Coronavirus: we separate myths from facts and give advice

[Anthea]

The law of generosity combatting
coronavirus in Pakistan

Outside grocery stores in Karachi, a remarkable scene has been unfolding over the past two weeks. Instead of rushing home after shopping to avoid being exposed to coronavirus, many Pakistanis are pausing outside to offer food, money or other charity to the many people on the street with no “place” to shelter-in-place. These generous offers are often accompanied with a request to the recipient: “Pray that [the coronavirus] ends soon.”

Amid the pandemic, Pakistanis are bonding together to assist the less fortunate in a unique and inspiring way. Specifically, many are offering zakat, the traditional Muslim charity tax, for daily wage earners who have no paid leave, health insurance or financial safety net.

In Arabic, “zakat” translates to “that which purifies”, and, according to the Five Pillars of Islam, it is one of the most important religious duties for Muslims. This mandatory alms-giving is calculated at 2.5% of a person’s annual excess wealth.

Strict parameters exist outlining the nisab,or threshold, beyond which a Muslim’s assets become liable for zakat, as well as who is eligible to receive it. Stemming from the belief that this world is transient and all is bestowed from the benevolence of the Creator, zakat upholds the idea that those less fortunate have a share in everything the community temporarily owns.

I am answerable if any of my neighbours go to bed hungry. How can I have an overstocked pantry while one of my neighbours is in need?

Pakistan contributes more than 1% of its GDP to charity, placing it among “far wealthier countries like the United Kingdom (1.3%) and Canada (1.2%) and around twice what India gives relative to GDP.” And a nationwide study found that 98% of Pakistanis give to charity or volunteer their time – a figure that far exceeds the number of people who are legally obligated to offer zakat.

Link to Full Article:

http://www.bbc.com/travel/story/2020033 ... n-pakistan

[Anthea]

Don't get infected by fake news

The internet and social media have changed the way we read news and get important information. While this online news is timely and relevant, it may also be fake

Fake news can be damaging to the public’s health in so many ways — people might panic, or consume the wrong medication. A major motivation that nefarious actors may have for peddling fake news is, of course, making money. Whether directly, by selling medications, or indirectly, by showing advertisements to a large number of people, fake news is a virus that we must protect ourselves — and that means being proactive in fighting back against fake news.

The global outbreak of COVID-19 has made it clear to all of us that we are living in an era of mass misinformation. Facebook has stated it intends to take action against a variety of fake news related to the novel coronavirus outbreak. These have come in a variety of forms: some reports either exaggerate or downplay the severity of outbreaks. Some spread unsound medical advice about social distancing being ineffective in preventing the transmission of the virus. Other fake reports herald the arrival of a somehow rapidly-developed vaccine that cures or prevents people from contracting the virus.

The British government is struggling to keep up with the spread of misinforming running wild on the internet, with misinformation being shared more widely than official information from the UK’s health services, the Guardian reported.

Any social media platform that is used by millions of people has a responsibility to do something about the spread of false information. Facebook has been working closely with the World Health Organization (WHO) to make reliable, authoritative and official information available. The company, which also owns Instagram and WhatsApp, has been attempting to connect its users to trustworthy news.

Links to WHO, UNICEF and Johns Hopkins School of Medicine appear in the top results when a user searches for news related to COVID-19, both on Facebook and Instagram. On WhatsApp, users can sign up to receive WHO Health Alerts which debunk myths and give users reliable information on the symptoms of the virus, and how to prevent its spread. Johns Hopkins is often more informative than WHO.

Since the debacle of Russian bots meddling the 2016 presidential election, social media companies have been under to take action against misinformation spreading on their platforms.

Companies like Facebook and YouTube have responded by applying anti-fake-news strategies that seem as if they would be effective. As a public-relations move, this is smart: The companies demonstrate that they are willing to take action, and the policies sound reasonable to the public.

But the outbreak of COVID-19 means it’s not just election results that are endangered, but fake news could actually constitute a real threat to people’s lives.

The pandemic of lies means that the time to collectively fight fake news is now. Doing so can help us to protect the mental and physical well-being of ourselves, families, friends and the entire community by creating an online environment that provides trustworthy news.

While these attempts show that Facebook is taking the spread of fake news seriously, we have to accept that fake news can never be completely eradicated.

Facebook has always considered itself a platform, not a policeman — so it’s our responsibility to inform ourselves about how fake news operates, and be vigilant about spotting it, so that we don’t fall victims to rumors, half-truths, scams, and falsehoods.

By following these tips, you can protect yourself from fake news — not just during the coronavirus, but after, too.

Consider the source: WHO and regional health authorities are the trusted sources of health news. News that you see posted on posted by a friend without any link to a trustworthy source is potentially fake.

Accounts that seem similar to the trustworthy sources: Some fake accounts attempt to seem similar to trustworthy ones. For example, @BBCNewsTonight mimics @BBCNews.

Encouragement to share: Fake news tends to motivate users to share.

Verify content: Check if the same news is repeated on websites of WHO and regional health authorities.

You can report fake news and block associated accounts. Most popular social media applications allow you to do this right in the app.

Dara Sherwani is the acting head of the Department of Information Science at The American University of Kurdistan.

https://www.rudaw.net/english/opinion/c ... -310320201

[Anthea]

Turks fight virus with secret
weapon: eau de cologne

In Turkey, sprinkling hands with cologne has long been a ritual for a visit to the barber, a meal at a restaurant or even a trip on the bus



It is seen as a symbol of hospitality, as well as an aid to hygiene, in a country that sets great store by both.

Now Turkish cologne - found in almost every household, either in the fridge or a closet - is seeing unprecedented demand as a weapon in the fight against the novel coronavirus.

Many Turks believe cologne, which has a high alcohol content, is effective in keeping hands and faces clean and thus warding off the risk of COVID-19.

Long queues could be seen outside cologne shops in Istanbul's busy spice market, in the historic Eminonu district, in early March before Turkey announced its first confirmed case.

Now shops and pharmacies have put up signs reading "cologne sold out".

People are commonly seen sprinkling cologne into their hands in the middle of the street, while taxi drivers offer doses to their clients.

An association in the northwestern city of Izmit is delivering free cologne as well as bread to the elderly, local media reported.

Selling out

Eyup Sabri Tuncer, a leading traditional cologne maker, said it has received tens of thousands of orders in recent weeks.

"In order for a healthy delivery to the customers... we have temporarily suspended further online orders,"

Bottles of cologne have flown off the shelves since Health Minister Fahrettin Koca urged Turks to use the liquid as an alternative hand sanitiser against the virus.

One user, Ilyas Gocdu, said he is using cologne three times more than before. "I believe it is more effective against germs as it contains alcohol," he said.

Demand is so great that a black market has developed for both cologne and other hand sanitisers, with Istanbul police raiding a manufacturing plant last week to confiscate products made "unhealthily".

Announcing his government's economic stimulus package last week, President Recep Tayyip Erdogan said face masks as well as cologne would be handed out free to people aged 65 and over.

Turkey has so far recorded 37 coronavirus-related deaths and 1,529 cases.

'A good hand sanitiser'

Professor Bulent Ertugrul, board member of the Turkish Society of Clinical Microbiology and Infectious Diseases, said alcohol can destroy the outer membrane of the coronavirus.

"As alcohol is a good solvent, it destroys this lipid envelope,"

Ertugrul said the best protection against the new coronavirus is washing one's hands after contact with the environment.

But he added: "If soap and water are not available, using a hand sanitiser that is at least 60 percent alcohol can help."

Cologne fits the bill, he said.

"As we know, cologne contains at least 70 percent alcohol," he said.

"That's why it is a good hand sanitiser against COVID-19."

https://www.rudaw.net/english/middleeas ... y/24032020

[Anthea]

Daily fevers in the US fall another
5% lower than experts predicted

Only one percent of Americans have fevers despite experts' predictions that twice as many would as the coronavirus pandemic continues to spread across the US

Kinsa Health, a medical technology company based in San Francisco, has been tracking daily fever readings using data from smart thermometers connected to the Internet.

On Tuesday, data showed that fevers were 56 percent lower than expected during this time of year.

They continue to decrease and were down an additional five percent, to 61 percent, on Wednesday.

Around this time of year, about 3.16 percent of Americans are expected to have fevers - but only 1.24 percent reported temperatures above 99F

Officials at Kinsa say the map indicates that social-distancing measures such as shelter-in-place orders and nursing homes barring visitors are helping reduce cases, decease the number of patients in hospitals and slow down deaths

A map of daily temperature readings collected by Kinsa Health show fevers across the US are 61% lower than experts' predictions

About 3.16 percent of Americans were expected to have fevers - but only 1.24 percent reported temperatures above 99F

Kinsa has been collecting at least 162,000 daily temperature readings from smart thermometers
Across the US, there are more than 200,000 confirmed cases of the virus and more than 4,000 deaths.
Kinsa has distributed more than one million thermometers and get about 162,000 temperature readings a day.

The thermometers upload the temperatures to a database (similar to Apple iCloud) and users can add other symptoms into an app.

'As specific diagnostic testing ramps us slowly, we're going to have to come up with other methods to figure out where [the virus is] spreading,' Dr Peter J Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, Texas, told DailyMail.com on Tuesday.

'I think [this] is a great method and it's very robust technology.'

HOW DOES KINSA ANALYZE READINGS

Kinsa has distributed one million smart thermometers from across the country

Users take their temperatures, which are then uploaded to a database

The company has received about 162,000 daily readings

People can then add other symptoms they are experiencing into an app

The app will offer advice on whether or not the person should consult their physician

Prior to using the tool to track COVID-19, Kinsa's tool has mostly been used to track where seasonal flu outbreaks are occurring.

Traditionally, the company's predictions have been two or three weeks ahead of those compiled by the Centers for Disease Control and Prevention.

With the coronavirus pandemic a new feature has been added to the map, which the company calls 'atypical' illnesses.

This tracks illnesses that don't match up with typical flu patterns and are likely due to the novel coronavirus.

According to The New York Times, fevers across the nation were dropping everywhere except in two areas, one in Louisiana and another in New Mexico, last Wednesday.

'Due to widespread social distancing, school closures, stay-at-home orders, etc. feverish illness levels are dropping in many regions,' Kinsa wrote on its website on March 24.

'This does not mean that COVID-19 cases are declining. In fact, we expect to see reported cases continue to surge in the near term, but it may indicate these measures are starting to slow the spread.'

But today, on April 1, every county in every state also showed that downward trend, which was signified in four shades of blue - light blue depicting fevers dropping by a small percentage and dark blue a large percentage

Particularly the West - aside from Northern California, Oregon and Washington - saw the biggest drops, by as much as 20 percent in some counties.

https://www.dailymail.co.uk/health/arti ... evers.html
The Midwest - Illinois, Iowa, Michigan, Minnesota, North Dakota, South Dakota and Wisconsin - also showed similar decreases.

'It's a good back-up system to traditional measures and the first sure sign I've seen that social distancing is working,' Dr Hotez said.

[Anthea]

How to understand
the death toll

Each day, news of more deaths is a huge source of alarm to people across the country - as well as a tragedy for the families involved

Projections of how bad the outbreak could get have prompted ministers to put the country into lockdown. But what are death figures really telling us? And how bad is it going to get?

Is coronavirus causing the deaths?

The death figures being reported daily are hospital cases where a person dies with the coronavirus infection in their body - because it is a notifiable disease cases have to be reported.

But what the figures do not tell us is to what extent the virus is causing the death.

It could be the major cause, a contributory factor or simply present when they are dying of something else.



Most people who die with coronavirus have an underlying health condition, such as heart disease or diabetes, that may be more of a factor.

For example, an 18-year-old in Coventry tested positive for coronavirus the day before he died and was reported as its youngest victim at the time.

But the hospital subsequently released a statement saying his death had been due to a separate "significant" health condition and not connected to the virus.

There are, however, other cases, including health workers and 13-year-old boy from London, who died with no known health conditions.

The Office for National Statistics is now trying to determine the proportion of these deaths that are caused specifically by coronavirus.

How many could die?

Link below to chart showing the estimated death toll from coronavirus in different scenarios

https://ichef.bbci.co.uk/news/624/cpspr ... ths-nc.png

Imperial College London modelling, used to inform government, has suggested 500,000 could have died by August in the UK if the virus was left to rip through the population.

It also warned the government's previous strategy to slow the spread by asking those with symptoms to self-isolate and shield the most vulnerable could have led to 250,000 deaths.

Now, it is hoped the lockdown will limit deaths to 20,000

But that does not mean 480,000 lives are being saved - many will die whether or not they get the virus.

Every year, about 600,000 people in the UK die. And the frail and elderly are most at risk, just as they are if they have coronavirus.

Nearly 10% of people aged over 80 will die in the next year, Prof Sir David Spiegelhalter, at the University of Cambridge, points out, and the risk of them dying if infected with coronavirus is almost exactly the same.

Link below to chart:

https://ichef.bbci.co.uk/news/624/cpspr ... tes-nc.png

That does not mean there will be no extra deaths - but, Sir David says, there will be "a substantial overlap".

"Many people who die of Covid [the disease caused by coronavirus] would have died anyway within a short period," he says.

Knowing exactly how many is impossible to tell at this stage.

Prof Neil Ferguson, the lead modeller at Imperial College London, has suggested it could be up to two-thirds.

But while deaths without the virus would be spread over the course of a year, those with the virus could come quickly and overwhelm the health service.

How effective is the lockdown?

The most immediate way to judge the current policy is to see if the health service manages to cope with the coronavirus cases it sees in the coming weeks.

Beyond that, the key measure will be what is called excess deaths - the difference between the expected number of deaths and actual deaths.

This is closely monitored during flu seasons. During recent winters, there have been about 17,000 excess deaths from flu a year, Public Health England says.



This, of course, can be done in the future only. But researchers at University College London have been trying to model it in advance.

If coronavirus turns out to be no more deadly than flu, the lockdown could limit the number of excess deaths to under 1,400 - more than 12,000 fewer than would have happened under the previous strategy of slowing its spread, before the decision was taken to move to lockdown.

If it turns out to be five times more deadly than flu, the lockdown could limit coronavirus to 6,900 extra deaths - more than 60,000 fewer than under the previous strategy.

What about the impact of the lockdown?

The lockdown, itself, however could cost lives.

Prof Robert Dinwall, from Nottingham Trent University, says "the collateral damage to society and the economy" could include:

mental health problems and suicides linked to self-isolation

heart problems from lack of activity

the impact on health from increased unemployment and reduced living standards

Others have also pointed to the health cost from steps such as delaying routine operations and cancer screening.

Meanwhile, University of Bristol researchers say the benefit of a long-term lockdown in reducing premature deaths could be outweighed by the lost life expectancy from a prolonged economic dip.

And the tipping point, they say, is a 6.4% decline in the size of the economy - on a par with what happened following the 2008 financial crash.

It would see a loss of three months of life on average across the population because of factors from declining living standards to poorer health care.

What will happen next?

The policies in place at the moment are aimed at suppressing the peak by stopping the spread of the virus.

Once the peak has passed, decisions will have to be taken about what to do next.

The virus will not simply have gone away and with a vaccine at least a year away, the challenge will be how to manage the virus.

A balance will need to be struck between keeping it at bay and trying to control its spread to avoid a second peak, while allowing the country to return to normal.

Seeing the full picture in terms of lives saved and lives lost will be essential in getting those calls right.

https://www.bbc.co.uk/news/health-51979654

[Anthea]

Putin extends
paid holiday until May

Russia's week-long paid leave will be extended until the end of the month, President Vladimir Putin has announced in a national address. The country is bracing for the possible rapid growth of Covid-19 cases

The move comes a day after the President acknowledged that the situation with COVID-19 in Russia was becoming "complicated," during a meeting with officials, conducted remotely. Deputy Prime Minister Tatyana Golikova used the opportunity to suggest extending the paid time off.

Putin said the peak of the coronavirus epidemic is yet to come both globally and in Russia. Moscow, which is the hardest hit Russian city, announced almost 600 new confirmed cases on Thursday.

“I've made a decision to extend the time off until the end of the month, that is, until April 30 inclusively, while maintaining wages for employees,” the President said.

According to Putin, the combination of isolation regimes and holidays will allow Russia "to buy time for proactive measures." However, he conceded it's too early to talk about turning the tide of infections.

The President added that before the end of this week he wants local governors to determine the level of danger in their regions and introduce appropriate preventative measures based on the “epidemiological situation" that pertains.

On Wednesday of last week, Putin surprised Russians when he declared the period from March 28 to April 5 a paid holiday. However, the rules don't apply to essential workers and those who can carry out their tasks from home. Following Putin's announcement, most Russian regions introduced partial lockdowns and self-isolation regimes.

Moscow business daily RBK reported that 64% of Russians worked this week regardless, citing data from research firm HeadHunter.

On Thursday it was revealed that the number of positive Covid-19 tests in Russia had reached 3,548, a rise of 771 over the previous 24 hours. In total, 30 people have so far died from coronavirus in the world's largest country.

https://www.rt.com/russia/484778-putin- ... te-russia/

It appears that Russia are taking more positive steps

Sadly, the UK government is not maintaining wages and a great many people here have neither money nor food

[Anthea]

How to make your own
coronavirus face mask

The worldwide coronavirus pandemic has led to a shortage of protective face masks, leading to a deluge of online tutorials ion how to make your own using a t-shirt or pillowcase

Homemade masks offer significantly less protection than the N95 medical masks, which are made of a thick, tightly woven material that fits over the face and can stop 95 per cent of all airborne particles.

Public Health England still does not recommend Britons wear face masks, unless in a medical setting.

But there are good reasons to think DIY masks could be effective in tackling the pandemic, as they have been widely used in Hong Kong,Mongolia and South Korea, countries that largely have the disease under control.

The World Health Organisation also currently does not recommend that people without the illness wear face masks, but it could be about to reverse its decision due to evidence from Hong Kong that they may be effective in fighting the virus.

And in a further sign that attitudes about masks are changing, LA's mayor, Eric Garcetti, yesterday told all four million of the city's residents that they must wear face masks at all times to slow the spread of the deadly pandemic.

MailOnline has investigated how you can make your own face mask using everyday household items such as a t-shirt, kitchen towel or vacuum bags.

How to make a face mask from a t-shirt

A YouTube tutorial by Runa Ray shows how to make a face mask without any need for sewing, using just a plain t-shirt.

First of all you need scissors, pencil and a ruler, and a t-shirt you don't mind being used to make a face mask.

Cut out a 16" by 4" rectangle from the middle of the t-shirt, then fold it in half, and measure four inches on either side.

Then mark the t-shirt with an even number of tassels on each side and use scissors to cut them.

Turn the t-shirt inside out and separate the corner tassels, but tie the remaining ones in-between.

Then with the remaining t-shirt material cut some ear straps using the hem of the shirt.

Attach the straps to the remaining outer tassels and you have yourself a face mask, with no sewing involved, and using an old t-shirt.

A slightly more complicated method has been perfected by researchers from the University of Pittsburgh also managed to design a face mask that could be used if 'commercial masks' are not available during a virus outbreak.

They used a regular cotton t-shirt, which was boiled for 10 minutes and then air-dried to sterilise the material, but also to shrink it.

The researchers used a marker and ruler to measure out what they wanted to cut and then formed the mask using an outer layer and then eight inner layers covering the nose and mouth.

The mask does not require any sewing, and instead involves it being tied multiple time around the face.

How to make a face mask from vacuum cleaner bags

By following the simple steps in the graphic, you can create your own face mask from a T-Shirt or vacuum cleaner bag,

Even UK politicians have got in on the act, with Gillian Martin, who is MSP for Aberdeenshire East, describing how she made a face mask from vacuum cleaner bags and elastic.

She told the Daily Record: 'I live in a small village and have been here for over 20 years. I don't want to worry or offend people when I go out.

'I started researching what other countries have been doing and came across a chart with the best materials to use to make a mask out of just about anything.'





'Just below medical material was a hoover bag. I have loads of them lying around and found Hepa-Flow bag that just goes on your Henry hoover'.

The chart the MSP is referring to from a University of Cambridge study which shows the materials that work the best against virus sized particles.

The top three are a surgical mask, vacuum cleaner bag and tea towel.

She added: 'I cut it up the bag and secured it with elastic. I live with my family of three who have all been self-isolating so I made one for each of us'.

Gillian Martin posted about her mask that she made from a vacuum cleaning bag



'I made it because I'm nervous of people coming up to me when I'm out walking the dog. I don't want to have to run away from them.'

Another popular YouTube method shows how to fold up a scarf, using hair ties at either end, to make a simple and easy no-sew mask. The same method can be used with a handkerchief and doesn't involve any sewing.

How to make a face mask from kitchen towel

For this you need two layers of kitchen towel and one of tissue.

You cut it in half, and then use masking tape on each end to ensure the mask is stiff.

Then you punch holes through either end of the mask and thread elastic bands through the holes.

Some Japanese women have even been posting instructions about how to make a face mask from a bra.

The method is simple and involves cutting off one cup with scissors and then sewing the bra straps on, so they can be attached to your face.

Do masks have to be complex to be effective?

The idea that masks do not have to be complex to be effective does have some support from recently published studies.

A University of Oxford study published this week concluded that surgical masks are just as effective at preventing respiratory infections as N95 masks for doctors, nurses and other health care workers.

It's too early for there to be reliable data on how well they prevent infection with COVID-19, but the study found the thinner, cheaper masks do work in flu outbreaks.

The difference between surgical or face masks and N95 masks lies in the size of particles that can - and more importantly, can't - get though the materials.

N95 respirators are made of thick, tightly woven and molded material that fits tightly over the face and can stop 95 percent of all airborne particles, while surgical masks are thinner, fit more loosely, and more porous.

This makes surgical masks much more comfortable to breathe and work in, but less effective at stopping small particles from entering your mouth and nose.

Droplets of saliva and mucous from coughs and sneezes are very small, and viral particles themselves are particularly tiny - in fact, they're about 20-times smaller than bacteria.

Experts universally agree that there's simply no replacement for thorough, frequent hand-washing for preventing disease transmission.

https://www.dailymail.co.uk/news/articl ... ction.html

[Anthea]

How to manage your
asthma during coronavirus

COVID-19 does not discriminate, it could affect anyone, but we are aware that it may cause more serious complications for those who have existing, underlying health conditions

One of these is asthma, a condition that affects some 235 million people around the world, according to the World Health Organization (WHO).

There has been little research into the effects of COVID-19 on people with asthma. One small study of 142 people suggested it has no effect on asthma. However, we are aware from other coronaviruses like the common cold, that they can trigger asthma flare-ups and attacks.

Therefore, until further research is available, asthma is considered a significant underlying health condition.

How severe can asthma be?

The severity of asthma and, therefore the everyday treatment and prognosis regarding coronavirus, can vary. If you have mild to moderate asthma, you would be considered part of the "at-risk" group of people thought more likely to suffer complications from the virus. But if your asthma is severe, you would be in the "extremely vulnerable" group.

If you fall within this extremely vulnerable group, it is assumed that your asthma is more "brittle" (difficult to control) and you may, therefore, be more likely to suffer from an asthma flare-up or an asthma attack should you be exposed to the virus.

The United Kingdom's National Health Service (NHS) defines those suffering from severe asthma as adults or children who are taking:

Biologic therapy - injections which work by blocking the immune activity that causes inflammation of the airways in asthmatics

Daily oral steroids

Oral antibiotics every week

Tiotropium - a long-lasting inhaler used in difficult or severe asthma to dilate the airways

A combination inhaler that contains a long-acting bronchodilator at a high daily steroid dose - these are "preventer" inhalers, for example, Seretide, Symbicort, Flutiform or Fostair, and contain a high daily dose

An inhaler with a high daily steroid as well as taking Montelukast - an oral tablet used to prevent and treat asthma

You may also be classed as having "severe" asthma if you have been admitted to hospital for your asthma in the last 12 months or if you have ever been admitted to an intensive care unit for your asthma.

Protecting yourself from coronavirus

Knowing the severity of your asthma is important because this will determine whether you should be adhering to strict social distancing measures, or whether you should be "shielded" entirely from other people by self-isolating.

Public Health England is one authority that has advised those with mild to moderate asthma to socially distance themselves.

If you fall into this category, you should be working from home when you can, staying home as much as possible, only leaving the house to pick up groceries, medication or to do one hour of exercise a day, and ensuring that in all these activities you are more than two metres away from anyone else.

If you are self-isolating due to having severe asthma, you must not leave your house, and you must not invite friends or family into your home.

Any food or medicines should be delivered to your front door and left there for you to pick up, and you must try and isolate yourself from anyone else in the household as much as possible.
If you have coronavirus symptoms

If you have severe asthma and are in this shielded group, it is important that you speak to a healthcare provider as soon as you get any symptoms of COVID-19.

This is because your symptoms have the potential to escalate quickly because of your asthma, so healthcare professionals will want to ensure they have you on their radar and are monitoring your symptoms.

If you have mild to moderate symptoms of asthma and you start to develop symptoms of COVID-19, you must stay at home for seven days, or for 14 days if you live in a household with others. Those you live with must also stay at home for at least 14 days.

You do not need to contact a healthcare provider unless your symptoms persist for longer than seven days, you have difficulty breathing or your symptoms are getting worse. Of course, if the symptoms are getting worse quickly, you should call the emergency services.

It can be difficult for some to differentiate whether a cough is related to their normal asthma, or if it could be COVID-19. If you are not sure, I would recommend speaking to your doctor.

Keeping a "peak flow" diary would be helpful.

This is a diary charting your symptoms and your peak flow measurements, which is essentially how quickly you can blow air out of your lungs through a peak flow metre. Many asthmatics have one of these, but if you do not, ask your healthcare provider about it.

If your airways are tight due to your asthma, you will not be able to blow out so quickly and your score will be low.

Keeping a record of your score will help your doctor determine the pattern of your symptoms and how different your breathing is to what would normally be predicted. It may also help them determine the next steps in treatment, so do keep yours up to date if possible.

Should I use my inhalers differently?

The best way for someone with asthma to stay healthy during this pandemic, and to recover if infected with COVID‐19, is to ensure their asthma is as stable as possible.

To ensure this, the advice is to continue taking your asthma medications regularly and as normal.

There is no need to change your inhalers as a pre-emptive measure against coronavirus. But it would be wise to ensure your inhalers have not expired and that you keep your reliever inhaler (usually the blue one) on your person.

Everyone with asthma should have an asthma action plan on hand. This is a document that is completed at your asthma review appointment with your practice nurse or GP.

It reminds you of your everyday routine and what to take - in terms of your inhalers and any other add-on asthma medication you may have been prescribed - when you are feeling well and your asthma is well managed.

It also tells you what to do if you start to feel more unwell with your asthma, or indeed if you are having an asthma attack.

If you do not have an asthma action plan, now is a good time to speak to your healthcare provider about it, ensuring you are taking the correct inhalers and that you know what to do if your asthma worsens.

How to look after your inhalers

In the midst of the COVID-19 outbreak, there have been reports of shortages of inhalers. This is likely to be because some people are stockpiling inhalers in the fear that they will need more if they become sick.

This is very sad, because those who do then end up truly needing them will be left without. While it is important to ensure a sufficient supply of medication at home and to order them in plenty of time to ensure they do not run out, rather than over-ordering, I would instead suggest making the most of the inhalers you have now.

This can be done, first, by ensuring an adequate inhaler technique. There are multiple videos online to remind you of the perfect inhaler technique to ensure you are getting the most out of your inhalers,

I recommend Asthma UK for excellent information and videos on how to use your inhaler correctly:

https://www.asthma.org.uk/advice/inhaler-videos/

Second, ensure you are looking after your inhaler properly. Each type of inhaler will come with instructions on how to best clean, store and look after your inhaler.

If you have a "press-and-breathe" metered-dose inhaler, it is important that you only wash the plastic parts in warm, running water - never the metal canister - ensuring you dry it thoroughly inside and out before putting the metal canister back in.

If you have a dry powder inhaler, you should not use water at all, as the moisture can affect the powder. Simply use a dry cloth to wipe the mouthpiece.

Please remember not to share inhalers as this is a cross-contamination risk.

https://www.aljazeera.com/indepth/featu ... 27386.html

[Anthea]

Coronavirus on Navajo Nation

COVID-19 could 'wipe out' tribal communities with at-risk populations, New Mexico Governor Michelle Lujan Grisham warns

A steep rise in coronavirus cases on the Navajo Nation in the western part of the United States has caused concern among regional leaders, who worry the tribal lands are ill-equipped to handle the pandemic and the federal government is taking too long to address needs.

The Navajo Nation Department of Health and Navajo Area Indian Health Service reported 174 COVID-19 cases in the Navajo Nation on Wednesday, along with seven COVID-19-related deaths. There were roughly 49 confirmed cases one week ago.

The Navajo Nation is a 71,000 square kilometre (27,413 square mile) semi-autonomous territory spanning three US states - Arizona, New Mexico, and Utah. It essentially serves as a reservation for the over 350,000 Navajo (or Dine, in their language) people who live there.

Navajo Nation leaders have increased restrictions in order to avoid this dire outcome.

The Navajo Nation has been under a shelter-in-place order since March 13, with a curfew since March 30, in an effort to slow travel, according to Jonathan Nez, president of the Navajo Nation.

The curfew lasts from 8pm to 5am and excludes essential employees travelling to and from work, though they must have documentation to justify their travel.

But Navajo leaders have reportedly criticised the wider effort to contain the virus, with some pointing to what they say was the delayed closure of the Grand Canyon National Park.

The Navajo Nation and county leaders lobbied for the Grand Canyon to close for weeks, as tourists who wish to see the East Rim of the park must drive through tribal lands. It was closed on Tuesday.

"The closure of the park took longer than it should've, but we're glad it's finally closed," Nez was quoted by local media as saying.

'Wipe out'

While the closure of the Grand Canyon is seen as a positive step, officials worry the coronavirus poses a serious threat to US Indigenous peoples.

New Mexico Governor Michelle Lujan Grisham said she was "very worried" about the spikes in coronavirus cases on the Navajo Nation in a call with US President Donald Trump.

The pandemic "could wipe out those tribal nations", Lujan Grisham told ABC News earlier this week.

Police have reportedly started enforcing the curfew, driving through Navajo communities, stopping drivers and using intercoms to inform residents of Tuba City, Arizona that the lockdown was in effect.

While the curfew in the Navajo Nation is viewed as necessary by health and tribal officials, it could create challenges for Navajo citizens on tribal lands.

For example, there are only 13 full-service supermarkets on Navajo Nation lands, according to Partners In Health, a health advocacy organisation. Many people travel to so-called "border towns" such as Flagstaff, Arizona, or Farmington, New Mexico, for shopping.

The Navajo Nation also has a notable unsheltered population, which also lives in or around "border towns", where some face discrimination.

Al Jazeera contacted the Navajo Nation about efforts to address these challenges, but did not immediately receive a response.

Navajo Nation authorities and the Arizona National Guard have set up emergency centres that will help with medical and food aid, according to local reports.

Federal aid

The massive $2 trillion emergency coronavirus aid bill passed by Congress on March 25 allotted $64m to the Indian Health Service (IHS), the federal agency that oversees healthcare among tribal nations in the US.

The sum is designated for testing for the coronavirus, according to the bill.

Rear Admiral Michael D Weahkee, the IHS principal deputy director, said in a statement sent to Al Jazeera that Congress has passed further bills, including $1bn in funds to fight the coronavirus outbreak.

"IHS headquarters is working to get resources out to the front lines as quickly as possible. This week we held rapid tribal consultation and urban confer sessions to guide our distribution of $134 million in new resources to respond to coronavirus … in American Indian and Alaska Native communities.

"These funds will support IHS and tribal and urban Indian organizations in our response", Weahkee concluded.

https://www.aljazeera.com/news/2020/04/ ... 15214.html

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I have heard other positive reports of hydroxycloroquine so feel it important to include it here: Anthea

Man who survived COVID-19

Rio Giardinieri says anti-malaria drug saved his life: 'I didn't believe I was going to be here by the morning'

Diagnosed with pneumonia and coronavirus, Rio Giardinieri, 52, was admitted to the ICU at Joe DiMaggio hospital in South Florida. After more than a week without showing any improvement, doctors told him there was nothing more they could do. Desperately ill, Giardinieri started saying his "goodbyes" to family and friends.

That's when a friend told him there was a potential "cure" for coronavirus, an anti-malaria drug called hydroxycloroquine. Though doctors at the hospital said they couldn't prescribe hydroxycloroquine, they put Giardinieri in touch with an infectious disease doctor who authorized the use. The next morning, he says he woke up feeling "absolutely perfect."

Giardinieri joined Glenn Beck on the radio program Tuesday to share his remarkable story and to weigh in on why he thinks information about this promising treatment for COVID-19 isn't being made more readily available.

"I'm not a scientist. I'm not a doctor. I can just tell you how I feel. And I know that I was not doing well. In my mind, I didn't believe I was going to be here by the morning," Giardinieri said. "I don't know what else to attribute [for recovery] but that medicine ... and it's not just me that it's worked for. There're many people this has worked for. So, you know, I certainly understand the hospital's position. They may not be too happy about me telling the story. But the facts are the facts."

https://www.theblaze.com/glenn-radio/an ... n=theblaze

[Anthea]

Hydroxychloroquine

Doctors worldwide say malaria drug is the best coronavirus treatment

Doctors around the globe report that the malaria drug hydroxychloroquine seems the most effective treatment they've tried for coronavirus patients - but less than half as many doctors are prescribing it in the US as in other hard-hit countries like Spain.

A survey of 6,200 doctors around the globe reveals that while few corners of the world are untouched by the virus, the pandemic is being handled very differently from country-to-country.

And in some measures, the US continues to fall behind other nations' responses.

For example, an American waits an average of four to five days to get results back after being tested for COVID-19. Half of doctors in Europe and most in China get the test results back within 24-hours.

Dr Murali Doraiswamy, an adviser to Sermo, urged that countries should take note of what is working for doctors and governments elsewhere and move quickly to adopt practices that are saving lives.

Hydroxychloroquine was deemed the most effective coronavirus treatment comared to other options by more doctors worldwide than any other in a global survey

HOW ARE DOCTORS AROUND THE WORLD TREATING CORONAVIRUS?

Doctors and governments spanning the globe are scrambling to test and development treatments for coronavirus.

While most nation's have issued guidance for doctors to standardize care for coronavirus patients, there are no clinically proven treatments for the devastating infection that has killed more than 55,000 people worldwide.

The World Health Organization (WHO) has launched a multinational trial of several treatments, including hydroxychloroquine and remdesivir, a drug developed to treat Ebola, taking place in countries including Argentina, Bahrain, Canada, France, Iran, Norway, South Africa, Spain, Switzerland and Thailand.

The US is not included in the WHO trial but, like many other nations, is running its own clinical tests of both of those drugs.

Hydroxychloroquine trials have begun in states like New York, Minnesota and Washington, and the US Food and Drug Administration (FDA) gave the drug emergency use authorization on Sunday for doctors to prescribe to adult and teen patients if clinical trials aren't available.

Rapid tests were among the needs cited by doctors around the world and in the US, getting test results takes between four and five days - far longer than in most countries

With that shift, the drug should be more widely available and prescribed in the US, but as of the Sermo survey, just 23 percent of US doctors reported giving it to COVID-19 patients, lagging far behind many other countries.

In Italy, nearly half of all doctors reported prescribing the drug, which is also used to treat lupus and rheumatoid arthritis.

More than 70 percent of Spanish doctors are giving the drug to coronavirus patients, as are 41 percent in Brazil, 39 percent in Mexico and 28 percent in France.

However, it's used even less commonly in Germany (17 percent), Canada (16 percent), the UK (13 percent) and Japan (seven percent).

Globally, painkillers are still the category of drugs most often given to coronavirus patients, followed by the antibiotic azithromycin, which is sometimes given in combination with hydroxychloroquine, the third-most-prescribed drug.

HOW DOES CORONAVIRUS TESTING IN THE US COMPARE TO OTHER COUNTRIES?

As of this week, has tested far more people for coronavirus than other countries like South Korea and Italy.

But that milestone was a long time coming, after the CDC blundered its original test and delays abounded.

Still, the US is testing fewer people per capita - a smaller percentage of its population - than is South Korea.

And the wider availability of test kits has not translated into faster results as of yet.

In the US, doctors who responded to Sermo's survey said they waited an average of four to five days to get the results.

Ten percent said their patients were left wondering whether or not they had COVID-19 for more than a eek.

Only 14 percent of US doctors said they got results within 24-hours.

In Europe and Japan, half of all doctors had their patients' test results in 24 hours.

Nearly three quarters of Japanese doctors heard back rom labs a day later on average and eight percent had results within the hour.

Protective gear like masks, gowns and face shield, was rated the most dire need of most doctors treating coronavirus

HOW COUNTRIES ARE COPING WITH SUPPLY SHORTAGES

The clock is ticking in hard-hit nations that are experiencing shortages or awaiting their supplies of ventilators for critically ill coronavirus patients and personal protective equipment (PPE) like masks and gowns to run out.

Looming shortages mean making tough calls about prioritizing groups of people.

Virtually all nations - with China as the exception - give ventilators first to people who have a shot at recovery, those who are in worst condition and first responders like doctors and nurses.

Nearly half of respondents to Sermo's survey said that those who could beat the infection got ventilators first, 21 percent considered a high risk of death a top deciding factor and 15 percent said that whether someone was a first responder to the coronavirus crisis was an important factor.

But the order of importance of those factors varied from country to country.

In the US, whether someone was a nurse, doctor, health care worker or other first responder played a more significant role in whether they were considered first for a ventilator than in most countries.

Japan, France and Italy placed particular weight on a patient's age.

Brazil and Russia take how high-risk a given patient is into account first.

However, around the world, doctors said that PPE was actually the greatest need.

In fact, second to protective gear, doctors said that fast COVID-19 testing kits were more necessary even than ventilators - although the same may not be true in every location, such as New York City, where ventilator capacity is expected to be exceeded over the weekend.

New York City emergency medicine physician, Dr Kamini Doobay, said coronavirus is unlike anything she's seen before. Although most doctors around the world said they need PPE more than anything, New York is particularly in need of ventilators

DOCTORS LOOK AHEAD TO THE FUTURE OF THE PANDEMIC

Worldwide, doctors agree: the pandemic is far from over.

More than 80 percent of physicians told Sermo they expect a second wave.

Even more American doctors - 90 percent - anticipate at coronavirus will ramp up again later in the year, although just half of Chinese doctors said the same.

Two-thirds of American doctors also believe that we're still three to four weeks away from the peak of the pandemic in the US.

As a result, 63 percent said that the US government should wait at least six weeks from now to lift restrictions on movement intended to slow the spread.

https://www.dailymail.co.uk/health/arti ... tment.html

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Can an N95 mask
protect from new?

Face masks are reportedly selling out in cities across Asia as concerns over the spread of a deadly new coronavirus grow. China’s National Health Commission has deployed masks to healthcare workers responding to the outbreak, and millions of masks have been sent to residents of Wuhan, according to reports. But will these masks stop people from catching the virus?

We know the coronavirus is airborne, and that it can be transmitted between people. Researchers believe that the virus may have made the jump from animals to people via the inhalation of airborne particles in a seafood market that sold live wild animals. So it makes sense to cover your nose and mouth.

There are two main types of face masks that are being used to do that. One is a standard surgical mask – the kind worn by surgeons during operations. These masks are designed to block liquid droplets, and might lower the chance of catching the virus from another person.

But these masks do NOT offer full protection against airborne viruses. For a start, they don’t fully seal off the nose and mouth – particles can still get in. And very small particles can simply pass through the material of the mask. These masks also leave the wearer’s eyes exposed – and there’s a chance the virus can infect that way. “They might help, but it’s not clear they give you total protection,” says Mark Woolhouse at the University of Edinburgh, UK.

One-use masks

The World Health Organization recommends that all healthcare workers treating people with the virus wear these surgical masks, along with gloves, goggles and gowns. Surgical masks are thought to be more effective in a clinical setting because they are accompanied by other protective equipment and stringent hygiene practices. The masks are also frequently replaced – surgical masks are not designed to be used more than once.

N95 respirators offer more protection. Such devices are designed to prevent 95 per cent of small particles from entering the nose and mouth area. But they only work if they fit properly, and aren’t suitable for children or people with facial hair.

N95 respirators can also make it more difficult for a person to breathe, so could be dangerous for someone showing symptoms of infection of the new coronavirus, which include coughing and shortness of breath.

Avoid large gatherings

There are other precautions people in China can take to avoid catching the virus. Local authorities are advising residents to avoid large public gatherings, for example. The Lunar New Year holiday has been prolonged to keep people off work and out of school. And practising good hand hygiene can help.

For most people outside China who haven’t been to one of the affected regions, the risk of catching the virus remains low for now. Health authorities are cautioning against travelling to the affected region, and it always makes sense to practice good hand hygiene.

If you are worried about your symptoms, and think you may have the virus, call for medical advice before visiting a hospital and potentially spreading the infection, suggests Robin Thompson at the University of Oxford.

https://www.newscientist.com/article/22 ... ronavirus/

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Some good news!

Number of people who’ve RECOVERED from Covid-19 passes quarter of a million

Perhaps the most under-reported statistic in the entire coronavirus pandemic passed an important milestone on Sunday as 250,000 were marked as having recovered from the illness.

The onward march of the death toll and number of confirmed cases has prompted countless hours of media coverage, as the virus spread around the globe. However, the number of people who are officially recorded as having recovered from the disease receives far less attention.

The important stat climbed past the quarter of a million barrier (to 252,478) on Sunday, as more than 20 percent of confirmed carriers of the virus have officially overcome the disease, according to the Johns Hopkins Coronavirus Resource Center.

Of course, this represents only a portion of the total number of people who have actually beaten the virus, as most experience only a mild illness, or even no symptoms at all, and overcome it without needing medical care.

Experts have noted that one of the most significant figures of the entire outbreak is the number of people who have contracted the disease and recovered from without ever registering in the official statistics.

The total number of cases of Covid-19 around the world stood at approximately 1.2 million on Sunday, and the number of fatalities surged past 65,000. Health authorities in countries across the world again stressed the importance of observing social distancing, lockdowns and other measures brought in to try and wrestle the outbreak under control.

https://www.rt.com/news/485027-recovere ... es-250000/

On a personal level:

I have friends who have been tested as Covid-19 positive, but have had little or no symptoms

[Anthea]

Low-risk activities to resume in Iran

Iran: COVID-19 infection rates start to steady

"Medium and low-risk" activities in Iran are to resume from next week, President Hassan Rouhani announced on Sunday, in an easing of some restrictive government measures to combat the spread of COVID-19.

A new "Smart Distancing" programme was discussed at a session of the National Task Force for Fighting Coronavirus on Sunday, according to a statement by Rouhani published by the official President.ir website.

“Today, we decided to use a step-by-step process to reopen the activities, and it was the suggestion of the Ministry of Health and Medical Education that the activities should begin gradually,” read the statement. "It was decided that from April 11, the country's provinces can start businesses; this was about medium and low-risk businesses, but high-risk businesses are still banned until the April 19, for which decision will be made later."

"Risky businesses like sports centres and activities that require a large population are still banned until further notice," the statement added.

Schools and universities are to remain shut until April 18, continuing to teach classes online. Religious and cultural events will also banned until the same day, as will intercity, non-essential commercial traffic.

The easing of restrictions comes amid a slight decline in the national COVID-19 death and case tolls.

Iran - the Middle Eastern country hardest hit by the pandemic - has recorded 58,226 cases of infection, health ministry spokesman Kianoush Jahanpour said at a daily coronavirus update press briefing on Sunday.

The death toll has risen to 3,603, Jahanpour added, after 151 more deaths were recorded in the 24 hours leading up to his announcement.

Rouhani insisted in the statement that the resumption of these "medium and low-risk" activities is not a sign of a government taking self-isolation or social distancing to prevent the spread of the highly contagious virus lightly.

“Starting these activities does not mean that we have violated or forgotten the principle of staying at home, and again those who do not need to be present on the street and in society, are preferred to look after themselves and stay home,” he added.

Iranian authorities received international criticism last month for their failure to implement restrictions on movement quickly enough, despite polling data from the time showing that a majority of Iranians supported a complete lockdown of urban areas to help contain the coronavirus outbreak.

Health officials in turn berated the Iranian public for not adhering to lockdown measures during the Newroz (New Year) holiday period, which came to an official end on Saturday.

https://www.rudaw.net/english/middleeast/iran/05042020

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Impact of COVID-19 on
Middle East conflicts?

The novel coronavirus has put global trade on hold, placed half of the world population in confinement and has the potential to topple governments and reshape diplomatic relations

The United Nations has appealed for ceasefires in all the major conflicts rocking the planet, with its chief Antonio Guterres on Friday warning "the worst is yet to come". But it remains unclear what the pandemic's impact will be on the multiple wars roiling the Middle East.

Here is an overview of the impact so far on the conflicts in Syria, Yemen, Libya and Iraq:

Syria

The COVID-19 outbreak turned into a pandemic just as a ceasefire reached by the two main foreign power brokers in Syria's nine-year-old war – Russia and Turkey – was taking effect.

The three million people living in the ceasefire zone, in the country's northwestern region of Idlib, had little hope the deal would hold.

Yet fears the coronavirus could spread like wildfire across the devastated country appear to have given the truce an extended lease of life.

According to the Syrian Observatory for Human Rights, the month of March saw the lowest civilian death toll since the conflict started in 2011, with 103 deaths.

The ability of the multiple administrations in Syria – the Damascus government, the autonomous Kurdish administration in the northeast and the jihadist-led alliance that runs Idlib – to manage the coronavirus threat is key to their credibility.

"This epidemic is a way for Damascus to show that the Syrian state is efficient and all territories should be returned under its governance," analyst Fabrice Balanche said.

However the pandemic and the global mobilisation it requires could precipitate the departure of US-led troops from Syria and neighbouring Iraq.

This in turn could create a vacuum in which the Islamic State jihadist group, still reeling from the demise of its "caliphate" a year ago, could seek to step up its attacks.

Yemen

The Yemeni government and the Huthi rebels initially responded positively to the UN appeal for a ceasefire, as did neighbouring Saudi Arabia, which leads a military coalition in support of the government.

That rare glimmer of hope in the five-year-old conflict was short-lived however and last week Saudi air defences intercepted ballistic missiles over Riyadh and a border city fired by the Iran-backed rebels.

The Saudi-led coalition retaliated by striking Huthi targets in the rebel-held capital Sanaa on Monday.

Talks have repeatedly faltered but the UN envoy Martin Griffiths is holding daily consultations in a bid to clinch a nationwide ceasefire.

More flare-ups in Yemen could compound a humanitarian crisis often described as the worst in the world and invite a coronavirus outbreak of catastrophic proportions.

In a country where the health infrastructure has collapsed, where water is a rare commodity and where 24 million people require humanitarian assistance, the population fears being wiped out if a ceasefire doesn't allow for adequate aid.

"People will end up dying on the streets, bodies will be rotting in the open," said Mohammed Omar, a taxi driver in the Red Sea port city of Hodeida.

Libya

Much like Yemen, the main protagonists in the Libyan conflict initially welcomed the UN ceasefire call but swiftly resumed hostilities.

Fierce fighting has rocked the south of the capital Tripoli in recent days, suggesting the risk of a major coronavirus outbreak is not enough to make guns fall silent.

Turkey has recently played a key role in the conflict, throwing its weight behind the UN-recognised Government of National Accord.

Fabrice Balanche predicted that accelerated Western disengagement from Middle East conflicts could limit Turkish support to the GNA.

That could eventually favour forces loyal to eastern-based strongman Khalifa Haftar, who launched an assault on Tripoli one year ago and has the backing of Russia, Egypt and the United Arab Emirates.

Western countries have been hit hardest by the pandemic, which could prompt them to divert both military resources and peace-brokering capacity from foreign conflicts.

A report by the International Crisis Group said European officials had reported that efforts to secure a ceasefire in Libya were no longer receiving high-level attention due to the pandemic.

Iraq

Iraq is no longer gripped by fully-fledged conflict but it remains vulnerable to an Islamic State resurgence in some regions and its two main foreign backers are at each other's throats.

Iran and the United States are two of the countries most affected by the coronavirus but there has been no sign of any let-up in their battle for influence that has largely played out on Iraqi soil.

With most non-US troops in the coalition now gone and some bases evacuated, American personnel are now regrouped in a handful of locations in Iraq.

Washington has deployed Patriot air defence missiles, prompting fears of a fresh escalation with Tehran, whose proxies it blames for a spate of rocket attacks on bases housing US troops.

https://www.rudaw.net/english/middleeast/050420201