Billions for pipelines in a pandemic?

350.ORG
Tue, Mar 31, 2020
Friends,

Today, I was filled with rage after waking up to the news that Jason Kenney is handing over a billion dollars to the Keystone XL pipeline in the midst of a global pandemic.1
The announcement comes just two days after he laid off 26,000 public education workers on a Saturday afternoon.

Then, a couple of hours later during his daily press conference, Justin Trudeau defended the continued construction of the TransMountain pipeline.2 While telling millions of Canadians to stay at home to stop the spread of COVID-19, he had the nerve to justify cramming thousands of oil workers into man camps on unceded Indigenous lands.

Let’s be clear. There is no way that either of these projects can be built without risking further spread of COVID-19 to workers, rural communities, and the Indigenous nations whose territories they pass through.

To top it all off, these decisions to prop up oil and gas companies are coming not only at a time when oil is worth next to nothing, but at a time when hundreds of thousands of people are worried about paying their April 1st rent and while health care workers across the country are struggling to get the equipment they need to protect themselves.

Right now, millions of people across Alberta, Canada, and around the world are stepping up to have each others’ backs, and we expect our governments to do the same. But instead of supporting working people, they’re making the shameful decision to bail out Big Oil billionaires.


That’s why we’ve published 5 principles for a just recovery from COVID-19. Sign onto them here to speak up in support of providing relief to people, workers and communities not fossil fuel companies.


I honestly can’t say what went through Jason Kenney or Justin Trudeau’s minds when they made their respective decisions.


I do know that we can’t make it out of this crisis by worsening the compounding crises of climate change and economic inequality. When I talk to my family, friends, and neighbours, they all agree — priority number one right now must be to save lives and help one another through this pandemic.


If you agree, add your name to the 5 principles for a just recovery from the COVID-19 pandemic.


Together, we can make it through this,
Emma

References:


1. TC Energy to proceed with Keystone XL pipeline after US$1.1 billion investment from Alberta government

2. National Post: Construction on Trans Mountain pipeline goes on, company says, as First Nations concerned over COVID-19 risks



Keystone XL Oil Pipeline Gets Go-Ahead After Alberta Puts Up $1.1 Billion

Kevin Orland,Bloomberg•March 31, 2020



(Bloomberg) -- North America’s most infamous oil pipeline project just got a surprise $5.3 billion financial aid package from Alberta as the Canadian province fights to rescue its battered oil-sands industry.

Keystone XL, which for years has faced court challenges and environmental opposition in the U.S., will get a $1.1 billion investment and a $4.2 billion loan guarantee from Alberta to help TC Energy Corp. build the line to the U.S. Gulf of Mexico. The Calgary-based pipeline giant said it will invest the remaining $2.7 billion.

Once touted by Canada as a key step to turn the country into an energy superpower, the project counted celebrities like Mark Ruffalo and Daryl Hannah among foes who pressured the Obama administration to block it.

Approval from President Donald Trump years later came at a time when investing in the project was far from certain as the Canadian oil industry was cutting costs, competing output from U.S. shale fields abounded and hurdles at state levels emerged.

The move to start construction now, when the crude market has crashed and the project still faces roadblocks in the U.S., shows how critical the fight for the oil industry’s survival has become in Alberta, home to the world’s third-largest crude reserves. The province’s benchmark crude is trading at a record low of $4.09 a barrel.

A shortage of pipeline capacity in the landlocked Canadian province has weighed on local crude prices and restrained producers’ ability to increase output long before the recent oil market collapse. The Covid-19 pandemic and a battle for market share between Saudi Arabia and Russia have further darkened the outlook.

“This investment in Keystone XL is a bold move to re-take control of our province’s economic destiny,” Alberta Premier Jason Kenney said in a statement. Kenney said Alberta would plan to sell its shares to TC at a profit after the project is completed and estimated that Keystone XL would help provide C$30 billion in tax and royalty revenues for the province over the next 20 years.

TC Energy, previously known as TransCanada, rose 6.3% to C$61.94 at 12:22 p.m. in Toronto. The shares had dropped 16% this year through Monday amid a broader meltdown in global equity markets.

Moody’s Investors Service changed the credit outlook for TC to negative from stable on Tuesday, citing the added risks of building Keystone XL. The credit rating firm said the project’s construction could be disrupted by “demonstrations and civil unrest” as well as ongoing legal and regulatory challenges. Political risks could lead the project’s outright cancellation, the firm said.

“The negative outlook reflects the very high level of execution risk related to the environmental, social and governance factors associated with the Keystone XL pipeline project,” Gavin McFarlane, a Moody’s vice president and senior credit officer, said in a note.

Moody’s rates TC’s debt Baa2, the second-lowest investment grade.

When Keystone XL enters service in 2023, the 1,200-mile (1,900-kilometer) conduit will help carry 830,000 barrels of crude a day -- more than last month’s daily production from OPEC member Venezuela.

Among obstacles still facing TC Energy before Keystone XL can be completed, environmental organizations and indigenous groups are challenging the project in U.S. District Court in Montana.

The U.S. presidential election in November also could pose a threat to the project, with much of the Democratic party opposed to the pipeline. Former U.S. President Barack Obama rejected a key permit for Keystone XL in 2015, bringing the pipeline to a halt, but President Donald Trump revived the project by reversing that decision early in his term.

The project has gathered momentum in recent months. The U.S. Interior Department in January authorized construction across a swath of federal land in Montana, and TC Energy had announced plans to move ahead with pre-construction work on the line this year.

Keystone XL already has 20-year agreements to transport 575,000 barrels of crude per day, and contracts for 115,000 barrels of capacity on the existing Keystone line will shift to the new facilities under renewed 20-year contracts once Keystone XL enters service, TC Energy said Tuesday.

“Strong commercial and financial support positions us to prudently build and fund the project,” TC Energy Chief Executive Officer Russ Girling said in a statement.

©2020 Bloomberg L.P.


Disputed Canada-US oil pipeline work to start in April

MATTHEW BROWN, Associated Press•March 31, 2020

Keystone XL Pipeline
FILE - In this Oct. 29, 2019 file photo, opponents of the Keystone XL oil pipeline from Canada demonstrate in sub-freezing temperatures in Billings, Mont. Alberta is investing $1.1 billion in the disputed Keystone XL pipeline, a project that Alberta Premier Jason Kenney says is crucial for the province's economy. (AP Photo/Matthew Brown, File)
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BILLINGS, Mont. (AP) — A Canadian company said Tuesday it plans to start construction of the disputed Keystone XL oil sands pipeline through the U.S. Midwest in April, after lining up customers and money for a proposal that is bitterly opposed by environmentalists and some American Indian tribes.

Construction would begin at the pipeline's border crossing in Montana, said TC Energy spokesman Terry Cunha. That would be a milestone for a project first proposed in 2008.

The announcement came after the company secured $1.1 billion in financing from the Canadian provincial government of Alberta to cover construction through 2020 and agreements for the transport of 575,000 barrels of oil daily.

Despite plunging oil prices in recent weeks, Alberta Premier Jason Kenney said the province's resource-dependent economy could not afford for Keystone XL to be delayed until after the coronavirus pandemic and a global economic downturn have passed.

“This investment in Keystone XL is a bold move to retake control of our province's economic destiny and put it firmly back in the hands of the owners of our natural resources, the people of Alberta," Kenney said.

A spokeswoman for Montana Gov. Steve Bullock said he had been in contact with Kenney to raise concerns over an estimated 100 workers coming into the state for the line's construction. Bullock said that could further strain rural health systems facing the coronavirus.

“TC Energy holds a tremendous responsibility to appropriately manage or eliminate this risk and we will continue to monitor the plans for that response," Bullock spokeswoman Marissa Perry said.

There was only one confirmed infection as of Friday from eastern Montana counties along the line's route, but the virus has been spreading in rural areas in recent days.

Company representatives said they would follow the guidance of government and health authorities to determine the best way to keep construction crews and the public safe.

The pipeline was rejected twice by the administration of President Barack Obama over worries it could make climate change worse. President Donald Trump has been a strong proponent of the $8 billion project and issued it a permit that environmentalists say was illegal.

A court hearing in the permit dispute is set for April 16 before U.S. District Judge Brian Morris in Great Falls. Morris has previously ruled against the project.

The company has previously said it also plans in April to begin work on camps where pipeline construction workers would live in Fallon County, Montana and Haakon County, South Dakota.

The company said the 1,200-mile (1,930-kilometer) pipeline would start sending oil to the U.S. in 2023. It's designed to move up to 830,000 barrels (35 million gallons) of crude daily at from the oil sand fields of western Canada to Steele City, Nebraska, where it would connect to other pipelines that feed oil refineries on the U.S. Gulf Coast.

Opponents in January asked Morris to block any work. They said clearing and tree felling along the route would destroy bird and wildlife habitat. Native American tribes along the pipeline route have said that the pipeline could break and spill oil into waterways like Montana's Missouri River.

The judge in December had initially denied a request from environmentalists to block construction because no work was immediately planned.

TC Energy filed reports with court in recent weeks declaring its intentions to start work.

“At this time, we are continuing with our planned activities and will adjust if it becomes necessary," Cunha said.

The remaining $6.9 billion in construction costs is expected to be funded through a $4.2 billion loan guaranteed by the Alberta government and a $2.7 billion investment by TC Energy.

Once the project is complete, TC Energy expects to buy back the Alberta government's investment and refinance the $4.2 billion loan.

"We thank U.S. President Donald Trump and Alberta Premier Jason Kenney as well as many government officials across North America for their advocacy without which, individually and collectively, this project could not have advanced," TC Energy chief executive Russ Girling said in a statement.

A representative of the Sierra Club said the decision to push forward with the project amid the coronavirus pandemic was “a shameful new low" for the company. Pipeline opponents contend workers could inadvertently spread the virus to rural areas with limited health care services.

“By barreling forward with construction during a global pandemic, TC Energy is putting already vulnerable communities at even greater risk," said the Sierra Club's Catherine Collentine. “We will continue to fight to ensure this dangerous pipeline is never completed."

Opposition to another pipeline built through the region several years ago, the Dakota Access Pipeline, culminated in months of protests, sometimes violent, near the Standing Rock Sioux Reservation that straddles the North Dakota-South Dakota state line.

Lawmakers in some states have sought to curb the possibility of similar protests against Keystone XL.

South Dakota Gov. Kristi Noem successfully pushed a legislative measure to revive the state's criminal and civil penalties for rioting and inciting a riot, drawing demonstrations from groups opposed to the pipeline. The law she signed last week enacts criminal and civil penalties for people who “urge” force or violence.

Noem said she spoke with TC Energy on Monday and did not expect construction to begin in South Dakota until the summer.

Another oil pipeline in TC Energy’s Keystone network in October spilled an estimated 383,000 gallons (1.4 million liters) of oil in eastern North Dakota.

Critics have said a damaging spill from Keystone XL is inevitable given the length of the line and the many rivers and other waterways it would cross beneath.
___
Associated Press writers Stephen Groves contributed from Sioux Falls, South Dakota and Rob Gillies from Toronto.

Preliminary research describes method to disinfect badly needed respirators

by Bill Hathaway, Yale University
 

Credit: CC0 Public Domain

Vaporized hydrogen peroxide can disinfect respirator masks used by health care workers treating patients infected with COVID-19 virus, according to preliminary findings by Yale researchers.

Although researchers did not test for its ability to disinfect COVID-19, a device that circulates vaporized hydrogen peroxide and commonly used to disinfect hospital rooms can clear three types of viruses placed on N95-respirators, found the study, now in expedited peer review.

These respirator masks offer state-of-the art protection against infection for health care workers, and are in extremely high demand in pandemic-stricken regions of the country. But after use, they can harbor viral particles, and can potentially infect health care workers.

The device, made by the international firm Bioquell, is in use in some hospitals for sanitizing rooms where patients with highly infectious diseases have been treated.
In theory, thousands of respirator masks could be cleansed of pathogens daily in dedicated areas of a hospital by using vaporized hydrogen peroxide, the authors say.

The study was conducted at Yale New Haven Hospital by Yale's Patrick Kenney, assistant professor of urology; Richard Martinello, associate professor of medicine (infectious diseases) and pediatrics; and Benjamin Chan, research scientist in ecology and evolutionary biology. It has been posted on MedRxiv, a site that posts unpublished research from scientists.

The site cautions that research posted there should not be used to inform clinical-care decisions until published in a peer-reviewed journal. Kenney said he hopes that expedited approval for publication will come within the next few daysFollow the latest news on the coronavirus (COVID-19) outbreak

More information: Patrick Kenney et al. Hydrogen Peroxide Vapor sterilization of N95 respirators for reuse, (2020). DOI: 10.1101/2020.03.24.20041087

More evidence COVID-19 survivors' blood could help very ill patients

by Amy Norton MARCH 31, 2020


A small study out of China bolsters the notion that transfusing the antibody-enriched blood of people who've survived COVID-19 could help patients still fighting for their lives against the disease.

The study of five critically ill patients from near the initial epicenter of the novel coronavirus pandemic found that all five patients survived COVID-19 following the transfusion.

If the findings are replicated in larger trials, widespread use of the treatment "could help change the course of this pandemic," wrote Drs. John Roback and Jeannette Guarner of Emory Medical Laboratories, affiliated with Emory University in Atlanta.

Roback and Guarner wrote an editorial accompanying the new Chinese study, which was published online March 27 in the Journal of the American Medical Association.

Despite the fact that tens of thousands of people have died from COVID-19 around the world, the vast majority—about 85%—of cases are actually asymptomatic or mild, similar to a cold or flu. But people who pass through COVID-19 relatively unharmed acquire a powerful immunological legacy: Antibodies in their blood that can recognize and attack the new coronavirus.

There are currently no drugs or vaccines to help fight COVID-19. However, early in the pandemic, doctors understood that blood donations from survivors might help protect or treat other people, according to some infectious disease experts.

The notion is far from new. In the first half of the 20th century, doctors used "convalescent serum" in an effort to treat people during outbreaks of viral infections like measles, mumps and influenza—including during the 1918 Spanish flu pandemic.

The principle is fairly simple: When a pathogen invades the body, the immune system produces antibodies that latch onto the enemy, marking it for destruction. After recovery, those antibodies remain circulating in a person's blood, for anywhere from months to years.

In theory, transferring some of those antibodies to other people with the same virus could help their bodies fight it off. Or, given to healthy people—like the health care workers on the front lines—the antibodies might offer some temporary protection from infection.


A long history in medicine
In the midst of the COVID-19 pandemic—with no vaccine or antiviral drug coming soon—antibodies from recovering patients could provide a "stopgap" measure, according to Drs. Arturo Casadevall and Liise-anne Pirofski. It's an approach called "convalescent serum."

Casadevall, of the Johns Hopkins School of Public Health in Baltimore, and Pirofski, of Albert Einstein College of Medicine in New York City, laid out their case in the March 16 online edition of the Journal of Clinical Investigation.

For one, the authors pointed out, convalescent serum is not a thing of the past. It has been tried in limited numbers of patients during more-recent viral crises, including the 2003 SARS (severe acute respiratory syndrome) epidemic, the 2009 "swine flu" epidemic, and the 2012 outbreak of MERS (Middle East respiratory syndrome).

Reports on those attempts indicate the antibody treatment generally reduced the severity of patients' illnesses and improved survival.

"In addition to public health containment and mitigation protocols, this may be our only near-term option for treating and preventing COVID-19," Casadevall said in a statement from Johns Hopkins. "And it is something we can start putting into place in the next few weeks and months."

The new Chinese study offers more evidence that convalescent serum works.

The research was led by Dr. Yingxia Liu, of a hospital affiliated with the Southern University of Science and Technology in Shenzhen, China, near the city of Wuhan, where the COVID-19 pandemic began.

Liu's team focused on the plight of five extremely ill patients who required mechanical ventilation in the intensive care unit to breathe. They had also received antiviral medications and other drugs.

Desperate to save them, physicians transfused the donated blood of COVID-19 survivors into the very sick patients. Within just three days, fever began to subside in four of the five patients, there was a reversal in their progression to organ failure, viral loads fells, and by 12 days after the transfusion, four of the patients had recovered from acute respiratory distress syndrome (ARDS), which so often proves fatal to patients.

As of the end of March, three of the patients have been discharged from the hospital, the Chinese authors said, and the other two are now in stable condition.

First U.S. patients being treated

Use of convalescent serum "is a good idea. It's something that's been used before, and we know how to do it," said Dr. Gregory Poland, who heads the Vaccine Research Group at the Mayo Clinic, in Rochester, Minn.

That's not to say doctors can just start doing it. "You still have to go through the FDA," Poland said, referring to the U.S. Food and Drug Administration.

Now, Houston Methodist hospital in Texas announced that it has "received FDA approval Saturday to become the first academic medical center in the nation to transfuse donated plasma from a recovered COVID-19 patient into a critically ill patient."

The transfusion occurred Saturday evening, the hospital said in a news release.

The treatment is also being planned for use by doctors elsewhere. In New York City earlier this week, Governor Andrew Cuomo said that recruitment will soon begin for plasma donations from COVID-19 survivors, and initially would focus on the New York City suburb of New Rochelle, N.Y., which has been hit hard by the outbreak.

Also, New York hospital system Mount Sinai, in collaboration with the state's Blood Center and Department of Health, said trials in the technique could begin as early as the beginning of April.

Doctors' experience with the general approach is not limited to viral pandemics, Poland pointed out. They routinely use injections of immune globulin—purified antibody preparations taken from donated human blood—to treat certain medical conditions.

In addition, modern blood-banking techniques, which screen for infectious agents, should ensure any such tactic against COVID-19 would be as safe as a standard blood transfusion, Poland said.

Maintaining safety

Standard protocols will be needed, including logistic matters like coordination among local doctors, blood banks and hospitals, according to Casadevall.

"We'll have to put protocols in place to make sure that the use of this sera [blood] is safe," Casadevall said. But, he added, "we're not talking about research and development—this is something that physicians, blood banks, and hospitals already know how to do and can do today."

Dr. Bruce Y. Lee is a professor of health policy management at City University of New York. He said the convalescent serum idea is "certainly worth exploring."

"We're in a situation where the toolbox is pretty empty," Lee said.

Both he and Poland pointed to some key unknowns, including: How long do antibodies against this novel virus last? What amount of antibody would be necessary to help treat the infection or offer some protection?

What is clear is that any protection would be temporary. "This would not replace a vaccine," Lee stressed. Vaccines, he noted, work by training the immune system to launch its own response to an invader, which involves more than antibodies.

And what about people who've recovered from COVID-19? Are they immune to it, at least for a while? There have been reports from China and Japan of patients being declared infection-free then testing positive again.

However, Poland said those cases probably reflect an issue with the testing. "I don't think they represent re-infections," he said. "That would be highly unusual."


Explore furtherFollow the latest news on the coronavirus (COVID-19) outbreak
More information: The World Health Organization has updates on COVID-19.

China's control measures may have prevented 700,000 COVID-19 cases: study

by Pennsylvania State University

Credit: CC0 Public Domain

China's control measures during the first 50 days of the COVID-19 epidemic may have delayed the spread of the virus to cities outside of Wuhan by several days and, by interrupting transmission nationwide, prevented more than 700,000 infections across the country, according to an international team of researchers. The findings, published today (March 31) in the journal Science, could be useful to countries that are still in early phases of the COVID-19 outbreak.


"The number of confirmed cases in China by day 50 (February 19) of the epidemic, was around 30,000," said Christopher Dye, visiting professor of zoology and visiting fellow at the Oxford Martin School, University of Oxford. "Our analysis suggests that without the Wuhan travel ban and the national emergency response there would have been more than 700,000 confirmed COVID-19 cases outside of Wuhan by that date. China's control measures appear to have worked by successfully breaking the chain of transmission—preventing contact between infectious and susceptible people."

The researchers used a unique combination of case reports, human movement data and public health intervention information to investigate the spread and control of COVID-19. They examined the movements of 4.3 million people out of Wuhan before the travel ban, the types and timing of control measures implemented across the cities of China and the numbers of COVID-19 cases reported each day in every city.

"One fascinating aspect of our work is that it shows the power of novel data streams such as cell phone mobility data," said Ottar Bjornstad, distinguished professor of entomology and biology, Penn State. "Since the time period we studied included the Spring Festival holiday and Chinese Lunar New Year, we were able to compare patterns of travel into and out of Wuhan during the outbreak with cell phone data from two previous spring festivals. The analysis revealed an extraordinary reduction in movement following the travel ban of January 23, 2020. Based on this data, we could also calculate the likely reduction in Wuhan-associated cases in other cities across China."

The team's model also analyzed the specific effects of the Wuhan shutdown and found that it delayed the arrival of COVID-19 in other cities by several days. "This delay provided extra time to prepare for the arrival of COVID-19 in more than 130 cities," said Huaiyu Tian, associate professor of epidemiology, Beijing Normal University.

These cities banned public gatherings, closed entertainment venues and suspended public transport, among other actions. As a result, they reported 33% fewer confirmed cases during the first week of their outbreaks than cities that did not implement a Level 1 Response.

While the control measures taken thus far have reduced the number of COVID-19 infections to very low levels, China, is by no means out of the woods.

"Given the small fraction of the Chinese population that has been infected, a much larger number of people remains at risk of COVID-19," said Tian. "We are acutely aware that resident or imported infections could lead to a resurgence of transmission."

Bjornstad noted that SARS-CoV-2 may establish as a human endemic globally in the years to come.

"It is critical to keep in mind that this virgin epidemic likely will affect people of different ages and susceptibilities, and therefore have different fatality levels, than possible subsequent seasonal epidemics," he said.
Travel restrictions are most useful in the early and late phase of an epidemic: study
More information: Science (2020). DOI: 10.1126/science.abb6105
Coronavirus measures may have already averted up to 120,000 deaths across Europe

by Ryan O'hare, Dr Sabine L. Van Elsland, Imperial College London

Credit: Imperial College London

Strong social distancing measures to slow and suppress the spread of COVID-19 across Europe are estimated to have averted thousands of deaths.
The findings come from a new analysis by researchers at Imperial College London, which estimates the potential impact of interventions in 11 European countries to counter the coronavirus pandemic—including school closures and national lockdowns.

According to the research, up to 120,000 deaths may have already been averted in 11 countries, including the UK, Italy and Spain. However, they add that the estimated proportion of people to have been infected with the virus may only be between 2 to 12% of the population (2.7% in the UK).

The report is the thirteenth to be released by The WHO Collaborating Centre for Infectious Disease Modelling within the MRC Centre for Global Infectious Disease Analysis (GIDA), Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA).

Europe-wide response

Many European countries have now implemented unprecedented measures to mitigate the impact of COVID-19, including isolation of confirmed and suspected cases, closing schools and universities, banning mass-gatherings, and most recently, wide-scale social distancing including local and national lockdowns.

Such interventions are aimed at managing the epidemic to prevent an unmitigated rise in cases which would overload health care capacity. Now, the latest modeling shows that they may be having a significant impact, potentially averting up to 120,000 deaths across Europe.

Dr. Samir Bhatt, report author and Senior Lecturer from the School of Public Health, said: "It is of course a difficult time for Europe, but governments have taken significant steps to ensure health systems do not get overwhelmed. There is sound evidence that these have started to work and have flattened the curve.

"We believe a large number of lives have been saved. However, it is too soon to say if we have managed to fully control epidemics and more difficult decisions will need to be taken in the coming weeks"

Dr. Seth Flaxman, first author on the latest study, added: "Even as the death toll continues to mount, we see enough signal in the data to conclude that sustained, drastic actions taken by European governments have already saved lives by driving down the number of new infections each day.

"But because these interventions are very recent in most countries, and there is a lag between infection and death, it will take longer—from days to weeks—for these effects to be reflected in the number of daily deaths."

Intervention timings for the 11 European countries included in the analysis. Credit: Imperial College London

Modeling the impact

In the latest report, researchers aimed to model the likely impact of interventions in place on reducing loss of life. The team used real-time daily data from the European Centre of Disease Control (ECDC) on the number of deaths in 11 European countries: Austria, Belgium, Denmark, France, Germany, Italy, Norway, Spain, Sweden, Switzerland and the United Kingdom.

The models focused on reproductive number—the average number of new infections generated by each infected person. It was assumed that changes in reproductive number are an immediate response to these interventions being implemented, rather than broader gradual changes in behavior. Overall, the models estimate that countries have managed to reduce their reproductive number.

The team's analysis shows that with the current interventions remaining in place, that measures across all 11 countries will have averted between 21,000 and 120,000 deaths up to 31 March. They add that many more deaths will be averted by keeping interventions in place until transmission drops to low levels.

"Our results suggest that interventions such as social distancing or lockdowns have already saved many lives and will continue to save lives," explained Professor Axel Gandy, Chair of Statistics within the Department of Mathematics. "The impact of the pandemic is extreme—but it would have been much worse without the interventions. Keeping interventions in place is crucial for controlling it."

In addition to reducing deaths, the latest report estimates that between 7 and 43 million people have been infected with the coronavirus (SARS-CoV-2) across all 11 countries up to 28th March, representing between 1.88% and 11.43% of the population.

Given the lag of 2-3 weeks between when transmission changes occur and when their impact can be observed in trends in deaths, it may still be too early to show for most of the 11 countries that recent interventions have been effective.

The researchers stress that the results are strongly driven by the data from countries with more advanced epidemics, and earlier interventions. It is critical, they explain, that the current social distancing measures remain in place, and trends in cases and deaths are closely monitored in the coming days and weeks to provide reassurance that transmission of the virus is slowing.

Professor Christl Donnelly, Professor of Statistical Epidemiology within the School of Public Health, said: "Europeans, like many people elsewhere, have changed their lives profoundly in recent weeks. This report makes clear early evidence of the benefits of these social distancing measures. By keeping our distance from each other, we limit the opportunities for the virus to spread and reduce the risks of illness and even death among those around us."

Professor Neil Ferguson, Director of J-IDEA at Imperial, added: "This analysis show that the interventions European countries have put in place have significantly slowed the spread of COVID-19. However, it is not yet clear whether or how quickly these measures will cause the numbers of new cases to decline. Data collected in the next two weeks will be crucial to refining our assessment of this key point."

Report author Dr. Swapnil Mishra, a Research Associate within the School of Public Health, said: "We implement a novel scientific model of the epidemic within a robust statistical framework. It is a fully Bayesian analysis, so we do not just look at a single scenario, but rather thousands of plausible scenarios and counterfactuals. Our analysis suggests in these difficult times interventions are required and necessary to keep the pandemic in control."

Explore furtherFollow the latest news on the coronavirus (COVID-19) outbreak

More information: Estimating the number of infections and the impact of non-pharmaceutical interventions on COVID-19 in 11 European countries: www.imperial.ac.uk/mrc-global- … e-analysis/covid-19/

Provided by Imperial College London

Trump calls it a COVID-19 fix.
 Now lupus patients can't get their drug

by Lisa Gutierrez, MARCH 31, 2020

Credit: CC0 Public Domain

Before Aisha Kelley headed to the pharmacy last week, she heard from a fellow lupus patient that she might have trouble getting her prescription filled.

Her medication, hydroxychloroquine, sold by the brand name Plaquenil, keeps her body from turning against her. It is considered the most important drug for lupus patients, but now is also being investigated as a possible treatment for the new coronavirus.

Before Plaquenil, Kelley's children had to help her shower and dress because the autoimmune disease made her legs wobbly like Jell-O.

Before Plaquenil, sitting on the sofa exhausted her.

Before Plaquenil, her thick, shiny hair fell out in clumps.

At the Price Chopper pharmacy in Mission, Kan., the pharmacist told her she could only have a 10-day supply, not her usual 30-day.

"Well, do you know when you're going to get it?" Kelley asked him.

He couldn't tell her.

Pharmacies across the country have run out of the medication used by millions of lupus and rheumatoid arthritis patients, a drug many of them have taken daily for years.

Hydroxychloroquine started selling out after President Donald Trump touted it as a possible "game changer" treatment for the coronavirus. A French study released this month suggested that the drug, along with the antibiotic azithromycin, could be effective in treating COVID-19 patients.

Now supplies have dried up. And some patients are considering rationing their daily dosages, or skipping some days altogether, as health advocates and physicians caution them not to panic.

"My fear is I will be put in the hospital, and I don't want to go into the hospital," said Misty Helm, a 48-year-old lupus patient in Lexington, Mo.

She was diagnosed in 2004 after years of trying to keep weight on her body and watching her hands and feet swell up like sausages as she worked 22 years in the automotive industry, including a decade at Ford's Claycomo plant in Kansas City.

"It's not a fun disease," she said.

Reports have surfaced that people are stockpiling the drug. Now Missouri pharmacy officials have cautioned health care providers to stop prescribing the drug for a use it's not approved for.


Pharmacy boards across the country have reported that doctors are hoarding the drugs by writing prescriptions for themselves and family members, The Associated Press reported.

Several states, including Kentucky, Ohio, Nevada, Texas, and now Missouri, have issued restrictions or guidelines on how the drugs should be prescribed.

"Prescribing hydroxychloroquine, chloroquine and azithromycin for family, friends and co-workers in anticipation of a COVID-19 related illness can significantly impact drug supplies and may lead to improper use," said a joint statement last week from the Missouri State Board of Registration for the Healing Arts, and the Missouri Board of Pharmacy.

Because people scooped it up to use for coronavirus, Kelley now has enough of the little white pills—including ones she hasn't taken yet from her last refill—to last her for about two weeks.

"I'm nervous. I'm not going to lie," Kelley said.

Last week the Lupus Foundation of America, American College of Rheumatology, American Academy of Dermatology, and the Arthritis Foundation urged the White House task force and governors across the country to step in.

The Food and Drug Administration has approved hydroxychloroquine and chloroquine only for treating lupus, rheumatoid arthritis and malaria, the groups said in a joint statement, which noted their support for "rigorous clinical trials" to investigate the drugs for COVID-19 use.

"Already today, many of our patients are not able to fill their prescriptions, due to major shortages of hydroxychloroquine, with validated reports across the country of pharmacies having depleted their supplies and half of the drugs' manufacturers reporting back orders," they wrote.

After the French study came out, "we called around to our regional pharmacies and every pharmacy had several hundred tablets of Plaquenil available," said Alfred Kim, a rheumatologist and director of the Lupus Clinic at Washington University in St. Louis.

"But the issue then came afterwards, where social media, even state leaders, have made hydroxychloroquine ... have called it a cure. This obviously skyrocketed interest in Plaquenil."

Based upon limited anecdotal data, both hydroxychloroquine and chloroquine are being used to treat hospitalized coronavirus patients around the world, including the United States, according to the Centers for Disease Control and Prevention.

And though it has not approved the drugs specifically to treat COVID-19, the FDA quickly approved clinical trials underway in Minnesota and New York.

Trump tweeted on March 22: "HYDROXYCHLOROQUINE & AZITHROMYCIN, taken together, have a real chance to be one of the biggest game changers in the history of medicine. The FDA has moved mountains—Thank You! Hopefully they will BOTH (H works better with A, International Journal of Antimicrobial Agents) ... be put in use IMMEDIATELY. PEOPLE ARE DYING, MOVE FAST, and GOD BLESS EVERYONE!"

"We saw it blow up over the weekend because President Trump keeps talking about it," said Amy Ondr, president of the Heartland Chapter of the Lupus Foundation of America, which covers Missouri and eastern Kansas.

"It's being prescribed off-label, and it shouldn't be. There is no approved use for this for COVID-19, though some physicians are still prescribing it to patients. We're getting a lot of questions like 'what if we run out?' We don't give medical advice."

But she does know what can happen to lupus patients who don't use their medication. It's called a lupus flair, "where their disease activity goes up," Ondr said. "That's when you can get damage to organs.

"Plaquenil kind of helps maintain their disease, so that is their fear, that if they go off the drug or they have to start cutting back on the dosage that they'll go into a lupus flair which potentially could be life-threatening for them."

Kim said stock has now "dwindled near zero and the supply chain hasn't quite caught up yet."

You can't get Plaquenil without a prescription. "It's definitely physicians and other health care providers, such as dentists, that are prescribing this," he said. "And there have been reports, which I have been able to confirm, unfortunately, of several prescribers who have been hoarding it.

"In my view this is an unethical use of the powers that they have to be able to leverage prescription medicines to treat certain diseases. Here in this specific case, the data is so weak that justification to treat COVID-19 patients is poor.

"But on top of that, there's absolutely no data whatsoever that supports its use as a preventative. So that's what people are using it for, as a preventative ... overinterpreting results that are already compromised due to study design issues."

The four health advocacy groups asked the government to work with the pharmaceutical industry to ramp up production and make 90-day supplies available on an ongoing basis to patients using the drugs for their approved use.

Kim said several drugmakers have already said they are going to make more. His clinic has put in a request to Novartis, which announced it is donating up to 130 million doses of generic hydroxychloroquine for use in clinical trials for treating COVID-19.

"We don't want to come across also as sounding like we don't want this drug to go to people with COVID-19. Of course we do," said Ondr. "We just want to have a little bit of responsibility here of what's happening."

Helm said as soon as she got an email from the Lupus Foundation warning her about the shortage she called her pharmacy in Lexington, but it was too late. They told her they didn't have any more Plaquenil and couldn't tell her when they would get more.

Helm said this has never happened before.

"It's frustrating because they had to know this was going to cause a shortage and that other people who are taking it were going to be affected," she said.

Her phone had been ringing so much all week that La Tanya Pitts-Lipprand of Kansas City did something she never does.

"Normally I don't get on Facebook like this. However, the last couple of days I've been getting a lot of calls concerning the announcement they're going to be using, in some cases, Plaquenil, for the virus," she said in a video she posted on the Facebook page of Marlene's Kaleidoscope, a lupus nonprofit she started in 2017.

Pitts-Lapprand, who is 52, was diagnosed with lupus nearly 30 years ago. When she went to CVS to get her usual three-month supply of Plaquenil a couple weekends ago, the pharmacist limited her to just one month because there wasn't enough.

In the video she talked about taking phone calls from fearful patients, "worried about not being able to get their medicine at this time. I want everybody to understand, we will get through this.

"Today I got four calls about people with their fears and concerns and they're talking about rationing out their medicine, like take it today but not take it tomorrow or cut it in half, or hold onto it until they feel sick and then have to take it.

"I am not a doctor. I am somebody who has been having lupus for over 27 years. And I personally don't think that's a good idea."

Ondr has gotten the same calls.

"This is a drug that very many lupus patients are on, sometimes it's first-line drug for people who are diagnosed with lupus. So they've been on it for a long time," said Ondr. "They're panicking. They're running out. The pharmacies don't have it."

Kim is trying to tamp down the panic among his patients, reassuring them that more is on the way.

He's also telling them to try mail-order outlets, which might have more stock. One company, Express Scripts, "has done a great job of trying to shore up supplies," he said.

The caveat: That advice is based on information that changes nearly every day. "The situation is so dynamic and changing," he said.

"So right now, I think the best thing (for patients) to do is to continue taking the medicine until they run out. Be in communication with their prescriber, usually their rheumatologist, to get a better understanding of the lay of the land."

In the meantime, Pitts-Lipprand has launched a one-woman campaign, knowing that stress is not good for anyone living with lupus. Given stay-at-home orders in the Kansas City area right now, she can't meet one-on-one with anyone right now. But she'll be back soon on Facebook.

"I want everyone to calm down," she said.

---30---

Joe Biden is the worst imaginable challenger to Trump right now
 Ryan Cooper, The Week•March 29, 2020



















For anyone plugged in to the news firehose about the coronavirus pandemic, it has been extremely bizarre to watch President Trump's approval rating. He has botched the crisis beyond belief, and the United States now has the biggest outbreak in the world. Because of his ongoing failure to secure stockpiles of medical supplies, doctors and nurses are re-using protective gear over and over, and suiting up in garbage bags and page protectors to treat COVID-19 patients. Some have already caught the virus and died — along with over 1,300 others at time of writing, which is very likely an underestimate.

Yet Trump's approval rating keeps going up. Poll averages show a marked bump in favorable ratings, a recent Washington Post/ABC poll has him above water. He does even better on the coronavirus response, with a Gallup poll finding him at 60 percent approval of his handling of the situation.

This is what happens when the Democratic Party, de facto led at this point by its presumptive presidential nominee Joe Biden, refuses to make the case that Trump is in fact responsible for the severity of the disaster. Biden is proving to be about the worst imaginable nominee to take on Trump.

Now, Biden is not entirely to blame here. Surely some of Trump's approval bump can be chalked up to the usual "rally around the flag" effect that tends to happen at times of crisis, and the fact that we are likely still in the very early stages of the pandemic.

But if we dig into the numbers, some of the bump in Trump's approval rating is coming from changes in Democratic attitudes. A Pew poll, for instance, found that Democratic and Democratic-leaning voters nearly doubled their approval of Trump over the last few weeks, from 7 to 12 percent. It's not a huge change, but it could make the difference between Trump winning or losing in an election which is likely to be close.

As has been made abundantly clear, Democratic voters tend to take their cues from Democratic elites. The party rallied around Biden in lockstep right before Super Tuesday, and voters fell in line. Biden won multiple states he has not visited in months and in which he had no campaign offices. And now that he's the probable nominee, Biden is not savaging Trump's response. On the contrary, his campaign says they are hesitant to even criticize him at all. "As much as I dislike Trump and think what a bad job he's doing, there's a danger now that attacking him can backfire on you if you get too far out there. I don't think the public wants to hear criticism of Trump right now," one adviser told Politico.

Indeed, Biden has barely been doing anything. As the outbreak became a full-blown crisis, Biden disappeared for almost an entire week. His campaign said it was trying to figure out how to do video livestreams, something any 12-year-old could set up in about 15 minutes. (Hey guys: Any smartphone with Twitter, YouTube, or Twitch installed can become a broadcasting device with the press of a single button.) When Biden did finally appear, he gave some scripted addresses that still had technical foul-ups, and did softball interviews where he still occasionally trailed off mid-sentence.

People crave leadership during times of crisis, as evidence by the sudden surge of positive sentiment towards New York Governor Andrew Cuomo, who seriously mishandled the initial crisis response, and is still trying to cut Medicaid, but has been giving reassuring daily press conferences where he seems like he is on top of the situation. Washington state Governor Jay Inslee did a much, much better job (just compare the numbers in New York to those in Washington state), but has gotten comparatively little attention precisely because there are a lot fewer cases and deaths (and there are many fewer reporters in Seattle than New York City).

Trump, meanwhile, is similarly out there on TV every day boasting about how what he's doing is so smart and good. What he's saying is insanely irresponsible and has already gotten people killed, but absent an effective response from the Democratic leadership, it can appear to casual news consumers as though he has the situation in hand. Democratic backbenchers and various journalists are screaming themselves hoarse, but it plainly isn't working.

Biden's strategy appears to be to coast to the presidency in basically the same way he coasted to the nomination: Keep public appearances and therefore embarrassing verbal flubs to a minimum, and rely on Trump's disastrous governance to do all the work for him. But this is a horribly risky strategy. Biden is already a candidate whose awful record will make it harder to attack Trump on trade, protecting Social Security and Medicare, corruption, mental fitness, and his treatment of women — indeed, just recently a former Biden staffer came forward with an allegation that he had sexually assaulted her 26 years ago. Hunkering down and refusing to criticize Trump's world-historical bungling risks him successfully arguing that it was an unforeseeable disaster and he did the best anyone could have done.

Contrary to these half-baked notions that the public doesn't want to hear criticism of Trump, we saw during impeachment that once Democrats actually started going through with it, approval jumped — largely because the liberal rank-and-file took that as a cue it was indeed a good idea. It's just another instance of the Democratic establishment's habit of hiding their desire to avoid conflict and do nothing behind an imagined obstacle of public opinion, when in fact they can change those opinions dramatically by offering a strong and clear alternative.

Moreover, if and when Biden does become president, he will be in charge of a country in ruins. Fixing the place up will require extremely energetic leadership. But both Biden, his campaign, and the Democratic establishment seem to believe that if they just pretend hard enough, everything will go back to normal on its own. It is willful blindness on par with the worst Trump loyalists.

As Easter, Passover and Ramadan near, religious leaders adapt holiday observances during the coronavirus pandemic

Elise Solé, Yahoo Lifestyle•March 31, 2020

As the coronavirus pandemic spreads, religious institutions — and how we celebrate holidays — are changing. (Photo: Getty Images)

Churches, synagogues and mosques are closing to contain the coronavirus global pandemic, and religion is traversing a new virtual world without physicality or roadmaps for prayer and celebration. As such, religious leaders are employing artistic license and bending holy rules while families create new rituals that respect social distancing.

Last week, Pope Francis was depicted praying alone in a haunting photograph captured in Rome’s St. Peter's Square while public celebrations for Holy Week festivities (Palm Sunday, Holy Thursday and Good Friday) will pivot to livestream, per the Vatican website. And “considering the rapidly evolving situation” of the pandemic, a decree called “In time of COVID-19” outlines resources to amend April holidays, including Easter.

Churches are holding “drive-thru” services, and a New Jersey bishop has eased rules for the remainder of Lent (until April 9), permitting the consumption of meat on Fridays, except on Good Friday, “given the difficulties of obtaining some types of food and the many other sacrifices which we are suddenly experiencing given the coronavirus,” according to a tweet from the Diocese of Metuchen.

From the Bishop's Desk:

"I have granted a dispensation from abstaining from meat on Fridays for the rest of Lent, except Good Friday which is universal law. " - Most Rev. James F. Checchio, Bishop of Metuchen pic.twitter.com/Lwr1GBso6n

— Diocese of Metuchen (@diocesemetuchen) March 26, 2020

Meanwhile, bar and bat mitzvahs, large Jewish coming-of-age ceremonies which demand years of vigorous studying and preparation, have been moved online or postponed. And Israeli Prime Minister Benjamin Netanyahu has encouraged Jewish, Christian and Muslim citizens to “avoid family visits” during respective April holidays.

In Georgia, St. Anne Catholic Church in Columbus provides virtual-only services on social media (an option since January 2019 to include elderly, homebound or military members), but speaking to empty naves, not friendly faces, got lonely. So last week, leaders taped photographs of congregant faces onto their pews.

“From the altar, there’s now a sea of photos,” Rev. Emanuel Vasconcelos tells Yahoo Lifestyle. “It’s a way to stay united in prayer, not look out into an empty space.”

Designing a fair seating chart for 650 photos was hard, as regulars have their preferred places, but the church did its best. “This has been a challenge for everyone — we’ve never faced anything like this in our lifetime,” he says. When pandemic restrictions are eventually lifted, there may be a ceremonial photo removal.

On March 15, the Clackamas United Church of Christ (UCC) in Milwaukie, Ore. closed for the first time since its inception in 1895. “This is a political, economical and spiritual crises and everyone is anxious,” Pastor Adam Ericksen tells Yahoo Lifestyle. “It brings up a lot of questions about where God is in all this.”

Bible study and prayer meetings via Zoom haven’t been easy for everyone, so Ericksen has personally counseled his 70 communicants over the phone and created a phone tree pairing “buddies” together for spiritual support. There are plans to organize a multi-church online Easter service and possibly a 72-hour “Easter Triduum” from the evening of Holy Thursday to Easter morning with pastors taking shifts to lead continuous prayers.

And the church posted an outdoor sign displaying the phone number for a “senior loneliness line” during isolation. “Nothing will go smoothly but we have to embrace the mess and go with the flow,” says Ericksen, who is planning an at-home Easter egg hunt for his three children.

Rabbi Josh Stanton of the East End Temple in Manhattan has brought his entire synagogue online, including bat-and-bar mitzvah tutoring and Shabbat services. “Judaism is 4,000 years old and records that date back to plagues and quarantines have guided us,” he tells Yahoo Lifestyle. “We’ve had this in our religious discord for generations.”

Ahead of Passover, which falls between April 8 and 16 and observes the freeing of Israelites from slavery in Egypt, Stanton says “we’re trying to host the world’s largest virtual seder that’s open to the world — singing, eating and reflecting together, even if it’s not at the same table. This Passover could be holier than any other time in our lives.”

Families traditionally abstain from or donate leavened bread (which contains yeast) and avoid technology, but Stanton dismisses perfectionism. “What matters is intention and in circumstances like this, creativity.” When food is scarce, he says, there’s little reason to discard bread, and technology is permissible for online seders provided cameras are activated one hour before sundown.

“Why not have a virtual seder with someone in Israel or South America?” says Stanton. “This might forever change Passover.”

For the holy month of Ramadan, this year from April 23 to May 23, Muslims self-reflect and perform good deeds, and pray and fast from dawn to sunset. “This is done in groups, however while living in our comfort zones, we can rely on online services,” Imam Tahir Kukaj, vice president of the Albanian Islamic Cultural Center in Long Island, N.Y. and chaplain of the New York Police Department, tells Yahoo Lifestyle.

At the end of the month, a celebration called Eid al-Fitr breaks the month-long fast. Typically held in mosques or outdoor areas, it’s marked by a feast with lamb, desserts and other dishes. “We have to play by the rules in isolation,” says Kukaj. “This year, how about we celebrate modestly and donate any money toward finding a cure for this virus? Why not invest in science?” says Kukaj, adding that celebrators can “eat whatever is available to you.”

SEE

https://plawiuk.blogspot.com/search?q=RAMADAN

https://plawiuk.blogspot.com/search?q=PASSOVER

https://plawiuk.blogspot.com/2007/04/pagan-origins-of-easter.html

Informal discussions begin on 9/11-style commission on coronavirus response

Carol E. Lee and Courtney Kube and Leigh Ann Caldwell,
NBC News•March 31, 2020

WASHINGTON — Informal discussions have begun on Capitol Hill about possibly creating a panel to scrutinize the Trump administration’s response to the coronavirus pandemic that would be modeled after the commission that investigated the 9/11 attacks, according to four people familiar with the discussions.

They described the discussions as “very preliminary” and mostly involving congressional Democrats.

One option that’s been raised is the potential inclusion of a plan to review the administration’s response in the annual National Defense Authorization Act, two of the people familiar with the discussions said.

The review would focus on lessons learned about the government’s preparedness and what the administration could have handled better, they said. They said the goal would be to put in place a more effective plan for handling a pandemic in the future

A wholesale examination of the administration’s response could gain traction with the passing of a gruesome milestone on Tuesday, when the number of deaths in the U.S. from coronavirus surpassed the number of people who were killed on 9/11.

But the formation of any commission, or possible congressional investigations, wouldn’t happen until after the country is through the current crisis, the people familiar with the discussions said. Some lawmakers have suggested putting off any investigation until after November’s presidential election, they said.

The bipartisan 9/11 Commission was created by legislation signed into law by President George W. Bush to review the government’s preparedness for and response to the 2001 terrorist attacks. It was formed a year after the attacks and two years before Bush was up for re-election.

President Donald Trump has defended his administration’s handling of the coronavirus pandemic, and his White House has repeatedly bucked congressional oversight.

The people familiar with the discussions said expectations are low for a review that has broad bipartisan support in Congress and the backing of the White House, particularly in an election year.

“I don’t know that you would get administration buy-in for something like that,” a senior administration official said. “Then if the Democrats do one, it’s all one-sided.”

Any plan for a review that was tucked into the National Defense Authorization Act would require support from Senate Republicans and the White House.

Separately, Congress wrote into the third Coronavirus relief bill, the CARES Act, a number of accountability provisions to monitor the administration’s response to the pandemic and the distribution of billions of dollars of federal funds.

And the House Oversight and Reform Committee has already begun asking questions about the lack of access to testing early on in the crisis even as chairwoman Carolyn Maloney, D-N.Y., says the committee would dig deep into the administration’s response after the crisis is over.

“The committee’s top priority is the health and safety of the American people, so we have been working to push the administration to identify and fix problems and to share more accurate information with the public,” Maloney said in a statement. “There is no doubt that the administration has mishandled this entire crisis, and our committee will certainly be engaged in robust oversight to review what happened and how to avoid these mistakes in the future.”

House Speaker Nancy Pelosi raised the prospect of an investigation on Sunday, saying Trump’s response cost lives and questioning whether he was leveling with Americans early on about the threat of the crisis.

“What did he know and when did he know it?” Pelosi said in an interview on CNN. “That's for an after-action review.”

Coronavirus: What the world can learn from Ebola fight

BBC•March 30, 2020

Ellen Johnson Sirleaf

Ellen Johnson Sirleaf, who made history as Africa's first elected female president, led Liberia for 12 years including during the 2014-16 Ebola outbreak that killed nearly 5,000 people in her country.

The BBC asked the Nobel Peace Laureate for her reflections on the current coronavirus crisis.

Dear fellow citizens of the world,

On 19 October 2014, at the height of the deadly Ebola outbreak in West Africa, when 2,000 of my citizens had already perished and infections were growing exponentially, I wrote a letter to the world pleading for the mobilisation of personnel and resources.

I demanded a show of global unity to avert what we feared would be a worldwide pandemic.

Today, I take this opportunity to raise my voice in a message of solidarity.

Ebola in West Africa. 2014-16 [ 11,325 people died in all ] [ 4,810 people died in Liberia ],[ 3,956 people died in Sierra Leone ],[ 2,544 people died in Guinea ], Source: Source: CDC, Image: People wearing protective gear

Almost six years ago, I explained how Liberia's post-conflict economy, and its fragile healthcare system, made it vulnerable to the rapid spread of disease, and I contended that how the world responded to the localised crisis in West Africa, would define our collective healthcare security.

I argued that an uncontrolled contagion, no matter where in the world, and no matter how localised, is a threat to all of humanity.

The world responded positively. And did so boldly.

President Sirleaf, seen here at the White House in 2015, worked with the leaders of neighbouring countries Sierra Leone (L) and Guinea (R) as well as the US to defeat Ebola

A mass mobilization of resources led by the UN, the World Health Organization, and the US followed. We defeated it together. As a result, today there are effective experimental vaccines and antivirals thanks to the collaboration of the best scientific minds around the world.

In the face of the coronavirus outbreak, I am making a similar plea to my fellow world citizens. I do this with an acute awareness that while African nations have so far been spared the worst, it is only a matter of time until it batters the continent which is the least prepared to fight it.

We must act to slow down, break the chain of transmission, and flatten the curve.

The lessons Liberia learned from the Ebola crisis can be applied to the spread of coronavirus

It is clear that lapses were made in the initial response to the virus, from Asia to Europe, to the Americas.

Cues were missed. Time was wasted.

Information was hidden, minimised, and manipulated. Trust was broken.
'I made the same mistakes'

Fear drove people to run, to hide, to hoard to protect their own, when the only solution is, and remains based in the community.

I know this. I made all of those missteps in 2014, and so did the world's responders. But we self-corrected, and we did it together.

We are at a critical juncture as borders are closing around the world to slow the rate of transmission.

"Every person, in every nation, needs to do their part. This realisation led to our turning point of disease control in West Africa"", Source: Ellen Johnson Sirleaf, Source description: President of Liberia, 2005-17, Image: Ellen Johnson SirleafMore

Let us not take the wrong cue from this. It does not mean that we are on our own, every country for themselves. On the contrary, it is the sign of a communal response, that border closures make a difference.

Watching from my home in Monrovia, what most encourages today, is the opening up of expertise and the fact that knowledge, scientific discovery, equipment, medicines and personnel are being shared.

It is happening within nations, and increasingly across international borders; an indispensable, albeit delayed reaction, that every person, in every nation, needs to do their part.
'We emerged resilient'

This realisation led to our turning point of disease control in West Africa.

In Liberia, we emerged resilient from the Ebola epidemic, and stronger as a society, with health protocols in place that are enabling us to manage the Covid-19 disease.

I fervently believe this is the path we are all on.

I have full faith in the relentless spirit of the individual, a conviction that leaders emerge in times of crisis at every level of society, and that our religious and communal differences pale in comparison to our collective belief in the power of prayer, and our respective faith in God.

As we all hunker down in the next few weeks, I pray for the health and well-being of our global citizens, and I ask that everyone remember that our humanity now relies on the essential truth that a life well-lived is a life in the service to others.

India’s coronavirus emergency just beginning as lockdown threatens to turn into human tragedy

Joe Wallen, The Telegraph•March 31, 2020

Up to twelve people share can one room in the Sarai Kale Khan slum in New Delhi - Cheena Kapoor

A week after Narendra Modi ordered the largest national lockdown the planet has ever seen and Delhi's Bhogal market is little quieter than usual.

Rather than being confined to home to stop the spread of Covid-19, large groups of residents instead huddle together in the shade, drinking tea and playing cards.

Street vendors continue to hawk fresh fruit and vegetables and the police watch as daily life in the capital's backstreets continues, apparently content to enforce movement restrictions only on the capital's major thoroughfares.

The failure to abide by the prime minister's decree is due to necessity, rather than defiance, said Muhammad Asif, 21, a cycle-rickshaw driver scanning the crowd for customers.

The three-week-long social distancing precautions ordered by Mr Modi are an unaffordable luxury for tens of millions of daily-wage labourers.

Muhammad Asif, 21, says despite the lockdown he will carry on driving his rickshaw to feed his family - Cheena Kapoor

With no savings to his name, Mr Asif cannot afford to remain at home and needs his daily earnings of a little over £5 to cover food, rent and medical bills for his family.

“We absolutely do not have any money to take the government precautions,” Mr Asif he explained.

Sanitiser, a mask, soap and even excess water to wash his hands are beyond his reach.

“If death has to come, it will come wherever I am, I can’t afford to run away,” he says.

The problem of millions forced to choose between poverty and defying restrictions is quickly turning into both a public health and political headache for the Indian leader.

An estimated 120 million Indian labourers are in the same predicament as Mr Asif, and Mr Modi has been accused of causing a humanitarian disaster by locking down the cities and unleashing a wave of poor migrant workers.

Many of those who have been forced out of work have streamed back along highways and railway lines to their home states and villages, potentially spreading the coronavirus infection into the country's hinterlands.

Mr Modi's lockdown was a knee-jerk reaction without thought for the consequences to the poor, claimed Manish Tewari, an MP for the Congress party.

“You have millions of poor, marginalised, displaced on the march and the government has left them to their own fate,” he told the Telegraph.

Sudhir Choudhury, 25 and Uttam Mani, 20 are rag pickers, 

searching through Delhi's rubbish for items to sell to recyclers - Cheena Kapoor

“You have millions of people carrying their meagre belongings and having to march hundreds of kilometres to find safety.”

The spectacle of destitute workers setting out to walk hundreds of miles home after they lost their jobs caused Mr Modi to make a rare apology at the weekend.

Many of those hardest hit are from his own party faithful.

"I apologise for taking these harsh steps that have caused difficulties in your lives, especially the poor people," Mr Modi said in his monthly address on Sunday, broadcast on state radio.

"I know some of you will be angry with me. But these tough measures were needed to win this battle."

While India by Tuesday had reported barely 1,500 cases and fewer than 50 deaths, health officials fear the virus could wreak havoc in the world's second most populated nation.

A lack of testing is thought to hide a far more widespread infection among the 1.3 billion population.

Moreover, in a country which spends little on healthcare and where many poor extended families live in cramped lodgings, the conditions could favour a rapid spread of the killer virus.

It was business as usual in Bhogal market, as Delhi residents ignored curfew to carry out their daily shopping - Cheena Kapoor

India's young population may be expected to provide some protection from worst of the death rates seen elsewhere.

The median age in the country is 28, compared with 47 in Italy.

But at the same time, the country is plagued with health conditions known to increase the impact of the pneumonia-causing virus.

India has more diabetics than any other country, while it also has the highest burden of tuberculosis. Indian cities top the world for the worst air pollution.

Faced with the threat, and a widespread failure to comply with restrictions, some neighbourhoods were taking their own protective measures on Tuesday.

After the south Delhi neighbourhood of Nizamuddin was identified as one of 10 coronavirus hotpots, residents of the neighbouring Sarai Kale Khan area used police barricades to block a connecting underpass.

Those trying to cross were threatened.

One distraught mother said she had crossed to buy groceries and become trapped, unable to reach her young children stranded on the other side.

Women stranded in Nizamuddin plead to be let through a

 makeshift barricade to their homes in Sarai Kale Khan - Cheena Kapoor

Several streets away, the Telegraph was chased away by an angry mob claiming the disease is only being spread by foreigners.

Back at Bhogal market, Rakesh Kumar Jain, a 60-year-old greengrocer, said business was good despite the lockdown.

Few people had fridges, forcing them to come out and shop each day and add to the daily crowds, he said.

“People are seeing all the facilities around them in the market, so why would they stay at home,” added one resident, Sanjay Goel,from his balcony.

“They are leaving their homes even for one lemon. It is going to spread.”