“We are shaped by our thoughts; we become what we think. When the mind is pure, joy follows like a shadow that never leaves.”

“When you do things from your soul, you feel a river moving in you, a joy.”

“He who binds to himself a joy Does the winged life destroy; But he who kisses the joy as it flies Lives in eternity’s sun rise”
William Blake

“I have drunken deep of joy, and I will taste no other wine tonight.”
Percy Bysshe Shelley

“The pain of parting is nothing to the joy of meeting again.”
Charles Dickens (Nicholas Nickleby)

“To get the full value of joy you must have someone to divide it with.”
Mark Twain


For many of us joy is something that has been missing in your lives this year. With so much sadness and despair around, it’s difficult to think about joy. Having experienced so much turmoil and tragedy, we might even feel guilty wishing to experience joyful moments. Many of the experiences that bring us joy, such as human contact, family meetings, fulfilling employment and the opportunity to be creative and kind are missing. Unfortunately, the pandemic is not over and with little in the way of hope ahead of us we must rekindle a sense of joy in ourselves and those around us.

Buddha said in his teachings said “Live in Joy, In love, Even among those who hate. Live in joy, In health, Even among the afflicted. Live in joy, In peace, Even among the troubled. Look within. Be still. Free from fear and attachment, Know the sweet joy of living in the way”
I have put together some poems about joy. Please enjoy and reflect on them.

The Buddha (5th-4th Centaury BCE)
The Buddha was a philosopher, mendicant, meditator, spiritual teacher, and religious leader who lived in Ancient India. He is revered as the founder of the world religion of Buddhism and worshiped by most Buddhist schools as the Enlightened One who has transcended Karma and escaped the cycle of birth and rebirth.

Let us live in joy, not hating those who hate us.
Among those who hate us, we live free of hate.
Let us live in joy,
free from disease among those who are diseased.
Among those who are diseased, let us live free of disease.
Let us live in joy, free from greed among the greedy.
Among those who are greedy, we live free of greed.
Let us live in joy, though we possess nothing.
Let us live feeding on joy, like the bright gods.

Michael Drayton (1563-1631)
Michael Drayton was an English poet who came to prominence in the Elizabethan era.
He was born at Hartshill in Warwickshire in 1563 and as a youth he became page to Sir Henry Goodeere of Polesworth. Goodeere is to be credited for Drayton’s education. Drayton fell in love with Sir Henry’s daughter, Anne, who served as an inspiration. Little is known of Drayton’s early years, though it has been suggested that he may have served in the army, before settling down in London in 1590.
Drayton’s career as a poet was long: from his first published work in 1591 to his last in 1630. Drayton constantly revised his works, rewriting and reissuing them, sometimes under different titles.

Sonnet Xli: Why Do I Speak Of Joy
Love’s Lunacy

Why do I speak of joy, or write of love,
When my heart is the very den of horror,
And in my soul the pains of Hell I prove,
With all his torments and infernal terror?
What should I say? What yet remains to do?
My brain is dry with weeping all too long,
My sighs be spent in uttering my woe,
And I want words wherewith to tell my wrong;
But, still distracted in Love’s lunacy,
And, bedlam-like, thus raging in my grief,
Now rail upon her hair, then on her eye,
Now call her Goddess, then I call her thief,
Now I deny her, then I do confess her,
Now do I curse her, then again I bless her.

William Blake (1757-1826)
William Blake was an English poet, painter, visionary and printmaker. Largely unrecognised during his lifetime, Blake is now considered a seminal figure in the history of the poetry and visual arts of the Romantic Age.

Infant Joy

‘I have no name;
I am but two days old.’
What shall I call thee?
‘I happy am,
Joy is my name.’
Sweet joy befall thee!

Pretty joy!
Sweet joy, but two days old.
Sweet Joy I call thee:
Thou dost smile,
I sing the while;
Sweet joy befall thee!

Listen to “Infant Joy” sung by Andreas Weller to an arrangement written by Vaughan Williams


He who binds to himself a joy
Does the winged life destroy;
But he who kisses the joy as it flies
Lives in eternity’s sun rise.

Listen to “Eternity” sung by Andreas Weller to an arrangement written by Vaughan Williams

Johann Wolfgang von Goethe (1749-1832)
Johann Wolfgang von Goethe was a German writer and statesman. His works include: four novels; epic and lyric poetry; prose and verse dramas; memoirs; an autobiography; literary and aesthetic criticism; and treatises on botany, anatomy, and colour. He is considered the greatest German literary figure of the modern era

Joy And Sorrow

As a fisher-boy I fared

To the black rock in the sea,
And, while false gifts I prepared.

Listen’d and sang merrily,
Down descended the decoy,

Soon a fish attack’d the bait;
One exultant shout of joy,–

And the fish was captured straight.

Ah! on shore, and to the wood

Past the cliffs, o’er stock and stone,
One foot’s traces I pursued,

And the maiden was alone.
Lips were silent, eyes downcast

As a clasp-knife snaps the bait,
With her snare she seized me fast,

And the boy was captured straight.

Heav’n knows who’s the happy swain

That she rambles with anew!
I must dare the sea again,

Spite of wind and weather too.
When the great and little fish

Wail and flounder in my net,
Straight returns my eager wish

In her arms to revel yet!

Jane Austen (1775-1817)
Jane Austen was an English novelist known primarily for her six major novels, which interpret, critique and comment upon the British landed gentry at the end of the 18th century. Austen’s plots often explore the dependence of women on marriage in the pursuit of favourable social standing and economic security.
She is considered one of the greatest English novelists, revered around the world. Not generally known as a poet, she wrote this autobiographical poem “My Dearest Frank, I wish you joy” to her brother. Early in the poem, Jane Austen reveals that her sister-in-law has recently had a baby boy. Jane is glad that the birth was not as difficult as that of a previous child, Mary Jane. The poem is full of optimism and she hopes that the child will turn out to be a good child, and “well deserve his Parents’ Love!” Jane also hopes that the child will have similar traits to her brother, as revealed in the line: “Another Francis William see!” Just when it seems Jane Austen is expecting too much from the boy, thinking of him as being fearless, she looks forward to the child’s “saucy words and fiery ways”. She also wants the boy to grow up to be as “considerate and kind” as his father.
As a great lover of her novels, I find this very personal poem intriguing giving us some insight into the private Jane Austen.

My dearest Frank, I wish you joy
My dearest Frank, I wish you joy
Of Mary’s safety with a Boy,
Whose birth has given little pain
Compared with that of Mary Jane.–
May he a growing Blessing prove,
And well deserve his Parents’ Love!–
Endow’d with Art’s and Nature’s Good,
Thy Name possessing with thy Blood,
In him, in all his ways, may we
Another Francis WIlliam see!–
Thy infant days may he inherit,
THey warmth, nay insolence of spirit;–
We would not with one foult dispense
To weaken the resemblance.
May he revive thy Nursery sin,
Peeping as daringly within,
His curley Locks but just descried,
With ‘Bet, my be not come to bide.’–
Fearless of danger, braving pain,
And threaten’d very oft in vain,
Still may one Terror daunt his Soul,
One needful engine of Controul
Be found in this sublime array,
A neigbouring Donkey’s aweful Bray.
So may his equal faults as Child,
Produce Maturity as mild!
His saucy words and fiery ways
In early Childhood’s pettish days,
In Manhood, shew his Father’s mind
Like him, considerate and Kind;
All Gentleness to those around,
And anger only not to wound.
Then like his Father too, he must,
To his own former struggles just,
Feel his Deserts with honest Glow,
And all his self-improvement know.
A native fault may thus give birth
To the best blessing, conscious Worth.
As for ourselves we’re very well;
As unaffected prose will tell.–
Cassandra’s pen will paint our state,
The many comforts that await
Our Chawton home, how much we find
Already in it, to our mind;
And how convinced, that when complete
It will all other Houses beat
The ever have been made or mended,
With rooms concise, or rooms distended.
You’ll find us very snug next year,
Perhaps with Charles and Fanny near,
For now it often does delight us
To fancy them just over-right us.—
My Dearest Frank, I Wish You Joy – Jane Austen (Poetry reading) | Jordan Harling Reads

Walt Whitman (1819-1892)
Walt Whitman was an American poet, essayist, and journalist. A humanist, he was a part of the transition to realism in American poetry. Whitman is among the most influential of American poets, often called the father of free verse.

A Song of Joys (extract)

O to make the most jubilant song!
Full of music-full of manhood, womanhood, infancy!
Full of common employments-full of grain and trees.
O for the voices of animals-O for the swiftness and balance of fishes!
O for the dropping of raindrops in a song!
O for the sunshine and motion of waves in a song!
O the joy of my spirit-it is uncaged-it darts like lightning!
It is not enough to have this globe or a certain time,
I will have thousands of globes and all time.
O the engineer’s joys! to go with a locomotive!
To hear the hiss of steam, the merry shriek, the steam-whistle, the
laughing locomotive!
To push with resistless way and speed off in the distance.
O the gleesome saunter over fields and hillsides!
The leaves and flowers of the commonest weeds, the moist fresh
stillness of the woods,
The exquisite smell of the earth at daybreak, and all through the

Walt Whitman/ Leaves of Grass #7: A Song of Joys

Emily Dickenson (1830-1836)
I can’t avoid including poems by this remarkable poet. Emily Elizabeth Dickinson was an American poet. Little known during her life, she has since been regarded as one of the most important figures in American poetry. Dickinson was born in Amherst, Massachusetts, into a prominent family with strong ties to its community

‘Tis so much joy!

‘Tis so much joy! ‘Tis so much joy!
If I should fail, what poverty!
And yet, as poor as I,
Have ventured all upon a throw!
Have gained! Yes! Hesitated so—
This side the Victory!

Life is but Life! And Death, but Death!
Bliss is, but Bliss, and Breath but Breath!
And if indeed I fail,
At least, to know the worst, is sweet!
Defeat means nothing but Defeat,
No drearier, can befall!

And if I gain! Oh Gun at Sea!
Oh Bells, that in the Steeples be!
At first, repeat it slow!
For Heaven is a different thing,
Conjectured, and waked sudden in—
And might extinguish me!

T is so much joy – Emily Dickinson

Sri Aurobindo (1872-1950)
Sri Aurobindo was an Indian philosopher, yogi, guru, poet, and nationalist. He joined the Indian movement for independence from British rule, for a while was one of its influential leaders and then became a spiritual reformer, introducing his visions on human progress and spiritual evolution
Savitri: A Legend and a Symbol is an epic poem in blank verse by Sri Aurobindo, based upon the theology from the Mahabharata. Its central theme revolves around the transcendence of man as the consummation of terrestrial evolution and the emergence of an immortal supramental gnostic race upon earth.

Extracts from Savitri

Even joy itself becomes a poisonous draught;
Its hunger is made a dreadful hook of Fate.
All means are held good to catch a single beam,
Eternity sacrificed for a moment’s bliss:
Yet for joy and not for sorrow earth was made
And not as a dream in endless suffering Time.

Even in this labour and dolour of Ignorance,
On the hard perilous ground of difficult earth,
In spite of death and evil circumstance
A will to live persists, a joy to be.
There is a joy in all that meets the sense,
A joy in all experience of the soul,
A joy in evil and a joy in good,
A joy in virtue and a joy in sin:
Indifferent to the threat of Karmic law,
Joy dares to grow upon forbidden soil,
Its sap runs through the plant and flowers of Pain:
It thrills with the drama of fate and tragic doom,
It tears its food from sorrow and ecstasy,
On danger and difficulty whets its strength;
It wallows with the reptile and the worm
And lifts its head, an equal of the stars;
It shares the faeries’ dance, dines with the gnome:
It basks in the light and heat of many suns,
The sun of Beauty and the sun of Power.

Sri Chinmoy (1931)
Sri Chinmoy has been a poet from a young age. He began writing poetry whilst a in the Sri Aurobindo Ashram. His poetry has always been a reflection and revelation of his own spiritual experiences.
Sri Chinmoy was born in 1931 in India. At a young age he lost both parents and therefore moved to the Sri Aurobindo Ashram in Pondicherry. After 20 years in the ashram he followed an inner command to go to America to share the wisdom of yoga to seekers in the West. Since 1964 Sri Chinmoy has sought tirelessly to inspire others to lead better more fulfilling lives. As well as being a noted poet Sri Chinmoy is also a musician and has given several hundred free concerts of meditative music.

A little joy have I of ceaseless joy

A little joy have I of ceaseless joy,
A little day of timeless day.
Yet knows no bound this empty show of mine;
I march along a goalless way.
O Love! A desert within me ever pines.
Do turn it into a song of dawn.
I know not in what hour of evil night
Thou art, my Lord, from me withdrawn.
Life now must reach Thy Breath of Bliss supreme,
Make Thee the one and only Guide.
Thou art the Bridge between my death and birth;
O let my longings in Thee abide.

Songs of Joy

Hallelujah: Medical Mums Sing in Solidarity
Medical mums and their families across Australia and New Zealand collaborated from various stages of COVID lockdown and stress. We shook off our inhibitions, dusted off our instruments and made something beautiful.

What a Wonderful World: Louis Armstrong

Best of Joy: Michael Jackson

The Beach Boys: Good Vibrations

The Beatles: Here comes the sun

Today’s Posts
New articles published in Rural and Remote Health:
5954 – North America – Rural–urban disparities in the distribution of dental caries among children in south-eastern Louisiana: a cross-sectional study
This original research article reports on a study designed to compare the prevalence of dental caries among rural and urban elementary school-aged children in the United States. Findings indicate higher prevalence of dental caries in rural than in urban communities.
6325 – Europe – Clinical characteristics of SARS-CoV-2 infection in a rural area in Germany
As of 1 May, 2020, more than 3.4 million cases of confirmed SARS-CoV-2 infections and more than 240,000 deaths due to Coronavirus Disease 2019 (COVID-19) had been reported worldwide. In Germany, about 85% of the COVID-19 patients are cared for mostly by family physicians in community practices, which allows hospitals to concentrate on critically ill patients. This Letter to the Editor reports on the first cohort of SARS-CoV-2 infected patients in a rural district in Germany.
5954 – North America – Rural–urban disparities in the distribution of dental caries among children in south-eastern Louisiana: a cross-sectional study
This original research article reports on a study designed to compare the prevalence of dental caries among rural and urban elementary school-aged children in the United States. Findings indicate higher prevalence of dental caries in rural than in urban communities.

5893 – Australasia – Childhood exhaust burns in rural and remote regions
Paediatric burns are a leading cause of childhood injuries, having significant physical and psychological impact to both parents and child. This Research Letter highlights a concerning trend in vehicle exhaust burns in children, requiring complex and challenging wound care in rural and remote Australia.
5919 – North America – Indigenous Youth Mentorship Program: a descriptive case study of implementation in Alberta, Canada
The Indigenous Youth Mentorship program is a Canadian health promotion initiative designed to reduce chronic disease risk factors, and improve health and well-being for Indigenous youth. This project report draws on a case study approach to describe the implementation of an Indigenous Youth Mentorship Program First Nations community schools in the province of Alberta. It provides information for development and implementation of similar programs health promotion programs for Indigenous youth in Canada and internationally.
5985 – Latin America – Functional dependence among older adults: a cross-sectional study with a rural population of southern Brazil
Despite the aging population in Brazil, little is known about the occurrence of functional dependency in rural older adults. This cross-sectional study estimated a high prevalence of functional dependency among community-dwelling older adults in a rural area in Rio Grande do Sul state, Brazil.

1. USA: Scientific American: Trump’s COVID Infection Puts Him in Multiple High-Risk Categories
The president is age 74, male and heavy—all factors linked to more severe cases of the illness. President Donald Trump and First Lady Melania Trump have both tested positive for SARS-CoV-2—the virus that causes COVID-19—and are isolating themselves, the president announced in a tweet early Friday morning. The news came in the midst of a pandemic that has killed more than 207,000 people in the U.S., and just weeks before the presidential election.
“This evening I received confirmation that both President Trump and First Lady Melania Trump have tested positive for the SARS-CoV-2 virus,” wrote the president’s doctor Sean Conley in a recent statement. “The President and First Lady are both well at this time, and they plan to remain at home within the White House during their convalescence.” News had emerged on Thursday evening that Hope Hicks, a senior adviser to the president, had tested positive for COVID. Earlier this week she traveled with Trump to a campaign event and to his debate with Joe Biden.

2. Senegal: BBC: Coronavirus in Senegal: Keeping Covid-19 at bay
Despite only having seven doctors for every 100,000 people, Senegal has been widely praised for its handling of the coronavirus pandemic. The BBC’s Mayeni Jones and Naomi Scherbel-Ball look at how the country has managed to keep Covid-19 in check.
“When the first case came, we were very anxious and I was angry because it was an imported case,” says Dr Khardiata Diallo, who co-ordinates the epidemic treatment centre at Fann Hospital in the capital, Dakar.
“We worried that we lacked equipment, for the treatment of coronavirus there were just 12 beds with limited oxygen supplies for the whole country.”
That was in late February when a Frenchman had returned to Dakar from a skiing holiday with a fever, sore throat and headache.
He was Senegal’s first case of Covid-19, the second reported case in sub-Saharan Africa.
Dr Diallo, who was part of the team that treated the country’s single Ebola case during the West African outbreak of 2014 as well as other cholera outbreaks over the last 15 years, knew they needed to act quickly to contain the pandemic.

3. International: BBC: Animation: How do pandemics end?
We are in the grip of a pandemic like none other in living memory. While people are pinning their hopes on a vaccine to wipe it out, the fact is most of the infections faced by our ancestors are still with us.
Scroll down ↓ to find out how some of those pandemics came to an end, giving us clues as to how our future may unfold.
S ED Animation

4. USA: Business Insider: Filipinos make up 4% of nurses in the US, but 31.5% of nurse deaths from COVID-19
• Nurses of Filipino descent comprise just 4% of the US workforce, but nearly a third of registered nurse deaths due to COVID-19, according to a new report from the National Nurses United union.
• NNU estimates that 1,718 healthcare workers have died due to the disease and related complications, including 213 registered nurses.
• The largest non-white ethnic group to die of the disease was nurses of Filipino descent, who account for 31.5% of the workforce’s COVID-19 deaths.
• The data sheds light on one of the ways Asian Americans have suffered from the COVID-19 pandemic. Pew Research Center estimated the unemployment rate for Asian American workers may have been 20.3% in May, on par with those for Black and Hispanic Americans.
Nurses of Filipino descent comprise just 4% of the workforce, but nearly a third of registered nurse deaths due to COVID-19. National Nurses United, the country’s largest nurse union, released a report Monday detailing COVID-19 deaths among nurses and other healthcare workers. NNU estimates that 1,718 healthcare workers have died due to the disease and related complications, including 213 registered nurses.
Nurses of color made up more than half of the nurse deaths due to COVID-19, despite only making up 24.1% of the workforce.

5. The Atlantic: This Overlooked Variable Is the Key to the Pandemic: It’s not R.
There’s something strange about this coronavirus pandemic. Even after months of extensive research by the global scientific community, many questions remain open.
Why, for instance, was there such an enormous death toll in northern Italy, but not the rest of the country? Just three contiguous regions in northern Italy have 25,000 of the country’s nearly 36,000 total deaths; just one region, Lombardy, has about 17,000 deaths. Almost all of these were concentrated in the first few months of the outbreak. What happened in Guayaquil, Ecuador, in April, when so many died so quickly that bodies were abandoned in the sidewalks and streets?* Why, in the spring of 2020, did so few cities account for a substantial portion of global deaths, while many others with similar density, weather, age distribution, and travel patterns were spared? What can we really learn from Sweden, hailed as a great success by some because of its low case counts and deaths as the rest of Europe experiences a second wave, and as a big failure by others because it did not lock down and suffered excessive death rates earlier in the pandemic? Why did widespread predictions of catastrophe in Japan not bear out? The baffling examples go on.
By now many people have heard about R0—the basic reproductive number of a pathogen, a measure of its contagiousness on average. But unless you’ve been reading scientific journals, you’re less likely to have encountered k, the measure of its dispersion. The definition of k is a mouthful, but it’s simply a way of asking whether a virus spreads in a steady manner or in big bursts, whereby one person infects many, all at once. After nine months of collecting epidemiological data, we know that this is an overdispersed pathogen, meaning that it tends to spread in clusters, but this knowledge has not yet fully entered our way of thinking about the pandemic—or our preventive practices.
The now-famed R0 (pronounced as “r-naught”) is an average measure of a pathogen’s contagiousness, or the mean number of susceptible people expected to become infected after being exposed to a person with the disease. If one ill person infects three others on average, the R0 is three. This parameter has been widely touted as a key factor in understanding how the pandemic operates. News media have produced multiple explainers and visualizations for it. Movies praised for their scientific accuracy on pandemics are lauded for having characters explain the “all-important” R0. Dashboards track its real-time evolution, often referred to as R or Rt, in response to our interventions. (If people are masking and isolating or immunity is rising, a disease can’t spread the same way anymore, hence the difference between R0 and R.)

6. USA: Time Magazine: COVID-19 Cases Are Rising Among U.S. Children as Schools Reopen
After preying heavily on the elderly in the spring, the coronavirus is increasingly infecting American children and teens in a trend authorities say appears fueled by school reopenings and the resumption of sports, playdates and other activities.
Children of all ages now make up 10% of all U.S cases, up from 2% in April, the American Academy of Pediatrics reported Tuesday. And the Centers for Disease Control and Prevention said Monday that the incidence of COVID-19 in school-age children began rising in early September as many youngsters returned to their classrooms.
About two times more teens were infected than younger children, the CDC report said. Most infected children have mild cases; hospitalizations and death rates are much lower than in adults.
Dr. Sally Goza, president of the American Academy of Pediatrics, said the rising numbers are a big concern and underscore the importance of masks, hand-washing, social distancing and other precautions.
“While children generally don’t get as sick with the coronavirus as adults, they are not immune and there is much to learn about how easily they can transmit it to others,’’ she said in a statement.

7. The Lancet: Lancet COVID-19 Commission Statement on the occasion of the 75th session of the UN General Assembly
The Lancet COVID-19 Commission was launched on July 9, 2020, to assist governments, civil society, and UN institutions in responding effectively to the COVID-19 pandemic. The Commission aims to offer practical solutions to the four main global challenges posed by the pandemic: suppressing the pandemic by means of pharmaceutical and non-pharmaceutical interventions; overcoming humanitarian emergencies, including poverty, hunger, and mental distress, caused by the pandemic; restructuring public and private finances in the wake of the pandemic; and rebuilding the world economy in an inclusive, resilient, and sustainable way that is aligned with the Sustainable Development Goals (SDGs) and the Paris Climate Agreement. Many creative solutions are already being implemented, and a key aim of the Commission is to accelerate their adoption worldwide.

8. USA: CDC: A National Public Health Framework for the Prevention and Control of Vector-Borne Diseases in Humans
Our nation’s ability to defend against the present and future threat of vector-borne diseases relies on a comprehensive national system that is able to detect, prevent, and respond to these threats. A concerted and sustained effort is needed to address significant challenges and reverse the upward trends in illness, suffering, and death from vector-borne diseases. This effort must enhance collaboration, coordination, and communication across human, animal, and environmental health sectors, as well as other relevant sectors, to address vector-borne threats at the human-animal-environment interface (a One Health approach).
To reverse the current upward trends in vector-borne diseases and to increase the nation’s ability to protect the U.S. population from these diseases, five federal departments and the Environmental Protection Agency contributed to developing a national framework for vector- borne disease prevention and control. These federal partners represent the primary federal departments and agencies engaged in vector-borne disease prevention and control (see Participant List).
A National Public Health Framework for the Prevention and Control of Vector-Borne Diseases in Humans is consistent with the National Biodefense Strategy’s objective 2.11, to promote measures to prevent or reduce the spread of naturally occurring infectious diseases (Sub-objective 2.1.3: strengthen multidisciplinary efforts to control vector- borne disease domestically and internationally).

9. USA: Huffington Post: As A Doctor, Here’s The First Thing I Thought When I Found Out Trump Has COVID-19
“Is it wrong for a doctor to be writing these words? I would argue, in fact, that it is precisely in line with the ethics of my profession.”
When I learned that Donald Trump is infected with COVID-19, I did not have the normal reaction that I would have, as a doctor, to an overweight septuagenarian getting infected with this deadly virus. Instead, I immediately thought of the positives that could come out of this. Not because I revel in suffering but precisely because I ardently desire millions more people to avoid the death and disability that this virus invites. A virus that snuffs out life indiscriminately. Or perhaps a little too discriminatingly in certain populations, most of whom are not represented in the Trump inner circle.
Maybe Donald and Melania will finally, though inadvertently, be the effective spokespeople for this virus that reason, logic, science, compassion and morality dictated that they be 200,000 lives ago. Perhaps this will be the wake-up call that the tens of millions who adore him, who hang on his every word, who look to him for guidance and leadership, so much so that they are willing to consider ingesting bleach, will heed. Maybe, just maybe, this is the jolt of reality that only this reality TV star can provide. Is it wrong for a doctor to be writing these words? I would argue, in fact, that it is precisely in line with the ethics of my profession to welcome the dissemination and augmentation of public health awareness in the context of this pandemic and our country’s failed response to it. For some who follow Hollywood types, it was beloved Tom Hanks and Rita Wilson whose diagnoses snapped people to attention at the start of this pandemic to take it with the gravity it deserved. For sports fans, it was the stories coming out of the NBA with Rudy Gobert’s ridiculous mic touching stunt and the souring of his relationship with Donovan Mitchell after the Utah Jazz coronavirus outbreak.
S ED Humanities

10. Lebanon: Norwegian Refugee Council: “Discrimination is part of our everyday lives”
“Disasters like this can bring out the worst in people,” says Neji, a 25-year-old Syrian refugee in Beirut. He has been living as a refugee for the past six years and has faced discrimination. As the situation in Lebanon deteriorates, he is feeling increasingly unsafe in the country where he once sought refuge.
On 4 August 2020 Beirut was hit by a massive explosion that devastated thousands of lives. The Norwegian Refugee Council (NRC) has been repairing homes and providing cash-for-rent support to enable people to live in safe and dignified conditions. It was while we were assessing the needs of those living in the most affected areas that we met 25-year-old Neji*. His life has been characterised by chaos and conflict for several years. Today, he lives in a two-room apartment with seven other Syrian men. On the day of the explosion, Neji was at home when he heard what he thought were fireworks. He stepped out into the courtyard around the corner and saw smoke rising from the port, less than 1 km away from where he lives. People in his neighbourhood started to gather outside wondering what might be on fire. Little did they know that just few minutes later, they would be in the middle of the worst explosion in the history of Lebanon.
“In a few seconds, our lives turned upside down,” says Neji. “No-one expected an explosion – we thought it was only a fire in one of the hangars. It was tremendously loud, and the pressure wave threw people off the ground. Glass shattered everywhere and concrete bricks were falling around us from the buildings that were collapsing.”
“At first I thought that a missile had been fired at the port, so I needed to get away. Slowly, I realised that wasn’t the case,” Neji continues. “In Syria, I experienced a lot of bombings but nothing I saw there can be compared to this explosion. It has been devastating.”

11. India: IDR: Mental health and COVID-19 in India: What we know so far and where we go from here.
To fully realise the mental health crisis that India faces in relation to COVID-19, one has to begin with recognising the very serious situation that existed even before the pandemic. The government’s National Mental Health Survey reported that about 10 percent of adults meet diagnostic criteria for a mental health condition (ranging from mood and anxiety disorders to severe mental illness). The Global Burden of Disease study estimated that nearly 200 million people in India have experienced a mental disorder, nearly half of whom suffer from depressive or anxiety disorders. India accounts for more than a third of the female suicides globally, nearly a fourth of all male suicides, and suicide has been the leading cause of death in young Indians.
Yet, the government has spent very little on mental healthcare (estimated at less than one percent of the health budget), and this expenditure has been almost entirely on doctors, drugs, and hospitals in urban areas. There is little community-oriented mental healthcare anywhere in the country. Unsurprisingly, between 70 to 92 percent of affected individuals have received no care from any source, of any kind, for their mental health conditions.
COVID-19 will impact mental health in two phases: One can consider the impact of the pandemic on mental health in two phases: The first is the acute phase, which coincided with the lockdown—the period when the pandemic surged through the country. The second phase will unfold in the months ahead, as the virus starts to get contained, but the economic fallout of the pandemic begins to bite deeper.

12. International: International Nursing Review: Leveraging nurse practitioner capacities to achieve global health for all: COVID‐19 and beyond
To argue that nurse practitioners have been under‐utilized generally in the current global health environment, creating barriers to achieving universal health coverage and the Sustainable Development Goals. Nurse practitioners are advanced practice nurses possessing expert knowledge and leadership skills that can be optimized to narrow disparities and ensure access to high‐quality health care globally. Nurses worldwide have been challenged to meet global public health needs in the context of COVID‐19 (SARS‐CoV‐2 virus), and there are early indications that nurse practitioners are being called upon to the full extent of their capabilities in the current pandemic.
Several international reports, nursing and health organizations have called for continued investment in and development of nursing to improve mechanisms that promote cost‐effective and universally accessible care. Expanding nurse practitioner scopes of practice across nations will leverage their clinical capacities, policy and advocacy skills, and talents to lead at all levels.
Ongoing empirical data and policy change is needed to enable the full scope and strategic utilization of nurse practitioners across healthcare systems and contexts.
Widespread education regarding nurse practitioner capacities for interdisciplinary partners, policymakers and the public is needed. Policies that safely expand their roles are critical. Role titles and remuneration reflective of their scope and service are required to lead, sustain and grow the workforce internationally.

13. UK: The Lancet: Building a resilient NHS, for COVID-19 and beyond
The UK response to the COVID-19 pandemic has been ill prepared, patchy, confused, and incompetent. From initial equivocations, to a series of policy U turns and conflicts with scientific advisers, to vague public health guidance, the UK’s COVID-19 performance has fallen disastrously short and undoubtedly cost lives. It has pushed the National Health Service (NHS) to the brink. Having wasted a summer of opportunity to strengthen systems to suppress viral transmission following an easing of lockdown restrictions, the UK Government is facing a winter wave of COVID-19 with no strategy in sight. Lives, wellbeing, economic recovery, and public trust are at stake—but the government is still failing.
Transmission of SARS-CoV-2 has sharply escalated. The Chief Medical Officer and Chief Scientific Adviser implied on Sept 21 that the UK could have about 50 000 cases per day by mid-October, and 200 deaths per day by mid-November. In a worst-case scenario, this second wave could result in 81 000 excess deaths from COVID-19 by March, 2021, and 27 000 excess deaths unrelated to COVID-19. The Prime Minister Boris Johnson has called the NHS “beloved”. But without more support, NHS hospitals will again be overwhelmed by admissions. Without a plan to address the alarming levels of NHS staff stress and absenteeism, and 44 000 nursing vacancies, the system could collapse.

14. UK: The Guardian: Nurses barred from NHS 111 Covid clinical division after 60% of calls unsafe
The NHS 111 service has permanently stopped nurses and other healthcare professionals in a clinical division handling calls with people suspected of having Covid-19 after an audit of recorded calls found more than 60% were not safe.
The audit was triggered in July after many of the medical professionals recruited to work in that clinical division of the 111 service sounded the alarm, saying they did not feel “properly skilled and competent” to fulfil such a critical role.
An investigation was launched into several individual cases after the initial review found that assurances could not be given “in regard to the safety of these calls”, according to an email, seen by the Guardian, from the clinical assurance director of the National Covid-19 Pandemic Response Service. In a further email on 14 August, she told staff that after listening to a “significant number” of calls “so far over 60% … have not passed the criteria demonstrating a safe call”
A number of “clinical incidents” were being investigated, she said, because some calls “may have resulted in harm”. One case had been “escalated as a serious untoward incident with potential harm to the patient”.
https://amp.theguardian.com/world/2020/oct/01/nurses-barred-from-nhs-111-covid-clinical-service-after-60-of-calls-unsafeTop of Form

15. South Africa: African Journal of Primary Health Care and Family Medicine: Turnaround times – the Achilles’ heel of community screening and testing in Cape Town, South Africa: A short report
Early in the course of the coronavirus infection disease 2019 (COVID-19) pandemic in South Africa, the Department of Health implemented a policy of community screening and testing (CST). This was based on a community-orientated primary care approach and was a key strategy in limiting the spread of the pandemic, but it struggled with long turnaround times (TATs) for the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) reverse transcriptase polymerase chain reaction test. The local experience at Symphony Way Community Day Centre (Delft, Cape Town), highlighted these challenges. The first positive tests had a median TAT of 4.5 days, peaking at 29 days in mid-May 2020. Issues that contributed to long TATs were unavailability of viral transport medium, sample delivery and storage difficulties, staffing problems, scarcity of testing supplies and other samples prioritised over CST samples. At Symphony Way, many patients who tested COVID-19 positive had abandoned their self-isolation because of the delay in results. Employers were unhappy with prolonged sick leave whilst waiting for results and patients were concerned about not getting paid or job loss. The CST policy relies on a rapid TAT to be successful. Once the TAT is delayed, the process of contacting patients, and tracing and quarantining contacts becomes ineffective. With hindsight, other countries’ difficulties in upscaling testing should have served as warning. Community screening and testing was scaled back from 18 May 2020, and testing policy was changed to only include high-risk patients from 29 May 2020. The delayed TATs meant that the CST policy had no beneficial impact at local level.

16. USA: Family Medicine: Something Old, Something New: The Syndemic of Racism and COVID-19 and Its Implications for Medical Education
Two seismic issues, racism and COVID-19, have engaged the United States in the last several months, acting together to create what is known as a syndemic—a set of linked health problems that interact synergis- tically to contribute to excess burden of dis- ease in a population—that seriously impacts the health of all of us. Racism is old; it has always been a defining characteristic of our country. Triggered by episodes of police kill- ing of people of color, particularly the murder of George Floyd, we have seen extraordinari- ly broad discussion about it. The Black Lives Matter movement reminds us of the history of racism in the United States, from slavery, to lynchings and Jim Crow segregation, to mass incarceration (the “New Jim Crow”), and the inequity that begins at birth for every Black child as a result of the social constructs of race and racism.
COVID-19 is new, the biggest world-wide pandemic at least since the 1918 influenza pandemic. While it started in China, the Unit- ed States has become the world epicenter of the disease with the most cases and deaths (over 5 million cases, more than a quarter of all those in the world, and nearly 200,000 deaths as of this writing). As everywhere, the disease has hit the poorest, sickest, and most vulnerable communities the hardest; in the United States that has meant minorities, in whom the infection rate is at least twice that of Whites. The causal virus SARS-CoV-2 does not discriminate, but the society in which it occurs does. People of color, and especially
African Americans, have far higher rates of most chronic diseases, which makes them more vulnerable both to becoming infected and for worse outcomes when infected. Even before COVID, African Americans had mortality rates much higher than those of Whites, particularly for the most common chronic diseases: diabe- tes, cancer, heart disease, and stroke.

17. International: One World Organisation for Animal Health: Guidelines for Working with Free-Ranging Wild Mammals in the Era of the COVID-19 Pandemic
The SARS-CoV-2 virus, the cause of COVID-19, emerged as a human pathogen in 2019. While it is thought to have a zoonotic source, the original wildlife reservoir and any potential intermediate hosts have not yet been identified. Phylogenetic analyses suggest the progenitor virus is related to beta-coronaviruses previously identified in bats. At this time, SARS-CoV-2 should be considered a human pathogen with people acting as reservoir and sustaining transmission. There is a possibility SARS-CoV-2 will become endemic in the human population and thus be considered as a potential reverse zoonosis to wildlife as with infectious diseases such as tuberculosis and influenza. Currently the risk of human-to-animal transmission to non-captive wildlife species warrants concern. A number of cases have demonstrated natural human-to-animal transmission of SARS- CoV-2 in felids, canids and mustelids, the majority due to close and prolonged contact with infected households or people, and none has involved free-ranging wildlife. The identification of close phylogenetically-related viruses (e.g. in bats and pangolins), the presence of important cell receptor proteins (ACE2 receptors) and infection following natural exposure or experimental inoculation suggest that a wide range of mammalian species may be susceptible to SARS-CoV-2. Knowledge and experience with human-to-animal transmission with other human respiratory pathogens (e.g. metapneumovirus, measles, other human coronaviruses and tuberculosis) indicates that some species taxonomically closely related to humans (e.g. non-human primates) would likely be susceptible to infection and/or clinical disease caused by SARS-CoV-2. There are valid concerns about the health of individuals or populations if infected with the virus and/or a wildlife population becoming a reservoir for SARS-CoV-2. Any wildlife species/taxa that becomes a reservoir for SARS-CoV-2 could pose a continued public health risk of zoonosis, a risk for the transmission of SARS-CoV-2 to other animal species, and the risk of negative perceptions of that species resulting in human threats to the species or their populations.

18. Jama: Efficacy and Safety of Hydroxychloroquine vs Placebo for Pre-exposure SARS-CoV-2 Prophylaxis Among Health Care Workers: A Randomized Clinical Trial
Results Of the 132 randomized participants (median age, 33 years [range, 20-66 years]; 91 women [69%]), 125 (94.7%) were evaluable for the primary outcome. There was no significant difference in infection rates in participants randomized to receive hydroxychloroquine compared with placebo (4 of 64 [6.3%] vs 4 of 61 [6.6%]; P > .99). Mild adverse events were more common in participants taking hydroxychloroquine compared with placebo (45% vs 26%; P = .04); rates of treatment discontinuation were similar in both arms (19% vs 16%; P = .81). The median change in QTc (baseline to 4-week evaluation) did not differ between arms (hydroxychloroquine: 4 milliseconds; 95% CI, −9 to 17; vs placebo: 3 milliseconds; 95% CI, −5 to 11; P = .98). Of the 8 participants with positive results for SARS-CoV-2 (6.4%), 6 developed viral symptoms; none required hospitalization, and all clinically recovered.
Conclusions and Relevance In this randomized clinical trial, although limited by early termination, there was no clinical benefit of hydroxychloroquine administered daily for 8 weeks as pre-exposure prophylaxis in hospital-based HCWs exposed to patients with COVID-19.

19. International: Select Science: Tracking COVID-19 ‘super spreading’ events with viral sequencing
Hear how one trailblazing lab at the Broad Institute of MIT and Harvard is using automated sample tracking to monitor pandemics such as Ebola Virus Disease and COVID-19
The Sabeti Lab at the Broad Institute of MIT and Harvard is no stranger to handling difficult and dangerous viral outbreaks. During the Ebola Virus Disease (EVD) outbreak of 2013-2016, the lab was responsible for sequencing the Ebola virus (EBOV) genome, and their more recent work using single-cell gene expression analysis and transcriptomics of tissues in non-human primate models hopes to further aid the understanding of the pathology, progression, and evolution of EVD. However, with the emergence of the novel SARS-CoV-2 pathogen, the lab is now readjusting its focus and applying this existing expertise to address this new pandemic.
“The scale of this project was big, and it unfolded quickly. We had to rapidly build new systems to deal with this challenge,” Kat DeRuff, research associate in the Sabeti Lab, shares. “Luckily, we were able to adapt what we had set up for the Ebola project, and eLABJournalwas absolutely crucial in this work.”
The novel coronavirus is known to mutate approximately every 10 days, meaning that if a large group of people has the exact same virus, this must be spreading rapidly within that group without time to mutate. The main aim of the Sabeti lab’s project is to identify case introductions and dissect ‘super spreading’ events in the Greater Boston area. To achieve this, the lab is sequencing the SARS-CoV-2 genomes in patient samples and creating transmission trees based on who has what mutation.

20. International: Tortoise Media: Podcast: Long haul: Hundreds of thousands of people who thought they’d recovered from Covid-19 are still ill. Why?
Coronavirus can kill, or pass through a body unnoticed. Its effects in the short term are wildly unpredictable. But as we learn to live with this new virus we’re discovering more of its grisly secrets. One of them is that the damage it does to the body in the long run might leave a dreadful legacy. This is the story – as much as we know it – of Long Covid.
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21. Canada: McMaster: Video: $4M launches national study on COVID-19 antibodies in older adults
A $4-million investment from Canada’s COVID-19 Immunity Task Force will launch a national study to investigate the burden of SARS-CoV-2 infection among aging Canadians, a population that has been shown to be at greatest risk for severe outcomes from COVID-19 disease.
The study will be carried out by the Canadian Longitudinal Study on Aging (CLSA), a national platform for research on aging led by McMaster University and involving more than 10 academic and hospital research sites across the country.
The CLSA’s COVID-19 Seroprevalence Study will collect and analyze blood samples from more than 19,000 CLSA participants in 10 provinces. In addition to providing blood samples, the CLSA’s study participants will complete a questionnaire that collects information on symptoms, risks factors, health-care use, and the psychosocial and economic impacts of COVID-19.
Linking the results about the presence of antibodies and other immune markers obtained from the blood sample analyses to the CLSA’s questionnaire findings will paint a more comprehensive picture of the prevalence of SARS-CoV-2 and the impact of COVID-19 among older adults in Canada.
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22. Europe: CNN: Countries across Europe set grim Covid-19 records as restrictions are reimposed
As Europe transitions from summer into fall, countries that claimed to have the coronavirus under control are once again seeing a surge in infections. The United Kingdom, which has the biggest death toll on the continent, reported 12,872 new Covid-19 cases on Saturday, more than double the country’s most recent seven-day rolling average, according to official figures. Although the UK government blamed the spike on a “technical issue” where previously unreported infections from the past week had been added to the total, Prime Minister Boris Johnson warned Sunday: “This could be a very tough winter for all of us. It’s gonna continue to be bumpy through to Christmas,” Johnson told the BBC’s Andrew Marr. “It may even be bumpy beyond,” he said. According to the British government, the UK so far has a total of 480,017 recorded Covid-19 cases and 42,317 deaths.

23. USA: Reuters: Moderna COVID-19 vaccine appears safe, shows signs of working in older adults – study
Results from an early safety study of Moderna Inc’s coronavirus vaccine candidate in older adults showed that it produced virus-neutralizing antibodies at levels similar to those seen in younger adults, with side effects roughly on par with high-dose flu shots, researchers said on Tuesday.
The study, published in the New England Journal of Medicine, offers a more complete picture of the vaccine’s safety in older adults, a group at increased risk of severe complications from COVID-19.
The findings are reassuring because immunity tends to weaken with age, Dr. Evan Anderson, one of the study’s lead researchers from Emory University in Atlanta, said in a phone interview.
The study was an extension of Moderna’s Phase I safety trial, first conducted in individuals aged 18-55. It tested two doses of Moderna’s vaccine – 25 micrograms and 100 micrograms – in 40 adults aged 56 to 70 and 71 and older.

24. International: Cambridge University Press: COVID-19 opens a window of reflection for comparative health systems and global health research
The Covid-19 crisis that led to the loss of thousands of lives and initiated one of the most complex social and economic upheavals has also a created a window of reflection for health systems researchers to revisit our major concepts, frameworks, and underlying assumptions. This commentary reviews two literatures that remain rather separate: comparative health policy and global health. First, I examine whether convergence in circumstances brought about by the spread of Covid-19 creates opportunities for learning “about” as well as unpacking the motivations of policy actors and how they use the cross-national information. However, given the emphasis on national policy actors and processes, this literature may overlook the importance of global actors, institutions and ideas. Second, global health differentiates itself with an emphasis on multilateralism as a political positioning and its multidisciplinary and multi-sectoral approach. However, the global health field is also challenged to consider its mission, political standing on multilateralism, changing relationships between North and South and its commitment to multidisciplinary approach. I argue that health systems scholars should use the window of opportunity created by Covid-19 pandemic to reexamine their methodologies and rearticulate their positioning by acknowledging the voice and agency of the Global South.

25. India: Reuters: India’s coronavirus infections rise to 6.63 million
India’s coronavirus case tally rose by 74,442 in the last 24 hours to 6.63 million on Monday morning, data from the health ministry showed.
Deaths from coronavirus infections rose by 903 to 102,685, the ministry said.
India’s death toll from the novel coronavirus rose past 100,000 on Saturday, only the third country in the world to reach that bleak milestone, after the United States and Brazil, and its epidemic shows no sign of abating.
Last week, India further eased restrictions and permitted states to open schools and movie theatres.

26. International: MOLECULAR FRONTIERS JOURNAL: One Health—the Key to Preventing COVID-19 from Becoming the New Normal
While we experience the most significant zoonotic pandemic in 100 years, we would do well to consider how we arrived at this historic moment and how we will prevent the next pandemic. In this commentary, we explore the human drivers of emerging infectious diseases and contend that a One Health approach—in which multiple disciplines work together to ensure the health of environments, humans, and non-human animals—is imperative to get through this pandemic and to prevent future ones. The year 2020 will be remembered in the coming decades as the year we made the changes demanded by the moment or as the year humans failed to change our over-consumptive course with nature, and COVID-19 was soon forgotten as just another in a long list of coming pandemics. We are hopeful for the first of these options, but fearful that the latter is more likely. As we write this commentary, the 7.8 billion humans on Earth today are nine months into a pandemic unlike any since the 1918–1919 Spanish Flu in which 50–100 million people died. Although the number of COVID-19-related human deaths thus far is closer to one million than to 50 million, there remains no clear vision of when or how the pandemic will end. As we start to come out from sheltering-in-place to interacting with each other again, all be it with face masks and social distancing guidelines, the realities of this pandemic and the hardships experienced by people around the world should not be under appreciated. These facts, along with the trillion-dollar economic fallout associated with this novel pathogen, make it clear that we must consider both how we got here and how we will prevent similar zoonotic pandemics in the future1.

27. UK: Evening Standard: None of this seems real: NHS and key workers share their experiences of being on the coronavirus frontline
Key workers who have spent months on the frontline in the fight against coronavirus are sharing their own experiences with the public.
Through the Humans of Covid-19 project, individuals highlight the toll working in hospitals during a pandemic has taken on their mental health and explain in just a few paragraphs how it feels to lose a patient as a medic.
Others talk about how they have seen communities come together in the wake of coronavirus. Like its inspiration, the hugely successful Humans of New York series, Humans of Covid-19 sees the picture and story of a different person shared daily on social media.
It was launched at the end of April by Benjamin Rosen, a 28-year-old junior doctor working in a busy London A&E department.
Dr Rosen told the Standard he started the project to encourage people to take social distancing seriously.

UK: The Guardian: How universities tricked students into returning to campus
Students were promised face-to-face teaching, but as soon as their fees and rents were secured, institutions turned their backs on them
The outbreaks of coronavirus as students return to universities were not just predictable: they were predicted. In August, the Independent Sage group of scientists called on universities to make online teaching the “default option”. The main lecturers’ union, UCU, echoed this call. Even not-so-independent Sage (the official body that advises the government) warned in early September that “significant outbreaks” associated with universities were “highly likely”, hinting at the prospect of local lockdowns to prevent students from returning home for Christmas.
To blame the outbreaks on illicit or ill-advised partying by students is to miss the point. Any policy that relies on perfect compliance by imperfect human beings is flawed. But even an outbreak of monkish self-restraint among the nation’s undergraduates would not make a return to face-to-face teaching safe. The problem is not human fallibility, but the nature of the virus itself.
Scientists have been telling us for some time now that Covid-19 is an airborne disease. Although face coverings and physical distancing can protect against the kind of droplets produced by coughing and sneezing, they’re no matchfor “aerosols” – tiny particles less than 10 microns in diameter, produced by ordinary breathing. These are small enough to pass through the fabric of masks and light enough to remain airborne for many minutes, circulating on air currents and accumulating in greater concentrations the longer people are together in a confined or poorly ventilated space – a pretty good description of a typical university teaching room.

28. USA: Washington Post: CDC’s credibility is eroded by internal blunders and external attacks as coronavirus vaccine campaigns loom
For decades, the agency stood at the forefront of fighting disease outbreaks. This time, it’s dealing with a crisis of its own. The Centers for Disease Control and Prevention was created to stop deadly pathogens. It battled malaria and polio. It helped eradicate smallpox. It sent intrepid disease doctors to Africa to fight Ebola. Over the course of seven decades, it became the world’s most admired public health agency. The CDC had been preparing for decades for this moment — the arrival of a virus rampaging across the planet, inflicting widespread death and suffering.
But 2020 has been a disaster for the CDC. The agency’s response to the worst public health crisis in a century — the coronavirus pandemic — has been marked by technical blunders and botched messaging. The agency has endured false accusations andinterference by Trump administration political appointees. Worst of all, the CDC has experienced a loss of institutional credibility at a time when the nation desperately needs to know whom to trust.

29. USA: National Institutes of Health: NIH establishes Centers for Research in Emerging Infectious Diseases
The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, today announced that it has awarded 11 grants with a total first-year value of approximately $17 million to establish the Centers for Research in Emerging Infectious Diseases (CREID). The global network will involve multidisciplinary investigations into how and where viruses and other pathogens emerge from wildlife and spillover to cause disease in people. NIAID intends to provide approximately $82 million over five years to support the network.
“The impact of the COVID-19 pandemic serves as a potent reminder of the devastation that can be wrought when a new virus infects humans for the first time,” said NIAID Director Anthony S. Fauci. “The CREID network will enable early warnings of emerging diseases wherever they occur, which will be critical to rapid responses. The knowledge gained through this research will increase our preparedness for future outbreaks.”

30. France: BBC: Coronavirus: Paris to shut bars and raise alert to maximum
Paris will shut all bars completely from Tuesday as the French government raises the city’s coronavirus alert to maximum following a sustained period of high infection rates. The restrictions will last two weeks, with full details to be announced on Monday, Prime Minister Jean Castex’s office announced. On Sunday France reported 12,565 cases of Covid-19. The southern city of Marseille closed bars and restaurants last week. France’s maximum alert level comes into force when the infection rate in a locality exceeds 250 per 100,000 people and at least 30% of intensive care beds are reserved for Covid-19 patients.
“These measures, indispensable in the fight to curb the virus’ spread, will apply to Paris and the three departments immediately surrounding it, for a duration of two weeks,” the prime minister’s office explained.
Restaurants in the city will have to put in place new sanitary arrangements in order to stay open and university lecture halls must be no more than half-full.
But restaurants and bistros that serve food as well as alcohol can stay open, as long as they register contact details from customers and shut their doors at 22:00.
Working from home must be prioritised “now more than ever”, the statement said.

31. Russia: Reuters: Russia’s new coronavirus cases top 10,000 for first time since mid-May
Russia reported 10,499 new coronavirus cases on Sunday, the highest number of daily infections since May 15, when the outbreak was at its peak and lockdowns were in place. Russia’s coronavirus crisis centre said that 107 coronavirus deaths had been confirmed in the last 24 hours, which took the official national death toll to 21,358.

32. Italy: Reuters: Italian government set to impose new curbs to tackle COVID-19 resurgence
The Italian government will likely impose new restrictions on the country in the coming week to try to beat back rising numbers of coronavirus cases, Health Minister Roberto Speranza said on Sunday.
The cabinet is due to meet on Tuesday to decide how to respond to an increase in infections, with southern Italian regions for the first time looking vulnerable to the disease.
“The battle isn’t over. We don’t have the numbers seen in other European countries … but we are in a phase of significant growth and I hope the country finds a spirit of unity,” Speranza told state broadcaster RAI.
The measures under review include making the wearing of masks obligatory outdoors across the whole country and re-introducing curbs on social gatherings.
“Masks are fundamental. The more we can get them used by Italians the better it will be,” said Speranza. Mask-wearing is currently compulsory in just five of Italy’s 20 regions, mainly in the south.

33. USA: Sage Journals: COVID-19 Pandemic Highlights the Need for Teaching Health Communication to Public Health Students
The COVID-19 pandemic precipitated a deluge of scholarly publications and scientific outreach. Information about the novel coronavirus has spread rapidly through both traditional news and social media platforms. Timely scientific literature is paramount to public health, but it must be paired with nuanced and tailored outreach and messaging. Despite being a core public health competency, not all public health science students receive training in these skills. The media response to the COVID-19 pandemic reveals a fundamental misunderstanding by the general public about the scientific process and cultivates a narrative that too often places blame on individuals for structural inequities. An influx of research without audience-appropriate interpretations, coupled with a lack of representation in the news media, threatens to erode trust in science. To address these challenges, schools and programs of public health might reflect on their curricula and consider placing a greater emphasis on health communication.

34. International: Wall Street Journal: Philosophy for a Time of Crisis
From Socrates to Camus, thinkers have asked how to respond when adversity turns our lives upside down
Thanks to the pandemic and its economic fallout, we are all philosophers now. The “slow cure,” as philosophy has been called, is exactly what we need. This is philosophy not as metaphysical musing but as originally conceived by the ancient Greeks: practical, therapeutic medicine for the soul.
Philosophy helps us to untangle the knotty ethical questions raised by the pandemic, but it can also help us to answer far more personal but equally urgent quandaries. How to endure the unendurable? How to find certainty in an uncertain universe? Philosophy provides no easy answers, but it reframes our questions and alters our perspectives—a skill that is helpful during good times and invaluable during bad ones. Philosophy is well acquainted with bad times. Many of history’s greatest thinkers did their most lasting work during pandemics, economic upheaval and social unrest. Theirs is an earned wisdom—and a portable one. Unlike information or technology, wisdom is never rendered obsolete. Philosophy’s insights are more relevant than ever.
Covid-19 has humbled us, unmoored us. Nothing seems certain anymore. Good, Socrates would say. Western philosophy’s patron saint and first martyr would surely recognize our plight. He lived during Athens’ decline as a great power, a fall accelerated by military adventurism and the bubonic plague.
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35. Syria: Care: Video: My Name is Marwa
This International Day of the Girl, Nia Sioux raises her voice alongside Marwa to tell the story of a girl’s dedication and perseverance in Marwa’s own words.
Marwa, a Syrian refugee, missed two years of school after war displaced her family. A financing program helped her go back to school to pursue her dream of becoming a lawyer.
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36. Ecuador: Care: See How One Family in Ecuador is Recovering From COVID-19
Angélica Romero was infected last spring, had to stop work, and is still trying to recover. Here’s a glimpse at how she and her family spend their days at home.
Angélica Romero lives in Guayaquil, Ecuador, with her husband Maximiliano Ayoví and their three children. Angélica, who makes a living as a domestic worker, contracted COVID-19 in the spring and became so ill she nearly died. Her husband was also infected around the same time. Last spring, Guayaquil was among the cities in Latin America worst hit by COVID-19, with The New York Times and others reporting that the city’s total coronavirus deaths could be up to 15 times higher than official counts as many people were dying at home and bodies were being left in the streets.

37. Ireland: BBC: Coronavirus: Highest level restrictions recommended in Republic of Ireland
The highest level of coronavirus restrictions should be introduced across the Republic of Ireland, public health experts have said.
The National Public Health Emergency Team (NPHET) made the recommendation to the government on Sunday night. Level Five restrictions would see all indoor gatherings banned and bars and restaurants only able to operate takeaway services.
Politicians are expected to meet the chief medical officer on Monday.
The measures would be in place for four weeks. A length NPHET meeting took place earlier on Sunday to discuss the rise in Covid-19 cases in the county, RTÉ reported. Any move to new restrictions would have to be considered by the Covid-19 oversight group, the cabinet sub-committee and the full cabinet which is currently scheduled to meet on Tuesday.
There were 364 new Covid-19 cases recorded on Sunday, with no additional deaths reported. Other level five restrictions include weddings being limited to six people and no sports fixtures being held, as well as prohibiting visits to other people’s homes.

38. USA: CNN: Only 3 states are reporting declines in new coronavirus cases as the US hits its highest daily rate in 2 months
Only three US states are reporting a decline in new Covid-19 cases compared to last week, as the country hit its highest daily rate of new cases in almost two months.
As of Saturday night, new cases were down in Texas, Missouri and South Carolina, while 21 states reported a rise in cases and a little more than half held steady compared with the week before.
Friday, there were 54,506 new reported cases, according to Johns Hopkins University, the highest single day case number since 64,601 cases were reported on August 14.
From September 29 to October 3, there were an average of 46,500 cases per day — the most cases in a five-day period since August 14-18, JHU data showed.
The climbing coronavirus count comes as the President joined the more than 7.3 million people who have tested positive for Covid-19 in the US, a sobering reminder of the virus’ reach as health experts urge continued vigilance during the fall and winter months.
The 21 states reporting a rise in new cases are Alaska, Connecticut, Delaware, Idaho, Indiana, Kentucky, Maryland, Massachusetts, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, Ohio, Pennsylvania, Rhode Island, Vermont, Wisconsin and Wyoming.

39. UK: Institute of Medical Leadership and Management: Covid-19: Reflections from the hidden frontline – psychiatric care
At the height of the global pandemic, medical students remained in lockdown and we watched our colleagues, professors, consultants, trainees, doctors, nurses, other health professionals and mentors battling this unprecedented crisis on the frontlines.
We heard constantly of the tremendous burden Covid-19 had placed on emergency departments, intensive care units and care homes across the UK and worldwide, but we were unaware of what was happening in mental health units. Eventually, as lockdown restrictions eased in the UK, medical schools grappled with trusts to get students back onto academic placements. Our first stop was a psychiatric intensive care unit at the renowned Bethlem Royal Hospital in South East London, but nothing had prepared us for what we were about to experience on the hidden frontline.
Psychiatric hospitals have been plagued by the coronavirus across the UK, yet garnered little media attention. A psychiatric intensive care unit (PICU) can be complex and challenging at the best of times, but particularly with regard to observing social distancing and other Covid guidelines, due to the nature and level of acuity of illness, structure and environment, among other associated factors. A PICU must meet patients’ medical, psychological and sociocultural needs. Covid-19 swabs have become mandatory upon admission and this is a challenge in itself. At the height of the pandemic, Croydon PICU cared for seven Covid-positive patients and the staff felt proud of the care they provided and have shared this learning widely.

40. Nature: Nature Milestones in Vaccines
Edward Jenner (1749–1823), a physician from Gloucestershire in England, is widely regarded as the ‘father of vaccination’ However, the origins of vaccination lie further back in time and also further afield. In fact, at the time Jenner reported his famous story about inoculating young James Phipps with cowpox and then demonstrating immunity to smallpox, the procedure of ‘variolation’ (referred to then as ‘inoculation’), by which pus is taken from a smallpox blister and introduced into a scratch in the skin of an uninfected person to confer protection, was already well established.
Although smallpox variolation dramatically reduced infection-induced fatality rates, it still carried significant risks, including the potential to trigger new smallpox outbreaks. In addition, it relied upon a constant supply of smallpox-infected individuals as a source of inoculation material. As variolation became more widely practised in the 18th century, an ostensibly simple observation started to gain more attention, with profound consequences for not only smallpox, but also many other infectious diseases.

41. USA: Washington Post: The code: How genetic science helped
expose a secret coronavirus outbreak
It wasn’t until their colleagues began to disappear that workers at Agri Star Meat and Poultry realized there was a killer in their midst.
First came the rumors that rabbis at the kosher plant had been quarantined. Then a man who worked in the poultry department fell ill. They heard whispers about friends of friends who had been stricken with scorching fevers and unbearable chills — characteristic symptoms of the novel coronavirus.
Where was the contagion coming from?
No one would say. Not Agri Star’s wealthy owner, who didn’t shut down production lines after cases were confirmed among workers. Not the Iowa Occupational Safety and Health Administration, which closed a complaint containing multiple allegations against the plant without an inspection. Not Iowa Gov. Kim Reynolds ®, whose administration threatened to prosecute officials who released covid data and did not conduct testing at the plant until seven weeks after the first infections.

42. Spain: Corriere Della Sera: Coronavirus: ecco le responsabilità della Cina
Coronavirus: here are China’s responsibilities
È accaduto anche con la pandemia da Coronavirus: la Cina, dal 1945 membro del Consiglio di sicurezza dell’Onu con diritto di veto, tace o nega da sempre quando le si chiede conto di come rispetta i diritti umani, in questo caso la libertà di informazione. Stavolta però il suo silenzio viene pagato anche da molti altri Paesi.
Il South China Morning Post, storico quotidiano di Hong Kong, riporta più volte informazioni da fonti governative: il primo contagio del nuovo morbo è stato registrato in Cina il 17 novembre 2019. L’informazione all’Oms dovrebbe essere immediata, ma le autorità attendono fino al 31 dicembre prima di comunicare al corrispondente ufficio di Pechino una «strana polmonite» sviluppatasi a Wuhan nel mercato di animali vivi. I «wet market» erano già i principali indiziati del precedente Sars-Cov1 del 2002. Però solo il 9 gennaio 2020 Pechino parla di «nuovo coronavirus» simile al precedente Sars. Il 30 gennaio l’Oms dichiara l’emergenza internazionale.

43. USA: CBS Pittsburg: Women’s Mental Health Almost 3 Times As Likely To Be Affected By The Pandemic, Study Says
“I think there’s a lot of decision fatigue. We’re making decisions constantly, and it’s exhausting,” a local clinical psychiatrist says.
Mental health during the pandemic has been a struggle for some people, but especially women.
“They tend to take on more of the burden and the mental burden of organizing, like, everyone’s life,” says Rebecca Weinberg, PsyD with AHN Women’s Behavioral Health. “Women feel like they have to choose between their financial security and potentially their physical health, and the health of their family.”
In a study by CARE, a nonprofit advocacy group, women are almost three times as likely to have been affected by mental health issues over the last six months: 27% of women, versus 10% of men, report anxiety, loss of appetite, difficulty sleeping and trouble completing everyday tasks.Dr. Weinberg’s patients bring up these issues.“A lot about anxiety, getting the virus, or exposing older family members and being frustrated and lonely. Women are certainly talking about financial impact of COVID, if they or their partners have been laid off. Having kids in virtual school is a huge stress. Or do you make the decision to send your child to school if it’s an option, and what type of risk are you accepting?” says Dr. Weinberg.

44. UK: BBC: Coronavirus: NHS faces pandemic ‘triple whammy’ this winter
The NHS is facing a “triple whammy” of rising Covid-19 cases, a major backlog in treatment and reduced capacity due to infection-control measures, according to health bosses. The NHS Confederation report on the English NHS said more investment was desperately needed. The NHS bosses also called on ministers to be “honest and realistic” about waiting lists for treatment. It comes despite the government promising an extra £3bn this winter.That money – announced over the summer – was intended to:
help hospitals cope with the extra-infection control measures required
pay for patients to be treated privately for routine treatment, such as knee and hip replacements But hospitals are still performing only half the number of routine operations they normally would.

45. Nature: SARS-CoV-2 vaccines in development
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in late 2019 in China and caused a coronavirus disease 2019 (COVID-19) pandemic. To mitigate the public health, economic and societal impacts of the virus, a vaccine is urgently needed. The development of SARS-CoV-2 vaccines was initiated in early January 2020 when the sequence of the virus became available and moved at record speed with one Phase I trial already starting in March 2020 and currently more than 180 vaccines in various stages of development. Phase I/II trial data is already available for several vaccine candidates and many have moved into Phase III trials. The data available so far suggests that effective and safe vaccines might become available within months rather than years.

46. UK: BBC: Coronavirus: How does the Covid-19 alert level system work?
How is the alert level set?
Risk levels are measured by a five-level, colour-coded alert system.
The government unveiled the system in May. The prime minister said it would help decide how tough social-distancing measures should be.
There are five levels:
• Level five (red) – a “material risk of healthcare services being overwhelmed” – extremely strict social distancing
• Level four – a high or rising level of transmission – enforced social distancing
• Level three – the virus is in general circulation – social distancing relaxed
• Level two – the number of cases and transmission are low – minimal social distancing
• Level one (green) – Covid-19 is no longer present in the UK – no social distancing

47. UK: BBC: Covid: Is it time we learned to live with the virus?
The constant mantra is the virus must be suppressed and contained. But how do you do this when people can be infectious without knowing they have it? Where it can be passed on silently because people do not develop symptoms?
The nation has been brought to a standstill once at immense cost to the economy, education and health more generally. And now with cases rising there is the threat of new national restrictions, while large parts of the country have already found themselves back in partial lockdown. But are we fighting a losing battle? Do we instead need to learn to live with the virus?

48. Nature: How COVID-19 can damage the brain
Some people who become ill with the coronavirus develop neurological symptoms. Scientists are struggling to understand why.
The woman had seen lions and monkeys in her house. She was becoming disoriented and aggressive towards others, and was convinced that her husband was an impostor. She was in her mid-50s — decades older than the age at which psychosis typically develops — and had no psychiatric history. What she did have, however, was COVID-19. Hers was one of the first known cases of someone developing psychosis after contracting the disease.
In the early months of the COVID-19 pandemic, doctors struggled to keep patients breathing, and focused mainly on treating damage to the lungs and circulatory system. But even then, evidence for neurological effects was accumulating. Some people hospitalized with COVID-19 were experiencing delirium: they were confused, disorientated and agitated. In April, a group in Japan published the first report of someone with COVID-19 who had swelling and inflammation in brain tissues. Another report4 described a patient with deterioration of myelin, a fatty coating that protects neurons and is irreversibly damaged in neurodegenerative diseases such as multiple sclerosis.
“The neurological symptoms are only becoming more and more scary,” says Alysson Muotri, a neuroscientist at the University of California, San Diego, in La Jolla.
The list now includes stroke, brain haemorrhage and memory loss. It is not unheard of for serious diseases to cause such effects, but the scale of the COVID-19 pandemic means that thousands or even tens of thousands of people could already have these symptoms, and some might be facing lifelong problems as a result.

49. UK: BBC: Covid-19: Prince Charles highlights coronavirus impact on young people
The Prince of Wales has highlighted the impact of the pandemic on young people, saying it is a “particularly difficult time to be young”.
In a rare article, published in the Sunday Telegraph, Prince Charles suggested there could be one million young people “needing urgent help”.
And he said the challenge of helping those in need was “unquestionably vast, but it is not insurmountable”.
There have been many warnings over the impact of the virus on young people.
Researchers warned that education gaps between richer and poorer pupils widened during the lockdown, while experts said the drop in face-to-face contact could damage teenagers in the long-run.

50. New Zealand: Washington Post: New Zealand says travel bubble with parts of Australia could be within reach
New Zealand Prime Minister Jacinda Ardern raised hopes Monday that a travel bubble with Australia could still be within reach, after a resurgence of the novel coronavirus disrupted similar plans earlier this year.
“Previously, [Canberra] wanted a whole of Australia approach, and we said that would slow things down,” Ardern told TVNZ. “They’re now moving to a hotspot regime,” under which movement would be restricted in some areas, according to the rate of new infections.
The number of new cases in Australia had surged in recent months during the Southern Hemisphere’s winter, with the state of Victoria at the center of the outbreak. But officials there hope to be able to ease most restrictions over the coming weeks. This month, Australia began recording daily increases in the low double digits, down from more than 700 new daily infections at the peak of the outbreak.

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