Going Viral: Just 10 days left of this lock down

Saturday June 20, 9am

IS THERE ANYBODY OUT THERE?

AFTER 12 WEEKS, THE END OF MY LOCKDOWN IS JUST 10 DAYS AWAY

UK’S COVID-19 ALERT LEVEL LOWERED AFTER 'STEADY' FALL IN CASES

As things stand right now, come June 29 I will be taking a car ferry from Ireland to Britain.

June 29 is a day that has been circled on my calendar for weeks now, ever since the government in Dublin outlined a phased plan to left lockdown restrictions necessary to flatten the curve and beat back this deadly coronavirus pandemic.

Right now, my movements are limited to within my county of Wexford on the southeast corner of Ireland, many shops and businesses remained closed but are slowly opening, and the social-distancing rule of two metres remains in place with facemasks recommended for public transport and other situations.

But the distance limitation is lifted on June 29 – hence my ability to travel to England.

I will spend a week there before taking a ferry across the English Channel to France, then take about 10 days driving down to the bottom of Spain. From Cadiz, I’ll take another car ferry to the Canary Islands where I live for part of the year.

It will be a journey of liberation in many ways – seeing cities and communities re-open again after the pandemic.

While the UK currently has a quarantine rule in place for all travellers, travellers from Ireland are exempt. I won’t have to go into 14 days of self-isolation again. I’ve already had to do that once, when I returned to Ireland from Bali in late March.

LOWER COVID-19 THREAT LEVEL IN THE UK

There is more good news in that since Friday morning, the British government there has reduced the COVID-19 threat level from four to three.

The UK’s chief medical officers said the move was recommended by the Joint Biosecurity Centre after a “steady decrease” in COVID-19 cases in England, Scotland, Wales and Northern Ireland.

Level four means the virus is in general circulation and that transmission is high or rising exponentially, while level three means the epidemic is in general circulation.

The Department of Health said the level has been changed “with immediate effect”.

In a statement, the chief medical officers said: “There has been a steady decrease in cases we have seen in all four nations, and this continues. It does not mean that the pandemic is over. The virus is still in general circulation, and localised outbreaks are likely to occur. We have made progress against the virus thanks to the efforts of the public and we need the public to continue to follow the guidelines carefully to ensure this progress continues.”

At level five, transmission is high or rising and there is a risk healthcare services will be overwhelmed. Level one means coronavirus is no longer known to be in the UK.

Level three is when the epidemic is in general circulation and gradual easing of restrictions can take place, while level two is when the number of cases and transmission is low and “no or minimal” restrictions are required.

CHINA PUBLISHES BEIJING COVID-19 GENOME DATA, OFFICIALS SUGGEST A EUROPEAN STRAIN

China has released genome sequencing data for the coronavirus responsible for a recent outbreak in Beijng, with officials saying on Friday it identified a European strain based on preliminary studies.

China, which had been under pressure to make the data public sooner rather than later as COVID-19 cases mounted in the country’s capital, said it had also submitted the data to the World Health Organisation.

Details published on China’s National Microbiology Data Centre website revealed the genome data was based on three samples – two human and one environmental – collected on June 11.

That was the same day Beijing reported its first new local COVID-19 infection in months. In the eight days since, the city has reported a total of 183 cases, linked to the sprawling wholesale food centre of Xinfadi in the city’s southwest.

“According to preliminary genomic and epidemiological study results, the virus is from Europe, but it is different from the virus currently spreading in Europe,” Chinese Centre for Disease Control and Prevention (CDC) official Zhang Yong said in an article published on Friday. “It’s older than the virus currently spreading in Europe.”

SEVERAL POSSIBILITIES

Zhang said there were several possibilities as to how the virus arrived in China.

“It could have been hidden in imported frozen food products, or it was lurking in some dark and humid environment such as Xinfadi, with the environment not having been disinfected or sterilised,” Zhang wrote in the article posted on the Central Commission for Discipline Inspection’s website.

Wu Zunyou, the CDC’s chief epidemiology expert, had told state media earlier this week the Beijing strain was similar to Europe’s, although not necessarily directly transmitted from European countries. Wu did not elaborate on those comments made before the release of the genome sequence.

The coronavirus strains found in the United States and Russia were mostly from Europe, he added.

The first major cluster of new coronavirus infections was traced to the Huanan seafood market in Wuhan in December. It has since spread globally, infecting almost 8.5 million people and killing around 450,000.

Meanwhile, Singaporeans can wine and dine at restaurants, work out at the gym and socialise with no more than five people at a time as of Friday, when the city-state removed most of its pandemic lockdown restrictions.

FRESH SPIKE IN INFECTIONS

The latest relaxation comes as reopenings in many places around the world are touching off fresh spikes in infections, raising questions about how to live with the virus without causing unnecessary deaths or economic catastrophe.

Getting back to business in Singapore came as China declared a fresh outbreak in Beijing under control after confirming 25 new cases among some 360,000 people tested. That was up by just four from a day earlier.

Singapore’s shopping centre, gyms, parks and other public facilities reopened their doors with strict social distancing and other precautions.

After at first appearing to have been a model for containing the virus, the country of only 5.8 million has one of the highest infection rates in Asia with 41,473 cases, mostly linked to foreign workers’ dormitories.

Authorities say such cases have declined, with no new large clusters and a stable number of other cases despite a partial economic reopening two weeks ago.

Wee Cheng Yan, a gym trainer, said it felt good to return to work after two months at home.

“Definitely, interaction has been lacking the past few months,” he said.

“Watching a lot of TV. Doing a bit of resistance band training, which is not as effective as working out in the gym.”

Gym members still must make appointments and are limited to only two hours a day. The steam rooms remained shut and clients must wear masks at most times.

CONTACT SPORTS BANNED

Contact sports, concerts, trade fairs, singing lessons and mass religious meetings are still banned and entertainment venues such as cinemas, karaokes and bars remain shut.

The pandemic is waxing and waning in many places, with numbers of cases soaring in Indonesia and India, Brazil and Mexico but appearing to be under control or contained in Thailand, Japan, Vietnam and New Zealand.

Japan’s foreign minister, Toshimitsu Motegi, said on Friday that Japan and Vietnam have agreed to partially lift travel bans and ease restrictions step by step under the understanding that both countries have their outbreaks largely under control.

Vietnam is among four countries that Japan is discussing resuming mutual visits in phases. It is seeking similar arrangements with Thailand, Australia and New Zealand.

In South Korea, officials reported 49 cases of COVID-19 on Friday as the virus continues to spread in the densely populated capital area of Seoul, where half of its 51 million people live.

About 30 to 50 new cases have been confirmed per day since late May.

MEME OF THE DAY

I came across this on Facebook and ironically, I thought I’d share it with you – just in case!

RESEARCHERS REPORT RARE NEUROLOGICAL CONDITION IN A FEW COVID-19 PATIENTS

Doctors in Europe are documenting a few COVID-19 patients who’ve later developed a rare and potentially dangerous neurological condition that is typically connected to other viral infections.

Researchers in the United Kingdom and Italy have reported cases of COVID-19 where the patients later developed Guillain-Barre syndrome (GBS), a condition in which the patient’s own immune system attacks the nerves, leading to a weakness in the face or the extremities and even near-complete paralysis.

GBS typically emerges in the days and weeks following a respiratory or digestive tract infection, although it’s still unclear what causes the disorder.

A case report from mid-May in the New England Journal of Medicine shows five people between Feb. 28 and March 21 in northern Italy developed Guillain-Barre syndrome following a COVID-19 infection. Four of the patients initially developed lower limb weakness, while the fifth developed paralysis in their face.

The symptoms began to present between five and 10 days of their COVID-19 symptoms. After four weeks of medical treatment, two of the patients remained in hospital, two were receiving physical therapy for their condition and one had recovered to the point where they could walk independently.

LIKELY AN UNCOMMON OCCURENCE

Dr. Isaac Bogoch, an infectious disease specialist at the University of Toronto, isn’t surprised by an apparent connection between COVID-19 and GBS, but believes if it was a common occurrence, we would have heard about it by now.

“It's still a rare event and no one would be surprised if there were going to be cases of Guillain-Barre associated with COVID-19,” he told CTV News. “Especially in a global pandemic, there's probably going to be some people that develop it.

“It probably is truly a signal among the noise, it’s just how big is that actual signal?”

A similar report in the British Medical Journal documents the case of a 57-year-old man from the United Kingdom who diagnosed with Guillain-Barre syndrome following a COVID-19 infection.

“This is the first reported case of this rare neurological complication of COVID-19 in the UK, but it adds to a small but growing body of international evidence to suggest a significant association between these two conditions,” the report states. “Increasing appreciation of this by clinicians will ensure earlier diagnosis, monitoring and treatment of patients presenting with this.”

A third study, published in Neurological Sciences in early May, examines the case of a woman who had developed a paralysis in her face just days after experiencing a mild respiratory conditions. A nasal swab determined she had COVID-19 and she was later diagnosed with GBS.

In a statement, the Public Health Agency of Canada said it is aware of the three case reports, however, any connection between GBS and COVD-19 “remains unproven.”

“The Public Health Agency of Canada continues to monitor scientific publication for new complications associated with COVID-19,” the statement continued.

DOCTORS ARE ‘ON THE LOOKOUT’

Bogoch said he hasn’t heard or seen any similar cases in Canada, but doctors have been “on the lookout.”

He added that while he does expect an uptick in GBS related to COVID-19 once researchers can look at a bigger picture of the data, but how big that uptick is remains to be seen.

“At the end of the day, it would be nice to have some systematic data to really evaluate that and look at a number of reported cases in the context of the pandemic compared to other years,” he said. “It will probably be a slight uptick in cases, but maybe not as big as, for example, other viral infections like Zika.”

During the Zika outbreak in 2016, a report out of seven countries in South America and the Caribbean showed GBS at up to 9.8 times the pre-Zika rate, although the complication was still rare.

The US Centers for Disease Control states that GBS is ”strongly associated” associated with Zika, although only a small portion of people with Zika later developed GBS.

TAKING STOCK

HOW I’M PRETENDING TO GROW £10,000 IN PLAY MONEY

Another day of losses to round out another dismal week – down £268 on Thursday’s trading.

A reminder that this is all pretend, I started out in lockdown with £10,000 – about Dh45,000 to invest on the London Stock Exchange, I don’t pay for trades and I can only buy or sell when the market is closed. There’s no minimum on the amount of share I can buy.

Ryanair and Halfords were marginally up, with PowerHouse and Dignity both down. There’s no trading on Saturday and Sunday. I’ll look at everything and reset my portfolio before trading begins on Monday. But a major shakeup is in order.

This is how things stand.

Net worth £12615.38

Dignity, 700 shares: £1872.50

Halfords, 1500 shares: £2529.00

PowerHouse, 1200 shares: £3870.00

Ryanair, 375 shares: £4335.00

Cash in hand: £8.88

£ loss on last trading day: £268.00

% gain overall: 26.1 per cent

£ Gain overall: £2,615.38

BLOOD PLASMA FROM PEOPLE WHO RECOVERED IS A SAFE COVID-19 TREATMENT, STUDY SAYS

A large study of 20,000 hospitalised COVID-19 patients who received transfusions of blood plasma of people who have recovered found the treatment was safe and suggests giving it to people early in the disease may be beneficial.

The treatment, called convalescent plasma, is based on a century-old idea in medicine that has been used against measles, influenza and Ebola. People who recover from an infection have virus-fighting antibodies floating in their blood, and transfusions of their plasma — the clear liquid after blood cells are removed — may give recipients’ immune systems an assist in fighting off the virus.

The study, published Thursday in Mayo Clinic Proceedings, is the largest analysis yet of an experimental treatment rapidly deployed in the early weeks of the pandemic through a grass-roots effort by doctors. What started as a proposal in a medical journal rapidly drew more than 2,000 medical institutions into a collaborative effort to work out the logistics of collecting and deploying the plasma.

The results are encouraging, showing severe adverse events were rare, in less than 1 per cent of patients. But they also highlight the difficulty of conducting conclusive studies in the midst of a global pandemic — and add to a body of inconclusive and sometimes conflicting evidence about the approach.

“The actionable message here is that this is safe, inexpensive, and the mortality rates in sick patients are quite low,” said Michael Joyner, an anesthesiologist at the Mayo Clinic who led the study.

‘CHICKEN AND EGG’ CONUNDRUM

But he acknowledged there is a “chicken and egg” conundrum in trying to conclusively determine the effectiveness of the treatment. The patients were given the treatment through an expanded access programme created by the US Food and Drug Administration, not in a clinical trial in which patients are randomly assigned to receive the treatment or a placebo.

The data, he pointed out, are consistent with the treatment being beneficial. Among the first 5,000 patients who received a plasma transfusion, the death rate in the week after the transfusion was 12 per cent. That first group of patients received transfusions at a time when plasma was often in short supply and was administered to patients late in their illness. In the larger study, the mortality rate fell to less than 9 per cent.

There is no comparison group of patients who did not receive plasma, but the researchers speculate the death rate may have dropped because plasma became more widely available and was given earlier in the disease, which is when doctors say it is more likely to work, based on use in other diseases.

But other factors could also explain that drop in mortality — as the pandemic went on, doctors might have gotten better at treating COVID-19 patients, or people with less severe illness may have begun to show up at the hospital and receive the treatment.

“You’d like to have the gold standard of evidence in something this important, and I feel like it always ends up here with this approach,” said Jeffrey P. Henderson, an infectious-disease specialist at Washington University in St. Louis who has been working on the effort to use plasma. “It’s pushed into action quickly, because there’s no other option, and there’s a theoretical reason in the moment that it works.”

SOMETIMES METHOD PROVES INCONCLUSIVE

While the theory that convalescent plasma could offer a stopgap until better therapeutics are developed has a firm foundation in medical history, the evidence it works has often been inconclusive. In an Ebola outbreak in Guinea, a study found the approach did not have an effect. But studies also found the levels of antibodies can vary widely, and those who saw little effect may have gotten too low of a dose.

In many cases, convalescent plasma as a COVID-19 treatment took a while to get off the ground and only got going when the outbreak was on the downturn, which further complicates the data analysis. A study from China, published in the Journal of the American Medical Association, found no effect from plasma, but the study was terminated early and never enrolled enough patients. A small study from researchers at Mount Sinai Health System in New York that compared patients who received plasma with similar patients who did not found a suggestion of a significant benefit — about half as many patients died in the group who received it versus those who did not.

COMPONENTS OF IMMUNE RESPONSE

Joyner said his team is working to do similar studies comparing patients who received plasma with similar patients who did not. They are also analysing the level of antibodies that neutralise the virus in the plasma to see if there is evidence that a certain dose was linked to a better outcome. But he noted blood plasma is a complicated biological fluid with many different types of antibodies and, at this point, scientists still do not know what other components of the immune response could play an important role.

Sean Liu, an assistant professor in the division of infectious diseases at Mount Sinai Health System who led work suggesting beneficial effects among a small group of patients, said that initially the criteria at his hospital were strict about who could get plasma because the supply was limited. Now, it is far more available because so many patients who have recovered are eager to do their part to help others.

“Now, anyone who has severe COVID-19 and is admitted … we tend to give plasma, because it’s available, and that’s in large part because of the community — the New Yorkers in the area who’ve been donating,” Liu said.

COVIDIOTS, YOBS AND GOONS

A reminder that there is justice – even for covidiots

ARIZONA SHERIFF WHO FLOUTED STAY-AT-HOME ORDER TESTS POSITIVE FOR CORONAVIRUS

An Arizona sheriff who refused to enforce the governor’s stay-at-home order because he believed it was unconstitutional tested positive for coronavirus earlier this week, the sheriff said Wednesday.

Pinal County Sheriff Mark Lamb said in a statement that he was tested before a planned visit to the White House, where President Donald Trump met with law enforcement officials during a signing ceremony on Wednesday.

“To make it explicitly clear, I did not attend the event or meet with the President as a result of the positive test following White House screening procedures,” he said in a Facebook post. “I will be self-quarantining for the next 14 days minimum.”

Lamb, who said he was asymptomatic when he tested positive, believes he was infected during a campaign event on Saturday.

“Unfortunately, as a law enforcement official and elected leader, we do not have the luxury of staying home,” he said. “This line of work is inherently dangerous, and that is a risk we take when we sign up for the job.”

SHERIFF WOULDN’T ENFORCE LOCKDOWN RULES

On May 1, after Gov. Doug Ducey extended a statewide stay-at-home order, Lamb told local news outlets that he wouldn’t cite or arrest business owners who flouted the extension.

“Obviously, the governor’s issued an order, and, potentially, if I don’t follow through with that order I could face a misdemeanor charge,” Lamb told NBC. “But on the other hand, you have the supreme law of the land, which is the Constitution.”

He added: “It is not the right thing to cite them or arrest them for this. We don’t want to create criminals out of innocent people.”

Lamb said his "heart goes out to anyone who has lost a loved one" from the virus, but in a separate interview with a local newspaper, the Arizona Republic, he said that the stay-at-home order had lasted too long.

“The numbers don’t justify the actions anymore,” he said, according to the newspaper. “Three hundred deaths is not a significant enough number to continue to ruin the economy.”

The stay-at-home order was lifted on May 15 and Arizona has since seen record-setting spike in coronavirus cases.

QUESTIONS AND ANSWERS

I’m not an expert, but I might be able to help you make a bit of sense of this. And we can all get through it together. Isn’t this what this is all about.

Send your questions for me to Readers@gulfnews.com.

That’s it for now. Let’s check in with each other tomorrow. I have used files from Reuters, AP, DW, Sky News, Twitter and other European and North American media outlets in today’s blog. And remember to stay safe.

Mick O’Reilly is the Gulf News Foreign Correspondent based in Europe