Changing Patterns of Emerging Zoonotic Diseases in Wildlife, Domestic Animals, and Humans Linked to Biodiversity Loss and Globalization
A Alonso Aguirre
ILAR Journal,

Volume 58
Issue 3
2017

 Pages 315–318, https://doi.org/10.1093/ilar/ilx035

PDF

Abstract

The fundamental human threats to biodiversity including habitat destruction, globalization, and species loss have led to ecosystem disruptions altering infectious disease transmission patterns, the accumulation of toxic pollutants, and the invasion of alien species and pathogens. To top it all, the profound role of climate change on many ecological processes has affected the inability of many species to adapt to these relatively rapid changes. This special issue, “Zoonotic Disease Ecology: Effects on Humans, Domestic Animals and Wildlife,” explores the complex interactions of emerging infectious diseases across taxa linked to many of these anthropogenic and environmental drivers. Selected emerging zoonoses including RNA viruses, Rift Valley fever, trypanosomiasis, Hanta virus infection, and other vector-borne diseases are discussed in detail. Also, coprophagous beetles are proposed as important vectors in the transmission and maintenance of infectious pathogens. An overview of the impacts of climate change in emerging disease ecology within the context of Brazil as a case study is provided. Animal Care and Use Committee requirements were investigated, concluding that ecology journals have low rates of explicit statements regarding the welfare and wellbing of wildlife during experimental studies. Most of the solutions to protect biodiversity and predicting and preventing the next epidemic in humans originating from wildlife are oriented towards the developed world and are less useful for biodiverse, low-income economies. We need the development of regional policies to address these issues at the local level.

Article Contents
Abstract
Tick-Borne Zoonoses in the United States: Persistent and Emerging Threats to Human Health
Coprophagous Insects and the Ecology of Infectious Disease of Wildlife
Are RNA Viruses Candidate Agents for the Next Global Pandemic? A Review
RVF: Does Wildlife Play a Role?
The Animal Wildlife Act and the Conduct and Publishing of Wildlife Research in the United States
Toward an Ecological Framework for Assessing Reservoirs of Vector-Borne Pathogens: Wildlife Reservoirs of Trypanosoma cruzi across the Southern United States
The Impact of Global Environmental Changes on Infectious Disease Emergence with a Focus on Risks for Brazil
Species Identity Supersedes the Dilution Effect Concerning Hantavirus Prevalence at Sites across Texas and Mexico
References

Zoonoses 3 Prediction and prevention of the next pandemic zoonosis THE LANCET DECEMBER 1, 2012
Stephen S Morse, Jonna A K Mazet, Mark Woolhouse, Colin R Parrish, Dennis Carroll, William B Karesh, Carlos Zambrana-Torrelio, W Ian Lipkin, Peter Daszak
Most pandemics—eg, HIV/AIDS, severe acute respiratory syndrome, pandemic infl uenza—originate in animals, are caused by viruses, and are driven to emerge by ecological, behavioural, or socioeconomic changes. Despite their substantial eff ects on global public health and growing understanding of the process by which they emerge, no pandemic has been predicted before infecting human beings. We review what is known about the pathogens that emerge, the hosts that they originate in, and the factors that drive their emergence. We discuss challenges to their control and new eff orts to predict pandemics, target surveillance to the most crucial interfaces, and identify prevention strategies. New mathematical modelling, diagnostic, communications, and informatics technologies can identify and report hitherto unknown microbes in other species, and thus new risk assessment approaches are needed to identify microbes most likely to cause human disease. We lay out a series of research and surveillance opportunities and goals that could help to overcome these challenges and move the global pandemic strategy from response to pre-emption.


Brazilian Journal of Infectious DiseasesPrint version ISSN 1413-8670On-line version ISSN 1678-4391
Braz J Infect Dis vol.22 no.1 Salvador Jan./feb. 2018
https://doi.org/10.1016/j.bjid.2017.11.003

LETTERS TO THE EDITOR

Zoonotic spillover and emerging viral diseases – time to intensify zoonoses surveillance in Brazil
Joel Henrique Ellwanger1
José Artur Bogo Chies* 1

1Laboratório de Imunobiologia e Imunogenética, Programa de Pós-Graduação em Genética e Biologia Molecular, Departamento de Genética, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil

Dear Editor:
Are we prepared to face newly emerging viral diseases? This question is as recurrent as the emergence of new viruses and the reemergence of neglected infectious diseases. Of note, Central and South America are considered world hotspots for the emergence of new mammalian viral zoonoses.1 Due to the size of its territory, Brazil lies at the center of these hotspots.

Zoonotic Diseases of Public Health Importance - NCDC

https://ncdc.gov.in › WriteReadData › File618

new and emerging zoonotic diseases, like Ebola, Zika Virus Disease and ... Besides serving as a reference book, the ... situation-report-12-02-2016.pdf).

UP TO DATE REFERENCE MANUAL FROM INDIA 2016

A brief guide to emerging infectious diseases and zoonoses
A brief guide to emerging infectious diseases and zoonoses.
1. Communicable Diseases, Emerging
2. Zoonoses – epidemiology – prevention and control.
3. Virus Diseases.
4. Bacterial Infections. 
5. Parasitic Diseases. 
6. Pest Control
ISBN 978-92-9022-458-7(NLM classification: WA 110

© World Health Organization 2014
All rights reserved.Requests for publications, or for permission to reproduce or translate WHO publications – whether for sale orfor noncommercial distribution – can be obtained from SEARO Library, World Health Organization, RegionalOffice for South-East Asia, Indraprastha Estate, Mahatma Gandhi Marg, New Delhi 110 002, India (fax: +91 1123370197; e-mail: searolibrary@who.int).

Bats and Viruses - Journal of Wildlife Diseases

https://www.jwildlifedis.org › doi › pdf

by AT Gilbert - ‎2017 - ‎Related articles

Book reviews express the opinions of the individual authors regarding the value of the book's ... zoonosis. The potential for aerosol transmis- sion of rabies virus from massive aggregations ... the recent popular book Spillover (Quammen.

SPILLOVER: ANIMAL INFECTIONS AND THE NEXT HUMAN PANDEMIC

(PDF) Spillover: Animal Infections and the Next Human ...

https://www.researchgate.net › publication › 279755005_Spillover_Anima...

These diseases can't be well understood. until the principles of zoonotic spillover are. understood. Secondly, a large part of my book is de-. voted to these big ...

AUTHOR INTERVIEW 

THE AUTHOR OF SPILLOVER IS A SCIENCE JOURNALIST
“Intrepid disease ecologists are hiking into forests, climbing through caves,… and sleuthing the mysteries of reservoir host and spillover.” David Quammen
THE ROYAL SCOTTISH GEOGRAPHICAL SOCIETY JOURNAL
Winter 2013 -14 Zoonoses Reservoirs, reasons and the role of viruses • RSGS’s First ‘Explorer-in Residence’ • Zoonotic Geographies – A Multi-Faceted Issue • Viruses, Evolution & Spillover • Living Patterns, Vaccines & Vermin •

Book
 A journey of zoonotic discovery
 Many of the students I teach will no doubt enjoy David Quammen’s Spillover: Animal Infections and the Next Human Pandemic; they are always excited about patients haemorrhaging blood everywhere, there being no cure, and the arguments about what happens next. Quammen’s fast-paced book tracks various zoonotic pathogens across the globe as he tells the contrasting stories of, among others, Hendra virus infection, the viral haemorrhagic fevers caused by Marburg or Ebola virus, severe acute respiratory syndrome (SARS), and HIV/AIDS. Quammen makes it clear from the outset that if we are to halt this epidemic of zoonotic cases we must stop destroying natural ecosystems at a “cataclysmic rate”. And it’s from this perspective that Quammen relates his account of these viruses, making the point that “It’s not that they target us especially. It’s just that we are so obtrusively, abundantly available.” Readers will be enthralled by his tales of tramping into caves looking for bats and pythons and even the odd cobra, or feeding gorillas in central Africa. Quammen does this well, keeping back from the action and documenting his encounters with the experts. We follow the author as he interviews scientists, survivors, and local people in horse farms, jungles, and high-biosecurity laboratories in such countries as Bangladesh, the Congo, and China. As we travel alongside him, we realise that each chapter is essentially a mixture of news and research fi ndings, with interviews and travelogue thrown in.

GUNS , GERMS, AND STEEL

PDF COPY
https://archive.org/details/fp_Jared_Diamond-Guns_Germs_and_Steel

Guns, Germs, and Steel - eScholarship@UMMS

escholarship.umassmed.edu › cgi › viewcontent

PDF

by H Fenigsohn - ‎2011 BOOK REVIEW

Jared Diamond, Guns, Germs, and Steel: The Fates of Human Societies (W.W. Norton &. Company), 1997. Reviewed November 2011 by Harvey Fenigsohn.

DVD

https://www.amazon.com/National-Geographic-Special-Presentation-Germs/dp/0792292553

How coronavirus turned a 'niche market' into a necessity for the world's doctors

Curogram COO: We're seeing unprecedented demand for telemedicine in this crisis

Brooke DiPalma Associate Producer Yahoo Finance 29 March 2020

As coronavirus, or COVID-19, continues to spread with nearly 680,000 confirmed cases worldwide as of Saturday morning, telemedicine is seeing an unprecedented demand as physicians see more patients remotely, according to industry executives.

The COO of Curogram — a HIPAA-compliant online platform that allows patients and doctors to text and meet through a “virtual online clinic” — says his team is “literally” working 20 hours a day amid the increased demand due to the pandemic.

“As you can imagine telemedicine a month ago was a niche market with minimal demand,” Curogram COO Michael Hsu told Yahoo Finance’s The First Trade on Friday. “And overnight it has become a need of every doctor in the country and the world.”
‘We have more than tripled our staff’

Meanwhile, demand for Doxy.me — a free, HIPAA-compliant, product that allows doctors and patients to video chat — has “increased a thousandfold,” according to its founder, Brandon Welch.

“We have more than tripled our staff in the last month,” Welch told Yahoo Finance, in order to meet the demand for doctors to have the “immediate ability” to see their patients remotely.

More doctors may be seeing patients remotely for the foreseeable future. Image: Getty

Due to the contagion of the new virus, countries and cities around the world have implemented mandatory lockdowns, and more and more physicians — as well as psychotherapists — are seeing their patients remotely. The American Medical Association (AMA) has noted that remote health care — either through the phone, email, or other means — can play a major role in giving patients access to care during a pandemic.

Services like Doxy.me and Curogram allow medical professionals and therapists to comply with the Health Insurance Portability and Accountability Act, or HIPAA, which protects patient privacy.

On Friday, President Donald Trump signed a $2 trillion coronavirus stimulus package that makes it easier for doctors to see patients remotely — in part by increasing telehealth coverage under Medicare, according to the AMA.

The American Telemedicine Association commended the bill for increasing access to remote medical care, saying it will provide “much-needed support to America’s health care providers who are migrating patients to virtual care platforms to reduce exposure to COVID-19.”

While telemedicine is particularly crucial during a viral outbreak, Curogram COO Michael Hsu contends the medical industry is seeing a “paradigm shift” with regards to telemedicine that could be long-lasting.

In the future, Hsu says we’ll see a “vast majority of doctors shifting maybe upwards of 25% to even 50% of their volume to telemedicine.” Amid an economic downturn that saw over 3 million jobless claims reported last week, his company is now hiring.

---30---

Britain orders 10,000 ventilators in fight against coronavirus -source

By Costas Pitas Reuters29 March 2020

LONDON (Reuters) - Britain has placed an order for 10,000 ventilators to be made by a consortium of companies including Ford , Airbus and Rolls-Royce as part of efforts to fight the coronavirus, an industry source told Reuters.

Governments around the world are trying to boost the number of ventilators - mechanical breathing devices that can blow air and oxygen into the lungs - available to their health services.

The equipment is crucial for the care of people who suffer lung failure, which can be one of the complications suffered by patients with severe COVID-19, the disease caused by the coronavirus. But they do not necessarily save people.

An announcement is due on Monday, the source said.

British media previously reported the news. A spokeswoman at Prime Minister Boris Johnson's Downing Street office declined to offer an immediate comment when contacted by Reuters.

Britain's publicly funded National Health Service has a little more than 8,000 ventilators at its disposal, senior government minister Michael Gove said on Sunday.

The government is boosting capacity through agreements made with the private sector and overseas suppliers as well as domestic production.

"We've done a deal with (vacuum cleaner company) Dyson, which means that - provided all the appropriate tests are passed - we can have an additional 10,000 ventilators," Gove said.

"There are other companies, from McLaren to Rolls-Royce and others, who are changing the way in which they manufacture in order to join in the national effort to increase the ventilator capacity available."

McLaren said its Formula One car-making, data and electronics operations are fulfilling a number of tasks to help with the crisis, including making components.

"McLaren Automotive is facilitating duplicating and expanding the production of existing devices to meet demand ...(and) is designing bespoke trolleys on which the ventilators are fixed for use in clinical settings."




(Reporting by Costas Pitas; Editing by Louise Heavens and David Goodman)

Trip.com Group Chairman James Liang: Beware the xenophobia epidemic

UNTV News 29 March 2020

SHANGHAI, March 29, 2020 /PRNewswire/ — James Liang is an economist and entrepreneur. Trip.com Group Ltd. is one of the world’s largest OTAs. The following are his thoughts on current events. These opinions are his own, and do not necessarily reflect those of Trip.com Group Ltd. as a whole:

The international outbreak of COVID-19 has been met with encouraging mutual support from many countries, but unfortunately, xenophobia and anti-global tendencies have also become more apparent than ever.

Following the initial outbreak of the virus in Wuhan, countries began to close their borders, and in some places, people of Asian appearance were blamed for allegedly spreading the ‘Chinese virus’. Conversely, during the initial stages of the outbreak in China, one popular theory postulated that the disease was in fact a genetic weapon designed to target Chinese, and Asians more widely.

A month later, as the outbreak continues to spread across Europe and the US, such baseless speculations should cease gaining traction. Similarly, it should be clear by now that the virus does not belong to one country, and that racial profiling should stop, in the same way that over one month ago, residents of Hubei should not have been ostracized in China.

In this crisis, humanity shares a single fate, and to achieve victory, the world must come together to affirm global co-operation, and prevent an ‘outbreak’ of blind xenophobia.

At a time when the world depends on their leadership to affirm solidarity, it is regrettable that some world leaders such as US President Donald Trump have only further stirred negative sentiment, joining fearmongers in making incendiary comments like dubbing the COVID-19 novel coronavirus ‘the Chinese virus’ on Twitter. By the same logic, the 2009 outbreak of H1N1 in North America could’ve been called the ‘American flu’ — but nobody stooped so low as to stigmatize it.

Of course, viruses know no borders, race, or ideology. The World Health Organization (WHO) explicitly named the virus in a neutral manner precisely to avoid discriminatory association with regions, races or classes. The world must be vigilant not to let xenophobia manifest at times like this, when countries should come together to secure a victory for humanity.

Sharing of information

Despite the various stigmas and allegations that have inevitably arisen, and although the health authorities in Wuhan and Hubei Province made various errors of judgment during the initial stages of the COVID-19 outbreak, following the intervention of the central government, China worked to provide information to WHO and the international community as quickly as possible. When the virus was confirmed to be a novel strand of coronavirus, the country ensured that the complete gene sequence, primers and probes were made available internationally. As the containment effort progressed, China shared findings related to epidemic prevention control measures and treatment methods, and held dozens of remote sessions with organizations like WHO, ASEAN, the European Union, and countries including Japan, Korea, Russia, Germany, France and the US. This information would prove to be invaluable to other countries later in the global fight against the pandemic.

Just as some of the world was occupied with heaping the blame on China, commentators in the country were quick to entertain all sorts of international conspiracies. On 29 January, the internationally renowned New England Journal of Medicine published a paper on the initial outbreak in Wuhan, which found that the virus may have been transmitted between humans as early as mid-December 2019, and that as early as 11 January 2020, there were already 200 confirmed cases in Wuhan. This article, co-written by researchers from various institutions including the Chinese Center for Disease Control and Prevention, the Hubei Center for Disease Control and Prevention, and the University of Hong Kong, conducted retrospective analysis on the early stages of the epidemic on the basis of data that was only made available later. Some online commentators questioned whether the authors had intentionally concealed this data in order to secure a publication. But such postulations couldn’t be further from the truth. As epidemiologists argue, availability of information is critical to the effective containment of an outbreak. The publication of this article in an international forum in late January, written on the basis of data that was available at the time, had nothing to do with the fact that the epidemic did not receive the attention that it should have in China in December 2019. In reality, the timely publication of these papers was conducive to ensuring that the outbreak received due attention in the international community, and that effective measures were able to be formulated.

Recently, following effective containment of the epidemic in China, the country shared its findings with the world so that other countries would benefit, and a global victory could be secured. For example, shortly after WHO designated the outbreak as a pandemic, a forum that brought together 60 countries and WHO was held in Beijing, at which Chinese experts shared their findings in the earlier stages of epidemic control. Having effectively contained the outbreak at home, China has demonstrated a strong willingness to contribute to securing a global victory in the fight against the COVID-19 outbreak, in the same way that others came to its assistance in its moment of need.

Developing a cure

Experts argue that medicines and vaccines for the virus are the greatest hopes for humanity to achieve a victory in the fight against COVID-19, and there have been a number of international developments in this regard.

The most prominent development thus far is Radixivir, a drug developed by US biotechnology company Gilead Sciences, which has produced encouraging preliminary results in a 14-patient clinical trial held in Japan, in which most patients recovered. Although randomized double-blind controlled trials are needed for conclusive results, due to the urgent need for treatment, Gilead is expected to produce sufficient supply to support treatment worldwide in the near future.

On 16 March, a China-developed COVID-19 vaccine proceeded to the trial stage for the first time. On the same day, the US National Institute of Allergy and Infectious Diseases announced that a US-developed vaccine for COVID-19 had also entered the first stage of clinical trials, and that volunteers had already begun to receive experimental injections. Germany, the UK, France, Japan, Israel and other countries have also been working as part of an international effort to develop a vaccine for the virus.

The timely development of a safe and effective vaccine is of top priority for prevention of widespread COVID-19 infection. Only through working together can countries have confidence in these new medical developments and beat the virus.

Providing support

In the early days of the outbreak in China, masks were a scarce commodity. In response, Japan, South Korea and others, sent medical masks and protective clothing to the country. Packages from Japan with words of encouragement drawn from Chinese poetry were well-received online, and became a symbol of mutual support between countries in the fight against the epidemic.

By March, however, when the number of new cases across many Chinese provinces had reached nil, the number of diagnoses outside China had quickly grown to exceed the total number of cases within China, and various countries began to experience similar shortages of medical supplies. In response, China transitioned from the role of beneficiary to benefactor. In addition to government support, international enterprises based in the country made significant contributions. Trip.com Group donated 1 million masks to various countries including Japan, South Korea and Italy, and the Alibaba Foundation donated masks, protective clothing and test kits to 54 countries in Africa. These donations were significant not only in terms of their material value, but as symbols of the determination and willingness of international enterprises and society to support other countries in overcoming this common challenge.

In addition to medical essentials, China also reciprocated the support it received earlier from other nations by sending teams of medical experts to countries and regions severely affected by the outbreak to assist with prevention and control. On 12 March, medical experts from the National Health Commission and the Chinese Red Cross arrived in Rome with 31 tons of medical supplies to support Italy in the fight against the epidemic, after having already sent support teams to Iran and Iraq.

Experts will agree that with the support of other countries, China achieved encouraging results in containing the outbreak. Now, the country has much to share in terms of both resources and findings, and has expressed a willingness to contribute to a global solution to the outbreak.

Improving screening and quarantine

In the early stages of the epidemic, many countries implemented entry restrictions for Chinese nationals. As the situation begins to improve in China and worsen in other parts of the world, the country has introduced stricter quarantine policies for travelers arriving from abroad, to prevent a second outbreak in the country. On 16 March, for example, Beijing city implemented a policy requiring all international arrivals, regardless of origin and nationality, to quarantine at designated locations at their own expense for 14 days. Shanghai also announced regulations requiring all international arrivals with recent travel history in heavily affected countries and regions, which are updated according to the latest available information, to quarantine for 14 days.

Economists have argued that the measures taken in Shanghai are more precise and conducive to allowing life to return to normal, and ultimately, containing the outbreak without causing unnecessary damage to the economy. Countries must work together, not alone, to prevent a second outbreak. Concerns to do with false reporting could be addressed by working with international telecommunications companies to verify the travel history of travelers, developing an international system on the basis of the ‘health code’ currently in use in China. More precise identification of at-risk travelers would also allow restrictions to be opened up for countries and regions with comparatively better epidemic control (for example, Japan, Singapore, Hong Kong, Macao and Taiwan). This would serve to reduce obstacles to daily life, business and exchanges, as well as concentrating the use of relatively limited resources on the isolation of areas with material risk.

Conclusion

Once seamless and frequent exchanges have been disrupted by the pandemic, and the impacts of these disruptions may very well be as significant as the epidemic itself. This experience is also a wake-up call. Having unprecedented restrictions placed on communications and exchanges has forced many of us to search for alternatives where we might not have otherwise.

The barriers to exchange that have been imposed upon us in this desperate time should also serve as a sobering reminder that there remain various self-imposed, and unnecessary barriers to productive exchange between countries, which we should alleviate. As economists have argued for some time, breaking down the various barriers to trade between the US and China, and ensuring that key channels for information sharing and communications such as the Internet remain open are imperative to ensuring the future of the world economy.

Unfortunately, in the same way that entry-exit restrictions made travel virtually impossible, experts have argued that the so-called ‘Great Firewall of China‘ has continued to serve as a significant hurdle to important international exchanges. With unprecedented restrictions on movement and contact worldwide, and scores of people taking temporary refuge in their home countries, alternative digital avenues for cross-border communications have a determining role to play in allowing economic activity to continue, and it is critical that these are not hindered by unnecessary restrictions. Students shouldn’t have to worry about being unable to access their university’s official website due to the Internet restrictions of the ‘Great Firewall’, for example.

Under the impetus of the present epidemic, a failure to address these evident pitfalls runs the risk of sending globalization backwards.

During times like these, the importance of international co-operation becomes apparent. When China faced the initial outbreak, many countries extended a helping hand, and now that the epidemic has been brought under control, China has reciprocated by offering its findings and resources to help other countries overcome this common challenge. Our actions in this epidemic determine not the fate of a single country, ethnicity, or ideology, but of the human race.

Viruses are the common enemy of humanity. The present epidemic has given us a chance to reflect deeply on the true meaning of a common destiny for all of humanity, and brought the pitfalls of present to our immediate attention. Countries will need to work together closely to respond to the challenges that we collectively face, and to break down the barriers to exchange that still exist. Only then can we truly secure a victory for humanity.

Logo – https://photos.prnasia.com/prnh/20191111/2638489-1-LOGO?lang=0

Related Links :

http://www.ctrip.com

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Pressure to provide equipment grows after two UK doctors die

Robert Booth, Denis Campbell and Matthew Weaver The Guardian 29 March 2020



The deaths of the first British doctors from Covid-19 have intensified pressure on ministers to accelerate the supply of protective equipment and address growing fears among frontline staff that they risk catching and spreading coronavirus.

As the UK’s death toll from the virus rose to 1,228 over the weekend, two surgeons were confirmed to have died in what the NHS medical director described as “a stark reminder to the whole country that we all must take this crisis seriously”.

Amged El-Hawrani, a 55-year-old ear, nose and throat consultant, died on Saturday at Leicester Royal Infirmary, while Adil El Tayar, 63, an organ transplant specialist, died on Wednesday at West Middlesex University Hospital in London, it emerged. Both had contracted Covid-19.

As they mourned the death of their colleagues, doctors’ and nurses’ groups attacked continuing shortages of protective equipment – from masks to gowns – and complained that there was still confusion despite fresh official guidance about their proper use. There were further calls to ramp up testing of NHS workers.

Jenny Harries, deputy chief medical officer, said fatalities were expected to increase. With Britain beginning its second full week under effective lockdown, she indicated that normal life was not likely to resume for three to six months – and “it is plausible it could go further than that”, she cautioned.

What do the restrictions involve?
People in the UK will only be allowed to leave their home for the following purposes:Shopping for basic necessities, as infrequently as possibleOne form of exercise a day – for example a run, walk, or cycle – alone or with members of your householdAny medical need, to provide care or to help a vulnerable personTravelling to and from work, but only where this is absolutely necessary and cannot be done from home
Police will have the powers to enforce the rules, including through fines and dispersing gatherings. To ensure compliance with the instruction to stay at home, the government will:Close all shops selling non-essential goods, including clothing and electronic stores and other premises including libraries, playgrounds and outdoor gyms, and places of worshipStop all gatherings of more than two people in public – excluding people you live withStop all social events, including weddings, baptisms and other ceremonies, but excluding funerals
Parks will remain open for exercise, but gatherings will be dispersed.

On Monday, the public was asked to stop all non-essential travel, work from home if possible, and limit exercise to once a day, with a ban of gatherings of more than two people. All pubs, restaurants, cafes, cinemas and gyms have been told to close.

Harries said: “Over time – probably over the next six months – we will have a three-week review, we will see where we’re going. We need to keep that lid on and then gradually we will be able to hopefully adjust some of the social distancing measures and gradually get us all back to normal.

“So I think three weeks for review. Two or three months to see whether we’ve really squashed it, with about three to six months ideally, and lots of uncertainty in that, but then to see at which point we can actually get back to normal. It is plausible that it could go further than that.”

Harries described El-Hawrani’s death as “a worrying event”, adding: “It is in no one’s interests that we lose our colleagues.” Stephen Powis, NHS national medical director, said his death was “not just an individual human tragedy, but a stark reminder to the whole country that we all must take this crisis seriously”. Pradeep Kumar, a surgeon, said he was angry at the loss of his friend. “Did it have to be this way?” he said. “Such a waste of precious life.”

Tayar had spent his final days volunteering to stem the outbreak in an A&E department in the Midlands. “He wanted to be deployed where he would be most useful in the crisis,” his cousin, British-Sudanese journalist Zeinab Badawi, said.

Symptoms are defined by the NHS as either:a high temperature - you feel hot to touch on your chest or backa new continuous cough - this means you've started coughing repeatedly
NHS advice is that anyone with symptoms should stay at home for at least 7 days.

If you live with other people, they should stay at home for at least 14 days, to avoid spreading the infection outside the home.
After 14 days, anyone you live with who does not have symptoms can return to their normal routine. But, if anyone in your home gets symptoms, they should stay at home for 7 days from the day their symptoms start. Even if it means they're at home for longer than 14 days.
If you live with someone who is 70 or over, has a long-term condition, is pregnant or has a weakened immune system, try to find somewhere else for them to stay for 14 days.
If you have to stay at home together, try to keep away from each other as much as possible.
After 7 days, if you no longer have a high temperature you can return to your normal routine.
If you still have a high temperature, stay at home until your temperature returns to normal.


If you still have a cough after 7 days, but your temperature is normal, you do not need to continue staying at home. A cough can last for several weeks after the infection has gone.

Staying at home means you should:not go to work, school or public areasnot use public transport or taxisnot have visitors, such as friends and family, in your homenot go out to buy food or collect medicine – order them by phone or online, or ask someone else to drop them off at your home
You can use your garden, if you have one. You can also leave the house to exercise – but stay at least 2 metres away from other people.
If you have symptoms of coronavirus, use the NHS 111 coronavirus service to find out what to do.
Source: NHS England on 23 March 2020

Boris Johnson, who continues to suffer “mild symptoms” of Covid-19, released a video on Sunday night announcing that 20,000 former NHS workers had returned to the frontline, up from 7,500 on Monday.

At least 2,660 doctors have heeded the call to return from retirement to fight the pandemic, but hundreds have warned that they will not do so or increase their hours unless they are guaranteed proper compensation if they die, the Guardian has learned.

The families of doctors who leave the NHS pension scheme are not normally paid death-in-service compensation, which is worth over two years’ salary. The department of health and social care said it was “considering proposals to offer further support for those returning to the frontline”.

With supplies of personal protective equipment (PPE) becoming the key concern for frontline health workers, Robert Jenrick, the communities secretary, insisted that he understood the urgent need for protection.

At the the daily government press conference, he said over 200m items of protective kit had been delivered so far, including 170m masks, 42.8m gloves, 13.7m aprons, 2.3m pairs of eye protectors and 182,000 gowns to 58,000 “healthcare settings”, including hospitals and GP surgeries.

Addressing “all those who rely on this equipment, and their families and loved ones”, Jenrick said: “We will not stop until we have got you the equipment you need.”

NHS England and Public Health England (PHE) have acknowledged there had been distribution and supply problems. In a letter sent on Saturday to hospitals, GPs and commissioning bodies, their leaders said they were “now confident that all logistical issues are being solved and that every part of the NHS that needs PPE will be supplied in good time with adequate stock”.

But Chaand Nagpaul, chair of the British Medical Association council, said: “The reality is that [PPE is] still not reaching hundreds, if not thousands, of frontline staff on the ground – with current reports from around the country from doctors that supplies are running out, being rationed or of inadequate protection.

“We already have many doctors telling us that they’re extremely concerned that they feel the level of PPE that they currently have is not adequate to protect themselves and their colleagues against Covid-19 … Doctors here will understandably be concerned when they see images in the media of their colleagues around the world treating patients in full overalls and full face protection, and asking why the same is not recommended or available here.”

Guidance issued over the weekend by NHS England and PHE about how the equipment should be used also diverges from World Health Organization (WHO) guidelines, doctors said. It instructs frontline workers to use goggles in procedures most likely to generate virus-carrying aerosols, such as inserting a breathing tube.

It states that aprons rather than disposable full-sleeve gowns can be worn in other cases. The British Medical Association said this differs from WHO guidance on gowns and goggles for all healthcare workers dealing with suspected or confirmed coronavirus cases.

Nurses said the latest official guidance about personal protection “lacks any credibility”. “Every minute we wait for new guidance is a minute too long,” said Dame Donna Kinnair, Royal College of Nursing general secretary. “The confusion must stop. We need action.”

NHS England said it was reviewing the guidance and would issue new instructions on what equipment to wear in what circumstances in the coming days.

Dr Claudia Paoloni, president of HCSA, the hospital doctors’ union, said there was no “luxury of days”. “Royal Colleges have been taking matters into their own hands with reinterpretations of the guidance, which is causing confusion and contradiction on the ground,” she said. “Some trusts have broken ranks and rightly introduced more stringent measures. The rate at which the disease is progressing means the government and PHE need to get on top of this, and quickly.”

Two hundred and nine fatalities from coronavirus were announced in the UK on Sunday. The increase was smaller than feared, but health experts cautioned against seeing any glimmer of hope.

The Department for Health and Social Care announced that 19,522 people had tested positive for the disease in the UK, following another 6,961 tests in the last day. That testing rate is short of the 10,000 tests the government has promised and well short of the 25,000 tests a day that Boris Johnson promised.

The former prime minister Tony Blair joined the former health secretary, Jeremy Hunt, in calling for ramping up testing for the virus. Speaking on Sky News, Blair said: “It is all about getting to mass testing as fast as possible, because we have to know who has the disease and who has had the disease in order to get the lockdown eased and get people back to work.”

ICU Eyewear and Contour Optik Heed the Call and Expand Production Capacity to Hundreds of Millions of PPE and COVID-19 Test Kits

Business Wire 29 March 2020



Available to Hospitals, States and Government Agencies

The Companies are also Donating 100,000 Face Masks and 50,000 Face Shields in California

ICU Eyewear (ICU), in partnership with Contour Optik, has pivoted its production resources to meet our country’s urgent need for Personal Protective Equipment (PPE) and COVID-19 test kits. Nationwide demand for PPE has far exceeded supply, putting healthcare workers and other essential service providers at risk. ICU has significant capacity, resources and relationships in the medical supply industry, and protection for healthcare providers is ICU’s top priority. Bottom Line: ICU has the ability to supply bulk quantities of PPE now.

This press release features multimedia. View the full release here: https://www.businesswire.com/news/home/20200329005025/en/

"We are working with our partner companies in China to assist them in going through the FDA regulatory process. 

https://plawiuk.blogspot.com/2020/03/rushed-production-netherlands-recalls.html

This ensures that our products meet U.S standards so they can be imported and placed into the hands of the providers who need them," says ICU CEO Kirk Hobbs.


ICU is able to produce and ship the following in mass quantities:

- N95 face masks
- KN95 (Emergency Use Authorization from the FDA for the KN95 is underway)
- ASTM Levels 1, 2, and 3 face masks
- Goggles, face shields, gloves and other protective equipment

For example, ICU can manufacture KN95’s at a rate of 1 million per day, and ASTM Levels 1 and 2 face masks at a rate of over 5 million per day.



ICU is also North America’s exclusive agent for Mole Bioscience. Together we are working to get COVID-19 test kits to market as quickly as possible. The FDA’s requisite EUA process is underway and once that approval is granted, tests will be available immediately.

"ICU and Contour are pleased to be donating a total of 100,000 masks and 50,000 face shields to medical organizations in underserved communities throughout the state of California in this time of great need," added David Chao, Contour Optik chief executive officer.

About ICU/Contour Optik Partnership

ICU Eyewear is a California-based company that has been in business for 20+ years. We are an FDA-certified supplier of eyewear focused on the retail channel with customers including Target, Whole Foods and Office Depot.

Given the need for PPE (Personal Protective Equipment) due to the Covid-19 epidemic, we have focused significant resources on the production, importation and distribution of PPE and Covid-19 test kits. We are able to support the emergency demand for these materials in the United States because Contour has specialized knowledge and experience in the production of PPE. It was drafted by the Chinese government to produce surgical goggles and face shields during the peak of their own COVID-19 crisis. As a member of the consortium of companies called upon to produce PPE for the Chinese outbreak, Contour developed connections and relationships throughout the Chinese PPE supply-chain. Contour and ICU have developed supply relationships with key manufacturers for all of the PPE items, and are currently taking purchase orders and delivering.

Contact information:

Sales and bulk orders:

KelleyJonesICU@gmail.com or

ErikaMueckeICU@gmail.com

For product specific information visit www.icueyewear.com/ppe.

View source version on businesswire.com: https://www.businesswire.com/news/home/20200329005025/en/