ID	Document
1	"coronavirus: its true origin and history text extraction from html file; language identification https://elrc-share.eu under review 2020 coronavirus: its true origin and history text/html https://www.modernghana.com/news/993080/coronavirus-its-true-origin-and-history.html en_2020_04_878.xml_59.html coronavirus: its true origin and history by dr e.k.hayford, cdg-gh listen to article the caucus for democratic governance, ghana (cdg--gh), through its research and its attempt to help arrest and deport covid-19 from ghana, has come across vital information, which might be of interest to ghanaians varying suggestions we were originally given to understand, that the virus originated from the transfusions from snakes and bats. others suggested it came from chinese biological weapons. yet others suggested it was from the fish markets conditions in wuhan. be it as it may, the correct origin which goes beyond these assertions is left to the discretion of the individual. spanish flu the history of viruses with pandemic definitions first registered its presence on our planet one hundred and twenty years ago. it all started in 1918, when radio wave was introduced in spain to improve global radio spectrum frequency transmissions. the result experts say was the spanish flu pandemic. the pandemic lasted for two years; from 1918-1920 and affected 500 million people out of which 50 million people died. east asian flu the second major pandemic occurred after the second world war ; the 1957 east asian flu pandemic with h2n2 virus. during this period, satellites were mounted for global use of radio waves, radar signals and field transmissions. the virus which was identified in february 1957, affected over 50 million people out of which 1,5 million died. hong kong flu the third major influenza pandemic that affected the world, was in 1968; the hong kong flu pandemic; the h3n2-virus. it lasted between 1968-1970. it affected about 500 million and about 2.5 million people died. corona virus unfortunately in 2019, another pandemic, the corona virus pandemic is causing worrying human loses. a few years ago, g5 system, was introduced which generally was said to be dangerous because of its high radio frequency. g5 is more efficient compared to g1, g2, g3, and g4. the frequency of g5 is about 10 times higher then g4 and the radio frequency, is used in running satellites, electricity, cars, hospitals, airports, ships, major cities and the control of major economies. origin of covid-19 corona virus was first found in wuhan in the province of hubei in china; in december 2019. as at 31st march 2020, covid-19 had been reported in 200 countries with 308,000 cases and 39,000 deaths. it is said to have started because of proliferation of g5 radar satellites for communication. the chinese telecommunication giant-huawei, in partnership with vodafone, has extensive satellite stations in wuhan with extreme high radiation frequencies. the effect of the radiation from g5 systems on the human cells, according to expects, poisons the cells and induces these viruses. of late, the 5g system were set up extensively in italy, spain and britain, explaining why these three countries are badly affected by corona virus. in europe, russia did not proliferate g5 in its cities and so was spared from corona virus fatalities. g5 is only found in russian military setups. causal effects the question i am asking ( and i guess you are also asking) is : what is the true cause of the covid-19 ? what is causing the symptoms? how does our bodies react to radio frequency radiation? which radiations does g5 emit - alpha radiation, beta radiation, gamma radiation or x-ray radiation and in what quantities? these are questions we have to answer, if we desire to know the causal relationship between human cells and g5 radiation. resume looking at the above history, one would very quickly conclude by blaming excessive g5 radiation. we however have to allow our communication and medical experts to lead the discussion. the cat is out of the sack and we should be concerned about our health and safety. dr e.k.hayford cdg-gh 0277606338 / 0507694343 disclaimer: ""the views/contents expressed in this article are the sole responsibility of the author(s) and do not neccessarily reflect those of modern ghana. modern ghana will not be responsible or liable for any inaccurate or incorrect statements contained in this article."" more on this story"
1	"indian-origin cardiac surgeon dies in uk from covid-19 | india news,the indian express text extraction from html file; language identification https://elrc-share.eu under review 2020 indian-origin cardiac surgeon dies in uk from covid-19 | india news,the indian express text/html https://indianexpress.com/article/india/indian-origin-cardiac-surgeon-dies-in-uk-from-covid-19-6352042/ indian in uk coronavirus death indians in uk coronavirus uk coronavirus cases indian express news en_2020_04_5501.xml_188.html indian-origin cardiac surgeon dies in uk from covid-19 indian-origin cardiac surgeon dies in uk from covid-19 cardiff and vale university health board posted a tribute to the medic, who had studied for his medical degree in india, and said the 58-year-old ""jitu"" will be missed greatly after he passed away on monday. by: pti | london | published: april 7, 2020 9:08:51 pm pedestrians are scarce in the city of london, the financial district, during what is normally the morning rush hour on monday, march 23, 2020. (andrew testa/the new york times) an indian-origin cardiac surgeon who had tested positive for the novel coronavirus has died at a hospital in cardiff in the uk, where a number of medics have lost their lives on the frontlines of the covid-19 pandemic . jitendra kumar rathod, associate specialist in cardio-thoracic surgery at the university hospital of wales (uhw), was described as an “incredibly dedicated surgeon” by his national health service (nhs) workplace. cardiff and vale university health board posted a tribute to the medic, who had studied for his medical degree in india, and said the 58-year-old “jitu” will be missed greatly after he passed away on monday. “jitu had worked in the department of cardio-thoracic surgery since the mid-1990s and came back to uhw in 2006 after a brief stint abroad,” the board said. “he was an incredibly dedicated surgeon who cared deeply for his patients. he was well-liked and greatly respected by one and all. he was a very compassionate and a wonderful human being,” the tribute read. the board added that his commitment to the hospital's special facility had been “exemplary”. rathod is survived by his wife and two sons. he is among a growing number of medics who have lost their lives on the frontlines of the coronavirus pandemic across uk hospitals, where the covid-19 death toll mounted to 5,373. over 208,800 people have been tested in the uk, of which more than 51,600 have tested positive, including the country's prime minister boris johnson. according to johns hopkins university, there are over 1.34 million confirmed coronavirus cases across the world and over 74,000 people have died from the disease. the us has the highest number of covid-19 cases in the world at 364,723, followed by spain (136,675), italy (132,547) and germany (102,453). ? the indian express is now on telegram. click here to join our channel (@indianexpress) and stay updated with the latest headlines for all the latest india news , download indian express app. tags:"
1	"tehran academic: covid-19 may have originated in u.s. | memri text extraction from html file; language identification https://elrc-share.eu under review 2020 tehran academic: covid-19 may have originated in u.s. | memri text/html https://www.memri.org/tv/tehran-university-lecturer-foad-izadi-maybe-coronavirus-originated-in-america-like-spanish-flu en_2020_04_5302.xml_42.html mar 31, 2020 share video: tehran university lecturer foad izadi: covid-19 may have originated in the u.s. like the spanish flu did #7919 | 02:43 source: irib ofogh tv (iran) tehran university lecturer foad izadi said in a march 31, 2020 episode of iranian filmmaker nader talebzadeh's show on ofogh tv (iran) that he does not know whether covid-19 was manufactured in the united states, but that some americans reported symptoms of coronavirus before the virus officially spread to the united states. he speculated that this, along with president trump's statement that 40,000 americans had died of the flu in the previous year, may be an indication that the coronavirus started in the united states before spreading to china and other parts of the world. he said that this is what had happened with the spanish flu, which he said originated in kansas but was given its name because of a conflict between the u.s. and spain and because america's propaganda had been more effective than spain's. foad izadi: ""the question about whether america created [the coronavirus] requires a certain kind of expertise, i do not know. with that being said, there's a point or two here. if it isn't man-made, and if it spread in society naturally, then which country got the disease first is an important detail. it appears - you know, some of our friends are in america. since december, we have been asking some of them how they are doing. they told us that people were getting sick with a disease that nobody had had before."" interviewer: ""before january."" foad izadi: ""right. this was before it became a serious matter even in china. [...] foad izadi: ""you know that there have been such cases in the past. one hundred years ago, there was a flu called the spanish flu."" interviewer: ""in 1918."" foad izadi: ""right. it was first transferred to humans in kansas. they say that this flu infected humans at a pig farm in kansas. the reason it was called ""the spanish flu"" was because there was a conflict between america and spain. the u.s. had better propaganda, and spain wasn't doing so well, so this is the name that [the disease] as given. [the spanish flu] infected a lot of people in spain, like today's [virus]. spain has the second-highest infection rate in europe, but the truth is that the problem had been created in america, and that the [spanish flu] had started in america. it may be that [the coronavirus] also started in america before being transferred to china and spreading. you probably remember that when this all started, trump said in a speech that last year, 40,000 people died from the flu. it could be that some of them [died] from coronavirus, but were listed as having died from the flu. [...] foad izadi: ""it seems that what we are seeing, both in terms of the number of deaths and the number of infected people, the virus has suddenly started [to spread] quickly in america... the reason for this may be that this is an american virus that started in america before spreading to china and other places."" latest clips clip #8248 | august 27, 2020"
3	historical coronaviruses show evidence of seasonality & immunity - neuroscience news text extraction from html file; language identification https://elrc-share.eu under review 2020 historical coronaviruses show evidence of seasonality & immunity - neuroscience news text/html https://neurosciencenews.com/coronaviruses-seasonality-immunity-16054/?utm_source=feedburner&utm_medium=feed&utm_campaign=feed%3a+neuroscience-rss-feeds-neuroscience-news+%28neuroscience+news+updates%29 en_2020_04_865.xml_20.html neuroscience news neuroscience neuroscience research articles are provided. what is neuroscience? neuroscience is the scientific study of nervous systems. neuroscience can involve research from many branches of science including those involving neurology, brain science, neurobiology, psychology, computer science, artificial intelligence, statistics, prosthetics, neuroimaging, engineering, medicine, physics, mathematics, pharmacology, electrophysiology, biology, robotics and technology. neuroscience neuroscience research articles are provided. what is neuroscience? neuroscience is the scientific study of nervous systems. neuroscience can involve research from many branches of science including those involving neurology, brain science, neurobiology, psychology, computer science, artificial intelligence, statistics, prosthetics, neuroimaging, engineering, medicine, physics, mathematics, pharmacology, electrophysiology, biology, robotics and technology. - these articles focus mainly on neurology research. - what is neurology? - definition of neurology: a science involved in the study of the nervous systems, especially of the diseases and disorders affecting them. - neurology research can include information involving brain research, neurological disorders, medicine, brain cancer, peripheral nervous systems, central nervous systems, nerve damage, brain tumors, seizures, neurosurgery, electrophysiology, bmi, brain injuries, paralysis and spinal cord treatments. psychology what is psychology? definition of psychology: psychology is the study of behavior in an individual, or group. psychology news articles are listed below. ai ai artificial intelligence articles involve programming, neural engineering, artificial neural networks, artificial life, a-life, floyds, boids, emergence, machine learning, neuralbots, neuralrobotics, computational neuroscience and more involving a.i. research. robotics robotics robotics articles will cover robotics research press releases. robotics news from universities, labs, researchers, engineers, students, high schools, conventions, competitions and more are posted and welcome. neurotech neurotech neurotechnology research articles deal with robotics, ai, deep learning, machine learning, brain computer interfaces, neuroprosthetics, neural implants and more. read the latest neurotech news articles below. · april 1, 2020 summary: historical data from flu watch about other coronaviruses reveals they appear to have a seasonal pattern, with peaks occurring during winter. only small amounts of other coronavirus infections were transmitted during the summer. the findings support the hypothesis that covid-19 may have lower levels of transmission during the summer, but this may reverse during the winter months if there is still a large, susceptible population. source: ucl using historical data, a ucl research team has found that levels of infection from three common coronaviruses appear to have followed a seasonal pattern in england, with peaks occurring during winter and broadly at the same time as influenza. the researchers found that only small amounts of coronavirus were transmitted in the summer. the study, published today in wellcome open research as a pre-print ahead of peer review, uses data from the flu watch community cohort study from 2006 to 2011. first author dr rob aldridge (ucl institute of health informatics) said, “covid-19 is a disease caused by the new coronavirus sars-cov2, but other related viruses have been around for some time. when we began data collection in 2006 there were at least three commonly circulating coronaviruses in the uk.” he and his colleagues used data their team had previously collected from the cohort study to understand whether there were greater numbers of infections caused by these coronaviruses in the winter or summer. they also looked at whether people got infected with these common coronaviruses more than once, knowing this information can show whether people developed immunity to the virus. “our findings support the idea that in the uk we could see continued but lower levels of coronavirus transmission in the summer, but this may reverse in the winter if there is still a large susceptible population at that point,” dr aldridge said. “however, given this is a novel virus, we don't know if this seasonal pattern will hold over the summer due to high levels of susceptibility in the population. for this reason, it is crucial that we all act now to follow current health advice. washing your hands and staying at home means you not only reduce your risk of getting covid-19, but you are also protecting others by greatly reducing the chances of the virus spreading further in the community. “acting now gives scientists more time to develop vaccines and test new treatments for covid-19, and it gives the nhs time to continue to get ready to help those that get sick. “to understand more about whether covid-19 will follow a pattern of higher numbers of infection in the winter, we need to learn from other countries in the southern hemisphere with temperate climates to see if this pattern of increasing levels of infection is observed during their winters over the coming months,” he added. participants of the medical research council and wellcome-funded flu watch study in england were contacted weekly to report any symptoms of respiratory illnesses, and sent in swabs if they were ill. the current investigation included data from 199 positive cases of coronaviruses across three winters (november to march) and one summer (may to september) from 2006 to 2009. the researchers also looked at data from the following two winters to identify people who had a second coronavirus infection and see whether anyone was reinfected by the same virus. the researchers were looking at infection patterns of three coronaviruses, hcov-nl63, hcov-oc43, and hcov-229e, which they say bear similar symptoms to mild cases of sars-cov-2. they found that the highest rates of coronavirus infections were in february, and very low in the summer season, when only four cases were detected. the findings are in line with previous research in other countries finding evidence that coronaviruses are seasonal in winter in temperate climates, with greater variation in tropical climates. this illustration, created at the centers for disease control and prevention (cdc), reveals ultrastructural morphology exhibited by coronaviruses. the image is credited to cdc public health image library. last author ellen fragaszy (ucl institute of health informatics and the london school of hygiene & tropical medicine) said: “in temperate regions, many respiratory viruses follow a seasonal pattern with winter peaks during the ‘cold and flu season'. we believe this seasonality is driven in part by environmental factors such as temperature, humidity and sunlight which affect both virus survival and how well our immune systems can respond to these infections. “seasonality is also likely to be driven by our own behaviours such as our tendency when it's cold to spend more time indoors, with the windows shut and in close contact with other people.” the researchers say their results also provide some evidence of immunity against reinfection by the same virus, as they did not identify any people who were reinfected by the same virus. based on their simulations, if people had no immunity after being infected, the probability of zero reinfections by the same virus in their study sample was only 3.48%, which they say suggests some immunity is likely. the researchers say that more research is needed to see if their results will also apply to the sars-cov-2 virus, but given the lack of data on the novel virus, they hope that their findings can help inform the public health response. “we cautiously infer from this that we might expect there to be some levels of immunity after infection with sars-cov2, but we don't know how strong or long this will last,” said dr aldridge. “our results support the idea that a vaccine could induce immunity to sars-cov2, but we need vaccine trials to examine this in detail and whilst this urgent and important work is being carried out, we all need to act to slow the spread of infection down and give scientists time to work on developing these new vaccines.” about this coronavirus research article source:
3	bcg, tuberculosis vaccine, being tested for use against covid-19 text extraction from html file; language identification https://elrc-share.eu under review 2020 bcg, tuberculosis vaccine, being tested for use against covid-19 text/html https://tribuneonlineng.com/bcg-tuberculosis-vaccine-being-tested-for-use-against-covid-19/ en_2020_04_718.xml_56.html bcg, tuberculosis vaccine, being tested for use against covid-19 bcg, tuberculosis vaccine, being tested for use against covid-19 on apr 1, 2020 share is there any relationship between the low number of cases of covid-19 in sub-sahara african countries and the sustenance of bacille calmette-guerin (bcg) vaccination as part of their national immunisation programmes? researchers in europe and australia are examining whether bcg, a tuberculosis vaccine, can be an effective boost to the immune system to help it fight off the novel coronavirus. a report by forbes' eric mack said that clinical trials of the bcg vaccine, which was first developed in the early 1920s, are planned in europe and australia to see if it can help reduce the prevalence and severity of covid-19 symptoms. in nigeria, bcg vaccination is part of the national programme on immunization (npi), and it is given within the first week of the life of babies. there are similar programmes in other african countries. italy and the united states, two of the countries hit hardest by the pandemic, do not have universal bcg vaccination policies. according to the forbes report, researchers from the murdoch children's research institute (mcri) in melbourne, australia, are currently working to enrol 4,000 healthcare workers from hospitals around australia in one study. “this trial will allow the vaccine's effectiveness against covid-19 symptoms to be properly tested, and may help save the lives of our heroic frontline healthcare workers,” mcri director professor kathryn north said in a release. “there has been a long history of reports of bcg producing a series of beneficial immune responses,” dr gonzalo otazu from new york institute of technology, college of osteopathic medicine, told forbes. “for instance, a study in guinea-bissau found that children vaccinated with bcg were observed to have a 50 per cent reduction in overall mortality, which was attributed to the vaccine's effect on reducing respiratory infections and sepsis.” a separate large-scale study is planned to include older patients and health care workers at several hospitals in germany and similar trials are in the works in the netherlands, the uk and greece. this work is very different from the efforts underway to develop a vaccine to confer specific immunity to the novel coronavirus, sars-cov2. bcg has a spotty track record giving immunity against even the disease it was developed for, tuberculosis. but as one of the few tools available to fight that disease, it has stuck around for decades and a number of studies have shown that it seems to offer other benefits. a who review in 2014 gave the findings that bcg may reduce overall mortality a very low confidence rating, however. other reviews have been more favourable. still, researchers hope that bcg could be a bridge that suppresses the overall impact of the coronavirus pandemic until a new, targeted vaccine is ready. scientists at the max planck institute for infection biology developed the vaccine candidate vpm1002 based off of bcg earlier this century, which will be used for the trial starting soon in germany. vpm1002 has been shown to protect the respiratory tracts of mice from viral infections. “in addition, vpm1002 can be manufactured using state-of-the-art manufacturing methods which would make millions of doses available in a very short time”, says adar c. poonawalla, ceo and executive director, serum institute of india in a statement. unicef trains journalists in adamawa on covid-19 coverage otazu has been working with researchers to look at possible correlations between national bcg vaccination policies and the impact of covid-19 on a country's population. “we found that there was a reduction in the number of deaths attributed to covid-19 per million inhabitants in countries that have universal bcg vaccination (usually at birth) compared to the countries that never established such policy,” he said. “the earlier the establishment of such policy, the stronger the reduction in mortality, consistent with a protection to the elderly population which is more severely affected by covid-19.” otazu and his colleagues have produced a paper outlining their findings that is awaiting peer review. he stresses that “although correlations are strong, our study is correlational and does not demonstrate the effectiveness of bcg against covid-19.” bcg, if it works at all, said forbes, may not be able to help everyone touched by covid-19. it is not recommended for people with compromised immune systems or pregnant women.
3	expert reaction to british american tobacco working on a covid-19 vaccine | science media centre text extraction from html file; language identification https://elrc-share.eu under review 2020 expert reaction to british american tobacco working on a covid-19 vaccine | science media centre text/html https://www.sciencemediacentre.org/expert-reaction-to-british-american-tobacco-working-on-a-covid-19-vaccine/ en_2020_04_844.xml_10.html expert reaction to british american tobacco working on a covid-19 vaccine british american tobacco have announced that they are working on a covid-19 vaccine. prof julian ma, hotung chair of molecular immunology, and director, institute for infection and immunity, st. george's hospital medical school, university of london, said: “this is actually the second press release from a major plant manufacturing company about progress towards developing a sars-cov2 vaccine in plants. the first came out on march 12th from medicago - https://media.medicago.com/webfolder_download/cdd5b616fa32c817ec7d1023f4c75231/medicago-covid-19-press-release-final-en/3c26d750813c907f2af077cdc20f7a7049a7155b/medicago-covid-19-press-release-final-en.pdf “there is little detail in the current release from kbp describing the nature of the vaccine candidate developed by kbp, but it is likely to be similar to medicago's approach of developing virus-like particles (vlps), essentially non-infectious empty virus shells which look like virus from the outside, but do not contain essential components required for viral replication. both companies will be using nicotiana benthamiana to make these vaccines, which is not the species of tobacco which is used for smoking. instead, it is a weedy relative, which has no other commercial value. “however, nicotiana benthamiana offers an extremely exciting opportunity to tackle global diseases. the manufacturing system is really fast, hugely scalable and potentially cheaper than the conventional manufacturing systems we use for vaccines (for example, eggs for influenza virus vaccine). in particularly it is a technology that might make vaccines more affordable and accessible for people in low and middle income countries. this is important for a disease which is spreading to every country in the world. it will be no use making an expensive vaccine, which is only accessible by rich people in the first world. “the press release by kbp reports an important milestone for the company, but they are still a long way from making a vaccine. importantly, it still needs to be determined how safe their vaccine will be and how potent in inducing protective immunity in humans.”
4	coronavirus: why death and mortality rates differ - bbc future text extraction from html file; language identification https://elrc-share.eu under review 2020 coronavirus: why death and mortality rates differ - bbc future text/html https://www.bbc.com/future/article/20200401-coronavirus-why-death-and-mortality-rates-differ future article story covid-19-tag/health en_2020_04_936.xml_44.html coronavirus: why death and mortality rates differ by martha henriques 2nd april 2020 in italy, the death rate from covid-19 is more than 10 times greater than in germany. why does the death rate vary so much internationally? i in italy, an epicentre of the new coronavirus outbreak, the death rate at the end of march stood at a sobering 11% . meanwhile in neighbouring germany, the same virus led to fatality rates of just 1%. in china, it was 4%, while israel had the lowest rate worldwide, at 0.35%. at first it can seem surprising that the same virus - which doesn't seem to have mutated significantly as it has spread - can lead to such widely differing reported mortality rates. and even within one country, the rate appears to change over time. so what's going on? several main factors account for much of the difference we're seeing - and perhaps the most important come down to simply how we're counting, as well as testing, cases. differing death rates first, there is confusion about what people mean by “death rate”. this confusion can make countries' numbers look vastly different, even if their populations are dying at the same rate. there are, in fact, two kinds of fatality rate. the first is the proportion of people who die who have tested positive for the disease. this is called the “case fatality rate”. the second kind is the proportion of people who die after having the infection overall; as many of these will never be picked up, this figure has to be an estimate. this is the “infection fatality rate”. in other words, the case fatality rate describes how many people doctors can be sure are killed by the infection, versus how many people the virus kills overall, says carl heneghan, an epidemiologist and director of the centre for evidence-based medicine at the university of oxford; he is also a gp in recovery from a suspected covid-19 infection. you might also like: why children are not immune to covid-19 to see what a difference this makes, consider 100 people who have been infected with covid-19. ten of them have it so severely that they go into hospital, where they test positive for covid-19. the other 90 are not tested at all. one of the hospital patients then dies from the virus. the other 99 people survive. that would give a case fatality rate of one in 10, or 10%. but the infection fatality rate would be just one in 100, or 1%. the lack of widespread, systematic testing in most countries is the main source of discrepancies in death rates internationally so if some countries only test patients ill enough to go to hospital - and don't test the less-ill (or even asymptomatic) covid-19 patients who don't get to hospital (which is what the uk is currently doing) - the death rate can appear higher than in countries where testing is widespread (such as germany or south korea). impact of testing even if you're careful to compare the same type of fatality rate across countries, it's easy to see how testing more, or fewer, people would change the results. in fact, the lack of widespread, systematic testing in most countries is the main source of discrepancies in death rates internationally, says dietrich rothenbacher, director of the institute of epidemiology and medical biometry at the university of ulm in germany. as a result, the current figures are “not at all” directly comparable between countries, he says. this is because, to get an accurate figure across a population, it is necessary to test not just symptomatic cases, but asymptomatic people too. having that data would give an accurate picture of how the pandemic is affecting whole populations, not just the sick. “currently we have a huge bias in the numbers coming from different countries - therefore the data are not directly comparable,” he says. “what we need to really have valid and comparable numbers would be a defined and systematic way to choose a representative sampling frame.” the village of vò in northern italy is an example of why testing is important not just to get accurate data, but to contain covid-19 . when the first covid-19 case in vò was confirmed, testing was rolled out to the entire village of 3,300 people. the results showed that at the time of the “first case”, 3% of the village was already infected, but showing no or few symptoms. italy's case fatality rate from covid-19 is markedly higher than elsewhere in the world, which is largely down to how cases are detected (credit: worldometer/bbc) a widespread testing programme in iceland shows a similar picture. iceland has tested more than 3% of its population of around 365,000 people so far , both those who show symptoms and those who don't. by extrapolating the results, the testing programme estimated that 0.5% of iceland's population was likely to have had covid-19. but even this figure may be slightly low because asymptomatic people are less likely to seek out testing, notes heneghan. it is thought that the actual figure could be closer to 1% of iceland's population, which would mean roughly 3,650 infections. an added difficulty is that this data is not from peer-reviewed research, but rather is almost real-time clinical data - which can be messy and come with many caveats. what figures like these do underline, says sheila bird of the university of cambridge's mrc biostatistics unit, is the importance of widespread testing to help inform public health measures. “if you never actually develop symptoms but had encountered the virus, that would be an infection, but it is an ‘uncountable' one - uncountable until the time that we have an antibody test,” says bird. antibody tests detect the traces of an immune response to the virus and reveal who has had an infection. those tests are the game-changers that could reveal who has developed immunity to the virus and can safely return to daily life without risk of infection or of spreading the virus. “that's why the development of that test and its deployment is so terribly important,” says bird. in vò, the spread of covid-19 was halted after two weeks, as both the widespread testing and strict follow-up measures allowed for the targeted and effective containment of infections. iceland, so far, has had only two covid-19 deaths. what counts as a covid-19 death? there are other factors that alter the death rate, too. one of them is what doctors actually count as a covid-19 death. at first it might seem simple enough: if a patient dies while infected with covid-19, they died of covid-19. when the first covid-19 case in vò, italy was confirmed, testing was rolled out to the entire village (credit: getty images) but what if they had an underlying condition, such as asthma, which was exacerbated by covid-19? or what if the patient died from something seemingly less related to covid-19, which is a respiratory disease - such as, say, a brain aneurysm? which condition should be considered the cause of death? even within a country, official statistics can vary according to what you count . in the uk, for example, the department of health and social care releases daily updates on how many people who tested positive for covid-19 died that day. this includes any patient who tested positive for covid-19 but who might have died from another condition (for example, terminal cancer). but the uk's office for national statistics counts all deaths as covid-19 where covid-19 was mentioned on the death certificate, regardless of whether they were tested or if it was merely a suspected case of covid-19. adding to the complexity of trying to understand the death rates is that the two are out of sync, since the ons way of counting can only happen after a death certificate has been issued, so takes longer. “the issue is not really about right or wrong, but about each source of data having its own strengths and weaknesses,” sarah caul, head of mortality analysis at ons, writes in a blog post on the different ways of counting deaths . this is not necessarily a source of discrepancy between most countries, though, as many are counting deaths in the same way. italy counts any death of a patient who has covid-19 as a death caused by covid-19; so does germany and hong kong. in the us, doctors have more discretion: they are asked to record whether the patient died “as a result of this illness” when reporting covid-19 deaths to the centers for disease control and prevention. it could be easy to see how a physician might believe that a covid-19 patient who died of, say, a heart attack or brain aneurysm didn't die as a result of covid-19, and so wouldn't report accordingly. importantly, though, while this might make a difference when the data is analysed months or years from now, this doesn't translate into any difference in the death statistics at the moment. at present in the us, any death of a covid-19 patient, no matter what the physician believes to be the direct cause, is counted for public reporting as a covid-19 death. “i expect that the final death certificate will have covid along with pre-existing conditions, should there be any,” says cécile viboud, an epidemiologist at the fogarty international center at the national institutes of health. “but at this point, any covid-positive case who dies will be tallied in the us death count.” so what counts as a covid-19 death will affect our overall understanding of the lethality of the disease in the long run, but it most likely isn't playing a huge factor between countries. complex causes the picture is murkier still when patients have not had a covid-19 test, but are a suspected case. given that many deaths from covid-19 are in people who have underlying health issues , doctors still have to make the call on the cause of death. the picture is even more complicated when patients have not had a covid-19 test, but are a suspected case (credit: getty images) during an epidemic, doctors are more likely to attribute a death with complex causes as being caused by the disease in question - a trait known as ascertainment bias . “we know, during an epidemic, people will call every death as though it's related to covid-19. but that is not the case,” says heneghan. “always, when people look back at the case notes and assign causation, they realise they will have overestimated the case fatality in relation to the disease.” the reason for the bias is that “there's a tendency to focus on the worst-case scenario”, says heneghan. “that's the only message that gets out there.” one example is the h1n1 pandemic of 2009, known as swine flu. early case fatality rate estimates were inflated by a factor of more than 10. even 10 weeks into the epidemic, estimates varied widely between countries, coming in between 0.1% and 5.1% . when medics later had a chance to go through case documents and evaluate cases, the actual h1n1 case death rate was far lower, at 0.02% . that's not a cause for complacency, says heneghan. but it could be an antidote to some of the alarm at the very high reported death rates in some countries. hidden deaths while over-counting deaths among recorded covid-19 cases may lead to overestimation of the death rate, there is another factor that could mean the death rate is also - confusingly - being underestimated at the same time. this is the problem of hidden deaths from covid-19: those people who die from the disease who are never tested. this comes into play when health services are overwhelmed and even those patients who have severe symptoms of the virus are not taken into hospital to be tested and treated, simply because there isn't capacity. in the small italian town of nembro, in lombardy, only 31 people have officially died from covid-19. but one preliminary study has found that it's likely that far more people have died from covid-19. that's because the overall death rate - not just from covid-19, but from all causes - was four times higher this year than in the same period last year . ordinarily, around 35 people die in the first months of the year in nembro. this year, 158 people were registered to have died. this jump in excess deaths is speculated to be down to undiagnosed and untested cases of covid-19. there's nothing to say that going into an intensive care unit is going to have a better outcome compared with care in the community - carl heneghan the number of hospital beds available could also play a role, as countries with lower capacity in their health services may have to start making decisions sooner about which covid-19 cases to prioritise for treatment. this could lead to more covid-19 deaths in the community that go untested (and uncounted), as people with symptoms stay away. while this might lead to more uncounted deaths, it may not necessarily translate into to more deaths overall. “there's nothing to say that going into an intensive care unit is going to have a better outcome compared with care in the community,” says heneghan. more important than the number of beds available in hospitals, he says, is the way the beds are organised. if covid-19 patients are in close proximity to other patients - or if doctors move between covid-19 and non-covid-19 wards - it heightens the risk of spreading the disease. “that is why you need separate hospitals for separate infection teams,” he says. what role does age play? as well as differences caused by clinical definitions of what counts as a covid-19 death and the numbers of people going untested, there are other factors that mean the virus hits some countries harder than others. one that has been put forward by italian doctors is the age profile of a country. in 2019, nearly a quarter of the italian population was 65 years or older, compared to only 11% in china. the overall case fatality rate in italy as of mid-march was 7.2% - much higher than china's rate of 2.3% at a comparable stage of its epidemic . but from the ages of zero to 69, the two country's case fatality rates are comparable, note researchers from the istituto superiore di sanità in rome. nearly a quarter of the italian population is 65 years or older, compared to only 11% in china (credit: getty images) among the oldest patients, though, italy and china part ways. the 70-79 age group in italy had a case fatality rate of 12.8%, while china's was 8%. for the over-80s, the difference was more pronounced still: italy's was 20.2% and china's 14.8%. the reason for this discrepancy is still a bit of a mystery, the researchers note. heneghan suspects that one factor at play in italy's high figures could be not to do with the virus itself, but with bacteria. the country has the highest numbers of deaths due to antimicrobial resistance in the eu - in fact, a third of all eu deaths from antimicrobial resistance happen in italy. while antibiotics do precisely nothing to tackle a virus, a viral infection can often open the way for secondary infections or complications like bacterial pneumonia. if that then can't be treated properly with antibiotics because the bacteria is resistant, then this can be what kills the patient, not the virus itself. “this is an incredibly important part of the whole story,” says heneghan. “and it is particularly prevalent in the elderly.” as well as age, the overall health of the population has been highlighted as another contributing factor - particularly given that people who have underlying health problems are more vulnerable. while that might play a contributing role, this doesn't explain why some countries are reporting more covid-19 deaths than others: italy is consistently ranked as one of the world's healthiest countries , for example, and has a longer healthy life expectancy than china . for younger age groups, the case fatality rates in italy and china are comparabe, but for the oldest age groups italy's death rate is higher (credit: onder et al./jama/bbc) trying to get a handle on exactly how lethal covid-19 is will prove a knotty problem for some time yet. it may never be possible to get a true, reliable count of the deaths due to covid-19, as testing in many parts of the world has been too slow to roll out. as time goes on, the estimate of the covid-19 death rate is likely to improve, as clinicians are eventually able to go through case notes and tease out the tangle of factors that contributed to each covid-19 patient's death. for now, while hospitals are filled with acutely ill patients and doctors and nurses are working overtime to care for them, that careful analysis is going to have to wait. -- as an award-winning science site, bbc future is committed to bringing you evidence-based analysis and myth-busting stories around the new coronavirus. you can read more of our covid-19 coverage here . -- join one million future fans by liking us on facebook , or follow us on twitter or instagram . if you liked this story, sign up for the weekly bbc.com features newsletter , called “the essential list”. a handpicked selection of stories from bbc future, culture, worklife, and travel, delivered to your inbox every friday.
4	coronavirus: why death and mortality rates differ - bbc future text extraction from html file; language identification https://elrc-share.eu under review 2020 coronavirus: why death and mortality rates differ - bbc future text/html https://www.bbc.com/future/article/20200401-coronavirus-why-death-and-mortality-rates-differ future article story covid-19-tag/health en_2020_04_947.xml_96.html coronavirus: why death and mortality rates differ by martha henriques 2nd april 2020 in italy, the death rate from covid-19 is more than 10 times greater than in germany. why does the death rate vary so much internationally? i in italy, an epicentre of the new coronavirus outbreak, the death rate at the end of march stood at a sobering 11% . meanwhile in neighbouring germany, the same virus led to fatality rates of just 1%. in china, it was 4%, while israel had the lowest rate worldwide, at 0.35%. at first it can seem surprising that the same virus - which doesn't seem to have mutated significantly as it has spread - can lead to such widely differing reported mortality rates. and even within one country, the rate appears to change over time. so what's going on? several main factors account for much of the difference we're seeing - and perhaps the most important come down to simply how we're counting, as well as testing, cases. differing death rates first, there is confusion about what people mean by “death rate”. this confusion can make countries' numbers look vastly different, even if their populations are dying at the same rate. there are, in fact, two kinds of fatality rate. the first is the proportion of people who die who have tested positive for the disease. this is called the “case fatality rate”. the second kind is the proportion of people who die after having the infection overall; as many of these will never be picked up, this figure has to be an estimate. this is the “infection fatality rate”. in other words, the case fatality rate describes how many people doctors can be sure are killed by the infection, versus how many people the virus kills overall, says carl heneghan, an epidemiologist and director of the centre for evidence-based medicine at the university of oxford; he is also a gp in recovery from a suspected covid-19 infection. you might also like: why children are not immune to covid-19 to see what a difference this makes, consider 100 people who have been infected with covid-19. ten of them have it so severely that they go into hospital, where they test positive for covid-19. the other 90 are not tested at all. one of the hospital patients then dies from the virus. the other 99 people survive. that would give a case fatality rate of one in 10, or 10%. but the infection fatality rate would be just one in 100, or 1%. the lack of widespread, systematic testing in most countries is the main source of discrepancies in death rates internationally so if some countries only test patients ill enough to go to hospital - and don't test the less-ill (or even asymptomatic) covid-19 patients who don't get to hospital (which is what the uk is currently doing) - the death rate can appear higher than in countries where testing is widespread (such as germany or south korea). impact of testing even if you're careful to compare the same type of fatality rate across countries, it's easy to see how testing more, or fewer, people would change the results. in fact, the lack of widespread, systematic testing in most countries is the main source of discrepancies in death rates internationally, says dietrich rothenbacher, director of the institute of epidemiology and medical biometry at the university of ulm in germany. as a result, the current figures are “not at all” directly comparable between countries, he says. this is because, to get an accurate figure across a population, it is necessary to test not just symptomatic cases, but asymptomatic people too. having that data would give an accurate picture of how the pandemic is affecting whole populations, not just the sick. “currently we have a huge bias in the numbers coming from different countries - therefore the data are not directly comparable,” he says. “what we need to really have valid and comparable numbers would be a defined and systematic way to choose a representative sampling frame.” the village of vò in northern italy is an example of why testing is important not just to get accurate data, but to contain covid-19 . when the first covid-19 case in vò was confirmed, testing was rolled out to the entire village of 3,300 people. the results showed that at the time of the “first case”, 3% of the village was already infected, but showing no or few symptoms. italy's case fatality rate from covid-19 is markedly higher than elsewhere in the world, which is largely down to how cases are detected (credit: worldometer/bbc) a widespread testing programme in iceland shows a similar picture. iceland has tested more than 3% of its population of around 365,000 people so far , both those who show symptoms and those who don't. by extrapolating the results, the testing programme estimated that 0.5% of iceland's population was likely to have had covid-19. but even this figure may be slightly low because asymptomatic people are less likely to seek out testing, notes heneghan. it is thought that the actual figure could be closer to 1% of iceland's population, which would mean roughly 3,650 infections. an added difficulty is that this data is not from peer-reviewed research, but rather is almost real-time clinical data - which can be messy and come with many caveats. what figures like these do underline, says sheila bird of the university of cambridge's mrc biostatistics unit, is the importance of widespread testing to help inform public health measures. “if you never actually develop symptoms but had encountered the virus, that would be an infection, but it is an ‘uncountable' one - uncountable until the time that we have an antibody test,” says bird. antibody tests detect the traces of an immune response to the virus and reveal who has had an infection. those tests are the game-changers that could reveal who has developed immunity to the virus and can safely return to daily life without risk of infection or of spreading the virus. “that's why the development of that test and its deployment is so terribly important,” says bird. in vò, the spread of covid-19 was halted after two weeks, as both the widespread testing and strict follow-up measures allowed for the targeted and effective containment of infections. iceland, so far, has had only two covid-19 deaths. what counts as a covid-19 death? there are other factors that alter the death rate, too. one of them is what doctors actually count as a covid-19 death. at first it might seem simple enough: if a patient dies while infected with covid-19, they died of covid-19. when the first covid-19 case in vò, italy was confirmed, testing was rolled out to the entire village (credit: getty images) but what if they had an underlying condition, such as asthma, which was exacerbated by covid-19? or what if the patient died from something seemingly less related to covid-19, which is a respiratory disease - such as, say, a brain aneurysm? which condition should be considered the cause of death? even within a country, official statistics can vary according to what you count . in the uk, for example, the department of health and social care releases daily updates on how many people who tested positive for covid-19 died that day. this includes any patient who tested positive for covid-19 but who might have died from another condition (for example, terminal cancer). but the uk's office for national statistics counts all deaths as covid-19 where covid-19 was mentioned on the death certificate, regardless of whether they were tested or if it was merely a suspected case of covid-19. adding to the complexity of trying to understand the death rates is that the two are out of sync, since the ons way of counting can only happen after a death certificate has been issued, so takes longer. “the issue is not really about right or wrong, but about each source of data having its own strengths and weaknesses,” sarah caul, head of mortality analysis at ons, writes in a blog post on the different ways of counting deaths . this is not necessarily a source of discrepancy between most countries, though, as many are counting deaths in the same way. italy counts any death of a patient who has covid-19 as a death caused by covid-19; so does germany and hong kong. in the us, doctors have more discretion: they are asked to record whether the patient died “as a result of this illness” when reporting covid-19 deaths to the centers for disease control and prevention. it could be easy to see how a physician might believe that a covid-19 patient who died of, say, a heart attack or brain aneurysm didn't die as a result of covid-19, and so wouldn't report accordingly. importantly, though, while this might make a difference when the data is analysed months or years from now, this doesn't translate into any difference in the death statistics at the moment. at present in the us, any death of a covid-19 patient, no matter what the physician believes to be the direct cause, is counted for public reporting as a covid-19 death. “i expect that the final death certificate will have covid along with pre-existing conditions, should there be any,” says cécile viboud, an epidemiologist at the fogarty international center at the national institutes of health. “but at this point, any covid-positive case who dies will be tallied in the us death count.” so what counts as a covid-19 death will affect our overall understanding of the lethality of the disease in the long run, but it most likely isn't playing a huge factor between countries. complex causes the picture is murkier still when patients have not had a covid-19 test, but are a suspected case. given that many deaths from covid-19 are in people who have underlying health issues , doctors still have to make the call on the cause of death. the picture is even more complicated when patients have not had a covid-19 test, but are a suspected case (credit: getty images) during an epidemic, doctors are more likely to attribute a death with complex causes as being caused by the disease in question - a trait known as ascertainment bias . “we know, during an epidemic, people will call every death as though it's related to covid-19. but that is not the case,” says heneghan. “always, when people look back at the case notes and assign causation, they realise they will have overestimated the case fatality in relation to the disease.” the reason for the bias is that “there's a tendency to focus on the worst-case scenario”, says heneghan. “that's the only message that gets out there.” one example is the h1n1 pandemic of 2009, known as swine flu. early case fatality rate estimates were inflated by a factor of more than 10. even 10 weeks into the epidemic, estimates varied widely between countries, coming in between 0.1% and 5.1% . when medics later had a chance to go through case documents and evaluate cases, the actual h1n1 case death rate was far lower, at 0.02% . that's not a cause for complacency, says heneghan. but it could be an antidote to some of the alarm at the very high reported death rates in some countries. hidden deaths while over-counting deaths among recorded covid-19 cases may lead to overestimation of the death rate, there is another factor that could mean the death rate is also - confusingly - being underestimated at the same time. this is the problem of hidden deaths from covid-19: those people who die from the disease who are never tested. this comes into play when health services are overwhelmed and even those patients who have severe symptoms of the virus are not taken into hospital to be tested and treated, simply because there isn't capacity. in the small italian town of nembro, in lombardy, only 31 people have officially died from covid-19. but one preliminary study has found that it's likely that far more people have died from covid-19. that's because the overall death rate - not just from covid-19, but from all causes - was four times higher this year than in the same period last year . ordinarily, around 35 people die in the first months of the year in nembro. this year, 158 people were registered to have died. this jump in excess deaths is speculated to be down to undiagnosed and untested cases of covid-19. there's nothing to say that going into an intensive care unit is going to have a better outcome compared with care in the community - carl heneghan the number of hospital beds available could also play a role, as countries with lower capacity in their health services may have to start making decisions sooner about which covid-19 cases to prioritise for treatment. this could lead to more covid-19 deaths in the community that go untested (and uncounted), as people with symptoms stay away. while this might lead to more uncounted deaths, it may not necessarily translate into to more deaths overall. “there's nothing to say that going into an intensive care unit is going to have a better outcome compared with care in the community,” says heneghan. more important than the number of beds available in hospitals, he says, is the way the beds are organised. if covid-19 patients are in close proximity to other patients - or if doctors move between covid-19 and non-covid-19 wards - it heightens the risk of spreading the disease. “that is why you need separate hospitals for separate infection teams,” he says. what role does age play? as well as differences caused by clinical definitions of what counts as a covid-19 death and the numbers of people going untested, there are other factors that mean the virus hits some countries harder than others. one that has been put forward by italian doctors is the age profile of a country. in 2019, nearly a quarter of the italian population was 65 years or older, compared to only 11% in china. the overall case fatality rate in italy as of mid-march was 7.2% - much higher than china's rate of 2.3% at a comparable stage of its epidemic . but from the ages of zero to 69, the two country's case fatality rates are comparable, note researchers from the istituto superiore di sanità in rome. nearly a quarter of the italian population is 65 years or older, compared to only 11% in china (credit: getty images) among the oldest patients, though, italy and china part ways. the 70-79 age group in italy had a case fatality rate of 12.8%, while china's was 8%. for the over-80s, the difference was more pronounced still: italy's was 20.2% and china's 14.8%. the reason for this discrepancy is still a bit of a mystery, the researchers note. heneghan suspects that one factor at play in italy's high figures could be not to do with the virus itself, but with bacteria. the country has the highest numbers of deaths due to antimicrobial resistance in the eu - in fact, a third of all eu deaths from antimicrobial resistance happen in italy. while antibiotics do precisely nothing to tackle a virus, a viral infection can often open the way for secondary infections or complications like bacterial pneumonia. if that then can't be treated properly with antibiotics because the bacteria is resistant, then this can be what kills the patient, not the virus itself. “this is an incredibly important part of the whole story,” says heneghan. “and it is particularly prevalent in the elderly.” as well as age, the overall health of the population has been highlighted as another contributing factor - particularly given that people who have underlying health problems are more vulnerable. while that might play a contributing role, this doesn't explain why some countries are reporting more covid-19 deaths than others: italy is consistently ranked as one of the world's healthiest countries , for example, and has a longer healthy life expectancy than china . for younger age groups, the case fatality rates in italy and china are comparabe, but for the oldest age groups italy's death rate is higher (credit: onder et al./jama/bbc) trying to get a handle on exactly how lethal covid-19 is will prove a knotty problem for some time yet. it may never be possible to get a true, reliable count of the deaths due to covid-19, as testing in many parts of the world has been too slow to roll out. as time goes on, the estimate of the covid-19 death rate is likely to improve, as clinicians are eventually able to go through case notes and tease out the tangle of factors that contributed to each covid-19 patient's death. for now, while hospitals are filled with acutely ill patients and doctors and nurses are working overtime to care for them, that careful analysis is going to have to wait. -- as an award-winning science site, bbc future is committed to bringing you evidence-based analysis and myth-busting stories around the new coronavirus. you can read more of our covid-19 coverage here . -- join one million future fans by liking us on facebook , or follow us on twitter or instagram . if you liked this story, sign up for the weekly bbc.com features newsletter , called “the essential list”. a handpicked selection of stories from bbc future, culture, worklife, and travel, delivered to your inbox every friday.
4	dr. larry bookman: covid-19 deaths also underreported text extraction from html file; language identification https://elrc-share.eu under review 2020 dr. larry bookman: covid-19 deaths also underreported text/html http://oklahoman.com/article/5659185/dr-larry-bookman-covid-19-deaths-also-underreported?custom_click=rss&utm_campaign=feed%3a%20newsok%2fhome%20%28newsok.com%20rss%20-%20home%29&utm_medium=feed&utm_source=feedburner oklahoma city okc health news chris casteel coronavirus en_2020_04_925.xml_33.html newsok: oklahoma city news, sports, weather & entertainment dr. larry bookman: covid-19 deaths also underreported published: thu, april 2, 2020 1:03 am updated: thu, april 2, 2020 1:10 am shares oklahoma closings coronavirus in oklahoma: videos live updates: coronavirus in oklahoma coronavirus in oklahoma: what do you want to know? coronavirus in oklahoma: what we know, latest updates for the last few weeks, dr. larry bookman, an oklahoma city physician and president of the oklahoma state medical association, has been speaking on various platforms about covid-19 and challenges faced by the state. on wednesday, he talked to the oklahoman about covid-19 deaths and shortages of critical equipment. questions and answers have been edited for brevity and clarity. q: there has been a lot of discussion about how the confirmed case numbers from the oklahoma state health department don't represent the scope of infection. are deaths also underreported? a: our reporting - today, 719 positive cases with 30 deaths - is all underreporting. the experts have said, statistically, you can expect a tenfold number to be the actual number of cases. so in our state, 719 times 10 - there's 7,000 patients out there that are carrying the virus. the number of deaths that are directly attributable to covid-19 are only those that have tested positive and have died, usually of respiratory illness what's not being figured in is that we know now that even those who get better pulmonary-wise often will die from cardiac damage caused by the virus. this is well documented and now coming out in the literature more - that many people beyond what we see as dying from respiratory illnesses are dying afterwards - a week or two weeks later - from covid-19-induced heart injury. and so those numbers, no, are not being included in the 30 deaths. those 30 are people who have been in the hospital, generally on ventilators, who we tested and were positive and then ended up dying. so that's all we're looking at is our hospitalized patients who have died in the hospital with classic symptoms. but there are far more than that. but we don't really know how many more there are. related to this story show more hospitals are reporting hundreds of hospitalized persons under investigation, many in icu. so there could be people dying from it that have symptoms but haven't been tested. the osma has actually talked with our state forensic pathologist to see if it's possible to test all people who die from heart, lung or undisclosed reasons post mortem. and those would be interesting numbers to see. but right now, because of the critical lack of tests that we've had, we can't really use them on people that have died when we need to be using them on people who are alive, trying to find out what we can do to help them. but eventually those are numbers that need to come out. how critical is the need for ventilators? (cited state health department figures from tuesday of available icu beds and ventilators, which allow patients to breathe). both of those numbers are not going to be adequate if we reach the surge that is expected. state leaders said they were already in discussions with various entities, including the national guard, about building temporary structures (for hospital beds). anybody who's watching television or reading the newspaper knows that ventilators throughout the world are at a shortage. our state's been working very hard to try to acquire ventilators. but we are not one of the hotspots at this time. therefore, ventilators are being sent to the new york, chicago, los angeles areas over oklahoma. but they are working diligently. they know we have an inadequate number of ventilators. and they are certainly working to build those numbers up as quickly as they can.
6	"coronavirus: south korea testing could flatten pandemic curve in us areas text extraction from html file; language identification https://elrc-share.eu under review 2020 coronavirus: south korea testing could flatten pandemic curve in us areas text/html https://www.cnbc.com/2020/04/07/coronavirus-south-korea-testing-could-flatten-pandemic-curve-in-us-areas.html fda health diagnostic testing services disease outbreaks disease pandemics pandemic covid-19 coronavirus business health care industry politics breaking news politics medication south korea science environment united states weather business news en_2020_04_5465.xml_38.html dan mangan @_danmangan key points broad testing of people for the coronavirus as was done in south korea could slow the spread of the disease in parts of the united states that have relatively few cases, an infectious diseases expert said. south korea has been lauded for knocking down a covid-19 outbreak there after employing an aggressive strategy of testing more than 440,000 people for the virus and other mitigation measures. new york gov. andrew cuomo, whose state currently has the most number of covid-19 cases in the u.s., emphasized the need to improve rapid testing capacity. a south korean soldier wearing a banner reading ""covid-19 free"" and a protective mask stands at a temperature screening point at incheon international airport in incheon, south korea, on monday, march 9, 2020. seongjoon cho | bloomberg | getty images ""broad testing"" of people for the coronavirus as was done in south korea could significantly slow the spread of the disease in parts of the united states that now have relatively few cases of covid-19, an infectious diseases expert said tuesday. but it remains to be seen whether enough reliable coronavirus tests and sufficient supplies of related equipment can be deployed in those regions, which include large swaths of the western u.s., quickly enough to flatten the disease's upward curve there. south korea has been lauded for knocking down a covid-19 outbreak after employing an aggressive strategy of testing more than 440,000 people for the virus, along with other mitigation measures. video13:4113:41 coronavirus the united states currently is engaged in an emergency effort to ""flatten the curve,"" or the rate of increase in new covid-19 cases, in order to avoid overwhelming the capacity of hospital systems and to lower the death rate from the virus. dr. angela caliendo said tuesday that south korea's experience ""shows you the importance of testing."" ""i do think the testing they did in south korea was very important in controlling their outbreak,"" said caliendo, an infectious diseases professor at brown university's alpert medical school. with their widespread testing program, south korean authorities were able to identify infected people, isolate them and trace their contacts with other people, who then also could be tested. if the united states had adequate testing, ""you could consider areas of the country that are at different points of the virus"" spread progression, caliendo said during a call with reporters arranged by the infectious diseases society of america. and if those areas' residents received ""more broad testing"" than the levels seen elsewhere in the u.s. ""you could imagine where you would mimic, in some regions at least"" the experience of south korea in suppressing the spread of covid-19, she said. ""there are areas in this country that have not been hit"" to the same extent as other areas, she noted. caliendo said that south korea benefited from having several companies that produce chemical reagents used in virus testing. getting broad-based testing of americans could take some time. dr. kimberly hanson, a professor of pathology at the university of utah school of medicine, said on the conference call that currently, unlike the early days of the outbreak in the u.s., there are about two dozen types of coronavirus tests available for rapidly screening people. ""our goal is to test everybody who has symptoms in the community,"" hanson said. ""we don't have enough testing right now where we are able to test everybody who is symptomatic, but we are ramping up really well."" but in the meantime, she said, ""the main limitation we're facing now is actually having shortages of other pieces around the tests themselves,"" such as swabs and tubes to collect samples. ""we've faced some serious shortages of swabs,"" hanson said. ""we have colleagues who are faced with shortages of the reagents."" hanson also noted that states that have been ""hotbeds"" of covid-19 outbreaks are seeking more testing done than elsewhere. data reviewed by cnbc shows wide variations in the amount of tests per capita throughout the u.s. a number of states that could, as caliendo suggested, see a lower outbreak curve if they adopted a south korea-type testing regimen are among those states with the lowest number of tests per capita currently. both hanson and caliendo mentioned the need to improve the quality of testing. ""overall, what we have on our hands right now are good tests, but no test is perfect,"" caliendo said. and she noted that the level of experience of the person performing the test can affect the specimen quality the doctors said it will be particularly important to improve serological tests, which can reveal whether people who do not have symptoms of covid-19 have developed antibodies for the disease, and who could transmit the virus to others. results of serological tests take longer than rapid tests. ""ideally, we're going to need to couple acute diagnoses"" from rapid screening tests ""with serologic testing,"" hanson said. ""because they will give us an idea of who is left in our community who is at risk of developing an infection,"" she said. she said that having a clear picture of how many people are carrying the virus ""will be very important to determining"" by the fall and winter ""where we need to limit people's social interactions."" caliendo said there ""are are a couple of"" serological tests approved on an emergency use basis by the u.s. food and drug administration ""right now."" but, she added, ""we don't know how well they perform."" caliendo pointed out that ""typically, antibodies take a week or so to form."" ""you will have patients who have infections ... but who do not have antibodies"" that would show up when they are tested, caliendo said. that means tests performed in later weeks of infections might be better at assessing overall infection rates. hanson added that another factor to consider is the open question of whether a person who has developed antibodies to covid-19 can develop the disease again. ""we still need to work out what developing an antibody response means, whether it's protective or not,"" hanson said. during a news conference tuesday, new york gov. andrew cuomo, whose state currently has the most number of covid-19 cases in the u.s., emphasized the need to improve rapid testing capacity so that new york and surrounding states can start returning to normal life. ""you have to have that testing, and you have to have that testing on scale,"" cuomo said, referring to the types of tests that can determine whether someone has the coronavirus within 15 minutes. ""we have about a 50,000-person testing capacity, which is nice but not of a scale that's going to make a large difference."" he said that no single private company currently has the capacity to produce enough rapid coronavirus tests to satisfy the number that will need to be done. cuomo encouraged companies that might be able to increase their capacity to contact new york state's empire development corp., which is willing to fund companies for that effort. cuomo also said that the new york state health department has developed and approved testing for coronavirus antibodies, but added that such testing capacity has to be increased. -- additional reporting by noah higgins-dunn . related tags"
6	"dcn dx to present comprehensive webinar on rapid diagnostics | markets insider text extraction from html file; language identification https://elrc-share.eu under review 2020 dcn dx to present comprehensive webinar on rapid diagnostics | markets insider text/html https://markets.businessinsider.com/news/stocks/dcn-dx-to-present-comprehensive-webinar-on-rapid-diagnostics-1029071650 en_2020_04_5244.xml_43.html dcn dx to present comprehensive webinar on rapid diagnostics press release pr newswire apr. 7, 2020, 02:38 pm carlsbad, calif., april 7, 2020 /prnewswire/ -- dcn dx, an industry-leading expert in the field of rapid diagnostics, will present a three-part webinar series on the fundamentals and use of rapid diagnostics. register for the webinar series here. you can watch their related youtube series on-demand here. i. point-of-care diagnostics: the fundamentals april 7, 2020 | 9 a.m. pdt | 12 p.m. edt | 6 p.m. cest what do we mean by ""point-of-care testing""? what are rapid diagnostics? and what is lateral flow, the versatile technology that many of these tests are based on? this webinar will look at the fundamentals of point-of-care testing through the lens of the current covid-19 pandemic. the topics to be covered include: point-of-care testing, point of care sampling, and the difference between the two what are rapid diagnostic tests (rdts)? the difference between molecular testing and protein testing lateral flow technology and its potential uses roles in pandemic response testing strategies and realities for low- and middle-income countries vs. developed countries ii. getting useful data from rapid diagnostics, now and in the future april 14, 2020 | 9 a.m. pdt | 12 p.m. edt | 6 p.m. cest developing a rapid diagnostic test is one thing. manufacturing them in quantities of hundreds of millions and ensuring they produce quality data in the field that is actionable is another. what are the challenges in the rapid testing ecosystem that limit our ability to respond quickly and are there ways that we can improve this process, both during the covid-19 pandemic and in the future? this webinar will discuss: sampling in the field: blood, feces, saliva, and more interpretation of results: digital vs. visual innovations contributing to better testing now (and in the future) the logistics of mass manufacturing of a novel test and getting quality rapid diagnostics tests to the public iii. getting technical: what's in a diagnostic test? how do we make better rapid tests? april 21, 2020 | 9 a.m. pdt | 12 p.m. edt | 6 p.m. cest a rapid diagnostic test can be a life saver in the hands of a healthcare professional in the field. nowhere is this truer than in situations in which time is of the essence. that's why it's important to ensure our healthcare providers get the tools and the data they need, when they need them. but as today's covid-19 epidemic has demonstrated, the right supplies aren't always available when they're needed. one way to mitigate this challenge is to examine our development and production process to streamline or eliminate bottlenecks where they occur. this webinar will discuss: can we react faster and still be safe and effective? balancing the risks and benefits of reducing regulation technical opportunities for improvement in decentralized testing at the point of care getting better data: is digital the way to go? cell phones and self-contained readers at the point-of-care since its founding more than 15 years ago, dcn dx has been committed to furthering the rapid diagnostic test market through the continued evolution of technologies and applications related to lateral flow assays. for more information about dcn dx, visit dcndx.com. for more information contact:"
6	"hll introduces 'makesure' rapid diagnostic antibody kit for corona detection | business standard news text extraction from html file; language identification https://elrc-share.eu under review 2020 hll introduces 'makesure' rapid diagnostic antibody kit for corona detection | business standard news text/html https://www.business-standard.com/article/news-ani/hll-introduces-makesure-rapid-diagnostic-antibody-kit-for-corona-detection-120040701536_1.html condoms hll lifecare indian companies established health india hll moods condoms ministry of health and social welfare antibody lifespring hospitals central government respiratory infection hll lifecare limited virus infection coronavirus en_2020_04_5376.xml_27.html hll introduces 'makesure' rapid diagnostic antibody kit for corona detection topics type address separated by commas your email: enter the characters shown in the image. send me a copy: 30 covid-19 hospitals declared in maharashtra, 81 fresh cases reported hll lifecare limited, a central government enterprise under the ministry of health and family welfare, has developed the rapid antibody diagnostic kit for covid-19. ""the kit is one-step novel coronavirus igm/igg antibody detection from the human serum, plasma and/or whole blood obtained from the patient with signs and symptoms of respiratory infection,"" said the hll in a release. the kit has been manufactured at hll's rapid diagnostic kit manufacturing facility at manesar and has been validated and approved by the niv, pune and the icmr for use in india. ""this device is designed to aid in the rapid differential diagnosis of covid-19 virus infection in large population screening in our country during the current pandemic situation and this shall support in the management of control and treatment of coronavirus disease,"" adds the release. ""the test result can be obtained from the patient sample within 15-20 minutes. hll is the first indian government company received the approval from the icmr for manufacturing and supplying the rapid antibody kit for covid-19 detection,"" the release further says. the kit manufactured by hll will be marketed under the brand name of ""makesure"" -- covid igm/igg antibody detection. the principle of 'makesure' covid-19 igm/igg antibody test kit is based on antibody capture immunochromatographic assay for the simultaneous detection of igm and igg antibodies to covid-19 virus in human serum, plasma and/or whole blood samples. according to the release, hll is planning to manufacture two lakh kits for supplying to various government units within the next 10 days. (this story has not been edited by business standard staff and is auto-generated from a syndicated feed.) first published: tue, april 07 2020. 20:29 ist"
7	bio rad laboratories : rad announces the launch of a serology assay to detect coronavirus (covid-19) antibodies | marketscreener text extraction from html file; language identification https://elrc-share.eu under review 2020 bio rad laboratories : rad announces the launch of a serology assay to detect coronavirus (covid-19) antibodies | marketscreener text/html surperformance https://www.marketscreener.com/bio-rad-laboratories-inc-4174247/news/bio-rad-laboratories-rad-announces-the-launch-of-a-serology-assay-to-detect-coronavirus-covid-19-30377403/?utm_medium=rss&utm_content=20200407 bio-rad laboratories inc. stock exchange news information press release global leader of life science research and clinical diagnostic today announced that the company is launching immunoassay kit to | bio | en_2020_04_5235.xml_192.html bio rad laboratories : rad announces the launch of a serology assay to detect coronavirus (covid-19) antibodies 0 (you can enter multiple email addresses separated by commas) message : *required fields bio-rad laboratories, inc. (nyse: bio and biob), a global leader of life science research and clinical diagnostic products, today announced that the company is launching a blood-based immunoassay kit to identify antibodies to the coronavirus sars-cov-2, the virus associated with covid-19. preliminary performance of the assay has been established and the kit is now undergoing clinical evaluation in several hospitals to further confirm clinical performance. initial data collected on more than 700 samples has demonstrated specificity above 99 percent. after infection with sars-cov-2, viral antigens stimulate the body's immune system to produce antibodies to fight the virus. bio-rad believes its blood-based immunoassay kit will help clinicians determine if an individual has been infected by the virus and therefore has developed an immune response against sars-cov-2. “using a serology test to support the diagnosis of covid-19 and to screen populations can provide a more complete understanding of infection rates as well as immunity,” said dara wright, bio-rad clinical diagnostics group evp & president. “the detection of antibodies to sars-cov-2 on a large scale may be used to guide public authorities in their decisions to lift partial or total containment orders according to the serological status of the population. molecular and serology testing are highly complementary in this regard,” she said. bio-rad's immunoassay kit detects total immunoglobulin (igg, igm, and iga), an approach which appears to be more sensitive than assays against a single immunoglobulin1. the test was designed for use manually or on an automated immunoassay platform, such as bio-rad's evolis system, which offers high throughput processing and sample traceability. bio-rad plans to offer the immunoassay kit globally. in the united states, the company intends to use the fda's emergency use authorization process to expedite u.s. availability. to learn more about how bio-rad products are being used in the fight against covid-19, please visit our newsroom at https://www.bio-rad.com/en-us/corporate/newsroom?id=1006 bio-rad and evolis are trademarks of bio-rad laboratories, inc., in certain jurisdictions. about bio-rad bio-rad laboratories, inc. (nyse: bio and biob) is a global leader in developing, manufacturing, and marketing a broad range of innovative products for the life science research and clinical diagnostic markets. with a focus on quality and customer service for over 65 years, our products advance the discovery process and improve healthcare. our customers are university and research institutions, hospitals, public health and commercial laboratories, biotechnology, pharmaceutical, as well as applied laboratories that include food safety and environmental quality. founded in 1952, bio-rad is based in hercules, california, and has a global network of operations with more than 8,100 employees worldwide. bio-rad had revenues exceeding $2.3 billion in 2019. for more information, please visit bio-rad.com. this release may be deemed to contain certain forward-looking statements within the meaning of the private securities litigation reform act of 1995. these forward-looking statements include, without limitation, statements we make regarding our expectations regarding our products. forward-looking statements generally can be identified by the use of forward-looking terminology such as “plan”, “believe,” “expect,” “anticipate,” “may,” “will,” “intend,” “estimate,” “continue,” or similar expressions or the negative of those terms or expressions, although not all forward-looking statements contain these words. such statements involve risks and uncertainties, which could cause actual results to vary materially from those expressed in or indicated by the forward-looking statements. these risks and uncertainties include our ability to develop and market new or improved products, our ability to compete effectively, international legal and regulatory risks, and product quality and liability issues. for further information regarding our risks and uncertainties, please refer to the “risk factors” and “management's discussion and analysis of financial condition and results of operation” in bio-rad's public reports filed with the securities and exchange commission, including our most recent annual report on form 10-k and our quarterly reports on form 10-q. bio-rad cautions you not to place undue reliance on forward-looking statements, which reflect an analysis only and speak only as of the date hereof. we disclaim any obligation to update these forward-looking statements. view source version on businesswire.com: https://www.businesswire.com/news/home/20200407005285/en/ business wire 2020
7	"coronavirus testing methods: what you need to know text extraction from html file; language identification https://elrc-share.eu under review 2020 coronavirus testing methods: what you need to know application/xhtml+xml https://www.aljazeera.com/news/2020/03/coronavirus-testing-methods-200330142718434.html en_2020_04_5154.xml_120.html coronavirus: which countries have confirmed new cases? tedros and other experts agree that mass testing for covid-19, the disease caused by the coronavirus, would allow positive cases to be isolated and help identify those who came in contact with them, helping to curb further transmission. but how does testing happen and how does it help? here is what you need to know about coronavirus testing: what coronavirus tests are available? naat tests the most commonly used coronavirus tests are the who-recommended nucleic acid amplification tests (naat), which detect the sars-cov-2 virus responsible for the covid-19 disease. the specimen is usually collected from the upper respiratory tract using the nasopharyngeal swab technique - in which a sample is gathered from the throat behind the nose, containing a mixture of mucous and saliva. the rt-pcr testing process can take up to 3-4 hours [file: edgard garrido/reuters] samples are brought to a specialised laboratory and tested for sars-cov-2 using a real-time reverse-transcription polymerase chain reaction (rrt-pcr) assay - a method used to detect the presence of ""specific genetic material from a pathogen"". ""from reputable laboratories, they [naat] are very reliable,"" anna wald, head of allergy and infectious diseases division at university of washington, told al jazeera. wald said that while the technique was good and did not warrant any improvements, it was ""just not available enough"". the testing process can take up to 3-4 hours, with results available to patients within several days in most countries. serological tests a serological test is used to detect antibodies present in blood serum. antibodies are proteins produced by white blood cells to fight foreign bodies such as antigens. according to johns hopkins university, ""the serum includes antibodies to specific components of pathogens, called antigens ... recognised by the immune system as foreign and are targeted by the immune response"". according to authors of a recent pre-print, but yet to be peer-reviewed study , serological tests can help detect the rate of infection in a community, and hence determine the rate of mortality from the disease. the study also asserts the test can help identify individuals who have developed antibodies to the sars-cov-2 virus, allowing them to serve as donors to those currently infected with covid-19. scientist linqi zhang in his laboratory where he researches covid-19 antibodies for possible use in a drug at tsinghua university's research center for public health in beijing [file: thomas peter /reuters] for some, it is too early to tell exactly how effective serology tests will be in tackling covid-19. ""it is not clear if they will be a game-changer at this time,"" waleed javaid, director of infection prevention and control at mount sinai in new york, told al jazeera. ""serology tests tell you about possible infection or exposure in the past, but not if you are currently infectious,"" he said. currently, serology tests are in developing stages for both commercial and non-commercial use, and only a handful of countries like china and singapore use it for coronavirus testing. on april 2, the us food and drug administration approved the first serological test produced by biotechnology company cellex, that tests for coronavirus antibodies in blood obtained from pricking a finger. the test can reveal if a person has covid-19 in approximately 15 minutes, the company claims. who will get tested? testing for coronavirus in most parts of the world is largely prioritised for those above 65 and severely ill patients. many people who show mild symptoms are unlikely to get tested in countries such as the united states , often due to lack of testing kits. the who has recommended that if a person tests positive, it is important to figure out those they came into ""close contact with up to two days before they developed symptoms and test those people too"", but only those who show symptoms. where can you get tested? in most countries, coronavirus tests take place largely in specialised labs and medical facilities like hospitals and clinics. however, in recent weeks, some countries like germany, canada, the united arab emirates and south korea have opened up testing centres outside of traditional hospital settings. in south korea, many cities have started authorising road-side tests, touted to cut testing time to about a third, while also lowering the risk of catching the virus - since the individual is in his vehicle. the entire process is believed to take approximately 10 minutes. ""a drive-through sampling site is developed to overcome bottleneck in sampling process,"" lee hyukmin of the yonsei university college of medicine in seoul, told al jazeera. medical staff wearing protective suites work to take samples from drivers with suspected symptoms of the coronavirus at a ""drive-through"" virus test facility in goyang, south korea [ahn young-joon/ap] ""it is a good solution for rapid sampling. in korea, the sampling process is very time-consuming because of bio-safety issues to protect healthcare personnel. so, enough tests cannot be done even with early expansion of lab capacity,"" hyukmin added. several companies in the us claim to have created home-based coronavirus kits. however, the us food and drug administration has strongly asserted that it has not ""authorised any test that is available to purchase for testing yourself at home for covid-19"". in bangladesh, researchers have produced a testing kit which they say can detect sars-cov-2 antibodies in 15 minutes. the kits, which have been approved by the bangladeshi government for production, cost a mere $3 each. researchers in senegal announced in late march a new home-based coronavirus test that costs approximately $1 - and can detect an active infection using a saliva swab, or a previously undetected case using an at-home finger-prick blood test to that identifies antibodies to the virus. infectious diseases specialist at the university health network in toronto abdu sharkawy believes home-based kits would allow a significant expansion of testing. but he added that home tests are more likely to be ""less sensitive than lab-based tests"". is mass testing feasible? germany and south korea have been widely praised for their efforts to aggressively test for coronavirus on a mass scale, with the former claiming it has the capacity to conduct 500,000 tests a week. however, for many countries, especially middle/low-income nations, testing on a large scale may not be feasible. ""i think the unique challenges in low and middle-income countries, many of which are recognised as having high burdens of (other) diseases, may be more related to the lack of financial safety net,"" maia lesosky of cape town university in south africa, told al jazeera. elaborating further, lesosky said the choice to implement mass testing for a new disease could very well take away the ""capacity to diagnose or treat existing diseases"". the stream | can south africa's strained health system cope with covid-19? (25:32) in the context of her own country, south africa, one the worst affected countries in africa, lesosky said it was a large country and not all areas are easily accessible, which ""translates directly into logistical challenges in reaching remote communities to provide testing"". ""anything was possible with enough funding"", she said, however, in the absence of it, the ""benefits of mass testing need to be weighed carefully against potential drawbacks"". moreover, lesosky stressed: ""mass testing ... can be beneficial only if it is closely tied to public health programmes to limit further spread"", such as separate testing and treatment facilities and restriction of public gathering. ""this may be of greater challenge where healthcare systems are less robust,"" she added. source: al jazeera"
7	covid-19 specific testing :: chemviews magazine :: chemistryviews text extraction from html file; language identification https://elrc-share.eu under review 2020 covid-19 specific testing :: chemviews magazine :: chemistryviews application/xhtml+xml https://www.chemistryviews.org/details/ezine/11232602/covid-19_specific_testing.html en_2020_04_5115.xml_58.html covid-19 specific testing published date: 07 april 2020 copyright: wiley-vch the picture describes how coronavirus testing work reverse transcription polymerase chain reaction (rt-pcr) test currently, pcr tests for sars-cov-2 are used. these tests detect the rna of the coronavirus and, by this, active infections. the test is only reliable in the first week of the disease. the virus then migrates further into the lungs. it then becomes difficult to detect using nasal or throat swabs. antibody test or serological tests about 80 % of covid-19 infections are mild. what if i've already had the virus and i didn't notice? can the virus be detected retrospectively? you can do that with antibody tests. the antibody test only takes effect after a few days if antibodies have formed in the blood. it is not suitable for detecting active infections in the early phase of the disease. point-of-care, handheld antibody tests are currently being developed. they will be rolled out quickly once they are sensitive and specific enough. beyond conventional antibody and antigen tests, researchers are developing other diagnostic technologies. the gene editing technique crispr can, for example, be adapted to recognize and cut specific genetic sequences in sars-cov-2. this can then be identified via color changes. references fatima amanat, thi nguyen, veronika chromikova, shirin strohmeier, daniel stadlbauer, andres javier, kaijun jiang, guha asthagiri-arunkumar, jose polanco, maria bermudez-gonzalez, daniel caplivski, allen cheng, katherine kedzierska, olli vapalahti, view orcid profilejussi hepojoki, viviana simon, florian krammer, a serological assay to detect sars-cov-2 seroconversion in humans , medrxiv 2020. https://doi.org/10.1101/2020.03.17.20037713 also of interest what we know about the new coronavirus and covid-19 - articles published in chemistryviews related to sars-cov-2
10	"coronavirus peak in colorado ""slightly delayed,"" polis says, but more social distancing needed text extraction from html file; language identification https://elrc-share.eu under review 2020 coronavirus peak in colorado ""slightly delayed,"" polis says, but more social distancing needed text/html https://www.thedenverchannel.com/news/coronavirus/coronavirus-peak-in-colorado-slightly-delayed-polis-says-but-more-social-distancing-needed how many coronavirus cases in colorado coronavirus cases in colorado coronavirus colorado coronavirus in colorado coronavirus coronavirus denver covid-19 how many covid-19 in colorado polis covid19 cases denver en_2020_04_93.xml_84.html coronavirus peak in colorado ""slightly delayed,"" polis says, but more social distancing needed gov. jared polis showing data monday that doubling rates are slowing to every five days. posted at 1:45 pm, mar 30, 2020 and last updated 2020-03-30 21:49:24-04 centennial, colo. - gov. jared polis on monday said new data showed that ""we have successfully slightly delayed the peak"" of known coronavirus cases in colorado but that enacting more social distancing measures - including last week's statewide stay-at-home order - was crucial to slowing the spread of covid-19 even further. the data released by the governor monday showed the spread of the virus appears to be approaching a doubling rate of every five days, compared to recent doubling rates of every two days. the data likely reflected the initial social distancing measures across the state earlier this month, including bans on gatherings of 250 or more people, school closures and the shutdown of dining at bars and restaurants. the impact of prohibitions on gatherings of 10 or more people is expected to be reflected in data in coming days. polis emphasized that a doubling rate of every five days is still a very infectious spread of the virus - and that there are still likely thousands more unknown cases in state - and that data likely won't reflect the impact of last week's stay-at-home order for another week or more. the data on how new social distancing measures impact the spread of the virus lags behind by about 12 days, polis said. ""we hope [additional social distancing] has a bigger effect"" on the slowing of coronavirus in the state, polis said. slowing the doubling rate of cases in the state will be crucial for hospitals to handle the surge of coronavirus patients. last week, polis released that showed how colorado would need thousands of additional intensive care beds, if social distancing wasn't taken. more | ""it's real and it's scary"": uchealth doctor describes covid-19 effects inside hospitals, on patients the number of known coronavirus cases in colorado rose to 2,627 by monday. the total number of deaths rose to 51. more case data was expected to be released later monday afternoon. the data on social distancing's impact lags behind because of how the virus is identified, polis explained. the average time from exposure to symptoms is 4-5 days, and, in some cases, longer. after that, it often takes several more days from a patient being symptomatic to testing positive and then later being hospitalized. the state is also using real-time data, such as traffic volume, to measure the amount of social distancing, polis said. while traffic numbers don't take into account residents walking outside, traffic volume has been reduced by 60%, compared to levels three weeks ago. the traffic volume reduction needs to be in the 70%-80% range, polis said, but the major drop over the last three weeks was ""a positive indicator"" of social distancing. ""the more people stay at home, the sooner we can squash the virus,"" polis said. copyright 2020 scripps media, inc. all rights reserved. this material may not be published, broadcast, rewritten, or redistributed. sign up for the rebound newsletter and receive up to date information. now signed up to receive the rebound newsletter."
10	"social distancing may negatively impact mental health, experts warn | fox news text extraction from html file; language identification https://elrc-share.eu under review 2020 social distancing may negatively impact mental health, experts warn | fox news text/html https://www.foxnews.com/science/social-distancing-may-negatively-impact-mental-health-experts-warn en_2020_04_860.xml_128.html social distancing may negatively impact mental health, experts warn fox news flash top headlines are here. check out what's clicking on foxnews.com. get all the latest news on coronavirus and more delivered daily to your inbox. sign up here . more than 280 million americans in 35 states and washington, d.c., are under stay-at-home orders that restrict their movement to the bare essentials to slow the spread of coronavirus . although the topic of has not been studied widely, experts believe social distancing can negatively impact mental health. it's hard to find an aspect of life in the u.s. that hasn't been upended by the global pandemic. most public schools and colleges have sent students home and switched to virtual classrooms; nursing homes and senior centers are barring visitors; companies large and small told employees to work from home; and restaurants, hotels, gyms and bars have been shuttered. a review of research in the lancet on the psychological impact of the practice found that many people experienced both short- and long-term negative effects from being quarantined. researchers found that of 2,760 quarantined people, 34 percent, or 938 individuals, reported high levels of psychological distress, which can indicate mental health problems such as anxiety and depression, during the outbreak compared with 12 percent of non-quarantined individuals. bill gates says nationwide shutdown, more testing needed to 'save lives' and restart economy alexis rickmers walks around chandler pond and gallagher park in boston on march 18, 2020. she is among many people suffering from anxiety, paranoia, and hypochondria amid the coronavirus. she says daily walks help. (photo by lane turner/the boston globe via getty images) ""for some people, a lack of social connectedness feels as impactful as not eating,” joshua morganstein, a psychiatrist and disaster mental health expert at the uniformed services university in bethesda, md., told science news . common responses to the covid-19 pandemic include fear, anxiety, sadness, loneliness and a general sense of unease. besides staying connected via non-physical means, psychologists recommend getting some time outdoors in the sun, regular meditation, recalling something good and simply managing your own expectations. “be easy on yourself,” julie kolzet, a licensed psychologist in new york city, told psycom . “it's not an easy time. do what you can.” christina garnett, a licensed clinical social worker, said that not being able to go out can make some people feel lonely or depressed -- but she cautioned that social distance does not have to mean isolation. the social worker told kmov that staying in touch using cellphones and other technology, whether to text, call or video chat, can help during the current crisis. kolzet said that ""looking for the good"" is another sound coping strategy."
10	"social distancing crawling and normalization ilsp european language resource coordination https://elrc-share.eu under review 2020 social distancing text/html wikimedia foundation 2020-06-11 https://en.wikipedia.org/wiki/social_distancing https://creativecommons.org/licenses/by-sa/3.0/ infectious diseases wikipedia-en-22677497.html in public health, social distancing, also called physical distancing, is a set of non-pharmaceutical interventions or measures intended to prevent the spread of a contagious disease by maintaining a physical distance between people and reducing the number of times people come into close contact with each other. it typically involves keeping a certain distance from others (the distance specified may differ from time to time and country to country) and avoiding gathering together in large groups. by reducing the probability that a given uninfected person will come into physical contact with an infected person, the disease transmission can be suppressed, resulting in fewer deaths. the measures are used in combination with good respiratory hygiene, face masks and hand washing by a population. during the covid-19 pandemic, the world health organization (who) suggested favoring the term ""physical distancing"" as opposed to ""social distancing"", in keeping with the fact that it is a physical distance which prevents transmission; people can remain socially connected via technology. to slow down the spread of infectious diseases and avoid overburdening healthcare systems, particularly during a pandemic, several social-distancing measures are used, including the closing of schools and workplaces, isolation, quarantine, restricting the movement of people and the cancellation of mass gatherings. although the term was only introduced in the twenty-first century, social-distancing measures date back to at least the fifth century bc. the bible contains one of the earliest known references to the practice in the book of leviticus 13:46: ""and the leper in whom the plague is ... he shall dwell alone; [outside] the camp shall his habitation be."" during the plague of justinian of 541 to 542, emperor justinian enforced an ineffective quarantine on the byzantine empire, including dumping bodies into the sea; he predominantly blamed the widespread outbreak on ""jews, samaritans, pagans, heretics, arians, montanists and homosexuals"". in modern times, social distancing measures have been successfully implemented in several epidemics. in st. louis, shortly after the first cases of influenza were detected in the city during the 1918 flu pandemic, authorities implemented school closures, bans on public gatherings and other social-distancing interventions. the case fatality rates in st. louis were much less than in philadelphia, which despite having cases of influenza, allowed a mass parade to continue and did not introduce social distancing until more than two weeks after its first cases. authorities have encouraged or mandated social distancing during the covid-19 pandemic. social distancing measures are more effective when the infectious disease spreads via one or more of the following methods: droplet contact (coughing or sneezing) direct physical contact (including sexual contact) indirect physical contact (e.g., by touching a contaminated surface) airborne transmission (if the microorganism can survive in the air for long periods); the efficacy of social distancing to contain airborne viruses compared to other measures, such as widespread mask usage, is disputed the measures are less effective when an infection is transmitted primarily via contaminated water or food or by vectors such as mosquitoes or other insects. drawbacks of social distancing can include loneliness, reduced productivity and the loss of other benefits associated with human interaction. definition the centers for disease control and prevention (cdc) have described social distancing as a set of ""methods for reducing frequency and closeness of contact between people in order to decrease the risk of transmission of disease"". during the 2009 flu pandemic the who described social distancing as ""keeping at least an arm's length distance from others, [and] minimizing gatherings"". it is combined with good respiratory hygiene and hand washing, and is considered the most feasible way to reduce or delay a pandemic. during the covid-19 pandemic, the cdc revised the definition of social distancing as ""remaining out of congregate settings, avoiding mass gatherings, and maintaining distance (approximately six feet or two meters) from others when possible"". it is not clear why six feet was chosen. recent studies have suggested that droplets from a sneeze or forceful breathing during exercise can travel over six meters. some have suggested the required distance is based on debunked research from the 1930s and 1940s or confusion regarding units of measurement. researchers and science writers have recommended that larger social distances and/or both mask wearing and social distancing be required. measures knowing that a disease is circulating may trigger a change in behavior by people choosing to stay away from public places and other people. when implemented to control epidemics, such social distancing can result in benefits but with an economic cost. research indicates that measures must be applied rigorously and immediately in order to be effective. several social distancing measures are used to control the spread of contagious illnesses. avoiding physical contact keeping at least two-metre (six-foot) distance (in the us or uk) or 1.5 metres distance (in australia) or 1 metre distance (in france or italy) from each other and avoiding hugs and gestures that involve direct physical contact, reduce the risk of becoming infected during flu pandemics and the coronavirus pandemic of 2020. these distances of separation, in addition to personal hygiene measures, are also recommended at places of work. where possible it may be recommended to work from home. various alternatives have been proposed for the tradition of handshaking. the gesture of namaste, placing one's palms together, fingers pointing upwards, drawing the hands to the heart, is one non-touch alternative. during the covid-19 pandemic in the united kingdom, this gesture was used by prince charles upon greeting reception guests, and has been recommended by the director-general of the who, tedros adhanom ghebreyesus, and israeli prime minister benjamin netanyahu. other alternatives include the popular thumbs up gesture, the wave, the shaka (or ""hang loose"") sign, and placing a palm on your heart, as practiced in parts of iran. school closures mathematical modeling has shown that transmission of an outbreak may be delayed by closing schools. however, effectiveness depends on the contacts children maintain outside of school. often, one parent has to take time off work, and prolonged closures may be required. these factors could result in social and economic disruption. workplace closures modeling and simulation studies based on u.s. data suggest that if 10% of affected workplaces are closed, the overall infection transmission rate is around 11.9% and the epidemic peak time is slightly delayed. in contrast, if 33% of affected workplaces are closed, the attack rate decreases to 4.9%, and the peak time is delayed by one week. workplace closures include closure of ""non-essential"" businesses and social services (""non-essential"" means those facilities that do not maintain primary functions in the community, as opposed to essential services). canceling mass gatherings cancellation of mass gatherings includes sports events, films or musical shows. evidence suggesting that mass gatherings increase the potential for infectious disease transmission is inconclusive. anecdotal evidence suggests certain types of mass gatherings may be associated with increased risk of influenza transmission, and may also ""seed"" new strains into an area, instigating community transmission in a pandemic. during the 1918 influenza pandemic, military parades in philadelphia and boston may have been responsible for spreading the disease by mixing infected sailors with crowds of civilians. restricting mass gatherings, in combination with other social distancing interventions, may help reduce transmission. travel restrictions border restrictions or internal travel restrictions are unlikely to delay an epidemic by more than two to three weeks unless implemented with over 99% coverage. airport screening was found to be ineffective in preventing viral transmission during the 2003 sars outbreak in canada and the u.s. strict border controls between austria and the ottoman empire, imposed from 1770 until 1871 to prevent persons infected with the bubonic plague from entering austria, were reportedly effective, as there were no major outbreaks of plague in austrian territory after they were established, whereas the ottoman empire continued to suffer frequent epidemics of plague until the mid-nineteenth century. a northeastern university study published in march 2020 found that ""travel restrictions to and from china only slow down the international spread of covid-19 [when] combined with efforts to reduce transmission on a community and an individual level. [...] travel restrictions aren't enough unless we couple it with social distancing."" the study found that the travel ban in wuhan delayed the spread of the disease to other parts of mainland china only by three to five days, although it did reduce the spread of international cases by as much as 80 percent. shielding shielding measures for individuals include limiting face-to-face contacts, conducting business by phone or online, avoiding public places and reducing unnecessary travel. quarantine during the 2003 sars outbreak in singapore, approximately 8000 people were subjected to mandatory home quarantine and an additional 4300 were required to self-monitor for symptoms and make daily telephone contact with health authorities as a means of controlling the epidemic. although only 58 of these individuals were eventually diagnosed with sars, public health officials were satisfied that this measure assisted in preventing further spread of the infection. voluntary self-isolation may have helped reduce transmission of influenza in texas in 2009. short and long-term negative psychological effects have been reported. stay-at-home orders the objective of stay-at-home orders is to reduce day-to-day contact with between people and thereby reduce the spread of infection during the covid-19 pandemic, early and aggressive implementation of stay-at-home orders was effective in ""flattening the curve"" and provided the much needed time for healthcare systems to increase their capacity while reducing the number of peak cases during the initial wave of illness. it is important for public health authorities to follow disease trends closely to re-implement appropriate social distancing policies, including stay-at-home orders, if secondary covid-19 waves appear. cordon sanitaire in 1995, a cordon sanitaire was used to control an outbreak of ebola virus disease in kikwit, zaire. president mobutu sese seko surrounded the town with troops and suspended all flights into the community. inside kikwit, the world health organization and zaire's medical teams erected further cordons sanitaires, isolating burial and treatment zones from the general population and successfully containing the infection. protective sequestration during the 1918 influenza epidemic, the town of gunnison, colorado, isolated itself for two months to prevent an introduction of the infection. highways were barricaded and arriving train passengers were quarantined for five days. as a result of the isolation, no one died of influenza in gunnison during the epidemic. several other communities adopted similar measures. other measures other measures include shutting down or limiting mass transit and closure of sport facilities (community swimming pools, youth clubs, gymnasiums). due to the highly interconnected nature of modern transportation hubs, a highly contagious illness can achieve rapid geographic spread if appropriate mitigation measures are not taken early. consequently, highly coordinated efforts must be put into place early during an outbreak to proactively monitor, detect, and isolate any potentially infectious individuals. if community spread is present, more aggressive measures may be required, up to and including complete cessation of travel in/out of a specific geographic area. history leper colonies and lazarettos were established as a means of preventing the spread of leprosy and other contagious diseases through social distancing, until transmission was understood and effective treatments invented. 1916 new york city polio epidemic during the 1916 new york city polio epidemic, when there were more than 27,000 cases and more than 6,000 deaths due to polio in the united states, with more than 2,000 deaths in new york city alone, movie theaters were closed, meetings were cancelled, public gatherings were almost non-existent, and children were warned not to drink from water fountains, and told to avoid amusement parks, swimming pools and beaches. influenza, 1918 to present during the influenza pandemic of 1918, philadelphia saw its first cases of influenza on 17 september. the city continued with its planned parade and gathering of more than 200000 people on 28 september and over the subsequent three days, the city's 31 hospitals became fully occupied. during the week ending 16 october, over 4500 people died. social distancing measures were introduced on 3 october, on the orders of st. louis physician max c. starkloff, more than two weeks after the first case. unlike philadelphia, st. louis experienced its first cases of influenza on 5 october and the city took two days to implement several social distancing measures, including closing schools, theatres, and other places where people get together. it banned public gatherings, including funerals. the actions slowed the spread of influenza in st. louis and a spike in cases and deaths, as had happened in philadelphia, did not occur. the final death rate in st. louis increased following a second wave of cases, but remained overall less than in other cities. bootsma and ferguson analyzed social distancing interventions in sixteen u.s. cities during the 1918 epidemic and found that time-limited interventions reduced total mortality only moderately (perhaps 10–30%), and that the impact was often very limited because the interventions were introduced too late and lifted too early. it was observed that several cities experienced a second epidemic peak after social distancing controls were lifted, because susceptible individuals who had been protected were now exposed. school closures were shown to reduce morbidity from the asian flu by 90% during the 1957–1958 pandemic, and up to 50% in controlling influenza in the u.s., 2004–2008. similarly, mandatory school closures and other social distancing measures were associated with a 29% to 37% reduction in influenza transmission rates during the 2009 flu epidemic in mexico. during the swine flu outbreak in 2009 in the uk, in an article titled ""closure of schools during an influenza pandemic"" published in the lancet infectious diseases, a group of epidemiologists endorsed the closure of schools to interrupt the course of the infection, slow the further spread and buy time to research and produce a vaccine. having studied previous influenza pandemics including the 1918 flu pandemic, the influenza pandemic of 1957 and the 1968 flu pandemic, they reported on the economic and workforce effect school closure would have, particularly with a large percentage of doctors and nurses being women, of whom half had children under the age of 16. they also looked at the dynamics of the spread of influenza in france during french school holidays and noted that cases of flu dropped when schools closed and re-emerged when they re-opened. they noted that when teachers in israel went on strike during the flu season of 1999–2000, visits to doctors and the number of respiratory infections dropped by more than a fifth and more than two fifths respectively. sars 2003 during the sars outbreak of 2003, social distancing measures such as banning large gatherings, closing schools and theaters, and other public places, supplemented public health measures such as finding and isolating affected people, quarantining their close contacts, and infection control procedures. this was combined with wearing masks for certain people. during this time in canada, ""community quarantine"" was used to reduce transmission of the disease with moderate success. covid-19 pandemic during the covid-19 pandemic, social distancing and related measures are emphasized by several governments as alternatives to an enforced quarantine of heavily affected areas. according to unesco monitoring, more than a hundred countries have implemented nationwide school closures in response to covid-19, impacting over half the world's student population. in the united kingdom, the government advised the public to avoid public spaces, and cinemas and theaters voluntarily closed to encourage the government's message. with many people disbelieving that covid-19 is any worse than the seasonal flu, it has been difficult to convince the public—especially teens and young adults—to voluntarily adopt social distancing practices. in belgium, media reported a rave was attended by at least 300 before it was broken up by local authorities. in france teens making nonessential trips are fined up to us$150. beaches were closed in florida and alabama to disperse partygoers during spring break. weddings were broken up in new jersey and an 8 p.m. curfew was imposed in newark. new york, new jersey, connecticut and pennsylvania were the first states to adopt coordinated social distancing policies which closed down non-essential businesses and restricted large gatherings. shelter in place orders in california were extended to the entire state on 19 march. on the same day texas declared a public disaster and imposed statewide restrictions. these preventive measures such as social-distancing and self-isolation prompted the widespread closure of primary, secondary, and post-secondary schools in more than 120 countries. as of 23 march 2020, more than 1.2 billion learners were out of school due to school closures in response to covid-19. given low rates of covid-19 symptoms among children, the effectiveness of school closures has been called into question. even when school closures are temporary, it carries high social and economic costs. however, the significance of children in spreading covid-19 is unclear. while the full impact of school closures during the coronavirus pandemic are not yet known, unesco advises that school closures have negative impacts on local economies and on learning outcomes for students. in early march 2020, the sentiment ""stay the fuck home"" was coined by florian reifschneider, a german engineer and was quickly echoed by notable celebrities such as taylor swift, ariana grande and busy philipps in hopes of reducing and delaying the peak of the outbreak. facebook, twitter and instagram also joined the campaign with similar hashtags, stickers and filters under #staythefhome, #stayhome, #staythefuckhome and began trending across social media. the website claims to have reached about two million people online and says the text has been translated into 17 languages. drawbacks there are concerns that social distancing can have adverse affects on participants' mental health. it may lead to stress, anxiety, depression or panic, especially for individuals with preexisting conditions such as anxiety disorders, obsessive compulsive disorders, and paranoia. widespread media coverage about a pandemic, its impact on economy, and resulting hardships may create anxiety. change in daily circumstances and uncertainty about the future may add onto the mental stress of being away from other people. portrayal in literature in his 1957 science fiction novel the naked sun, isaac asimov portrays a planet where people live with social distancing. they are spread out, miles from each other, across a sparsely-populated world. communication is primarily through technology. a male and a female still need to engage in sex to make a baby, but it is seen as a dangerous, nasty chore. in contrast, when communication is through technology the situation is the reverse: there is no modesty, and casual nudity is frequent. the novel's point of departure is a murder: this seemingly idyllic world, in fact, has serious social problems. theoretical basis from the perspective of epidemiology, the basic goal behind social distancing is to decrease the effective reproduction number, r e or r , which in the absence of social distancing would equate to the basic reproduction number, i.e. the average number of secondary infected individuals generated from one primary infected individual in a population where all individuals are equally susceptible to a disease. in a basic model of social distancing, where a proportion f of the population engages in social distancing to decrease their interpersonal contacts to a fraction a of their normal contacts, the new effective reproduction number r is given by: where the value of r can be brought below 1 for sufficiently long, containment is achieved, and the number infected should decrease. see also coronavirus party herd immunity pest house stay-at-home order references external links"
11	tdmn text extraction from html file; language identification https://elrc-share.eu under review 2020 tdmn text/html https://www.dallasnews.com/opinion/commentary/2020/04/06/n-texas-hospitals-will-ensure-equity-and-fairness-if-they-must-ration-coronavirus-treatment/ en_2020_04_4879.xml_136.html n. texas hospitals will ensure equity and fairness if they must ration coronavirus treatment the north texas mass critical care plan is a positive step. by brian williams email icon the coronavirus pandemic could be devastating for racial minorities in dallas county. as the number of cases rises , citizens are rightfully concerned about who is getting tested and who will receive treatment. for those who exist on the margins of health care justice, access to life-saving treatment is never guaranteed. fortunately, the north texas mass critical care plan is designed to maximize equitable allocation of medical resources when they become scarce. imagine 10 of your family members and close friends are infected with coronavirus. eight will have no symptoms or mild disease; yet, they may still infect others, which is why social distancing measures are important. the remaining two will have severe enough illness requiring admission to the hospital for life support. for a patient with severe coronavirus infection, life support means being connected to a ventilator - a breathing machine - without which, they would die. it also means having qualified doctors, nurses and respiratory technicians to manage the vent. all may be in short supply due to the increasing number of covid-positive patients. dallas county has a plan for this eventuality. by wire services and tom steele health care leaders developed the north texas mass critical care triage guidelines 15 years ago in preparation for a pandemic respiratory crisis such as we are in. since the health care infrastructure of dallas county may be unable to sustain increasing numbers of critically ill patients, the guidelines maximize equitable allocation of resources, such as ventilators, should they become scarce. the goal is to provide the maximum benefit to the most people. age, wealth and race are not triage criteria. intuitively, critical care resources would be given to patients first arriving at the hospital, a disadvantage to citizens without proximity to a health care facility due to geography, lack of reliable transportation or income. also, centuries of health care injustice means racial minorities have a higher percentage of diseases, such as asthma and diabetes, which may exacerbate a coronavirus infection. this could potentially make them ineligible for scarce, life-saving resources. by defining objective criteria for physicians to triage patients, priority is given to those whom treatment most likely would be life-saving. the north texas mass critical care plan was prescient in considering many of the recommendations highlighted in a recent new england journal of medicine about allocation of medical resources for covid-19 . it is impossible to correct endemic health care inequities that disadvantage racial minorities staring down the barrel of this pandemic. there will be no sudden eradication of racial disparities in health due to coronavirus. however, the mass critical care plan accounts for this reality to ensure anyone needing critical care in north texas will have equal opportunity to receive it. together we will get through this pandemic. we do not know when it will end or how many will die, but with a unified commitment to health care justice we can become better for it. the north texas mass critical care plan is a positive step to manifesting that vision. dr. brian williams is the special adviser for health equity for dallas county judge clay jenkins and an associate professor of trauma and acute care surgery at the university of chicago. he wrote this column for the dallas morning news. twitter: @bhwilliamsmd
11	should doctors have the right to withhold care from the sickest coronavirus patients? - the new york times text extraction from html file; language identification https://elrc-share.eu under review 2020 should doctors have the right to withhold care from the sickest coronavirus patients? - the new york times text/html https://www.nytimes.com/2020/04/01/nyregion/coronavirus-doctors-patients.html en_2020_04_695.xml_28.html by joseph goldstein , michael rothfeld and benjamin weiser april 1, 2020 one patient had lymphoma and heart failure. another was 85 years old with metastatic cancer. a third was 83 and had dementia and lung disease. all were critically ill with the coronavirus, and, a doctor said, all were hooked up to ventilators in recent weeks at a major manhattan hospital. but soon, patients such as those might not receive similar aggressive treatment. as people with the virus overwhelm new york city hospitals, doctors have stepped up pressure on state health officials to give them a rare and unsettling power: the right to withhold care from patients who are not likely to recover. dwindling supplies mean there might not be enough ventilators or other items for everyone, and many doctors say they are growing increasingly uneasy with treating every patient equally. they believe medical workers soon might need to make difficult choices about treatment. “usually, the standard is to intubate and do cpr and do all those things,” said dr. angela mills, the chief of emergency medicine services at newyork-presbyterian/columbia university medical center. “there's no question about it; that will not most likely be sustainable.” new york is the epicenter of the coronavirus in the united states, but doctors have wrestled with questions over whether, and how, to ration care from the beginning of the global outbreak. in china, many patients with covid-19 were initially turned away from hospitals, and in italy, hospitals have given younger, healthier patients priority for ventilators over older, sicker adults . the problem is a grim and wrenching one, and the experience of doctors in new york could signal what is to come for their colleagues in other states, which have begun dusting off triage plans . as of wednesday, there were 83,712 confirmed cases of the coronavirus in new york state, health officials said. more than 47,000 of those cases were in new york city, where, city officials said, 1,374 patients had died. the new york chapter of the american college of physicians, a national organization of internists, wrote to gov. andrew m. cuomo last week, asking that he issue an executive order granting doctors immunity from liability for the decisions they make “when the need for allocation of ventilators results in some patients being denied access.” mr. cuomo has repeatedly said he does not want to allow hospitals to ration care. no hospital has yet run out of ventilators, he has said. some hospitals are experimenting with putting multiple people on one machine. “there's no protocol,” mr. cuomo said on tuesday when asked if there would be a triage for patients if critical supplies run out. see more updates more live coverage: markets still, state health officials have had discussions with hospital representatives about how to quickly enact new rules if they are needed, according to people familiar with the matter. two weeks ago, a draft was circulated, although nothing has been implemented. a spokeswoman for the state department of health declined to answer questions about the discussions and instead referred to mr. cuomo's stance that triage should not be necessary. she also pointed to a recent executive order by mr. cuomo that would protect doctors from lawsuits in covid-related cases, but an american college of physicians representative said on wednesday that the order did not go far enough. in the face of inaction from albany, hospitals and physicians in new york have been talking among themselves in recent days to formalize common guidelines. “the goal is to have some kind of overarching concept of how to deal with a pandemic that we've never dealt with before - how to deal with the level of illness we've never seen before,” said dr. stuart kessler, the emergency department director at elmhurst hospital center, a particularly hard-hit public hospital in queens. the new york times spoke to six doctors at five major city hospitals who said they worried they soon would have to decide on their own not to take the most aggressive lifesaving measures in every case. in addition to the moral anguish that may cause, some feared they would run the risk of lawsuits or even criminal charges if they went against the wishes of a patient or family. steven a. mcdonald, an emergency room doctor at newyork-presbyterian, said he wrote to his supervisors on tuesday asking for guidelines for making decisions about who should receive a ventilator and who should not. “the feedback i got from my department is that the hospital wants to wait for the governor to come down with their own guidelines,” he said. hospitalizations and admissions to intensive care units are growing in new york, although at a slower pace than they were two weeks ago. mr. cuomo has said they are expected to peak in the next two weeks to a month, unnerving doctors. “we are on the battlefield. we are in the trenches and in the middle of a war,” said dr. robert l. klitzman, the director of the masters of bioethics programs at columbia university. “and we have not trained our medical staff to deal with military battlefield medicine and ethics.” at individual hospitals, there have been moments when a surge of patients has overwhelmed resources and staff. “we teeter on the brink of needing to ration ventilators, and then we back off for a little bit,” said dr. tia powell, the director of the montefiore einstein center for bioethics, part of montefiore medical center in the bronx. image tents outside montefiore medical center in the bronx. at individual hospitals, there have been moments when a surge of patients has overwhelmed resources and staff.credit...desiree rios for the new york times other equipment, such as intravenous pumps needed for delivering medicine to patients on ventilators, has also been in short supply in some places. dr. mcdonald said that when he arrived to work at newyork-presbyterian/allen hospital in upper manhattan on monday, the hospital was redirecting ambulances to other facilities. when he asked why, he said he was told the hospital had run out of ventilators - until a patient's death freed one up. he said he wondered what would happen if other hospitals were also at capacity. “at some point, we're just going to have to take these patients and process them accordingly,” he said. a spokeswoman for the hospital declined to comment. employers have to provide a safe workplace with policies that protect everyone equally. and if one of your co-workers tests positive for the coronavirus, the c.d.c. has said that employers should tell their employees -- without giving you the sick employee's name -- that they may have been exposed to the virus. a connecticut man, john schalhoub, said doctors seemed to be making decisions about rationing care when his mother- and father-in-law both were admitted to elmhurst hospital center. mr. schalhoub said he learned through an insurance company that his mother-in-law had tested positive for the coronavirus, but he did not receive his father-in-law's results. his in-laws, rong-hua xie and mei-chun huang, both 88, were given supplemental oxygen through face masks. but mr. schalhoub said doctors explained neither would be given a ventilator if they ultimately needed one. “they're basically saying that the use of ventilators is a last resort, but they have not had success with them with people of advanced age,” mr. schalhoub said. dr. mitchell katz, the head of new york city's public hospital system, said none of the facilities he oversees had yet had to prioritize who gets a ventilator. “to my knowledge, no ethical system would ever use age as a sole criteria,” dr. katz wrote in an email. ms. huang died on tuesday. she was not given a ventilator or other lifesaving measures, mr. schalhoub said. generally, hospitals follow the desires of patients or their families in how far doctors should go to save their lives. but soon those directives might not carry the same weight. “if you have an advance directive that says, ‘i want everything done for me,' in a pandemic that will not count,” said arthur l. caplan, a professor of bioethics at the new york university school of medicine. “what will count is whether you're likely to benefit more than the next guy or next woman.” image a tent and refrigerated trailer behind weill cornell medical center on tuesday.credit...stephen speranza for the new york times the state already had a plan for rationing ventilators in the event of a pandemic. in 2007, a state task force devised a formula , revised in 2015, to help hospitals decide who would get ventilators. it suggested hospitals form triage committees to weigh different factors, including likelihood of survival. it also envisioned a lottery system in some instances, and taking people off ventilators if they did not improve in a relatively short amount of time. but the department of health has not instructed hospitals to use the guidelines, and they remain little more than a template for how hospitals might approach the problem. and some changes would be needed to adapt to what is known about covid-19, such as that some patients need to be on ventilators for a week or two before improving, doctors said. “we know from the data coming in about covid that they need more time,” said dr. powell of montefiore, who was a member of the task force that produced the 2015 report. it is, however, receiving renewed interest. in mid-march, dr. powell and some other members of the task force participated in a conference call with the department of health and representatives of several major hospital systems, several participants said. about two weeks ago, a five-page draft based on the 2015 guidelines was circulating, the participants said. in interviews, some said they had expected the state would authorize a plan soon after the call. “there was always the expectation they would implement crisis standards of care guidelines, and they have not issued a statement doing that,” dr. powell said. a participant in the process, who requested anonymity because the person was not authorized to speak about sensitive internal discussions, said guidelines were still being drafted. one doctor at weill cornell medical center, on manhattan's upper east side, said that he had been wondering what to do in a hypothetical scenario: there are two covid-19 patients in hospital rooms, but only one ventilator left. without guidelines that authorize him to use his judgment, does he let a colleague help one patient while “i walk slowly to the door with the 90-year-old?” he asked. jesse mckinley contributed reporting.
11	should doctors have the right to withhold care from the sickest coronavirus patients? - the new york times text extraction from html file; language identification https://elrc-share.eu under review 2020 should doctors have the right to withhold care from the sickest coronavirus patients? - the new york times text/html https://www.nytimes.com/2020/04/01/nyregion/coronavirus-doctors-patients.html en_2020_04_688.xml_181.html by joseph goldstein , michael rothfeld and benjamin weiser april 1, 2020 one patient had lymphoma and heart failure. another was 85 years old with metastatic cancer. a third was 83 and had dementia and lung disease. all were critically ill with the coronavirus, and, a doctor said, all were hooked up to ventilators in recent weeks at a major manhattan hospital. but soon, patients such as those might not receive similar aggressive treatment. as people with the virus overwhelm new york city hospitals, doctors have stepped up pressure on state health officials to give them a rare and unsettling power: the right to withhold care from patients who are not likely to recover. dwindling supplies mean there might not be enough ventilators or other items for everyone, and many doctors say they are growing increasingly uneasy with treating every patient equally. they believe medical workers soon might need to make difficult choices about treatment. “usually, the standard is to intubate and do cpr and do all those things,” said dr. angela mills, the chief of emergency medicine services at newyork-presbyterian/columbia university medical center. “there's no question about it; that will not most likely be sustainable.” new york is the epicenter of the coronavirus in the united states, but doctors have wrestled with questions over whether, and how, to ration care from the beginning of the global outbreak. in china, many patients with covid-19 were initially turned away from hospitals, and in italy, hospitals have given younger, healthier patients priority for ventilators over older, sicker adults . the problem is a grim and wrenching one, and the experience of doctors in new york could signal what is to come for their colleagues in other states, which have begun dusting off triage plans . as of wednesday, there were 83,712 confirmed cases of the coronavirus in new york state, health officials said. more than 47,000 of those cases were in new york city, where, city officials said, 1,374 patients had died. the new york chapter of the american college of physicians, a national organization of internists, wrote to gov. andrew m. cuomo last week, asking that he issue an executive order granting doctors immunity from liability for the decisions they make “when the need for allocation of ventilators results in some patients being denied access.” mr. cuomo has repeatedly said he does not want to allow hospitals to ration care. no hospital has yet run out of ventilators, he has said. some hospitals are experimenting with putting multiple people on one machine. “there's no protocol,” mr. cuomo said on tuesday when asked if there would be a triage for patients if critical supplies run out. see more updates more live coverage: markets still, state health officials have had discussions with hospital representatives about how to quickly enact new rules if they are needed, according to people familiar with the matter. two weeks ago, a draft was circulated, although nothing has been implemented. a spokeswoman for the state department of health declined to answer questions about the discussions and instead referred to mr. cuomo's stance that triage should not be necessary. she also pointed to a recent executive order by mr. cuomo that would protect doctors from lawsuits in covid-related cases, but an american college of physicians representative said on wednesday that the order did not go far enough. in the face of inaction from albany, hospitals and physicians in new york have been talking among themselves in recent days to formalize common guidelines. “the goal is to have some kind of overarching concept of how to deal with a pandemic that we've never dealt with before - how to deal with the level of illness we've never seen before,” said dr. stuart kessler, the emergency department director at elmhurst hospital center, a particularly hard-hit public hospital in queens. the new york times spoke to six doctors at five major city hospitals who said they worried they soon would have to decide on their own not to take the most aggressive lifesaving measures in every case. in addition to the moral anguish that may cause, some feared they would run the risk of lawsuits or even criminal charges if they went against the wishes of a patient or family. steven a. mcdonald, an emergency room doctor at newyork-presbyterian, said he wrote to his supervisors on tuesday asking for guidelines for making decisions about who should receive a ventilator and who should not. “the feedback i got from my department is that the hospital wants to wait for the governor to come down with their own guidelines,” he said. hospitalizations and admissions to intensive care units are growing in new york, although at a slower pace than they were two weeks ago. mr. cuomo has said they are expected to peak in the next two weeks to a month, unnerving doctors. “we are on the battlefield. we are in the trenches and in the middle of a war,” said dr. robert l. klitzman, the director of the masters of bioethics programs at columbia university. “and we have not trained our medical staff to deal with military battlefield medicine and ethics.” at individual hospitals, there have been moments when a surge of patients has overwhelmed resources and staff. “we teeter on the brink of needing to ration ventilators, and then we back off for a little bit,” said dr. tia powell, the director of the montefiore einstein center for bioethics, part of montefiore medical center in the bronx. image tents outside montefiore medical center in the bronx. at individual hospitals, there have been moments when a surge of patients has overwhelmed resources and staff.credit...desiree rios for the new york times other equipment, such as intravenous pumps needed for delivering medicine to patients on ventilators, has also been in short supply in some places. dr. mcdonald said that when he arrived to work at newyork-presbyterian/allen hospital in upper manhattan on monday, the hospital was redirecting ambulances to other facilities. when he asked why, he said he was told the hospital had run out of ventilators - until a patient's death freed one up. he said he wondered what would happen if other hospitals were also at capacity. “at some point, we're just going to have to take these patients and process them accordingly,” he said. a spokeswoman for the hospital declined to comment. employers have to provide a safe workplace with policies that protect everyone equally. and if one of your co-workers tests positive for the coronavirus, the c.d.c. has said that employers should tell their employees -- without giving you the sick employee's name -- that they may have been exposed to the virus. a connecticut man, john schalhoub, said doctors seemed to be making decisions about rationing care when his mother- and father-in-law both were admitted to elmhurst hospital center. mr. schalhoub said he learned through an insurance company that his mother-in-law had tested positive for the coronavirus, but he did not receive his father-in-law's results. his in-laws, rong-hua xie and mei-chun huang, both 88, were given supplemental oxygen through face masks. but mr. schalhoub said doctors explained neither would be given a ventilator if they ultimately needed one. “they're basically saying that the use of ventilators is a last resort, but they have not had success with them with people of advanced age,” mr. schalhoub said. dr. mitchell katz, the head of new york city's public hospital system, said none of the facilities he oversees had yet had to prioritize who gets a ventilator. “to my knowledge, no ethical system would ever use age as a sole criteria,” dr. katz wrote in an email. ms. huang died on tuesday. she was not given a ventilator or other lifesaving measures, mr. schalhoub said. generally, hospitals follow the desires of patients or their families in how far doctors should go to save their lives. but soon those directives might not carry the same weight. “if you have an advance directive that says, ‘i want everything done for me,' in a pandemic that will not count,” said arthur l. caplan, a professor of bioethics at the new york university school of medicine. “what will count is whether you're likely to benefit more than the next guy or next woman.” image a tent and refrigerated trailer behind weill cornell medical center on tuesday.credit...stephen speranza for the new york times the state already had a plan for rationing ventilators in the event of a pandemic. in 2007, a state task force devised a formula , revised in 2015, to help hospitals decide who would get ventilators. it suggested hospitals form triage committees to weigh different factors, including likelihood of survival. it also envisioned a lottery system in some instances, and taking people off ventilators if they did not improve in a relatively short amount of time. but the department of health has not instructed hospitals to use the guidelines, and they remain little more than a template for how hospitals might approach the problem. and some changes would be needed to adapt to what is known about covid-19, such as that some patients need to be on ventilators for a week or two before improving, doctors said. “we know from the data coming in about covid that they need more time,” said dr. powell of montefiore, who was a member of the task force that produced the 2015 report. it is, however, receiving renewed interest. in mid-march, dr. powell and some other members of the task force participated in a conference call with the department of health and representatives of several major hospital systems, several participants said. about two weeks ago, a five-page draft based on the 2015 guidelines was circulating, the participants said. in interviews, some said they had expected the state would authorize a plan soon after the call. “there was always the expectation they would implement crisis standards of care guidelines, and they have not issued a statement doing that,” dr. powell said. a participant in the process, who requested anonymity because the person was not authorized to speak about sensitive internal discussions, said guidelines were still being drafted. one doctor at weill cornell medical center, on manhattan's upper east side, said that he had been wondering what to do in a hypothetical scenario: there are two covid-19 patients in hospital rooms, but only one ventilator left. without guidelines that authorize him to use his judgment, does he let a colleague help one patient while “i walk slowly to the door with the 90-year-old?” he asked. jesse mckinley contributed reporting.
12	aspetar offers ways to deal with effects of self-isolation text extraction from html file; language identification https://elrc-share.eu under review 2020 aspetar offers ways to deal with effects of self-isolation text/html https://www.gulf-times.com/story/659867/aspetar-offers-ways-to-deal-with-effects-of-self-i en_2020_04_919.xml_107.html aspetar offers ways to deal with effects of self-isolation april 02 2020 02:17 am aspetar experts advise athletes to stay and train at home. text size: a a experts from aspetar, qatar's world-level specialised orthopaedic and sports medicine hospital, and the first of its kind in the middle east, have offered methods for how to deal with the psychological effects of self-isolation. the outbreak of the novel coronavirus (covid-19) has caused many changes in the schedule and behaviour of individuals and athletes, especially after self-isolation at home was declared as the best way to limit the spread of the pandemic, according to a statement. however, self-isolation has different psychological effects on everybody and in particular in athletes; this is mainly due to the changing lifestyle that has made some feeling the pressure of negative emotions such as sadness, anxiety, anger and frustration. this pandemic has caused a change in people's daily habits and routines. also, due to rapid access to media outlets and social media platforms, many are overwhelmed with news and information about the pandemic, in particular when fake news and dubious cures are circulated. this aggravates negative emotions which may lead to sleep disorders and eventually affect mental health. aspetar experts suggest that individuals should focus on controlling their routines and concentrate on what is within their control; this will help to cope with and overcome negative emotions, uncertainty and discomfort over time. it is important to consider this situation as a positive challenge; negative feelings are natural responses to change and uncertainty. athletes are not the only ones who suffer from this situation and feelings. scientific research has highlighted what may happen when individuals are isolated alone and/or in small groups. “self-isolation at home or quarantine is a completely new and unfamiliar situation for athletes and even the public, and as a result there are no detailed research studies on this subject,” says dr marco cardinale, executive director of research and scientific support at aspetar. however, research in other cohorts, such as the military, astronauts and special operations, provide some useful guidance on what we need to focus on to support everyone in the current scenario. one of the key aspects to focus on is the ability to maintain healthy sleep patterns over the course of self-isolation or quarantine.” athletes are all advised to stay and train at home. following the closure of sports clubs and training sites they not be able to train as usual. this challenge should not stop them from maintaining fitness by finding alternative solutions and training routines. the measures put in place to reduce covid-19 infections include social and physical distancing; changes in daily routine are inevitable. sofiane suissi, clinical and sports psychologist at aspetar, said: “the covid-19 pandemic and the use of home isolation or social distancing and the possible associated negative effects, require us to face and deal with a new situation; this include dealing with psychological changes created by the noise of social networking. we also need to deal with isolation and we are forced to think creatively about how to manage and control changing emotional situations and moods; this is especially true for athletes.” aspetar experts advise athletes to continue their training and maintain normal daily routines as far as possible. however, athletes should not only focus on physical readiness, as mental and psychological readiness play a major role. especially now that many competitions have been cancelled or postponed, including the 2020 tokyo olympic games. one of the points highlighted by karim khalladi, clinical and sports psychologist in aspetar, is that fear of contracting covid-19 and excessive stress and anxiety associated with the rapidly increasing spread of the disease can have a large influence on the athlete's psyche. aspetar has developed easy to follow messages and guidelines on how to deal with the stress caused by home isolation/quarantine, in particular highlighting the importance of quality sleep. “healthy sleep habits can have a positive effect on mood and eating behaviours in athletes. athletes need to know that maintaining healthy sleep habits and routines can help to maintain and protect the immune system. it also helps athletes to cope better with a prolonged period away from normal training and group routines. athletes should therefore to make sure that they go to sleep at appropriate times and not too late, and wake up after having at least eight hours of sleep. they should not sleep until late in the morning.” aspetar's guidelines included many useful tips for dealing with stress. useful suggestions to cope with stress: l train regularly: you can still train at home and work on various aspects of your fitness. don't let the coronavirus stop you! however - do not train when you feel ill. l take care of your body: try to eat healthy well-balanced meals, get plenty of sleep and avoid alcohol and tobacco. l keep a routine: daily life is different with the restrictions imposed to stop the spread of the virus. classes are virtual. practices, training sessions, and competitions are cancelled. despite these unusual circumstances, try to maintain your normal routines. go to bed early and wake up early. l stay connected with others: share your concerns and how you are feeling with a friend or family member. maintain healthy relationships and build a strong support system. physical distancing is the key to containing this pandemic. but you can use technology such as facetime, skype, whatsapp, house party and snapchat to stay in contact with family and friends (rather than texts or calls). l take ‘news' breaks: try to avoid watching, reading, or listening to news stories all day. try to focus on things in your life that are going well and that you can control. l stay informed: if you want to be informed about the current situation, make sure to get news from reliable sources such as the ministry of public health. don't trust news from unreliable sources (fake news) and messages about miraculous supplements/cures. you can also visit the covid-19 evidence for athletes service on the aspetar website. l take time: to lift your spirit you can pray, meditate or help others in need. l realise: the whole world is dealing with these challenges, and you are not alone. all athletes are facing the same challenges and are supporting each other using social media.
12	filipche: quarantine, isolation, social distancing proven to curb coronavirus spread – миа text extraction from html file; language identification https://elrc-share.eu under review 2020 filipche: quarantine, isolation, social distancing proven to curb coronavirus spread – миа text/html https://mia.mk/filipche-quarantine-isolation-social-distancing-proven-to-curb-coronavirus-spread/?lang=en en_2020_04_365.xml_115.html facebook twitter linkedin pinterest skopje, 1 april 2020 (mia) - quarantine, isolation, and social distancing are some of the measures proven to curb the spread of covid-19 and protect public health, health minister venko filipche posted on his facebook profile on wednesday. however, the minister underlined, we can't in these critical times neglect our mental health. he pointed out several ways how best to take care of ourselves and others in these difficult moments: social distancing is a measure that entails maintaining a physical distance between people and reducing the number of times people come into close contact with each other. it's the most lenient measure that everyone should abide to. quarantine requires physical separation and restriction of movement of people that might have been exposed to the infection. it lasts until medial personnel determines that the exposed person does not show symptoms of the virus. isolation is the process of separating the sick people from the healthy ones. people are usually isolated in health facilities or in their own homes (self-isolation). people who practice social isolation, or are quarantined, or isolated can experience unpleasant thoughts and feelings. it's not unusual to be afraid, anxious, or concerned for your own health and the health of your loved ones. friends or family members who are forced to be quarantined together might develop a sense of resentment. discomfort and irritation may also be caused by increased attention on one's health. taking a leave of absence from work, lower income, lack of job security, and challenges that arise from going grocery shopping may cause added worries. feelings that may develop in these situations include: concern over executing everyday activities while taking care of children and the elderly, anxiety over what the future could bring, loneliness due to separation from loved ones, anger due to other people's lack of concern for others, boredom over lack of activities, foul mood, increased or decreased appetite, oversleeping or lack of sleep, as well as increased consumption of alcohol and cigarettes. however, there are ways to deal with this situation. listed below are things we can do to stabilize emotional states. take into consideration the level of risk you or your loved one might be in. people on social media, or even traditional media outlets, have different positions on the level of risk involved in these types of situations. their opinions are likely to be incorrect and unfounded. the best thing you can do is stay up to date with current events. when you hear some news, you should always check the source of the information to make sure it comes from a relevant institution or agency. however, avoid overexposure to news, as this might increase your anxiety. limit the amount of information you, and especially your children, receive. for any medical advice regarding your health or the health of your loved ones, contact your family doctor via telephone, skype, viber, messenger, etc. таг
12	"south africa: nzimande urges students to become covid-19 ambassadors - allafrica.com text extraction from html file; language identification https://elrc-share.eu under review 2020 south africa: nzimande urges students to become covid-19 ambassadors - allafrica.com text/html https://allafrica.com/stories/202004050168.html africa news politics economy trade business sports current events travel south africa southern africa governance health and medicine coronavirus education en_2020_04_3695.xml_77.html south africa south africa: nzimande urges students to become covid-19 ambassadors 4 april 2020 sanews.gov.za (tshwane) higher education, science and technology minister, dr blade nzimande, on saturday encouraged tvet college students, who have come out of quarantine, to become ambassadors of the effectiveness of the covid-19 lockdown. ""you are the best evangelists of a lockdown because you, above anyone else, have seen that a lockdown does work. i urge you to spread the message to south africans, [of] what a lockdown can do. wuhan was able to reduce the level of infections because they had a lockdown,"" said the minister. the minister made these comments at a send-off ceremony for 76 technical and vocational education and training (tvet) college students, who were repatriated from china. ""today you are leaving for your homes to be reunited with you families after spending several months in china, and the last 14 days in quarantine,"" said nzimande at the ceremony held at gauteng's birchwood hotel. the students spent 14 days in quarantine at the hotel, which the minister subsequently declared as a green zone. the send-off comes as south africa marked day 9 of the national 21-day lockdown announced by president cyril ramaphosa last month. the lockdown is aimed at curbing the spread of the coronavirus (covid-19). the minister said the decision to place all south africans in quarantine, who have come from outside the borders of the country, is the correct one. this as the virus continues to wreak havoc around the globe. as of 3 april, south africa had 1 505 confirmed cases of covid-19, with seven deaths, and two deaths still to be confirmed. nzimande urged the students to continue to practice social distancing and encourage those they come across of the importance of washing hands. ""leaving the confines of birchwood, you are going to go to your respective provinces, and i would like you to maintain the same discipline when you are in your home environments, of social distancing, encourage people to wash their hands and to report to their health facilities any signs of this disease,"" he said. students still in quarantine while the 76 were on their way to their respective homes, four more students are yet to complete their quarantine. ""i'm aware that four students will still have to complete their quarantine until tuesday, as they had arrived later. we would like to assure them that we will continue to provide them with the same level of support,"" said nzimande. close error! there was a problem processing your submission. please try again later. the minister said government will continue to implement the necessary health interventions, and economic and social measures to contain the spread of the disease and to alleviate its effects on people. ""these are unusual and difficult times for all of us, especially for a country with the limited resources that we have. as a government and a people, we will overcome this. ""what this time has shown is how we could rapidly pull government departments together to work towards a common purpose, such as making this quarantine exercise a coordinated one,"" the minister said. the majority of the 80 students (including those still in quarantine) are from gauteng (33), as well as a private student; followed by those from the free state (13), north west (9), mpumalanga (7), kwazulu-natal (6), eastern cape (1) and the western cape (1)."
13	"what are the main modes of transmission for covid-19? | live science text extraction from html file; language identification https://elrc-share.eu under review 2020 what are the main modes of transmission for covid-19? | live science text/html https://www.livescience.com/how-covid-19-spreads-transmission-routes.html en_2020_04_5458.xml_31.html we still don't fully understand how the new coronavirus spreads, but we're learning more every day. shares comments (3) (image: © shutterstock) the new coronavirus has upended all of our usual calculus about seemingly ordinary activities. is running past someone on the street safe? how about shopping in a grocery store with a 6-foot (2 meters) distance? and what about packages and takeout? and which of these activities poses the biggest risk? unfortunately, there's a lot we still don't know about the way the virus that causes covid-19 spreads. ""at this point, i don't think anyone can take a group of people with covid, say how each person has become infected, and then say that xx% got infected with droplets and yy% got infected via touching surfaces,"" dr. jeffrey n. martin, a professor in the department of epidemiology and biostatistics at the university of california, san francisco, told live science in an email. ""i don't think this kind of study has ever been done for any infection. in most individual persons, we do not know how the person got infected."" but as time goes on, we're learning more. here's what we do know about how the new coronavirus, sars-cov-2, spreads. respiratory transmission while the basic outlines of disease transmission have not been upended by covid-19, there are some nuances that could play an important role in the spread of the disease. from the beginning, the centers for disease control and prevention (cdc) have said that sars-cov-2 is a respiratory virus, and as such, it is mainly transmitted between people through ""respiratory droplets"" when symptomatic people sneeze or cough. this idea, that large droplets of virus-laden mucus are the primary mode of transmission, guides the cdc's advice to maintain at least a 6-foot distance between you and other people. the thinking is that gravity causes those large droplets (which are bigger than about .0002 inches, or 5 microns, in size) to fall to the ground within a distance of 6 feet from the infected person. but that 6-foot guideline is more of a ballpark estimate than a hard and fast rule, said josh santarpia, the research director of countering weapons of mass destruction program at the university of nebraska's national strategic research institute. ""there really isn't anything magic about standing 6 feet away from someone that you are interacting with directly. if you stand talking to someone who is infected with the virus, whether it's 3 feet or 6 feet, there is going to be some risk of infection,"" santarpia told live science in an email. that's because even large respiratory droplets can travel fairly far if the airflow conditions are right, santarpia said. and some experts believe the 6-foot rule is based on outdated information. ""6 feet is probably not safe enough. the 3-6 foot rule is based on a few studies from the 1930s and 1940s, which have since been shown to be wrong - droplets can travel farther than 6 feet,"" said raina macintyre, a principal research fellow and professor of global biosecurity, who heads the biosecurity program at the kirby institute, in australia. ""yet hospital infection control experts continue to believe this rule. it's like the flat earth theory - anyone who tries to discuss the actual evidence is shouted down by a chorus of believers.” another complicating factor is that at least 25% of the people who are transmitting the virus may be asymptomatic at the time, said dr. robert redfield, director of the centers for disease control and prevention, live science previously reported. that suggests coughs and sneezes aren't necessary to transmit the virus, though it's not clear whether simply breathing spreads the virus, or whether talking is required. coronavirus faq - can people spread the coronavirus after they recover? aerosol transmission in order for the virus to be spread without being coughed or sneezed in large drops of mucus, it has to somehow be able to suspend in the air for long enough to infect passersby. and that's another complicating factor in figuring out transmission: people emit virus particles in a range of sizes, and some are small enough to be considered aerosols , or fine particles that can stay suspended in the air for hours and can travel with air currents across tens of feet. a study published march 17 in the new england journal of medicine found that virus particles that were aerosolized could remain viable for up to 3 hours. what's not clear from this data is whether the virus is commonly transmitted via aerosols, or how long the virus remains infectious in aerosols in real-world settings. in that study, researchers used an extremely high concentration of virus particles, which may not reflect those shed by people with the disease. ""to my knowledge, there is no definitive evidence of transmission where aerosol was the only possible route,"" santarpia told live science. (for instance, even someone who's not sneezing may emit respiratory droplets when talking, because people may spit when talking, and those droplets could be deposited on surfaces.) one case study is suggestive however; a choir group in skagit, washington, met for a two-hour practice in early march. no one was symptomatic, so singers weren't coughing or sneezing out infected droplets. and everyone kept their distance. but when all was said and done, 45 people became infected with covid-19 and at least two people died from the virus, the los angeles times reported . that suggested the viral particles were shed as aerosols by someone, before being inhaled or otherwise acquired by other choir members. a 2019 study in the journal nature scientific reports found that people emit more aerosol particles when talking, and that louder speech volumes correlate to more aerosol particles being emitted. that case, along with those studies, suggest that the virus can be routinely transmitted via aerosols, though other routes of transmission (such as large droplets being emitted during singing or speech) are still possible explanations. in the 2003 sars outbreak, aerosol transmission occurred during hospital procedures that generated large volumes of aerosols, such as intubation. contact transmission there's one other route that's thought to play a role in the spread of covid-19: contact transmission. in that situation, viral particles emitted from the respiratory tract of an infected individual land on a surface. then, another person touches that object, then touches their nose, mouth or eyes. the virus then sneaks into the body via the mucous membranes, infecting the second person. so far, no one knows how common this mode of transmission is, but it does seem to be possible. one study found that sars-cov-2 could remain viable on surfaces such as cardboard for up to 24 hours, and on plastic and steel for 2 to 3 days. santarpia has studied viral surface contamination in the context of patients hospitalized with covid-19 at the university of nebraska medical center. in that study, which was published march 26 on the preprint database medrxiv , santarpia and his colleagues found viral contamination in air samples, on surfaces such as toilets, and on frequently touched surfaces. also on march 26, the cdc published a report on the coronavirus-stricken diamond princess cruise ship. an investigative team found traces of rna from sars-cov-2 on surfaces throughout the cruise ship, in the cabins of both symptomatic and asymptomatic infected passengers, up to 17 days later - though no evidence suggests this viral rna was still infectious. (sars-cov-2 is an rna virus, meaning its main genetic material is rna, not dna .) another case report published by the cdc - this time from singapore - also suggests contact with contaminated surfaces can transmit the virus. in that case, a person who was infected with sars-cov-2, but not yet symptomatic, attended a church service. later in the day, another person sat in the same seat, and also came down with covid-19. whether the virus was contracted via a contaminated surface, or potentially a lingering aerosol, however, couldn't be ascertained. is food safe? so far, there's no evidence that the virus is transmitted via food. the virus will not live long in food proper, and while it's possible that food packaging from groceries or takeout could contain small concentrations of virus particles, it is easy to mitigate this risk by washing your hands after handling groceries or takeout, ben chapman, a professor and food safety specialist at north carolina state university, previously told live science . related: how to shop for groceries during the covid-19 pandemic the takeaway? the fact that so many seemingly innocuous activities can transmit the virus can be scary. and it can be even scarier not knowing the actual risks associated with each transmission route - without that information, how can we take the right steps to protect ourselves? but ultimately, there's some reassurance in the data as well. ""what is true is that persons who have a member of their household infected with the virus have a higher probability of getting infected with covid than people who do not have a member of their household infected. this tells us a lot. this tells us that close contact is the most important factor,"" martin said. briefly passing a person on the street, at a distance of 6 feet, is likely to pose a low risk of infection, martin said. chatting at a distance of 6 feet with that same person for a few hours will be higher risk, he said. ultimately, social distancing is a powerful tool to cut all the hypothesized routes of transmission, experts said. ""if the other person is shedding virus into the air, the longer you stand near them, the greater the chance you have to be exposed to the virus,"" linsey marr, who studies the transport of air pollutants in the department of civil and environmental engineering at virginia tech, told live science. live science editor-in-chief jeanna bryner and staff writer yasemin saplakoglu contributed reporting to this article."
13	"covid-19 may spread through breathing and talking — but we don't know how much | live science text extraction from html file; language identification https://elrc-share.eu under review 2020 covid-19 may spread through breathing and talking — but we don't know how much | live science text/html https://www.livescience.com/covid19-coronavirus-transmission-through-speech.html en_2020_04_5524.xml_194.html covid-19 may spread through breathing and talking - but we don't know how much speech-related spread could help explain why people can spread the virus before they develop a cough. shares - can people spread the coronavirus after they recover? people infected with covid-19 may spread the disease when they speak and breathe, not only when they let out a hearty cough. although these modes of transmission could help to explain how asymptomatic and mildly infected people fuel the virus' spread , researchers don't yet know whether tiny particles expelled in breath infect more people than large droplets spewed through coughs, experts told live science. ""there's a possibility"" that covid-19 primarily spreads via fluid particles less than 0.0002 inches (5 microns) in diameter, known as aerosols , which can be emitted when people speak, said william ristenpart, a professor of chemical engineering at university of california, davis. ""we just don't know,"" he said. related: live updates on covid-19 what about coughing? the world health organization still states that covid-19 spreads mostly through direct contact with infected people and with infected large respiratory droplets, which measure more than 0.0002 inches in diameter. the hefty droplets fly from a person's mouth when they cough or sneeze, falling to the ground by the time they've traveled only a few feet. however, mounting evidence suggests that aerosols may spur transmission more than once thought, and these smaller particles ""can remain aloft for a considerable amount of time,"" on the order of hours, said jeffrey shaman, an epidemiologist and head of the climate and health program at columbia university in new york city. in one anecdotal account, dozens of choir members contracted covid-19 after a rehearsal, despite members not reporting symptoms and keeping their distance from each other throughout rehearsal, the los angeles times reported . in a study published in march in the new england journal of medicine , researchers described how aerosolized coronavirus particles can remain viable for up to three hours in the air, meaning they could infect a person hours after being expelled. shaman noted that the study authors sampled the air for just three hours, meaning the virus could potentially remain viable for longer. until scientists learn more about the true viability of the virus in a variety of settings and conditions, they have to consider all potential routes of transmission in their attempts to slow transmission, he added. that means people should maintain strict social distancing and wear a mask when out, even if you don't feel ill. ""you have this issue where people are unwittingly spreading the virus around,"" shaman told live science. even imperfect homemade masks likely disrupt the movement of droplets and aerosols exiting your mouth, he said. ""i would suspect that masks help."" evidence for spread through speech the notion that the novel coronavirus sars-cov-2 might be ""airborne"" has been a point of contention throughout the pandemic , the journal nature reported . evidence suggests that the related virus sars-cov, which triggered outbreaks of severe acute respiratory syndrome in the early 2000s, likely spread through aerosols but only in health care settings and other specific scenarios, live science previously reported . but from the start of the covid-19 pandemic, ""people were getting up and saying definitively"" that the disease mostly transmits through respiratory droplets, shaman said. related: 20 of the worst epidemics and pandemics in history in reality, no one knew that for sure, he said. ""we don't observe the transmission process … we actually don't know how respiratory diseases are transmitted,"" shaman said. while scientists understand the various routes by which respiratory viruses can enter the body, determining which route a pathogen prefers can be incredibly difficult, ristenpart added. although scientists have studied influenza for decades, its primary route of transmission remains a mystery, he said. that said, evidence does suggest that people emit aerosols while they speak and that the particles can shuttle viral material between hosts. ""the basic idea that speech releases aerosol particles has been known for decades,"" ristenpart told live science. however, even within the medical community, speech often isn't acknowledged as a potential conveyer of infectious pathogens, he added. many particles emitted through speech measure only a micron across, rendering them invisible to the naked eye. ""when you sneeze, you see a spray,"" which may bias people towards thinking that respiratory droplets contribute heavily to spread, he said. related: 10 deadly diseases that hopped across species though less obvious than a wet sneeze, aerosols are still large enough to carry pathogens like the measles virus, influenza viruses and mycobacterium tuberculosis, and they can be generated through speech in several ways, ristenpart said. mucus-like fluid that clings to thin blood vessels in the lungs can break off in droplets as people inhale and exhale, according to a 2011 study in the journal of aerosol science , and the same can happen as the vocal cords vibrate, snapping open and closed to generate different sounds. people also expel ""spittle"" from their mouths as they speak, ristenpart said. both breath and speech generate aerosols in these ways, but speech can generate about 10 times more aerosols than breathing alone, according to a 2009 report in the same journal . in a 2019 study in the journal nature scientific reports , ristenpart and his colleagues investigated how many of these tiny particles people let off in a normal conversation; they found that people expel between one and 50 aerosol particles per second as they speak, depending on their volume, or how loud they speak. a follow-up study published in january in the journal plos one revealed that certain units of sound generate more aerosols than others; for example, the ""e"" sound in ""need"" produces more particles than the ""a"" in ""saw."" but still, the sheer volume of a person's voice acts as the main determinant of whether someone emits many particles or few. ""the take-home message there is that the louder you speak, the more aerosol particles are generated,"" ristenpart said. certain individuals are so-called speech superemitters and give off about 10 times the number of particles as others, on average, although the reason remains unknown. in the context of covid-19, superemitters could potentially act as superspreaders, releasing thousands of infectious particles into the surrounding air in a matter of minutes. ""a 10-minute conversation with an infected, asymptomatic superemitter talking in a normal volume thus would yield an invisible 'cloud' of approximately 6,000 aerosol particles,"" ristenpart wrote in a report published april 3 in the journal aerosol science and technology . at this point, however, we don't know how infectious that aerosolized cloud might be, he said. many unknowns to determine how speech and breathing contribute to covid-19 transmission, scientists must learn how much virus the average aerosol contains and how much virus one must inhale to become infected, ristenpart wrote in aerosol science and technology. tracking how the aerosols move in different environments, when subjected to different air flows, would also provide key clues about the risk of transmission, he noted. for instance, a turbulent air flow could carry an infectious cloud far away from the original speaker, but could also dilute the viral concentration to a relatively harmless level, he wrote. future research could also address how varying levels of humidity, wind and heat affect aerosols and the viruses held within them, shaman said. more practically, until scientists can resolve these unknowns, ""the need is to just distance ourselves so we can get everything in order right now,"" he added. while the role of speech-generated aerosols in covid-19 transmission remains hypothetical, for now, ""unfortunately, i haven't seen any data that's inconsistent with that hypothesis,"" ristenpart said."
13	"to curb coronavirus, what’s behind the wearing of a mask? text extraction from html file; language identification https://elrc-share.eu under review 2020 to curb coronavirus, what’s behind the wearing of a mask? text/html https://www.news-medical.net/news/20200407/to-curb-coronavirus-whate28099s-behind-the-wearing-of-a-mask.aspx coronavirus breathing health care pandemic public health running virus en_2020_04_5492.xml_92.html to curb coronavirus, what's behind the wearing of a mask? download pdf copy reviewed by emily henderson, b.sc.apr 7 2020 the centers for disease control and prevention on friday recommended wearing cloth face masks when going out, especially to places like grocery stores and pharmacies. that's because a ""significant portion"" of people with the virus lack symptoms or can transmit the disease through close contact before they show signs of illness, the cdc said. it is not recommending people try to purchase n95 or surgical masks, and the federal agency included online instructions on making masks out of materials at home. the recommendation is optional. president donald trump, for instance, said he didn't envision wearing one . but in recent days, the number of people sporting some type of protective face gear appears to have soared. so what gives? many experts agree that wearing a mask probably won't keep people from getting the coronavirus, but it might help prevent those with the disease - especially those without symptoms - from spreading it. the cdc's announcement - which came after days of deliberation among white house officials, the coronavirus task force and other public health figures about the need for such a guideline - brings with it caution. first, masks could give people a false sense of security. ""we don't want people to feel like, 'oh, i'm wearing a mask. i'm protected and i'm protecting others,'"" said dr. deborah birx, during a white house briefing last week before the cdc issued its recommendation. birx, a member of the president's coronavirus task force, made clear that wearing a mask would not replace the need for frequent hand-washing and continued social distancing. another concern is that the recommendation could further strain the supply of medical-grade masks for health care workers, if consumers flooded the market to get their hands on one. earlier statements from u.s. officials downplayed the use of face masks in public, in part for this reason. but those messages ran counter to what other countries - particularly in asia - have recommended or required. face masks have been ubiquitous in countries such as china, south korea and japan during the outbreak. before the cdc recommendation, residents in some hard-hit american cities, such as los angeles and new york, were encouraged to wear masks in public. riverside county in southern california mandated it. another issue: homemade masks - and some store-bought ones - don't fit as tightly as medical masks. ""virus can sneak around the edges,"" said melissa perry, a professor of environmental and occupational health at george washington university in washington, d.c. there's also the matter of the fabric. ""what i see are people buying masks on the web that are fashionable, but the fabric is thin,"" said john lednicky, an aerovirologist at the university of florida, who studies how viruses spread through the air. ""if the weave is not tight enough, the virus will go right through them."" still, he said, a homemade mask ""is better than nothing"" if it could block some particles expelled by an infected person. but he cautioned that a mask protects only the nose and mouth areas. another route of transmission is through the eyes. so, again, don't touch your face or rub your eyes if possible. might eyeglasses add protection from particles? ""there's some protection from eyeglasses, but there's a lot of space around eyeglasses, so air currents can still hit your eyes,"" he said. and one more caution: ""when putting it on and taking it off, you have to be careful. you might end up getting virus all over your hands,"" said marcus plescia, chief medical officer with the association of state and territorial health officials. ""discard it carefully."" if it's made of fabric, wash it. if it's paper or some other material, put it in a sealed plastic bag and throw it away. wash your hands after. transmission out of thin air? researchers are debating whether simply talking or breathing can send tiny virus particles airborne - and whether those bits would be in great enough quantity to allow for transmission to another person. related stories study suggests natural uv radiation protects against coronavirus this critical question has no clear answer. no doubt a cough or sneeze can shoot out droplets several feet, but those are relatively large and heavy and quickly fall to the ground, researchers say. still, that's a main route of transmission because the droplets can either land on a close contact - defined by the world health organization as within 1 meter - or fall on surfaces, which other people then touch, possibly picking up the virus. staying 6 feet away from others and washing your hands a lot helps reduce the risk packed by droplets. but what about smaller particles - those aerosols created simply by exhaling that can float in the air longer? evidence is not clear. a special panel last week released a report reviewing studies from the u.s. and china, raising the possibility of airborne transmission. the studies' findings suggest that normal breathing can release aerosolized virus, according to the letter from a special pandemic committee at the national academy of sciences to the head of the white house's office of science and technology policy. but, the committee added, ""one must be cautious,"" because what the studies found may not represent ""viable virus in sufficient amounts to produce infection."" the who , in a march 20 report, took a more cautious approach, saying there isn't enough information to say such tiny particles are airborne outside of medical settings. aerosols containing the virus can occur during some medical procedures, such as ventilating a patient, the who said, which puts health care workers at risk. further study is needed, the report concluded, to see if the virus shows up in air samples in patient rooms where no such procedures took place and ""whether viable virus is found and what role it may play in transmission."" given the uncertainty, the bottom line, lednicky and others said, is to avoid close contact and take other reasonable protective steps. masks are good to ensure that you are not transmitting the virus to others. but don't forget about that 6-foot zone of personal space. how does this translate to everyday life? experts agree that in the midst of this pandemic - while people are encouraged to stay at home and isolate - it's still important for physical and mental health to get exercise by walking or running. but what happens when you cross paths with another person, who may not be wearing a mask? ""more distance is better no matter what,"" said dr. georges benjamin, executive director of the american public health association, who said there is only a small likelihood that you are running through a mist that might contain the virus. ""if you want to hold your breath [while passing near others], fine, but it's probably not necessary,"" he said. and then there's your neighbor's friendly dog. researchers don't believe pets can transmit the disease. still, to protect the pet, they suggest that those who are sick to avoid caring for or sharing their food with the animal, said benjamin. because keeping a proper distance from your neighbor is also key, it might be a good idea to skip the dog-petting. ""i would just say 'hi' right now,"" said benjamin. overall, most health officials appear to consider masks a good idea. but they agree on three constants in this quickly changing matter: keep your distance from others outside your household. wash your hands - often. and don't touch your face. this article was reprinted from khn.org with permission from the henry j. kaiser family foundation. kaiser health news, an editorially independent news service, is a program of the kaiser family foundation, a nonpartisan health care policy research organization unaffiliated with kaiser permanente."
14	"coronavirus: fears dogs and cats could be 'super spreaders' as virologist questions safety | uk | news | express.co.uk text extraction from html file; language identification https://elrc-share.eu under review 2020 coronavirus: fears dogs and cats could be 'super spreaders' as virologist questions safety | uk | news | express.co.uk text/html https://www.express.co.uk/news/uk/1265758/coronavirus-uk-news-pet-owners-risk-animals-covid-19-cases-number-latest-bbc-chris-smith en_2020_04_4620.xml_61.html at this difficult time for frontline doctors and nurses, sign up here to show your support now to our brave nhs heroes . coronavirus warning: pet owners at risk of infection from potential animal super-spreaders (image: bbc) coronavirus uk news pet owners risk animals covid (image: bbc) he continued: ""it's thought that puppy caught it from its owner. ""so we're pretty comfortable that animals might catch this. ""what we don't know is if this is a two-way street. ""if it goes into the dog, can the dog or the cat or whatever else catches it, then give it back to its owner or another owner or a family member?"" coronavirus uk news pet owners risk animals covid (image: bbc) the virologist said: ""we don't know how infectious these animals are yet, we just know that potentially they could become infected. ""it is an important question though because when it comes to infection control, we may keep our social distance but cats, as well all know if you've ever owned one, go roaming from one house to another and dogs go and sniff everything they possibly can. ""so they could end up being vectors or super-spreaders for this."" don't miss reduce chances of catching coronavirus (image: express) trending dr smith added: ""these are important questions that we're going to have to answer quite soon."" ron kennedy from glasgow also submitted a question, asking if humans are at risk of infection from our own cats and dogs. dr smith told the bbc: ""potentially yes, and that's where the issue lies. ""at the moment, people are doing these tests, they can prove that the animals potentially are getting infected. ""what we don't know is if they are sufficiently infectious to secrete the virus back into the environment, back into the air or in licks and kisses they give their owners and potentially transmit it back in the other direction."" related articles"
14	moment vile thug arrested after claiming he was coronavirus 'super spreader' and coughing at police - birmingham live text extraction from html file; language identification https://elrc-share.eu under review 2020 moment vile thug arrested after claiming he was coronavirus 'super spreader' and coughing at police - birmingham live text/html https://www.birminghammail.co.uk/news/midlands-news/moment-vile-thug-arrested-after-18056369 coronavirus en_2020_04_5218.xml_101.html news moment vile thug arrested after claiming he was coronavirus 'super spreader' and coughing at police christopher mckendrick, 58, was stopped after members of the public reported seeing him waving a 2ft plank of wood above his head share james rodger head of trends 13:17, 7 apr 2020 latest news straight to your inbox subscribe when you subscribe we will use the information you provide to send you these newsletters. sometimes they'll include recommendations for other related newsletters or services we offer. our privacy notice explains more about how we use your data, and your rights. you can unsubscribe at any time. thank you for subscribingwe have more newsletters show me see our privacy notice invalid email this is the moment a vile oddball was arrested after he told police he was a covid-19 “super spreader” - before coughing at them. christopher mckendrick, 58, was stopped after members of the public reported seeing him waving a 2ft plank of wood above his head. police dashed to the canal towpath in swarkestone, south derbys., after he threatened people exercising at 3.30pm last thursday (2/4). but when officers approached him and asked if he had coronavirus, he replied: “i've already had it, i've got over it and now i am a super spreader so…”. shockingly, he then coughed in the direction of three officers before being arrested. read more
14	moment vile thug arrested after claiming he was coronavirus 'super spreader' and coughing at police - birmingham live text extraction from html file; language identification https://elrc-share.eu under review 2020 moment vile thug arrested after claiming he was coronavirus 'super spreader' and coughing at police - birmingham live text/html https://www.birminghammail.co.uk/news/midlands-news/moment-vile-thug-arrested-after-18056369 coronavirus en_2020_04_5344.xml_8.html news moment vile thug arrested after claiming he was coronavirus 'super spreader' and coughing at police christopher mckendrick, 58, was stopped after members of the public reported seeing him waving a 2ft plank of wood above his head share james rodger head of trends 13:17, 7 apr 2020 latest news straight to your inbox subscribe when you subscribe we will use the information you provide to send you these newsletters. sometimes they'll include recommendations for other related newsletters or services we offer. our privacy notice explains more about how we use your data, and your rights. you can unsubscribe at any time. thank you for subscribingwe have more newsletters show me see our privacy notice invalid email this is the moment a vile oddball was arrested after he told police he was a covid-19 “super spreader” - before coughing at them. christopher mckendrick, 58, was stopped after members of the public reported seeing him waving a 2ft plank of wood above his head. police dashed to the canal towpath in swarkestone, south derbys., after he threatened people exercising at 3.30pm last thursday (2/4). but when officers approached him and asked if he had coronavirus, he replied: “i've already had it, i've got over it and now i am a super spreader so…”. shockingly, he then coughed in the direction of three officers before being arrested. read more
18	council of chief medical officers of health communication: use of non-medical masks (or facial coverings) by the public | markets insider text extraction from html file; language identification https://elrc-share.eu under review 2020 council of chief medical officers of health communication: use of non-medical masks (or facial coverings) by the public | markets insider text/html https://markets.businessinsider.com/news/stocks/council-of-chief-medical-officers-of-health-communication-use-of-non-medical-masks-or-facial-coverings-by-the-public-1029073594 en_2020_04_5623.xml_67.html council of chief medical officers of health communication: use of non-medical masks (or facial coverings) by the public press release pr newswire apr. 7, 2020, 11:10 pm ottawa, april 7, 2020 /cnw/ - canadian public health guidance related to covid-19 has been changing as the evidence base and our understanding of covid-19 is rapidly evolving. we are continually looking at the evidence as it is being produced and working with our partners across the country and around the world to learn more. now that more countries have had large numbers of cases and have analysed transmission patterns, recent studies provide evidence that transmission of the virus can happen from infected people-before they develop symptoms. we refer to this as pre-symptomatic transmission. there is also evidence that some infected people who never develop symptoms are also able to transmit the virus. this is called asymptomatic transmission. we do not know how much of a role pre-symptomatic and asymptomatic transmission play in driving this epidemic at this time-but we know that it is occurring among those with close contact or in close physical settings. while the primary driver of the global pandemic of covid-19 has been individuals with visible symptoms (coughing and respiratory droplets are key ways the virus is spread), evidence of asymptomatic or pre-symptomatic transmission points to the importance of everyone, even those who feel fine, following the proven methods of preventing transmission. to prevent transmission of covid-19 here is what we know is proven: staying home as much as possible physical distancing protecting the most vulnerable from infection and exposure to others covering your cough with tissues or your sleeve it is critical that these measures continue. healthcare workers need medical masks, including surgical, medical procedure masks and respirators such as n95 masks. it is extremely important that we keep the supply of medical masks for healthcare workers where it is urgently needed for medical procedures and to care for individuals who have covid-19. wearing a non-medical mask (e.g., homemade cloth mask) in the community has not been proven to protect the person wearing it. however, the use of a non-medical mask or facial covering can be an additional measure you can take to protect others around you. wearing a non-medical mask is another way of covering your mouth and nose to prevent your respiratory droplets from contaminating others or landing on surfaces. a cloth mask or face covering can reduce the chance that others are coming into contact with your respiratory droplets, in the same way that our recommendation to cover your cough with tissues or your sleeve can reduce that chance. for short periods of time when physical distancing is not possible in public settings (e.g., grocery shopping, in close settings such as public transit), wearing a non-medical mask is one way to protect those around you. non-medical masks or facial coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance. with the emerging information regarding pre-symptomatic and asymptomatic transmission, and our goal to stop the spread of covid-19 by all means possible, wearing a non-medical mask-even if you have no symptoms-is an additional measure you can take to try to protect others around you. if wearing a non-medical mask makes you feel safer and stops you from touching your nose and mouth, that is also good. remember not to touch or rub your eyes as that is another route of infection. wearing a non-medical mask when in public or other settings is not a replacement for following proven measures such as hand washing and physical distancing. canadians need to understand exactly what wearing a mask will achieve, and that if they choose to wear non-medical masks they need to be used safely. the website canada.ca/coronavirus is updated with information on the measures you should take, such as hand washing, when putting a mask on or taking it off. there is also information on how to wash cloth masks or safely dispose of other non-medical masks (such as dust masks). if you choose to use a non-medical mask, it should be well-fitted (non-gaping). people should also be aware that masks can become contaminated on the outside or when touched by hands. avoid moving the mask around or adjusting it often. also, masks should not be shared with others. the bottom line is that medical masks must be preserved for healthcare workers. please remember that non-medical masks will not prevent covid-19 spread without consistent and strict adherence to good hygiene and public health measures, including frequent handwashing and physical distancing. wearing a non-medical mask in the community does not mean you can back off the public health measures that we know work to protect you; no mask will ever replace physical distancing. we want to emphasize that all of the recommendations regarding staying home, physical distancing, and hand hygiene are based on what we know will work best to protect you and your family from infection. source public health agency of canada markets insider and business insider editorial teams were not involved in the creation of this post.
18	save a mask for future proper use | the chronicle text extraction from html file; language identification https://elrc-share.eu under review 2020 save a mask for future proper use | the chronicle text/html https://www.chronicle.co.zw/save-a-mask-for-future-proper-use/ en_2020_04_897.xml_135.html save a mask for future proper use 02 apr, 2020 - 00:04 the chronicle noel munzabwa, chronicle correspondent since the outbreak of covid-19 recently, there has been a rational upsurge in consumption and a panic-inspired irrational medical face mask fashion craze. even on public transport, the mask has become a common sight. for many it seems a noble way of protection against the novel coronavirus which causes covid-19. but for a pharmaceutical mind, this common sight on our streets and on our public transport system represents wastage of critical protective material at a time of need. in my two decades of pharmaceutical practice, for even five minutes of prescribed use, being an asthmatic, a mask has presented discomfort and difficulty in breathing. how much more for these day long users? even worse for three of my fellow passengers on a 300-kilometre bus journey between johannesburg, south africa and mbabane, eswatini a few weeks ago. some of us are in panic mode. that is understandable because of the covid-19 pandemic. i have seen this panic all around, even from my own daughter. through what she has read online, watched on television or heard from various radio stations she is totally in a panic mode. she has justifiably introduced the hand sanitizer and just the other day she tried to force a face mask on me. not to hurt her i had to find a polite way to show reluctance which was equally met by a forced self quarantine threat. she is not alone in this panic, there are hundreds if not thousands others out there in those medical face masks. is it an informed use, called rational use in pharmaceutical language or just panic use bordering on fear laced up with inadequate information, called irrational use? the latter sounds loudly true. are those people roaming around the streets coughing and/or sneezing; or are they either health providers or caregivers - some of the prescribed and rationale use of face masks? the world health organization (who) on the 19th of march published a paper, “advice on the use of masks in the community, during home care, and in health care settings in the context of covid-19.” the paper states that wearing a medical mask is one of the prevention measures that can limit the spread of certain respiratory diseases, including covid-19. however, the use of a mask alone is insufficient to provide an adequate level of protection, thus other measures should also be adopted. if masks are used, they must be combined with hand hygiene and other infection prevention and control (ipc) measures to prevent human-to-human transmission of covid-19. who has developed guidance for home care and health care settings on ipc strategies for use when covid-19 is suspected. wearing medical masks when not indicated may result in unnecessary costs and procurement burdens and create a false sense of security that can lead to the neglect of other essential measures, such as hand hygiene practices, who said. further, using a mask incorrectly may hamper its effectiveness in reducing the risk of transmission. the document sought to provide rapid advice on the use of medical masks in communities, at home, and in health care facilities in areas that have reported outbreaks of covid-19. it is intended for public health and ipc professionals, health care managers, health care workers, and community health workers. it will be revised as more data become available. current information suggests that the route of human-to-human transmission of covid-19 is either via respiratory droplets or contact. any person who is within one metre (in close contact) of someone who has respiratory symptoms (e.g. sneezing, coughing, etc.) is at risk of being exposed to potentially infective respiratory droplets. a medical mask is not required for people who are not sick as there is no evidence of its usefulness in protecting them. however, masks might be worn in some countries, in accordance with local cultural habits. but is there any cultural link to this current misuse? a big no. if masks are used, best practices should be followed about how to wear, remove, and dispose of them, and for hand hygiene after removal. wearing a medical mask is one of the prevention measures that can limit the spread of certain respiratory diseases, including covid-19. however, the use of a mask alone is insufficient to provide an adequate level of protection, and other measures should also be adopted. if masks are used, they must be combined with hand hygiene and other infection prevention and control measures to prevent human-to-human transmission of covid-19. here are the guidelines on medical face mask usage as prescribed world health organisation if you are healthy, you only need to wear a mask if you are taking care of a person with suspected 2019-ncov infection. wear a mask if you are coughing or sneezing. masks are effective only when used in combination with frequent hand-cleaning with alcohol-based hand rub or soap and water. if you wear a mask, then you must know how to use it and dispose of it properly. when and how to wear medical masks to protect against coronavirus - before putting on a mask, clean hands with alcohol-based hand rub or soap and water. - cover mouth and nose with mask and make sure there are no gaps between your face and the mask. - avoid touching the mask while using it; if you do, clean your hands with alcohol-based hand rub or soap and water. - replace the mask with a new one as soon as it is damp and do not re-use single-use masks. - to remove the mask: remove it from behind (do not touch the front of mask); discard immediately in a closed bin; clean hands with alcohol-based hand rub or soap and water. - save a mask for future proper use. noel munzabwa is a pharmacy technician with more than 20 years of experience. - @noelmunzabwa share this:
18	"gbh_logo_purple_rgb text extraction from html file; language identification https://elrc-share.eu under review 2020 gbh_logo_purple_rgb text/html https://www.pri.org/stories/2020-04-01/will-us-ever-mimic-asia-s-culture-universal-masking en_2020_04_792.xml_143.html covid-19: the latest from the world will the us ever mimic asia's culture of ‘universal masking'? across much of asia, masks are considered an essential weapon in the war against the new coronavirus. should americans follow suit? listen to the story. <iframe frameborder=""0"" src=""https://www.pri.org/node/184971/embedded"" height=""50"" width=""100%""></iframe> a doctor wears a protective mask as he walks outside mount sinai hospital in manhattan during the outbreak of the coronavirus disease (covid-19) in new york, april 1, 2020. credit: brendan mcdermid/reuters share having fended off the first surge of covid-19 cases, asian health officials are now looking over at a virus-ravaged us and asking: shouldn't more americans wear surgical masks? china's top virologist, george gao, is one of them. educated at both harvard and oxford universities, and now heading the chinese center for disease control and prevention, he was recently asked to lend advice to other nations. “the big mistake in the us and europe, in my opinion, is that people aren't wearing masks.” george gao, virologist, china “the big mistake in the us and europe, in my opinion,” gao told science magazine , “is that people aren't wearing masks.” across much of asia, masks are considered an essential weapon in the war against the new coronavirus. nations and territories such as south korea, hong kong and taiwan promote “universal masking” - the idea that everyone in public should be masked up, even if they feel perfectly fine. as in the us, officials in parts of asia were initially caught off guard and faced a shortage of surgical masks. but unlike america, the taiwanese and south korean governments quickly intervened to boost the supply of masks - propelled by a conviction that universal masking really helps. that belief is not widespread in the us, where the surgeon general says putting the masses in masks makes the virus spread faster. as us surgeon general dr. jerome adams told fox and friends , “folks who don't know how to wear them properly tend to touch their faces a lot and can actually increase the spread of coronavirus.” seriously people- stop buying masks! they are not effective in preventing general public from catching #coronavirus , but if healthcare providers can't get them to care for sick patients, it puts them and our communities at risk! - u.s. surgeon general (@surgeon_general) february 29, 2020 at the moment, with american hospitals pleading with the federal government for more high-grade masks, universal masking would be difficult to execute in the us. but as the virus spreads, should america make it a priority to put everyone in masks - at least those in crowded environments? related: how the world bank group is helping developing countries respond to covid-19 there are studies - such as one published by the national institutes of health - suggesting masks help prevent an infected person from spreading the coronavirus, especially if it's a high-grade, n95 mask. a paper published in peer-reviewed journal, the lancet , suggests universal masking can be effective “if supplies permit.” yet, the world health organization continues to assert that masks are not needed for anyone who does not show symptoms. (the centers for disease control and prevention, after having issued similar opinions, is reconsidering the question. ) what many fail to grasp is that masks are more about “preventing the spread of disease rather than preventing getting the disease,” said linfa wang, a leading infectious disease expert. he heads a research team jointly run by duke university and the national university of singapore. the point of universal masking, wang says, is to cover the faces of people who are infected but don't yet know it. many people carrying the new coronavirus are oblivious that they spread viral droplets each time they open their mouths. yet, if they follow who guidelines, they wouldn't put on a mask until symptoms arise. “if every citizen can abide by that rule, that's a good thing. but i know that, in certain societies, it's hard, right? people are less educated or economically at a different stage. or less obedient as a society.” linfa wang, infectious disease expert, duke university and the national university of singapore thus the imperative, wang says, to slap a mask on everyone. “if every citizen can abide by that rule, that's a good thing,” wang said. “but i know that, in certain societies, it's hard, right? people are less educated or economically at a different stage. or less obedient as a society.” related: madrid's health system under duress as ice rink turns into morgue “if your prime minister says ‘wear a mask,' but only two out of 10 sick people follow the advice,” he said, “then the society will be in trouble.” masks are far from foolproof and all masks are not created equal. a snug-fitting n95 mask - which is supposed to filter out 95% of incoming particles - is far superior to one made of cotton. in fact, who says cloth masks “are not recommended under any circumstances.” whether cotton masks are better than nothing is debated. one study suggests cloth masks - which grow moist from breath - hardly filter out any particles at all and “may result in increased risk of infection.” yet, the cdc is considering urging americans to wear cloth masks in public; there are too few n95 masks available even for front-line health care workers. “the outside of your mask may be enriched with viral particles so, when you're taking it off - if you're not careful - you can get an infection.” linfa wang, infectious disease expert, duke university and the national university of singapore even the best masks require careful handling and an educated public. echoing the us surgeon general's fears, wang said, “the outside of your mask may be enriched with viral particles so, when you're taking it off - if you're not careful - you can get an infection.” still, he says, an informed public can learn to handle masks properly and benefit from their mass adoption. before the united states can consider universal masking, it will first have to satisfy hospitals' urgent needs for n95 masks - and then import or produce enough masks to outfit the general public (or at least those living in crowded areas). related: combat in the world's biggest conflict areas not slowing down despite covid-19 then, american health care officials would need to absorb the advice coming from their peers in south korea and china. but in a crisis, societies are capable of changing habits quickly. another infectious disease expert, joseph tsang , has joined the chorus of asian specialists urging americans to consider universal masking. he hopes the us can overcome cultural barriers, such as the intimation that anyone in a surgical mask must be ill. tsang points out that even in hong kong - where walking the streets unmasked is now taboo - it was also once unusual to see crowds with their faces covered. then came a previous coronavirus - sars (severe acute respiratory syndrome) - that hit in 2003. before long, the popularity of masks exploded. “that changed everything for us,” tsang said. “we've learned those painful lessons already … and we all know to be vigilant with wearing masks to stop that painful experience from happening again.” want a seat at the table? every morning, the editorial team at public radio's international news show the world meets to plan what they'll cover that day. want to see what's on deck? sign up for our daily newsletter top of the world and get the big stories we're tracking delivered to your inbox every weekday morning. categories:"
19	household cleaning products that kill covid-19: 5 to buy and use text extraction from html file; language identification https://elrc-share.eu under review 2020 household cleaning products that kill covid-19: 5 to buy and use text/html https://www.inverse.com/mind-body/cleaning-products-that-kill-covid-19 en_2020_04_3646.xml_1.html household cleaning products that kill covid-19: 5 to buy and use lena ciric 4.5.2020 11:29 am covid-19 has only been around for a few months, so at this point, scientists don't know that much about it. but more is being learned every day. we now know, for example, it can live on surfaces for up to nine days and survives in the air for a few hours . we also now know that the virus particles are shed through saliva and fluids coughed up from the lungs. and that the virus can also be shed from our feces . it's easy for an infected person to spread the virus particles through coughing, touching other people or leaving the virus on surfaces. undoubtedly, hand-washing after being in public spaces is key to reduce the spread of covid-19 . but what should we be doing in our homes to eliminate it? two recent studies have investigated how long coronaviruses survive on different surfaces. the research looked at a number of different viruses including sars-cov-2 - the coronavirus that has caused covid-19 . and it found that the survival times varied according to the type of surface. the virus survived for longest on stainless steel and plastic - for up to nine days . the shortest survival times of one day was for paper and cardboard. table of time surviving in air and on surfaces. lena ciric the amount of virus particles during this time does reduce, but it's worrying that the particles can last for days rather than hours or minutes on a surface. so, how good are the cleaning products already in your cupboards at killing sars-cov-2? there is some good news in the list below. 5. soap and water soap and water are your first line of defense to remove the virus from surfaces. soap interferes with the fats in the virus shell and lifts the virus from surfaces and this is then rinsed off by water. of course, you also need to wash your hands when you come in from the shops and wash your food as normal. 4. bleach the active ingredient in bleach - sodium hypochlorite - is very effective at killing the virus. make sure you leave the bleach to work for 10-15 minutes then give the surface a wipe with a clean cloth. the bleach works by destroying the protein and what's known as the ribonucleic acid (rna) of the virus - this is the substance that gives the blueprint for making more virus particles when you become infected. be sure to use the bleach as directed on the bottle. 3. surgical spirit surgical spirit is mostly made up of alcohol ethanol. ethanol has been shown to kill coronaviruses in as little as 30 seconds . like bleach, the alcohol destroys the protein and rna that the virus is made up of. moisten a cloth with some neat surgical spirit and rub it over a surface. this will evaporate and you will not need to wipe it off. target your home's high-touch surfaces. stock-asso/shutterstock 2. surface wipes the active ingredient in surface wipes in an antiseptic -- usually benzalkonium chloride. the wipes work by physically removing germs through the pressure you apply when you use them, and the germs then attach to the wipe. they also leave a layer of the antiseptic on the surface that works to kill germs. the antiseptic works well on bacteria as well as on coronaviruses that infect mice and dogs - but it seems to make no difference to the spread of human coronavirus . antiseptics work by disrupting the fats in pathogen cells, but sars-cov-2 does not contain many fats. so far, there is no evidence that antiseptics can kill human coronaviruses. 1. hand sanitizers a word of warning though about hand sanitizers . the main ingredient in hand sanitizers that will kill sars-cov-2 is ethanol, the alcohol in the surgical spirit. but its concentration in the sanitizer is very important -- it has to be over 70 % or it will not kill the virus effectively. one thing you can also do is make sure you air out the spaces you are spending time in regularly. an infected person will produce thousands of tiny droplets that contain the virus every time they cough. sars-cov-2 can survive in the air for up to three hours . so by opening the window, you can remove and disperse the droplets and reduce the amount of virus in the air - which will reduce the risk of infection for others. we are living in uncertain times but it's reassuring to know that we have some weapons we can use to fight covid-19 in our homes. the bottom line: keep washing your hands, use 70% hand sanitizer, dust off the bleach and open a window to let in the spring air. this article was originally published on the conversation by lena ciric at ucl. read the original article here . related tags
19	how can sanitizer be dangerous? | thehealthsite.com text extraction from html file; language identification https://elrc-share.eu under review 2020 how can sanitizer be dangerous? | thehealthsite.com text/html https://www.thehealthsite.com/news/coronavirus-live-update-in-depth-dont-burn-yourself-while-using-a-hand-sanitizer-737554/ en_2020_04_4268.xml_55.html also read - loss of smell and taste in covid-19 patients is profound but recovery rate is higher too what makes a hand sanitizer inflammable? the ethyl alcohol content of hand sanitizers is quite high, around 62 per cent. this is an extremely inflammable chemical. so, is it okay to switch to non-alcohol-based sanitizers to keep ourselves safe from covid-19 and fire? unfortunately, no. experts are of the opinion that they aren't effective. moreover, non-alcohol based hand sanitizers comprise of an antibiotic element called triclosan which is also said to be dangerous for our health. various studies on the component are still in progress. what precautions should be taken? you need to be cautious while using a hand sanitizer. here are a few precautions you need to take: · keep sanitizers away from kids · avoid keeping the sanitizer near your kitchen's gas stove or any inflammable thing which can catch fire. · try not to use a sanitizer at home. instead, use good old soap and water to clean your hands if you want to avoid fire hazards. other health impacts of using a hand sanitizer as suggested above, whenever you are at home make use of soap and water to wash your hands. use sanitizers only when you have to step out as the using them everytime can be hazardous. if you are a obsessed with cleanliness and cannot do without a sanitizer take a look at these dangers which hand sanitizers carry with them: bacteria become antibiotic resistant antibiotics are used to kill the bacteria but what if these pathogens get immune to them? triclosan, an antibiotic compound used as an ingredient in sanitizers make bacteria resistant towards antibiotics. also, it ends up killing the good bacteria in your body as well. poisoning by alcohol alcohol-based sanitizers don't contain triclosan but that doesn't make them completely safe. other active ingredients like ethyl alcohol and isopropyl alcohol may lead to alcohol poisoning, if you drink it accidentally. triclosan can cause hormone problem another harmful effect of triclosan is that it can cause hormonal imbalance. studies conducted on animals have shown that this component may take your hormonal balance haywire. weakens the immune system even though sanitizers are used to build your immunity against germs, some studies have shown that triclosan can actually harm your immune system. this can make you vulnerable to infections and allergies. according to a study conducted at the university of michigan school of public health , high levels of triclosan make kids and teens more vulnerable to hay fever and allergies.
19	"coronavirus: expert discusses the biggest myths and how to correctly wash your hands | express.co.uk text extraction from html file; language identification https://elrc-share.eu under review 2020 coronavirus: expert discusses the biggest myths and how to correctly wash your hands | express.co.uk text/html https://www.express.co.uk/life-style/health/1263568/coronavirus-update-tips-hand-sanitizer-washing-moisturize en_2020_04_683.xml_198.html coronavirus: myths debunked by expert regarding the spread of covid-19 (image: getty images) myth 2 the virus is a living organism that we can kill “it is not alive. it is a protein chain of rna within a protective layer of fat. ""since the virus is a protein super molecule rather than a living organism, you cannot kill it. ""it will, however, decay spontaneously given enough time. the time it takes to break down depends on the environment temperature, humidity and type of material upon which it settles,” said dr baiarda. myth 3 sars-cov-2 is a hardy virus dr baiarda said: “it isn't. sars-cov-2 is surprisingly fragile. the only protection it has is a thin outer layer of lipid or fat. ""that is why any soap or detergent will destroy it - even washing up liquid works well. by dissolving the external lipid layer of the virus, the virus is rendered completely inert and unable to penetrate human cells. hence why washing hands often with soap and water is so important.” don't miss myth 4 if the delivery drivers wear gloves, they won't spread it dr baiarda answered: “this is wrong. every item that a gloved hand touches can be contaminated. ""according to a recent study from the new england journal of medicine, the virus can live up to eight hours on cardboard. ""to stay safe, the best advice is not to touch the parcel until ideally the following day.” myth 5 the virus can't be passed on by food “it can be transferred easily. if someone who has the virus on their hands touches food, it is very likely to become contaminated for many hours. ""to denature and inactivate the virus, food should either be washed or cooked at 65 degrees celsius at least for four minutes or more,” said dr baiarda. coronavirus: moisturizing hands is also important in the bid to not further spread the virus (image: getty images) read more coronavirus symptoms: the sign in your nose to look out for myth 6 alcohol-based sanitizer with a 60 percent alcohol concentration is as effective as washing your hands in soap and water dr baiarda added: “this is wrong. squirting a little bit of alcohol gel on your palms and rubbing them together is not effective. ""you need to cover the entire surface of both hands including fingers and thumbs, but this should be done only after the hands are free of any residues - such as after sneezing. ""the small nozzle on bottles of sanitizer are part of the problem, as people assume a small amount is ample.” myth 7 drinking alcohol will prevent people getting the virus “this is not true. the only alcohol that will help to prevent the spread of the virus is that in hand sanitizers. ""this is only for external use and even then, it is only effective if it has a concentration of 60 percent or above, if you use enough and in the right way,” answered dr baiarda. trending myth 8 moisturising hands after washing reduces cleanliness “incorrect. moisturising the skin is very important. the virus can lodge itself in damaged skin on your hands cracked by repeated washing, so its important to try to avoid this. ""keeping fingernails short will reduce the risk of sheltering and passing on the virus too, “said dr baiarda. myth 9 washing hands isn't as important when self-isolating, as you're all virus-free dr baiarda said: “wrong. if there are any external items entering your home, hand washing remains important. every time you wash your hands you will break the chain of infection. ""if in doubt, give them a wash. do this for at least 20 seconds with warm, soapy water and if you have paper towels that you can throw away, this is better than using a communal towel. if using towels, dedicate one to each person in the house, keep them separate and wash them daily. myth 10 vinegar is good for keeping bathrooms and kitchens free of the virus “incorrect. vinegar will not work against the virus and is not advised. the cleaning of bathrooms, kitchens and surfaces is still best carried out with hot water from the tap and a surface detergent as you have always done. ""if you have a case of the virus in your house and want to disinfect common areas, you can use a dilution of household bleach or hydrogen peroxide - this is a mild antiseptic,” answered dr baiarda. related articles"
21	"infant mortality crawling and normalization ilsp european language resource coordination https://elrc-share.eu under review 2020 infant mortality text/html wikimedia foundation 2020-06-11 https://en.wikipedia.org/wiki/infant_mortality https://creativecommons.org/licenses/by-sa/3.0/ public health wikipedia-en-71617.html infant mortality is the death of young children under the age of 1. this death toll is measured by the infant mortality rate (imr), which is the number of deaths of children under one year of age per 1000 live births. the under-five mortality rate, which is referred to as the child mortality rate, is also an important statistic, considering the infant mortality rate focuses only on children under one year of age. premature birth is the biggest contributor to the imr. other leading causes of infant mortality are birth asphyxia, pneumonia, congenital malformations, term birth complications such as abnormal presentation of the foetus umbilical cord prolapse, or prolonged labor, neonatal infection, diarrhoea, malaria, measles and malnutrition. one of the most common preventable causes of infant mortality is smoking during pregnancy. many factors contribute to infant mortality, such as the mother's level of education, environmental conditions, and political and medical infrastructure. improving sanitation, access to clean drinking water, immunization against infectious diseases, and other public health measures can help reduce high rates of infant mortality. in 1990 9 million infants younger than 1 year died globally. until 2015 this number has almost halved to 4.6 million infant deaths. over the same period, the infant mortality rate declined from 65 deaths per 1,000 live births to 29 deaths per 1,000. child mortality is the death of a child before the child's fifth birthday, measured as the under-5 child mortality rate (u5mr). national statistics sometimes group these two mortality rates together. globally, 5.4 million children died before their fifth birthday in 2017. in 1990 the number of child deaths was 12.6 million. more than 60% of these deaths are seen as being avoidable with low-cost measures such as continuous breast-feeding, vaccinations and improved nutrition. the child mortality rate, but not the infant mortality rate, was an indicator used to monitor progress towards the fourth goal of the millennium development goals of the united nations for the year 2015. a reduction of the child mortality is now a target in the sustainable development goals for goal number 3 (""ensure healthy lives and promote well-being for all at all ages""). throughout the world, infant mortality rate (imr) fluctuates drastically, and according to biotechnology and health sciences, education and life expectancy in the country is the leading indicator of imr. this study was conducted across 135 countries over the course of 11 years, with the continent of africa having the highest infant mortality rate of any region studied with 68 deaths per 1,000 live births. classification infant mortality rate (imr) is the number of deaths per 1,000 live births of children under one year of age. the rate for a given region is the number of children dying under one year of age, divided by the number of live births during the year, multiplied by 1,000. forms of infant mortality: perinatal mortality is late fetal death (22 weeks gestation to birth), or death of a newborn up to one week postpartum. neonatal mortality is newborn death occurring within 28 days postpartum. neonatal death is often attributed to inadequate access to basic medical care, during pregnancy and after delivery. this accounts for 40–60% of infant mortality in developing countries. postneonatal mortality is the death of children aged 29 days to one year. the major contributors to postneonatal death are malnutrition, infectious disease, troubled pregnancy, sudden infant death syndrome and problems with the home environment. causes causes of infant mortality directly lead to the death. environmental and social barriers prevent access to basic medical resources and thus contribute to an increasing infant mortality rate; 99% of infant deaths occur in developing countries, and 86% of these deaths are due to infections, premature births, complications during delivery, and perinatal asphyxia and birth injuries. greatest percentage reduction of infant mortality occurs in countries that already have low rates of infant mortality. common causes are preventable with low-cost measures. in the united states, a primary determinant of infant mortality risk is infant birth weight with lower birth weights increasing the risk of infant mortality. the determinants of low birth weight include socio-economic, psychological, behavioral and environmental factors. medical causes of infant mortality and deaths that are related to medical conditions include: low birth weight, sudden infant death syndrome, malnutrition, congenital malformations, and infectious diseases, low income for health care including neglected tropical diseases. congenital malformations congenital malformations are birth defects that babies are born with, such as cleft lip and palate, down syndrome, and heart defects. some congenital malformations may be more likely when the mother consumes alcohol, but it can also be a cause of genetics or have an unknown cause. congenital malformations have had a significant impact on infant mortality. malnutrition and infectious diseases were the main cause of death in more undeveloped countries. in the caribbean and latin america, congenital malformations only accounted for 5% of the infant deaths in these countries while malnutrition and infectious diseases took 7% to 27% of infants in the 1980s. in more developed countries such as the united states, there was a rise in infant deaths due to congenital malformations. these birth defects mostly had to do with heart and central nervous system. in the 19th century, there was a decrease in the number of infant deaths from heart diseases. from 1979 to 1997, there was a 39% decline in infant mortality due to heart problems. low birth weight low birth weight makes up 60–80% of the infant mortality rate in developing countries. the new england journal of medicine stated that ""the lowest mortality rates occur among infants weighing 3,000 to 3,500 g (6.6 to 7.7 lb). for infants born weighing 2,500 g (5.5 lb) or less, the mortality rate rapidly increases with decreasing weight, and most of the infants weighing 1,000 g (2.2 lb) or less die. as compared with normal-birth-weight infants, those with low weight at birth are almost 40 times more likely to die in the neonatal period; for infants with very low weight at birth the relative risk of neonatal death is almost 200 times greater."" infant mortality due to low birth weight is usually a direct cause stemming from other medical complications such as preterm birth, poor maternal nutritional status, lack of prenatal care, maternal sickness during pregnancy, and an unhygienic home environments. along with birth weight, period of gestation makes up the two most important predictors of an infant's chances of survival and their overall health. according to the new england journal of medicine, ""in the past two decades, the infant mortality rate (deaths under one year of age per thousand live births) in the united states has declined sharply."" low birth weights from african american mothers remain twice as high as that of white women. lbw may be the leading cause of infant deaths, and it is greatly preventable. although it is preventable, the solutions may not be the easiest but effective programs to help prevent lbw are a combination of health care, education, environment, mental modification and public policy, influencing a culture supporting lifestyle. preterm birth is the leading cause of newborn deaths worldwide. even though america excels past many other countries in the care and saving of premature infants, the percentage of american woman who deliver prematurely is comparable to those in developing countries. reasons for this include teenage pregnancy, increase in pregnant mothers over the age of thirty-five, increase in the use of in-vitro fertilization which increases the risk of multiple births, obesity and diabetes. also, women who do not have access to health care are less likely to visit a doctor, therefore increasing their risk of delivering prematurely. sudden infant death syndrome sudden infant death syndrome (sids) is a syndrome where an infant dies in their sleep with no reason behind it. even with a complete autopsy, no one has been able to figure out what causes this disease. this disease is more common in western countries. even though researchers are not sure what causes this disease, they have discovered that it is healthier for babies to sleep on their backs instead of their stomachs. this discovery saved many families from the tragedy that this disease causes. scientists have also discovered three causes within a model they created called ""the contemporary triple risk model"". this model states that three conditions such as the mother smoking while pregnant, the age of the infant, and stress referring to conditions such as overheating, prone sleeping, co-sleeping, and head covering. malnutrition malnutrition or undernutrition is defined as inadequate intake of nourishment, such as proteins and vitamins, which adversely affects the growth, energy and development of people all over the world. it is especially prevalent in women and infants under 5 who live in developing countries within the poorer regions of africa, asia, and latin america. children are most vulnerable as they have yet to fully develop a strong immune system, as well as being dependent upon parents to provide the necessary food and nutritional intake. it is estimated that about 3.5 million children die each year as a result of childhood or maternal malnutrition, with stunted growth, low body weight and low birth weight accounting for about 2.2 million associated deaths. factors which contribute to malnutrition are socioeconomic, environmental, gender status, regional location, and breastfeeding cultural practices. it is difficult to assess the most pressing factor as they can intertwine and vary among regions. adverse effects of malnutrition children suffering from malnutrition face adverse physical effects such as stunting, wasting, or being overweight. such characteristics entail difference in weight-and-height ratios for age in comparison to adequate standards. in africa the number of stunted children has risen, while asia holds the most children under 5 suffering from wasting. the amount of overweight children has increased among all regions of the globe. inadequate nutrients adversely effect physical and cognitive developments, increasing susceptibility to severe health problems. micronutrient deficiency such as iron has been linked to children with anemia, fatigue, and poor brain development. similarly, the lack of vitamin a is the leading cause of blindness among malnourished children. the outcome of malnutrition in children results in decreased ability of the immune system to fight infections, resulting in higher rates of death from diseases such as malaria, respiratory disease and diarrhea. infectious diseases babies born in low to middle income countries in sub-saharan africa and southern asia are at the highest risk of neonatal death. bacterial infections of the bloodstream, lungs, and the brain's covering (meningitis) are responsible for 25% of neonatal deaths. newborns can acquire infections during birth from bacteria that are present in their mother's reproductive tract. the mother may not be aware of the infection, or she may have an untreated pelvic inflammatory disease or sexually transmitted disease. these bacteria can move up the vaginal canal into the amniotic sac surrounding the baby. maternal blood-borne infection is another route of bacterial infection from mother to baby. neonatal infection is also more likely with the premature rupture of the membranes (prom) of the amniotic sac. seven out of ten childhood deaths are due to infectious diseases: acute respiratory infection, diarrhea, measles, and malaria. acute respiratory infection such as pneumonia, bronchitis, and bronchiolitis account for 30% of childhood deaths; 95% of pneumonia cases occur in the developing world. diarrhea is the second-largest cause of childhood mortality in the world, while malaria causes 11% of childhood deaths. measles is the fifth-largest cause of childhood mortality. folic acid for mothers is one way to combat iron deficiency. a few public health measures used to lower levels of iron deficiency anemia include iodize salt or drinking water, and include vitamin a and multivitamin supplements into a mother's diet. a deficiency of this vitamin causes certain types of anemia (low red blood cell count). environmental infant mortality rate can be a measure of a nation's health and social condition. it is a composite of a number of component rates which have their separate relationship with various social factors and can often be seen as an indicator to measure the level of socioeconomic disparity within a country. organic water pollution is a better indicator of infant mortality than health expenditures per capita. water contaminated with various pathogens houses a host of parasitic and microbial infections. infectious disease and parasites are carried via water pollution from animal wastes. areas of low socioeconomic status are more prone to inadequate plumbing infrastructure, and poorly maintained facilities. the burning of inefficient fuels doubles the rate of children under 5 years old with acute respiratory tract infections. climate and geography often play a role in sanitation conditions. for example, the inaccessibility of clean water exacerbates poor sanitation conditions. people who live in areas where particulate matter (pm) air pollution is higher tend to have more health problems across the board. short-term and long-term effects of ambient air pollution are associated with an increased mortality rate, including infant mortality. air pollution is consistently associated with post neonatal mortality due to respiratory effects and sudden infant death syndrome. specifically, air pollution is highly associated with sids in the united states during the post-neonatal stage. high infant mortality is exacerbated because newborns are a vulnerable subgroup that is affected by air pollution. newborns who were born into these environments are no exception. women who are exposed to greater air pollution on a daily basis who are pregnant should be closely watched by their doctors, as well as after the baby is born. babies who live in areas with less air pollution have a greater chance of living until their first birthday. as expected, babies who live in environments with more air pollution are at greater risk for infant mortality. areas that have higher air pollution also have a greater chance of having a higher population density, higher crime rates and lower income levels, all of which can lead to higher infant mortality rates. the key pollutant for infant mortality rates is carbon monoxide. carbon monoxide is a colorless, odorless gas that does great harm especially to infants because of their immature respiratory system. another major pollutant is second-hand smoke, which is a pollutant that can have detrimental effects on a fetus. according to the american journal of public health, ""in 2006, more than 42 000 americans died of second hand smoke-attributable diseases, including more than 41 000 adults and nearly 900 infants ... fully 36% of the infants who died of low birth weight caused by exposure to maternal smoking in utero were blacks, as were 28% of those dying of respiratory distress syndrome, 25% dying of other respiratory conditions, and 24% dying of sudden infant death syndrome."" the american journal of epidemiology also stated that ""compared with nonsmoking women having their first birth, women who smoked less than one pack of cigarettes per day had a 25% greater risk of mortality, and those who smoked one or more packs per day had a 56% greater risk. among women having their second or higher birth, smokers experienced 30% greater mortality than nonsmokers."" modern research in the united states on racial disparities in infant mortality suggests a link between the institutionalized racism that pervades the environment and high rates of african american infant mortality. in synthesis of this research, it has been observed that ""african american infant mortality remains elevated due to the social arrangements that exist between groups and the lifelong experiences responding to the resultant power dynamics of these arrangements."" it is important to note that infant mortality rates do not decline among african americans even if their socio-economic status does improve. parker dominguez at the university of southern california has made some headway in determining the reasoning behind this, claiming black women are more prone to psychological stress than other women of different races in the united states. stress is a lead factor in inducing labor in pregnant women, and therefore high levels of stress during pregnancy could lead to premature births that have the potential to be fatal for the infant. early childhood trauma early childhood trauma includes physical, sexual, and psychological abuse of a child ages zero to five years-old. trauma in early development has extreme impact over the course of a lifetime and is a significant contributor to infant mortality. developing organs are fragile. when an infant is shaken, beaten, strangled, or raped the impact is exponentially more destructive than when the same abuse occurs in a fully developed body. studies estimate that 1–2 per 100,000 u.s. children annually are fatally injured. unfortunately, it is reasonable to assume that these statistics under represent actual mortality. three-quarters (74.8 percent) of child fatalities in ffy 2015 involved children younger than 3 years, and children younger than 1 year accounted for 49.4 percent of all fatalities. in particular, correctly identifying deaths due to neglect is problematic and children with sudden unexpected death or those with what appear to be unintentional causes on the surface often have preventable risk factors which are substantially similar to those in families with maltreatment. there is a direct relationship between age of maltreatment/injury and risk for death. the younger an infant is, the more dangerous the maltreatment. family configuration, child gender, social isolation, lack of support, maternal youth, marital status, poverty, parental aces, and parenting practices are thought to contribute to increased risk. socio-economic factors social class is a major factor in infant mortality, both historically and today. between 1912 and 1915, the children's bureau in the united states examined data across eight cities and nearly 23,000 live births. they discovered that lower incomes tend to correlate with higher infant mortality. in cases where the father had no income, the rate of infant mortality was 357% more than that for the highest income earners ($1,250+). differences between races were also apparent. african-american mothers experience infant mortality at a rate 44% higher than average; however, research indicates that socio-economic factors do not totally account for the racial disparities in infant mortality. while infant mortality is normally negatively correlated with gdp, there may indeed be some opposing short-term effects from a recession. a recent study by the economist showed that economic slowdowns reduce the amount of air pollution, which results in a lower infant mortality rate. in the late 1970s and early 1980s, the recession's impact on air quality is estimated to have saved around 1,300 us babies. it is only during deep recessions that infant mortality increases. according to norbert schady and marc-françois smitz, recessions when gdp per capita drops by 15% or more increase infant mortality. social class dictates which medical services are available to an individual. disparities due to socioeconomic factors have been exacerbated by advances in medical technology. developed countries, most notably the united states, have seen a divergence between those living in poverty who cannot afford medical advanced resources, leading to an increased chance of infant mortality, and others. political modernization perspective, the neo-classical economic theory that scarce goods are most effectively distributed to the market, say that the level of political democracy influences the rate of infant mortality. developing nations with democratic governments tend to be more responsive to public opinion, social movements, and special interest groups for issues like infant mortality. in contrast, non-democratic governments are more interested in corporate issues and less so in health issues. democratic status effects the dependency a nation has towards its economic state via export, investments from multinational corporations and international lending institutions. levels of socioeconomic development and global integration are inversely related to a nation's infant mortality rate. dependency perspective occurs in a global capital system. a nation's internal impact is highly influenced by its position in the global economy and has adverse effects on the survival of children in developing countries. countries can experience disproportionate effects from its trade and stratification within the global system. it aids in the global division of labor, distorting the domestic economy of developing nations. the dependency of developing nations can lead to a reduce rate of economic growth, increase income inequality inter- and intra-national, and adversely affects the wellbeing of a nation's population. a collective cooperation between economic countries plays a role in development policies in the poorer, peripheral, countries of the world. these economic factors present challenges to governments' public health policies. if the nation's ability to raise its own revenues is compromised, governments will lose funding for its health service programs, including services that aim in decreasing infant mortality rates. peripheral countries face higher levels of vulnerability to the possible negative effects of globalization and trade in relation to key countries in the global market. even with a strong economy and economic growth (measured by a country's gross national product), the advances of medical technologies may not be felt by everyone, lending itself to increasing social disparities. in england from 2014 to 2017 a rise in infant mortality was experienced disproportionately in the most deprived local authorities where the previously declining trend in infant mortality was reversed with an additional 24 infant deaths per 100,000 live births per year relative to the previous trend war in policy, there is a lag time between realization of a problem's possible solution and actual implementation of policy solutions. infant mortality rates correlate with war, political unrest, and government corruption. in most cases, war-affected areas will experience a significant increase in infant mortality rates. having a war taking place where a woman is planning on having a baby is not only stressful on the mother and foetus, but also has several detrimental effects. however, many other significant factors influence infant mortality rates in war-torn areas. health care systems in developing countries in the midst of war often collapse. attaining basic medical supplies and care becomes increasingly difficult. during the yugoslav wars in the 1990s bosnia experienced a 60% decrease in child immunizations. preventable diseases can quickly become epidemic given the medical conditions during war. many developing countries rely on foreign aid for basic nutrition. transport of aid becomes significantly more difficult in times of war. in most situations the average weight of a population will drop substantially. expecting mothers are affected even more by lack of access to food and water. during the yugoslav wars in bosnia the number of premature babies born increased and the average birth weight decreased. there have been several instances in recent years of systematic rape as a weapon of war. women who become pregnant as a result of war rape face even more significant challenges in bearing a healthy child. studies suggest that women who experience sexual violence before or during pregnancy are more likely to experience infant death in their children. causes of infant mortality in abused women range from physical side effects of the initial trauma to psychological effects that lead to poor adjustment to society. many women who became pregnant by rape in bosnia were isolated from their hometowns making life after childbirth exponentially more difficult. medicine and biology developing countries have a lack of access to affordable and professional health care resources, and skilled personnel during deliveries. countries with histories of extreme poverty also have a pattern of epidemics, endemic infectious diseases, and low levels of access to maternal and child healthcare. the american academy of pediatrics recommends that infants need multiple doses of vaccines such as diphtheria-tetanus-acellular pertussis vaccine, haemophilus influenzae type b (hib) vaccine, hepatitis b (hepb) vaccine, inactivated polio vaccine (ipv), and pneumococcal vaccine (pcv). research was conducted by the institute of medicine's immunization safety review committee concluded that there is no relationship between these vaccines and risk of sids in infants. this tells us that not only is it extremely necessary for every child to get these vaccines to prevent serious diseases, but there is no reason to believe that if your child does receive an immunization that it will have any effect on their risk of sids. cultural high rates of infant mortality occur in developing countries where financial and material resources are scarce and there is a high tolerance to high number of infant deaths. there are circumstances where a number of developing countries to breed a culture where situations of infant mortality such as favoring male babies over female babies are the norm. in developing countries such as brazil, infant mortality rates are commonly not recorded due to failure to register for death certificates. failure to register is mainly due to the potential loss of time and money and other indirect costs to the family. even with resource opportunities such as the 1973 public registry law 6015, which allowed free registration for low-income families, the requirements to qualify hold back individuals who are not contracted workers. another cultural reason for infant mortality, such as what is happening in ghana, is that ""besides the obvious, like rutted roads, there are prejudices against wives or newborns leaving the house."" because of this it is making it even more difficult for the women and newborns to get the treatment that is available to them and that is needed. cultural influences and lifestyle habits in the united states can account for some deaths in infants throughout the years. according to the journal of the american medical association ""the post neonatal mortality risk (28 to 364 days) was highest among continental puerto ricans"" compared to babies of the non-hispanic race. examples of this include teenage pregnancy, obesity, diabetes and smoking. all are possible causes of premature births, which constitute the second highest cause of infant mortality. ethnic differences experienced in the united states are accompanied by higher prevalence of behavioral risk factors and sociodemographic challenges that each ethnic group faces. gender favoritism historically, males have had higher infant mortality rates than females. the difference between male and female infant mortality rates have been dependent on environmental, social, and economic conditions. more specifically, males are biologically more vulnerable to infections and conditions associated with prematurity and development. before 1970, the reasons for male infant mortality were due to infections, and chronic degenerative diseases. however, since 1970, certain cultures emphasizing males has led to a decrease in the infant mortality gap between males and females. also, medical advances have resulted in a growing number of male infants surviving at higher rates than females due to the initial high infant mortality rate of males. genetic components results in newborn females being biologically advantaged when it comes to surviving their first birthday. males, biologically, have lower chances of surviving infancy in comparison to female babies. as infant mortality rates saw a decrease on a global scale, the gender most affected by infant mortality changed from males experiences a biological disadvantage, to females facing a societal disadvantage. some developing nations have social and cultural patterns that reflects adult discrimination to favor boys over girls for their future potential to contribute to the household production level. a country's ethnic composition, homogeneous versus heterogeneous, can explain social attitudes and practices. heterogeneous level is a strong predictor in explaining infant mortality. birth spacing birth spacing is the time between births. births spaced at least three years apart from one another are associated with the lowest rate of mortality. the longer the interval between births, the lower the risk for having any birthing complications, and infant, childhood and maternal mortality. higher rates of pre-term births, and low birth weight are associated with birth to conception intervals of less than six months and abortion to pregnancy interval of less than six months. shorter intervals between births increase the chances of chronic and general under-nutrition; 57% of women in 55 developing countries reported birth spaces shorter than three years; 26% report birth spacing of less than two years. only 20% of post-partum women report wanting another birth within two years; however, only 40% are taking necessary steps such as family planning to achieve the birth intervals they want. unplanned pregnancies and birth intervals of less than twenty-four months are known to correlate with low birth weights and delivery complications. also, women who are already small in stature tend to deliver smaller than average babies, perpetuating a cycle of being underweight. prevention and outcomes to reduce infant mortality rates across the world health practitioners, governments, and non-governmental organizations have worked to create institutions, programs and policies to generate better health outcomes. improvements such as better sanitation practices have proven to be effective in reducing public health outbreaks and rates of disease among mothers and children. efforts to increase a households' income through direct assistance or economic opportunities decreases mortality rates, as families possess some means for more food and access to healthcare. education campaigns, disseminating knowledge among urban and rural regions, and better access to education attainment prove to be an effective strategy to reduce infant and mother mortality rates. current efforts from ngos and governments are focused developing human resources, strengthening health information systems, health services delivery, etc. improvements in such areas have increased regional health systems and aided in efforts to reduce mortality rates. public health reductions in infant mortality are possible in any stage of a country's development. rate reductions are evidence that a country is advancing in human knowledge, social institutions and physical capital. governments can reduce the mortality rates by addressing the combined need for education (such as universal primary education), nutrition, and access to basic maternal and infant health services. a policy focus has the potential to aid those most at risk for infant and childhood mortality allows rural, poor and migrant populations. reducing chances of babies being born at low birth weights and contracting pneumonia can be accomplished by improving air quality. improving hygiene can prevent infant mortality. home-based technology to chlorinate, filter, and solar disinfection for organic water pollution could reduce cases of diarrhea in children by up to 48%. improvements in food supplies and sanitation has been shown to work in the united states' most vulnerable populations, one being african americans. overall, women's health status need to remain high. simple behavioral changes, such as hand washing with soap, can significantly reduce the rate of infant mortality from respiratory and diarrheal diseases. according to unicef, hand washing with soap before eating and after using the toilet can save more lives of children than any single vaccine or medical intervention, by cutting deaths from diarrhea and acute respiratory infections. future problems for mothers and babies can be prevented. it is important that women of reproductive age adopt healthy behaviors in everyday life, such as taking folic acid, maintaining a healthy diet and weight, being physically active, avoiding tobacco use, and avoiding excessive alcohol and drug use. if women follow some of the above guidelines, later complications can be prevented to help decrease the infant mortality rates. attending regular prenatal care check-ups will help improve the baby's chances of being delivered in safer conditions and surviving. focusing on preventing preterm and low birth weight deliveries throughout all populations can help to eliminate cases of infant mortality and decrease health care disparities within communities. in the united states, these two goals have decreased infant mortality rates on a regional population, it has yet to see further progress on a national level. medical treatments technological advances in medicine would decrease the infant mortality rate and an increased access to such technologies could decrease racial and ethnic disparities. it has been shown that technological determinants are influenced by social determinants. those who cannot afford to utilize advances in medicine tend to show higher rates of infant mortality. technological advances has, in a way, contributed to the social disparities observed today. providing equal access has the potential to decrease socioeconomic disparities in infant mortality. specifically, cambodia is facing issues with a disease that is unfortunately killing infants. the symptoms only last 24 hours and the result is death. as stated if technological advances were increased in countries it would make it easier to find the solution to diseases such as this. recently, there have been declines in the united states that could be attributed to advances in technology. advancements in the neonatal intensive care unit can be related to the decline in infant mortality in addition to the advancement of surfactants. however, the importance of the advancement of technology remains unclear as the number of high-risk births increases in the united states. education it has been well documented that increased education among mothers, communities, and local health workers results in better family planning, improvement on children's health, and lower rates of children's deaths. high-risk areas, such as sub-saharan africa, have demonstrated that an increase in women's education attainment leads to a reduction in infant mortality by about 35%. similarly, coordinated efforts to train community health workers in diagnosis, treatment, malnutrition prevention, reporting and referral services has reduced infant mortality in children under 5 as much as 38%. public health campaigns centered around the ""first 1,000 days"" of conception have been successful in providing cost-effective supplemental nutrition programs, as well as assisting young mothers in sanitation, hygiene and breastfeeding promotion. increased intake of nutrients and better sanitation habits have a positive impact on health, especially developing children. educational attainment and public health campaigns provide the knowledge and means to practice better habits and leads to better outcomes against infant mortality rates. income awareness of health services, education, and economic opportunities provide means to sustain and increase chance of development and survival. a decrease on gpd, for example, results in increased rates of infant mortality. negative effects on household income reduces amount being spent on food and healthcare, affecting the quality of life and access to medical services to ensure full development and survival. on the contrary, increased household income translates to more access to nutrients and healthcare, reducing the risks associated with malnutrition and infant mortality. moreover, increased aggregate household incomes will produce better health facilities, water and sewer infrastructures for the entire community. policies granting women employment raises their status and autonomy. having a gainful employment can raise the perceived worth of females. this can lead to an increase in the number of women getting an education and a decrease in the number of female infanticide. in the social modernization perspective, education leads to development. higher number of skilled workers means more earning and further economic growth. according to the economic modernization perspective, this is one type economic growth viewed as the driving force behind the increase in development and standard of living in a country. this is further explained by the modernization theory- economic development promotes physical wellbeing. as economy rises, so do technological advances and thus, medical advances in access to clean water, health care facilities, education, and diet. these changes may decrease infant mortality. economically, governments could reduce infant mortality by building and strengthening capacity in human resources. increasing human resources such as physicians, nurses, and other health professionals will increase the number of skilled attendants and the number of people able to give out immunized against diseases such as measles. increasing the number of skilled professionals is negatively correlated with maternal, infant, and childhood mortality. between 1960 and 2000, the infant mortality rate decreased by half as the number of physicians increased by four folds. with the addition of one physician to every 1000 persons in a population, infant mortality will reduce by 30%. in certain parts of the u.s., specific modern programs aim to reduce levels of infant mortality. an example of one such program is the 'healthy me, healthy you' program based in northeast texas. it intends to identify factors that contribute to negative birth outcomes throughout a 37-county area. an additional program that aims to reduce infant mortality is the ""best babies zone"" (bbz) based at the university of california, berkeley. the bbz uses the life course approach to address the structural causes of poor birth outcomes and toxic stress in three u.s. neighborhoods. by employing community-generated solutions, the best babies zone's ultimate goal is to achieve health equity in communities that are disproportionately impacted by infant death. differences in measurement the infant mortality rate correlates very strongly with, and is among the best predictors of, state failure. imr is therefore also a useful indicator of a country's level of health or development, and is a component of the physical quality of life index. however, the method of calculating imr often varies widely between countries, and is based on how they define a live birth and how many premature infants are born in the country. reporting of infant mortality rates can be inconsistent, and may be understated, depending on a nation's live birth criterion, vital registration system, and reporting practices. the reported imr provides one statistic which reflects the standard of living in each nation. changes in the infant mortality rate reflect social and technical capacities of a nation's population. the world health organization (who) defines a live birth as any infant born demonstrating independent signs of life, including breathing, heartbeat, umbilical cord pulsation or definite movement of voluntary muscles. this definition is used in austria, for example. the who definition is also used in germany, but with one slight modification: muscle movement is not considered to be a sign of life. many countries, however, including certain european states (e.g. france) and japan, only count as live births cases where an infant breathes at birth, which makes their reported imr numbers somewhat lower and increases their rates of perinatal mortality. in the czech republic and bulgaria, for instance, requirements for live birth are even higher. although many countries have vital registration systems and certain reporting practices, there are many inaccuracies, particularly in undeveloped nations, in the statistics of the number of infants dying. studies have shown that comparing three information sources (official registries, household surveys, and popular reporters) that the ""popular death reporters"" are the most accurate. popular death reporters include midwives, gravediggers, coffin builders, priests, and others—essentially people who knew the most about the child's death. in developing nations, access to vital registries, and other government-run systems which record births and deaths, is difficult for poor families for several reasons. these struggles force stress on families, and make them take drastic measures in unofficial death ceremonies for their deceased infants. as a result, government statistics will inaccurately reflect a nation's infant mortality rate. popular death reporters have first-hand information, and provided this information can be collected and collated, can provide reliable data which provide a nation with accurate death counts and meaningful causes of deaths that can be measured/studied. unicef uses a statistical methodology to account for reporting differences among countries: unicef compiles infant mortality country estimates derived from all sources and methods of estimation obtained either from standard reports, direct estimation from micro data sets, or from unicef's yearly exercise. in order to sort out differences between estimates produced from different sources, with different methods, unicef developed, in coordination with who, the wb and unsd, an estimation methodology that minimizes the errors embodied in each estimate and harmonize trends along time. since the estimates are not necessarily the exact values used as input for the model, they are often not recognized as the official imr estimates used at the country level. however, as mentioned before, these estimates minimize errors and maximize the consistency of trends along time. another challenge to comparability is the practice of counting frail or premature infants who die before the normal due date as miscarriages (spontaneous abortions) or those who die during or immediately after childbirth as stillborn. therefore, the quality of a country's documentation of perinatal mortality can matter greatly to the accuracy of its infant mortality statistics. this point is reinforced by the demographer ansley coale, who finds dubiously high ratios of reported stillbirths to infant deaths in hong kong and japan in the first 24 hours after birth, a pattern that is consistent with the high recorded sex ratios at birth in those countries. it suggests not only that many female infants who die in the first 24 hours are misreported as stillbirths rather than infant deaths, but also that those countries do not follow who recommendations for the reporting of live births and infant deaths. another seemingly paradoxical finding, is that when countries with poor medical services introduce new medical centers and services, instead of declining, the reported imrs often increase for a time. this is mainly because improvement in access to medical care is often accompanied by improvement in the registration of births and deaths. deaths that might have occurred in a remote or rural area, and not been reported to the government, might now be reported by the new medical personnel or facilities. thus, even if the new health services reduce the actual imr, the reported imr may increase. collecting the accurate statistics of infant mortality rate could be an issue in some rural communities in developing countries. in those communities, some other alternative methods for calculating infant mortality rate are emerged, for example, popular death reporting and household survey. the country-to-country variation in child mortality rates is huge, and growing wider despite the progress. among the world's roughly 200 nations, only somalia showed no decrease in the under-5 mortality rate over the past two decades.the lowest rate in 2011 was in singapore, which had 2.6 deaths of children under age 5 per 1,000 live births. the highest was in sierra leone, which had 185 child deaths per 1,000 births. the global rate is 51 deaths per 1,000 births. for the united states, the rate is eight per 1,000 births. infant mortality rate (imr) is not only a group of statistic but instead it is a reflection of the socioeconomic development and effectively represents the presence of medical services in the countries. imr is an effective resource for the health department to make decision on medical resources reallocation. imr also formulates the global health strategies and help evaluate the program success. the existence of imr helps solve the inadequacies of the other vital statistic systems for global health as most of the vital statistic systems usually neglect the infant mortality statistic number from the poor. there are certain amounts of unrecorded infant deaths in the rural area as they do not have information about infant mortality rate statistic or do not have the concept about reporting early infant death. europe and america the exclusion of any high-risk infants from the denominator or numerator in reported imrs can cause problems in making comparisons. many countries, including the united states, sweden and germany, count an infant exhibiting any sign of life as alive, no matter the month of gestation or the size, but according to united states some other countries differ in these practices. all of the countries named adopted the who definitions in the late 1980s or early 1990s, which are used throughout the european union. however, in 2009, the us cdc issued a report that stated that the american rates of infant mortality were affected by the united states' high rates of premature babies compared to european countries. it also outlined the differences in reporting requirements between the united states and europe, noting that france, the czech republic, ireland, the netherlands, and poland do not report all live births of babies under 500 g and/or 22 weeks of gestation. however, the differences in reporting are unlikely to be the primary explanation for the united states' relatively low international ranking. rather, the report concluded that primary reason for the united states’ higher infant mortality rate when compared with europe was the united states’ much higher percentage of preterm births. russia until the 1990s, russia and the soviet union did not count, as a live birth or as an infant death, extremely premature infants (less than 1,000 g, less than 28 weeks gestational age, or less than 35 cm in length) that were born alive (breathed, had a heartbeat, or exhibited voluntary muscle movement) but failed to survive for at least seven days. although such extremely premature infants typically accounted for only about 0.5% of all live-born children, their exclusion from both the numerator and the denominator in the reported imr led to an estimated 22%–25% lower reported imr. in some cases, too, perhaps because hospitals or regional health departments were held accountable for lowering the imr in their catchment area, infant deaths that occurred in the 12th month were ""transferred"" statistically to the 13th month (i.e., the second year of life), and thus no longer classified as an infant death. brazil in certain rural developing areas, such as northeastern brazil, infant births are often not recorded in the first place, resulting in the discrepancies between the infant mortality rate (imr) and the actual amount of infant deaths. access to vital registry systems for infant births and deaths is an extremely difficult and expensive task for poor parents living in rural areas. government and bureaucracies tend to show an insensitivity to these parents and their recent suffering from a lost child, and produce broad disclaimers in the imr reports that the information has not been properly reported, resulting in these discrepancies. little has been done to address the underlying structural problems of the vital registry systems in respect to the lack of reporting from parents in rural areas, and in turn has created a gap between the official and popular meanings of child death. it is also argued that the bureaucratic separation of vital death recording from cultural death rituals is to blame for the inaccuracy of the infant mortality rate (imr). vital death registries often fail to recognize the cultural implications and importance of infant deaths. it is not to be said that vital registry systems are not an accurate representation of a region's socio-economic situation, but this is only the case if these statistics are valid, which is unfortunately not always the circumstance. ""popular death reporters"" is an alternative method for collecting and processing statistics on infant and child mortality. many regions may benefit from ""popular death reporters"" who are culturally linked to infants may be able to provide more accurate statistics on the incidence of infant mortality. according to ethnographic data, ""popular death reporters"" refers to people who had inside knowledge of anjinhos, including the grave-digger, gatekeeper, midwife, popular healers etc. —— all key participants in mortuary rituals. by combining the methods of household surveys, vital registries, and asking ""popular death reporters"" this can increase the validity of child mortality rates, but there are many barriers that can reflect the validity of our statistics of infant mortality. one of these barriers are political economic decisions. numbers are exaggerated when international funds are being doled out; and underestimated during reelection. the bureaucratic separation of vital death reporting and cultural death rituals stems in part due to structural violence. individuals living in rural areas of brazil need to invest large capital for lodging and travel in order to report infant birth to a brazilian assistance league office. the negative financial aspects deters registration, as often individuals are of lower income and cannot afford such expenses. similar to the lack of birth reporting, families in rural brazil face difficult choices based on already existing structural arrangements when choosing to report infant mortality. financial constraints such as reliance on food supplementations may also lead to skewed infant mortality data. in developing countries such as brazil the deaths of impoverished infants are regularly unrecorded into the countries vital registration system; this causes a skew statistically. culturally validity and contextual soundness can be used to ground the meaning of mortality from a statistical standpoint. in northeast brazil they have accomplished this standpoint while conducting an ethnographic study combined with an alternative method to survey infant mortality. these types of techniques can develop quality ethnographic data that will ultimately lead to a better portrayal of the magnitude of infant mortality in the region. political economic reasons have been seen to skew the infant mortality data in the past when governor ceara devised his presidency campaign on reducing the infant mortality rate during his term in office. by using this new way of surveying, these instances can be minimized and removed, overall creating accurate and sound data. epidemiology for the world, and for both less developed countries (ldcs) and more developed countries (mdcs), imr declined significantly between 1960 and 2001. according to the state of the world's mothers report by save the children, the world imr declined from 126 in 1960 to 57 in 2001. however, imr was, and remains, higher in ldcs. in 2001, the imr for ldcs (91) was about 10 times as large as it was for mdcs (8). on average, for ldcs, the imr is 17 times as higher than that of mdcs. also, while both ldcs and mdcs made significant reductions in infant mortality rates, reductions among less developed countries are, on average, much less than those among the more developed countries. among many low- and middle-income countries, there is also substantial variation in infant mortality rate at a subnational level. a factor of about 67 separate countries with the highest and lowest reported infant mortality rates. the top and bottom five countries by this measure (taken from the world factbook's 2013 estimates) are shown below. according to guillot, gerland, pelletier and saabneh ""birth histories, however, are subject to a number of errors, including omission of deaths and age misreporting errors."" united states the infant mortality rate in the us decreased by 2.3% to a historic low of 582 infant deaths per 100,000 live births in 2014. of the 27 most developed countries, the u.s. has the highest infant mortality rate, despite spending much more on health care per capita. significant racial and socio-economic differences in the united states affect the imr, in contrast with other developed countries, which have more homogeneous populations. in particular, imr varies greatly by race in the us. the average imr for the whole country is therefore not a fair representation of the wide variations that exist between segments of the population. many theories have been explored as to why these racial differences exist with socio economic factors usually coming out as a reasonable explanation. however, more studies have been conducted around this matter, and the largest advancement is around the idea of stress and how it affects pregnancy. in the 1850s, the infant mortality rate in the united states was estimated at 216.8 per 1,000 babies born for whites and 340.0 per 1,000 for african americans, but rates have significantly declined in the west in modern times. this declining rate has been mainly due to modern improvements in basic health care, technology, and medical advances. in the last century, the infant mortality rate has decreased by 93%. overall, the rates have decreased drastically from 20 deaths in 1970 to 6.9 deaths in 2003 (per every 1000 live births). in 2003, the leading causes of infant mortality in the united states were congenital anomalies, disorders related to immaturity, aids, and maternal complications. babies born with low birth weight increased to 8.1% while cigarette smoking during pregnancy declined to 10.2%. this reflected the amount of low birth weights concluding that 12.4% of births from smokers were low birth weights compared with 7.7% of such births from non-smokers. according to the new york times, ""the main reason for the high rate is preterm delivery, and there was a 10% increase in such births from 2000 to 2006."" between 2007 and 2011, however, the preterm birth rate has decreased every year. in 2011 there was an 11.73% rate of babies born before the 37th week of gestation, down from a high of 12.80% in 2006. economic expenditures on labor and delivery and neonatal care are relatively high in the united states. a conventional birth averages us$9,775 with a c-section costing us$15,041. preterm births in the us have been estimated to cost $51,600 per child, with a total yearly cost of $26.2 billion. despite this spending, several reports state that infant mortality rate in the united states is significantly higher than in other developed nations. estimates vary; the cia's world factbook ranks the us 55th internationally in 2014, with a rate of 6.17, while the un figures from 2005-2010 place the us 34th. aforementioned differences in measurement could play a substantial role in the disparity between the us and other nations. a non-viable live birth in the us could be registered as a stillbirth in similarly developed nations like japan, sweden, norway, ireland, the netherlands, and france – thereby reducing the infant death count. neonatal intensive care is also more likely to be applied in the us to marginally viable infants, although such interventions have been found to increase both costs and disability. a study following the implementation of the born alive infant protection act of 2002 found universal resuscitation of infants born between 20–23 weeks increased the neonatal spending burden by $313.3 million while simultaneously decreasing quality-adjusted life years by 329.3. the vast majority of research conducted in the late twentieth and early twenty-first century indicates that african-american infants are more than twice as likely to die in their first year of life than white infants. although following a decline from 13.63 to 11.46 deaths per 1000 live births from 2005 to 2010, non-hispanic black mothers continued to report a rate 2.2 times as high as that for non-hispanic white mothers. contemporary research findings have demonstrated that nationwide racial disparities in infant mortality are linked to the experiential state of the mother and that these disparities cannot be totally accounted for by socio-economic, behavioral or genetic factors. the hispanic paradox, an effect observed in other health indicators, appears in the infant mortality rate, as well. hispanic mothers see an imr comparable to non-hispanic white mothers, despite lower educational attainment and economic status. a study in north carolina, for example, concluded that ""white women who did not complete high school have a lower infant mortality rate than black college graduates."" according to mustillo's cardia (coronary artery risk development in young adults) study, ""self reported experiences of racial discrimination were associated with pre-term and low-birthweight deliveries, and such experiences may contribute to black-white disparities in prenatal outcomes."" likewise, dozens of population-based studies indicate that ""the subjective, or perceived experience of racial discrimination is strongly associated with an increased risk of infant death and with poor health prospects for future generations of african americans."" african american while earlier parts of this article have addressed the racial differences in infant deaths, a closer look into the effects of racial differences within the country is necessary to view discrepancies. non-hispanic black women lead all other racial groups in imr with a rate of 11.3, while the infant mortality rate among white women is 5.1. black women in the united states experience a shorter life expectancy than white women, so while a higher imr amongst black women is not necessarily out of line, it is still rather disturbing. while the popular argument leads to the idea that due to the trend of a lower socio-economic status had by black women there is in an increased likelihood of a child suffering. while this does correlate, the theory that it is the contributing factor falls apart when we look at latino imr in the united states. latino people are almost just as likely to experience poverty as blacks in the u.s., however, the infant mortality rate of latinos is much closer to white women than it is to black women. the poverty rates of blacks and latinos are 24.1% and 21.4% respectively. if there is a direct correlation, then the imr of these two groups should be rather similar, however, blacks have an imr double that of latinos. also, as black women move out of poverty or never experienced it in the first place, their imr is not much lower than their counterparts experiencing higher levels of poverty. some believe black women are predisposed to a higher imr, meaning ancestrally speaking, all black women from african descent should experience an elevated rate. this theory is quickly disproven by looking at women of african descent who have immigrated to the united states. these women who come from a completely different social context are not prone to the higher imr experienced by american-born black women. tyan parker dominguez at the university of southern california offers a theory to explain the disproportionally high imr among black women in the united states. she claims african american women experience stress at much higher rates than any other group in the country. stress produces particular hormones that induce labor and contribute to other pregnancy problems. considering early births are one of the leading causes of death of infants under the age of one, induced labor is a very legitimate factor. the idea of stress spans socio-economic status as parker dominguez claims stress for lower-class women comes from unstable family life and chronic worry over poverty. for black middle-class women, battling racism, real or perceived, can be an extreme stressor. arline geronimus, a professor at the university of michigan school of public health calls the phenomenon ""weathering."" she claims constantly dealing with disadvantages and racial prejudice causes black women's birth outcomes to deteriorate with age. therefore, younger black women may experience stress with pregnancy due to social and economic factors, but older women experience stress at a compounding rate and therefore have pregnancy complications aside from economic factors. mary o. hearst, a professor in the department of public health at saint catherine university, researched the effects of segregation on the african american community to see if it contributed to the high imr amongst black children. hearst claims that residential segregation contributes to the high rates because of the political, economic, and negative health implications it poses on black mothers regardless of their socioeconomic status. racism, economic disparities, and sexism in segregated communities are all examples of the daily stressors that pregnant black women face that can affect their pregnancies with conditions such as pre-eclampsia and hypertension. studies have also shown that high imr is due to the inadequate care that pregnant african americans receive compared to other women in the country. this unequal treatment stems from the idea that there are racial medical differences and is also rooted in racial biases and controlled images of black women. because of this unequal treatment, research finds that black women do not receive the same urgency in medical care and are not taken as seriously regarding pain they feel or complications they think they are having, as exemplified by the complications tennis-star serena williams faced during her delivery. strides have been made, however, to combat this epidemic. in los angeles county, health officials have partnered with non-profits around the city to help black women after the delivery of their child. one non-profit in particular has made a large impact on many lives is great beginnings for black babies in inglewood. the non-profit centers around helping women deal with stress by forming support networks, keeping an open dialogue around race and family life, and also finding these women a secure place in the workforce. some research argues that to end high imr amongst black children, the country needs to fix the social and societal issues that plague african americans. some scholars argue that issues such as institutional racism, mass incarceration, poverty, and health care disparities that are present amongst the african american country need to be addressed by the united states government in order for policy to be created to combat these issues. following this theory, if institutional inequalities are addresses and repaired by the united states government, daily stressors for african americans, and african american women in particular, will be reduced, therefore lessening the risk of complications in pregnancy and infant mortality. others argue that adding diversity in the health care industry can help reduce the high imr because more representation can tackle deep-rooted racial biases and stereotypes that exist towards african american women. another more recent form of action to reduce high imr amongst black children is the use of doulas throughout pregnancy. united kingdom a study published in the british medical journal in 2019 found that the rate of infant mortality in england had increased with an additional 24 infant deaths per 100 000 live births per year. there was no significant change from the pre-existing trend in the most affluent local authorities. the rise disproportionately affected the poorest areas of the country, and was attributed largely to rising child poverty, as a result of sustained reductions in the welfare benefits available to families with children. history it was in the early 1900s that countries around the world started to notice that there was a need for better child health care services. europe started this rally, the united states fell behind them by creating a campaign to decrease the infant mortality rate. with this program, they were able to lower the imr to 10 deaths rather than 100 deaths per every 1000 births. infant mortality was also seen as a social problem when it was being noticed as a national problem. american women who had middle class standing with an educational background started to create a movement that provided housing for families of a lower class. by starting this, they were able to establish public health care and government agencies that were able to make more sanitary and healthier environments for infants. medical professionals helped further the cause for infant health by creating a pediatrics field that was experienced in medicine for children. united states decreases in infant mortality in given countries across the world during the 20th century have been linked to several common trends, scientific advancements, and social programs. some of these include the state improving sanitation, improving access to healthcare, improving education, and the development of medical advancements such as penicillin, and safer blood transfusions. in the united states, improving infant mortality in the early half of the 20th century meant tackling environmental factors. improving sanitation, and especially access to safe drinking water, helped the united states dramatically decrease infant mortality, a growing concern in the united states since the 1850s. on top of these environmental factors, during this time the united states endeavored to increase education and awareness regarding infant mortality. pasteurization of milk also helped the united states combat infant mortality in the early 1900s, a practice which allowed the united states to curb disease in infants. these factors, on top of a general increase in the standard of living for those living in urban settings, helped the united states make dramatic improvements in their rates of infant mortality in the early 20th century. although the overall infant mortality rate was sharply dropping during this time, within the united states infant mortality varied greatly among racial and socio-economic groups. the change in infant mortality from 1915 to 1933 was, for the white population, 98.6 in 1,000 to 52.8 in 1,000, and for the black population, 181.2 in 1,000 to 94.4 in 1,000. studies imply that this has a direct correlation with relative economic conditions between these populations. additionally, infant mortality in southern states was consistently 2% higher than other states in the us across a 20-year period from 1985. southern states also tend to perform worse in predictors for higher infant mortality, such as per capita income and poverty rate. in the latter half of the 20th century, a focus on greater access to medical care for women spurred declines in infant mortality in the united states. the implementation of medicaid, granting wider access to healthcare, contributed to a dramatic decrease in infant mortality, in addition to access to greater access to legal abortion and family-planning care, such the iud and the birth control pill. in the decades following the 1970s, the united states' decreasing infant mortality rates began to slow, falling behind china's, cuba's, and other developed countries'. funding for the federally subsidized medicaid and maternal and infant care was sharply reduced, and availability of prenatal care greatly decreased for low-income parents. china the people's republic of china's growth of medical resources in the latter half of the 20th century partly explains its dramatic improvement with regards to infant mortality during this time. part of this increase included the adoption of the rural cooperative medical system, which was founded in the 1950s. the cooperative medical system granted healthcare access to previously underserved rural populations, is estimated to have covered 90% of china's rural population throughout the 1960s. the cooperative medical system achieved an infant mortality rate of 25.09 per 1,000. the cooperative medical system was later defunded, leaving many rural populations to rely on an expensive fee-for-service system, although the rate continued to decline in general. this change in medical systems caused a socio-economic gap in accessibility to medical care in china, which fortunately was not reflected in its infant mortality rate of decline. prenatal care was increasingly used, even as the cooperative medical system was replaced, and delivery assistance remained accessible. china's one-child policy, adopted in the 1980s, negatively impacted its infant mortality. women carrying unapproved pregnancies faced state consequences and social stigma and were thus less likely to use prenatal care. additionally, economic realities and long-held cultural factors incentivized male offspring, leading some families who already had sons to avoid prenatal care or professional delivery services, and causing china to have unusually high female infant mortality rates during this time. see also list of countries by infant mortality rate miscarriage stillbirth related statistical categories: perinatal mortality only includes deaths between the foetal viability (22 weeks gestation) and the end of the 7th day after delivery. neonatal mortality only includes deaths in the first 28 days of life. postneonatal mortality only includes deaths after 28 days of life but before one year. child mortality includes deaths before the age of 5. . references external links child and infant mortality estimates for all countries - website by unicef"
21	"obstetric transition crawling and normalization ilsp european language resource coordination https://elrc-share.eu under review 2020 obstetric transition text/html wikimedia foundation 2020-06-11 https://en.wikipedia.org/wiki/obstetric_transition https://creativecommons.org/licenses/by-sa/3.0/ public health wikipedia-en-41136939.html in reproductive health, obstetric transition is a concept around the secular trend of countries gradually shifting from a pattern of high maternal mortality to low maternal mortality, from direct obstetric causes of maternal mortality to indirect causes, aging of maternal population, and moving from the natural history of pregnancy and childbirth to institutionalization of maternity care, medicalization and over medicalization. this concept was originally proposed in the latin american association of reproductive health researchers (alirh, 2013) in analogy of the epidemiological, demographic and nutritional transitions. overview in the last two decades, the world has seen a substantial reduction of maternal mortality.(1) considering that maternal mortality is vastly determined by social, societal and contextual factors, this reduction is important not only because of the number of lives that have been spared in this period (an estimated 2,000,000 between 1990 and 2010), but because it denotes that the world is making progress towards development and gender equality.(1,2) however, this progress is still insufficient, unequal and slow: recent estimates suggest that 287,000 women died of causes related to pregnancy and childbirth in 2010. maternal mortality remains a global tragedy, but the observed progress inspires the international community to believe and strive for the elimination of maternal mortality in the decades to come.(3) the vast majority of maternal deaths is avoidable and takes place in developing countries. in developed countries, the maternal mortality ratio can be as low as 10 maternal deaths per 100,000 live births while among the least developed countries it can be as a high as 1,000 maternal deaths or more per 100,000 live births.(4) this disparity is also observed within countries and when the population is disaggregated in quintiles of income or education.(5-7) thus, countries, regions within countries and different population groups within country experience a specific momentum in a dynamic process of reduction of maternal mortality, which may benefit from specific approaches. in 1929, thompson described the phenomenon of demographic transition characterized by a gradual shift from a pattern of high mortality and high fertility to a pattern of low mortality and low fertility.(8) omram (1971) described the epidemiologic transition, with a shift from a pattern of high prevalence of communicable diseases to a pattern of high prevalence of non-communicable diseases.(9) finally, poppkin (1993) proposed the nutritional transition model, which helps to understand the transformations in human diets and the global epidemic of obesity.(10) these transitions and other socioeconomic and cultural changes (e.g. globalization, urbanization) led us to develop the concept of ""obstetric transition"" (11). concept as a result of the millennium development goals project, improved data related to maternal mortality and severe maternal morbidity became available for the period between 1990 and 2010. altogether, these data reflect a secular trend where countries are gradually shifting from a pattern of high maternal mortality to low maternal mortality, from direct obstetric causes of maternal mortality to indirect causes, moving from the natural history of pregnancy and childbirth to institutionalization of maternity care, medicalization and over medicalization, and aging of maternal population. this is the ""obstetric transition"" phenomenon, which has implications for the strategies aimed at reducing maternal mortality. figure 1 presents trends of maternal mortality by world region for the period 1990 to 2010 derived from recent estimates (2). considering that countries and world regions are transitioning in the same pathway towards elimination of maternal deaths, five stages can be devised. countries are experiencing this transition at different paces, and have started this process in different moments of their history (e.g. most developed countries started their transitions more than a century ago, while some developing countries have started their transition much more recently). classification in the stage i (mmr&gt; 1,000 / 100,000) most women are experiencing a situation close to the natural history of pregnancy and childbirth, with very little being done – if anything at all – to reduce the risk of maternal mortality at the population level. considering 2010 data, chad and somalia are countries that could illustrate this stage. hopefully, as time passes (and progress occurs), no country will remain in this stage. stage i is characterized by very high maternal mortality, high fertility and the predominance of direct causes of maternal deaths together with a substantial proportion of deaths attributable to communicable diseases such as malaria. in the stage ii (mmr: 999 – 300) mortality and fertility remain very high, with a similar pattern of causes as compared to the stage i. however, a greater proportion of women in the population are being able to somewhat detach from the natural history of pregnancy and childbirth. several countries in the sub-saharan africa could illustrate the stage ii. for stages i and ii, the main issue is access to care. in general, these are countries with a substantial lack of basic infrastructure (such as roads, transportation, health facilities), very low education levels (particularly female literacy), weak health systems, severe shortages of skilled birth attendants and low capacity to deliver essential life-saving interventions. in this context, poor quality of care functions as deterrent for generating demand for health services. in countries in these stages, focus should be directed to creating the basic infra-structure and implement maternal-mortality primary prevention measures (e.g. family planning, iron supplementation, insecticide treated nets, intersectorial measures to remove barriers to access the health system). as the minimal infra-structure is created, health services should strive to deliver quality care in order to become a sensible alternative to pregnant women (demand generation). (21) in the obstetric transition, the tipping point occurs in the stage iii. in this stage the mortality is still high (mmr 299 – 100 maternal deaths / 100,000 live births), the fertility is variable and direct causes of mortality still predominates. this is a complex stage because access remain an issue for a great deal of the population, but as a large proportion of pregnant women are indeed reaching health facilities, quality of care becomes a major determinant of health outcomes. not only primary prevention is important, but also secondary and tertiary prevention are critical for improving maternal health outcomes in this stage. in other words, quality of care, with skilled birth attendance and appropriate management of complications and disabilities, is essential to reduce maternal mortality. india, guatemala and south africa are countries that could illustrate this stage. in the stage iv (mmr &lt;50 maternal deaths / 100,000 live births), the maternal mortality is moderate or low, there is low fertility and the indirect causes of maternal mortality, particularly the non-communicable diseases, acquire greater importance. in order to further advance the reduction of maternal mortality, the main issue becomes quality of care and elimination of delays within health systems. another aspect that emerges in this stage is the growing role of over medicalization as a threat to quality and improved health outcomes. various asian countries and most latin american countries have joined developed countries in this stage. in the stage v, all avoidable maternal deaths are indeed avoided. the maternal mortality rate is very low, the fertility is low or very low, and the non-communicable diseases are the main causes of maternal mortality. as this is an aspirational, largely theoretical stage at the moment, the maternal mortality levels remain uncertain, but could be lower than 5 maternal deaths per 100,000 live births. the main issue in this stage would be the sustainability of excellence in quality of care. it is worth noting that the main purpose of this framework is to illustrate different phases of a dynamic process and offer a rational for different focus and solutions for reducing mortality according to the stage in the obstetric transition. the ranges of maternal mortality ratio uses to define the proposed stages of obstetric transition are frequently in country stratification, (2, 16) but the boundaries between these stages are somewhat imprecise and one stage tends to fade into another. progression is not always linear and, largely due to equity issues, different stages often co-exist in the same country. see also demographic transition epidemiological transition maternal mortality maternal near miss nutritional transition perinatal mortality references"
21	coronavirus: why death and mortality rates differ - bbc future text extraction from html file; language identification https://elrc-share.eu under review 2020 coronavirus: why death and mortality rates differ - bbc future text/html https://www.bbc.com/future/article/20200401-coronavirus-why-death-and-mortality-rates-differ future article story covid-19-tag/health en_2020_04_947.xml_96.html coronavirus: why death and mortality rates differ by martha henriques 2nd april 2020 in italy, the death rate from covid-19 is more than 10 times greater than in germany. why does the death rate vary so much internationally? i in italy, an epicentre of the new coronavirus outbreak, the death rate at the end of march stood at a sobering 11% . meanwhile in neighbouring germany, the same virus led to fatality rates of just 1%. in china, it was 4%, while israel had the lowest rate worldwide, at 0.35%. at first it can seem surprising that the same virus - which doesn't seem to have mutated significantly as it has spread - can lead to such widely differing reported mortality rates. and even within one country, the rate appears to change over time. so what's going on? several main factors account for much of the difference we're seeing - and perhaps the most important come down to simply how we're counting, as well as testing, cases. differing death rates first, there is confusion about what people mean by “death rate”. this confusion can make countries' numbers look vastly different, even if their populations are dying at the same rate. there are, in fact, two kinds of fatality rate. the first is the proportion of people who die who have tested positive for the disease. this is called the “case fatality rate”. the second kind is the proportion of people who die after having the infection overall; as many of these will never be picked up, this figure has to be an estimate. this is the “infection fatality rate”. in other words, the case fatality rate describes how many people doctors can be sure are killed by the infection, versus how many people the virus kills overall, says carl heneghan, an epidemiologist and director of the centre for evidence-based medicine at the university of oxford; he is also a gp in recovery from a suspected covid-19 infection. you might also like: why children are not immune to covid-19 to see what a difference this makes, consider 100 people who have been infected with covid-19. ten of them have it so severely that they go into hospital, where they test positive for covid-19. the other 90 are not tested at all. one of the hospital patients then dies from the virus. the other 99 people survive. that would give a case fatality rate of one in 10, or 10%. but the infection fatality rate would be just one in 100, or 1%. the lack of widespread, systematic testing in most countries is the main source of discrepancies in death rates internationally so if some countries only test patients ill enough to go to hospital - and don't test the less-ill (or even asymptomatic) covid-19 patients who don't get to hospital (which is what the uk is currently doing) - the death rate can appear higher than in countries where testing is widespread (such as germany or south korea). impact of testing even if you're careful to compare the same type of fatality rate across countries, it's easy to see how testing more, or fewer, people would change the results. in fact, the lack of widespread, systematic testing in most countries is the main source of discrepancies in death rates internationally, says dietrich rothenbacher, director of the institute of epidemiology and medical biometry at the university of ulm in germany. as a result, the current figures are “not at all” directly comparable between countries, he says. this is because, to get an accurate figure across a population, it is necessary to test not just symptomatic cases, but asymptomatic people too. having that data would give an accurate picture of how the pandemic is affecting whole populations, not just the sick. “currently we have a huge bias in the numbers coming from different countries - therefore the data are not directly comparable,” he says. “what we need to really have valid and comparable numbers would be a defined and systematic way to choose a representative sampling frame.” the village of vò in northern italy is an example of why testing is important not just to get accurate data, but to contain covid-19 . when the first covid-19 case in vò was confirmed, testing was rolled out to the entire village of 3,300 people. the results showed that at the time of the “first case”, 3% of the village was already infected, but showing no or few symptoms. italy's case fatality rate from covid-19 is markedly higher than elsewhere in the world, which is largely down to how cases are detected (credit: worldometer/bbc) a widespread testing programme in iceland shows a similar picture. iceland has tested more than 3% of its population of around 365,000 people so far , both those who show symptoms and those who don't. by extrapolating the results, the testing programme estimated that 0.5% of iceland's population was likely to have had covid-19. but even this figure may be slightly low because asymptomatic people are less likely to seek out testing, notes heneghan. it is thought that the actual figure could be closer to 1% of iceland's population, which would mean roughly 3,650 infections. an added difficulty is that this data is not from peer-reviewed research, but rather is almost real-time clinical data - which can be messy and come with many caveats. what figures like these do underline, says sheila bird of the university of cambridge's mrc biostatistics unit, is the importance of widespread testing to help inform public health measures. “if you never actually develop symptoms but had encountered the virus, that would be an infection, but it is an ‘uncountable' one - uncountable until the time that we have an antibody test,” says bird. antibody tests detect the traces of an immune response to the virus and reveal who has had an infection. those tests are the game-changers that could reveal who has developed immunity to the virus and can safely return to daily life without risk of infection or of spreading the virus. “that's why the development of that test and its deployment is so terribly important,” says bird. in vò, the spread of covid-19 was halted after two weeks, as both the widespread testing and strict follow-up measures allowed for the targeted and effective containment of infections. iceland, so far, has had only two covid-19 deaths. what counts as a covid-19 death? there are other factors that alter the death rate, too. one of them is what doctors actually count as a covid-19 death. at first it might seem simple enough: if a patient dies while infected with covid-19, they died of covid-19. when the first covid-19 case in vò, italy was confirmed, testing was rolled out to the entire village (credit: getty images) but what if they had an underlying condition, such as asthma, which was exacerbated by covid-19? or what if the patient died from something seemingly less related to covid-19, which is a respiratory disease - such as, say, a brain aneurysm? which condition should be considered the cause of death? even within a country, official statistics can vary according to what you count . in the uk, for example, the department of health and social care releases daily updates on how many people who tested positive for covid-19 died that day. this includes any patient who tested positive for covid-19 but who might have died from another condition (for example, terminal cancer). but the uk's office for national statistics counts all deaths as covid-19 where covid-19 was mentioned on the death certificate, regardless of whether they were tested or if it was merely a suspected case of covid-19. adding to the complexity of trying to understand the death rates is that the two are out of sync, since the ons way of counting can only happen after a death certificate has been issued, so takes longer. “the issue is not really about right or wrong, but about each source of data having its own strengths and weaknesses,” sarah caul, head of mortality analysis at ons, writes in a blog post on the different ways of counting deaths . this is not necessarily a source of discrepancy between most countries, though, as many are counting deaths in the same way. italy counts any death of a patient who has covid-19 as a death caused by covid-19; so does germany and hong kong. in the us, doctors have more discretion: they are asked to record whether the patient died “as a result of this illness” when reporting covid-19 deaths to the centers for disease control and prevention. it could be easy to see how a physician might believe that a covid-19 patient who died of, say, a heart attack or brain aneurysm didn't die as a result of covid-19, and so wouldn't report accordingly. importantly, though, while this might make a difference when the data is analysed months or years from now, this doesn't translate into any difference in the death statistics at the moment. at present in the us, any death of a covid-19 patient, no matter what the physician believes to be the direct cause, is counted for public reporting as a covid-19 death. “i expect that the final death certificate will have covid along with pre-existing conditions, should there be any,” says cécile viboud, an epidemiologist at the fogarty international center at the national institutes of health. “but at this point, any covid-positive case who dies will be tallied in the us death count.” so what counts as a covid-19 death will affect our overall understanding of the lethality of the disease in the long run, but it most likely isn't playing a huge factor between countries. complex causes the picture is murkier still when patients have not had a covid-19 test, but are a suspected case. given that many deaths from covid-19 are in people who have underlying health issues , doctors still have to make the call on the cause of death. the picture is even more complicated when patients have not had a covid-19 test, but are a suspected case (credit: getty images) during an epidemic, doctors are more likely to attribute a death with complex causes as being caused by the disease in question - a trait known as ascertainment bias . “we know, during an epidemic, people will call every death as though it's related to covid-19. but that is not the case,” says heneghan. “always, when people look back at the case notes and assign causation, they realise they will have overestimated the case fatality in relation to the disease.” the reason for the bias is that “there's a tendency to focus on the worst-case scenario”, says heneghan. “that's the only message that gets out there.” one example is the h1n1 pandemic of 2009, known as swine flu. early case fatality rate estimates were inflated by a factor of more than 10. even 10 weeks into the epidemic, estimates varied widely between countries, coming in between 0.1% and 5.1% . when medics later had a chance to go through case documents and evaluate cases, the actual h1n1 case death rate was far lower, at 0.02% . that's not a cause for complacency, says heneghan. but it could be an antidote to some of the alarm at the very high reported death rates in some countries. hidden deaths while over-counting deaths among recorded covid-19 cases may lead to overestimation of the death rate, there is another factor that could mean the death rate is also - confusingly - being underestimated at the same time. this is the problem of hidden deaths from covid-19: those people who die from the disease who are never tested. this comes into play when health services are overwhelmed and even those patients who have severe symptoms of the virus are not taken into hospital to be tested and treated, simply because there isn't capacity. in the small italian town of nembro, in lombardy, only 31 people have officially died from covid-19. but one preliminary study has found that it's likely that far more people have died from covid-19. that's because the overall death rate - not just from covid-19, but from all causes - was four times higher this year than in the same period last year . ordinarily, around 35 people die in the first months of the year in nembro. this year, 158 people were registered to have died. this jump in excess deaths is speculated to be down to undiagnosed and untested cases of covid-19. there's nothing to say that going into an intensive care unit is going to have a better outcome compared with care in the community - carl heneghan the number of hospital beds available could also play a role, as countries with lower capacity in their health services may have to start making decisions sooner about which covid-19 cases to prioritise for treatment. this could lead to more covid-19 deaths in the community that go untested (and uncounted), as people with symptoms stay away. while this might lead to more uncounted deaths, it may not necessarily translate into to more deaths overall. “there's nothing to say that going into an intensive care unit is going to have a better outcome compared with care in the community,” says heneghan. more important than the number of beds available in hospitals, he says, is the way the beds are organised. if covid-19 patients are in close proximity to other patients - or if doctors move between covid-19 and non-covid-19 wards - it heightens the risk of spreading the disease. “that is why you need separate hospitals for separate infection teams,” he says. what role does age play? as well as differences caused by clinical definitions of what counts as a covid-19 death and the numbers of people going untested, there are other factors that mean the virus hits some countries harder than others. one that has been put forward by italian doctors is the age profile of a country. in 2019, nearly a quarter of the italian population was 65 years or older, compared to only 11% in china. the overall case fatality rate in italy as of mid-march was 7.2% - much higher than china's rate of 2.3% at a comparable stage of its epidemic . but from the ages of zero to 69, the two country's case fatality rates are comparable, note researchers from the istituto superiore di sanità in rome. nearly a quarter of the italian population is 65 years or older, compared to only 11% in china (credit: getty images) among the oldest patients, though, italy and china part ways. the 70-79 age group in italy had a case fatality rate of 12.8%, while china's was 8%. for the over-80s, the difference was more pronounced still: italy's was 20.2% and china's 14.8%. the reason for this discrepancy is still a bit of a mystery, the researchers note. heneghan suspects that one factor at play in italy's high figures could be not to do with the virus itself, but with bacteria. the country has the highest numbers of deaths due to antimicrobial resistance in the eu - in fact, a third of all eu deaths from antimicrobial resistance happen in italy. while antibiotics do precisely nothing to tackle a virus, a viral infection can often open the way for secondary infections or complications like bacterial pneumonia. if that then can't be treated properly with antibiotics because the bacteria is resistant, then this can be what kills the patient, not the virus itself. “this is an incredibly important part of the whole story,” says heneghan. “and it is particularly prevalent in the elderly.” as well as age, the overall health of the population has been highlighted as another contributing factor - particularly given that people who have underlying health problems are more vulnerable. while that might play a contributing role, this doesn't explain why some countries are reporting more covid-19 deaths than others: italy is consistently ranked as one of the world's healthiest countries , for example, and has a longer healthy life expectancy than china . for younger age groups, the case fatality rates in italy and china are comparabe, but for the oldest age groups italy's death rate is higher (credit: onder et al./jama/bbc) trying to get a handle on exactly how lethal covid-19 is will prove a knotty problem for some time yet. it may never be possible to get a true, reliable count of the deaths due to covid-19, as testing in many parts of the world has been too slow to roll out. as time goes on, the estimate of the covid-19 death rate is likely to improve, as clinicians are eventually able to go through case notes and tease out the tangle of factors that contributed to each covid-19 patient's death. for now, while hospitals are filled with acutely ill patients and doctors and nurses are working overtime to care for them, that careful analysis is going to have to wait. -- as an award-winning science site, bbc future is committed to bringing you evidence-based analysis and myth-busting stories around the new coronavirus. you can read more of our covid-19 coverage here . -- join one million future fans by liking us on facebook , or follow us on twitter or instagram . if you liked this story, sign up for the weekly bbc.com features newsletter , called “the essential list”. a handpicked selection of stories from bbc future, culture, worklife, and travel, delivered to your inbox every friday.
22	"pulmonary artery catheter crawling and normalization ilsp european language resource coordination https://elrc-share.eu under review 2020 pulmonary artery catheter text/html wikimedia foundation 2020-06-11 https://en.wikipedia.org/wiki/pulmonary_artery_catheter https://creativecommons.org/licenses/by-sa/3.0/ intensive care medicine wikipedia-en-1436516.html pulmonary artery catheterization (pac), or right heart catheterization, is the insertion of a catheter into a pulmonary artery. its purpose is diagnostic; it is used to detect heart failure or sepsis, monitor therapy, and evaluate the effects of drugs. the pulmonary artery catheter allows direct, simultaneous measurement of pressures in the right atrium, right ventricle, pulmonary artery, and the filling pressure (""wedge"" pressure) of the left atrium. the pulmonary artery catheter is frequently referred to as a swan-ganz catheter, in honor of its inventors jeremy swan and william ganz, from cedars-sinai medical center. indications general indications are: management of complicated myocardial infarction hypovolemia vs cardiogenic shock ventricular septal rupture (vsr) vs acute mitral regurgitation severe left ventricular failure right ventricular infarction unstable angina refractory ventricular tachycardia assessment of respiratory distress cardiogenic vs non-cardiogenic pulmonary edema primary vs secondary pulmonary hypertension assessment of type of shock assessment of therapy afterload reduction vasopressors beta blockers intra-aortic balloon counter-pulsation assessment of fluid requirement in critically ill patients hemorrhage sepsis acute kidney injury burns management of postoperative open heart surgical patients assessment of valvular heart disease assessment of cardiac tamponade/constriction no study has definitively demonstrated improved outcome in critically ill patients managed with pa catheters. given that the pa catheter is a monitoring tool and not a therapy in and of itself this is not entirely surprising. justification for its continued use rests on a large body of clinical experience, disadvantages of other cardiac output monitoring systems, its ability to accurately measure pulmonary artery pressure, and the potential to use the catheter as a direct conduit for drug administration into the pulmonary artery. procedure the catheter is introduced through a large vein—often the internal jugular, subclavian, or femoral veins. ease of placement for a pulmonary artery catheter from easiest to difficult is: right internal jugular &gt; left subclavian &gt; left internal jugular &gt; right subclavian. from this entry site, it is threaded through the right atrium of the heart, the right ventricle, and subsequently into the pulmonary artery. the passage of the catheter may be monitored by dynamic pressure readings from the catheter tip or with the aid of fluoroscopy. the standard pulmonary artery catheter has two lumens (swan-ganz) and is equipped with an inflatable balloon at the tip, which facilitates its placement into the pulmonary artery through the flow of blood. the balloon, when inflated, causes the catheter to ""wedge"" in a small pulmonary blood vessel. so wedged, the catheter can provide an indirect measurement of the pressure in the left atrium of the heart, showing a mean pressure, in addition to a, x, v, and y waves which have implications for status of the left atria and the mitral valve. left ventricular end diastolic pressure (lvedp) is measured using a different procedure, with a catheter that has directly crossed the aortic valve and is well positioned in the left ventricle. lv edp reflects fluid status of the individual in addition to heart health. see also pulmonary wedge pressure and ventricular pressure. technical developments thermal dilution the idea for a sail or balloon tip modification of ronald bradley's simple portex tubing method came about from swan's observation from the laguna beach ca shore of sail boats on the water on a relatively calm day. boats with conventional slot sails were still; one with a spinnaker was able to make reasonable headway. the concept of using thermodilution to measure cardiac output was originally the idea of arnost fronek. as a former colleague of fronek, ganz added the thermistor modification after swan showed him the initial balloon design, which was fabricated by edwards laboratories, which had previously contracted with swan as a consultant. after swan developed the initial balloon tip, ganz used fronek's idea and added a small thermistor (temperature probe) about 3 cm behind the tip. either cold 10 ml of saline (0.9% nacl) under 10° celsius or room temperature (not as accurate) is injected into an opening in the right atrium. as this cooler fluid passes the tip thermistor, a very brief drop in the blood temperature is recorded. a recent variation in design is the incorporation of a heating coil on the catheter (30 cm from the tip, residing in the atrium area) which eliminates the cold fluid bolus, a major factor in human technique variation. by attaching both the injector site and the ventricular thermistor to a small computer, the thermodilution curve can be plotted. if details about the patient's body mass index (size); core temp, systolic, diastolic, central venous pressure cvp (measured from the atrium by the third lumen simultaneously) and pulmonary artery pressure are input, a comprehensive flow vs pressure map can be calculated. in crude terms, this measurement compares left and right cardiac activity and calculates preload and afterload flow and pressures which, theoretically, can be stabilized or adjusted with drugs to either constrict or dilate the vessels (to raise or lower, respectively, the pressure of blood flowing to the lungs), in order to maximize oxygen for delivery to the body tissues. the ability to record results is not a guarantee of patient survivability. pharmacotherapy lumina modern catheters have multiple lumina — five or six are common — and have openings along the length to allow administration of inotropes and other drugs directly into the atrium. drugs to achieve these changes can be delivered into the atrium via the fourth lumen, usually dedicated to medication. common drugs used are various inotropes, norepinephrine or even atropine. a further set of calculations can be made by measuring the arterial blood and central venous (from the third lumen) and inputting these figures into a spreadsheet or the cardiac output computer, if so equipped, and plotting an oxygen delivery profile. svo2 measurement one further development in recent years has been the invention of a catheter with a fiber-optic based probe which is extended and lodged into the ventricle wall providing instant readings of svo2 or oxygen saturation of the ventricle tissues. this technique has a finite life as the sensor becomes coated with protein and it can irritate the ventricle via the contact area. alternatives various other techniques have largely relegated the pa catheter to history, e.g. the lithium dilution technique; the external bio-resistance monitor or the very simple and reliable technique of esophogeal doppler measurements of the descending aorta. complications the procedure is not without risk, and complications can be life-threatening. it can lead to arrhythmias, pseudoaneurysm formation or rupture of the pulmonary artery, thrombosis, infection, pneumothorax, bleeding, and other problems. controversy the benefit of the use of this type of catheter has been controversial. therefore, many clinicians minimize its use. evidence of benefit several studies in the 1980s seemed to show a benefit of the increase in physiological information. many reports showing benefit of the pa catheter are from anaesthetic, and intensive care settings. in these settings cardiovascular performance was optimized thinking patients would have supra-normal metabolic requirements. evidence of harm or lack of benefit contrary to earlier studies there is growing evidence the use of a pa catheter (pac) does not necessarily lead to improved outcome. one explanation could be that nurses and physicians are insufficiently knowledgeable to adequately interpret the pa catheter measurements. also, the benefits might be reduced by the complications from the use of the pac. furthermore, using information from the pac might result in a more aggressive therapy causing the detrimental effect. or, it could give rise to more harmful therapies (i.e. achieving supra-normal values could be associated with increased mortality). utility of pulmonary artery catheterization this interpretation of adolph ficks' formulation for cardiac output by time/temperature curves is an expedient but limited and invasive model of right heart performance. it remains an exceptional method of monitoring volume overload leading to pulmonary edema in an icu setting. a feature of the pulmonary artery catheter that has been largely ignored in the clinical setting is its ability to monitor total body oxygen extraction by measuring the mixed venous oxygen saturation. regardless of the value obtained by measurements of the cardiac output, the mixed venous oxygen saturation is an accurate parameter of total body blood flow and therefore cardiac output. the assumption that a low mixed venous oxygen saturation (normal = 60% except for the coronary sinus where it approximates 40% reflecting the high metabolic rate of the myocardium) represents less than adequate oxygen delivery is consistent with physiological and metabolic observations. high oxygen extraction is associated with low cardiac output and decreased mixed venous oxygen saturation. except during hypothermia and in severe sepsis, low mixed venous oxygen saturations are indication of inadequate hemodynamics. the ability of the pulmonary artery catheter to sample mixed venous blood is of great utility to manage low cardiac output states. non-invasive echocardiography and pulse-wave cardiac output monitoring are concordant with (and much safer) if not better than invasive methods defining right and left heart performance. the advent of mrsa and similar hospital based catheter infections now clearly limits the utility of this type of invasive cardiac icu intervention. notes references fronek, a; ganz, v (1959). ""[local thermodilution method of measuring minute volume and circulation rate in the peripheral vessels]"". československá fysiologie (in czech). 8 (3): 189. pmid 13671524. fronek, a; ganz, v (1960). ""measurement of flow in single blood vessels including cardiac output by local thermodilution"". circulation research. 8: 175–82. doi:10.1161/01.res.8.1.175. swan, hj; ganz, w; forrester, j; marcus, h; et al. (august 1970). ""catheterization of the heart in man with use of a flow-directed balloon-tipped catheter"". the new england journal of medicine. 283 (9): 447–51. doi:10.1056/nejm197008272830902. pmid 5434111. irwin, richard s.; rippe, james m. (2012). irwin and rippe's intensive care medicine (7th ed.). lippincott williams &amp; wilkins. isbn 9781451154207. marino, paul m. (2014). marino's the icu book (4th revised ed.). lippincott williams &amp; wilkins. isbn 9781451121186. irwin, richard s.; rippe, james m.; lisbon, alan; heard, stephen o. (2012). irwin &amp; rippe's procedures, techniques and minimally invasive monitoring in intensive care medicine. lippincott williams &amp; wilkins. isbn 9781451180237. further reading marik, pe (2013). ""obituary: pulmonary artery catheter 1970 to 2013"". annals of intensive care. 3 (1). 38. doi:10.1186/2110-5820-3-38. pmc 4175482. pmid 24286266. magder, s (january 2015). ""invasive hemodynamic monitoring"". critical care clinics. 31 (1): 67–87. doi:10.1016/j.ccc.2014.08.004. pmid 25435479. whitener, s; konoske, r; mark, jb (december 2014). ""pulmonary artery catheter"". best practice &amp; research: clinical anesthesiology. 28 (4): 323–35. doi:10.1016/j.bpa.2014.08.003. pmid 25480764. gidwani, uk; mohanty, b; chatterjee, k (november 2013). ""the pulmonary artery catheter: a critical reappraisal"". cardiology clinics. 31 (4): 545–65. doi:10.1016/j.ccl.2013.07.008. pmid 24188220. pulmonary artery catheterization at emedicine"
22	"extracorporeal membrane oxygenation crawling and normalization ilsp european language resource coordination https://elrc-share.eu under review 2020 extracorporeal membrane oxygenation text/html wikimedia foundation 2020-06-11 https://en.wikipedia.org/wiki/extracorporeal_membrane_oxygenation https://creativecommons.org/licenses/by-sa/3.0/ intensive care medicine wikipedia-en-444349.html extracorporeal membrane oxygenation (ecmo), also known as extracorporeal life support (ecls), is an extracorporeal technique of providing prolonged cardiac and respiratory support to persons whose heart and lungs are unable to provide an adequate amount of gas exchange or perfusion to sustain life. the technology for ecmo is largely derived from cardiopulmonary bypass, which provides shorter-term support with arrested native circulation. ecmo works by temporarily drawing blood from the body to allow artificial oxygenation of the red blood cells and removal of carbon dioxide. generally, it is used either post-cardiopulmonary bypass or in late-stage treatment of a person with profound heart and/or lung failure, although it is now seeing use as a treatment for cardiac arrest in certain centers, allowing treatment of the underlying cause of arrest while circulation and oxygenation are supported. ecmo is also used to support patients with the acute viral pneumonia associated with covid-19 in cases where artificial ventilation is not sufficient to sustain blood oxygenation levels. medical uses guidelines that describe the indications and practice of ecmo are published by the extracorporeal life support organization (elso). criteria for the initiation of ecmo vary by institution, but generally include acute severe cardiac or pulmonary failure that is potentially reversible and unresponsive to conventional management. examples of clinical situations that may prompt the initiation of ecmo include the following: hypoxemic respiratory failure with a ratio of arterial oxygen tension to fraction of inspired oxygen (pao2/fio2) of &lt;100 mmhg despite optimization of the ventilator settings, including the fraction of inspired oxygen (fio2), positive end-expiratory pressure (peep), and inspiratory to expiratory (i:e) ratio hypercapnic respiratory failure with an arterial ph &lt;7.20 refractory cardiogenic shock cardiac arrest failure to wean from cardiopulmonary bypass after cardiac surgery as a bridge to either heart transplantation or placement of a ventricular assist device as a bridge to lung transplantation septic shock is a more controversial but increasingly studied use of ecmo hypothermia, with a core temperature between 28 and 24 °c and cardiac instability, or with a core temperature below 24 °c. in those with cardiac arrest or cardiogenic shock, it appears to improve survival and good outcomes. use in covid-19 patients beginning in early february 2020, doctors in china have increasingly been using ecmo as an adjunct support for patients presenting with acute viral pneumonia associated with sars-cov-2 infection (covid-19) when, even after ventilation, the blood oxygenation levels remain too low to sustain the patient. the initial reports indicate that it is assisting in restoring patients' blood oxygen saturation and reducing fatalities among the approximately 3% of severe cases where it has been utilized. for critically ill patients, the mortality rate reduces from around 59-71% with conventional therapy to approximately 46% with extracorporeal membrane oxygenation. outcomes early studies had shown survival benefit with use of ecmo for people in acute respiratory failure especially in the setting of acute respiratory distress syndrome. a registry maintained by elso of nearly 51,000 people that have received ecmo has reported outcomes with 75% survival for neonatal respiratory failure, 56% survival for pediatric respiratory failure, and 55% survival for adult respiratory failure. other observational and uncontrolled clinical trials have reported survival rates from 50 to 70 percent. these reported survival rates are better than historical survival rates. even though ecmo is used for a range of conditions with varying mortality rates, early detection is key to prevent the progression of deterioration and increase survival outcomes. in the united kingdom, veno-venous ecmo deployment is concentrated in designated ecmo centers to potentially improve care and promote better outcomes. contraindications most contraindications are relative, balancing the risks of the procedure versus the potential benefits. the relative contraindications are: conditions incompatible with normal life if the person recovers preexisting conditions that affect the quality of life (cns status, end-stage malignancy, risk of systemic bleeding with anticoagulation) age and size futility: those who are too sick, have been on conventional therapy too long, or have a fatal diagnosis. side effects neurologic a common consequence in ecmo-treated adults is neurological injury, which may include intracerebral hemorrhage, subarachnoid hemorrhage, ischemic infarctions in susceptible areas of the brain, hypoxic-ischemic encephalopathy, unexplained coma, and brain death. bleeding occurs in 30 to 40 percent of those receiving ecmo and can be life-threatening. it is due to both the necessary continuous heparin infusion and platelet dysfunction. meticulous surgical technique, maintaining platelet counts greater than 100,000/mm3, and maintaining the target activated clotting time reduce the likelihood of bleeding. blood heparin-induced thrombocytopenia (hit) is increasingly common among people receiving ecmo. when hit is suspected, the heparin infusion is usually replaced by a non-heparin anticoagulant. there is retrograde blood flow in the descending aorta whenever the femoral artery and vein are used for va ecmo. stasis of the blood can occur if left ventricular output is not maintained, which may result in thrombosis. bridge to assist device in va ecmo, those whose cardiac function does not recover sufficiently to be weaned from ecmo may be bridged to a ventricular assist device (vad) or transplant. a variety of complications can occur during cannulation, including vessel perforation with bleeding, arterial dissection, distal ischemia, and incorrect location (e.g., venous cannula placed within the artery), but these events occur highly infrequently. children preterm infants are at unacceptably high risk for intraventricular hemorrhage (ivh) if administered ecmo at a gestational age less than 32 weeks. types there are several forms of ecmo; the two most common are veno-arterial (va) ecmo and veno-venous (vv) ecmo. in both modalities, blood drained from the venous system is oxygenated outside of the body. in va ecmo, this blood is returned to the arterial system and in vv ecmo the blood is returned to the venous system. in vv ecmo, no cardiac support is provided. veno-arterial in veno-arterial (va) ecmo, a venous cannula is usually placed in the right or left common femoral vein for extraction, and an arterial cannula is usually placed into the right or left femoral artery for infusion. the tip of the femoral venous cannula should be maintained near the junction of the inferior vena cava and right atrium, while the tip of the femoral arterial cannula is maintained in the iliac artery. in adults, accessing the femoral artery is preferred because the insertion is simpler. central va ecmo may be used if cardiopulmonary bypass has already been established or emergency re-sternotomy has been performed (with cannulae in the right atrium (or svc/ivc for tricuspid repair) and ascending aorta). va ecmo is typically reserved when native cardiac function is minimal to mitigate increased cardiac stroke work associated with pumping against retrograde flow delivered by the aortic cannula. veno-venous in veno-venous (vv) ecmo, cannulae are usually placed in the right common femoral vein for drainage and right internal jugular vein for infusion. alternatively, a dual-lumen catheter is inserted into the right internal jugular vein, draining blood from the superior and inferior vena cavae and returning it to the right atrium. initiation ecmo should be performed only by clinicians with training and experience in its initiation, maintenance, and discontinuation. ecmo insertion is typically performed in the operating room setting by a cardiothoracic surgeon. ecmo management is commonly performed by a registered nurse, respiratory therapist, or a perfusionist. once it has been decided to inititiate ecmo, the patient is anticoagulated with intravenous heparin to prevent thrombus formation from clotting off the oxygenator. prior to initiation, an iv bolus of heparin is given and measured to ensure that the act is between 300–350 seconds. once the act is between this range, ecmo can be initiated and a heparin drip will be started after as a maintenance dose. cannulation cannulae can be placed percutaneously by the seldinger technique, a relatively straightforward and common method for obtaining access to blood vessels, or via surgical cutdown. the largest cannulae that can be placed in the vessels are used in order to maximize flow and minimize shear stress. ecmo required for complications post-cardiac surgery can be placed directly into the appropriate chambers of the heart or great vessels. central cannulation via lateral thoracotomy allows patients awaiting lung transplantation to remain unsedated and ambulatory. titration following cannulation and connection to the ecmo circuit, the appropriate amount of blood flow through the ecmo circuit is determined using hemodynamic parameters and physical exam. goals of maintaining end-organ perfusion via ecmo circuit are balanced with sufficient physiologic blood flow through the heart to prevent stasis and subsequent formation of blood clot. maintenance once the initial respiratory and hemodynamic goals have been achieved, the blood flow is maintained at that rate. frequent assessment and adjustments are facilitated by continuous venous oximetry, which directly measures the oxyhemoglobin saturation of the blood in the venous limb of the ecmo circuit. special considerations vv ecmo is typically used for respiratory failure, while va ecmo is used for cardiac failure. there are unique considerations for each type of ecmo, which influence management. blood flow near-maximum flow rates are usually desired during vv ecmo to optimize oxygen delivery. in contrast, the flow rate used during va ecmo must be high enough to provide adequate perfusion pressure and venous oxyhemoglobin saturation (measured on drainage blood) but low enough to provide sufficient preload to maintain left ventricular output. diuresis since most people are fluid-overloaded when ecmo is initiated, aggressive diuresis is warranted once the patient is stable on ecmo. ultrafiltration can be easily added to the ecmo circuit if the patient has inadequate urine output. ecmo ""chatter"", or instability of ecmo waveforms, represents under-resuscitation and would support cessation of aggressive diuresis or ultrafiltration. left ventricular monitoring left ventricular output is rigorously monitored during va ecmo because left ventricular function can be impaired from increased afterload, which can in turn lead to formation of thrombus within the heart. weaning and discontinuing for those with respiratory failure, improvements in radiographic appearance, pulmonary compliance, and arterial oxyhemoglobin saturation indicate that the person may be ready to be taken off ecmo support. for those with cardiac failure, enhanced aortic pulsatility correlates with improved left ventricular output and indicates that they may be ready to be taken off ecmo support. if all markers are in good status, the blood flows on the ecmo will be slowly decreased and the patients parameters will be observed during this time to ensure that the patient can tolerate the changes. when the flows are below 2 liters per minute, permanent removal is attempted and the patient is continued to be monitored during this time until the cannulae can be removed. veno-venous ecmo liberation trial vv ecmo trials are performed by eliminating all countercurrent sweep gas through the oxygenator. extracorporeal blood flow remains constant, but gas transfer does not occur. they are then observed for several hours, during which the ventilator settings that are necessary to maintain adequate oxygenation and ventilation off ecmo are determined as indicated by arterial and venous blood gas results. veno-arterial ecmo liberation trial va ecmo trials require temporary clamping of both the drainage and infusion lines, while allowing the ecmo circuit to circulate through a bridge between the arterial and venous limbs. this prevents thrombosis of stagnant blood within the ecmo circuit. in addition, the arterial and venous lines should be flushed continuously with heparinized saline or intermittently with heparinized blood from the circuit. in general, va ecmo trials are shorter in duration than vv ecmo trials because of the higher risk of thrombus formation. history ecmo was developed in the 1950s by john gibbon, and then by c. walton lillehei. the first use for neonates was in 1965. banning gray lary, m.d. first demonstrated that intravenous oxygen could maintain life. his results were published in the surgical forum, november 1951. dr. lary commented on his initial work in a 2007 presentation wherein he writes, ""our research began by assembling an apparatus that, for the first time, kept animals alive while breathing pure nitrogen. this was accomplished with very small bubbles of oxygen injected into the blood stream. these bubbles were made by adding a ‘wetting agent’ to oxygen being forced through a porcelain filter into the venous blood stream. shortly after its initial presentation to the american college of surgeons, this apparatus was reviewed by walton lillehei who with dewall made the first practical heart lung machine that employed a bubble oxygenator. with variations such machines were used for the next twenty years."" society and culture manufacturers medtronic maquet (getinge group) sorin group terumo xenios ag (fresenius medical care) availability research a 2014 study showed that a factor xiia inhibitory antibody provides thromboprotection in extracorporeal circulation without increasing bleeding risk. experiments on neonatal animals showed that ecmo treatment can lead to apoptosis of enterocytes, damage of the intestinal mucosal barrier and bacterial translocation. this might explain greater severity of systemic inflammatory response syndrome in neonates. ecmo has also seen its use on cadavers as being able to increase the viability rate of transplanted organs. references external links american thoracic society, patient education: what is ecmo? (online-pdf)"
22	"intensive care unit crawling and normalization ilsp european language resource coordination https://elrc-share.eu under review 2020 intensive care unit text/html wikimedia foundation 2020-06-11 https://en.wikipedia.org/wiki/intensive_care_unit https://creativecommons.org/licenses/by-sa/3.0/ intensive care medicine wikipedia-en-6332859.html an intensive care unit (icu), also known as an intensive therapy unit or intensive treatment unit (itu) or critical care unit (ccu), is a special department of a hospital or health care facility that provides intensive treatment medicine. intensive care units cater to patients with severe or life-threatening illnesses and injuries, which require constant care, close supervision from life support equipment and medication in order to ensure normal bodily functions. they are staffed by highly trained physicians, nurses and respiratory therapists who specialize in caring for critically ill patients. icus are also distinguished from general hospital wards by a higher staff-to-patient ratio and access to advanced medical resources and equipment that is not routinely available elsewhere. common conditions that are treated within icus include acute respiratory distress syndrome, septic shock and other life-threatening conditions. patients may be referred directly from an emergency department or from a ward if they rapidly deteriorate, or immediately after surgery if the surgery is very invasive and the patient is at high risk of complications. history in 1854, florence nightingale left for the crimean war, where triage was used to separate seriously wounded soldiers from those with non-life-threatening conditions. until recently, it was reported that nightingale reduced mortality from 40% to 2% on the battlefield. although this was not the case, her experiences during the war formed the foundation for her later discovery of the importance of sanitary conditions in hospitals, a critical component of intensive care. in 1950, anesthesiologist peter safar established the concept of advanced life support, keeping patients sedated and ventilated in an intensive care environment. safar is considered to be the first practitioner of intensive care medicine as a speciality. in response to a polio epidemic (where many patients required constant ventilation and surveillance), bjørn aage ibsen established the first intensive care unit in copenhagen in 1953. the first application of this idea in the united states was in 1955 by william mosenthal, a surgeon at the dartmouth-hitchcock medical center. in the 1960s, the importance of cardiac arrhythmias as a source of morbidity and mortality in myocardial infarctions (heart attacks) was recognized. this led to the routine use of cardiac monitoring in icus, especially after heart attacks. staffing most studies addressing staffing of icus have had significant limitations, and this literature does not yet provide a consistent view of the best model to use. this subject is complicated by the fact that optimal icu staffing may depend on icu characteristics. despite calls for all icus to function as closed-model units with intensivists as the primary physician of record, evidence supporting this view is contradictory. likewise, studies of around-the-clock intensivist presence have not consistently shown that it is associated with superior outcomes. the data do not supply a consistent answer to the question of whether icus would obtain better outcomes if they added nurses to reduce their patient:nurse ratios. increasingly, nonphysician providers are playing innovative roles in the icu, and care provided by teams including nurse practitioners or physician assistants appears to be safe and comparable to that provided by other staffing models. the conditions of icu staffing will continue to change under the stresses of shortages of a variety of health care workers relevant to icu care, and increasing duty hour limitations for physician trainees. nonphysician providers, innovative staffing models, telemedicine, and other technologies will be increasingly used to cope with these realities. since only quantitative evaluation can tell us whether one staffing model is better than another, we need more research from multiple sites to develop a consistent and integrated understanding of this complex topic. specialities hospitals may have icus that cater to a specific medical requirement or patient, such as those listed below: neonatal intensive care unit (nicu). this specialty unit cares for neonatal patients who have not left the hospital after birth. common conditions cared for include prematurity and associated complications, congenital disorders such as congenital diaphragmatic hernia, or complications resulting from the birthing process. pediatric intensive care unit (picu). pediatric patients are treated in this intensive care unit for life-threatening conditions such as asthma, influenza, diabetic ketoacidosis, or traumatic neurological injury. surgical cases may also be referred to the picu postoperatively if the patient has a potential for rapid deterioration or if the patient requires monitoring, such as spinal infusions or surgeries involving the respiratory system such as removal of the tonsils or adenoids. some facilities also have specialized pediatric cardiac intensive care units, for patients with congenital heart disease are treated. these units also typically cater for cardiac transplantation and postoperative cardiac catheterization patients if those services are offered at the hospital. geriatric intensive-care unit (gicu), a special intensive care unit dedicated to management of critically ill elderly. psychiatric intensive care unit (psicu). patients who may voluntarily harm themselves are brought here for more vigorous monitoring. coronary care unit (ccu): also known as cardiac intensive care units (cicu) or cardiovascular intensive care unit (cvicu), this icu caters to patients specifically with congenital heart defects or life-threatening cardiac conditions such as a myocardial infarction or a cardiac arrest. neurological intensive care unit (neuroicu). patients are treated for brain aneurysms, brain tumors, stroke, rattlesnake bites and post surgical patients who have undergone various neurological surgeries performed by experienced neurosurgeons require constant neurological exams. nurses who work within these units have neurological certifications. once the patients are stable and removed from the ventilator, they are transferred to a neurological care unit. traumatic intensive care unit (ticu). these are found in hospitals certified in treating traumatic injuries/illnesses requiring a dedicated trauma emergency team equipped with the expertise to deal with serious complications. a traumatic specialist team includes surgeons, nurses, respiratory therapists, and radiological staff. post-anesthesia care unit (pacu): also known as the post-operative recovery unit, or recovery room, the pacu provides immediate post-op observation and stabilisation of patients following surgical operations and anesthesia. patients are usually held in such facilities for a limited amount of time and have to meet set physiological aspects before being transferred back to a ward with a qualified nurse escort. owing to high patient flow in recovery units, and to the bed management cycle, if a patient breaches a time frame and is too unstable to be transferred back to a ward, they are normally transferred to a high dependency unit (hdu) or post-operative critical care unit (poccu) in order to receive progressive treatment. high dependency unit (hdu): in the united kingdom and elsewhere (known as step down unit or progressive care unit in north america), most acute hospitals have a transitional high dependency unit (hdu) for patients who require close observation, treatment and nursing care that cannot be provided in a general ward, but whose care is not at a critical stage to warrant an (icu) bed. these units are also called step-down or progressive intensive recovery units and are utilised until a patient's condition stabilizes to qualify for discharge to a general ward or recovery unit. surgical intensive care unit (sicu): also known as the surgery critical care unit, the sicu is a specialized service in larger hospitals that provides inpatient care for critically ill patients on surgical services. as opposed to other icus, the care is managed by surgeons or anesthesiologists trained in critical-care. mobile icu mobile intensive care unit (micu) a specialized ambulance with the team and equipment to provide on-scene advanced life support and intensive care during transportation. these type of icus are generally used for people who are being transferred from hospitals and from home to a hospital. in the anglo american model of pre-hospitalisation care micus are generally crewed by (ect practitioners) or advanced life support paramedics. in the european model, mobile icu teams are usually managed by a critical care nurse and an emergency medicine physician/medical doctor (m.d). equipment and systems common equipment in an icu includes mechanical ventilators to assist breathing through an endotracheal tube or a tracheostomy tube; cardiac monitors for monitoring cardiac condition; equipment for the constant monitoring of bodily functions; a web of intravenous lines, feeding tubes, nasogastric tubes, suction pumps, drains, and catheters, syringe pumps; and a wide array of drugs to treat the primary condition(s) of hospitalization. medically induced comas, analgesics, and induced sedation are common icu tools needed and used to reduce pain and prevent secondary infections. quality of care the available data suggests a relation between icu volume and quality of care for mechanically ventilated patients. after adjustment for severity of illnesses, demographic variables, and characteristics of different icus (including staffing by intensivists), higher icu staffing was significantly associated with lower icu and hospital mortality rates. a ratio of 2 patients to 1 nurse is recommended for a medical icu, which contrasts to the ratio of 4:1 or 5:1 typically seen on medical floors. this varies from country to country, though; e.g., in australasia and the united kingdom, most icus are staffed on a 2:1 basis (for high-dependency patients who require closer monitoring or more intensive treatment than a hospital ward can offer) or on a 1:1 basis for patients requiring extreme intensive support and monitoring; for example, a patient on a mechanical ventilator with associated anaesthetics or sedation such as propofol, midazolam and use of strong analgesics such as morphine, fentanyl and/or remifentanil. international guidelines recommend that every patient gets checked for delirium every day (usually twice or as much required) using a validated clinical tool. the two most widely used are the confusion assessment method for the icu (cam-icu) and the intensive care delirium screening checklist (icdsc). there are translations of these tools in over 20 languages and they are used globally in many icu's. operational logistics in the united states, up to 20% of hospital beds can be labelled as intensive-care beds; in the united kingdom, intensive care usually will comprise only up to 2% of total beds. this high disparity is attributed to admission of patients in the uk only when considered the most severely ill. intensive care is an expensive healthcare service. a recent study conducted in the united states found that hospital stays involving icu services were 2.5 times more costly than other hospital stays. in the united kingdom in 2003–04, the average cost of funding an intensive care unit was: £838 per bed per day for a neonatal intensive care unit £1,702 per bed per day for a pediatric intensive care unit £1,328 per bed per day for an adult intensive care unit remote collaboration systems some hospitals have installed teleconferencing systems that allow doctors and nurses at a central facility (either in the same building, at a central location serving several local hospitals, or in rural locations another more urban facility) to collaborate with on-site staff and speak with patients (a form of telemedicine). this is variously called an eicu, virtual icu, or tele-icu. remote staff typically have access to vital signs from live monitoring systems, and telectronic health records so they may have access to a broader view of a patient's medical history. often bedside and remote staff have met in person and may rotate responsibilities. such systems are beneficial to intensive care units in order to ensure correct procedures are being followed for patients vulnerable to deterioration, to access vital signs remotely in order to keep patients that would have to be transferred to a larger facility if need be he/she may have demonstrated a significant decrease in stability. see also icu quality and management tools intensive care foundation, a charity in australia and new zealand intensive care medicine (journal) open-source ventilator references further reading lois reynolds; tilli tansey, eds. (2011), history of british intensive care, c. 1950–c. 2000, wellcome witnesses to contemporary medicine, history of modern biomedicine research group, isbn 978-0-902238-75-6, wikidata q29581786 external links ""intensive care"". nhs choices. uk: national health service. 2017-10-18. ""critical care"". medlineplus. us: national library of medicine, national institutes of health. society of critical care medicine icusteps – intensive care patient support charity organisation for critical care transportation reynolds, h.n.; rogove, h.; bander, j.; mccambridge, m.; et al. (december 2011). ""a working lexicon for the tele-intensive care unit: we need to define tele-intensive care unit to grow and understand it"" (pdf). telemedicine and e-health. 17 (10): 773–783. doi:10.1089/tmj.2011.0045. hdl:2027.42/90470. pmid 22029748. olson, terrah j. paul; brasel, karen j.; redmann, andrew j.; alexander, g. caleb; schwarze, margaret l. (january 2013). ""surgeon-reported conflict with intensivists about postoperative goals of care"". jama surgery. 148 (1): 29–35. doi:10.1001/jamasurgery.2013.403. pmc 3624604. pmid 23324837."
23	singapore reports 4th death from covid-19, a 68-year-old indonesian national - cna text extraction from html file; language identification https://elrc-share.eu under review 2020 singapore reports 4th death from covid-19, a 68-year-old indonesian national - cna text/html https://www.channelnewsasia.com/news/singapore/coronavirus-covid-19-death-moh-singapore-indonesian-12600750 coronavirus covid-19 en_2020_04_957.xml_125.html singapore reports 4th death from covid-19, a 68-year-old indonesian national toggle share menu singapore reports 4th death from covid-19, a 68-year-old indonesian national advertisement singapore reports 4th death from covid-19, a 68-year-old indonesian national the national centre for infectious diseases. (photo: rauf khan) 02 apr 2020 09:02am share this content bookmark singapore: singapore on thursday (apr 2) reported its fourth death related to covid-19, a 68-year-old indonesian national. the patient died from complications due to the disease at 6.43am on thursday, said the ministry of health (moh). he had a history of diabetes and hypertension. advertisement advertisement the man was a singapore work pass holder and had been in indonesia from jan 20 to mar 16. read: travel bans and covid-19: what happens when a deadly new virus keeps loved ones apart on mar 22, he was admitted to the national centre for infectious diseases (ncid) and was confirmed to have covid-19 on the same day. he was in the intensive care unit from mar 26, and developed serious complications, eventually succumbing to the disease after seven days. advertisement advertisement the ncid has reached out to the man's family and is extending assistance to them, said moh. the patient's profile matches that of case 476, which was first reported by moh on mar 23. read: daughter of man who died from covid-19 thanks singaporeans, healthcare staff the country saw its first deaths related to the novel coronavirus on mar 21 , a 75-year-old singaporean woman and a 64-year-old indonesian man. the woman had a history of chronic heart disease and hypertension and the man had a history of heart disease.
23	transfusion associated circulatory overload crawling and normalization ilsp european language resource coordination https://elrc-share.eu under review 2020 transfusion associated circulatory overload text/html wikimedia foundation 2020-06-11 https://en.wikipedia.org/wiki/transfusion_associated_circulatory_overload https://creativecommons.org/licenses/by-sa/3.0/ respiratory diseases wikipedia-en-18587751.html in transfusion medicine, transfusion associated circulatory overload (aka taco) is a transfusion reaction (an adverse effect of blood transfusion) that can occur due to a rapid transfusion of a large volume of blood, but can also occur during a single red cell transfusion (about 15% of cases). the fluid volume causes hypervolemia. symptoms and signs the primary symptoms of taco are dyspnea, orthopnea, peripheral edema, and rapid increase of blood pressure. taco must be suspected when there is respiratory distress with other signs, including pulmonary edema, unanticipated cardiovascular system changes, and evidence of fluid overload (including improvement after diuretic, morphine or nitrate treatment), during or up to 24 hours after transfusion. risk factors low albumin cardiovascular disease kidney disease lung disease severe anemia age (less than 3 years old and over 60 years old) diagnosis the international society of blood transfusion (isbt) working party on hemovigilance in collaboration with the international haemovigilance network (ihn) and aabb produced new reporting criteria in 2018. patients classified with taco should have acute onset or worsening respiratory distress or evidence of pulmonary edema, or both during or up to 12 hours after transfusion. they should have at least 3 of the following characteristics: acute or worsening respiratory distress (tachypnoea, shortness of breath, cyanosis, and decreased oxygen saturations) in the absence of other causes evidence of acute or worsening pulmonary edema (by physical examination, or chest imaging, or other non-invasive assessment of heart function e.g. echocardiogram) evidence of unanticipated cardiovascular system changes (tachycardia, hypertension, widened pulse pressure, jugular venous distension, peripheral edema) evidence of fluid overload (positive fluid balance, response to diuretic therapy with clinical improvement, change in the patient’s weight in the peri-transfusion period) changes in a relevant biomarker e.g. elevation in natriuretic peptide (np) levels (e.g. brain-natriuretic peptide (bnp), n-terminal (nt)-pro bnp) to greater than 1.5 times the pre-transfusion value. differential diagnosis taco and trali are both respiratory complications following a transfusion. taco and transfusion related acute lung injury (trali) are often difficult to distinguish in the acute situation. taco is usually associated with hypertension and responds well to diuretics, trali is often associated with hypotension and diuretics have a minimal effect. a normal natriuretic peptide level post-transfusion is seen with trali but not with taco. prevention transfusion associated circulatory overload is prevented by avoiding unnecessary transfusions, closely monitoring patients receiving transfusions, transfusing smaller volumes of blood at a slower rate, and considering the use of diuretics. a pre-transfusion taco checklist can be used to assess patients' risk of developing taco. management if taco is suspected stop the transfusion. treat with oxygen, diuretics, and other treatments for cardiac failure. occurrence it is difficult to determine the incidence of taco, but its incidence is estimated at about one in every 100 transfusions using active surveillance, and in one in every 10000 transfusions using passive surveillance. taco is the most commonly reported cause of transfusion-related death and major morbidity in the uk, and second most common cause in the usa. the risk increases with patients over the age of 60, patients with cardiac or pulmonary failure, renal impairment, hypoalbuminemia or anemia. references external links
23	"induced coma crawling and normalization ilsp european language resource coordination https://elrc-share.eu under review 2020 induced coma text/html wikimedia foundation 2020-06-11 https://en.wikipedia.org/wiki/induced_coma https://creativecommons.org/licenses/by-sa/3.0/ intensive care medicine wikipedia-en-1275750.html an induced coma, also known as a medically induced coma, a barbiturate-induced coma, or a barb coma, is a temporary coma (a deep state of unconsciousness) brought on by a controlled dose of a barbiturate drug, usually pentobarbital or thiopental. barbiturate comas are used to protect the brain during major neurosurgery, as a last line of treatment in certain cases of status epilepticus that have not responded to other treatments, and in refractory intracranial hypertension following traumatic brain injury. induced coma was a feature of the milwaukee protocol, a now-discredited method that was promoted as a means of treating rabies infection in people. induced coma usually results in significant systemic adverse effects. the patient is likely to completely lose respiratory drive and require mechanical ventilation. gut motility is reduced. hypotension can complicate efforts to maintain cerebral perfusion pressure and often requires the use of vasopressor drugs. hypokalemia often results. the completely immobile patient is at increased risk of bed sores as well as infection from indwelling lines. theory barbiturates reduce the metabolic rate of brain tissue, as well as the cerebral blood flow. with these reductions, the blood vessels in the brain narrow, decreasing the amount of space occupied by the brain, and hence the intracranial pressure. the hope is that, with the swelling relieved, the pressure decreases and some or all brain damage may be averted. several studies have supported this theory by showing reduced mortality when treating refractory intracranial hypertension with a barbiturate coma. about 60% of the glucose and oxygen use by the brain is meant for its electrical activity and the rest for all other activities such as metabolism. when barbiturates are given to brain injured patients for induced coma, they act by reducing the electrical activity of the brain, which reduces the metabolic and oxygen demand. the infusion dose rate of barbiturates is increased under monitoring by electroencephalography until burst suppression or cortical electrical silence (isoelectric ""flatline"") is attained. once there is improvement in the patient's general condition, the barbiturates are withdrawn gradually and the patient regains consciousness. controversy exists over the benefits of using barbiturates to control intracranial hypertension. some studies have shown that barbiturate-induced coma can reduce intracranial hypertension but does not necessarily prevent brain damage. furthermore, the reduction in intracranial hypertension may not be sustained. some randomized trials have failed to demonstrate any survival or morbidity benefit of induced coma in diverse conditions such as neurosurgical operations, head trauma, intracranial aneurysm rupture, intracranial hemorrhage, ischemic stroke, and status epilepticus. if the patient survives, cognitive impairment may also follow recovery from the coma. see also insulin shock therapy traumatic brain injury references"
24	fairburn police employee dies from covid-19, diabetes complications text extraction from html file; language identification https://elrc-share.eu under review 2020 fairburn police employee dies from covid-19, diabetes complications text/html https://www.ajc.com/news/breaking-news/fairburn-police-employee-dies-from-covid-diabetes-complications/3ylfhqhbxrylxtynorq8eo/ en_2020_04_5630.xml_150.html fairburn police employee dies from covid-19, diabetes complications cheryl catron by zachary hansen , the atlanta journal-constitution two days after falling ill, a fairburn police department employee died due to complications from covid-19 and diabetic ketoacidosis. cheryl catron worked for the department as a civilian administrative aide through last wednesday before becoming sick, police chief stoney mathis said in a facebook post. her condition worsened the following day, leading to her hospitalization. she died just before midnight friday. “we are heartbroken here,” he said in the post. “losing a member of our fairburn family is an awful thing to endure. our thoughts and prayers are with cheryl's family, friends and all those she loved. she will be greatly missed and never forgotten.” complete coverage: coronavirus in georgia catron's cousin created a gofundme page to assist with funeral costs. the family added that catron had diabetic ketacidosis, which is a potentially lethal complication of diabetes . “we know all of you had your own special relationships with her: she was your sister, auntie, cousin, niece, friend, classmate, colleague, etc. so we know with certainty that you share in our unbelievable grief at this time,” the page said. the police department said they did not announce the news until tuesday because they wanted to confirm she was a covid-19 victim before potentially sharing misinformation. the chief learned of the positive diagnosis from the family monday night. it is with a heavy heart that i must report the death of one of our wonderful fairburn pd team, ms. cheryl catron.... related: georgia police officer reportedly tests positive for coronavirus the department's lobby and administrative offices remain closed, and catron's coworkers who recently were in direct contact with her were ordered to self-quarantine. officers are still working the city's streets and detectives are working in rotating shifts to lessen their exposure, mathis added. “the officers are demonstrating incredible courage each day they come to work and start answering calls for help,” deputy chief anthony bazydlo told ajc.com. “their dedication to service is what's keeping us moving forward right now.” he also said the department has received “lots of calls and messages” showing support for catron's family and her coworkers. as of tuesday afternoon, the gofundme page had raised about $400. ajc.com has reached out to the city of fairburn about catron's death. in other news:
24	"utah governor signs law capping insulin co-pays at $30 for people with diabetes | markets insider text extraction from html file; language identification https://elrc-share.eu under review 2020 utah governor signs law capping insulin co-pays at $30 for people with diabetes | markets insider text/html https://markets.businessinsider.com/news/stocks/utah-governor-signs-law-capping-insulin-co-pays-at-30-for-people-with-diabetes-1029073600 en_2020_04_5623.xml_74.html utah governor signs law capping insulin co-pays at $30 for people with diabetes press release pr newswire apr. 7, 2020, 11:13 pm arlington, va., april 7, 2020 /prnewswire/ -- recently, utah governor gary herbert signed into law american diabetes association-supported legislation capping monthly copayments for insulin at $30 for a 30-day supply. house bill 207 (hb 207) also includes an emergency refill provision that will allow people without an up-to-date prescription to get insulin immediately rather than waiting until they are able to get a refill authorized by a physician, as well as a provision directing the utah department of insurance to issue a report that includes a summary of insulin pricing practices. the american diabetes association (ada) is encouraged that the utah governor and legislature have put the more than 206,000 people living with diabetes in utah at the forefront in this difficult time. ""right now, americans with diabetes are facing unprecedented financial challenges as the country responds to the coronavirus crisis,"" said lashawn mciver, md, mph, senior vice president of government affairs & advocacy for the ada. ""the high cost of insulin can have devastating consequences, often forcing those living with diabetes to make hard choices that can lead to devastating health complications. starting january 1, 2021, this new law will remove one of the burdens faced by many people with diabetes in utah who need insulin to live. we are grateful to governor herbert and the utah legislature, including bill sponsors representative norman thurston and senator deidre henderson, whose dedication to helping those with diabetes thrive made house bill 207 possible."" ""the diabetes community in utah has won a major victory now that house bill 207 has been approved. the new law provides several provisions that help to ensure that no one in utah will ever have to leave the pharmacy without their insulin,"" said representative thurston. ""diabetes in utah is a growing concern. the costs of prescription drugs like insulin have skyrocketed in recent years. many utah residents with diabetes have been forced to limit their insulin use because they simply cannot afford to fill the prescription,"" said timothy j. staley, utah advocacy chair for the ada. ""i am proud of our state for being at the forefront in taking legislative steps to help in combating this disease."" for more information about this legislation, please contact representative thurston at normthurston64@gmail.com. while this co-pay cap is a step forward in the fight for affordable insulin, the ada recognizes that people with diabetes need relief now more than ever to stay healthy and out of doctor's offices, emergency rooms, and hospitals. to address the immediate needs of people with diabetes in utah during the coronavirus pandemic, the ada has urged governor herbert to eliminate all cost-sharing for insulin in state-regulated health insurance plans and revert to the $30 co-pay cap when the crisis passes. the ada also urged state governors to ensure continuous access to health care for residents with diabetes who have lost their jobs due to the economic impact of the pandemic. the ada continues to be the driving force in federal and state efforts to ensure that insulin is affordable and accessible for all people who need it. take action today at diabetes.org/advocacy/platform. if you are struggling to pay for insulin or know someone who is, the ada has resources to help-visit insulinhelp.org. about the american diabetes association every day more than 4,000 people are newly diagnosed with diabetes in america. more than 122 million americans have diabetes or prediabetes and are striving to manage their lives while living with the disease. the american diabetes association (ada) is the nation's leading voluntary health organization fighting to bend the curve on the diabetes epidemic and help people living with diabetes thrive. for nearly 80 years the ada has been driving discovery and research to treat, manage and prevent diabetes, while working relentlessly for a cure. we help people with diabetes thrive by fighting for their rights and developing programs, advocacy and education designed to improve their quality of life. diabetes has brought us together. what we do next will make us connected for life. to learn more or to get involved, visit us at diabetes.org or call 1-800-diabetes (1-800-342-2383). join the fight with us on facebook (american diabetes association), twitter (@amdiabetesassn) and instagram (@amdiabetesassn). contact: alex day, 703-253-4843"
24	mexico official calls diet a factor as coronavirus death toll climbs - reuters text extraction from html file; language identification https://elrc-share.eu under review 2020 mexico official calls diet a factor as coronavirus death toll climbs - reuters text/html https://uk.reuters.com/article/us-health-coronavirus-mexico/mexico-official-calls-diet-a-factor-as-coronavirus-death-toll-climbs-idukkbn21n017 us health coronavirus mexico americas healthcare policy health / medicine south america / central america mexico government / politics infectious diseases general news diabetes respiratory conditions healthcare (trbc) communicable diseases diseases emerging market countries obesity epidemics en_2020_04_3458.xml_199.html april 5, 2020 / 1:34 am / 5 months ago mexico official calls diet a factor as coronavirus death toll climbs 2 min read file photo: a woman wearing protective mask and gloves walks in downtown mexico city, as mexico's government declared a health emergency and issued stricter rules to curb the spread of the coronavirus disease (covid-19), mexico april 3, 2020. reuters/carlos jasso mexico city (reuters) - mexican deputy hugo lopez-gatell said on saturday that decades of poor eating habits in the country have created an epidemic of obesity, diabetes and other related health complications that make its people more vulnerable to the novel coronavirus. the mexican health ministry has so far registered a total of 1,890 cases of the novel coronavirus and 79 deaths. related coverage mexican president, blackrock ceo discussed coronavirus impact “these people, unfortunately, had chronic diseases or were older,” lopez-gatell said during a press conference, adding that the country had one of the world's highest rates of diabetes and obesity. “this is the product of many years, at least four decades, of poor nutrition, a diet that has been created by products of low nutritional quality and very high calories, in particular in processed foods,” lopez-gatell said. the world health organization has said people with diabetes and its related health complications are among those most vulnerable to severe cases of the highly contagious and sometimes deadly illness caused by the new coronavirus. reporting by stefanie eschenbacher and adriana barrera; editing by david gregorio
1101	"sweden is vigilant while making anti-virus measures - china.org.cn text extraction from html file; language identification https://elrc-share.eu under review 2020 sweden is vigilant while making anti-virus measures - china.org.cn application/xhtml+xml http://www.china.org.cn/world/2020-04/01/content_75885112.htm sweden covid-19 en_2020_04_74.xml_197.html you are here: world > top news > sweden is vigilant while making anti-virus measures by wu jin e-mail china.org.cn, april 1, 2020 adjust font size: 下载安装flash播放器 ""the swedish government has been cautious while implementing every policy mapped out to fight against the global pandemic of covid-19,"" said yang li, a chinese working as the regional manager of china at jonkoping university in sweden. the measures that are being carried out consist of a minimum 30-day embargo on inbound trips from countries and regions outside the european union, home isolation, and the shift to online education. furthermore, the swedish government has also pledged to finance those whose incomes have been affected by home isolation. ""data and policies in sweden are very transparent. however, the government is cautious about making any decisions that may restrict the mobility of its people and impose a negative impact on the economy, while managing to prevent and control the epidemic,"" yang said. ""therefore,"" she continued, ""the government modifies policies in response to the situation, and no decisions are made once and for all."" according to yang, to prevent the public from overwhelming the country's finite health system, the policies are designed to give priority to those who need clinical treatments the most. ""different from chinese people, citizens in sweden rarely visit hospitals so long as the disease is not severe,"" the manager explained. in this sparsely populated nation, the government's primary policy is to dissuade people from gathering in large groups to reduce the chances of transmissions. ""despite pandemic percussions, life seems normal. for instance, there has been no shortage of daily supplies, though the shelves of toilet rolls and staple foods in local supermarkets empty occasionally,"" said yang. yet, the real problem is the protective medical necessities. however, some indigenous producers have already reinstalled assembly lines to embark on making face masks. while undergoing the pandemic in a foreign country, yang said that she will continue to work and stay in sweden. ""based on my knowledge, few chinese in sweden chose to return to china, because on the one hand, we still need to serve the overseas chinese students who remain in the country, and on the other hand, home isolation isn't hard in sweden. therefore, we opt to stay where we are,"" yang said. follow china.org.cn on twitter and facebook to join the conversation."
1101	"coronavirus: how sweden is battling the covid-19 with its “work under responsibility” motto text extraction from html file; language identification https://elrc-share.eu under review 2020 coronavirus: how sweden is battling the covid-19 with its “work under responsibility” motto text/html https://yourstory.com/2020/04/coronavirus-sweden-battling-covid-19-pandemic sweden coronavirus lockdown covid-19 en_2020_04_999.xml_138.html coronavirus: how sweden is battling the covid-19 with its “work under responsibility” motto by robin sukhia |2nd apr 2020 the novel coronavirus has taken over the world. markets have fallen, economies have come to a halt. each country is dealing with the pandemic in its own way. here's how sweden is battling the covid-19. 0 claps share on share on the covid-19 hit the world from nowhere, or did it? after sars, which started at the end of 2002, i think everyone travelling has some sort of understanding that this can happen, and likely would happen again. compared to the novel coronavirus, sars was rather mild but scary enough. the world today is very different than it was in 2002-03. globalism had not become the new normal - neither for business nor for the tourist. flying in europe or india today is as easy as taking a bus. also read no alcohol, no tourists, but life goes on in hong kong amid the crippling coronavirus pandemic the way forward for europe, it would have been great if there was a coherent strategy and a common body to manage the spread of the coronavirus, especially given the easiness of the mobility of people within the union. an eu body should be set up be allocated resources, as well as mandate and coordination responsibilities with all member state's health care departments and a direct link to all hospitals. this would give decision makers' better information in real-time to make better decisions. the eu has 446 million people while india has 1.3 billion. in a pandemic spread like coronavirus, you not only need a firm decision-making body to manage communication and resources, you want to have it as a citizen, it creates structure, reason, and a sense of calm in a fear spreading environment. in europe, all countries quickly went their own way without a clear eu direction. to be fair, eu leadership was never given such a management mandate for health crises, but perhaps in the future, they will. many countries have chosen a complete shutdown of everything from allowing citizens to step outside (only for necessities) to shutting down of public transportation and restaurants, and more. also read coronavirus in europe: quarantining as a tourist during the covid-19 lockdown what sweden did countries will make decisions based on their own set of circumstances and their ability to organise a response to the epidemic. my country sweden chose a somewhat different path. whether or not this is the right path, only time will tell. we have chosen not to shut down society, thereby allowing for public transport, restaurant visits, though seated guests are only allowed takeout, essentially letting businesses make their own judgement call. government offices also remain open. in general, a minimised public society. half of stockholm is working from home. on the corporate side, according to the stockholm chamber of commerce, this goes as high as 90 percent. because 50 percent of the swedish gdp is based on export, and it is understandable that business is taking a massive hit at the moment. with the shutting down of the service industry, i fear our economy will not recover from such a hit in a very long time also read covid-19 diary: why we will wait till next year to enjoy the cherry blossoms in japan work under responsibility the swedish model chosen here puts a lot of responsibility on the individual to be just that - responsible. this is rooted in our culture and through our workplace, mainly through a concept we call ""work under responsibility"". it basically means that you have more flexible working hours as long as you do your job. swedes also have a longstanding and implicit trust in authority. so, if the government asks us as citizens to do something that makes sense, we usually do it. in this case, it asked people, who show any kind of symptoms, to stay at home for two weeks. if they have the flu but can cope, they have been asked to stay at home in quarantine, until they are fine and then wait a few more days. the government have also asked people not to travel from highly-infected areas to low-infected areas, especially during the upcoming easter holidays. it has already told senior citizens and other risk groups to stay at home. generally, i would say it works and we can still allow for the economic wheel to keep spinning. another cultural aspect reflected well in the bbc article on march 29 is the fact that swede's are outdoor people. being outdoors is a way for people to stay physically and mentally healthy. i would argue that given the generally cold and definitely darker winter months, we are pretty good at staying at home as well. other factors particular to sweden is that there are only core family members living together - no grandparents. in fact, stockholm has a lot of one- or two person households. also read"
1101	"youtube icon text extraction from html file; language identification https://elrc-share.eu under review 2020 youtube icon text/html https://www.telegraph.co.uk/news/2020/04/01/sweden-may-have-escaped-lockdown-struggling-resist-socialism/ opinion sweden comment news economic crises pandemics and epidemics coronavirus en_2020_04_579.xml_74.html sweden may have escaped lockdown, but it is struggling to resist socialism save still open for business: drottninggatan ('queen's street') in stockholm on april 1 credit: fredrik sandberg/tt/epa-efe/shutterstock while much of europe is in a state of lockdown, sweden is pursuing a less restrictive strategy in response to the covid-19 epidemic. rather than imposing bans, the swedish government is focusing on informing citizens about how to minimise spread of the virus. many restaurants, gyms and stores remain open, along with most schools and pre-schools , and the government stresses that healthy students are legally required to show up for classes. nevertheless, much of the country's economic activity has come to a halt. as a response to the epidemic, moreover, economic policies are shifting towards state control, which might make recovery more difficult. sweden has a unique culture, built upon giving others personal space. if you sit down in a bus, the social rule is to sit as far away from others as you can. the same applies when choosing seats in a café or restaurant. it is common practice not to go out in the hall at the same time as the neighbors, in order to reduce unnecessary social contact. some swedes have the habit of kissing and hugging when they meet their friends, but seldom during flu season. such aspects of swedish culture prove useful in a time of quarantine since they minimise the risk of virus transmission. keeping space to others is after all, besides washing hands, one of the two key measures that citizens can use in order to reduce virus contamination. another important cultural difference is sweden's strong respect for authority. the advice of swedish governmental agencies has been largely followed by the population, reducing the need for strict bans. this can explain why sweden has been slower than other european nations to introduce bans on public meetings. sweden has a unique culture, built on giving others personal space credit: jonathan nackstrand/afp via getty images on march 12 a ban was put in place, for events including 500 people or more. these rules were largely followed, with the exception of after-ski events that allowed up to 499 people - enraging the government. since march 27 the rules have been tightened, banning events of 50 or more people . the authorities stress that while these rules do apply to graduation ceremonies, they do not include schools and preschools. the swedish strategy involves keeping schools open for as long as possible, so that parents are not forced to stay home and thereby bring the economy to a standstill. it remains to be seen how well these policies are working as sweden, like many other countries, struggles to deal with the current epidemic. the number of deaths has climbed from 3 on march 15, to 21 on march 11, to 110 on march 29. the number of people infected cannot be estimated with any accuracy, since tests are focused on patients and risk groups, similar to other medium-sized european countries struggling with the epidemic. while the less restrictive attitude of swedish authorities does allow some business to continue operating, overall the situation is problematic. according to the swedish public employment office, 36,800 people were informed during march 2020 that their employments were terminated. this is a record, surpassing 19,900 people fired in november 2008 during the latest great global financial crises. it even surpasses the 22 200 jobs lost during november 1992, during the great swedish crises in the beginning of the 1990s. what makes the recent reform unusual is the change in economic direction. after the crises in the 1990s, sweden went through three decades of reform, focused on increasing business freedom and reducing state involvement in the economy. during the latest weeks however, policies have again shifted towards state control. coronavirus live map .. swedish businesses are doing their bit to help during the crisis. h&m is manufacturing protective wear, initially planned for donation rather than sales. a local ikea store in the rural municipality of kållered donated 50,000 breathing masks to a public hospital. parts of swedish manufacturing are focused on manufacturing breathing apparatus and other necessities for combating the covid-19 epidemic. at the same time, the government's tone towards business has changed markedly during the crises. per bolund, minister for financial markets and one of the two spokespersons for the green party, has criticised volvo for planned dividends paid to stockowners. magdalena andersson, social democrat minister for finance, has suggested that stimulus support rules might change, so that businesses that continue with dividends are not granted them. the influential social democratic think tank arena idé has proposed that the government uses the stimulus to purchase up ownership share of private enterprises. according to their chief economists, sandro scocco, stimulus policy would be to ""donate money to the companies"". the think tank proposes that the government identifies viable businesses in need of aid during the crises, and instead of giving stimulus buys up ownership in them. magdalena andersson herself has recently, on the 30th of march, opened up to using government funds to buy up shares in private enterprises during the crisis. retraining: former scandinavian airlines flight attendants are learning basic skills on to assist in nursing homes and hospitals credit: ap photo/david keyton the leader of the left party has claimed that some private health operators are not helping during the crisis, and that the public sector must therefore be given the right to take over private firm operations. the socialist economic policies that sweden has spent three decades moving away from, are making a surprising comeback during the epidemic. these new economic policies would not have surfaced a few weeks ago, before the covid-19 epidemic. the public policy debate in sweden has gradually shifted towards individual and business liberty, and so has public opinion. the current government of sweden, made up of social democrats and the green party, bases its power on the january agreement of 2019. this agreement was signed with the liberals and the center party - both advocates of free market economic policies. it states that the government is to pursue tax cuts, increase business freedom and stop the attack against private health care. due to the agreement, in the beginning of 2020 the 5pc highest marginal tax rate of sweden was slashed. the next move, which seems to have been stopped now, was to privatise the unemployment office. suddenly, with the covid-19 crises, economic policies in sweden have shifted significantly towards state control. it remains to be seen how far this shift will be, and how it impacts on the nation's ability to recover from the crisis. dr. nima sanandaji is the author of 25 books on entrepreneurship and policy, and president of european centre for entrepreneurship and policy reform (ecepr). related topics"
1104	"wash first, then sanitize to prevent covid-19 | farm progress text extraction from html file; language identification https://elrc-share.eu under review 2020 wash first, then sanitize to prevent covid-19 | farm progress text/html https://www.farmprogress.com/rural-health/wash-first-then-sanitize-prevent-covid-19 en_2020_04_5521.xml_107.html brought to you by ron smith soap and water should be the first step to sanitize workspaces and tools following suspected contamination or as a routine cleaning practice. disinfectants follow as needed. wash first, then sanitize to prevent covid-19 farms not immune to covid-19 infection ron smith | apr 07, 2020 even though farms may be more isolated than businesses in town, they are still vulnerable to coronavirus infection. employees come in, deliveries come in, and farmers and others go out to pick up supplies and conduct business. related: southeast acreage: peanuts, corn up, cotton down, but covid-19 market so, farmers and ranchers should develop a system to protect workspaces, tools, produce, and vehicles to limit potential for exposure. information from the centers for disease control (cdc) indicates that the coronavirus that causes covid-19 may remain viable on several types of surfaces for hours. ""potential for transmission from surface to person remains a question,"" says achyut adhikari, assistant professor, lsu agcenter, baton rouge, louisiana. ""spread of the covid-19 virus occurs most frequently through close person-to-person contact - within about 6 feet - from either direct contact or respiratory droplets from coughs or sneezes,"" adhikar says. but he and washington county, tenn., extension agent adam watson agree that taking precautions, especially if someone with symptoms or someone who may have been in contact with a person infected by the virus comes onto the farm. ""following proper environmental and cleaning programs will limit survival of the covid-19 virus on surfaces,"" adhikar says. that program must begin with thorough cleaning followed by disinfecting, watson says. ""the same concerns exist on the farm that would exist in a home or business where an individual showing no symptoms could still be leaving germs behind for the next person,"" watson says. clean first clean before disinfecting, he says. ""a very basic component of produce food safety is that 'clean' surfaces can only happen if you clean with a detergent or soap with physical action such as scrubbing, rinse completely with potable water and then apply a sanitizer as directed by the label. sanitizers must contact the germs in order to kill them, and soiled surfaces prevent that contact."" farm operations offer many surfaces and items for which basic practices of using soap, water and sanitizers will not be adequate, watson says. electronic equipment, for instance, may require special attention. ""in these cases, following the basic principle of removing surface dirt, oil, etc., is essential before a sanitizer can be effective. that may mean using a couple of sanitizing wipes, one to remove the dirt and grime and a second to sanitize the surface. let me reiterate, sanitizers don't work if soiling on a surface prevents contact between the sanitizer and the germ."" what should a farmer clean or disinfect? a farm includes many places and items that may require disinfecting. ""sanitizing shared tools, equipment, etc., in addition to surfaces like doorknobs and light switches, would certainly be a good practice,"" watson says. ""if all the parties live under the same roof, we have less concern because of shared exposure, provided everyone follows basic social distancing and employs proper handwashing if they have to venture off the farm."" adhikar recommends the following process. 1. clean and sanitize all areas that could be touched. 2. prioritize routine cleaning operations for frequently touched objects such as harvesting tools, packing containers, surfaces that contact food, produce storage refrigerators, lockers, doorknobs, trash cans and any frequently accessed areas. 3. use a sanitizer registered with the environmental protection agency (epa) in your cleaning and sanitizing practices and properly follow label instructions for concentration, application method and contact time. 4. for use in food or surfaces that contact food, always check label guidelines to see if the disinfectant is safe and recommended as a food-grade product. how to clean surfaces: 1. first, clean dirty surfaces using a detergent or soap and water before disinfection. 2. for disinfection, diluted household bleach solutions and alcohol solutions with at least 70% alcohol, as well as other common epa-registered household disinfectants can be used against coronaviruses. adhikari says following manufacturer's recommendations for application and proper ventilation is essential. the cdc bleach solution includes: 5 tablespoons (1/3 cup) of bleach per gallon of water, or 4 teaspoons of bleach per quart of water interaction with coronavirus ""our concerns increase when multiple individuals from different households interact with the same equipment,"" watson says. ""where possible, assigning equipment or tools to individuals may make sense in the short term to reduce the chance of cross contamination and to reduce the need for cleaning and sanitizing."" if someone expects an infected individual has been in a farm facility or home, adhikari recommends these cdc guidelines for facilities. 1. close off areas used by any ill people and wait as long as practical before cleaning and disinfecting. if possible, wait until 24 hours. 2. cleaning personnel should wear disposable gloves and gowns for all cleaning tasks and discard the disposable items properly after completing the work. then they should wash their hands. in cases where soap and water are not available, hand sanitizer with 60% to 95% alcohol may be used. 3. soft, porous surfaces, like carpeted floor or rugs, should be cleaned first to remove visible contamination and then laundered with the warmest appropriate water setting. they should then be allowed to dry completely. using the proper product for the job also makes a difference. ""the basic supplies include potable water, soap or detergent, cleaning brushes, cloths or paper towels, and a sanitizer appropriate for the surface."" read the label watson says sanitizing wipes can be great tools but might come with limitations. ""make sure to read and follow label directions. for instance, many sanitizing wipes readily available are not allowed on food contact surfaces unless operators follow with a potable water rinse. ""a sorting table for produce would require rinsing with potable water before placing produce on it if certain sanitizing wipes were used,"" he says. handwashing handwashing remains a crucial part of farm disease prevention. ""producers may consider constructing a handwashing station if employees don't have access to a standard sink,"" watson says. ""a quick internet search will yield resources from cooperative extension on how to construct an on-farm handwashing station. (here's one https://bit.ly/2rkm0hh ) a hand sanitizer is good to use but should not replace proper handwashing."" product list watson and adhikari say the epa provides a good list of more than 300 sanitizers specifically recognized as killing the sars-cov-2 virus. the epa site ( https://bit.ly/3byknse ) provides information on products and contact time required for efficacy. ""currently, product availability may dictate the best product to use and you may have to do a little homework,"" watson says. ""search the internet for full product label by its epa registration number."" regardless of the product, every operation needs to develop a process to determine what needs to be cleaned and sanitized, limit exposure by limiting traffic and farm access and cleaning equipment, surfaces and tools correctly. watson and adhikari agree: wash first, then sanitize. it's that simple. suggested event"
1104	schriever stays operational despite covid-19 - gps world : gps world text extraction from html file; language identification https://elrc-share.eu under review 2020 schriever stays operational despite covid-19 - gps world : gps world application/xhtml+xml https://www.gpsworld.com/schriever-stays-operational-despite-covid-19/ en_2020_04_4750.xml_59.html schriever stays operational despite covid-19 0 comments news from the u.s. air force, 50th space wing despite the worldwide covid-19 response, the 50th space wing at schriever air force base continues to execute its critical operations, while ensuring the proper steps are taken to maintain airmen's health and well-being. as of march 20, there are no confirmed cases of covid-19 at the base. the 50th space wing commander, col. james e. smith, has enacted multiple safety measures - social distancing, minimum manning and temperature checks at restricted area portals - to protect airmen and the base's critical operations. no pandemic in space airman 1st class brice brewington, 4th space operations squadron, is an extremely high-frequency satellite systems operator. “it's critical we continue the mission during trying times,” brewington said. “although there is a pandemic here on earth, there's no pandemic in space and our adversaries aren't going to stop trying to gain superiority from us any time soon. we need to stay mission-ready rain, sleet, snow, hail and even during a pandemic to complete our mission at the most elite level possible.” to minimize transmission, 4th sops airmen use cleaning wipes and sanitation spray to clean their workstations. additionally, accountability is taken daily to make certain the squadron's airmen are feeling healthy and well. “i know the service i help provide is critical for [service members] down range,” brewington said. “i take my job very seriously. lives depend on it, and we can't let a pandemic slow down our operations.” 2 sops at their stations the 2nd space operations squadron is one of the united states space force's premier units. 2 sops operates the gps mission, providing a global utility to earth's population for free. “no matter what, we need to ensure this mission continues so the american people and the world know they can depend on us to be the gold standard in precision, navigation and timing,” said lt. col stephen toth, 2nd sops commander. some of the services that use gps to operate are ambulances, hospitals, police departments and fire departments. “it would make a global pandemic that much worse if we were to go down,” toth said. “it could prevent a lot of the day-to-day things we rely on from happening, it could be catastrophic.” according to a study conducted by u.s. department of transportation on the economic impact of gps, a 30 day outage could range from a 2.7 to 5.5 billion dollar economic loss. additionally, gps supports 14 of 16 essential industries in the u.s. “we'll remain reliable no matter what the condition the world is in,” toth said. “whether it be a pandemic, hurricane, tornado or any other type of crisis, we have plans and training for whatever threat we may face so the mission doesn't stop.” unlike other jobs across the department of defense, those directly conducting operations can't telework. they need to be in a sensitive compartmented information facility or restricted area in a secured area to perform the mission. airmen can access specific terminals and networks only accessible on the operations floor. “the american people can count on space and they can count on our military to continue to provide the level of capability that's expected no matter what's going on in the world,” toth said. “in times of crisis, people shouldn't have to question whether we'll be here or not, because we will and the mission won't stop.” senior master sgt. michael welch, 50th contracting squadron superintendent, distributes sanitizer to an airman at the 50th logistics readiness flight warehouse at schriever air force base, colorado, april 2, 2020. the 50th cons secured sanitizing supplies to units across the base to prevent airmen from contracting covid-19. (photo: u.s. air force / airman 1st class jonathan whitely) rapid response and decontamination the 50th space wing stood up the rapid response decontamination detail in response to covid-19 and hosted a training session march 26 in the wing headquarters building. the training highlighted the importance of having a crew on standby to keep the mission essential operations centers clean and functioning. “it's a 24/7 team trained and equipped for rapid response to support operations inside the restricted area,” said capt. james selix, 3rd space experimentation squadron weapons officer and r2d2 officer in charge. for operations crews to request r2d2 services, a squadron commander must call the team and they have 15-30 minutes to respond and initiate the cleaning operation. “we're expecting airmen do the preventative portion of their cleaning,” selix said. “we're not there to do it for them. we are activated when there are folks showing symptoms of covid-19 or have positive tests.” the crew has a priority system should they need to deconflict requests. “we want to be rapid to support operations,” selix said. “[airmen] are continuing their missions 24/7 and if their crews are doing deep cleanings, that's pulling them away from doing supports, contacting satellites or protecting the restricted area.” the detail will be operating in eight-hour shifts to ensure their 24/7 availability. they will be on standby to provide terminal cleanings and supplies to squadrons as needed. “this is a new enemy,” selix said. “this is a new fight for all of us. we're developing teams that make sense in the fight against covid-19, it takes all of us building the road as we walk it.” the crew has hydrogen-peroxide, disinfectant wipes, protective gear and cleaning sprays and solutions to ensure the operation floors are sanitized and operational. you may also like
1104	"avoid coronavirus in uber, a lyft, or rental car text extraction from html file; language identification https://elrc-share.eu under review 2020 avoid coronavirus in uber, a lyft, or rental car text/html https://news.yahoo.com/stay-safe-coronavirus-uber-lyft-215355859.html en_2020_04_5645.xml_160.html avoid coronavirus in uber, a lyft, or rental car keith barry may 8, 2020 consumer reports has no financial relationship with advertisers on this site. as parts of the country begin to reopen and more businesses require employees to travel to work, your options remain limited if you don't have a car of your own: it may be difficult to keep your distance on public transit , which could also be operating at reduced frequencies. and although rental bikes or scooters are a good option as the weather improves, they're not the right solution for everyone. ride-hailing services, such as uber and lyft, may seem like good alternatives. along with taxis, they continue to operate where local authorities allow. those who have a driver's license and a place to park have even more options, because rental cars and shared vehicles are still available-and may be more affordable than ever. but shared vehicles present unique risks when it comes to protecting riders and drivers. scientists say that the novel coronavirus is most likely to spread as a result of close contact, such as being directly coughed on or sneezed on by someone with the virus, or being within 6 feet of an infected person for 10 to 15 minutes or longer. and not all carriers of the virus exhibit symptoms. this makes traveling in a car with someone else riskier than traveling alone. the virus can survive on surfaces for hours or even days , too, so it's important that vehicles used at various times by multiple people are kept clean. cr spoke with experts in the ride-sharing, taxi, and rental car industries, and found out what sort of precautions they're taking. there also are additional steps you can take to minimize your own risks, such as requesting or looking for a taxi or other chauffeured car with a partition between the driver and passengers, instead of a typical uber or lyft that doesn't have one. the cdc has also provided a list of ways riders and drivers of shared vehicles can stay safe. or you could rent a car that you can thoroughly clean yourself, provided you have a place to park. and, of course, anyone leaving the house should follow recommendations for wearing a face covering or mask , no matter their method of transportation. story continues uber, lyft, and ride-hailing services although uber and lyft continue to operate in most areas, both companies are encouraging would-be riders to stay home if they can. neither offers rides shared between passengers who do not know each other, such as uberpool and lyft line. as of may 18, uber will require both drivers and passengers to wear face coverings or masks during rides anywhere in the u.s. uber says that drivers will have to take a photo of themselves wearing a mask before starting work. lyft does not yet have a similar rule in place, but a lyft spokeswoman told cr that the company has ""made drivers aware that it's required by law to wear a face covering in certain regions."" in addition, uber says it will enforce the cdc recommendation that passengers should sit only in the rear seat of a ride hailing vehicle, and will limit the number of passengers in a vehicle to three. passengers in any shared vehicle should also ensure that the driver has the vehicle's air vents set to fresh air, not recirculation-and to lower windows. drivers should not help passengers load luggage or belongings, either. both lyft and uber say they are providing masks and cleaning supplies to drivers, but that doesn't necessarily mean cars are clean. harry campbell, founder and ceo of “the rideshare guy,” a blog and podcast dedicated to ride-hailing services, says that because the responsibility to clean cars is left up to individual drivers, riders might not know how well the car they're taking has been cleaned. “some drivers are doing a great job, but others are not,” he told cr. in addition, some drivers have told campbell's podcast that they have not been able to access the cleaning supplies and protective equipment that are supposed to be available to them. when cr looked into the availability of these supplies, we found that drivers may have to travel a great distance to find a service center that's providing masks and sanitizers, which are available only in limited quantities. if you ride in an uber or a lyft, use hand sanitizer immediately after exiting the car if you have it, and wash your hands as soon as you can. even more important than the cleanliness of the cars used for uber and lyft is the health of the people who drive them, campbell says. “the cdc [centers for disease control and prevention] recommendation is to stay 6 feet away from someone, but when someone gets into the back of your car, it's pretty much impossible to follow that rule,” he says. and if a driver gets sick, there's a chance he or she can spread the virus to passengers, and vice versa. uber and lyft have started providing financial relief to drivers who are unable to work because of a covid-19 diagnosis or quarantine order, but the virus can also be transmitted by those who aren't showing symptoms of the disease. because drivers get paid only for the trips they take, drivers who may suspect they've been exposed to covid-19 but who still feel healthy or aren't displaying symptoms might choose to continue working, campbell says. “you're supposed to stay home from work. but as a driver, if you do that, you don't get paid,” he says. “none of these drivers are out there maliciously trying to spread this, but they're faced with a lot of tough choices.” taxis for the most part, traditional taxis may have a slight advantage over lyft and uber, but cleaning processes and precautions may differ depending on choices made by local cab companies. you may want to call their dispatch to ask about any specific protocols put in place before you take a ride, including the ability to prepay for a ride or make a contactless payment rather than using a shared credit card reader, and whether the driver will be wearing a mask. taxis tend to be serviced out of large fleet garages. it's easier for big companies to buy cleaning supplies in bulk than for individual drivers, who must rely on grocery stores and other retailers. that's the case at whc worldwide, a major fleet operator that owns taxi companies across the u.s. whc ceo bill george told cr that it has been able to purchase cleaning and protective equipment, which it is providing to its drivers. the company is taking other steps, as well. “we have purchased commercial vehicle foggers for each of our locations and trained staff to fog each car daily,” he says. these devices spray disinfectant throughout a vehicle's interior for deep cleaning. unlike uber and lyft vehicles, many taxis also have partitions installed between the driver and passenger, which may prevent the spread of infection through coughs and sneezes. george says his company has outfitted even more cars with such equipment. car-sharing: zipcar, getaround, and turo car-sharing services largely follow two models: short-term services like zipcar own and maintain the cars in their fleets much like a traditional rental car company, but they offer hourly rental options and distribute cars throughout cities rather than storing them at a central location. peer-to-peer services, such as turo and getaround, allow car owners to rent their private vehicles for a fee. many of these cars can be rented for long periods of time and often don't require person-to-person contact when picked up. though these services don't include drivers, any shared form of transportation can be risky during a pandemic, says neil abrams, a consultant who has worked with car rental and car-sharing companies for more than 40 years. “the controls over the cleaning and the maintenance aren't quite as rigorous or disciplined as you would have in, say, an airport rental location,” abrams says. “some of it is based on the honor system-that is, that the prior driver of a car is responsible for cleaning it.” on its website, zipcar says that it is unable to professionally clean cars after each booking but that vehicles are “regularly and rigorously cleaned using our sanitizing procedures.” getaround and turo each have instructions for how vehicle owners can clean their own vehicles. “we have asked renters to bring wipes and sanitizer with them during their trips, and have asked owners to clean their cars between trips as well as before and after personal use,” getaround spokeswoman meg murray told cr. all three services offer cars with contactless pickup options, so drivers never have to meet another person to exchange keys. these services also have waived some of the fees and penalties for cancellations and rebooking, and they have protocols in place to take a car out of service if they confirm that it has been used by someone with covid-19. zipcar introduced a new feature that allows customers to sign up for zipcar service using a smartphone instead of going through a more lengthy process. the company says it will allow those with valid drivers licenses to sign up for zipcar and access a vehicle in ""minutes."" if possible, renting one of these cars for an extended period of time allows you to clean it thoroughly before you use it, so you're aware of how well it has been cleaned the next time you drive. zipcar says it has changed its rental terms and conditions to accommodate increased demand for longer-term rentals. “in urban environments, we are seeing more demand for the exclusive use of a vehicle for the week or even the month,” says zipcar president tracey zhen. “to meet this demand, we are expanding our dedicated zipcar offering, which provides members longer-term, exclusive use of the same vehicle monday through friday.” cr recommends that when you get into a shared car, you should at a minimum wipe down the door handle, steering wheel, and gearshift. try not to touch your face when driving, and sanitize your hands when you leave the car. traditional rental cars abrams says that with the decrease in air travel, traditional rental car business has plummeted during the pandemic. as a result, many car rental locations have closed temporarily. but the locations that remain open can offer bargains for drivers in need of a car. “they are going to be giving the consumer much more favorable rates,” abrams says. for example, most rental car companies have waived extra fees that are usually charged to drivers younger than 25 and are dropping the cost of one-way and monthly rentals-although some of these offers are set to expire at the end of may. although hertz offered free long rentals to healthcare workers in new york city, that program has now come to a close. monthlong rentals in the area now cost upward of $1,000, and-unlike some car-sharing services-those cars don't come with dedicated parking spaces. all the major car rental companies say they have instituted additional cleaning protocols, but abrams says renters should still advocate for themselves. “the first thing a consumer should ask is ‘what are you doing to protect my safety?'” abrams told cr. he also recommends that renters take their own precautions before driving a car someone else has used-even if they've been assured that it has been professionally cleaned. “i would bring my sanitizer. i would bring my gloves. i would make sure that i'm the second line of defense when renting a vehicle.” cr recommends opening the windows to air the vehicle out when you first drive it, along with wiping down its interior and cleaning your own hands before and after driving. long-term renters who can afford a monthly rental fee and who have a place to park can sanitize their car without worrying that someone else has not cleaned it as thoroughly. but, abrams says, there's one drawback to a traditional car rental: there might not be a place to pick one up near where you live. “there are a lot fewer avis locations than, say, zipcar locations,” he says. (the avis budget group is zipcar's corporate parent.) “it's a very personal thing about who you trust. zipcar offers more flexibility, but avis may provide more confidence.” if possible, abrams says the best solution to getting around during this pandemic might not involve a car at all. “i'd find a pair of sneakers and just walk,” he says. editor's note: this story was updated on may 14, 2020, to reflect uber's new policy starting may 18 that its drivers wear masks while driving passengers. the story originally published on april 7. more from consumer reports:"
1105	neurosurgeon who became famous for separating conjoined twins died of covid-19. his real legacy is his humanity. – uci news text extraction from html file; language identification https://elrc-share.eu under review 2020 neurosurgeon who became famous for separating conjoined twins died of covid-19. his real legacy is his humanity. – uci news text/html https://news.uci.edu/2020/04/01/neurosurgeon-who-became-famous-for-separating-conjoined-twins-died-of-covid-19-his-real-legacy-is-his-humanity/ en_2020_04_938.xml_58.html neurosurgeon who became famous for separating conjoined twins died of covid-19. his real legacy is his humanity. [james] goodrich attended … orange coast college, and while there, a guest lecture by a university of california, irvine professor changed the trajectory of his life. the professor, james mcgaugh, a neuroscientist, became his lifelong mentor. because of that friendship, goodrich said, he learned to value people everywhere - to extend a hand to those who sought help, to embrace those unlike himself and help the most vulnerable. he went on to graduate from the university of california, irvine and then earn his medical degree from columbia university, where he also earned a doctorate of philosophy. “what's so wonderful about his story was this was a failed kid who scratched around and started over in life,” said mcgaugh, 88, in an interview this week. “he graduated at the top of his class, then came and worked with me.”
1105	"in memoriam: famous names and faces lost to coronavirus – nbc new york text extraction from html file; language identification https://elrc-share.eu under review 2020 in memoriam: famous names and faces lost to coronavirus – nbc new york text/html https://www.nbcnewyork.com/entertainment/in-memoriam-famous-names-and-faces-lost-to-coronavirus/2346892/ new york city restaurants u.s. jungle&#8221 india coronavirus pandemic tri-state age epicenter virus age name virus number kind tony covid ebola survivor doc describes covid-19 nightmare face coronavirus en_2020_04_914.xml_123.html updated on april 2, 2020 at 1:10 pm nbc universal, inc. the coronavirus pandemic has already infected more than 105,000 people in the tri-state and killed more than 2,600 -- young, old, rich, poor, the anonymous and the famous. these are some of the more prominent people to have died locally from the virus, whose u.s. epicenter is in new york city. terrence mcnally photo by charles sykes/invision/ap the acclaimed playwright and four-time tony winner for shows like ""ragtime"" and ""master class"" died at the age of 81 from the virus. floyd cardoz photo by charles sykes/invision/ap, file chef floyd cardoz, a winner of ""top chef masters"" and owner of a number of successful restaurants in new york and india, died at age 59 . mark blum brian killian/getty images the quintessential new york character actor -- the kind whose name you never knew, but whose face you recognized immediately from works like ""desperately seeking susan"" and ""mozart in the jungle"" -- died at age 69 . alan merrill michael putland/getty images the songwriter, best known for the joan jett classic ""i love rock 'n' roll,"" died march 29 in a new york hospital emergency room while waiting for an icu bed. adam schlesinger maury phillips the singer-songwriter, an emmy and grammy winner best known for his work with the band fountains of wayne (named after wayne, new jersey), died april 1 . kevin duffy judge kevin duffy, who oversaw high-profile nyc criminal cases in the 1990s including the 1993 world trade center bombing trial, the brink's robbery and shootout case, and the famed pizza connection mafia trial of the late 1980s, died april 1. bucky pizzarelli getty images for departures legendary jazz guitarist bucky pizzarelli, a new jersey musical icon, died april 1 at 94 from complications of coronavirus."
1105	coronavirus in india: dharavi man who had coronavirus dies, building sealed - rediff.com india news text extraction from html file; language identification https://elrc-share.eu under review 2020 coronavirus in india: dharavi man who had coronavirus dies, building sealed - rediff.com india news text/html https://www.rediff.com/news/report/dharavi-man-who-had-coronavirus-dies-building-sealed/20200401.htm dharavi slum rehabilitation authority brihanmumbai municipal corporation akg sion hospital asia en_2020_04_787.xml_106.html rediff.com » news » dharavi man who had coronavirus dies, building sealed dharavi man who had coronavirus dies, building sealed source: pti - edited by: roshneesh kmaneck april 01, 2020 23:39 ist get rediff news in your inbox: email a 46-year-old resident of dharavi area of mumbai who had contracted coronavirus died on wednesday evening, prompting the civic authorities to seal the building where he lived. densely-populated dharavi is famous as one of the largest slums in asia. the man, who lived in a building constructed under the slum rehabilitation authority scheme, had no foreign travel history, said a health official of the brihanmumbai municipal corporation. after he died at nearby government-run sion hospital, some 300 tenements in the building and around 30 shops were cordoned off by police. residents of the building have been quarantined at home. the deceased had a garment shop at akg nagar indharavi, the official said. mumbai has recorded over 180 coronavirus cases and about a dozen deaths of covid-19 patients so far. get rediff news in your inbox: email source: pti - edited by: roshneesh kmaneck © copyright 2020 pti. all rights reserved. republication or redistribution of pti content, including by framing or similar means, is expressly prohibited without the prior written consent.
1106	underscored text extraction from html file; language identification https://elrc-share.eu under review 2020 underscored text/html https://us.cnn.com/2020/03/20/cnn-underscored/cnn-underscoreds-coronavirus-coverage/index.html en_2020_04_5290.xml_16.html work for cnn follow cnn underscored cnn underscored is your guide to the everyday products and services that help you live a smarter, simpler and more fulfilling life. the content is created by cnn underscored. cnn news staff is not involved. when you make a purchase, we receive revenue. a roundup of cnn underscored's coronavirus coverage by sarai thompson updated wednesday, may 27, 2020 at 8:26 pm washing hands with soap and water is the first line of defense against the spread of germs the coronavirus (covid-19) has undeniably changed how we go about our daily lives. that's why the cnn underscored team has made it a priority to help you navigate through this time. we're continuously researching and interviewing experts, trying out new products and services and distilling information to give you the best options to shop for what you need and different ways to cope. from helping keep the kids entertained to tips on practicing self-care , we're here for you. we'll regularly update this page with guides and recommendations as the situation progresses. our latest coverage:
1106	"covid-19 pandemic: simple tips to improve mental health among college students text extraction from html file; language identification https://elrc-share.eu under review 2020 covid-19 pandemic: simple tips to improve mental health among college students text/html https://www.medindia.net/news/covid-19-pandemic-simple-tips-to-improve-mental-health-among-college-students-194117-1.htm covid-19 covid 19 lockdown mental health staying indoors all day social distancing covid 19 pandemic staying connected good sleep hygiene eat well en_2020_04_516.xml_198.html covid-19 pandemic: simple tips to improve mental health among college students by adeline dorcas on april 1, 2020 at 6:36 pm coronavirus news covid-10 lockdown has turned college students' lives upside down. adjusting to complicated schedules, managing highly competitive environments, and navigating new social situations can make them more stressful. with the national emergency of the coronavirus pandemic, college students' lives have been upended as they have been asked to leave campus and adjust to new living situations. empowering better health health tips as the director of psychological services in mclean hospital's college mental health program (cmhp), caitlin nevins, phd, and the cmhp team work with young adults to balance mental health with the demands of a college environment. nevins and her colleagues help their patients adjust to complicated schedules, manage highly competitive environments, and navigate new social situations. nevins offered these tips for college students and their families to help them cope. validate the experience it's important to remember that this isn't a vacation from school or a way to get out of classes. this is a sudden change, and a lossof community, graduation ceremonies, living environments, sporting events, etc. ""while we encourage students to practice gratitude and to continue on, this situation is still a disruption,"" said nevins. during this time, students can practice self-compassion for what they're going through. families can validate students' feelings and keep the lines of communication open about what's challenging and difficult about this change. maintain structure as much as possible in addition to switching from in-person classes to online learning, students have lost much of their routine. because of this, it's important to maintain a foundation of the coping skills. good sleep hygiene, nutrition, self-care, and activities outside of screen time are all part of this foundation. it's essential to retain these practices as much as possible, particularly if students' options are more limited in terms of what they can do and where they can go. make it easy to reach out for support it's important for students to be able to communicate if they don't feel like themselves. even if in-person supports may not be as readily available right now, many clinicians are able to provide assistance over the phone and through telehealth. ""students should have a low threshold for reaching out and exploring what resources their school can offer remotely,"" nevins suggested. ""living at home may not be ideal, or even feasible, for all students. now is an important time to access supports."" be mindful of exposure to the news it's important to stay informed, but it's also important to know when you need a pause from stressful news. take a break to watch a movie, read, or joke with friends. such practices will build resiliency for the stressful news that's arriving with increasing frequency. students should be aware of how the news is making them feel and how much media they can consume. it can be helpful to step back and practice extra self-care at this time. stay connected this is an isolating experience for students as a whole. consider moving beyond texting or social media to more interpersonal communications, such as phone or video calls with friends. make plans to watch shows remotely together or participate in other digital forms of dorm activities. this is a time to get creative about maintaining vital social connections. as nevins said, ""if anyone can do this, college students can: they're probably the best generation to understand how to stay connected and be resilient in times like this."" mclean's college mental health program (cmhp) helps college students with mental illnesses and adjustment issues live more productive lives to ensure the greatest probability of academic and personal success. source: newswise"
1106	new kitchen united webinar offers restaurants tips to optimize delivery and pick-up, demystifies paycheck protection program text extraction from html file; language identification https://elrc-share.eu under review 2020 new kitchen united webinar offers restaurants tips to optimize delivery and pick-up, demystifies paycheck protection program text/html surperformance https://www.marketscreener.com/news/new-kitchen-united-webinar-offers-restaurants-tips-to-optimize-delivery-and-pick-up-demystifies-pay--30379445/?utm_medium=rss&utm_content=20200407 en_2020_04_5365.xml_105.html new kitchen united webinar offers restaurants tips to optimize delivery and pick-up, demystifies paycheck protection program 0 (you can enter multiple email addresses separated by commas) message : *required fields kitchen united , the kitchen as a service company built to serve the fast growing world of off-premise dining, today announced it will host an informational webinar in an ongoing series to help restaurant operators navigate business during this challenging time. the webinar, scheduled for wednesday, april 8 at 10:30 a.m. pdt, will specifically address best practices for delivery and pick-up amid the covid-19 pandemic, and detailed insight on the paycheck protection program (ppp). restaurant brands of any size are invited to join the free webinar via https://info.kitchenunited.com/takeout-delivery-best-practices-covid-19 , as well as submit questions and topics of interest in advance. a replay will also be available on the company's website. kitchen united will share best practices for transitioning dine-in establishments to effective and efficient takeout and delivery businesses, and will cover topics from streamlining operations to marketing. specifically, the webinar will address efficiencies for front-of-house layout and operations, audience building and marketing messaging, and menu design and special product offerings. the webinar will also cover ppp and provide actionable steps that will help operators take advantage of the program in the immediate. the u.s. federal government's paycheck protection program authorizes up to $349 billion in forgivable loans to small businesses to pay their employees during the covid-19 crisis. “restaurants have had to make the difficult decision to significantly reduce staff or shutter business entirely at this time, and there is a lack of clarity on how the ppp loan program will actually work,” said jim collins, chief executive officer of kitchen united. “we'll try to clear up what we can and we'll point out where things remain unclear so restaurateurs can be smart about their next steps.” the webinar will be hosted by jim collins. kitchen united cfo michael montagano will cover ppp, and additional team members will share insights, including larrah pawlak, who heads operations, matt maroni, who leads kitchen design and client consultation, and elizabeth villa who will cover marketing topics. additional webinars will be produced by kitchen united to help restaurants on related topics. about kitchen united kitchen united is a kitchen as a service company that provides restaurant operators with a value-driven, low-risk way to enter into new markets, grow revenue through off-premise dining and expand delivery areas by removing barriers such as capital or technology challenges. for additional information, please visit: http://www.kitchenunited.com . view source version on businesswire.com: https://www.businesswire.com/news/home/20200407005642/en/ business wire 2020
1110	foreigners self-isolating in croatia: do you feel safer? tin from argentina in split text extraction from html file; language identification https://elrc-share.eu under review 2020 foreigners self-isolating in croatia: do you feel safer? tin from argentina in split application/xhtml+xml https://www.total-croatia-news.com/lifestyle/42542-tin-bojanic foreigner corona stories split coronavirus tin bojanic en_2020_04_615.xml_139.html foreigners self-isolating in croatia: do you feel safer? tin from argentina in split by paul bradbury 1 april 2020 april 1, 2020 - do foreigners in croatia feel more or less safe sitting out covid-19 here than in their home country, and what are their experiences? a new series on tcn, with tin bojanic from argentina our sixth contributor. oxford university recently published some research on government responses to coronavirus which showed that croatia currently has the strictest measures in the world. while inconvenient, this is a good thing in terms of reducing the spread of the virus, and i am certainly not alone in my admiration of the official croatian handling of this crisis in recent weeks, both in terms of action and communication. but what do other expats here think? and how does it compare with the response in their home country? would they rather sit this one out here or there? in the first of a new series on tcn, we will be featuring expats from all over the world to see what their views are on life in corona croatia rather than back home. having started with an excellent contribution from romanian mirela rus, american/irishman jason berry in split and gabriela lopez zubiria from mexico, steve gaunt in an english pub in a field in the middle of nowhere near vinkovci, barbara grauning from munich in istria - time to go back to split via buenos aires with tin bojanic, the popular owner of marvlvs library jazz bar. if you would like to contribute to this series, full details are below. now, over to tin. firstly, how are you? are you alone/with someone? tell us a little about your situation and sanity levels. i am like everyone i guess, wishing that this nightmare would finish as soon as possible. i am with my family and we are all good. i own a bar (marvlvs library jazz bar) in split's old town, and apart from financial losses, the big issue these days is that the city looks like it does at christmas or new year's, a ghost town, and there are no police around, so crime is enjoying a big party. to protect our businesses, we arranged with other owners, to walk around town checking on our properties and trying to clean the trash a little bit from the previous evening. also, there is a park where i live which has people drinking all night long, fighting each other and not allowing us to sleep, and leaving big amounts of trash behind that nobody ever will come to pick up or clean. when did you realise that corona was going to be a big issue? i do remember the previous flu viruses when i was living in madrid, so it is not new to me to see people with masks around town. but i realized this one was different in february at rome airport when i went through security in one minute because it was almost empty. and i started to get worried when politicians started to talk over scientists: nothing scares people more than that. what is your impression of the way croatia is dealing with the crisis? how safe do you feel? i understand that nobody was prepared for this around the world; this are times where people should understand the importance of choosing good leaders. i follow the idea that you have to pause this horror movie so you can organize the health system for when you will have to press play again. the virus is not going to disappear, and you will have to deal with that. my main concern is that dalmatia, in this case, cannot get through without a season, and unfortunately croatia cannot isolate itself as it does not produce all goods needed for its people (hopefully we learn from this too). but i feel cheated when i do my part, staying home, and only going to check on the bar for protection, and then i see all older people - who are at the biggest risk- during daylight sitting on the park in front of my house, and at night, as there are no bars, people drinking on the streets. why i am paying taxes if bars cannot sell alcohol but stores are good for that? no controls, more trash, and beers being sold without receipts. now compare that to your home country and how they are handling it. what is croatia doing better/worse? i am from argentina -and croatian as well- and i am in contact with my people and very well informed about what is going on there. the quarantine is stricter there than here, but the army and security forces are doing their job. argentina is better in that, if the government is smart enough, it can satisfy all needs and goods for its people as the country produces all, but there are many poor neighborhoods that if this virus gets in will be a total disaster. on the other hand, in argentina are talking about very low salaries of politicians and to deal with taxes in a circumstantial way. here there are no clear rules of what is going to happen regarding that and that was always the main problem for business in croatia. it is good that here they understood that running is very important as runners are in low risk to get the virus. in some countries they did not allow it at the beginning and now they make it happen again as they have learned. the world is learning day by day. what about official communications from the authorities, compared to your home country? up to now all the information that i got was by word of the mouth as on media is very confusing and they contradict themselves. to be honest, tcn was always one of my sources of news, and nowadays it has become a landmark against fake news. in argentina politicians are using this mess to position themselves trying to look they have an answer to everything and doing most of things wrong; but here in croatia i think politicians would love to hide away and not face this situation. what's the one thing you wish you had taken with you into self-isolation? my friends say to me that i should do the self-isolation at the bar where i have everything to survive: music, cinema, alcohol, cheeses and prosciutto… one thing you have learned about yourself, and one thing you have learned about others during this crisis. as a journalist i have been in conflict zones so is not the first time that i have to adapt myself to what is going on around. if i can read, i am good. my concern is that for most people is going to be hard to be all day at home, especially in dalmatia where people love to be on the streets. but the main thing is going to be - if quarantine is extended- that who is not going to run the risk of a virus if you are hungry or you need a job? if this goes on you will see few heroic acts and many miserable actions between people. not to finish on a depressing note i would like to say that we will make it through and croatia will proclaim independence once again, this time from a miserable invisible enemy. about myself. i am a croatian citizen and i was borne in buenos aires, argentina. i am a writer and journalist and i always had businesses like restaurants, magazines, editorials... and bars. my grandmother was from stari grad hvar, and years ago i came to croatia looking for to do something here. i found the house of marulic destroyed in the old town of split and i decided to refurbished and to take care of the building. now, to tribute the father of croatian literature, i opened 6 years ago a library jaz bar, where the jazz was my decision as it would not work out with only medieval music. now croatia is my home too. thanks tin, stay safe and see you on the other side. you can follow events at his bar and join him for a drink when all this over via the official facebook page .
1110	"search icon text extraction from html file; language identification https://elrc-share.eu under review 2020 search icon text/html https://www.telegraph.co.uk/health-fitness/body/self-isolate-stay-home-rules-shared-house-coronavirus/ uk coronavirus lockdown social distancing standard self-isolation coronavirus en_2020_04_584.xml_175.html jump to navigation how to self-isolate: the guidelines for staying at home during the coronavirus outbreak with the government backing a policy of self-isolation to tackle the spread of the coronavirus, we explain how to do it successfully coronavirus charity appeal - compact puff to donate page - article embed it seems that the window of opportunity to contain coronavirus is getting smaller. following the similar shut-down methods of governments in italy and ireland, the uk has been put on lockdown to help tackle the spread of coronavirus. here in the uk, health experts have confirmed that the disease is becoming truly widespread and the number of cases and deaths are drastically rising. the government has deployed a ‘self-isolation' strategy to tackle the disease, thanks in part to its success in containing the spread of sars in 2004. according to public health england, “self-isolation...is the most effective way of preventing the coronavirus from spreading.” so what does self isolation mean ? how should you deal with the realities of not leaving home, and what to do if you live with others? what does self-isolation mean? government guidelines define self-isolation as not going to work , school or public areas, not using public transport or having visitors to your home. the uk has closed its doors to pubs, theatres, restaurants and non-essential shops , as well as advising social gatherings with friends and families to stop. if possible, you're told to stay in a well ventilated room, with a window to the outside that can be opened. people outside of your household cannot visit, no matter how urgent it may be. if you do need to speak to someone urgently, do it over the phone. ""you want to avoid opportunities for transmission, so you can talk to people on the phone and you can talk to people at a distance but you want to minimise the chances they will come into contact with you directly,” says professor christl donnelly, professor of applied statistics at oxford university and professor of statistical epidemiology at imperial college london. prof donnelly says that if you're in a house where someone is self-isolating, you'll need to monitor your behaviour patterns closely: ""try to limit the possibility they will touch things that you've been touching. this isolation pod created by a company in milton keynes shows the measures which could be taken in order to successfully isolate someone. can i leave the house? since the new lockdown rules , people without symptoms can only leave the house for these reasons: shopping medical need or providing care travelling to or from work (if you can't work from home) how do i get food or supplies if i have symptoms? the nhs has advised anyone with these symptoms to stay at home for seven days, and if they live with other people to self-isolate for 14 days: a high temperature if you have any of these symptoms, you should order deliveries online. can i answer the door? no. if you do get food or supplies delivered, they must be left outside for you to collect once the deliverer has departed. dr lisa ackerley, a trustee of the royal society for public health and chartered environmental health practitioner , suggests you leave a note on the front door, with your number to ring if the delivery person needs to speak to you. what to do with your rubbish? all waste that has come into contact with isolated individuals who show symptoms should be double bagged in bin liners, and not disposed of until the patient has been passed clear of coronavirus. if the patient is diagnosed positive, you will be told what to do with the rubbish, as it will be treated as medical waste. how do i self-isolate while living with others? if you share with others, if possible you should use a separate bathroom to those you live with. ensure that everyone in the house uses separate towels both for drying themselves and for hand hygiene purposes. regular cleaning of the bathroom will be required, as well as the creation of a bathroom rota for showering or bathing, with the isolated person using the bathroom last and thoroughly cleaning it after use. when using communal spaces, the isolated person should wear a face mask if one has been supplied. an isolated person should ideally not be in the same room as others, and meals should be taken back to bedrooms to eat, and should ideally be washed in a dishwasher immediately after use. if you do not have a dishwasher, plates should be washed separately, and cleaned with a separate tea towel, according to government guidance. prof donnelly highlights the kitchen as an area to be aware: “a key thing would be not sharing the kitchen in a shared household. people could put plates of food for you at your door."" what to do if i have children? prof donnelly says that your decision “depends on the age of the child"" - it's hard to isolate yourself from a baby that needs around-the-clock care; easier to do so if your child or children are teenage. ""realistically i think families are going to make different decisions on their personal circumstances in their home and their personal risk assessment,” she adds. according to early research, children are less susceptible to coronavirus, with researchers in china reporting that none of the infants they identified with the disease had severe complications. cody meissner, an infectious disease expert and professor of pediatrics at tufts university school of medicine, told npr that “so far, it appears that more than 80pc of the [coronavirus] infections are pretty mild, no more severe than the common cold... and children appear to have even milder infections than adults”. do i need to wear a facemask? if advised to, then yes you should wear a face mask . if you have been told to but are unable to, those you live with need to wear them instead. read more: what are the best face masks to buy and how much should i pay for one? can i share household items? no. laundry, bedding and towels should be placed in a bag and washed once tests for sars-cov-2 are negative. what if i have a home care visit? boris johnson announced that all but essential visits to care homes should be cancelled to protect those who are most vulnerable - those over 70 - from the disease. but if it is essential, the usual hygiene rules apply. ""it is good practice for anyone coming into the house to immediately wash their hands or use a hand gel before they carry out their duties, and you should insist on this anyway, regardless of coronavirus,"" says dr ackerley. ""they may use disposable gloves, but these need to be a fresh pair for your house, and disposed of afterwards. ""upon leaving, they should also wash their hands and dispose of their face mask and then wash their hands again."" what should i do about work? guidance from public health england encourages those in self-isolation to impress the importance of self-isolation policies upon employers, not just in general but also in terms of preventing the spread of infection at work too. if you are well enough, make an agreement to work from home. coronavirus at work what else should i think about? ""have packs of antimicrobial wipes and hand sanitisers at various locations in the house and encourage use by everyone,"" says dr. ackerley. while the precautions are likely to be unnerving, it's worth remembering that many have recovered from the virus. if you have concerns about having coronavirus, guidance can be found on the nhs's website . related topics"
1110	foreigners self-isolating in croatia: do you feel safer? barbara in istria from munich text extraction from html file; language identification https://elrc-share.eu under review 2020 foreigners self-isolating in croatia: do you feel safer? barbara in istria from munich application/xhtml+xml https://www.total-croatia-news.com/lifestyle/42540-barbara-glauning coronavirus barbara glauning foreigner corona stories en_2020_04_531.xml_108.html foreigners self-isolating in croatia: do you feel safer? barbara in istria from munich by paul bradbury 1 april 2020 april 1, 2020 - do foreigners in croatia feel more or less safe sitting out covid-19 here than in their home country, and what are their experiences? a new series on tcn, with barbara glauning from munich our fifth contributor. oxford university recently published some research on government responses to coronavirus which showed that croatia currently has the strictest measures in the world. while inconvenient, this is a good thing in terms of reducing the spread of the virus, and i am certainly not alone in my admiration of the official croatian handling of this crisis in recent weeks, both in terms of action and communication. but what do other expats here think? and how does it compare with the response in their home country? would they rather sit this one out here or there? in the first of a new series on tcn, we will be featuring expats from all over the world to see what their views are on life in corona croatia rather than back home. having started with an excellent contribution from romanian mirela rus, american/irishman jason berry in split and gabriela lopez zubiria from mexico, steve gaunt in an english pub in a field in the middle of nowhere near vinkovci, how are things with barbara grauning from munich in istria? and is it better to be here or germany right now? if you would like to contribute to this series, full details are below. now, over to barbara. yes, i feel much safer in my istrian village višnjan than in my home town munich. although the regulations in bavaria are stronger than in the rest of germany the feeling in a village is much safer than in a big town like munich. firstly, how are you? are you alone/with someone? tell us a little about your situation and sanity levels. thank you, i am very well. i came here on march 14th, the first day of closed borders. the border police were surprised to see me. but as i have had a house here for 20 years and could present all papers of my ownership, they let me pass. of course i followed regulations of the home isolation orders for 14 days. i brought some food so it was easy for my to stay in my house. as i have a small garden, i can be as well outside, as far as the weather is fine. i am alone with my cat, she likes it the most of course! my wonderful neighbor is taking care of me, already for 20 years, so she gets me food from the shop, because she goes there every day to buy for her meals for her family. my problem was that my internet didn't work after the long winter. luckily i had installed last autumn online banking, but i never did online payments. but with the help of the bank clerk by phone i managed to make my first online payment. it is never too late to learn something new! as i am dividing my life for many years between munich and višnjan anyway - winter in munich, summer in istria- march 15th is my normal time to move. i have a job - actually two - that allow me to work from home. here and there i have an equipped office, therefore it is no big deal to be here until september. how long the lockdown will take, i can accept it, as long as it is not time to go swimming. i hope that by june we will be able to drive at least to the seaside again. when did you realise that corona was going to be a big issue? when i heard about the first cases in china and how fast the virus spread in asia, i watched things carefully. then the first infected people appeared not far away from munich, in fact next door. we all, my friends and colleagues started to be very carefully towards each other. no meetings anymore, no hugs and already taking care of physical distancing. the moment when the news spoke for the first time about countries were closing the borders, i packed my stuff into my car, actually 5 days earlier as planned, and left munich. it was a strange drive down to croatia through austria and slovenia. no controls nowhere, all toll stations on cc payments. the first people i saw after 5 hours were the policemen at the croatian border. what is your impression of the way croatia is dealing with the crisis? how safe do you feel? in my eyes croatia is dealing very well with the crisis. i can follow the daily report of the health ministry. my village is locked down. i even cannot drive to porec -9 km away- for supermarket shopping without official permission by the village authorities. but so far there is no need to leave the village, the 2 shops offer all i need. the security system is very well organized and it is amazing, how people accept and follow the regulations. and the results of the numbers show that the officials do a great job with their restrictions. now compare that to your home country and how they are handling it. what is croatia doing better/worse? of course i follow as well the german situation and how they handle it. i think that for german understanding they do a good job. the government still allows discussions about the measures and the federal system of the individual countries allow different customary actions concerning the isolation or lockdowns. better in germany of course is the fast taken decision about the financial support for smaller entrepreneurs, freelancers, artists, cultural people etc. how much it will influence the german economy will be shown in the future. concerning croatia i think that as well the european union should pay and support the country. what about official communications from the authorities, compared to your home country? as i don't have tv here in my house, i read online news in croatian and english on different sites. i read as well austrian newspapers online, because they are very well covering slovenia, croatia and other balkan countries. i am well informed and my croatian vocabulary increased a lot! a pity that countries of the eu and their media always look to asia, us or uk, but pay less or no attention to the smaller member countries like slovenia or croatia. it would be important for europe to read and see, how e.g. croatia is dealing with the virus. what's the one thing you wish you had taken with you into self-isolation? a whole box of oranges by crowd farming from spain. i have to find out if they can as well deliver to croatia. one thing you have learned about yourself, and one thing you have learned about others during this crisis. i am very well organized, even under the ‘pressure' of isolation. i can be on my own very well. of course i miss meeting with friends here, or going out for a coffee with them, but in times of social media there are possibilities to exchange ideas, meanings, feelings. i am in contact with other house owners around višnjan to keep them updated. normally they all had planned to spend easter here. i write more, i speak more on the phone and all my friends as well are much more communicating. my advantage is that i am used to be a ‘one-woman-show' even in munich, therefore i am the wrong person to ask about difficulties others may have in times of the isolation and lockdown. thanks barbara, stay safe and see you on the other side.
1113	"bill gates calls for nationwide shutdown to curb coronavirus pandemic - cnet text extraction from html file; language identification https://elrc-share.eu under review 2020 bill gates calls for nationwide shutdown to curb coronavirus pandemic - cnet text/html https://www.cnet.com/news/bill-gates-calls-for-nationwide-shut-down-to-curb-coronavirus-pandemic/#ftag=cad590a51e en_2020_04_635.xml_15.html bill gates calls for nationwide shutdown to curb coronavirus pandemic he also says leaders need to stop stoking rumors or panic buying. april 2, 2020 9:53 a.m. pt listen bill gates has some advice on how to deal with the pandemic. cnet for the most up-to-date news and information about the coronavirus pandemic, visit the who website . microsoft co-founder bill gates had already spoken about the coronavirus pandemic in a reddit ama in march. in a washington post op-ed tuesday, he offered more details on how the us can better deal with the fight against covid-19. the co-chair of the bill & melinda gates foundation suggested three steps for dealing with the health crisis. first, he says, there needs to be a nationwide approach to shutting down. ""the country's leaders need to be clear: shutdown anywhere means shutdown everywhere,"" he said tuesday. ""until the case numbers start to go down across america -- which could take 10 weeks or more -- no one can continue business as usual or relax the shutdown. any confusion about this point will only extend the economic pain, raise the odds that the virus will return, and cause more deaths."" coronavirus updates cnet coronavirus update keep track of the coronavirus pandemic. his second step focuses on testing. gates says the federal government needs to step up its efforts to test more people and to prioritize testing starting with medical workers and first responders. that echoes his remarks from his reddit ama on march 18 when he called the testing in the us at that point ""disorganized."" gates also said the system to purchase personal protective equipment, or ppe, which has governors outbidding each other , is only making matters worse. last, he says there needs to be a ""data-based approach to developing treatments and a vaccine."" he pointed out how leaders should not be stoking rumors or panic buying, referring to the drug hydroxychloroquine . hydroxychloroquine has been touted as a treatment for covid-19, spurred a rush to purchase it, although it's needed for those who have lupus. on thursday, gates went on cbs this morning to reiterate his points and said he thought the country would act more quickly. ""i thought we would respond a bit faster,"" he said. ""what we're doing, how we're having to change the economy here, in order to drop the number of cases, it's really unprecedented. even the issue of once you get the case numbers down, what does opening up look like?"" he also noted that very little investment was made to fight pandemics after his 2015 ted talk about the problem. ""i think this time, people will understand that this is a trillions-of-dollars event, it's going to be hundreds of thousands of lives on a global basis,"" he said. ""i think people will understand why the alarms were raised and for the next one, we'll be far more ready than we were for this one."" the gates foundation committed $100 million for the global response to the coronavirus outbreak back in february. it originally committed to $10 million in january when the outbreak started. now playing: watch this: studies test wearables as early coronavirus detection... 5:16 the information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives."
1113	"bill gates calls for nationwide shutdown to curb coronavirus pandemic - cnet text extraction from html file; language identification https://elrc-share.eu under review 2020 bill gates calls for nationwide shutdown to curb coronavirus pandemic - cnet text/html https://www.cnet.com/news/bill-gates-calls-for-nationwide-shutdown-to-curb-coronavirus-pandemic/ en_2020_04_666.xml_25.html bill gates calls for nationwide shutdown to curb coronavirus pandemic he also says leaders need to stop stoking rumors or panic buying. april 2, 2020 9:53 a.m. pt listen bill gates has some advice on how to deal with the pandemic. cnet for the most up-to-date news and information about the coronavirus pandemic, visit the who website . microsoft co-founder bill gates had already spoken about the coronavirus pandemic in a reddit ama in march. in a washington post op-ed tuesday, he offered more details on how the us can better deal with the fight against covid-19. the co-chair of the bill & melinda gates foundation suggested three steps for dealing with the health crisis. first, he says, there needs to be a nationwide approach to shutting down. ""the country's leaders need to be clear: shutdown anywhere means shutdown everywhere,"" he said tuesday. ""until the case numbers start to go down across america -- which could take 10 weeks or more -- no one can continue business as usual or relax the shutdown. any confusion about this point will only extend the economic pain, raise the odds that the virus will return, and cause more deaths."" coronavirus updates cnet coronavirus update keep track of the coronavirus pandemic. his second step focuses on testing. gates says the federal government needs to step up its efforts to test more people and to prioritize testing starting with medical workers and first responders. that echoes his remarks from his reddit ama on march 18 when he called the testing in the us at that point ""disorganized."" gates also said the system to purchase personal protective equipment, or ppe, which has governors outbidding each other , is only making matters worse. last, he says there needs to be a ""data-based approach to developing treatments and a vaccine."" he pointed out how leaders should not be stoking rumors or panic buying, referring to the drug hydroxychloroquine . hydroxychloroquine has been touted as a treatment for covid-19, spurred a rush to purchase it, although it's needed for those who have lupus. on thursday, gates went on cbs this morning to reiterate his points and said he thought the country would act more quickly. ""i thought we would respond a bit faster,"" he said. ""what we're doing, how we're having to change the economy here, in order to drop the number of cases, it's really unprecedented. even the issue of once you get the case numbers down, what does opening up look like?"" he also noted that very little investment was made to fight pandemics after his 2015 ted talk about the problem. ""i think this time, people will understand that this is a trillions-of-dollars event, it's going to be hundreds of thousands of lives on a global basis,"" he said. ""i think people will understand why the alarms were raised and for the next one, we'll be far more ready than we were for this one."" the gates foundation committed $100 million for the global response to the coronavirus outbreak back in february. it originally committed to $10 million in january when the outbreak started. now playing: watch this: studies test wearables as early coronavirus detection... 5:16 the information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives."
1113	"coronavirus: bill gates branded the nostradamus of disease by hacker group anonymous | weird | news | express.co.uk text extraction from html file; language identification https://elrc-share.eu under review 2020 coronavirus: bill gates branded the nostradamus of disease by hacker group anonymous | weird | news | express.co.uk text/html https://www.express.co.uk/news/weird/1263643/coronavirus-bill-gates-nostradamus-covid19-anonymous-latest-coronavirus-update en_2020_04_813.xml_158.html weird coronavirus: bill gates branded the 'nostradamus of disease' by hacker group anonymous coronavirus panic is sweeping the globe and the hacker group anonymous has branded billionaire bill gates the ""nostradamus of disease"" for his role in fighting covid-19. published: 15:09, thu, apr 2, 2020 | updated: 15:10, thu, apr 2, 2020 0 link copied coronavirus is close to infecting a million people after more than 950,000 total cases were reported on thursday afternoon. scientists worldwide are on the hunt for a coronavirus cure, with some funding support from billionaire and microsoft founder bill gates. trending back britain's brave nhs heroes - click here now speaking during a ted talk, mr gates said: ""not missiles, but microbes, we're not ready for the next pandemic."" more recently, he wrote an op-ed for the washington post in which he urged the white house to issue a country-wide lockdown to prevent further deaths from coronavirus disease (covid-19). the billionaire's actions have caught the attention of the infamous hacker group anonymous, which issued an open letter to mr gates this week. coronavirus: bill gates was branded the 'nostradamus of disease' by anonymous (image: getty) coronavirus: countries around the globe are on lockdown during the pandemic (image: express) read more coronavirus map live: britain braces for darkest day yet in the letter, anonymous claimed mr gates had advocated for strict measures, including a surveillance system that could track infected people. anonymous said: ""in the midst of a historical pandemic, much of the world is looking to you for solutions, and it seems that this is no mistake, because you have positioned yourself as the nostradamus of disease."" mr gates recently suggested implementing a ""national tracking system similar to south korea"" during an online ask me anything (ama) session on reddit. the billionaire also advocated for social distancing as a viable way to reduce the number of infections. related articles does social distancing work? coronavirus can travel 8m on droplets,... however, anonymous said: ""now, as frightened people around the world are demanding solutions and looking to people like you for answers, you have advocated for some extremely draconian measures, including a surveillance system to track down anyone who might be infected. we're not ready for the next pandemic bill gates ""of course, all of this sounds like a necessary step in a global pandemic, and this virus is a very real threat, but in china and other places where these measures have been implemented, human rights violations followed quickly after."" the move also involved him stepping down from the board of warren buffet's holding company berkshire hathaway. don't miss:"
1115	"calls grow to cancel rent, mortgage payments in coronavirus crisis text extraction from html file; language identification https://elrc-share.eu under review 2020 calls grow to cancel rent, mortgage payments in coronavirus crisis text/html https://www.kiro7.com/news/local/while-evictions-are-paused-washington-rent-is-still-due-millions/emnjji4jsretrjx2v3hkap3p64/ coronavirus coronavirus washington unemployment coronavirus rent due coronavirus paying rent paying rent during coronavirus coronavirus washington en_2020_04_958.xml_16.html calls grow to cancel rent, mortgage payments in coronavirus crisis video: city councilmembers around country call for temporary rent cancellation share by: graham johnson, kiro 7 news updated: april 1, 2020 - 8:31 am seattle - the coronavirus pandemic means a lot of frantic calls at the offices of seattle city council members. ""my office has been flooded with emails and calls. our neighbors are calling for rent assistance, for mortgage assistance,"" council member tammy morales said wednesday. morales said she's also hearing from property owners. “(they) say my small business tenants are shut so i understand they're not bringing in revenue, but i still have a mortgage to pay, so what am i supposed to do?"" content continues below the economic crisis is especially felt at the beginning of the month, when many rent and mortgage payments are due. ""we know that during this public health crisis, when people have been ordered to stay home, that those who have lost their jobs are now at risk of losing their homes and small businesses are at risk of shutting if they can't pay rent,"" morales said. morales on wednesday joined a virtual meeting with city council members from around the country, each supporting the message described by hillary ronen of the san francisco board of supervisors, who led the call. ""we need an immediate moratorium on mortgages and to cancel rent,"" ronen said. this week the seattle city council called on gov. jay inslee to suspend rent payments and on president trump to suspend mortgage payments. roger valdez of seattle for growth represents property owners. he opposes a moratorium and suggests a different approach. “it makes perfect sense for housing providers and residents to get together and say, ‘hey, i lost my job, let's work something out so we get through the other side of this problem,'” valdez said. more news from kiro 7"
1115	5 things to know if you can't pay your rent or mortgage text extraction from html file; language identification https://elrc-share.eu under review 2020 5 things to know if you can't pay your rent or mortgage text/html https://www.mynews13.com/fl/orlando/news/2020/04/01/coronavirus-evictions-foreclosures-florida orlando florida tampa coronavirus business osceola county news stephanie bechara affordable housing en_2020_04_903.xml_145.html 5 things to know if you can't pay your rent or mortgage published 5:18 pm et apr. 01, 2020 published 5:18 pm edt apr. 01, 2020 share kissimmee, fla. -- it's the first of the month and that means rent is due -- except for many during this global crisis , making that payment has become impossible. related: thousands in florida apply for rental assistance during coronavirus crisis here are five things to know for those who may be struggling to make ends meet: 1. stacy mccland a landlord/tenant attorney based in osceola county, assures residents you cannot get kicked out of your home or have your locks changed. there has to be an official type of notice giving three to 15 days' notice depending on the circumstances, she says. 2. democratic u.s. rep. darren soto, along with other elected officials, penned a bipartisan letter requesting the supreme court to stop evictions and foreclosures during the coronavirus national emergency. the orlando congressman whose 9th congressional district includes parts of orange and osceola counties, said the court has answered the call. he states that while eviction processes may be moving forward for some, the final aspect of this procedure that allows someone to take possession of your property has been blocked through april 17 by the florida supreme court. 3. mccland says that during this time, the most important thing you can do is to keep an open stream of communication with your bank or landlord when it comes to any financial hardships. she also recommends to put any type of payment arrangements or agreements in writing, even if it's through email. 4. mccland wants to remind residents that their rent or mortgage will still be due some day and to plan accordingly for that. “it's not a bad idea to even enter some sort of written agreement where you're going to have a written payment plan,” she said. “so maybe you will pay an extra $100 or $200 per month after this pandemic is over.” 5. the city of kissimmee is now providing foreclosure rental assistance and eviction prevention to low income residents impacted by the coronavirus . you must meet a certain criteria in order to apply. for more information, visit: www.kissimmee.org . related stories
1115	lose your job? furloughed? expert gives advice on how to pay your bills text extraction from html file; language identification https://elrc-share.eu under review 2020 lose your job? furloughed? expert gives advice on how to pay your bills text/html https://www.fox35orlando.com/news/lose-your-job-furloughed-expert-gives-advice-on-how-to-pay-your-bills en_2020_04_958.xml_3.html lose your job? furloughed? expert gives advice on how to pay your bills email expert gives advice on how to pay your bills it's the first of the month and bills due. so what do you if covid-19 has you suddenly unemployed, furloughed, or unable to pay up? lake mary, fla. - it's the first of the month and bills due. so what do you if covid-19 has you suddenly unemployed, furloughed, or unable to pay up? first, you need to budget accordingly. it's time to cut any non-essential expenses. that means ending your gym membership and trimming phone or internet plans. daycare or monthly commuting passes might be paused or lowered during unemployment. consider extra work if you can to bring in income. fpa is offering free financial guidance to americans in need. a nonprofit credit counseling agency can also provide low cost help managing debt and creating a household budget. mortgage or rent: “here's the first thing that you need to do. contact your landlord or your mortgage company. negotiate some arrangement,” certified wealth strategist kat almulla tells fox 35 news. if you rent, she recommends offering to pay a portion of what you typically pay. for homeowners, she says call your mortgage company. “give yourself a good 90-day leeway and see if you can defer all together, and then start the payments up. a lot of companies can put those three months of payment on the back end. they can say, 'well we'll extend your mortgage by three more months.' that won't hurt you,” almulla said. advertisement if you hold a mortgage backed by fannie mae or freddie mac - about half of all mortgage holders do - there is help. the mortgage buyers have suspended all foreclosures and evictions for homes owned by their companies. they've also expanded their forbearance program, which could suspend payments for up to a year. ask the company you make your payments to if you hold a fannie or freddie loan. the federal government has also halted foreclosures and evictions for mortgages insured by the federal housing administration. after those calls, almulla recommends figuring out what your daily necessities cost. “with the money that you have, the most critical thing is that you need to pay are food, utilities, medication,” almulla said. if necessary, consider seeking aid for basic needs such as food and shelter. or consider local food banks, which have more leniency in who they can help. united way can also help you find social service support you may qualify for in your area. utilities: gas, electric, and other utility providers often have assistance programs for customers who cannot pay in full. there are also government and charitable programs to help low-income or struggling households. ask the utility provider for referrals credit card debt: almulla recommends calling whoever carries the note on your car and your credit card company (if you're carrying a balance) and start negotiating. “credit card companies would rather work with you, even if you have to take a minimum payment and cut it in half, or even if you negotiate the interest on your credit card debit,” almulla said. auto loans: if you are struggling to pay your auto loan or other debt, reach out to your lender. they've been instructed by federal regulators to work with borrowers impacted by the virus. banks have said they are willing to make a variety of arrangements such as waiving fees, temporarily lowering interest rates or making other payment arrangements. student loans: federal loan borrowers can now seek an emergency administrative forbearance, which would allow them to postpone payments for up to 60 days. borrowers must contact a servicer to apply. the federal government also lowered the interest rate on all federally held student loans to 0%. however, that will not lower the monthly payment; instead it will apply the payment entirely to the principle balance. the government has also temporarily halted collections and wage garnishment for borrowers who've fallen behind on their federal student loans. it has instructed private collection agencies to follow suit. if you have private student loans, contact your servicer for their repayment options. in all negotiations, almulla says get the name and direct number for the person you're speaking to, write down the date and time of day you spoke, and ask for an email from that person, confirming the arrangement to which you have agreed. plus, give yourself some leeway. almulla says, at this point, we don't know how long the covid-19 pandemic will affect jobs. “i would look at doing everything in a 90-day period. don't think 30 days. give yourself 90 days, the whole second quarter,” almulla suggests. some information taken from the associated press. latest news
1116	what gets washed? u of guelph prof gives tips on grocery shopping during coronavirus pandemic | simcoe.com text extraction from html file; language identification https://elrc-share.eu under review 2020 what gets washed? u of guelph prof gives tips on grocery shopping during coronavirus pandemic | simcoe.com application/xhtml+xml https://www.simcoe.com/news-story/9921365-what-gets-washed-u-of-guelph-prof-gives-tips-on-grocery-shopping-during-coronavirus-pandemic/ en_2020_04_545.xml_97.html what gets washed? u of guelph prof gives tips on grocery shopping during coronavirus pandemic news guelph mercury in the times of covid-19, going to get food has become a very different experience. lineups to get in and out of stores aside, many ask what they should be doing to ensure their food is safe. what needs to be washed? what should be avoided? is this really a big deal? jeffrey farber, a food microbiologist at the university of guelph and the director of the canadian research institute for food safety, has published a video looking to dispel some myths around grocery shopping during this time. what gets washed? u of guelph prof gives tips on grocery shopping during coronavirus pandemic news guelph mercury in the times of covid-19, going to get food has become a very different experience. lineups to get in and out of stores aside, many ask what they should be doing to ensure their food is safe. what needs to be washed? what should be avoided? is this really a big deal? jeffrey farber, a food microbiologist at the university of guelph and the director of the canadian research institute for food safety, has published a video looking to dispel some myths around grocery shopping during this time. top stories what gets washed? u of guelph prof gives tips on grocery shopping during coronavirus pandemic news guelph mercury in the times of covid-19, going to get food has become a very different experience. lineups to get in and out of stores aside, many ask what they should be doing to ensure their food is safe. what needs to be washed? what should be avoided? is this really a big deal? jeffrey farber, a food microbiologist at the university of guelph and the director of the canadian research institute for food safety, has published a video looking to dispel some myths around grocery shopping during this time. top stories
1116	"what does your new normal look like? join cbc edmonton's visual storytelling experiment | cbc news text extraction from html file; language identification https://elrc-share.eu under review 2020 what does your new normal look like? join cbc edmonton's visual storytelling experiment | cbc news text/html https://www.cbc.ca/news/canada/edmonton/new-normal-cbc-edmonton-project-1.5520555?cmp=rss en_2020_04_2663.xml_56.html what does your new normal look like? join cbc edmonton's visual storytelling experiment social sharing edmonton ·video what does your new normal look like? join cbc edmonton's visual storytelling experiment working from home, doing video hangouts, watching a lot of netflix? what does the new normal look like to you? social sharing new video project aims to track your new normal cbc news · posted: may 11, 2020 12:00 pm mt | last updated: may 11 the covid-19 pandemic has come with its very own language including what many like to refer to as ""the new normal."" so we asked our cbc edmonton audience, what does your new normal look like? both dr. sinoj abraham and dr. anu stella mathews are u of a researchers. 4:00 ""what does this mean to albertans? it means that all of us need to be engaged in this response. we need to start thinking about what our new normal will look like over the coming months."" with those words on march 9, alberta's chief medical officer of health dr. deena hinshaw ushered in a phrase that has become the mantra of the covid-19 pandemic: the new normal. in a matter of weeks parks have closed, offices have shuttered, roads have been deserted and barstools have been emptied in favour of curbside pickup or takeout. this is the new normal. so what does that look like to you? the new normal: tammy trevor the covid-19 pandemic has come with its very own language including what many like to refer to as ""the new normal."" so we asked our cbc edmonton audience, what does your new normal look like? 3:41 the new normal: taylor chadwick the covid-19 pandemic has come with its very own language including what many like to refer to as ""the new normal."" so we asked our cbc edmonton audience, what does your new normal look like? 2:29 the new normal: celina loyer the covid-19 pandemic has come with its very own language including what many like to refer to as ""the new normal."" so we asked our cbc edmonton audience, what does your new normal look like? 3:36 the new normal: amanda patrick the covid-19 pandemic has come with its very own language including what many like to refer to as ""the new normal."" so we asked our cbc edmonton audience, what does your new normal look like? 2:42 the new normal: allison zinnick the covid-19 pandemic has come with its very own language including what many like to refer to as ""the new normal."" so we asked our cbc edmonton audience, what does your new normal look like? 3:11 the new normal: kristin raworth the covid-19 pandemic has come with its very own language including what many like to refer to as ""the new normal."" so we asked our cbc edmonton audience, what does your new normal look like? 2:42 we are asking you, our cbc edmonton audience, to share your new normal and what it means to you. to take part in our project, send your videos to webedmonton@cbc.ca with the subject line, my new normal. how to shoot your video: if you can start your video with the line below, that would be great! hi, i'm __[first and last name]__. i'm ____ years old and i live in __________. i used to be/worked as a _____________ but now _________. [insert your covid-19 story here] end with, ""this is my new normal,"" or something like that to wrap it up. that means: shoot in landscape (horizontal) mode. don't be too close to the camera - there should be room on either side of you, and some head room. try to include shoulders/top of torso in shot - this will leave us room for captioning without covering your face. position the camera at eye level or slightly higher to avoid the double-chin look. if there is more than one person in the shot, try to follow the same rules - head room, shoulders in the frame. set-up:"
1116	what places are closed in toronto because of coronavirus? | simcoe.com text extraction from html file; language identification https://elrc-share.eu under review 2020 what places are closed in toronto because of coronavirus? | simcoe.com application/xhtml+xml https://www.simcoe.com/news-story/9907789-what-places-are-closed-in-toronto-because-of-coronavirus-/ en_2020_04_477.xml_148.html what places are closed in toronto because of coronavirus? news toronto.com the covid-19 pandemic has forced several closures in toronto. as restrictions ease though, businesses that were once closed are open again. you can find what's open again in toronto here . closed: • ontario science centre - closed until further notice. • all publicly funded schools and school-run daycares - closed until further notice. what places are closed in toronto because of coronavirus? a running list of closures due to the covid-19 pandemic news toronto.com the covid-19 pandemic has forced several closures in toronto. as restrictions ease though, businesses that were once closed are open again. you can find what's open again in toronto here . closed: • ontario science centre - closed until further notice. related content • all publicly funded schools and school-run daycares - closed until further notice. top stories what places are closed in toronto because of coronavirus? a running list of closures due to the covid-19 pandemic news toronto.com the covid-19 pandemic has forced several closures in toronto. as restrictions ease though, businesses that were once closed are open again. you can find what's open again in toronto here . closed: • ontario science centre - closed until further notice. related content
1120	"federal stimulus package offers more than direct cash payments to texas workers needing relief – nbc 5 dallas-fort worth text extraction from html file; language identification https://elrc-share.eu under review 2020 federal stimulus package offers more than direct cash payments to texas workers needing relief – nbc 5 dallas-fort worth text/html https://www.nbcdfw.com/news/coronavirus/federal-stimulus-package-offers-more-than-direct-cash-payments-to-texas-workers-needing-relief/2343780/ covid-19 texas states state employers employers employers businesses partners employee groups office slowdown loss weather events unemployment benefits stimulus package fund duration cash payments measures unemployment benefits pandemic emergency unemployment compensation mass claim benefits work share claims stimulus package behalf action relief passage paperwork claims process chargeback benefits work relief health reduction unemployment benefits claims job filing short-term compensation unemployment assistance disaster unemployment assistance pandemic stress coronavirus coronavirus stimulus greg abbott en_2020_04_926.xml_86.html updated on april 1, 2020 at 6:17 pm getty the recently passed $2 trillion federal stimulus package that will send direct cash payments to many americans also comes with unemployment benefits that will be available to more people and for a longer duration of time. a newly created pandemic emergency unemployment compensation (peuc) fund is empowering states to extend federally-funded unemployment benefits by an additional 13 weeks (past the usual 26 weeks). the fund also boost weekly benefits for those laid off, terminated or furloughed due to covid-19 by $600 per week. the measures also reduces paperwork and speeds the claims process by empowering employers to file one mass claim on behalf of all their employees laid off because of covid-19. it also eliminates any chargeback to texas employers for claims filed due to covid-19. coronavirus pandemic tarrant county reports 4 deaths, 154 confirmed covid-19 cases tuesday ""we appreciate the speedy passage of this stimulus package designed to provide much-needed relief for hardworking texas families who have been economically impacted by covid-19,"" said texas gov. greg abbott . ""while the state of texas continues to take action to protect public health, we are also committed to working with our federal partners to ensure texans have the financial relief they need during this time.” self-employed texans whose businesses have failed under the stress of the global pandemic may also be eligible as well. the governor's office said, like disaster unemployment assistance from weather events, pandemic unemployment assistance (pua) may be available for displaced workers not normally eligible for regular or extended benefits. workers whose hours have been reduced due to the covid-19 slowdown may qualify for work share, a federal short-term compensation program. employees whose work has been impacted by covid-19, whether by a reduction in hours or a loss of their job, are encouraged apply for unemployment benefits online or call 1-800-939-6631. employers can also utilize online filing for mass claims they file on behalf of employee groups laid off due to covid-19. this article tagged under:"
1120	"coronavirus in oklahoma: funds coming to assist gig workers, independent contractors idled by the pandemic text extraction from html file; language identification https://elrc-share.eu under review 2020 coronavirus in oklahoma: funds coming to assist gig workers, independent contractors idled by the pandemic text/html http://oklahoman.com/article/5659183/coronavirus-in-oklahoma-funds-coming-to-assist-gig-workers-independent-contractors-idled-by-the-pandemic?custom_click=rss&utm_source=feedburner&utm_medium=feed&utm_campaign=feed%3a+newsok%2fbusiness+%28newsok.com+rss+-+business%29 oklahoma city okc business politics news local capitol companies employment jack money coronavirus en_2020_04_908.xml_141.html newsok: oklahoma city news, sports, weather & entertainment coronavirus in oklahoma: funds coming to assist gig workers, independent contractors idled by the pandemic published: thu, april 2, 2020 1:03 am updated: thu, april 2, 2020 1:10 am shares oklahoma closings coronavirus in oklahoma: videos live updates: coronavirus in oklahoma coronavirus in oklahoma: what do you want to know? coronavirus in oklahoma: what we know, latest updates federal dollars to help gig economy workers and independent contractors idled by the new coronavirus pandemic are headed to oklahoma. those dollars will help each state's unemployment insurance system boost compensatory rates and lengthen the time benefits can be received for all idled workers, regardless of whether they work for themselves or someone else. funds are expected to arrive in mid-april, officials with the oklahoma employment security commission said wednesday. the commission is updating unemployment.ok.gov so idled self-employed workers will be able to use it to seek compensation. “we're grateful we will be able to provide temporary relief to individuals previously ineligible for unemployment insurance,” said robin roberson, executive director of the commission. “eligibility is key for gig workers, independent contractors and others to file a claim. “we want oklahomans to understand that the state does not create the eligibility requirements for this temporary assistance,"" roberson said. ""we are required to follow the guidelines set out by the u.s. department of labor.” who will be covered congress' coronavirus aid, relief and economic security act, commonly referred to as the cares act, mandates that independent contractors not eligible for regular or extended benefits under state or federal law will be covered in cases where they are unemployed, partially unemployed, or are unable or unavailable to work because of the coronavirus pandemic. related to this story the cares act authorizes states to provide unemployment compensation benefits to claimants in cases where: • the individual has been diagnosed with covid-19, or is experiencing symptoms of covid-19 and seeking medical diagnosis. • a member of the individual's household has been diagnosed with covid-19. • the individual is providing care for a family member or a member of the individual's household who has been diagnosed with covid-19. • there is a child or other person in the household for which the individual has primary caregiving responsibility who is unable to attend school or another facility that is closed as a direct result of the covid-19 public health emergency, and, school services or facility care is required for the individual to work. • the individual is unable to reach the place of employment because of a quarantine imposed as a direct result of the covid-19 public health emergency. • the individual is unable to reach the place of employment because the individual has been advised by a health provider to self-quarantine due to concerns related to covid-19. • the individual was scheduled to commence employment and does not have a job or is unable to reach the job as a direct result of the covid-19 public health emergency. • the individual has become the breadwinner or major support for a household because the head of household has died as a direct result of covid-19. • the individual's place of employment is closed as a direct result of the covid-19 public health emergency. persons who can telework with pay or are receiving paid sick leave or other paid benefits aren't eligible for the assistance under the program established by the cares act. self-employed workers will be required to submit internal revenue service form 1099s or tax returns to document their earnings as part of the application process. (story continued below...) additional support offered beyond extending unemployment insurance benefits to self-employed workers, officials said wednesday the cares act also includes federal dollars to boost compensation rates by $600 weekly for both self-employed and traditionally employed workers idled by the virus. it also provides dollars intended to help each state's unemployment insurance program to extend its typical benefits period (in oklahoma, that's 26 weeks) by another 13, through the end of this year. the cares act is the second stimulus effort congress undertook to address the coronavirus pandemic. earlier in march, it adopted the families first coronavirus response act, which required certain employers to provide their employees with paid sick leave or expanded family and medical leave policies for covid-19-related reasons, using federal dollars to offset costs. oklahoma employment security commission officials said it took the u.s. department of labor a couple of weeks to get the system and platform in place to begin sending states those additional dollars. unemployment assistance will now be available for gig workers. [dave morris/the oklahoman] <figure><img src=""//cdn2.newsok.biz/cache/r960-916492a3dc5d013d6b16aa2f646a4c0e.jpg"" alt=""photo - unemployment assistance will now be available for gig workers. [dave morris/the oklahoman] "" title="" unemployment assistance will now be available for gig workers. [dave morris/the oklahoman] ""><figcaption> unemployment assistance will now be available for gig workers. [dave morris/the oklahoman] </figcaption></figure><figure><img src=""//cdn2.newsok.biz/cache/r960-a55164f0eff6da854636f335531f7221.jpg"" alt=""photo - "" title=""""><figcaption></figcaption></figure> jack money jack money has worked for the oklahoman for more than 20 years. during that time, he has worked for the paper's city, state, metro and business news desks, including serving for a while as an assistant city editor. money has won state and regional... read more ›"
1120	"10 things you must know about filing for unemployment benefits text extraction from html file; language identification https://elrc-share.eu under review 2020 10 things you must know about filing for unemployment benefits text/html https://news.yahoo.com/10-things-must-know-filing-161536754.html en_2020_04_907.xml_59.html 10 things you must know about filing for unemployment benefits marc a. wojno, contributing writer, kiplinger's personal finance , april 16, 2020 getty images another 5.2 million workers filed for their first week of unemployment benefits in the week ending april 11, bringing the total who have sought compensation as covid-19 pandemic devastates the economy to over 22 million. notably, that's nearly all the jobs that were gained in the decade since the great recession. for many laid-off workers, this may be their first time dealing with the unemployment-benefits system, a joint state and federal program that provides those out of work with temporary yet steady cash payments to help them financially while finding a new job. the good news: legislation passed by congress significantly increases payments and the length of time that they're available, and extends eligibility to the self-employed - so many gig workers and contractors will be able to get unemployment benefits under the ""pandemic unemployment assistance"" program. but they may need to wait some time as states struggle to implement this new law during the surge in overall claims. let us help you navigate unemployment benefits to get you the help you deserve. the sooner you apply, the better. who qualifies for unemployment benefits? getty images unemployment benefits are available to workers who are unemployed ""through no fault of their own,"" such as a layoff. those fired for cause (such as misconduct), or who leave voluntarily or refuse an offer for work, need not apply. each state, district and territory sets its own guidelines for who is eligible and the amount of benefits. you must meet your state's criteria for wages earned or time worked during an established period, known as a ""base period,"" which is usually the first four out of the last five completed calendar quarters before the time that your claim is filed, according to the u.s. department of labor. the general rule of thumb is that unemployment benefits are based on a percentage of one's earnings - roughly between 40% and 60% - over a recent 52-week period, and paid out weekly over a period of between 12 to 28 weeks, depending on the state, and up to an additional 13 weeks extension. story continues if you've received a severance package from your former employer - usually in the form of a lump-sum payment - it's important to check with your state's labor department to see if you qualify for unemployment insurance. some states, such as california, don't disqualify you from receiving benefits if you have severance pay, be it a lump sum or in regular installments. but texas prohibits people from qualifying for unemployment benefits while receiving most types of severance pay, such as dismissal/separation income paid on termination of employment in addition to an employee's usual earnings from the employer at termination. how to apply for unemployment benefits getty images contact your state's unemployment insurance program office immediately upon unemployment, especially in light of the sharp increase of claims filed throughout the country over the past couple of weeks. check with the office to determine the preferred method of registering yourself in the system, be it online or by phone. while doing so in person was traditionally an option (that's how we got ""unemployment lines""), it's a bad idea now. keep in mind that registering your claim for unemployment benefits takes time to process, especially in light of the covid-19 pandemic, so budget your pocketbook accordingly before your first check appears. according to careeronestop, it usually takes two to three weeks after filing your claim to receive your first benefit check, but that estimate was from before the pandemic's impact. many state unemployment offices are struggling to keep up with the spike in demand. some states, and the district of columbia, require a one-week waiting period. in that case, you will file your first unemployment claim (in which you list the jobs you applied to that week), but you won't receive a payment. rather, your first payment would apply to the second week of your unemployment claim. many states, including california, hawaii and new york, have waived their waiting period as a result of the recent pandemic. and, under the new $2 trillion coronavirus aid, relief and economic security act (cares act), the relief package that provides financial assistance to families and businesses affected by the covid-19 pandemic, the federal government will provide temporary full funding for the first week of unemployment (see slide 5). check your state's site about changes to the waiting period. tap more resources from the labor department getty images the u.s. labor department's careeronestop site provides links to each state's relevant agency to speed your path to filing claims. the site also boasts a wealth of resources aimed at getting you back to work: education/training courses, job search resources and scores of toolkits for researching careers. how the coronavirus stimulus package changes the rules for unemployment benefits getty images two parts of the federal coronavirus rescue package have measures aimed at helping the unemployed: the families first coronavirus response act pumps an additional $1 billion into the unemployment compensation system to ease the burden on states processing and paying unemployment benefits. states with greater unemployment increases will receive more funds, and employers are encouraged to reduce the number of hours worked by employees in lieu of layoffs. states are also directed to ease eligibility requirements and access to unemployment benefits for workers who do lose their job. the federal government will also pay 100% of coronavirus-related extended unemployment compensation, instead of the usual 50%. the cares act provides even greater benefits. for example, it provides up to 39 weeks of unemployment benefits for self-employed people, independent contractors and others out of work because of the coronavirus pandemic who don't otherwise qualify for benefits. weekly unemployment checks are also increased by $600 through july. the federal government is also reimbursing states for the first week of unemployment benefits until the end of the year (states normally impose a one-week waiting period before paying benefits). an additional 13 weeks of benefits is included, too. that's what the law says. implementing it is up to the states, which have been waiting on official guidance from the federal department of labor on how to administer the new benefits. get your paperwork in order getty images the better prepared you are, the faster your claim will be processed (and happier is the rep who processes your claim). assemble supporting paperwork as if you're going to the department of motor vehicles -- but with the reward of a paycheck. your social security number alone is not enough (but it's a start). you will also need to provide the name, address, phone number and dates of employment from your most recent employer. for most people, this is all you need. some states, such as utah , require a driver's license as a form of identification. if you're not a u.s. citizen, but legally authorized to work in the u.s., you will need to provide your alien registration number (that eight- to nine-digit uscis number). for ex-military, have handy your dd214 form, which is your certificate of release or discharge from active duty (if you don't have it, you can request a copy through the u.s. department of veterans affairs' milconnect website ). former federal employees will need to provide either their standard form 8 (sf-8) or standard form 50 (sf-50) . if you receive, or will receive, severance pay from your former employer, you will need to provide documentation detailing your payout. qualified pension recipients should have their pension documentation at the ready. calculate your unemployment benefits getty images each state's unemployment office provides its own calculator - and explanation - to help you determine how much you will receive on a weekly basis. formulas can be as easy as taking the highest quarter of wages in your base period and dividing it by the number of weeks the state grants you unemployment compensation, to more complex formulas that incorporate additional factors. but unemployment offices try to be as transparent as possible. massachusetts' department of unemployment assistance, for example, provides an unemployment benefits determination calculator in which you enter the total wages you received in the past four quarters. upon entering the quarterly amounts, the calculator computes your weekly pay and the number of weeks you'll be paid unemployment benefits (26 weeks, in the case of the bay state). keep in mind that these calculators are intended to help you estimate your benefits and are intended only for advisory purposes. ultimately, it will be your state's computer system that will crunch your numbers and determine your official weekly amount. since benefits for the self-employed are a new phenomenon, don't expect estimates. how much will you get: stimulus check calculator yes, unemployment benefits are taxed. sorry! discovering that your unemployment benefits are taxed may not be nearly as shocking as the news of your job loss, but it can be just as tough to accept. after all, you just lost your job through no fault of your own -- why should uncle sam make you pay for your misfortune? the reality is that unemployment benefits are a form of income, and that income is taxable at both the federal and state level. there are some states, however, that completely exempt unemployment benefits from taxes. but state taxes vary from state to state , so make sure you review your state's unemployment tax policies. according to the internal revenue service, unemployment compensation, for the most part, includes any amounts received under federal or state unemployment compensation laws, including state unemployment insurance benefits and benefits paid to you by a state or the district of columbia from the federal unemployment trust fund. you have the option to have as much as 10% of your weekly benefits withheld for federal taxes. taxpayers will receive a form 1099-g from the irs, which shows the amount received and the amount of any federal income tax removed from your benefits. taxes may be withheld from unemployment benefits at the request of the benefits claimant by using form w-4v, while others who choose not to have their taxes withheld may need to make estimated tax payments during the year, according to the irs. see also: state taxes on unemployment benefits: what does your state do? file for unemployment benefits where you work, not where you live you should file your claim in the state where you worked. for instance, for residents of maryland and virginia who work in the district of columbia, it is required that you file your claim with the district of columbia. if you worked in multiple states, check with the unemployment office of the state you currently live in for information on how to file your claim appropriately with other states. you can get unemployment benefits even if you still have some work getty images obviously, if you're still working full-time, then you're not unemployed and, therefore, not eligible for unemployment benefits. but if, say, you've lost one job but kept another, or if you get paid for a temporary assignment, you can still collect unemployment benefits. however, they will be reduced accordingly to compensate for the additional income you're receiving. you must report your gross wages earned each week, not just your take-home pay. in missouri, for example, partial unemployment benefits are calculated by taking your weekly wages and subtracting $20, or 20% of your weekly benefit amount, whichever is greater. that amount is your deduction, which is then subtracted from your weekly benefit and rounded down to an even dollar amount. any withholding for federal taxes and such is taken from this amount. although state policies vary, as a general rule, if you perform part-time or temporary work, which includes self-employment, you are still required to fulfill your state's requirement of providing a list of new job searches each week. the district of columbia, for example, requires listing two job applications each week. and your state wants you to have the time to actively look for full-time employment, with the selfish goal of stopping payments of unemployment benefits to you when you return to work full time. budget for life on unemployment benefits getty images now that you've calculated how much you'll receive in unemployment benefits on a weekly basis, there's no better time to put pen to paper and budget for the next few months. ""this is an important time to determine your fixed and discretionary expenses,"" says lisa brown , chief strategy officer at financial planning firm brightworth in atlanta. brown recommends speaking with your mortgage company if you're a homeowner and inquiring with creditors, including credit card companies, to see if there are special programs for those whose jobs are impacted by the covid-19 pandemic and to see if you're eligible to defer or reduce monthly payments above and beyond what the government is proposing. creditors in particular want you to know that they're concerned about your financial wellbeing, and your ability to pay your bills. you've likely seen e-mails from mortgage services, credit card companies and banks expressing their commitment to help you stay on top of your finances. while it's better to maintain your monthly payments pre-virus and pre-unemployment, it might be worth it to reach out and inquire about your options to reduce your minimum monthly payments. brown also recommends that you look at how much money you have in your bank, and stretch it out as much as possible to avoid tapping into retirement accounts (which could come with a significant tax penalty)."
1122	"how a mobile app helped china to contain the spread of covid-19? text extraction from html file; language identification https://elrc-share.eu under review 2020 how a mobile app helped china to contain the spread of covid-19? text/html https://www.livemint.com/news/world/how-a-mobile-app-helped-china-to-contain-the-spread-of-covid-19-11585747212307.html coronavirus china south korea contact tracing en_2020_04_736.xml_51.html home > news > world >how a mobile app helped china to contain the spread of covid-19? 2 min read . updated: 01 apr 2020, 10:56 pm ist srishti choudhary an oxford university study recommends countries to explore digital contact-tracing to speed up their preventive actions the contact-tracing app works with the help of a central server, which is updated in real-time with new covid-19 cases share via china coronavirus south korea new delhi: a new study conducted by researchers at the university of oxford shows that the spread of the novel coronavirus is too fast to be contained by manual contact-tracing alone, and thus, recommends countries to explore the digital route to speed up their preventive actions. the study comes at a time when india, with a total of 1,590 infected persons so far, races against time to trace contacts of positive cases and put them in quarantine. according to scientists, the traditional approach of manual case isolation, contact tracing and quarantine are not fast enough for sars-cov-2, which has stunned the world for its high speed of transmission, infecting over 8.6 lakh people in just three months. and, by the time health authorities confirm a positive case and reach out to his/her contacts, the virus already infects a number of people. a delay of even a few days in finding the contacts could render these measures ineffective. “specifically, this delay can be avoided by using a mobile phone app, if used by a sufficient number of people,"" concluded the researchers in a paper published in the journal science. such an approach could keep incidence of new infections low. the contact-tracing app works with the help of a central server, which is updated in real-time with new positive covid-19 cases. the app builds a memory of proximity contacts based on gps locations. as soon as one person in the network requests a sars-cov-2 test using the app and gets ‘positive' result, it triggers an instant notification to possible close contacts, recommending necessary quarantine measures, while preserving the anonymity of the infected individual. the app allows the central database to collect data on user movement and coronavirus diagnosis and displays a green, amber or red code to relax or enforce restrictions on movement using artificial intelligence (ai). similar applications have been used by china and south korea, which have achieved significant success in suppressing the epidemic. fewer than 150 new cases have been reported each day during 2-23 march in china, down from thousands each day at the peak of the epidemic. south korea too had brought down new cases from 909 on 29 february to 76 on 24 march. but, since the usage of the app involves data protection and privacy issues, the study says there is need for careful oversight and people should be democratically entitled to decide whether to adopt this platform or not. “the intention is not to impose the technology as a permanent change to society, but we believe it is currently necessary and justified to protect public health. we recommend urgent exploration of means for intelligent physical distancing via digital contact tracing,"" the researchers concluded. subscribe to newsletters"
1122	contact tracing to be extended to suspected cases of covid-19 text extraction from html file; language identification https://elrc-share.eu under review 2020 contact tracing to be extended to suspected cases of covid-19 application/xhtml+xml https://www.thejournal.ie/contract-tracing-suspected-cases-5063938-apr2020/ city west coronavirus covid-19 hse leo varadkar making contact precaution simon harris en_2020_04_673.xml_33.html contact tracing to be extended to suspected cases of covid-19 a team of 1,400 health officials will work to trace and contact people. by press association wednesday 1 apr 2020, 4:41 pm apr 1st 2020, 4:41 pm 23,982 views 22 comments https://jrnl.ie/5063938 image: leon farrell/photocall ireland image: leon farrell/photocall ireland contact tracing will now be carried out for those suspected of having covid-19 under new measures to tackle the virus, the health minister has said. simon harris said a team of 1,400 health officials will work to trace and contact people who have been in close quarters with suspected cases, instead of only confirmed positive cases. harris was speaking at the new facility in citywest dublin, where more than 1,000 beds are being made available for those who need to self-isolate. he said: “as of the recommendation yesterday and working with our gps, if there are suspected cases of covid-19 the contact tracing can start before you get the positive result. “that seems like a sensible precaution because the whole purpose of the testing and contact tracing is to try and identify the virus as much as possible and isolate it to slow down the spread. “there will also be contact tracing for suspect cases before they're confirmed. and now that we have the resources in terms of 1,400 people, that seems like a sensible thing too. “the national public health emergency tracing team has now said we should not actually be waiting for a suspect case to be confirmed before contact tracing so if there are suspected cases of covid-19, the contact tracing can start before you actually need a positive test result.” taoiseach leo varadkar said there will be delays in the coming weeks with both testing and receiving results due to global shortages of equipment. he added: “it is important to bear in mind, getting your test results in itself doesn't actually determine whether or not you get any better. this is a virus that has no treatment. “so the fact that somebody is delayed in getting their test results doesn't actually determine in any way when they get better or not, but it does help us to identify more cases and do more tracing.” thejournal.ie's coronavirus newsletter cuts through the misinformation and noise with the clear facts you need to make informed choices. sign up here: short url
1122	alabama continues to trace contacts of people who test positive for covid-19 text extraction from html file; language identification https://elrc-share.eu under review 2020 alabama continues to trace contacts of people who test positive for covid-19 text/html https://www.al.com/news/2020/04/alabama-continues-to-trace-contacts-of-people-who-test-positive-for-covid-19.html en_2020_04_863.xml_184.html alabama continues to trace contacts of people who test positive for covid-19 posted apr 01, 2020 if a person tests positive for coronavirus at drive-up test sites like this one in fairhope, public health employees will interview them and attempt to notify people who may have come in close contact with the patient. facebook share by dennis pillion | dpillion@al.com as the number of positive coronavirus cases in alabama is now more than 1,000 , the alabama department of public health continues to attempt to interview each confirmed covid-19 patient and determine if they may have put others at risk. it's called contact tracing. adph conducts this tracing statewide, while mobile and jefferson county health departments follow-up with their patients in those two counties. “this is part of the normal epidemiology that [the department of] public health does all the time,” said dr. scott harris, state health officer and head of adph. “we will contact a person who has a certain type of infection and find out what their daily activities are, and who is in their household and who is in their workplace and try to make sure that we reach contacts and we continue to do this with covid-19.” harris said the adph does this for every confirmed case in alabama. “in each one of those [covid] cases, our epidemiology staff is aware of that case and has spoken with that person and has reached out to get in touch with those people who may have been considered contacts or may be at risk,” harris said. adph spokesperson arrol sheehan said the state department has “at least 85 staff members working on death investigations and contact tracing,” related to covid-19. the jefferson county department of health has 10 full-time staff and one intern in its epidemiology division. mobile county has four public health nurses and six disease intervention specialists who can conduct contact tracing interviews and notifications, though they may perform other duties as well. rendi murphree, epidemiologist at the mobile health department, said contact tracing can involve breaking the news to patients that they have tested positive. “sometimes we contact patients that haven't been told by their physician yet that they've tested positive, so we have to kind of muddle through that a little bit,” murphree said. “then do a complete interview of what they did, from the time that they had their first symptom onset and then minus two days. “so for two days prior to first symptom onset, we do an in depth contact investigation and identify anyone that they had close contact with.” for covid-19, close contact means anyone who has spent more than 15 minutes being within six feet of the patient. murphree said they ask for the names and contact info of all close contacts, who are then notified that they were identified as close contacts. because of health privacy laws, the identity of the patient is not disclosed, but the close contacts are notified as much as possible. murphree said social distancing makes contact tracing much easier. “the good thing about these community mitigation measures that have been put into place is that [the number of contacts] is not as big as it could be,” she said. “because most people that we contact, they're staying home and just being around family and or maybe one or two co-workers and that sort of thing. “so the messages, if people adhere to them, it makes the job less complex than if people were just going about their day to day lives in the community, going to the bank, picking their kids up from school, going to the skating rink, you know, weddings. it would just be extremely challenging if we still had that going on.” note to readers: if you purchase something through one of our affiliate links we may earn a commission. disclaimer
1123	"polarity medical announces development of virus-killing uv-c light automatic sterilizing devices for doorknobs, railings, pin pads and other cdc-defined high-touch areas text extraction from html file; language identification https://elrc-share.eu under review 2020 polarity medical announces development of virus-killing uv-c light automatic sterilizing devices for doorknobs, railings, pin pads and other cdc-defined high-touch areas text/html https://news.yahoo.com/polarity-medical-announces-development-virus-180400269.html en_2020_04_5517.xml_142.html mail advertisement polarity medical announces development of virus-killing uv-c light automatic sterilizing devices for doorknobs, railings, pin pads and other cdc-defined high-touch areas • april 7, 2020 s. fallsburg, n.y., april 7, 2020 /prnewswire/ -- polarity medical recently announced it has developed patent-pending designs for multiple uv-c light automatic sterilizing devices to help combat the spread of viruses, bacteria and other disease-causing pathogens. these uvc automatic sterilizing devices harness the germicidal properties of uvc light and can be easily installed in 15 minutes, retrofitted to any doorknob, handle or other high-touch area. polarity medical is currently seeking venture capital and strategic partnerships to speed manufacture and distribute these potentially life-saving devices. the first doorknob automatic sterilizer is easy to install and kills viruses with no delays. a green light lets users know it's always safe. no more constant wiping or hand-held uvc devices needed. ""the design came to me two weeks ago as i was caring for my mother as she battled an extreme flu,"" said uv automatic sterilizer inventor, dr. tom chi. ""she was using an oxygen concentrator and barely hanging on. at the same time my wife oversees a company that sterilizes hospital and urgent care contaminated treatment rooms so it's been a dynamic time. a big part of transmissibility comes from commonly touched surfaces which need to be repeatedly sterilized. and now we have an easy, reliable solution."" the sterilizer designs include an add-on unit that is placed around a doorknob. another features a uv-c light-emitting slip cover and a ""donut"" for doorknobs, levers and commercial handles. there is also a replacement unit for doorknobs that utilizes polarity medical's newly developed method to transfer power through the doorlatch directly into the uvc doorknob mechanism. it takes literally 10 seconds for uv-c light to sterilize a surface. not only will these devices make sterilization easy, they're also relatively inexpensive and the technology should dramatically reduce transmission of pathogens. it's a scary reality, but it only takes one contaminated surface to infect half an office staff in just a few hours. we need this technology now."" uv-c light: proven to kill pathogens ultraviolet germicidal irradiation (uvgi) is a well-established and trusted disinfection method that uses short-wavelength ultraviolet (uv-c) light to kill or permanently disable microorganisms and pathogens by destroying their dna and leaving them to survive and multiply. the technology is often employed in large-scale medical, water and air purification systems. higher concentrations of uv-c light are used to sterilize entire operating rooms and story continues uv-c disinfection is included in the united states e.p.a. and cdc guidelines as it can kill up to 99% of flu viruses and infection-causing bacteria. for the latest product development news and information related to the uv automatic sterilizers, follow polarity medical on social media: facebook . about tom chi: ""the pain whisperer"" tom chi is an entrepreneur, inventor and doctor of acupuncture and oriental medicine. he pioneered a breakthrough pain cure using his decades of kung fu and acupuncture mastery. tom is able to perceive soft tissue pain and injury in others while simultaneously permanently relieving their pain. he has demonstrated his abilities for live audiences on ""the doctors"" tv show, for oprah and in filming with dr. oz. he has treated and cured many medical doctors. tom is currently working to produce a televised show based on his abilities, titled ""new hope."" background footage may be seen here: https://www.youtube.com/watch?v=83tphudv6aa learn more about tom at: www.thepainwhisperer.com about polarity medical llc polarity medical is a medical device manufacturer that holds a number of patents, including fda-approved magnetized acupuncture needles and medical magnets. polarity medical is currently working to manufacture its latest design for uv-c automatic sterilizer units to help battle the worldwide covid-19 pandemic and other flus. learn more at: polarity medical media contact:"
1123	coronavirus: robots use light beams to zap hospital viruses text extraction from html file; language identification https://elrc-share.eu under review 2020 coronavirus: robots use light beams to zap hospital viruses text/html http://www.impactlab.net/2020/03/31/coronavirus-robots-use-light-beams-to-zap-hospital-viruses/ en_2020_04_827.xml_26.html coronavirus: robots use light beams to zap hospital viruses the uvd robot takes about 20 minutes to treat a room “please leave the room, close the door and start a disinfection,” says a voice from the robot. “it says it in chinese as well now,” simon ellison, vice president of uvd robots, tells me as he demonstrates the machine. through a glass window we watch as the self-driving machine navigates a mock-hospital room, where it kills microbes with a zap of ultraviolet light. “we had been growing the business at quite a high pace - but the coronavirus has kind of rocketed the demand,” says chief executive, per juul nielsen. he says “truckloads” of robots have been shipped to china, in particular wuhan. sales elsewhere in asia, and europe are also up. “italy has been showing a very strong demand,” adds mr nielsen. “they really are in a desperate situation. of course, we want to help them.” powerful uv light is already a proven means to kill microbes production has been accelerated and it now takes less than a day to make one robot at their facility in odense, denmark's third largest city and home to a growing robotics hub. glowing like light sabres, eight bulbs emit concentrated uv-c ultraviolet light. this destroys bacteria, viruses and other harmful microbes by damaging their dna and rna, so they can't multiply. it's also hazardous to humans, so we wait outside. the job is done in 10-20 minutes. afterwards there's a smell, much like burned hair. “there are a lot of problematic organisms that give rise to infections,” explains prof hans jørn kolmos, a professor of clinical microbiology, at the university of southern denmark, which helped develop the robot. “if you apply a proper dose of ultraviolet light in a proper period of time, then you can be pretty sure that you get rid of your organism.” he adds: “this type of disinfection can also be applied to epidemic situations, like the one we experience right now, with coronavirus disease.” uvd has tripled output of its disinfecting robots the robot was launched in early 2019, following six years of collaboration between parent firm, blue ocean robotics and odense university hospital where prof kolmos has overseen infection control. costing $67,000 (£53,370) each, the robot was designed to reduce the likelihood of hospital-acquired infections (hais) which can be costly to treat and cause loss of life. while there's been no specific testing to prove the robot's effectiveness against coronavirus, mr nielsen is confident it works. “coronavirus is very similar to other viruses like mers and sars. and we know that they are being killed by uv-c light,” he says. dr lena ciric, an associate professor at university college london and expert on molecular biology, agrees that uv disinfection robots can help fight coronavirus. disinfection robots are no “silver bullet”, says dr ciric. but she adds: “these [machines] provide an extra line of defence.” “we're in the run up to having a lot of coronavirus patients in the various hospitals. i think it's wise to be on top of the cleaning regimes… from an infection control point of view. ” to be fully effective, uv needs to fall directly on a surface. if lightwaves are blocked by dirt or obstacles, such shadow areas won't be disinfected. therefore manual cleaning is needed first. uv light has been used for decades in water and air purification, and used in laboratories. but combining them with autonomous robots is a recent development. the xenex lightstrike device american firm xenex has lightstrike, which has to be manually put in place, and delivers high-intensity uv light from a u-shaped bulb. the company has seen a surge in orders from italy, japan, thailand and south korea. xenex says numerous studies show that it's effective at reducing hospital-acquired infections and combating so-called superbugs. in 2014, one texan hospital used it in the clean-up after an ebola case. more than 500 healthcare facilities, mostly in the us, have the machine. in california and nebraska, it has already been put to use sanitising hospital rooms where coronavirus patients received treatment, the manufacturer says. in china, where the outbreak began, there has been an adoption of new technology to help fight the disease. the nation is already the highest spender on drones and robotics systems, according to a report from global research firm idc. leon xiao, senior research manager at idc china says robots have been used for a range of tasks, primarily disinfection, deliveries of drugs, medical devices and waste removal, and temperature-checking. ‘i think this is a breakthrough for greater use of robotics both for hospitals and other public places,” says mr xiao. however space in hospitals to deploy robots and acceptance by staff are challenges, he says. youibot has quickly developed its own disinfecting robot the coronavirus has spurred home-grown chinese robotics companies to innovate. shenzhen-based youibot was already making autonomous robots, and quickly adapted its technology to make a disinfection device. “we're trying to do something [to help], like every one here in china,” says youibot's keyman guan. the startup adapted its existing robotic base and software, adding thermal cameras and uv-c emitting bulbs. “for us technically, [it's] not as difficult as you imagine… actually it's just like lego,” says mr guan. youibot at a hospital in wuhan it has supplied factories, offices and an airport, and a hospital in wuhan. “it's running right now in the luggage hall… checking body temperature in the day, and it goes virus killing during the night,” he says. however the robot's efficacy hasn't yet been evaluated. meanwhile plant closures and other restrictions to curb coronavirus, have hampered getting parts. “the lack of one single component, [and] we cannot build a thing,” adds mr guan, though he notes things have improved in the last couple of weeks. “there are not many good things to say about epidemics,” says professor kolmus, but it has forced industry “to find new solutions”.
1123	an ontario elevator technician created a uv light treatment to make masks safe for reuse. so will it work? | the star text extraction from html file; language identification https://elrc-share.eu under review 2020 an ontario elevator technician created a uv light treatment to make masks safe for reuse. so will it work? | the star text/html https://www.thestar.com/news/gta/2020/04/06/an-ontario-elevator-technician-created-a-uv-light-treatment-to-make-masks-safe-for-reuse-so-will-it-work.html covid-19 acts of kindness n95 masks smg_gta smg2_news en_2020_04_5669.xml_58.html an ontario elevator technician created a uv light treatment to make masks safe for reuse. so will it work? by gilbert ngabo staff reporter tue., april 7, 2020timer4 min. read amid mounting concerns over the shortage of personal protective equipment for front-line workers fighting the spread of covid-19 , an ontario resident has designed what he says could be a partial solution - a uv light machine designed to sterilize n95 masks for reuse. farkas baranyai of wellington has teamed up with a couple of local craftspeople to assemble two models of the machine, sending one to a local health-care unit and another to a small hospital. “large hospitals may have their own sterilization systems, but our local health units are in dire need of protective equipment and how to take care of it,” said baranyai. baranyai, an elevator technician, said he happened to read a new york times article about how researchers at the university of nebraska medical centre were using uv rays to sterilize the masks. “i'm a problem solver, so i thought: i've assembled uv units before. if they can do that there, i can build a machine like that here,” he said. health-care workers across canada face a shortage of ppe, and premier doug ford said ontario could run out of the crucial n95 masks in a week. a shipment of millions of n95s was temporarily halted at the u.s. border this week as the country threatened to ban exports, increasing pressure. local manufacturers and university researchers have started producing masks. while research is inconclusive on whether the n95 masks (which keep out airborne particles) can be properly disinfected and safely reused - and which disinfectant methods work - baranyai says his uv light machine could help for now. he and two partners assembled the machine in 11 days, from concept to completion. he describes it as a stainless steel box with a hinged lid holding two uvc lights. the interior has a four-square-foot shelf that can hold about 20 masks at a time. foil tape helps reflect rays from the bottom and sides during sterilization. a fundraising effort he launched raised over $800, which helped him buy some materials. baranyai, who called he project a gesture for his community, feared hospitals would turn him down since health authorities have not officially approved. he noted it's hard to even find the proper channels during a crisis. the two health-care centres that received these uv light machines have yet to start using them, pending proper guidelines. joshua colby, an er physician at prince edward family health team, which received one of the two machines, said the use of uv light machines to sanitize masks is “a nascent field” with much uncertainty. he mentioned research underway at the children's hospital of eastern ontario on the machines' efficacy on n95 masks. uv light has been used for years in vent-hoods in academic centres where bacterial, viral and cell cultures were used and a sterile setting was needed. there's some evidence that too much uv light can damage the mask, so a balance has to be found, colby said. “i would say that if we run out of n95 masks, the uv light hood would be a good option to sterilize used masks, although this is based on tenuous research for which there are few guidelines,” he said. “i would certainly prefer to use a uv-light-sterilized n95 over a cloth mask if i were going in to see someone with covid-19.” an official from the lennox & addington county general hospital in napanee, where the second machine was sent, said they'll rely on guidance from ontrario's health ministry before using it. the ministry says the evidence on repurposing masks is new and evolving. it's working on options to ensure availability of ppe for health providers, including the repurposing or resterilization of n95s. in a memo to stakeholders this week, deputy health minister helen angus said the public health agency of canada has asked for used ppe to be saved for potential reuse. “ontario health is asking hospitals to store used ppe securely and is distributing a survey to understand hospital capacity for reprocessing, based on promising technologies to safely reuse ppe,” she wrote. loading... loading...loading...loading...loading...loading... loading... ronald hofmann, professor of civil and mineral engineering at the university of toronto, said the nebraska researchers have put out some protocols on using uv to disinfect n95 masks. the international uv association also believes using uv can sterilize n95 masks. hofmann said uv can work in theory but its effectiveness depends on the details. “the research community is scrambling right now to figure these things out,” he said. if a hospital runs out of new n95 masks, their choices are to wear nothing, reuse their masks without any treatment, or use some treatment that in theory can do a good job disinfecting them, he said. “we think that uv, along with heat treatment, and along with hydrogen peroxide vapour, are three good methods that show a lot of promise,” hofmann said. “but the devil is in the details.” gilbert ngabo is a breaking news reporter based in toronto. follow him on twitter: @dugilbo share:
1129	how to make hand sanitizer with fresh aloe plant text extraction from html file; language identification https://elrc-share.eu under review 2020 how to make hand sanitizer with fresh aloe plant text/html https://www.greenmatters.com/p/hand-sanitizer-fresh-aloe-plant home en_2020_04_5511.xml_27.html how to make hand sanitizer with fresh aloe plant updated 5 months ago being a plant lady has never paid off more than right now. as do-it-yourself hand sanitizer essentials went flying off the shelves amidst the coronavirus outbreak, many people are struggling to locate at-home hand sanitizer ingredients - which typically include aloe vera gel, 99 percent isopropyl alcohol, and (sometimes) essential oils. but if you have an aloe vera plant at home, you're already part of the way there! now, there are a few ways to make an effective hand sanitizer at home. one way is with isopropyl alcohol, but you will want to make sure that, at the very least, the isopropyl is 60 percent or above. isopropyl alcohol with an alcohol content of anywhere from 90 to 99 percent will likely be most efficient in killing covid-19 and other germs; however, if you can't get your hands on that (no pun intended), 99 percent rubbing alcohol will also work. if you don't have access to isopropyl alcohol, however, there is another household option that could work: vodka. of course, vodka may not be as efficient in killing germs as isopropyl but if it's all you got, it's certainly worth a shot. a high-proof grain-based alcohol, like everclear for example, which has anywhere from 75 to 95 percent, is your best bet. however, when vodka is diluted with aloe vera gel, the alcohol content decreases a bit, probably to about 60 percent or lower. that's why it is important to use the highest proof alcohol you have available. once you have your disinfectant agent, the next important ingredient is the aloe vera. if you're working with aloe vera gel straight from a plant , here's what you need to know. are hand sanitizers effective? source: istock hand sanitizers are effective and most importantly, then can be extremely helpful and efficient in curbing the covid-19 pandemic. coupling the use of hand sanitizer somewhat regularly with handwashing for 20 seconds is thought to help #flattenthecurve. (according to the experts at the center of disease control and prevention (cdc) and the world health organization (who) , you should wash your hands if you have access to soap and water; only use hand sanitizer if you're on the go or don't have access for any other reason.) to ensure your at-home hand sanitizer is its most effective, it's important to use a disinfectant agent (high-proof vodka or isopropyl alcohol) with a very high percentage, as mentioned above. the higher the alcohol content, the better chance your sanitizer has of fighting off covid-19 (and of course, other unwanted germs). since the cdc recommends using hand sanitizer with a total of 60 percent alcohol when it's said and done, a ¾ cup of 190 proof vodka - 95 percent alcohol - is the best-case scenario. after adding the other ingredients, a ¾ cup of 190 proof vodka will leave you with 64 percent estimated alcohol, according to willamette transplant . if you use an 80-proof vodka, which has 40 percent alcohol, you will end up with only 30 percent alcohol in your finished product. ingredients for diy hand sanitizer: source: istock to make diy hand sanitizer, you will need aloe vera gel, isopropyl alcohol (or high-proof vodka), and the essential oil of your choice. if you are working with a live aloe vera plant or a single cut of aloe vera, you'll need to squeeze out about ¼ cup of gel. for ¼ cup of gel, you will also need ¾ cup of your grain-based alcohol and about 10-15 drops of essential oil. (lavender, peppermint, and eucalyptus essential oils are some of our personal favorites for sanitizer.) make sure you have a spray or squeeze bottle to put the sanitizer in. this recipe will yield about 1 cup of sanitizer. how to cut your aloe vera plant: source: istock working with a plant or a cut of aloe vera from the grocery store? no problem. make sure to cut it about 2 to 3 inches from the base. cut the top, too, until the new top of your cut leaf is about 1-inch wide. down the spine of the leaf, slice the length and peel it off from the other side. inside, you'll find the aloe vera gel. peel back the leaf and slice the rest of that side until you can see all of the gel inside. now, use a spoon to remove the gel. how to prepare your aloe vera gel for diy hand sanitizer: source: istock now that your aloe vera plant is cut properly, you will have to prepare it for the sanitizer. since you're not dealing with already liquid gel, we recommend running the gel of the aloe vera through a blender to ensure that it's as liquid-y as possible. blending the plant's gel for about 30 seconds will turn the aloe vera gel into a foam consistency. before moving onto the next step, make sure there are no more chunks left in the gel. how to make diy hand sanitizer with an aloe vera plant: source: istock once your aloe vera gel has been blended for up to 30 seconds, measure out ¼ cup and add it to the ¾ cup of isopropyl alcohol or grain-based alcohol. blend it again for another 15 seconds to make sure it's mixed well. add 10 to 15 drops of your favorite essential oil in a spray or squeeze bottle. this diy hand sanitizer should be good for up to three weeks. more from green matters the best way to prevent contracting or spreading coronavirus is with thorough hand washing and social distancing . if you feel you may be experiencing symptoms of coronavirus, which include persistent cough (usually dry), fever, shortness of breath, and fatigue, please call your doctor before going to get tested. for comprehensive resources and updates, visit the cdc website . if you are experiencing anxiety about the virus, seek out mental health support from your provider or visit nami.org .
1129	how can sanitizer be dangerous? | thehealthsite.com text extraction from html file; language identification https://elrc-share.eu under review 2020 how can sanitizer be dangerous? | thehealthsite.com text/html https://www.thehealthsite.com/news/coronavirus-live-update-in-depth-dont-burn-yourself-while-using-a-hand-sanitizer-737554/ en_2020_04_4268.xml_55.html also read - loss of smell and taste in covid-19 patients is profound but recovery rate is higher too what makes a hand sanitizer inflammable? the ethyl alcohol content of hand sanitizers is quite high, around 62 per cent. this is an extremely inflammable chemical. so, is it okay to switch to non-alcohol-based sanitizers to keep ourselves safe from covid-19 and fire? unfortunately, no. experts are of the opinion that they aren't effective. moreover, non-alcohol based hand sanitizers comprise of an antibiotic element called triclosan which is also said to be dangerous for our health. various studies on the component are still in progress. what precautions should be taken? you need to be cautious while using a hand sanitizer. here are a few precautions you need to take: · keep sanitizers away from kids · avoid keeping the sanitizer near your kitchen's gas stove or any inflammable thing which can catch fire. · try not to use a sanitizer at home. instead, use good old soap and water to clean your hands if you want to avoid fire hazards. other health impacts of using a hand sanitizer as suggested above, whenever you are at home make use of soap and water to wash your hands. use sanitizers only when you have to step out as the using them everytime can be hazardous. if you are a obsessed with cleanliness and cannot do without a sanitizer take a look at these dangers which hand sanitizers carry with them: bacteria become antibiotic resistant antibiotics are used to kill the bacteria but what if these pathogens get immune to them? triclosan, an antibiotic compound used as an ingredient in sanitizers make bacteria resistant towards antibiotics. also, it ends up killing the good bacteria in your body as well. poisoning by alcohol alcohol-based sanitizers don't contain triclosan but that doesn't make them completely safe. other active ingredients like ethyl alcohol and isopropyl alcohol may lead to alcohol poisoning, if you drink it accidentally. triclosan can cause hormone problem another harmful effect of triclosan is that it can cause hormonal imbalance. studies conducted on animals have shown that this component may take your hormonal balance haywire. weakens the immune system even though sanitizers are used to build your immunity against germs, some studies have shown that triclosan can actually harm your immune system. this can make you vulnerable to infections and allergies. according to a study conducted at the university of michigan school of public health , high levels of triclosan make kids and teens more vulnerable to hay fever and allergies.
1129	where to buy the materials to make masks at home text extraction from html file; language identification https://elrc-share.eu under review 2020 where to buy the materials to make masks at home text/html https://news.yahoo.com/where-buy-materials-masks-home-215850759.html en_2020_04_4570.xml_146.html where to buy the materials to make masks at home courtney campbell, reviewed.com may 20, 2020 you can sew or craft your own face masks. - recommendations are independently chosen by reviewed's editors. purchases you make through our links may earn us a commission. editor's note: this story is no long being updated, but to find mask materials check out our updated story here. according to the centers for disease control and prevention (cdc), n95 masks are only recommended for health care workers protecting themselves from the spread of coronavirus (covid-19). however, many experts agree that wearing a mask in public could help prevent the spread of the disease. the world health organization (who) recommends using a face mask if you are taking care of a person suspected of having coronavirus, and the cdc is recommending that people wear “do-it-yourself cloth covering” while they're out and about. but with a national shortage of n95 masks and other loose-fitting surgical masks, you may be considering making one for yourself or others. good news: it's possible to make masks at home -even with limited crafting experience. how to make a mask this video from the detroit free press shows that you can fasten together your own mask by sewing together two pieces quilting fabric and elastic. for those who can't sew (or don't want to), this youtube tutorial shows you how to make a face mask using fabric, rubber bands, fabric glue, and an iron. more: how to make your own face mask to help stop the spread of the coronavirus where to get the materials to make a mask to make your own mask at home, you're going to need quilting fabric, elastic, a sewing kit/sewing machine or fabric glue, depending on the route you choose for crafting. while supplies may be limited for these items, we rounded all the retailers you can still order these materials from. quilting fabric get the elmer's 4oz craft bond glue at target for $3.69 how should you wear a mask according to the who , the use of a mask will only be effective in conjunction with proper hand washing and sanitization practices. you should wash your hands before and after applying your mask. while applying the mask, make sure your mouth is covered and that there are no gaps between your face and the mask. be sure not to touch the mask while wearing it. if you do touch your mask, wash your hands or use hand sanitizer immediately. you should take care to remove the mask from behind and not touch the front of the mask. if it's a disposable, toss the used mask or wash a reusable cloth mask in hot, soapy water. always clean your hands immediately after. step 2: so how do you actually remove your fabric mask? with the straps!! and remember, wash in hot soapy water to sanitize. - ellie murray (@epiellie) april 2, 2020 the product experts at reviewed have all your shopping needs covered. follow reviewed on facebook , twitter , and instagram for the latest deals, reviews, and more. prices were accurate at the time this article was published but may change over time.
1130	meriden schools report distance learning successes, challenges text extraction from html file; language identification https://elrc-share.eu under review 2020 meriden schools report distance learning successes, challenges text/html https://www.myrecordjournal.com/news/meriden/meriden-news/meriden-schools-advance-remote-learning-curriculum.html en_2020_04_895.xml_25.html meriden schools report distance learning successes, challenges meriden schools report distance learning successes, challenges teacher jacob butler works on a laptop in his eighth-grade classroom at lincoln middle school in meriden, thurs., mar. 5, 2020. dave zajac, record-journal april 01, 2020 05:57pm by mary ellen godin, record-journal staff meriden - as they enter the third week of remote learning, the city's public schools are leading other alliance districts in equipping students with chromebooks and implementing distance learning, school officials said. “regardless of socioeconomic status, all students must be able to access learning in a digital world,” said school superintendent mark benigni. “we've been increasing devices over the past 10 years. we had a strategic plan to get this district one to one. it made a difference for us as we began this work.” benigni and barbara haeffner, the director of teaching and innovation, planned to present the district's program to the newly formed state covid-19 learn from home task force wednesday afternoon. gov. ned lamont and education commissioner miguel cardona formed the task force to distribute 60,000 laptops for high school students from the partnership for connecticut, and 185,000 take home sets of learning materials from scholastic for pre-k to grade 8 students.the task force will distribute the materials to each of the state's 33 alliance districts, including meriden. the alliance district program identifies the state's lowest performing school districts, which typically receive additional state funds to help bridge the state's achievement gap. cardona is a former assistant superintendent for meriden public schools. meriden public schools used some of this funding and state grants to purchase the technology years ago. but it has applied to the task force for the pre-k to grade 8 book packets and laptops for high school students. haeffner said. benigni and other administrators shared the district's distance learning program at a remote meeting with board of education members tuesday night. “getting a device to a family where a student hasn't been using it, is going to be a real challenge,” benigni said. “we already had it. some of these (software) partners our students are familiar with.” benigni estimates about 93 percent of families in the district have wi-fi access either through internet service, or using their phones for hot spots. those without were given portable hot spot devices and the district had 34 on order when the schools closed march 13. after taking a survey of family needs, the school instructed parents of elementary school students who had not taken home chromebooks to pick up the devices at the schools using safe distancing techniques, said assistant superintendent of schools michael grove. “about 87 percent of elementary parents picked up a chromebook,” grove said. “we put it in a bag and labeled it and followed safe distance guidelines.” tracking another challenge was tracking family access to technology based on who checked out a chromebook. schools with high numbers of free lunch eligible students, such as john barry elementary, had a 99 percent check out rate, as opposed to thomas hooker elementary school, which has lower numbers of income eligible students and a lower number of chromebook checkouts. “my hope is we got the devices for those who want them and need them,” benigni said. the district uses google classroom and instructional software appropriate for grade level but the work is designed not to keep a child in front of a computer screen six hours a day, haeffner said. attendance is tracked via log-in to google classroom, and schools have reported 94 to 100 percent attendance. in its first week, meriden public school teachers and administrators sent 92,000 text messages via parent square to keep parents updated on notices, expectations and assignments. “parents were being bombarded,” said school board member rebecca wronski. “that's awesome. it means we're getting through.” close contact those messages have since been reduced, but close parent contact is maintained for families of special education students, who make up about 21 percent of the school system's 8,500 students. teachers are using google hangouts for classroom discussions and teachers and paraprofessionals continue to receive training remotely. administrators are in buildings in case a student has to return a broken laptop or a teacher needs access to a classroom, grove said. “many districts are just really getting started this week,” benigni said. “meriden wasted no time and took the bulls by the horns.” board members voted unanimously tuesday to eliminate the community service requirement for graduating seniors this year. it also voted to calculate senior class rankings at the end of the second term, instead of its usual practice of using third term results. members agreed with benigni that it was unfair to kick a student out of the top 10 after such a dramatic disruption. the learn from home task force chaired by guilford superintendent paul freeman and east hartford superintendent nate quesnel discussed its distribution plan wednesday. it has mailed letters to the 33 alliance district superintendents and expects completed applications on friday. the applications will document how many students need the laptops and instructional materials. they will also detail a safe distribution plan and a curriculum for use. the 60,000 laptops should be delivered to all districts by june. state education officials have not discussed extending learning into the summer. “the size of this challenge is like filling yankee stadium with students and making sure every student walks out with a laptop,” freeman said. “we have to make sure the students have connectivity in their homes and make sure those families can use those devices.” mgodin@record-journal.com203-317-2255twitter: @cconnbiz related stories:
1130	meriden schools report distance learning successes, challenges text extraction from html file; language identification https://elrc-share.eu under review 2020 meriden schools report distance learning successes, challenges text/html https://www.myrecordjournal.com/news/meriden/meriden-news/meriden-schools-advance-remote-learning-curriculum.html en_2020_04_919.xml_25.html meriden schools report distance learning successes, challenges meriden schools report distance learning successes, challenges teacher jacob butler works on a laptop in his eighth-grade classroom at lincoln middle school in meriden, thurs., mar. 5, 2020. dave zajac, record-journal april 01, 2020 05:57pm by mary ellen godin, record-journal staff meriden - as they enter the third week of remote learning, the city's public schools are leading other alliance districts in equipping students with chromebooks and implementing distance learning, school officials said. “regardless of socioeconomic status, all students must be able to access learning in a digital world,” said school superintendent mark benigni. “we've been increasing devices over the past 10 years. we had a strategic plan to get this district one to one. it made a difference for us as we began this work.” benigni and barbara haeffner, the director of teaching and innovation, planned to present the district's program to the newly formed state covid-19 learn from home task force wednesday afternoon. gov. ned lamont and education commissioner miguel cardona formed the task force to distribute 60,000 laptops for high school students from the partnership for connecticut, and 185,000 take home sets of learning materials from scholastic for pre-k to grade 8 students.the task force will distribute the materials to each of the state's 33 alliance districts, including meriden. the alliance district program identifies the state's lowest performing school districts, which typically receive additional state funds to help bridge the state's achievement gap. cardona is a former assistant superintendent for meriden public schools. meriden public schools used some of this funding and state grants to purchase the technology years ago. but it has applied to the task force for the pre-k to grade 8 book packets and laptops for high school students. haeffner said. benigni and other administrators shared the district's distance learning program at a remote meeting with board of education members tuesday night. “getting a device to a family where a student hasn't been using it, is going to be a real challenge,” benigni said. “we already had it. some of these (software) partners our students are familiar with.” benigni estimates about 93 percent of families in the district have wi-fi access either through internet service, or using their phones for hot spots. those without were given portable hot spot devices and the district had 34 on order when the schools closed march 13. after taking a survey of family needs, the school instructed parents of elementary school students who had not taken home chromebooks to pick up the devices at the schools using safe distancing techniques, said assistant superintendent of schools michael grove. “about 87 percent of elementary parents picked up a chromebook,” grove said. “we put it in a bag and labeled it and followed safe distance guidelines.” tracking another challenge was tracking family access to technology based on who checked out a chromebook. schools with high numbers of free lunch eligible students, such as john barry elementary, had a 99 percent check out rate, as opposed to thomas hooker elementary school, which has lower numbers of income eligible students and a lower number of chromebook checkouts. “my hope is we got the devices for those who want them and need them,” benigni said. the district uses google classroom and instructional software appropriate for grade level but the work is designed not to keep a child in front of a computer screen six hours a day, haeffner said. attendance is tracked via log-in to google classroom, and schools have reported 94 to 100 percent attendance. in its first week, meriden public school teachers and administrators sent 92,000 text messages via parent square to keep parents updated on notices, expectations and assignments. “parents were being bombarded,” said school board member rebecca wronski. “that's awesome. it means we're getting through.” close contact those messages have since been reduced, but close parent contact is maintained for families of special education students, who make up about 21 percent of the school system's 8,500 students. teachers are using google hangouts for classroom discussions and teachers and paraprofessionals continue to receive training remotely. administrators are in buildings in case a student has to return a broken laptop or a teacher needs access to a classroom, grove said. “many districts are just really getting started this week,” benigni said. “meriden wasted no time and took the bulls by the horns.” board members voted unanimously tuesday to eliminate the community service requirement for graduating seniors this year. it also voted to calculate senior class rankings at the end of the second term, instead of its usual practice of using third term results. members agreed with benigni that it was unfair to kick a student out of the top 10 after such a dramatic disruption. the learn from home task force chaired by guilford superintendent paul freeman and east hartford superintendent nate quesnel discussed its distribution plan wednesday. it has mailed letters to the 33 alliance district superintendents and expects completed applications on friday. the applications will document how many students need the laptops and instructional materials. they will also detail a safe distribution plan and a curriculum for use. the 60,000 laptops should be delivered to all districts by june. state education officials have not discussed extending learning into the summer. “the size of this challenge is like filling yankee stadium with students and making sure every student walks out with a laptop,” freeman said. “we have to make sure the students have connectivity in their homes and make sure those families can use those devices.” mgodin@record-journal.com203-317-2255twitter: @cconnbiz related stories:
1130	ordering 60,000 laptops during a coronavirus pandemic called a daunting task - connecticut post text extraction from html file; language identification https://elrc-share.eu under review 2020 ordering 60,000 laptops during a coronavirus pandemic called a daunting task - connecticut post text/html https://www.ctpost.com/local/article/ordering-60-000-laptops-during-a-coronavirus-15172327.php en_2020_04_839.xml_136.html ordering 60,000 laptops during a coronavirus pandemic called a daunting task updated 7:08 pm edt, wednesday, april 1, 2020 a boy does a mathematics exercise on a laptop during home schooling in charleroi on march 25, 2020, as children are forced to stay at home due to the covid-19, the disease caused by the novel coronavirus. - since march 18, new measures have been taken to avoid the spread of the covid-19. lessons at school are suspended but pupils and students continuing school work from home. (photo by virginie lefour / various sources / afp) / belgium out (photo by virginie lefour/belga/afp via getty images) photo: virginie lefour / belga/afp via getty images photo: virginie lefour / belga/afp via getty images image 1 of / 5 close image 1 of 5 a boy does a mathematics exercise on a laptop during home schooling in charleroi on march 25, 2020, as children are forced to stay at home due to the covid-19, the disease caused by the novel coronavirus. - since march 18, new measures have been taken to avoid the spread of the covid-19. lessons at school are suspended but pupils and students continuing school work from home. (photo by virginie lefour / various sources / afp) / belgium out (photo by virginie lefour/belga/afp via getty images) photo: virginie lefour / belga/afp via getty images ordering 60,000 laptops during a coronavirus pandemic called a daunting task 1 / 5 back to gallery getting 60,000 laptops into the hands of needy high school students around the state was likened wednesday to filling yankee stadium with students and making each one of them walked out with a computer. only the students aren't in the stands, but scattered across 33 school districts - and it is a middle of a coronavirus pandemic where a safe distribution trumps connectivity, east hartford schools superintendent nate quesnell said on wednesday “this would be a logistical challenge in a perfect environment,” added guilford schools superintendent paul freeman, quesnell's co-chair on a learn from home task force put together by gov. ned lamont. the last few weeks and the weeks that lie ahead are the opposite of a perfect environment, freeman said. freeman and quesnell, during a conference call with education reporters, said their goal is to bridge the digital divide for students who live in homes without computer access at a time when all students have become distance learners. with schools closed, many districts are now using computers to deliver course material. some have lent students computers that normally remain in school. that is not universally possible in some districts, such as bridgeport where there is not currently a computer for every student. some 42 percent of the state's 500,000 public school students live in alliance districts that will get first crack at the free computers. it's estimated about 50,000 are in high school. related stories free laptop distribution is a month away how many do not have computers or the internet at home is unknown. the task force and state department of education hope to learn that information by friday, when school superintendents complete an application for the free computers. the governing board of the partnership for connecticut, a public-private partnership, agreed on march 23 to allocate money for the laptops. the estimated $40 million cost is to be split between the state and the greenwich-based dalio philanthropies led by barbara and ray dalio. even working at “warp speed,” the co-chairs say computers won't hit school districts until late april or early may . some may not get the hardware until june. “there aren't 60,000 computers sitting in a warehouse,” quesnell said. “it will take time.” distribution will likely come in waves. the task force, which also includes schools superintendents from new haven, waterbury, middletown and winchester, has been meeting virtually since march 23, shortly after the partnership for connecticut announced they would fund the purchase of 60,000 laptops. they are looking to dell and hp, and hope to get a good deal given the bulk purchase - perhaps $350 a unit. it promises to give some districts a one computer per student ratio they've never before enjoyed. for now, charter schools, most of which exist in alliance districts, are not eligible for the program, officials said. in addition to the laptops, districts are getting packets of books for elementary and middle school students from scholastic - a gift from indra and raj nooyi, of the pepsi corporation. the 185,000 books and activity guides will be bundled by grade level and distributed to schools based on the number that alliance districts tell them are needed. families can keep the books. the computers will be owned by school districts. it will be up to districts to decided whether students can keep the equipment over the summer. a lot may depend on how long schools remain closed this spring. “this is the first step,” freeman said. nick simmons, lamont's coordinator of strategic initiatives, said the governor's office is working on phase two of the initiative which is making sure the computers can be connected to the internet. it is estimated that as many as 12 percent of households don't have the internet. lclambeck@ctpost.com; twitter/lclambeck
1135	"palestinians protest against heavy-handed israeli response to coronavirus lockdown | middle east eye text extraction from html file; language identification https://elrc-share.eu under review 2020 palestinians protest against heavy-handed israeli response to coronavirus lockdown | middle east eye text/html https://www.middleeasteye.net/news/coronavirus-protest-jaffa-covid-19-restrictions-police-brutality en_2020_04_904.xml_120.html occupation palestinians protest against heavy-handed israeli response to coronavirus lockdown israeli police fire rubber bullets and stun grenades at residents in jaffa who say covid-19 restrictions are leading to more 'police brutality' an image taken from video file of protests that erupted in jaffa on 1 april (screengrab) by haifa, israel published date: 1 april 2020 21:03 utc | last update: 4 months 3 weeks ago protests broke out on the streets of jaffa late on wednesday after police attacked five young men and arrested four, leading to an even more aggressive response from israeli officers in the predominantly palestinian community. videos circulating on social media showed police using rubber-coated steel bullets and stun grenades on jaffa's main street as protesters burned tyres and dumpsters. the incident is one of a long line of police brutality cases against palestinians in jaffa, and one that occurred during increased tensions amid a nationwide lockdown to slow the spread of coronavirus. 'the youth in jaffa have been going through police brutality on almost a daily basis' - abed abu shehadeh, jaffa city council member amir badran, a tel aviv-jaffa city council member and a lawyer, told middle east eye that the incident began when police stopped a teenager and asked for identification. due to covid-19 regulations, residents more than 100 metres from their homes can be issued tickets for breaking quarantine. badran said the teenager was near his home when the police approached him, but didn't have identification. the incident escalated, and the police became unnecessarily violent and ultimately arrested several men, issuing all of them 5,000-shekel ($1,388) tickets. a woman who tried to defend her sons was pushed to the ground during the interaction. #شاهد | شرطة الاحتلال تعتدي بعنف على عائلة فلسطينية في يافا وهو ما دفع الشبان للخروج بتظاهرات احتجاجية قبل قليل pic.twitter.com/ymxupvngmi - وكالة شهاب (@shehabagency) april 1, 2020 'this is not order' shortly after, videos from the incident circulated on social media, spurring people to protest against police brutality. dozens of police responded with hoses, rubber-coated steel bullets and stun grenades. there were reports from residents of injuries. ""there was no violation and no crime done to make this situation deteriorate as it did,"" badran said. badran said he went to the police station in jaffa on wednesday afternoon to ask the police what had happened. there has often been a disconnect, he said, between how leadership in the police station speaks with palestinian residents and the treatment from patrol officers who are actually involved in these police brutality cases. ""i explained to [the chief of police] that there is a gap between what the police have to do for work and order,"" badran said, arguing that the response to jaffa's protest had been too severe. ""this is not order,"" he said. israel's military turns on its people as coronavirus panic sets in read more » according to badran, israeli news and social media are now spreading ""fake news"", implying that the teenager was infected with the coronavirus disease and that's why the police arrested him. ""in order to cover the brutality of the policeman, this is what's being spread as fake news,"" badran said. abed abu shehadeh, another city council member from jaffa, spent the afternoon with family members of those arrested. he said the arrests happened at about 2pm local time, and by 4pm residents were protesting on jaffa's main street against police brutality. abu shehadeh said he contacted police to ask them to release the five men from incarceration. that was the aim of the protests, he said, and he told police that the people would go home if the men were released. police brutality is a daily occurrence worldwide, activists are asking governments to release people from jail to prevent the spread of covid-19. ""if there had been any crimes, they could investigate them two days, three days later,"" abu shehadeh said. ""what they said was 'we won't be blackmailed'"". the protests were a result of the long-held impression that police use excessive force in dealing with palestinian residents in israel. 'when a police force sees you as an enemy, this is what you get' - abed abu shehadeh, jaffa city council member on 22 march, two palestinian men were attacked by police during an arrest and later required medical attention. the men told reporters the attack was unprovoked. in 2017, protests also broke out after 22-year-old palestinian mahdi sa'adi was killed by police. in that case, police fired at sa'adi because he attempted to flee. palestinians in jaffa took to the streets to express their anger about the killing for days after. ""the youth in jaffa have been suffering through police brutality on almost a daily basis,"" abu shehadeh said. he said that most of the police officers serving in jaffa had previously been in the israeli army and were used to engaging with palestinians in the occupied west bank. ""when a police force sees you as an enemy, this is what you get."" a police statement issued late wednesday evening suggested that the protests had been an organised effort. police said they had arrested four people and ticketed a teenager for violating the covid-19 quarantine. recommended"
1135	"coronavirus: arab uprisings struggle amid lockdowns | middle east| news and analysis of events in the arab world | dw | 06.04.2020 text extraction from html file; language identification https://elrc-share.eu under review 2020 coronavirus: arab uprisings struggle amid lockdowns | middle east| news and analysis of events in the arab world | dw | 06.04.2020 text/html deutsche welle (www.dw.com) https://www.dw.com/en/arab-uprisings-struggle-amid-coronavirus/a-53027193 lebanon iraq coronavirus public health covid-19 epidemic en_2020_04_4880.xml_40.html read more: lebanon: from the penthouse to the outhouse lebanese authorities implemented restrictions on public life in late march, including a curfew aimed at preventing large gatherings. they demolished the main protest camp at martyrs' square in beirut, clearing out a core group of about 60 protesters. the camp had served as a hub for the protest movement's political action. it only took two days before small demonstrations surfaced in the suburbs of lebanese cities in defiance of the coronavirus lockdown. in beirut, protesters flouted the curfew, yelling ""we want to eat, we want to live."" in tripoli, lebanon's second-largest city, protesters took to the streets in cars and scooters, shouting: ""dying from the coronavirus is better than starving to death."" for many activists across the region, giving way to the pandemic isn't an option. until the end in iraq, more than 770 people have contracted the virus, including at least 54 who have died due to complications caused by the disease. authorities have enacted a nationwide lockdown as part of containment measures to slow the spread of covid-19. as a result, protest camps have thinned out across the country. the few protesters that remain maintain a rotating presence for fear that if they fully leave, it would spell the end of the movement. they've even developed their own measures to fight the coronavirus within the camps. coronavirus in the middle east: lock down or play down? iran: bearing the brunt with a high number of deaths and cases, iran has been a regional epicenter of the outbreak. several top officials have been infected and there are concerns the number of cases are higher than reported. the government has canceled friday prayers but health workers have complained they are under-equipped. iran has asked the international monetary fund for emergency funding. coronavirus in the middle east: lock down or play down? saudi arabia: strict measures saudi authorities banned international religious pilgrims early on, leaving the grand mosque's kaaba in mecca virtually empty. other measures have involved sanitizing streets and mosques, closing schools and universities, an extensive travel ban and fines of up to 500,000 riyals (€120,000/$133,000) for people hiding health details. it has also locked down the shiite-minority area of qatif. coronavirus in the middle east: lock down or play down? egypt: travel restrictions in cairo, hundreds of egyptians tried to get certificates showing they have a clean bill of health after saudi arabia announced new travel regulations. although egypt has only detected a low number of cases, more than 100 tourists returning from the country tested positive for the virus. officials have limited sermons to 15 minutes and cancelled large public gatherings. coronavirus in the middle east: lock down or play down? israel, west bank: shielding themselves from the world gatherings of less than 100 are still allowed, leaving visits to the wailing wall open. but israeli authorities have virtually halted air traffic in and out of its territory and tourists are required to self quarantine. the city of bethlehem has declared a state of emergency, emptying streets usually teeming ahead of easter. israeli researchers have said they are close to finding a covid-19 cure. coronavirus in the middle east: lock down or play down? kuwait: virtual lockdown as kuwaitis kept their distance at this makeshift testing center, the country entered a virtual lockdown, with the entire workforce given a two-week holiday from march 12. all commercial flights have been suspended from friday on, schools have been closed and gatherings at restaurants, malls and commercial centers have been banned. coronavirus in the middle east: lock down or play down? iraq: coronavirus fails to dampen protests iraq's protest movement has set up its own makeshift disinfection stations to counter the spread of covid-19. although iraq is highly prone to the outbreak due to its proximity and close relations with iran, protesters have been defiant, saying the government is the virus. elsewhere authorities have closed major public spaces and religious institutions have cancelled gatherings. author: tom allinson ""if we leave tahrir square, the snipers and security forces will take over and the movement will end,"" said alqasem ahmed, a young baghdad journalist who has helped articulate protesters' demands. since october, more than 600 people have been killed, many of them during clashes with government forces. before the pandemic, the iraqi government had struggled to contain the widespread demonstrations against corruption, lack of access to basic services and the country's sectarian political system. ""we have survived death, bullets and teargas for six months, so we can wait another six months until corona ends,"" ahmed said. protesters walk through a makeshift disinfection cabin on tahrir square in iraq with iraq's public healthcare system strained by decades of sanctions and underfunding, the coronavirus is only further fueling grievances. with record-low oil prices triggered by the global pandemic straining baghdad's ability to pay its massive public sector, iraqis face an even more uncertain future. ""these problems will make people go out to the streets in bigger numbers than ever before,"" said ahmed. ""before, society was divided between those who supported the protests and those who stayed home, but soon they will see why we are protesting and join us."" 'taking advantage of the epidemic' in algeria, the pandemic has also taken its toll on the protest movement. authorities appear to have instrumentalized coronavirus-related restrictions to deliberately silence internal dissent. last year, mass demonstrations against corruption and the ruling elite led to the ouster of longstanding ruler abdelaziz bouteflika and a subsequent presidential election, which was marred by irregularities. despite the government's political concessions to protesters' demands, demonstrations were still staged every friday until last month. iraq, like many other countries, has enforced a curfew to help fight the spread of the coronavirus algerian authorities not only banned public gatherings mid-march, they also took the opportunity to arrest several activists and journalists, including prominent opposition figure karim tabbou and reporters without borders (rsf) correspondent khaled drareni. rsf and other press freedom groups said they ""regret that the algerian authorities are taking advantage of the coronavirus epidemic to settle scores with independent journalism."" but the arrests haven't stopped the movement. in a video featuring prominent algerian activists about the novel coronavirus, one figure raised a placard that read: ""protect yourself so that the revolution has a future."" ""to be free, you have to live,"" said another activist."
1135	"emergency supplies of medical equipment to fight covid-19 being dispatched to quetta: ispr - pakistan - dawn.com text extraction from html file; language identification https://elrc-share.eu under review 2020 emergency supplies of medical equipment to fight covid-19 being dispatched to quetta: ispr - pakistan - dawn.com text/html https://www.dawn.com/news/1547141/quetta-doctors-wont-leave-lockup-until-provided-with-protective-gear-to-treat-covid-19-patients-says-yda?utm_source=feedburner&utm_medium=feed&utm_campaign=feed%3a+dawn-news+%28dawn+news%29 coronavirus en_2020_04_5018.xml_30.html emergency supplies of medical equipment to fight covid-19 being dispatched to quetta: ispr 26 young doctors protest against the unavailability of personal protective equipment in quetta on monday, april 6. - dawnnewstv/file emergency supplies of medical equipment, including personal protective equipment (ppes), are being dispatched to quetta on orders of the chief of army staff ""to help medical staff fight covid-19 effectively in balochistan"", said the army's media wing on tuesday. “doctors and paramedics are the frontline soldiers in this war. most advanced nations/govts are finding it extremely difficult to fight this pandemic,"" coas gen qamar javed bajwa was quoted as saying by inter-services public relations via twitter. ""pakistan government is striving hard to acquire and supply the required resources. in this hour of distress, we must remain patient and steadfast,” added bajwa. the directive comes a day after young doctors and paramedics gathered on the premises of civil hospital quetta and protested against the health authorities for not supplying safety gears and other preventive items to the doctors performing duty in hospitals. police said 30 doctors had been arrested for taking out a protest really in violation of section 144 of the code of criminal procedure imposed by the balochistan government in the provincial capital in connection with the lockdown. according to yda, however, more than 100 doctors and health workers were arrested. speaking to dawn today, dr rahim, a spokesman for the yda, said that that the arrested doctors will not leave the police stations until their demands were met and they were provided with protective gear. according to president of yda's balochistan chapter dr yasir achakzai, 15 doctors in the province had been diagnosed with the novel coronavirus so far but the government still had not supplied protective equipment. ""on one hand, the coronavirus is killing us and on the other, police are beating us up,"" achakzai said. a day earlier, achakzai said they were baton-charged by security forces, adding that ""dozens"" were arrested near the red zone. police had denied beating up the doctors. as matters escalated, a few members of the balochistan assembly reached the venue and tried to negotiate with the protesting doctors and paramedic staff. later in the day, chief minister jam kamal alyani said that he had met the yda doctors and had assured them of his government's full cooperation in their battle against covid-19 and in meeting their demands. 'doctors were arrested for their own protection' balochistan government spokesperson liaquat shahwani announced in a press conference that the demands of the protesting doctors had been met. commenting on monday's events, he said that doctors had been arrested ""for their own protection"". he said that the doctors ""were moving towards the cm secretariat in crowd"". ""our district administration, our police urged the doctors to return for the sake of their own health and that the government will fulfil their demands. they (doctors) were told that you are not observing social distancing [which is vital] to curb the spread of the coronavirus,"" shahwani said. ""they did not listen and so, for the sake of their protection, they were arrested for only one hour."" the government spokesperson added that even though all the doctors had been released, they have refused to leave the police stations. he regretted that the doctors had violated section 144 of the crpc without thinking the impression it would leave on the public. ""[the public] would think that if doctors are moving as a crowd without being exposed to danger, why would it threaten us? they will leave their homes too [...] the point of imposing a lockdown will be lost and we will not be able to control the outbreak of the coronavirus in the province."" shahwani added: ""we appeal to the doctors to [follow] the code of conduct followed globally, due to which they are called healers. healers do not abandon their patients in hospitals and come out on roads to protest for their rights, especially when the chief minister had held talks with them."" protest the young doctors and paramedics gathered on the premises of civil hospital quetta and started protest against the health authorities for not supplying safety gears and other preventive items to the doctors performing duty in hospitals. they were carrying placards and banners inscribed with demands, including removal of the health secretary and special health secretary. they chanted slogans against the provincial authorities, came out of the hospital premises and stated moving towards the officers club where the provincial cabinet was in meeting. police blocked the road leading to the club. the protesting doctors and health workers tried to break the cordon which led to a clash between them and police personnel. some protesters were injured when police used batons against them. police also arrested dozens of protesting doctors. a spokesman for the balochistan government termed the doctors' protest unjustified and claimed that the government had provided the required safety gears to all doctors, paramedics, nurses and other health workers performing duty in quarantine centres and isolation wards. “we do not understand the protest by the doctors who were not performing duties in quarantine centres and isolation wards of sheikh zayed and fatima jinnah chest hospitals,” liaquat shahwani had said. however, he said, the government had assured the protesting doctors that they would also be provided safety gears, adding that doctors had the right to criticise the government, but should not stop performing duties. he said china was also facing shortage of safety gears, adding that the national disaster management authority had supplied 50,000 n-95 masks which the health department was distributing among the doctors. advertisement"