop in some countries.
Brazil has had more than 4.5 million confirmed cases – the third highest tally in the world after the US and India – and has had the most deaths after the US.
Mexico, Argentina, Colombia and Peru have also had major outbreaks, and are in the top 10 countries with the most confirmed cases.
Is coronavirus still spreading in Latin America? Daily case numbers surged from May onwards, as they began to fall in European countries badly hit by the virus, like the UK, France and Italy.
Latin America is now the worst-hit region in the world, along with Asia.

21. USA: Washington Post: Trump officials seek greater control over CDC reports on coronavirus
Political appointees at the Department of Health and Human Services have sought to change, delay and prevent the release of reports about the coronavirus by the Centers for Disease Control and Prevention because they were viewed as undermining President Trump’s message that the pandemic is under control.
Michael Caputo, the top HHS spokesman, said in an interview Saturday that he and one of his advisers have been seeking greater scrutiny of the CDC’s weekly scientific dispatches, known as the Morbidity and Mortality Weekly Report, for the past 3½ months. The adviser, Paul Alexander, has sent repeated emails to the CDC seeking changes and demanding that the reports be halted until he could make edits.
The emails, first reported late Friday by Politico, describe the CDC documents, widely known as the MMWR, as being “hit pieces on the administration.” Caputo confirmed the authenticity of the emails.

22. USA: Washington Post: Trump’s appointees sought to censor what government scientists said about the coronavirus, emails show
Michael Caputo and his adviser pressed them to use White House talking points as the pandemic raged out control.
Trump political appointees tried to silence a longtime top official at the Centers for Disease Control and Prevention after she stressed the seriousness of the coronavirus, arguing her statements to a medical group contradicted those of top Trump administration officials, including Vice President Pence.
In a June 30 email, Paul Alexander, one of those appointees at the Department of Health and Human Services, excoriated Anne Schuchat, CDC principal deputy director, for remarks she made before the group affiliated with one of the nation’s leading medical journals. Schuchat, a physician, had spoken to JAMA Network the day before, saying she hoped the country could “take it seriously and slow the transmission,” adding that “we have way too much virus across the country … right now.” The emails were first reported by the New York Times.
Schuchat’s comments came as cases were surging across several southern and western states — even as the president and his top advisers were intent on reopening the country and boosting the economy. But Alexander wrote to his boss, Michael Caputo, assistant secretary for public affairs at HHS, reprimanding Schuchat and writing a seven-point takedown of her assessment.

23. UK: The Rural Coalition: The Rural Coalition: Rebuilding Rural: Growing Back Better
In 2017 the Rural Coalition set out its key principles, policies and actions to promote sustainable rural communities in England. Building on that earlier work, this document presents priorities for delivering a successful recovery across rural England following the Covid-19 pandemic and restrictions to contain the virus. It outlines our asks of Government, including measures we would wish to see reflected in the upcoming Comprehensive Spending Review.
As well as the urgent need to recover from the economic downturn and support communities, rural areas must benefit from the important Government commitments to level-up so that nowhere is left behind and for the UK to become net zero for greenhouse gas emissions by 2050. Added to which is the existing Government commitment, from 2019, to develop its vision for rural England.
Impacts of the pandemic and restrictions have
brought into focus and exacerbated a number of rural vulnerabilities, whilst at the same time highlighting
some notable strengths and opportunities. The national response needs to support rural areas to ensure not only that the recovery is equitable, but that it unlocks their potential to contribute fully to national growth and to grow back better.

24. UK: BBC Podcast: The Life Scientific: Sarah Gilbert on developing a vaccine for Covid-19
How did Sarah Gilbert and her Oxford team get so far, so fast in developing a vaccine for Covid-19?
Vaccinologist Sarah Gilbert is leading the development of one of the front-running vaccine candidates for COVID-19, from the University of Oxford and pharmaceutical company AstraZeneca. She tells the BBC’s The Life Scientific podcast about the breakneck speed of the process, how her team’s vaccine works and her hopes for the end game of the pandemic. “Safety is always paramount,” says Gilbert. “I know people are impatient to know the results, but we can’t get the result without doing these very careful clinical studies.”
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25. UK: BBC: Covid-19: UK volunteers could be given virus to test vaccine
The UK could be the first country in the world to carry out Covid “challenge trials” – where healthy volunteers are deliberately infected with coronavirus to test possible vaccines.
It is understood the studies – first reported by the Financial Times – would be conducted in London.
The UK government said it was holding discussions about developing a vaccine through such “human challenge studies”.
No contracts have yet been signed, the BBC understands.

26. USA: New York Times: These Coronavirus Trials Don’t Answer the One Question We Need to Know
We may not find out whether the vaccines prevent moderate or severe cases of Covid-19.
If you were to approve a coronavirus vaccine, would you approve one that you only knew protected people only from the most mild form of Covid-19, or one that would prevent its serious complications?
The answer is obvious. You would want to protect against the worst cases.
But that’s not how the companies testing three of the leading coronavirus vaccine candidates, Moderna, Pfizer and AstraZeneca, whose U.S. trial is on hold, are approaching the problem.
According to the protocols for their studies, which they released late last week, a vaccine could meet the companies’ benchmark for success if it lowered the risk of mild Covid-19, but was never shown to reduce moderate or severe forms of the disease, or the risk of hospitalization, admissions to the intensive care unit or death.
To say a vaccine works should mean that most people no longer run the risk of getting seriously sick. That’s not what these trials will determine.

27. Switzerland: Science Direct: Viral load of SARS-CoV-2 across patients and compared to other respiratory viruses
Abstract: RT-PCRs to detect SARS-CoV-2 RNA is key to manage the COVID-19 pandemic. We analyzed SARS-CoV-2 viral loads from 22′323 RT-PCR results according to samples types, gender, age, and health units. Viral load did not show any difference across age and appears to be a poor predictor of disease outcome. SARS-CoV-2 viral load showed similar high viral loads than the one observed for RSV and influenza B. The importance of viral load to predict contagiousness and to assess disease progression is discussed.

28. International: Tortoise Media: Heartache: Could Long Covid be creating a whole new category of heart disease?
n April, a team of cardiologists led by Professors Eike Nagel and Valentina Puntmann at Goethe University in Frankfurt started studying the hearts of people recently recovered from Covid-19. Within days, they discovered something alarming: months after recuperating from the most obvious Covid symptoms, patients were still presenting with cardiac problems including elevated levels of troponin (a protein related to heart damage) and inflammation.
“At the end of the first week of the study, when we had seen about five patients Dr Puntmann and I looked at each other and said: ‘This is shocking’,” Nagel wrote in an email. “We see much more involvement than we expected’.”
Their study, published in July, found that close to 80 per cent of recovered Covid patients still had cardiac abnormalities two to three months after diagnosis with the virus. For 60 per cent of them, the issue was continued inflammation of the heart muscle. That alone was a frightening finding, but more worrying was their discovery that even patients who had only mild or moderate symptoms of Covid – or no symptoms at all – still showed signs of heart damage.

29. Nature: Fast coronavirus tests: what they can and can’t do
Rapid antigen tests are designed to tell in a few minutes whether someone is infectious. Will they be game changers?
The United States leads the world in COVID-19 deaths but lags behind many countries both large and small in testing capacity. That could soon change.
At the end of August, the US Food and Drug Administration (FDA) granted emergency-use approval to a new credit-card-sized testing device for the coronavirus that costs US$5, gives results in 15 minutes and doesn’t require a laboratory or a machine for processing. The United States is spending $760 million on 150 million of these tests from health-care company Abbott Laboratories, headquartered in Abbott Park, Illinois, which plans to ramp up production to 50 million per month in October.
The tests detect specific proteins — known as antigens — on the surface of the virus, and can identify people who are at the peak of infection, when virus levels in the body are likely to be high. Proponents argue that this could be a game changer. Antigen tests could help to keep the pandemic at bay, because they can be rolled out in vast numbers and can spot those who are at greatest risk of spreading the disease. These tests are also a key element in the testing strategies of other countries, such as India and Italy.

30. Nepal: The Lancet: 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.

31. UK: BBC: Covid-19: UK could face 50,000 cases a day by October without action
The UK could see 50,000 new coronavirus cases a day by mid-October without further action, the government’s chief scientific adviser has warned.
Sir Patrick Vallance said that would be expected to lead to about “200-plus deaths per day” a month after that.
It comes as the PM prepares to chair a Cobra emergency committee meeting on Tuesday morning, then make a statement in the House of Commons.
On Monday, a further 4,368 daily cases were reported in the UK, up from 3,899.
A further 11 people have also died within 28 days of a positive test, although these figures tend to be lower over the weekend and on Mondays due to reporting delays.
Speaking at Downing Street alongside chief medical adviser, Prof Chris Whitty, Sir Patrick stressed the figures given were not a prediction, but added: “At the moment we think the epidemic is doubling roughly every seven days.
“If, and that’s quite a big if, but if that continues unabated, and this grows, doubling every seven days… if that continued you would end up with something like 50,000 cases in the middle of October per day.

32. Nature: Stillbirth rate rises dramatically during pandemic
Researchers stress need for antenatal care, as emerging data link disrupted pregnancy services to increase in stillbirths.
A slew of studies from around the world has reported a disturbing trend: since the coronavirus pandemic started, there has been a significant rise in the proportion of pregnancies ending in stillbirths, in which babies die in the womb. Researchers say that in some countries, pregnant women have received less care than they need because of lockdown restrictions and disruptions to health care. As a result, complications that can lead to stillbirths were probably missed, they say.
“What we’ve done is cause an unintended spike in stillbirth while trying to protect [pregnant women] from COVID-19,” says Jane Warland, a specialist in midwifery at the University of South Australia in Adelaide.
The largest study to report a rise in the stillbirth rate, based on data from more than 20,000 women who gave birth in 9 hospitals across Nepal, was published in The Lancet Global Health on 10 August1. It reported that stillbirths increased from 14 per 1,000 births before the country went into lockdown to stop the spread of the coronavirus in late March, to 21 per 1,000 births by the end of May — a rise of 50%. The sharpest rise was observed during the first four weeks of the lockdown, under which people were allowed to leave their homes only to buy food and receive essential care.

33. Russia: Researchers highlight ‘questionable’ data in Russian coronavirus vaccine trial results
Open letter flags results that appear to be duplicated and calls for access to the underlying data on the first COVID-19 vaccine to be approved for widespread use.
A group of researchers have expressed concern about repetitive patterns of data in a paper describing early-phase clinical trials of Russia’s coronavirus vaccine — the first jab worldwide to be approved for widespread use.
In an open letter to the study authors, who published the trial results1 this month in The Lancet, the researchers highlight values that seem to be duplicated, and warn that the paper presents its results only as box plots without providing a detailed breakdown of the data on which they are based. “While the research described in this study is potentially significant, the presentation of the data raises several concerns which require access to the original data to fully investigate”, the letter says. It has so far been signed by 38 scientists.
The trials tested two slightly different viral-vector vaccines — which use genetically engineered adenoviruses to produce coronavirus proteins in the body — on 76 volunteers. The results indicated that the vaccine produced a strong immune response, and that side effects were limited to mild, short-term effects, such as irritation at injection sites or headaches, in a few people. In August, the Russian authorities approved the vaccine, called Sputnik V, for widespread use, and have said that it could be available to the general public within months.

34. International: Ericson: Putting the spotlight on 5G in rural areas
The global pandemic has led to a renewed focus on closing the digital divide, which is primarily driven by changes in three areas. These changes in demand have created an opportunity to transform rural communities, and the decisions made in the next three years will have a major impact on their future.
5G rural broadband and the elimination of the digital divide is not a new phenomenon. Bridging the digital divide is needed not only to allow internet access at broadband speeds for rural consumers, but also to aid the creation of a clever countryside – the rural sibling to smart cities. Up until recently, we described rural broadband as centered around a few cornerstones:
• Satisfying consumers’ internet access needs – in lockstep with the technology evolution into fiber and 5G.
• Serving local businesses – in areas such as manufacturing, outdoor recreation, green energy production, and farming.
• Enabling anchor institutions to work well – education, healthcare, and first responders.
• Competing service offerings – provided by national or local fixed and mobile broadband service providers.
• Providing access to growing parts of the overall economy – many rural areas missed out on the digital economy growth that came after the previous market crisis in 2008.
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35. UK: RCGP: Press Release: Clear public messaging and effective test and trace ‘more crucial than ever’, says College in response to Chief Medical and Scientific Officers’ warnings of a second wave of COVID
Professor Martin Marshall, Chair of the Royal College of GPs said: “As the Chief Medical Officer and Chief Scientific Officer said this morning, we all have a role to play in ensuring we avoid a devastating second wave of COVID-19. It is essential that people continue to strictly follow Government advice including social distancing and good hygiene measures.
“Over the coming months general practice will play a key role managing COVID patients in the community, helping prevent an outbreak of winter flu through an expanded vaccination programme, and dealing with a backlog of cases caused by the national lockdown. But Government also has to play its part and it is now more crucial than ever that we have clarity and consistency in Government messaging so that everyone knows what their responsibilities are to keep themselves and each other safe.
“We are also aware of the difficult balance that Government has to strike with ensuring the virus is suppressed, whilst protecting jobs and the economy. General practice sees the impact of a struggling economy first-hand because of our broader impact on the health and wellbeing of patients. It is another reason why it is essential that NHS services are supported to remain functioning this winter.

36. Australia: The Advocate: Health Department RTI backlog balloons during COVID; transparency concerns raised
The backlog of Right to Information requests with the Health Department has grown to close to 60 during the coronavirus pandemic, with an academic claiming the department is failing to meet its statutory requirements.
The department took three months to acknowledge an information request made by Australian Community Media in June, despite having a requirement to make a decision within 20 working days. The acknowledgement attempted to treat the request as new from last week, with an apology offered.
The request was number 56 in the queue, while University of Tasmania RTI expert Rick Snell has a request sitting at number 33 – in which he sought a single document from the Health Department relating to a feasibility study.
This request has also passed its required timeframe for a decision.
Professor Snell said despite the pandemic, the department still had an obligation to respond to requests within the required timeframe.

37. UK: Wired: Will Covid-19 kill the pen and paper signature?
The pandemic has changed how the office operates. This could finally mean the end to printing, signing and scanning
As the shockwaves of Covid-19 rippled throughout society, they exposed a number of peculiar anachronisms that we have long taken for granted. Most obviously the notion of centralised offices – when internet connections are so fast and computers so cheap, why wasn’t distributed work more commonplace until now?
And, in the process of adopting the model, here’s something else we asked ourselves: why-oh-why do people still insist on wet-ink signatures? Printing off a document, signing it, scanning it, attaching the image and sending it by email – that’s the kind of convoluted process that belongs to 20 years ago, not to the perma-connected, device-synced, AI-driven internet era of today.
To entrepreneurs, frictions are opportunities. When Dropbox pivoted into making tools for collaborative working, it knew that it would have to confront this issue. After all, when teams are scattered across locations and timezones, productivity is predicated on seamless workflows, and waiting on a pen-and-ink signature is a dam. That’s why Dropbox acquired HelloSign last year – and integrating its technology may lead to innovations that go well beyond simply validating a document.

38. USA: Washington Post: Is the coronavirus spreading silently among kids? Testing limits make it hard to tell.
It is a nightmare repeatedly playing in parents’ minds: Their child is welcomed back to their classroom, but in the excitement the kids get too close to one another, sharing germs.
The children may not have coronavirus symptoms or be able to express that they are not feeling well, unwittingly spreading the virus as they continue to go to school or come into contact with adults.
Only when the older members of the family those more likely to show signs of infection get tested do they learn what has happened: It’s covid-19, and by then it’s everywhere.
As preschools, elementary schools and day cares welcome returning children nationwide this fall, researchers are hoping to learn more about the transmission of the coronavirus among younger children. But efforts to screen kids may be hindered by several factors: age limits at certain testing sites; fear of or discomfort from swab testing; and the tendency for children to not exhibit signs of infection, making them less likely to qualify for immediate testing.

39. Myanmar: Rohingya are being left to die at sea. Does anyone care?
Asia’s governments must put politics aside to protect the lives of desperate people
Deepmala Mahla is Asia region director of CARE. Hassan Noor is Asia regional director of Save the Children.
Last week some 300 Rohingya men, women, and children washed up on the shores of Indonesia’s Aceh province.
Starving and desperate, they had spent the past seven months on the open waters of the Andaman Sea, looking in vain for a safe harbor. The survivors said at least 30 people had died on the perilous journey.
For Rohingya, this is sadly nothing new, but rather a nightmarish history that keeps repeating. This year, hundreds have been left stranded on overcrowded and squalid boats across Asia. The governments of the 10-member Association of Southeast Asian Nations have turned their backs on them, closed their borders, ignored their plight, and refused to let boats disembark, leading to scores of deaths. Tellingly, the boat that landed in Aceh last week was rescued by Indonesian fishermen, not the Indonesian authorities.
Back in 2015, when hundreds of Rohingya people lost their lives at sea in what is now infamously known as the Asian boat crisis, ASEAN vowed to never again abandon them to the sea. Sadly, recent events have exposed the hollowness of those commitments. Ahead of another sailing season when refugees will once again take their chance on the high seas, South and Southeast Asia’s leaders must make a collective decision to choose lives over politics.

40. Nature: Study the role of Hubris in nations’ COVID-19 response
Many countries that see themselves as distinctive have handled the pandemic badly.
As an anthropologist who has studied disease outbreaks in Vietnam, I’ve been moved by the contrast between the experience of COVID-19 there and in the United States. By late April, my friends in Hanoi were posting pictures of celebrations and joyfully announcing “Social distancing is over!” I’m relieved that infection rates in Vietnam remain low, but their posts seem to come from a parallel universe as I and my family and friends in the United States continue to shelter in place. Just last year, the United States was considered one of the countries best equipped to confront a virus such as SARS-CoV-2. Others included the United Kingdom, Brazil and Chile — nations ranked by the comprehensive Global Health Security (GHS) Index as being among the world’s most prepared. Yet since the pandemic began, these countries have delivered some of the worst outcomes. The United States leads the world in both total cases and total deaths; Brazil’s fatalities are second. Chile’s per-capita cumulative case rate is the second-highest in Latin America, and the United Kingdom has the highest rate of COVID-19 deaths per capita of all the G7 countries. What might explain these staggering failures?
One thing these countries have in common is ‘exceptionalism’ — a view of themselves as outliers, in some way distinct from other nations. Their COVID-19 responses suggest that exceptionalist world views can be associated with worse public-health outcomes. Researching this association could help in redefining preparedness and allow more accurate prediction of pandemic successes and failures.
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