FDA OKs Remdesivir Emergency Use for Severe COVID-19 — From the first case diagnosed to a therapeutic in just weeks ........ the drug met its primary endpoint, a 31% significantly faster time to recovery over controls. ..... Department of Health and Human Services Secretary Alex Azar said the EUA is "another example of the Trump Administration moving as quickly as possible to use science to save lives" ....... the U.S. government will help to distribute remdesivir to hospitals in cities most heavily affected by the COVID-19 outbreak, adding "hospitals with intensive care units and other hospitals that the government deems most in need" will be prioritized, in part due to limited availability of drug supply.
highlights need to address longstanding inequities
....... In Louisiana, African Americans accounted for 70% of COVID-19 deaths, while comprising 33% of the population. In Michigan, they accounted for 14% of the population and 40% of deaths, and in Chicago, 56% of deaths and 30% of the population. In New York, black people are twice as likely as white people to die from the coronavirus. .......... decades of spatial segregation, inequitable access to testing and treatment, and withholding racial/ethnicity data from reports on virus outcomes. ......
"There is nothing different biologically about race. It is the conditions of our lives"
....... Predominantly black U.S. counties are experiencing a three-fold higher infection rate and a six-fold higher death rate than predominantly white counties. ........ Many of these communities are located in poor areas with high housing density, limited access to education, and high unemployment rates. Low socioeconomic status is independently a risk factor for poorer health outcomes and is forcing some individuals residing in these communities out of their homes and into the workforce. ......... African Americans are overrepresented in frontline jobs like the postal service or home health aid industry, leading to higher rates of exposure, Jones said........ In New York City, the national epicenter, 75% of frontline workers are people of color. ........ "People are starting to recognize these people as being part of the essential workforce and those people are disproportionately black and brown," Jones told MedPage Today. "We have not honored the essential nature of that work, just as we have not equipped respiratory technicians, nurses, and doctors in the hospital with the [personal protective equipment] they need." ........... African Americans shoulder a higher burden of chronic disease, with 40% higher rates of hypertension and 60% higher rate of diabetes than white Americans ....... a long legacy of spatial and occupational segregation ........ Bias was shown to permeate the medical treatment of black patients long before the pandemic ........ when the state initially launched drive-through testing, it became clear -- when one 90-year-old woman walked a mile in the heat to get tested -- this would not be accessible to many low-income individuals who didn't have cars ...... As Georgia Gov. Brian Kemp (R) forges ahead with plans to reopen tattoo parlors, hair salons, and bowling alleys, for example, the state's National Association for the Advancement of Colored People (NAACP) chapter criticized that decision, saying it would disproportionately affect people of color. Newly released CDC data showed more than 80% of hospitalized COVID-19 patients in the state were black. ........
"To us, it is another signal that maybe our lives are not valued."
the slumber of racism denial.
Are Stockholm's Hospitals About to Break? — "The situation is not improving and there are concerns of not enough PPE and health professionals" ....... The Swedish healthcare system has thus far withstood an onslaught of COVID-19 cases under the country's less restrictive approach to fighting the pandemic, but it can't hold out much longer unless cases subside, public health experts there warned. ........
Over the past month, the cumulative number of cases has climbed sharply with no sign of flattening
...... reaching about 22,000 in a nation of roughly 10 million. That's less on a per-capita basis than in the United States, but not by much. ...... this pertains mainly to Stockholm, which has been the hardest-hit part of the country. ........ there are concerns of not enough personal protective equipment [PPE] and health professionals." ........ Last week, a group of 22 clinicians, virologists, and researchers penned an op-ed in a Swedish business newspaper calling for the closure of schools and restaurants, and requiring PPE for those who work with the elderly. More than a month ago, 2,300 academics urged the government to tighten restrictions in order to protect the healthcare system. .......... "No one has tried this route, so why should we test it first in Sweden, without informed consent?" Cecilia Soderberg-Naucler, PhD, an immunologist at the Karolinska Institute ......... only high schools and universities have closed; businesses have remained open. Swedes have been asked to keep their distance in public, refrain from non-essential travel, and work from home when possible. Gatherings of more than 50 people are also banned, as are home care visits. ............ "Apart from a few popular streets in central Stockholm, the pedestrian traffic elsewhere is down anywhere from 50% to 90%" ........ "Home delivery of groceries has exploded in popularity, making it difficult to make an order." ......... Sweden's death rate has been far higher than its Scandinavian neighbors: about 250 per million as of Thursday, compared with roughly 75 per million in Denmark and 42 per million in Norway, both of which instituted lockdowns in mid-March. ......... attributed the higher death rate to extensive infections in the country's elderly care homes. He has said nearly half of the country's deaths have occurred in those facilities .......... has denied claims that their approach was to create herd immunity. ........... Time will simply tell and no one knows today what the correct strategy is, hence, the Swedish strategy is no more experimental than any other country. We are all groping in the dark." .......... "I like the idea of 'freedom with responsibility' as the Swedes have adopted; it'll probably also be easier on the economy," Knop told MedPage Today. "However, as a medical doctor it's tough to see the immediate greater impact on health."
This 7-Minute Morning Routine Will Change Your (Work) Life This routine takes seven minutes each morning before you start work. Will you follow it? ...... It's like the approach you make to the tee on a golf course. You plan out how you will hit the shot, which is more important than the actual swing. ........ You'll also need a journal. ......... You have to clear your head. ........ breathing deeply creates a calming effect in your brain and helps you focus. Intentional breathing is important at all times of the day. ....... Draw a picture or doodle an idea. It's a way to figure out what is important, and what is stressing you out. It is a record of your preparation and a way to help you look back and see, for these seven minutes, what was really important. Make sure you don't get too focused on the writing and not enough on the thinking. ......... make a brief plan--in only 30 seconds--to act on one of the items on your list. Just one. If you jotted down a note to deal with a conflict or to finish a report, decide to focus on that task and make sure you are intentional about addressing it.
— Paramendra Kumar Bhagat (@paramendra) May 2, 2020
Putin’s hold on Trump: “There have long been suspicions that a considerable amount of funds supporting the Trump Organization have come from Russian oligarchs, either via secretive holding companies based in offshore tax havens, or through Deutsche Bank.“https://t.co/sn5zshnQcQ
Get Ready for a Postcoronavirus World. The Economy Will Never Be the Same. Coronavirus: crackdowns, racism and forced quarantine heighten tension for Africans in Guangzhou Community representatives say Chinese authorities risk harming trade and relationships with African nations .... Some tough measures may be a cover for finding overstayers, the professor says Health care workers deserve our steadfast support, not just during a coronavirus pandemic It is an irony that Hong Kong is now stopping to clap for the health care workers who were harassed during last year’s protests ........ Attitudes around the world towards medics are not always appreciative: expect attitudes to change when these workers start demanding compensation for Covid-19 oversight Singapore’s addiction to growth is built on the backs of migrant workers Some 90 per cent of the island nation’s Covid-19 cases are linked to migrant worker dormitories – exposing ingrained social and systemic prejudices ..... The question is whether conditions, practices and attitudes towards these workers will change after the crisis has abated ............. The coronavirus outbreak that Singapore suppressed so well during its early onset surged in mid-April, metastasising in scores of overcrowded dormitories housing the bulk of the island’s 320,000 construction workers, most of whom are from India and Bangladesh. ........... As of yesterday, nearly a month after the state enforced a nationwide lockdown, Covid-19 cases linked to migrant worker dormitories account for nearly 90 per cent of Singapore’s cases, which at more than 17,500 is the highest in Southeast Asia. ........
Some 180,000 migrant workers have been placed in isolation.
......... Government regulations such as the minimum space criteria for housing migrant workers – a woeful 4.5 square metres per worker – are partly to blame for the calamity. But so are the employers who exploit those regulations, as well as the public who have tacitly accepted for years that living conditions unfit for ourselves are more than adequate for men like Periyakarrupan. ..........
These deeply ingrained social and systemic prejudices, which existed well before the current crisis, remain at play when the government distinguishes between “high migrant worker cases” and “low community transmission” – a distinction that merely reflects the wider public’s separation of such workers from mainstream society.
................ the literally tone-deaf community singalong of a national song, Home, to thank those who have virtually no option of ever making Singapore their true home. .........
Singapore’s economy, whose high-growth model is greatly dependent on cheap imported labour.
More than 323,000 migrant workers in the city state are currently confined to 43 mega-dormitories and 1,200 other similar places of residence where they are largely restricted to cramped rooms which house up to 20 people...... Nearly 80 per cent of the country’s 11,178 infections come from within the migrant worker community, following a series of outbreaks inside their dormitories that began in late March.
......... the stress the workers may be facing – amid worries about being the next to be infected and anxiety about a loss of wages – could have a long-term impact on their mental health. .........
“These mental health challenges arise amidst the fear of Covid-19 challenges, the absence of places for the workers to go to raise their concerns, and the fear of facing consequences if they raise their concerns”
.............. deeply concerning, with conditions for social distancing still not in place in the dormitories. ........ Chinese nationals – who make up one of the largest groups of Singapore’s low-wage migrant workers alongside Bangladeshis and Tamils from India – were not surveyed.
Coronavirus: why Singapore fears a ‘hidden reservoir’ of Covid-19 cases Coronavirus cases in the city state have ballooned past 10,000 from just 1,000 at the beginning of this month ...... While four in five have been traced to migrant worker dormitories, there are also concerns about cases where the infection’s origin remains unknown ....... The number of coronavirus infections in Singapore rose to 10,141 on Wednesday, a remarkable increase given the city state had only 1,000 cases on the first day of the month. ..... Almost 80 per cent of these infections are linked to migrant workers living in 43 mega-dormitories across the country. .......... about 68 per cent of community cases are considered “unlinked”, fuelling suspicions there is a “larger hidden reservoir” of cases within the rest of society. ......... The circuit breaker measures that have banned social gatherings and reduced public transport usage and traffic volume by 70 per cent have helped to reduce community transmission.
How did migrant worker dormitories become Singapore’s biggest coronavirus cluster? Cases in the island nation have more than quadrupled in the past two weeks, propelled by a surge in infections among migrant workers ....... The government has upped its efforts amid criticism, with former diplomat Bilahari Kausikan saying ‘we did drop the ball on foreign workers’ .......... There are 323,000 low-wage migrant workers in the country, who
take on jobs shunned by Singaporeans in industries such as construction, estate maintenance and manufacturing.
Their accommodation includes 43 mega-dormitories with more than 1,000 workers each, some 1,200 factory-converted dormitories which typically house 50 to 100 workers each, and temporary living quarters with around 40 workers on various construction sites. ........ Manpower minister Josephine Teo attributed this rapid spread to workers socialising across dormitories on their days off, then again with different groups of friends within their dormitories. “They might, you know, cook together, eat together. Relax together” ........ “We did drop the ball on foreign workers,” wrote former Singapore diplomat Bilahari Kausikan, an active commentator on social media. ......... the poor living conditions faced by these men. They sleep on bunk beds, 12 to 20 people packed into a room ventilated by small fans attached to the ceiling or walls. Hundreds of men on each floor share communal toilets and showering facilities. ........ workers are transported squeezed into the back of a truck, and not showing up for work leads to a fine – so many of them work despite being ill. ........
worker dormitories, where conditions are nearly ideal for transmission of infection
........ The 43 mega-dormitories that house 200,000 workers are operated by the likes of offshore and marine company Keppel and real estate firm Cushman & Wakefield, as well as listed companies such as Centurion, which also operates student hostels and workers’ accommodation in Malaysia and Australia. ..........
They charge construction companies who hire the workers S$300 to S$400 (US$210-US$280) per worker for lodging each month, while workers pay around S$130 a month for three catered meals a day.
Coronavirus: after Little India riot, Singapore promised migrant workers decent housing. What happened? Some 13,000 migrant workers in dorms – mostly from India, Bangladesh and China – have tested positive for Covid-19 since the start of April ....... Their living conditions have now become a matter of national debate amid criticism they were in the government’s blind spot ......... Before leaving his hometown of Dhaka 17 years ago in search of better wages in Singapore’s construction industry, Zakir Hossain Khokan was a freelance journalist in Bangladesh. ...... It cost S$10,000 (US$7,094) to pay the recruiters, but his family was able to raise the funds by selling land and taking out loans and the 41-year-old is now a quality assurance officer, living in one of the city state’s many crowded mega-dormitories......... Since the start of April, some 13,000 migrant workers living in dorms –
mostly labourers from India, Bangladesh and China
– have tested positive for the Covid-19 illness caused by the virus, constituting some 85 per cent of Singapore’s total infections. ........
Singapore had its first infection as early as January 23 and the first migrant worker caught the disease on February 8.
........ About one-third of the island nation’s 1 million-strong low-wage foreign workforce are packed into its 43 mega-dormitories and 1,200 factory-converted dormitories, as well as an undocumented number of temporary living quarters on construction sites. ........
low-wage workers appeared to be in Singapore’s blind spot in its handling of the pandemic, which had won plaudits early on.
.......... Koh said the way Singapore treated its foreign workers was “not First World but Third World”. ........ a riot in Little India in 2013. A road accident in December that year killed an Indian construction worker, angering other foreign workers who formed a 300-strong mob that set fire to police and emergency vehicles. Some 50 police officers were injured and the government had to mobilise its elite Gurkha contingent. ........ a committee of inquiry to investigate the riot. Residents testified that migrant workers, who visited Little India to buy groceries and remit money, would often congregate under apartment buildings to drink and eat. Some residents said they were unhappy that the workers littered, vomited and urinated there. ........ Another reason for the rapid spread was that most migrant workers continued to do their jobs even after some businesses in Singapore had begun to implement work-from-home arrangements and other mitigation efforts ......... In response to the surging rates of infection among migrant workers, Singapore gazetted 25 of its 43 dormitories as isolation zones, with workers staying in their rooms and meals sent to them. All construction has been halted and workers outside dorms have been put on stay-home notice. The government is also testing close to 3,000 workers a day and quickly isolating sick ones. In dorms with widespread infections, workers showing symptoms are isolated and monitored, and only tested later. ........ defended the dormitories, saying that they were “designed in normal times and deemed to be entirely appropriate”. “Two months ago, no one had heard of safe distancing, and no one envisaged anything like Covid-19” ........ “Their fear of speaking out and having visas revoked and lack of direct communication channels to the state are both structural problems that need to be addressed,” she said, suggesting that “a dorm management committee of sorts for each dormitory or a union of migrants to better represent migrant interests directly to the relevant ministries could be formed”. ............
While some workers might flee Singapore in the wake of the pandemic, advocates said more would come because of the enduring poverty in their homelands.
....... “Are migrant workers simply recipients of pity and charity? Or is it time for a rights-based approach that fully respects our shared humanity and concretely, legally and practically, empowers the workers? To change government policy, we need to change the mentality of society” ........ April 2020: Infections spiked throughout the month as the disease tore through dormitories, with more than 1,000 new cases on some days. By April 30, Singapore had more than 16,000 cases – nine in 10 of which were migrant workers. All construction was halted and workers who were not locked down were placed on stay-home notices
The Taiwanese pandemic response has been one of the best in the world and the public is giving credit to one man
...... Professionals and public praise calm, informative style and occasional displays of humour ........
Taiwan’s health minister Chen Shih-chung
............ “If you go clockwise, you will win, if you go anticlockwise, you will lose.” ....... With more than 3 million Covid-19 infections worldwide, Taiwan – which has reported just 429 cases and six deaths since January 21 – is one of the few places in the world to have kept the pandemic at bay. As of Friday, there had been no new cases in Taiwan for six consecutive days and no local transmission for 19 days in a row. ......... Chen’s swift response, timely orders and frank communications ..... the minister, who often tells reporters at the daily briefing: “Have a heart! We all should keep empathy in dealing with certain matters.” .........
praised Chen for being a good communicator with high emotional intelligence.
......... has worked hard to keep Taiwan’s pandemic response in the hands of health professionals. He has often stressed that
“political rhetoric would only spoil professionalism and confrontation serves only to split society”
. .......... In a March 26 opinion poll by Taiwan’s cable news network TVBS, Chen – who has become the most searched person on Google in the past few months in Taiwan – was given an approval rating of 91 per cent, highest by far of all Taiwan’s politicians, including Tsai. ......... “He is a workaholic, often giving his time to work and meetings,” she said, adding that when she asked her four-year-old son what gifts should be given for his dad’s birthday, he said: “Work meetings.”
anyone holding the contracts after their expiry on April 22 could be forced to take delivery of the crude oil in Cushing, Oklahoma.
......... “This is utterly disheartening and beyond any normal person's comprehension,” Wang said .......... That would make China’s oldest bank the biggest known victim of April’s melee in the global oil market, surpassing the collapse of Singapore’s Hin Leong oil-trading empire.......... Two decades since becoming a World Trade Organisation member, Chinese households – with
US$10 trillion in total savings
– are still limited by a dearth of investible options, forcing many adventurous investors to pursue high-yielding speculations often without proper appreciation of the associated risks. Over the years, these have veered from real estate to fine art and Bordeaux wine, to speculations in such exotic products as Pu’er tea and even the hoarding of garlic. .......... “All hope is gone,” Wang said. “I hadn't been able to sleep and I have no appetite to eat since this happened.”
Obese people could be at greater risk because they have reduced lung function and their immune systems may overreact
......... China,” where 6.6 per cent of adults were obese in 2016, compared with 29 per cent in England in 2017. ........ obese people are dying more than other groups because they have reduced lung function and possibly more inflammation in adipose tissue, the fatty tissue found under the skin and around internal organs. ....... This might then contribute to an enhanced “cytokine storm”, a potentially life-threatening overreaction by the body’s immune system.
It’s unfair to blame China for coronavirus pandemic, Lancet editor tells state media Richard Horton tells state broadcaster CCTV the rest of the world should try to work with China rather than pointing the finger ...... British medical journal’s editor-in-chief says ‘China is not responsible’ for the Covid-19 outbreak first identified in Wuhan .......... the international community should instead work with the Chinese authorities in dealing with the outbreak. ..........
“China didn’t want this epidemic”
....... “China isn’t responsible for this pandemic. It’s happened.” ....... The editor of the British-based medical journal offered a strong defence of China during the CCTV interview, saying that while it is important to understand the origin of the virus, it was “not helpful” and “not scientific” to seek for a patient zero and such efforts could be “highly stigmatising and discriminatory”. ........... “It’s very important to understand the origin of this virus and to study those origins scientifically and not to allow such conspiracy theories to contaminate our thinking,” he said, adding that
these would only “risk destabilising our response to this virus”
. ....... “What is very disappointing is seeing the politicians who are giving credibility to conspiracy theories … and damaging the potential and prospect of global collaboration by being so openly critical of other countries such as China and organisations such as the World Health Organisation. I don’t think that’s a helpful response,” Horton said, adding that
countries should work “intensively together” to address the challenge of the pandemic
. ....... Horton has been vocal in criticising Western governments’ slow response to the pandemic, and in the interview said that many leaders had ignored repeated warnings in a series of papers published in The Lancet about the danger and risk posed by the virus........ “Most Western countries and the United States of America wasted the whole of February and early March before they acted” ........ Last month Horton also criticised Donald Trump’s decision to halt funding to the World Health Organisation, calling it “a crime against humanity” on Twitter.
Dear Professor Stephen Powis—The appalling number of UK deaths from COVID-19 are not “unfortunate”, as you just said. They were not unlucky, inappropriate, or even regrettable. These 27 510 deaths are evidence of full-blown government misconduct.
