Day Sixty: Thursday 14th May 2020

Daily Diary: Tail Chasing!

Still in catch up. Writing, writing, writing.

I’ve been waiting for the ruling on general aviation all week. Finally, Nigel picked up on the letter from the Department for Transport and circulated it to the club on WhatsApp. The restrictions on leisure flying, including paragliding have not been lifted. In addition, the tardiness of the Government is that people’s hopes that had been lifted by Boris Johnson are then slammed down again.

Personally, at 68, I’m not going anywhere and certainly won’t go out to fly any time soon. But there are many other, especially younger pilots who are going to feel let down. It’s going to be hard to break the news, but it has to be done.

I’ve opened up Zoom for a brief chat at 8.30 pm with the committee. There’s a full club meeting scheduled tomorrow.

The Bigger Picture: Shockingly Unprepared But Evolving Rapidly.

We were shockingly unprepared.

How could we be so unready? It was common knowledge that there was a biosecurity threat. So many movies have been made about viral plagues they could be a genre in their own right. Health experts have warned about a coronavirus-like outbreak for years. But just like with previous epidemics, their recommendations were ignored, leaving countries around the world woefully underprepared.

The World Health Organisation has been criticised by some for its response to the Covid-19 pandemic, but the problem is deeper than that. Starting with the deep distrust of multinational corporations and their contribution to the widening divide between the rich and poor, which in turn has led to a global uber-class, there has been a lessened enthusiasm for the worldwide, along with a rise in more local and insular populism. In doing so, international organisations, such as the United Nations and World Health Organisation became caught in the fray, Trump on occasion hitting out at both of them, and he’s by no means alone in doing so. 

Nevertheless, there is no alternative to the WHO when it comes to fighting the disease, and any others that may appear in the future.

Another way in which the world was unprepared has been the mechanism by which scientific advances in preventing and treating a rapidly spreading disease such as Covid-19 went from research to medical practice. Traditionally, the process has been intentionally slow, careful and deliberate. But the pandemic moves far too fast for that.

So findings, such as in the case of remdesivir, go from pre-print to practice follow a fast track that brings with it its own set of problems, not least that the media get hold of the story and the public invest their hopes in it before everything is cut and dried. Data is released following preliminary analysis

The rationale’s easy to understand. In a pandemic, who doesn’t want insight into a useful therapy as soon as possible? So on this basis, the data becomes sufficient to allow Emergency Use Authorisation in hospitals, despite this is not the best approach to science or medicine.

Rather than release information in dribs and drabs, study sponsors whether a government, company, or university, should release all the results as soon as possible, especially when it comes to medicines for fighting a pandemic. Data should not be held back.

“If we can’t see the study protocol and a concise research report, you shouldn’t be talking about it in the news,” said Joseph Ross, a professor medicine and public health at Yale University, who studies clinical trial practices. “Instead, we now have a situation where partial data is disclosed and physicians have to use that to make a decision in the moment.”

Indeed. In the absence of full results, we lack further insight into safety or how the drug may work on subsets of patients. And for now, the extent to which remdesivir can prevent deaths – a key metric – is unsettled. Fewer patients died while on the drug than placebo, but the findings were not statistically significant and need further analysis.

But the decision moves from being scientific to being political.

So Dr Fauci, adviser and spokesman for President Trump, insists about the EUA for remdesivir “the conclusion will not change,”

Even so, until the data are released, doctors are left with a mix of facts and assumptions, we run the risk of making a decision based on the wrong info.”

And the combination of less rigour, along with allowing the media to access incomplete evidence about the efficacy and risks of treatments (and in time vaccines) allows for some members of the public to invest their faith and hope in more questionable therapies, such as hydroxychloroquine and ivermectin.

And that lowering of the bar will prove to be a growing problem as the pandemic progresses.

The Office for National Statistics has estimated that 136,000 people in England have been infected with Covid-19. Over thirty three thousand have died in the UK. By comparison, twenty seven thousand have died in France.

The independent SAGE group, twelve scientists and public health experts, warns that the UK will face further lockdowns if it follows the current path, calling the UK government to change its approaches to tackling Covid-19, and releasing a set of recommendations that challenge the current strategy. “We detect ambivalence in the Government’s strategic response, with some advisers promoting the idea of simply “flattening the curve” or ensuring the NHS is not overwhelmed. We find this attitude counter-productive and potentially dangerous,” their report states.

That ambivalence suggests that the Government simply didn’t ‘get it,’ having failed to engage with the crisis until it was fully upon the nation.

Jeremy Hunt, the former health secretary and Chair of the Parliamentary Health and Social Care Committee, said, “I don’t think it’s very important not to finger-point at the individuals, and I think the Government is getting excellent scientific advice. But to ask why it is that SAGE, the Government’s scientific advisory committee, didn’t model the South Korean test, track and trace approach that we are now adopting right at the beginning? The Government was given two very extreme options, the sort of extreme lockdown we are just coming out of, or mitigated herd immunity. And the middle way, the South Korean route, wasn’t modelled.

He also said that Covid-19 tests are taking much too long to be processed.

Sir Keir Starmer, Leader of the Opposition takes PM Johnson to task on care home deaths, using the Government’s own words and track record against it. How covid could be so carelessly sent untested from hospitals to care homes for such a vulnerable sector of society, seeding death after death like falling dominos, is an ignominious blunder, a stain on the Government and a failure of policy.

It’s unpreparedness, failure to mentally walk the walk, not even working through the findings of Exercise Cygnus carried out to test the UK’s readiness for a hypothetical flu pandemic, that leads to such catastrophes costing thousands of lives.

Meanwhile, Dr Nishant and his wife, Dr Meenal Viz are taking legal action to challenge the lawfulness of PPE guidance published by the Government, which they argue exposes healthcare workers to a greater risk of contracting Covid-19. The doctors also argue that the guidance is not in line with international standards set by the WHO or domestic legislation regarding health and safety at work, that it fails to address the greater risks faced by BAME healthcare workers and that the lack of clarity has resulted in inconsistent practices across NHS Trusts.

It’s a muddle. A mess. This time Johnson’s boosterism will not get us out of it.

Unlike the Brexit unicorns on the sunny uplands, people dying is for real.

Britain’s lack of preparedness and political focus on Brexit were the two key factors in the country’s economy shrinking at its fastest pace since the 2008 financial crash. The UK suffers a bigger economic hit than any other G7 economy. Chancellor Rishi Sunak admitted it was “very likely” the UK is in a “significant recession” as new figures showed. GDP fell by 2 per cent in the first three months of 2020. With just one week of lockdown in those stats the next quarter will be much worse.

There are losers, including struggling markets, such as airlines and oil and gas companies, that are sucking king’s ransoms from governments to keep them alive. 

Spectator sports wonder if they too will be among the losers. Can they survive the pandemic without spectators? Making professional games safe may be feasible.

Making them pay will be harder.

There are winners too. The biggest players are e-commerce – including Amazon, Alibaba and Walmart – have all experienced growth, thanks to the rise in online shopping.

Then there’s the economy that envelops our everyday lives.

  • English councils fear they will have to make budget cuts of 20 per cent and face a social care funding shortfall of £3.5 billion due to the pandemic.
  • House prices could take a year to recover from a Covid-19 slump, warn surveyors. As they call for stamp duty cut for downsizers.
  • A link between poverty and Covid-19 deaths in Scotland laid bare in shock new figures.

And the impact Covid-19 has had on the wider global economy. Economies are deeply intertwined, and the largest economies reach deeply into those of other countries.  So that when Australia has said that it will continue to push for an inquiry into the origins of Covid-19, even if it hurts trade relations, China responds by suspending beef imports from abattoirs and planning to impose tariffs on Australian barley, after warning that the inquiry could harm two-way trade ties.

The meat trade is more directly affected by the virus too. Meat processing plants have become hot spots and with a high incidence of affected workers, several meat processing plants have had to close, leading to a surge in American meat prices. Working conditions for migrants in German slaughterhouses are in the spotlight after more than 200 workers tested positive for Covid-19 at a factory near Caesfield, in the west of the country. Covid-19 outbreaks have also been identified in at least two other meat processing plants in Germany. The majority of people infected were from Romania and Bulgaria.

Warehouses have also become local epicentres for the outbreak. In a number of US states, officials demand that Amazon tell them how many warehouse workers have died from Covid-19. While in Britain the GMB union has called for the closure and deep cleaning of  fashion retailer ASOS’s warehouse at Little Houghton, near Barnsley, after reports emerged that workers have tested positive for Covid-19.

While billionaire and Tesla founder, Elon Musk, wins a legal battle with the State of California to reopen his car plant.

Early signs that business and manufacturing will weather the storm.

Even though it doesn’t feel like it at the moment.

Although we entered the pandemic poorly prepared, it has brought biomedical research front of stage.

The genomes of thousands of patients with coronavirus will be sequenced to understand how a person’s genetic make-up could influence susceptibility to the virus. The study will sequence the whole genomes – the genetic code – of up to 20,000 people who were previously in intensive care or who are currently in intensive care at 170 NHS units across the UK. Patients will have their results compared with 15,000 people who have suffered only mild or moderate symptoms. Experts hope to explain why some patients with Covid-19 experience mild infection, but others require intensive care or go on to die.

Meanwhile the consumer genomics companies 23andMe and Ancestry, each with tens of thousands of customers who have already been tested positive for Covid-19 have also joined the search for the relationship between our DNA and disease susceptibility.

The novel coronavirus known for infiltrating the body through the respiratory tract. However, researchers in Hong Kong are now warning that infection via the eyes is also a big risk, because the strain is stronger than previous coronaviruses. But they insist hand hygiene is still more important than wearing face protection.

Doctors in Bergamo, Italy have reported the first clear evidence of a link between Covid-19 and Kawasaki disease, a rare but serious inflammatory disorder that has required some children to undergo life-saving treatment in intensive care units. NHS bosses issued an alert to doctors after hospitals admitted between 75 and 100 children with a mixture of toxic shock and Kawasaki symptoms, typically including a fever, skin rashes, red eyes, cracked lips and abdominal pain. On Tuesday, medics at the Evelina London Children’s Hospital announced the death of a 14-year-old boy, the first known fatality from the condition in Britain. Doctors suspected early on that coronavirus played a role in the new disorder by triggering an excessive immune reaction in the children, but there was no proof that the two were linked.

The virus has changed, possibly irreversibly, how the process of medicine works. With a highly contagious airborne pathogen on the loose and the absence of a vaccine or especially efficacious medication keeping distance is the only option, one that has been around since Babylon had its first public health problem some time lost in antiquity.

That combines with the ultra-new. We can pick up what the good citizens of ancient Babylon would see as a work of magic, or maybe divine intervention, to see and even talk with each other. We can cheat isolation and being separated.

The massive decline in in-person doctor-patient consultations has been replaced in a rapid growth in telemedicine. In the US, Doctor on Demand becomes the first major telemedicine company to expand its services to Medicare Part B beneficiaries. My wife and I find ourselves, unable to get in touch with our long-standing family doctor, resorting ironically to our Babylon app.

And much as I would still like to meet up with our family doctor, who over decades has become an old friend who knows our personal journeys, at least in terms of our health, I have to accept that telemedicine has opened up new possibilities.

One has been with many vulnerable patients with opioid addiction. Coming to the clinic during a pandemic could well be more dangerous than staying home alone. In the US, Lev Facher reports in STAT that many doctors have taken advantage of new regulations that allow them to prescribe buprenorphine without evaluating patients in person, instead conducting visits by video chat or even by phone, and in some instances, it’s led to unexpected breakthroughs.

One doctor from Tennessee said that telehealth visits have allowed him to gain insight into his patients’ living situations, which has often led to critical discoveries about their life circumstances that he would otherwise have missed.

“I found three patients in the past two weeks that I didn’t know were homeless or living in a car. So we’ve been able to hook them up with some housing services that we have access to.”

Other doctors have argued the new allowances for telehealth and medication delivery could result in a sweeping expansion of treatment services in rural areas, where finding qualified doctors to conduct in-person visits is often difficult.

The Babylon Box can do more, as Erin Brodwin explains in STAT online magazine.

Tech companies, health providers, and patients alike were increasingly looking to remote devices like miniature electrocardiograms and blood pressure cuffs connected to the internet that let clinicians keep tabs on care from afar. Now, with virtual care emerging as a safer alternative to in-person care, remote heart monitoring tools may be having a breakout moment.

The devices could prove useful during the pandemic for a range of reasons, from their ability to catch undiagnosed heart abnormalities in patients missing routine medical appointments, to their usefulness in gauging Covid-19 patients’ responses to experimental medications that impact the heart.

Wearables like the kind made by Apple and Fitbit are already being tested as early warning systems to detect Covid-19 using data from the heart as well as insights on sleep and activity levels, all of which have been previously found to be helpful in predicting clusters of the flu.

There remains a question over whether the change in thinking around remote heart monitoring will stick after the pandemic subsides.

If virtual care — including remote heart monitoring — can give patients and clinicians a clearer picture of heart health in real time, experts project their use could become far more widespread in the coming months and years.

During which virtually all the heart-monitoring technology may well be Zio patches, Apple Watches, or Bluetooth phones for example.

Having said that, checks for cancer such as mammograms, lung x-rays, colonoscopies and smear tests still require in person visits and fears of Covid-19 have led to appointments dropping markedly. In the NHS the backlog was already worrying before the pandemic. It is set to get much worse.

Britain, amongst other countries, has been unprepared is in testing for the virus. The country hasn’t been clear, or honest, about what testing involves. We knew that test and trace had been effective in managing STDs, not least of all HIV/AIDS and some tropical diseases, such as Ebola,  brought in from the developing world by aid workers, with a limited number of contacts. That seems to have shaped public health thinking. Highly infectious airborne viruses, such as colds and flu were not considered sufficiently virulent.

The virus moves quickly, especially in an era of air transport, Britain’s borders were wide open, and by the time news reports were coming in about Covid-19 it was all too late – Covid-19 had arrived and established itself.

The spread of the virus might be tamed if people were to be tested in large volumes. But there simply isn’t the human or material capacity to test on such a huge scale. So the virus tears through the population, and getting a grip on the situation means setting priorities.

At this stage of the pandemic there are three: healthcare personnel and first responders, randomised testing of representative samples of the population to understand the overall pandemic dynamic, and high risk groups.

For a long time to come testing will be cumbersome, with PCR tests taking up to several days to produce results, and as has happened already the horse has bolted before the stable door is shut. Apps will prove inconsistent in tracing the virus and protecting individuals. Only when home-use lateral flow tests become widely available, with rapid results in less than half an hour, even if they are have a sensitivity of 80 per cent (see yesterday’s post about how the tests work), will testing have a widespread effectiveness.

If there is one aspect of dealing with the pandemic that Britain has been slow to adapt it has been the wearing of face masks. Despite the practice being commonplace in countries that had been hit by previous viral epidemics, such as South Korea, neither the Government nor public health leaders seem to have registered their significance. Throughout April the share of Americans wearing face masks increased dramatically, rising from 17 per cent in early April to 69 per cent by the third, although there is a considerable difference in usage rates geographically. By contrast, the UK languished at 26 per cent, despite the public’s very positive response to other measures, such as distancing, hand washing, avoiding public transport (which Brits have excelled at – working from home might have been a factor) and sanitiser.

Wearing a mask has been absent from the all too familiar Number Ten briefings, which focused on those other measures.

The Government’s advisers were themselves divided over the importance of masks, and there was a tacit messaging from Johnson’s libertarian government that somehow masks were an infringement of people’s liberties. Even leading politicians were heard to describe masks as muzzles and face nappies. Misinformation abounded, like wearing a mask for long hours to reduce the spread of Covid-19 will put you at risk of carbon dioxide poisoning.

It was nonsense. Hospital staff have long worn masks without such consequences. They mightn’t be especially comfortable, they do tend to mist up glasses, but that’s as far as it goes.

The precautionary principle, which I’ve personally adopted since before the lockdown when it comes to mask-wearing, in the same way as I look at my helmet, reserve parachute and pre-flight checks when paragliding, simply hasn’t been part of the playbook. For Boris Johnson it has always been the bold versus the timid, and masks are no exception.

But for the mask-wearing minority, people began to engage positively with the challenge. Some, like my sister started to make her own masks and went on to selling them to raise funds for her local hospice. She’s part of a growing mask-sewing army, lessening the acute shortage of masks by hospitals and setting a trend of mask individuality.

But masks never stop being a divisive issue.

Or as straightforward one, particularly where it overlaps with other divisive issues such as racism. Gabriel Felix, a black doctor, wrote in the medical online magazine STAT:

“With the emergence of Covid-19, I’ve spent time weighing the pros and cons of wearing a face mask on evening walks to pick up takeout food or to go to the grocery store. I often opted not to wear one so I wouldn’t be perceived as appearing “suspicious.” My decision-making went as far as limiting how often I went out after dark, knowing that some people will see a masked Black man as a threat.

Then I received a text alert from my city one morning telling me that using a face mask is now mandatory in public and that people who don’t comply with the order could face a $300 fine.

As a physician, I favour things that will help reduce the transmission of coronavirus infections. But as a Black man, I wondered how this order will affect people who look like me. I wondered if this order went into effect with any understanding of the fear and anxiety it could inflict on people of colour.”

In Flint, Michigan, a security guard at a Family Dollar store was fatally shot on a Friday afternoon after an altercation that had occurred over another customer refusing to wear a face covering, which is required in Michigan in any enclosed public space.

If covid teaches us anything, it’s nothing in life is ever that simple.

Even when there are a lot of folk telling you it is.

I’m not sure now whether this is a late message on my email feed from my local Nextdoor user group, or whether I was behind on catching up because of my birthday, but here it is:

“Police Notice: Coronavirus outbreak FAQs – what you can and can’t do. Thanks to your sacrifices, social distancing is working. But if we stop now, we risk increasing the spread of the coronavirus. The Government has now published ‘staying safe outside your home’ for guidance on what the new rules will mean. These will take place on Wednesday 13 May 2020.”

However, police in England revealed they have no powers to enforce two metre social distancing. New guidelines issued by the College of Policy and the National Police Chiefs’ Council urges officers to only enforce what is written in law. It is prudent. The loss of policing by consent in the longer term is a much bigger issue than managing the public during a pandemic.

Also in this new reality we find ourselves in:

Building sites are to stay open longer to ‘help workers follow social distancing.’ Sites in residential areas can remain operating until 9 pm and those in non-residential places can work later.

New cycle paths are being created to encourage people to hop onto their bikes rather than into their cars. Leaders and urban planners say it’s a unique opportunity to advance green policy goals while encouraging social distancing.

The Foreign Office has issued a warning for Brits with holidays booked for Spain. Following further border restrictions, only Spanish citizens, those who are legally resident in Spain, frontier workers or those who can prove they need to enter Spain for essential reasons will be allowed to enter the country. Only green residency certificates will be accepted as proof of residency in Spain and British travellers who are not resident and/or not in possession of this certificate should not attempt to enter the country. Padron certificates, utility bills and property deeds will not be accepted by Spanish authorities as proof of residency. British travellers who are not resident in Spain or do not have a residency certificate with them should not travel to Gibraltar and then attempt to enter Spain via the land frontier. From May 15, all new international arrivals entering Spain, including Spanish nationals and residents, will be required to self-isolate in their residence or hotel for a period of 14 days.

Holiday firms are accused of ‘bullying’ customers into paying balances. Customers have been told they must pay the remaining amount for their trips or lose their deposit.

Green and red zones: As summer approaches, governments fear the increased number of people will spark a fresh wave of infections. One study from Spain has an innovative solution. It suggests dividing Europe into red and green zones, according to the impact of Covid-19. Under the scheme, Europeans would be able to travel freely to and from proposed green zones, such as Norway, southern France and Scotland. Red zones, such as northern Spain, London and Sweden would be off-limits.

The EU is trying to salvage summer with social distancing rules for hotels.

But for some, like 39 year old Emiliane, who is spending lockdown in temporary accommodation in an inadequately converted office block Harlow, Middlesex, any idea of a holiday is a million miles away.

“I’m spending lockdown in a former office block with my two kids and I’m scared. I’ve felt scared living in this building,” she says.

Lockdown for many is horrible.

There has to be a way out.

And it has to be managed well.

Professor Mauro Guillén of the Wharton School of the University of Pennsylvania has advised a staggered reopening of businesses with periodic checks before proceeding. He has suggested an “incremental reopening,” with proper planning for transportation of people from home to work, and back to home. Alongside, there would have to be protocols in place for contact tracing if a worker falls ill, he said. In reopening schools, he has recommended that children be taken to school in groups of 20 per cent and step that up gradually while ensuring that the requisite testing and contact tracing capabilities are in place.

Well managed, lifting lockdown is achievable but in England the loosening of the rules remain confusing.

This problem is not unique to England. Protests have broken out in Madrid after the Spanish government eased the lockdown everywhere except for the capital and Barcelona. France is also leaving the lockdown, but the process is hampered by adversarial labour relations and distrust of government.

But elsewhere lifting lockdown goes more smoothly. Belgians resume social life. People in Belgium have been able to gather in small groups again after the government eased the country’s lockdown. Latvia, Lithuania and Estonia open borders to each other to form a ‘Baltic Bubble.’

One restaurant in Sweden is taking the new way of life as an opportunity to launch a truly unique dining experience. Bord For En, in the small town of Ronseter, lays out a single table a single chair and cooks up a three course meal for a single guest, once a day …. In the middle of a field.

In England, garden centres reopen. “Gardening helps me to deal with things,” one pleased customer declares.

Lifting the lockdown changes behaviour rapidly. Data published by location technology from TomTom shows that the level of road congestion in London at 8 am on Thursday was 19 per cent, up from 16 per cent a week earlier. Transport for London said there were 10 per cent more Tube journeys made between 5 am and 6 am on Thursday than the same period last week.

Well managed or not, clear or confusing, lockdowns in Britain and Europe are coming to an end and most are relieved.

In the US there is talk of lifting restrictions too and a growing desire to return to normality, even though polls indicate that a majority of Americans say that gatherings are unsafe, at least until July. Last week, the share of Americans staying home fell to 36 per cent, down from 44 per cent a few weeks ago.

In New York, the news about Covid-19 has improved over the past week. There have been fewer than 200 deaths in New York for two consecutive days, down from around 1,000 in early April. Nationwide, the number of confirmed new cases each day has finally begun to decline substantially.

As some governors consider easing social distancing restrictions, new estimates by researchers at Harvard University suggest that the United States cannot safely reopen unless it conducts more than three times the number of Covid-19 tests it is currently administering over the next month.

There is a growing gap between politicians and scientists and the medical profession. The main White House model now projects 147,000 people will die in the US by August 4th due to the easing of social distancing measures.

Dr Fauci testified to Congress that the country does not have the Covid-19 outbreak completely under control and the national death toll is “likely higher” than 80,000 as states begin to reopen.

A view which received sharp criticism from President Trump.

Wisconsin Governor, Tony Evers, a Democrat, had extended the prohibition on most travel and operation of non-essential businesses until May 26. But in a 4 to 3 ruling, the conservative-leaning court said that the measure had exceeded the top health official’s authority under state law.

Also in the US:

  • A new analysis says 80 per cent of people who have recently lost their jobs are likely eligible for healthcare coverage under Medicaid and Obamacare.
  • California State University, the nation’s largest four year public university system, cancelled in-person classes for the fall.
  • Paul Manafort, the former Trump campaign chairman, was released from prison to home confinement over fears of the spread of the coronavirus.

Most prisoners, without the connections in high places, were not so lucky.

Elsewhere in the world:

  • Pandemic fails to damp armed conflicts, despite truce calls.
  • The virus came late to Latin America, but death rates there are comparable to those in Europe.
  • A strong typhoon roared towards the Philippines as authorities work to evacuate tens of thousands of people, while avoiding overcrowding emergency shelters that could spread Covid-19. Governors say social distancing will be nearly impossible for residents staying at emergency shelters. Some shelters are now functioning as quarantine facilities, and they will have to be turned back to emergency storm shelters.
  • Taiwan responded quickly to the outbreak and appears to have limited its spread. Its government leveraged technology to trace and quarantine sick people, upped its mask production, and trained communities for lockdowns through large-scale simulations. At this stage it promises to come out of the pandemic stronger than ever, but there is still a long way to go.

While the unusual feature of today’s international news is a particular focus on so often much ignored and neglected Africa:

Lesotho: This tiny kingdom of has confirmed its first case of the coronavirus. Entirely surrounded by South Africa, which has more than 11,000 confirmed cases, Lesotho had been the only country in Africa without any reported infection. But this week dozens of people who arrived from Saudi Arabia via South Africa were tested and one case was found.

Uganda: A member of parliament was detained and tortured for ten days as the government and aligned paramilitary groups persecuted opponents in the name of halting the virus.

Liberia: Broadcaster Spoon FM closed its newsroom after its general manager was one of several journalists stopped by the police. Press pass issues were preventing journalists from informing communities on protection against the virus, she said, while a minister warned journalists that they would be ‘embarrassed’ at security checkpoints for not complying with the virus.

Cameroon: As battles with separatists continued, the government has banned humanitarian flights as part of its efforts to curb the spread of the virus.

Madagascar: Several African countries received shipments from Madagascar of a plant based ‘cure’ for Covid-19 promoted by president Andry Rejoelina, despite warnings from the WHO that its efficacy is unproven.

Tanzania: President John Magafuli denounced Covid-19 statistics from health officials as fake and “imperialist sabotage,” stopping release of further results, suspending the director of the national health laboratory and instituting an investigation. Tanzania also gets Madagascar’s anti-Covid-19 drink disputed by WHO.

Ethiopia: The government has been accused of using a state of emergency to crack down on freedom of speech.

Western Sahara: The wife of a Saharawi activist has called on occupying Morocco to free political prisoners from the country’s liberation movement as Covid-19 spreads through the nation’s jails.

Finally, another uplifting story.

Margaret Payne, a 90 year old woman raising money for health and emergency services by climbing the height of Suilvan, a Scottish mountain, on her stairs has said she is “looking forward to a good rest at the summit.”

Suilven is 2,398 ft (730m) high, and Margaret’s challenge means she’ll need to take 282 trips up her staircase in total.

Margaret is expected to take around two months to complete the challenge, which she says was inspired by the charity garden walks by 99-year-old veteran Captain Tom Moore, who has raised more than £18m for the NHS.

I’m hoping that such feats will mark what history will record as The First Lockdown. They tell a story of a moment in time, that like clapping for carers, will pass, but should never be forgotten.


Al Jazeera, Associated Press, BBC News, Care2, Crowd Justice, Daily Record, Economist, Euronews, Evening Standard, Financial Times, Forbes, France24, Guardian, Huffington Post, Independent, iNews, ITV News, Liverpool Echo, New Statesman, New York Times, Nextdoor, Open Democracy, Quartz, Royal Society, STAT, This Is Money, Wharton Business School University of Pennsylvania,

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