Covid-19 Watch: Global Divergence

Prepared by Professor Alan Whiteside, OBE, Chair of Global Health Policy, BSIA, Waterloo, Canada & Professor Emeritus, University of KwaZulu-Natal – www.alan-whiteside.com

Introduction

I have just finished reading Hilary Mantel’s latest (nearly 900 page) book, The Mirror and the Light, the last in her Thomas Cromwell trilogy. It is set during the reign of Henry VIII; it opens with the execution of Anne Boleyn and ends with Cromwell’s own beheading in 1540. I am halfway through George Alagiah’s book, The Burning Land, ‘a gripping, pacey thriller about corruption and homicide in South Africa’. Both are worth reading.

But what does this have to do with Covid-19? One of the problems with being immersed in a world-changing event like this pandemic is having a sense of proportion. Mantel’s work provides this. It is a window into the lives, hopes and fears of people 500 years ago. It is a realisation of the futility of much of what went on among fallible people. Alagiah interviewed me about HIV, more than 30 years ago, when he was a BBC correspondent based in Zimbabwe. His book is a realistic window into the struggles in South Africa of a few years ago. This is the pre-Covid-19 world. I wondered how it would change if it were written today. Will it date? Unfortunately, I don’t have Richard Horton’s book, The COVID-19 Catastrophe: What’s Gone Wrong and How to Stop It Happening Again, so that review will have to wait.

There is no startling new information this week. The numbers continue to rise at a truly alarming rate. The Americas are worst affected. In England pubs and other social centres are set to open on 4th July. The efforts to find treatments and develop vaccines continue, but global political and epidemiologic leadership remain lacking.

I am delighted to include a piece written by Jonathan Crush and Zhenzhong Si on ‘COVID-19 and Food Security in the Global South’. Under ‘Responses’ I have used the Association of Science of South Africa statement, lots of common sense there.

There are three items listed in the reference section. All three help to understand risks and should be of interest. We are getting a clearer sense of the disease.

The Numbers

On Wednesday there were over 10,450,628 cases, of which the US is leading with over two and a half million cases. Second was Brazil with close to one and a half million. Russia is third, although the number of daily cases is declining, followed by India with a steady increase in the number of daily cases. The United Kingdom remains in fifth place but here too the number of new cases has declined. China is reporting virtually no new cases as are Spain and Italy.

Globally the epidemic is not under control. The increase is coming from many countries across the world, Peru, and Chile have moved into sixth and seventh place ahead of Spain and Italy. People who look at the John Hopkins Coronavirus Resource Centre should click on any country of interest as they can then see the daily case rate.1 It took three months for the first one million people to become infected, but just eight days for the last million.

Table 1: Global and National Cumulative Numbers of Confirmed Covid-19 Cases (alphabetical order)2
Date Global cases China India ∞ Italy Russia Brazil South Africa Spain UK USA
15 Feb 69,000 68,400 3 2 0 0 2 9 43
4 Mar 93,000 80,480 3,100 3 4 0 222 86 149
18 Mar 201,500 81,100 35,700 147 372 116 13,900 2,600 7,800
1 Apr 861,000 82,400 110,600 2,777 6,836 1,400 104,100 29,900 213,400
15 Apr 1,982,552 83,351 162,488 24,490 28,280 2,415 174,060 94,845 609,422
29 Apr 3,117,756 83,940 201,505 99,399 79,685 4,996 232,128 162,350 1,012,583
13 May 4,262,799 84,018 221,216 232,243 180,000* 11,350 228,030 227,741 1,369,964
27 May 5,594,175 84,103 230,555 362,342 291,222 24,264 236,259 266,599 1,681,418
3 June 6,382,951 84,159 233,515 423,186 555,383 35,812 239,932 279,392 1,831,821
10 June 7,250,909 84,198 235,561 493,023 739,503 52,991 241,966 290,581 1,979,893
24 June 9,264,569 84,653° 456,183 238,833 598,878 1,145,906 106,108 245,752 307,682 2,347,022
1 July 10,477,554 84,785 585,481 240,578 646,929 1,402,041 151,209 249,271 314,160 2,636,538

*estimate °this does not make sense ∞will add greater detail next week

It is hard to compare absolute numbers for China with 1.439 billion people, with the United States’ 331 million, or South Africa’s 59 million. To make useful assessments we need to look at rates as shown in Table 2.

Table 2: Covid-19 Deaths and Cases per million (alphabetical order)3
China France Italy Russia South Korea South Africa Spain UK USA
Deaths per million (19 May) 3.33 421.07 529.64 18.84 Error* Error* 593.04* 523.33 275.8
Total cases per million (20 May) 58.4 2,189 3,736 1,991 216 277 4,953 3,629 4,557
Deaths per million (26 May) 3.33 424.27 544.04 25.15 5.21 8.32 574.31 555.19 299.79
Total cases per million (25 or 26 May) 58.4 2,225 3,806 2,421 216 398 5,034 3,847 4,964
Deaths per million (3 June) 3.33 429.83 533.93 33.56 5.27 Error* 580.58 587.24 320.93
Total cases per million (2 or 3 June) 58.4 2,320 3,856 2,905 225 579 5,125 4,070 5,472
Deaths per million (17 June) 3.33 438.73 568.76 49.01 5.38 27.14 580.78 627.71 354.46
Total cases per million (16 or 17 June) 58 2,410 3,924 3,681 237 1,239 5,221 4,372 6,386
Deaths per million (23 June) 3.33 442 573 59 5 38 606 865 370
Total cases per million (22 or 23 June) 58 2,462 3,942 4,058 243 1,712 ° 4,497 6,985
Deaths per million (1 July) 3.33 444 574 63 5 43 606 655 385
Total cases per million (30 June or 1 July) 58 2,516 3,976 4,393 249 2,432 ° 4,595 7,826

*misread these data °data missing

Global and National Divergence

There are over 10 million Covid-19 cases globally and over half a million deaths. The head of the World Health Organization (WHO), Dr Tedros Adhanom Ghebreyesus, issued a warning on Monday 29th June that the pandemic “is not even close to being over.” He said in a press conference

“We all want this to be over. We all want to get on with our lives. But the hard reality is this is not even close to being over. … We’re all in this together, and we’re all in this for the long haul”.4

In the Americas the situation is bleak, on Sunday 28th June 60% of new cases were from there. Brazil and the USA lead the field.

Countries

Boris Johnson believes the UK is emerging from the worst of the epidemic. He is, however, not speaking for the UK. Nicola Sturgeon in Scotland is determined to go at her own pace in easing the lockdown. In fact, she has gone so far as to suggest people coming to Scotland from other parts of the UK could have to go into quarantine if infection rates get worse. She said:

“I hope that need won’t arise because I very much hope that we will see infection levels fall in Scotland, as they are right now, and fall in the rest of the UK. But from a public health perspective we have to be able to consider all options.”5

The need for tailored responses is increasingly evident. In England, for the first time, a specific town, Leicester, has been put under additional lockdown measures. This was announced in the House of Commons on 29th June by Health Secretary Matthew Hancock. The infection rate of 135 per 100,000 people, three times higher than the next highest local area in England.6 Schools in Leicester will close on Thursday 2nd July. Hancock wants everyone with symptoms to come forward for testing, although it is not clear what this will achieve. There are important lessons as parts of the world which seemed to have Covid-19 under control are seeing localised outbreaks. These must be addressed immediately and effectively. Examples include a night club in South Korea, an abattoir in North Rhine-Westphalia in Germany, and the city of Melbourne in Australia.

The data graphs are moving mostly in the wrong direction in parts of the Americas, south Asia and Africa.7 The US has the most infections and most deaths from Covid-19 anywhere in the world and extraordinary increases are being seen in some states, notably Arizona, Texas and Florida. In response Governors are defying the Trumpian optimism and re-imposing restrictions. Brazil is catastrophic and India is in fourth place for the absolute number of cases.

The numbers are growing across Africa. South Africa leads the way. As of today, the cumulative number of confirmed Covid-19 cases in South Africa is 151,209. The Western Cape has 42.5%, followed by Gauteng with 27.6%, the Eastern Cape with 18.2% and KwaZulu-Natal with 6.3%. This can partly be explained by the fact that the Western Cape saw the first cases. The mortality rate is 1.8%.8 Minister of Health Dr Zweli Mkhize, noted ‘“extreme concern” at a “fatigue” that appears to have set in three months after the country went into lockdown on 23 March and as the Covid-19 curve in South Africa is about to spike.9 I fear cases numbers in Africa will rise rapidly.

Locations

As indicated above, certain workspaces are higher risk than others. The disgrace of this pandemic, in the UK and Canada at any rate, has been the care homes. In Canada 81% of Covid-19 deaths were in care homes. This was double the rate in the rest of the OECD.10 In the UK, according to the Guardian, the risk of death in a care home was 13 times higher than in Germany.11 This is not to say that there are not excellent care homes that cherish their residents, of course there are. The reality though is that carers in most countries are poorly paid, have low status, and were at the end of the line when it came to getting protective equipment. There will be commissions of enquiry when this is over, these will be national and hopefully international. Care homes, the elderly and how we regard and treat them must be high on the agenda.

Responses

The Academy of Science of South Africa (ASSAf) is a statutory academy, established to provide evidence-based advice on issues of pressing national concern. Most senior academics are members and their public statement on Covid-19 provides common-sense guidelines that are applicable beyond South Africa.12 There are three key points: including scientists from a broad range of disciplines; operating beyond national borders; and looking beyond the crisis.

Covid-19 is more than a medical problem. Their statement notes, for example:

‘Psychologists need to advise on the far-reaching mental health costs of the pandemic following extreme forms of isolation. Sociologists need to advise on the efficacy of social distancing in human settlements marked by inequality …. Political scientists must advise on the norms that should govern the relationship between government and its citizens in emergency conditions.’

This multidisciplinary approach to scientific advice is crucial.

The focus should be on the regional African context. ‘A virus, especially this rapid transmission coronavirus, does not respect national borders.’ South Africa is a regional hub for medicine and commerce. In normal times thousands of people cross the borders daily. Regional connectedness needs to be considered because of the nature of a public health crisis and as a ‘statement of solidarity with African neighbour states with even more precarious national health systems’.

Finally ASSAf notes ‘while it is understandable that the work of the National Coronavirus Command Council deals with managing the immediate crisis, it is not too soon for a broad range of scientific advice to be drawn on to address urgent concerns such as the future of the economy, business, education, human settlements, the environment and, of course, health care reform’. The statement calls for ‘resetting the country’ whilst addressing fault lines exposed by Covid-19.

Most importantly, especially for the UK and US contexts, ASSAf recognises there is ‘an indispensable connection between science and the public trust. In the face of a pandemic, with all the fear and uncertainty of a novel virus, the credibility of governmental authority depends more than usual on winning the trust of the public.’ There is a lot in this statement. I quoted more than normal because it is so apt, especially the last point on trust. It seems in the UK the irresponsible Dominic Cummings is back in the public consciousness, while senior civil servant Mark Sedwill has resigned (or has been pushed).


COVID-19 and Food Security in the Global South by Jonathan Crush and Zhenzhong Si13

There is widespread agreement that a primary indirect consequence of the COVID-19 pandemic across the Global South is a dramatic increase in the prevalence of hunger and food insecurity. The FAO has called the food security consequences of the global COVID-19 pandemic a crisis within a crisis, while the World Food Programme calls it a hunger pandemic, warning that 30 million people could die of starvation. The number of severely food insecure people could double from 130 million to 265 million by the end of 2020. The disruption to food systems and security in LMIC cities has important implications for epidemic control and the current and future food security of urban residents. Impaired food security, in terms of malnutrition, caloric deficit and decreased dietary diversity, may increase susceptibility to infection and worsen the well-being of the infected. The interconnections between food insecurity and the outbreak highlight the urgent need to examine and improve food security interventions during and in the aftermath of viral epidemics.

The dramatic increase in food insecurity in LMIC cities is partly a function of the disruption of national and globalized food supply chains. Food access in urban areas is highly contingent on the importation of food from the hinterland, other parts of a country or from global markets. While food production, distribution and retailing is generally considered an ‘essential service’ many states have allowed formal retailers, such as supermarkets and their supply chains, to remain operational while shutting down the informal food sector on which the urban poor depend for food and income. In addition, restrictions on internal movement and international travel have negatively affected informal cross-border trade in foodstuffs.

Containment measures had an immediate and severe impact on food security in many Southern cities, through the disruption of food supply chains, bans on informal food markets and street vending, controls on movement, layoffs and unemployment, a precipitous decline in household income, and the shuttering of school feeding programs. Most poor urban households live in conditions where individual social distancing measures are impossible to implement or enforce. Particularly vulnerable are the urban poor in low-income and informal settlements and, within these areas, population sub-groups such as female-headed households, young children, older adults, day labourers, informal sector workers, the homeless, and migrants and refugees.

In China, quarantined residents resorted en masse to online food purchasing and delivery. However, this option is non-existent for the urban poor in many LMIC cities. Most households have no means of ordering food online and there is limited or non-existent delivery infrastructure. Hunger and the search for food drive desperate people to defy containment measures. Social unrest, including looting of food outlets and delivery trucks, is growing in many cities. Some governments have introduced or ramped up existing social protection and food distribution programs while others have focused on ensuring compliance through force. In some countries, such as India, non-governmental organizations have been more effective than the state in collecting and distributing food to the needy.

Since 2014, the Hungry Cities Partnership at the Balsillie School has focused its attention on the transformation of food systems accompanying rapid urbanization in the Global South and the vulnerability of urbanizing populations to food insecurity in its various forms – food availability, food access, food utilization, food safety and food stability over time. We have conducted comprehensive city-wide household food security surveys, surveyed informal food vendors in city markets and on the streets, and examined the impact of the supermarket revolution and online retailing on the food environment. We have also researched the governance of urban food systems and the impact on food consumption behaviour. Central to this research has been a focus on city markets, including wet markets which achieved a certain media notoriety during the COVID-19 pandemic, and their role in providing affordable food to urban residents. In 2020, as the impact of the pandemic on food systems and food security became increasingly apparent, HCP was awarded a CIHR COVID-19 Rapid Research Funding grant to research the food security and social policy implications of public health responses to the COVID-19 pandemic in China with a focus on the two major cities of Wuhan and Nanjing. We are now planning to scale up this research to seven additional countries: Ecuador, India, Jamaica, Kenya, Mexico, South Africa and Zimbabwe. Our main objectives are as follows:

  • Examine the nature and impact of public health containment and mitigation responses to COVID-19 on food systems and household food security in affected cities in the Global South;
  • Undertake a longitudinal analysis of COVID-19 induced changes in levels and drivers of food insecurity through comparison with pre-COVID baseline survey data collected by HCP;
  • Assess the effectiveness of government, business, NGO, community organizations and other stakeholder social policy responses to food security challenges and promote more effective policy measures and responses;
  • Provide critical decision-making and pandemic response data to international and local stakeholders to inform broader global debates and policy pubic health and social policy responses to the COVID-19 pandemic; and
  • Strengthen the capacity of researchers and research institutions to respond rapidly to ongoing food security challenges arising from the COVID-19 pandemic.

In conclusion, population-level containment strategies have been particularly hard on the urban poor and vulnerable population groups such as female-headed households, children, youth, the homeless, informal sector employers and employees, casual workers, the unemployed, and migrants and refugees. As a direct result, a secondary pandemic of hunger and food insecurity is now impacting many of these groups. An effective and sustainable global response to the COVID-19 (and any further) viral pandemics must therefore ensure that food security is an essential piece of the containment and mitigation puzzle.


Conclusion

Although lockdown was necessary, in the short term, to avoid health services being overwhelmed, it has to end, or economies will tank. The resultant depression will last for a generation. People will not get education, immunisation, and social support. National lockdowns are a blunt instrument. They must be replaced by much more focused and sophisticated testing, tracing and isolating policies. The situation in the USA is desperate but the steady increase in so many other countries means the WHO warning that this epidemic is not over is true.

References (risks)

Wall Street Journal, ‘How Exactly Do You Catch Covid-19? There Is a Growing Consensus
Surface contamination and fleeting encounters are less of a worry than close-up, person-to-person interactions for extended periods’ 16th June https://www.wsj.com/articles/how-exactly-do-you-catch-covid-19-there-is-a-growing-consensus-11592317650

Professor Erin Bromage, Comparative Immunologist and Professor of Biology, University of Massachusetts Dartmouth. http://www.erinbromage.com/post/the-risks-know-them-avoid-them

Vox, Why you’re unlikely to get the coronavirus from runners or cyclists: Understanding the key concepts of transmissibility and infectious dose should reassure you. 3rd June http://www.vox.com/future-perfect/2020/4/24/21233226/coronavirus-runners-cyclists-airborne-infectious-dose

Thank you for reading, reposting and providing comments. What I write is public domain so please share, forward and disseminate. My contact is: awhiteside@balsillieschool.ca


  1. John Hopkins Coronavirus Resource Centre coronavirus.jhu.edu/map.html
  2. These data are from the JHUM website. The countries are chosen because of their epidemics.
  3. Deaths http://www.statista.com/statistics/1104709/coronavirus-deaths-worldwide-per-million-inhabitants/
    Case per million ourworldindata.org/grapher/total-confirmed-cases-of-covid-19-per-million-people
  4. https://www.cnbc.com/2020/06/29/who-warns-coronavirus-pandemic-is-speeding-up-as-countries-ease-lockdown-rules.html
  5. https://www.dailyrecord.co.uk/news/scottish-news/nicola-sturgeon-coronavirus-update-live-22274978
  6. http://www.theguardian.com/uk-news/2020/jun/30/leicester-lockdown-what-are-the-new-covid-19-restrictions
  7. http://www.bbc.co.uk/news/health-53210553
  8. http://www.gov.za/speeches/minister-zweli-mkhize-confirms-total-144-264-cases-coronavirus-covid-19-29-jun-2020-0000
  9. http://www.dailymaverick.co.za/article/2020-06-30-protect-lives-pleads-mkhize-as-sa-heads-into-eye-of-covid-19-storm
  10. http://www.theglobeandmail.com/canada/article-new-data-show-canada-ranks-among-worlds-worst-for-ltc-deaths
  11. http://www.theguardian.com/world/2020/jun/28/covid-19-risk-of-death-in-uk-care-homes-13-times-higher-than-in-germany
  12. https://www.assaf.org.za/files/2020/ASSAf%20Public%20Statement%20Corona%2018%20May%202020.pdf
  13. Jonathan Crush and Zhenzong Zi are at the Balsillie School of International Affairs. Jonathan is University Research Professor at Wilfrid Laurier University. He established the Hungry Cities Partnership. Zhenzhong is a QES postdoctoral fellow researching food security and vendors of Nanjing in the Hungry Cities Partnership.

Covid-19 Watch: Missing voices

Prepared by Professor Alan Whiteside, OBE, Chair of Global Health Policy, BSIA, Waterloo, Canada & Professor Emeritus, University of KwaZulu-Natal – www.alan-whiteside.com

Introduction

There was hopeful news from the University of Oxford last week of a treatment breakthrough: low doses of the steroid dexamethasone can cut mortality. This has not been contradicted or undermined – yet! This is encouraging. Elsewhere the number of new infections continues to climb, South America being seen as the current hotspot. I find South Africa particularly worrying, due to my close connections with that nation.

Summer has arrived in England, although one can never entirely count on it. On Sunday, Father’s Day, my family and I went up to the north Norfolk coast for takeaway chips and a walk on the beach. The little town of Sheringham is normally teeming with tourists at this time of year. There were a fair number of people about, but most shops were closed, and there was a slight tension in the air as families tried to make their way along narrow pavements.

Driving along the coast past the huge, empty holiday parks of serried mobile homes, and shuttered country pubs, brought home what an economic disaster this pandemic is. North Norfolk’s economy is dependent on tourism, and there was no one about. Mind you the message from the area, which has one of the oldest populations in the UK, was ‘please stay away and protect our residents’. We don’t know how badly the economy has been damaged and when we will see recovery. We have no idea how many people on furlough will be re-employed. We don’t know which establishments will be able to reopen. Most of the resource rich world has mechanisms in place to reduce suffering. The major impact will be psychological and everyone is affected. In the resource poor world who knows!

Continue reading

Covid-19 Watch: A different background

Prepared by Professor Alan Whiteside, OBE, Chair of Global Health Policy, BSIA, Waterloo, Canada & Professor Emeritus, University of KwaZulu-Natal – www.alan-whiteside.com

Introduction

Over the weeks following the murder of George Floyd in Minneapolis there have been global protests. The Black Lives Matter campaign gained momentum and there have been demonstrations around the world. These gatherings have often been ‘illegal’ in terms of the Covid-19 regulations, but they have been allowed to proceed. Encouragingly most demonstrators are visibly wearing masks or face coverings. Is demonstrating worth it when the Covid-19 risk undoubtedly increases? Clearly the demonstrators, and I, think so and authorities do not want confrontations.

As I finished writing this week, news came of a breakthrough in treatment. Scientists at the University of Oxford announced low doses of a readily available steroid, dexamethasone, cut mortality rates. The gains are not huge, one life saved for every eight patients on a ventilator and one for every 20-25 treated with oxygen. The treatment takes 10 days and costs about £5 per dose.1 Also in the news are encouraging results from other drugs. This points, in my view, as in AIDS treatment, to a combination therapy being the most effective response.

This week my guest columnist is Arnau van Wyngaard, an ordained minister of the Swaziland Reformed Church, with whom I have written over many years.
Continue reading

Covid-19 Watch: Anger Grows

Prepared by Professor Alan Whiteside, OBE, Chair of Global Health Policy, BSIA, Waterloo, Canada & Professor Emeritus, University of KwaZulu-Natal – www.alan-whiteside.com

Introduction

The month of May was incredibly dry in the UK, I do not think there was a drop of rain in the east of England. Fortunately, on Friday 5th June it started to rain, and we had consistent showers over the weekend. It is amazing how quickly the green is returning to the dry, brown lawn. Would that we were able to recover as quickly from the Covid-19 crisis.

The sad reality is that it will take us years to get over the pandemic. We can, albeit imperfectly, count the number of people who have died. It is possible, in countries with developed functioning health systems, to get an idea of the number of cases. There is a degree of uncertainty as to the scale of the epidemic in countries with fewer resources. Once we have the antibody test, we will be able to establish how many people have been infected.

It is also a matter of record how countries reacted and what the lockdowns they imposed looked like. In many nations we have an idea of how much money governments have set aside for Covid-19. This is in terms of both direct support and income forgone, for example through tax holidays. Once it is over, we know the direct costs of providing treatment and all spent on prevention. There will be inquiries into how governments, international organisations and the global community responded to the pandemic. I do not think they will make comfortable reading.

Continue reading

Covid-19 Watch: Distractions

Prepared by Professor Alan Whiteside, OBE, Chair of Global Health Policy, BSIA, Waterloo, Canada & Professor Emeritus, University of KwaZulu-Natal – www.alan-whiteside.com

Introduction

Cities in the USA have erupted in flames as civil unrest and protest spread. In the UK the government’s credibility is in shreds. The World Health Organisation’s leadership is lacking. In many poorer nations the leadership and populations watch horrified as their economies contract, and, in time, may collapse. This is a global crisis; no country is untouched.

Perhaps the most obvious hit, other than deserted streets and empty city centres, has been in decreased mobility of populations, both business and leisure travellers. There are few aircraft flying and hotels and resorts are empty. Tourism and travel have, over the past few decades, become major contributors to Gross Domestic Product (GDP) and employment. Macau leads the table with 72.2% of GDP from travel and tourism. In Thailand it contributes 21.6%, in Greece 20.6%, in the UK 11%, and in South Africa 8.6%.1 Tourism employs 11.6% of those working in the UK, in Greece it is 23.9%.2

There is not much reason for optimism in the short term. While the spread of Covid-19 is under control in some areas, in others the numbers continue to rise. However, this crisis is an opportunity to reset the global discourse, establish what is important to us individually, as nations and as humans.

Continue reading

Covid-19 Watch: Politics

Prepared by Professor Alan Whiteside, OBE, Chair of Global Health Policy, BSIA, Waterloo, Canada & Professor Emeritus, University of KwaZulu-Natal – www.alan-whiteside.com1

Introduction

Over the past week I have watched increasing infighting and politicisation both over the Covid-19 pandemic and the response. In the UK Dominic Cummings, a senior advisor to Boris Johnson, became the story when he flagrantly disobeyed lockdown orders, though he, and the government, claim he did not. The Tanzanian president denies the epidemic, the South African emergence from lockdown is fraught, and there was a political attack on Professor Glenda Gray, President of the South African Medical Research Council (SAMRC) and a member of the Ministerial Advisory Council (MAC).

I write these communiques from a well-appointed shed in the garden of my home in Norwich, UK. My sanity is helped as spring is well advanced and I can leave the door open and revel in bird song. The robin sits just outside on the hawthorn bush and looks at me quizzically. My youth spent in church brings to mind:

“Behold the fowls of the air: for they sow not, neither do they reap, nor gather into barns; yet your heavenly Father feedeth them.” Matthew 6:25-34, King James Version.

The suburban wildlife does not care about the pandemic. In fact, the hedgehog said, “Pandemic, what pandemic”.2 This week has seen the changes in the countries with the worst entrenched epidemics (Table 1). The US leads the field followed by Brazil, Russia and the UK. Spain and Italy are relegated to fifth and sixth.
Continue reading

Covid-19 Watch: The ‘Leader Board’ Changes

Prepared by Professor Alan Whiteside, OBE, Chair of Global Health Policy, BSIA, Waterloo, Canada & Professor Emeritus, University of KwaZulu-Natal – www.alan-whiteside.com1

Introduction

The Covid-19-driven lockdowns have led to a range of reactions, from acceptance to seeing it as an assault on liberty. The responses depend on many things: national and regional politics; family situations; resources; resilience; and, of course, the severity of the regulations. The rules are being eased in most countries, but the manner and speed varies greatly. In this blog I will focus on lockdowns, the effect they have, are going to have, and how we might get out of them.

This week has seen significant changes in the countries with the worst epidemics (Table 1). South Korea is being dropped from my table, they had 10,000 confirmed cases in early April and took over a month to add a further 1,000. There are outbreaks but it no longer needs to be discussed, other than as a success. Brazil is the replacement country; it now ranks third in the world.
Continue reading

Covid-19 Watch: Reproduction Rates, Graphs and Face Masks

Prepared by Professor Alan Whiteside, OBE, Chair of Global Health Policy, BSIA, Waterloo, Canada & Professor Emeritus, University of KwaZulu-Natal – www.alan-whiteside.com1

Introduction

When writing I use quotations, aphorisms, and occasionally lines of poetry. Leonard Courtney (1832 – 1918), a British politician and president of the Royal Statistical Society said, ‘the price of peace is eternal vigilance’. Our watchword must be ‘the price of epidemic control is eternal vigilance.’2 The Covid-19 pandemic is entering a new phase. That is not to suggest it is under control or that the battle is over. Far from it. In some countries cases and deaths continue to climb, in others the control is precarious. We need to monitor, and be ready to act.

This week has been especially fascinating with interesting new developments. There is more evidence the virus reached Europe before the end of 2019. In addition to the case in France, a choir in Bradford (UK) reported a cluster of illness in early January. It began with the partner of a man who returned from business in Wuhan on 17 or 18 December.3 Korea was a poster child for epidemic control but in the last week has seen a small number of new cases.

Continue reading

Covid-19 Continues

For the past two months I have not written my usual personal blog for my website. There is a reason for this, the Covid-19 pandemic. Covid-19 is the greatest global challenge I have seen. It could be outstripped by a climate catastrophe, but for now it is all consuming. Given the work I have done on HIV and AIDS I am supposed to know a bit about pandemic diseases. It is worth remembering that like AIDS, Covid-19 is a retrovirus that transferred across the species barrier into humans. AIDS was recognised as a new disease in 1981. There were scares with SARS, Ebola, Zika and MERS, but none developed into a major pandemic.

In four short months Covid-19 has claimed over 250,000 lives and infected more than 3,500,000 million people. I began posting a weekly communique on Covid-19 to share what we know and need to know. This replaced the personal monthly blog I have written for more than 10 years. You have, along with several other hundred people, signed up for the communique and now you are getting this additional piece, so please feel free to delete it.

I originally wrote the monthly offering because I had something to say and share. It was just two sides of an A4 sheet when printed, and the reason was to keep the price of postage down.

“Ah ha”, I hear, “But it is on the website and sent electronically, so what is this postage business?”

Well, several of my elderly relatives are either self-confessed luddites or just lack technological skills, and don’t have email, so it was printed and posted to them. Yes, in an envelope with stamps on.

Continue reading

Covid-19 Watch: Science and Social Impact

Prepared by Professor Alan Whiteside, OBE, Chair of Global Health Policy, BSIA, Waterloo, Canada & Professor Emeritus, University of KwaZulu-Natal – www.alan-whiteside.com1

Introduction

‘The times they are a-changin’’ as Bob Dylan sang in 1964.2 Much is happening and some of it is good. The numbers in Europe’s worst affected countries are stable or declining. Some countries are tentatively starting the process of emerging from lockdown. The feared increases in Africa are still to materialise, the USA with the world’s worst epidemic is experiencing waves with a slight downward trend. That is the good news. On the debit side some leaderships have lost it and economic and social impacts are emerging. They are worse than we dreamed. I have key, usually short, readings at the end.

Continue reading