Why the US is experiencing a coronavirus plateau

News Network
June 9, 2020

Washington, Jun 9: When epidemiologists talked about "flattening the curve," they probably didn't mean it this way: the US hit its peak coronavirus caseload in April, but since that time the graph has been on a seemingly unending plateau.

That's unlike several other hard-hit countries which have successfully pushed down their numbers of new cases, including Spain and Italy, which now have bell-shaped curves.

Experts say the prolonged nature of the US epidemic is the result of the cumulative impact of regional outbreaks, as the virus that started out primarily on the coasts and in major cities moves inward.

Layered on top of that are the effects of lifting lockdowns in parts of the country that are experiencing rising cases, as well as a lapse in compliance with social distancing guidelines because of economic hardship, and in some cases a belief that the threat is overstated.

"The US is a large country both in geography and population, and the virus is at very different stages in different parts of the country," Tom Frieden, a former director of the Centers for Disease Control and Prevention told AFP.

The US saw more than 35,000 new cases for several days in April. While that figure has declined, it has still been exceeding 20,000 regularly in recent days.

By contrast, Italy was regularly hitting more than 5,000 cases per day in March but is currently experiencing figures in the low hundreds.

"We did not act quickly and robustly enough to stop the virus spreading initially, and data indicate that it travelled from initial hotspots along major transport routes into other urban and rural areas," added Frieden, now CEO of the non-profit Resolve to Save Lives.

To wit: the East Coast states of New York, New Jersey and Massachusetts accounted for about 50 percent of all cases until about a month or so ago -- but now the geographic footprint of the US epidemic has shifted to the Midwest and southeast, including Florida.

Another key problem, said Jennifer Nuzzo, an epidemiologist at Johns Hopkins, is that the United States is still not doing enough testing, contact tracing and isolation.

After coming late to the testing party -- for reasons ranging from technical issues to regulatory hurdles -- the US has now conducted more COVID-19 tests than any other country.

It even has one of the highest per capita rates per country of 62 per 1,000 people, according to the website ourworldindata.org -- better than Germany (52 per 1,000) and South Korea (20 per 1,000).

But according to Nuzzo, these numbers are misleading, because "the amount of testing that a country should do should be scaled to the size of its epidemic.

"The United States has the largest epidemic in the world so obviously we need to do a lot more testing than any other country."

For Johns Hopkins, the more important metric is the positivity rate -- that is, out of all tests conducted, how many came back positive for COVID-19.

As of June 7, the United States had an average daily positivity rate of 14 percent, well above the World Health Organization guideline of 5 percent over two weeks before social distancing guidelines should be relaxed.

By contrast, Germany, which has tested far fewer people in relation to its population, has a positivity rate of 5 percent.

Even if testing were scaled up, carrying out tests in of itself does very little good without the next steps -- finding out who was exposed and then asking them to isolate.

Here also, too many US states are lagging woefully behind.

Texas, which is experiencing a surge in cases after relaxing its lockdown, is a case in point. The state targeted hiring a modest 4,000 tracers by June, but according to local reports is still more than a thousand shy of even that goal.

Opt-in app based efforts have also been slow to get off the ground.

Then there is the fact that some people are growing tired of lockdowns, while others don't have the economic luxury of being able to stay home for prolonged periods.

The government sent some 160 million Americans a single stimulus check of up to $1,200 back in April but it's not clear whether more will be forthcoming.

Still others, particularly in so-called red states under Republican leadership, have chafed under restrictions and mask-wearing guidelines that they see as an affront to their personal freedom.

"The US is kind of on the extreme of the individual liberty side," Sten Vermund, dean of the Yale School of Public Health, told AFP.

Part of this has to do with mixed messaging from Republican leaders, including President Donald Trump, said Nuzzo.

"We have had at the highest political level an assertion that this is a situation that's been overblown, and that maybe certain protective behaviors are not necessary," she said.

More recently, tens of thousands of people across the country have taken to the streets to protest the killing on an unarmed black man by police, risking coronavirus infection to demonstrate against the public health threat of racialized state violence.

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News Network
February 24,2020

Beijing, Feb 24: The lockdown of Guo Jing's neighbourhood in Wuhan -- the city at the heart of China's new coronavirus epidemic -- came suddenly and without warning.

Unable to go out, the 29-year-old is now sealed inside her compound where she has to depend on online group-buying services to get food.

"Living for at least another month isn't an issue," Guo told news agency, explaining that she had her own stash of pickled vegetables and salted eggs.

But what scares her most is the lack of control -- first, the entire city was sealed off, and then residents were limited to exiting their compound once every three days.

Now even that has been taken away.

Guo is among some 11 million residents in Wuhan, a city in central Hubei province that has been under effective quarantine since January 23 as Chinese authorities race to contain the epidemic.

Since then, its people have faced a number of tightening controls over daily life as the death toll from the virus swelled to over 2,500 in China alone.

But the new rules this month barring residents from leaving their neighbourhoods are the most restrictive yet -- and for some, threaten their livelihoods.

"I still don't know where to buy things once we've finished eating what we have at home," said Pan Hongsheng, who lives with his wife and two children.

Some neighbourhoods have organised group-buying services, where supermarkets deliver orders in bulk.

But in Pan's community, "no one cares".

"The three-year-old doesn't even have any milk powder left," Pan told news agency, adding that he has been unable to send medicine to his in-laws -- both in their eighties -- as they live in a different area.

"I feel like a refugee."

The "closed management of neighbourhoods is bound to bring some inconvenience to the lives of the people", Qian Yuankun, vice secretary of Hubei's Communist Party committee, said at a press briefing last week.

Authorities on Monday allowed healthy non-residents of the city to leave if they never had contact with patients, but restrictions remained on those who live in Wuhan.

Demand for group-buying food delivery services has rocketed with the new restrictions, with supermarkets and neighbourhood committees scrambling to fill orders.

Most group-buying services operate through Chinese messaging app WeChat, which has ad-hoc chat groups for meat, vegetables, milk -- even "hot dry noodles", a famous Wuhan dish.

More sophisticated shops and compounds have their own mini-app inside WeChat, where residents can choose packages priced by weight before orders are sent in bulk to grocery stores.

In Guo's neighbourhood, for instance, a 6.5-kilogramme (14.3-pound) set of five vegetables, including potatoes and baby cabbage, costs 50 yuan ($7.11).

"You have no way to choose what you like to eat," Guo said. "You cannot have personal preferences anymore."

The group-buying model is also more difficult for smaller communities to adopt, as supermarkets have minimum order requirements for delivery.

"To be honest, there's nothing we can do," said Yang Nan, manager of Lao Cun Zhang supermarket, which requires a minimum of 30 orders.

"We only have four cars," she said, explaining that the store did not have the staff to handle smaller orders.

Another supermarket told AFP it capped its daily delivery load to 1,000 orders per day.

"Hiring staff is difficult," said Wang Xiuwen, who works at the store's logistics division, adding that they are wary about hiring too many outsiders for fear of infection.

Closing off communities has split the city into silos, with different neighbourhoods rolling out controls of varying intensity.

In some compounds, residents have easier access to food -- albeit a smaller selection than normal -- and one woman said her family pays delivery drivers to run grocery errands.

Her compound has not been sealed off either, the 24-year-old told AFP under condition of anonymity, though they are limited to one person leaving at a time.

Some districts have implemented their own rules, such as prohibiting supermarkets from selling to individuals, forcing neighbourhoods to buy in bulk or not at all.

"In the neighbourhood where I live, the reality is really terrible," said David Dai, who is based on the outskirts of Wuhan.

Though his apartment complex has organised group-buying, Dai said residents were unhappy with price and quality.

"A lot of tomatoes, a lot of onions -- they were already rotten," he told , estimating over a third of the food had to be thrown away.

His family must "totally depend" on themselves, added the 49-year-old, who has resorted to saving and drying turnip skins to add nutrients to future meals.

The uncertainty of not knowing when the controls will be lifted is also frustrating, said Ma Chen, a man in his 30s who lives alone.

"I have no way of knowing how much (food) I should buy."

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News Network
April 7,2020

London, Apr 7: British Prime Minister Boris Johnson was moved to the intensive care unit of a London hospital after his coronavirus symptoms worsened Monday, just a day after he was admitted for what were said to be routine tests.

Johnson was admitted to St. Thomas’ Hospital late Sunday, 10 days after he was diagnosed with COVID-19, the first major world leader to be confirmed to have the virus.

Downing Street said Johnson was conscious and did not require ventilation, but he was moved into intensive care in case he needs it later, his office said in a statement.

Britain has no official post of deputy prime minister, but Foreign Secretary Dominic Raab has been designated to take over should Johnson become incapacitated.

Hours earlier, Johnson tweeted that he was in good spirits and thanked the National Health Service for taking care of him and others with the disease.

“On the advice of my doctor, I went into hospital for some routine tests as I’m still experiencing coronavirus symptoms,″ Johnson said in the tweet. “I’m in good spirits and keeping in touch with my team, as we work together to fight this virus and keep everyone safe.″

The prime minister's spokesman said earlier Monday that Johnson had spent a comfortable night and remained in charge of government after being admitted to the hospital because his cough and fever persisted.

Johnson's spokesman, James Slack, refused to say what kind of tests Johnson was undergoing. He insisted that "the PM remains in charge of the government."

“He is receiving updates in hospital and is continuing to receive a (ministerial red) box" of files and briefing papers, Slack said.

Prime Minister Narendra Modi on Monday hoped that his British counterpart Boris Johnson, admitted to a hospital for treatment of coronavirus, finds himself in perfect health soon.

"Hang in there, Prime Minister @BorisJohnson! Hope to see you out of hospital and in perfect health very soon," the prime minister wrote on Twitter.

The 55-year-old leader had been quarantined in his Downing Street residence since being diagnosed with COVID-19 on March 26. He continued to preside at daily meetings on the outbreak until Sunday. He released several video messages during his 10 days in isolation urging Britons to stay home and observe social distancing measures to help slow the spread of the virus.

Speaking earlier at the government's daily coronavirus press briefing, Raab said Johnson was being “regularly updated," but said he had not spoken to him since Saturday.

“He's in charge, but he’ll continue to take doctors’ advice on what to do next," Raab said.

Politicians from all parties wished Johnson a quick recovery. Opposition Labour Party leader Keir Starmer tweeted: “Terribly sad news. All the country’s thoughts are with the Prime Minister and his family during this incredibly difficult time."

Johnson's fiancee, Carrie Symonds, who is pregnant, is herself recovering from coronavirus symptoms.

Johnson was admitted to the hospital as a message to the nation from Queen Elizabeth II was being broadcast Sunday evening. The 93-year-old monarch urged the public to show resolve and follow advice to stay inside.

Concerns had been growing about Johnson’s welfare ever since he posted a message Friday saying that he was feeling better, though was still feverish.

The virus causes mild to moderate symptoms in most people, but for some, especially older adults and the infirm, it can cause pneumonia and lead to death.

The government said Monday that 51,608 people had been confirmed to have the coronavirus in Britain, 5,373 of whom have died.

Derek Hill, a professor of medical imaging science at University College London, said that since COVID-19 causes difficulty breathing, one test performed on people with the disease is lung imaging with ultrasound or CT scans to see how badly they might be affected.

Hill said there are various types of breathing help, depending on the person and the difficulties.

“The reasons some people get seriously ill with COVID-19 while others have minor symptoms is not yet fully understood,″ Hill said. “But doctors managing these patients report that more men than women have serious problems, and patients who are overweight or have previous health problems are at higher risk."

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News Network
January 23,2020

Beijing, Jan 23: China is putting on lockdown a city of 11 million people considered the epicenter of the new coronavirus outbreak that has killed 17 and infected nearly 600 people, as health authorities around the world work to prevent a global pandemic.

The previously unknown coronavirus strain is believed to have emerged late last year from illegally traded wildlife at an animal market in the central Chinese city of Wuhan. Cases have been detected as far away as the United States, stoking fears the virus is already spreading worldwide.

Wuhan's local government said it would shut down all urban transport networks and suspend outgoing flights from the city as of 10 a.m. (0200 GMT) Thursday, state media reported, adding that the government is urging citizens to not leave the city in the absence of special circumstances.

Contrasting with its secrecy over the 2002-03 Severe Acute Respiratory Syndrome (SARS), which killed nearly 800 people, China's communist government has this time given regular updates to try to avoid panic as millions of people travel for the Chinese Lunar New Year holiday.

Chinese authorities have confirmed 571 cases and 17 deaths as of end-Wednesday, state television reported on Thursday. There are eight other known cases around the world - Thailand has confirmed four cases, while the United States, Taiwan, South Korea and Japan have each reported one.

Vice Premier Sun Chunlan said during a visit to Wuhan that authorities needed to be open about the spread of the virus and their efforts to contain it, the official Xinhua news agency reported on Thursday, comments likely to reassure global health experts.

After a meeting at its Geneva headquarters on Wednesday, the World Health Organization (WHO) said it would decide on Thursday whether to declare the outbreak a global health emergency, which would step up the international response.

If it does so, it will be the sixth international public health emergency to be declared in the last decade.

WHO Director-General Tedros Adhanom Ghebreyesus told reporters in Geneva that China's actions so far were "very strong" but called in Beijing to take "more and significant measures to limit or minimise the international spread".

"We stressed to them that by having a strong action not only they will control the outbreak in their country but they will also minimise the chances of this outbreak spreading internationally. So they recognise that," he said.

A senior U.S. State Department official also called on China to "play a bigger role in global health so they taking more and significant measures to limit or minimise the international spread".

"The lack of transparency in the past, especially with SARS ... gives us concern that that may be the case here," the official said, adding however that there were "positive signs that they have taken action in Wuhan".

Fears of a pandemic initially spooked markets but they regained their footing on Wednesday, with investors citing the robust response from authorities as reassuring.

VIRUS SPREADING

The outbreak began in Wuhan, a major transportation hub as well as central China's main industrial and commercial centre, and has now spread to other major population centers including Beijing, Shanghai and Hong Kong.

There is no known cure for the virus. Symptoms include fever, difficulty in breathing and cough, similar to many other respiratory illnesses, and can cause pneumonia.

Chinese authorities are still investigating the origins of the virus, though they confirmed the outbreak began at a market in Wuhan with illegal wildlife transactions and that it can spread from one person to another via respiratory transmission. Among confirmed patients are 15 medical workers, further adding to worries about a possible global pandemic.

Many Chinese were canceling trips, buying face masks, avoiding public places such as cinemas and shopping centers, and even turning to an online plague simulation game as a way to cope.

Airports globally stepped up screening passengers from China and the European Centre for Disease Control and Prevention (ECDC) said in a risk assessment that further global spread of the virus was likely.

Britain joined other countries including Australia in advising citizens against all but essential travel to Wuhan.

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