Going Viral: To meet or not to meet? That is the question

I’m rather old fashioned in that I use a diary book to keep track of what I need to do or where I need to go.

Now, health officials in Europe says, we should all keep track of who we meet during the course of each day. Yes, it is part of the new normal, and yes – it will help stop the spread or will help curtail any second flare-ups of this nasty pandemic.

While apps are being rolled out across Europe and are in varying stages of development, testing or usage, nothing beats pen and paper. Yes, I am just a little old-fashioned!

In Ireland, where I have been under strict lockdown restrictions for the past nine weeks, the National Public Health Emergency Team (NPHET) is continued to urge people to comply with social distancing by keeping more than two metres apart.

As things stand now, I can only exercise within 5 kilometres of my home and have to limit shopping and other activities as much as possible. Hopefully, the restrictions will be lifted a little more come June 6 – but there will still be a long was to go.

“We do recognise that people are out and about that bit more,” said Dr Ronan Gynn, Deputy Chief Medical Officer. “Particularly with the bank holiday weekend and particularly with good weather.”

“If they are meeting people, in as much as possible, if they keep a record of who they are meeting, that will help in the event they’re a confirmed case,” he said. “That will help public health teams and the contact tracers to make contact more quickly and ensure insofar as possible that the spread is stopped.”

I don’t think it would do any of us harm to keep track of who we meet and where. Contract tracing is one essential pillar in getting things back to normal as much as possible.

BRITAIN FACING ‘DANGEROUS MOMENT’ AS SCIENTISTS JOIN TOGETHER TO HIGHLIGHT ‘HUGE RISK’ OF LOCKDOWN EASING

It is a bank holiday in Ireland this weekend and the weather is glorious. So too in Britain, where top public health officials are warning that the UK is facing a “very dangerous moment” with the easing of lockdown restrictions.

In London, Professor Jonathan Van-Tam, the deputy chief medical officer called for people to show restraint as shutdown measures are eased in England from Monday.

He told the daily Downing Street press conference that the government and the public had a “dual responsibility” to prevent a second wave of the virus, adding: “I believe this is also a very dangerous moment. We have to get this right.”

Prime Minister Boris Johnson announced last week that from Monday in England, friends and family can meet in parks and gardens in socially distanced groups of six.

But as people flocked to beaches and beauty spots in the sweltering heat over the weekend, Professor Peter Horby, of the University of Oxford, joined scientists Jeremy Farrar and Professor John Edmunds, all members of the Scientific Advisory Group for Emergencies (Sage), to warn that ministers are taking risks.

SCIENTIFIC OPINIONS VARY – BUT EXPERTS ARE URGING CAUTION

Prof Van-Tam said scientific opinions “always vary to some extent”, and told the press conference that the lockdown easing must go “painstakingly” slowly.

“This is a dual responsibility here of government to go slowly and carefully and to take the advice from the scientists,” Prof Van-Tam said. “Advice of the scientists to watch this whole thing very closely over the next few weeks. And, of the public in general to actually follow the guidance. Don’t tear the pants out of it, and don’t go further than the guidance actually says”.

The comments came as Culture Secretary Oliver Dowden announced that elite sport events would begin again next week behind closed doors.

Declaring that “football is coming back”, Dowden said: “Football, tennis, horse racing, Formula 1, cricket, golf, rugby, snooker and others are all set to return to our screens shortly.

“I’m glad to confirm today that a third of matches to finish the season will now be free to view including the Liverpool v Everton derby and live Premier League football will be on the BBC for the first time in its history.”

As an Everton fan since I was some eight years of age – five decades of frustration – this game with Liverpool is the biggest of the season.

DIFFERENT EXPERTS AND DIFFERENT PERSPECTIVES

Asked for his response to experts who have expressed concern the lockdown is being eased too quickly in England, Mowden said it must be remembered there are more than 50 scientists in Sage “all of whom will have their different perspectives”.

He told the daily briefing that scientists are “absolutely right to urge caution”.

Infections

But Professor Robert West, a participant in the Scientific Pandemic Influenza Group on Behaviours (SPI-B) which advises Sage, emphasised that some 8,000 infections and 400 deaths a day are still occurring.

Speaking in a personal capacity, he told the PA news agency: “Put all this together and you have a huge risk, and it’s not just me saying that, that there will be an increase in infection rates.

Because we don’t have track and trace in place, we won’t know whether this easing of the lockdown has caused (an) increase in infections for some time, by which time it will be well under way, the second peak will be well under way.

“The government is not taking its responsibilities for political leadership seriously.

‘IT’S ABOUT SAVING LIVES’

“This should not be treated as a political crisis but as a health crisis, if you treat it as a political crisis it’s all about managing your reputation, if you treat it as a health crisis it’s about saving lives.”

When asked whether he believes news about the PM’s key adviser Dominic Cummings travelling from London to Durham during the full lockdown would have an impact on people sticking to the latest rules, the UCL scientist said: “Trust in authority telling you to do things is very important when it comes to people adhering to those rules.

“When people see something like the Cummings affair… that’s not a recipe for trust.”

The easing of England’s lockdown will also signal the reopening of schools to allow some students to return, and more shops will resume trading along with outdoor retailers and car showrooms.

Prof Van-Tam told the press conference that the lockdown easing must go “painstakingly” slowly, adding: “The scientists will continue to give that advice to the Government. No apologies for that, we will absolutely continue to do that.”

LOCKDOWN RULES APPLY TO ALL

In answer to a question at the briefing about Dominic Cummings, Professor Van-Tam said: “In my opinion the rules are clear and they have always been clear. In my opinion they are for the benefit of all. In my opinion they apply to all.”

Asked if he agrees it is too soon to ease more of the lockdown, Prof Horby told BBC Radio 4’s Today programme: “Actually, I do. We have still got 8,000 cases a day.”

He added that although measures taken so far “have been very successful in… decreasing the numbers”, it is vital “we don’t lose control again”.

He said one of the key issues is the National Health Service Test and Trace system, which has been rolled out across England with the help of 25,000 contact tracers.

But the programme will not be operational at a local level until the end of next month, while an accompanying app is delayed by several weeks.

Prof Horby added: “We are entering a period where there is a risk of increasing transmission, but we don’t yet have that safety net fully in place.”

SCHOOLS ARE SUPPOSED TO REOPEN IN ENGLAND ON MONDAY

Another Sage member, Professor Calum Semple, insisted that a “brave” political decision had been taken on schools reopening “were everything normal”, but cautioned that high levels of transmission were still being seen, according to the BBC.

Farrar also said the track and trace system needs to be “fully working” before measures are eased, warning the virus is still spreading “too fast to lift lockdown in England”.

In Scotland, people can now meet others from one other household at a time as long as it is outdoors, but social distancing should continue and groups must be a maximum of eight people.

People in Wales will be allowed to meet up with others outdoors from Monday.

In Northern Ireland, more retailers can open and small outdoor weddings will receive the go-ahead from June 8 if the coronavirus infection rate remains under control.

QUESTIONS ABOUT COVID-19 TEST ACCURACY RAISED ACROSS THE TESTING SPECTRUM

Another of the elements that will help us all get back to the new normal will be accurate testing, making sure it’s widespread, along with the comprehensive track and trace system in place as outlined above. I’ve been watching developments carefully in the course of writing this blog over the past nine weeks and I think South Korea seem to have it dialled.

But one of the big issues facing public health officials – at least in the US – is that the testing regimen may not be up to par, if only because of the accuracy of the results provided by those tests.

For Sarah Bowen, it all started with a sore throat. Not the kind of searing pain she’d feel with strep, she said, but a throat irritation that just didn’t feel right.

“By the end of the day, it just got a little worse and I didn’t feel great. I felt like I might be coming down with something. And the next day, things got worse,” Bowen, 31, of Portland, Oregon, said.

WAS ABLE TO GET IMMEDIATE TEST FOR COVID-19

Bowen works at a doctor’s office, where she was immediately able to get tested for COVID-19, on May 8. It came back negative, and her doctor said the symptoms were most likely allergies or another virus.

But from there, things snowballed. Bowen developed headaches, a stuffy nose, hot flash symptoms and constant headaches. By day six, she felt like she was hit by a truck. She had extreme fatigue and a burning sensation in her chest.

“I started getting shortness of breath if I went upstairs to get water or something,” Bowen said. “It got worse when I moved around.”

Two days later, she took another test for COVID. Again, it came back negative.

But despite her symptoms, her doctor didn’t believe she had the virus, because there weren’t many cases in the Portland suburb where she lives. Frustrated, Bowen continued to isolate alone in the downstairs of her home. She didn’t want to take any chances.

“It’s one thing to get sick and know it’s a cold or the flu. But to get sick during a pandemic and to be kind of dismissed, makes you feel crazy,” she said.

FALSE NEGATIVES MAY BE MORE COMMON THAN REALISED

Bowen’s diagnosis remains unclear, but her experience raises questions about the accuracy of diagnostic tests for the disease. Indeed, as more and more people have access to testing, new data show that false negatives on COVID-19 tests may be more common than first realised.

And as the U.S. starts to reopen, accurate testing is one of the most important tools in states' arsenals to track — and stop — the spread of the coronavirus.

Since the pandemic started spreading across the United States in March, nearly 70 tests have received emergency use authorisation from the US Food and Drug Administration. Many of these tests were developed at a breakneck pace in an effort to get tests out to as many people as possible.

But while no test is perfect, experts told NBC News that these particular tests — used to diagnose COVID-19 — may be missing up to 20 per cent of positive cases.

One key reason behind these so-called false negatives may be how the testing samples are collected.

SCIENTISTS SAY THAT COLLECTION METHOD IS RIPE FOR ERROR

“The false negatives are mainly due to specimen acquisition, not the testing per se,” said Dr. Alan Wells, medical director for the University of Pittsburgh Medical Centre clinical laboratories and a professor of pathology at the University of Pittsburgh.

Most tests use a method called polymerase chain reaction or PCR. It detects coronavirus genetic material that’s present when the virus is active. Clinicians typically collect a sample for testing from the back of a person’s throat — where the virus is presumed to be — with a long nasopharyngeal swab.

But scientists say that collection method is ripe for error.

“You’re sampling blindly. You’re hoping you get the right spot. Then as the disease progresses, the virus might migrate down into your lungs,” Wells said, adding that once it’s in the lungs, that nasopharyngeal swab may not pick up any virus if it’s already been cleared from the throat.

“You have to be at the right place at the right time,” he said.

Another type of diagnostic test forgoes the uncomfortable swab altogether, and instead uses saliva collected in a test tube. Once the sample arrives in the lab, it’s tested the same way, with PCR.

But Wells said those tests could fare even worse.

SALIVA TESTS COULD END UP MISSING UP TO 50 PER CENT OF CASES

“The reason for pharyngeal swabs is the virus preferentially infects and replicates starting way back in the inner cavities of the nose and not out in front,” where it may come into contact with saliva, Wells said, adding that saliva tests could end up missing up to 50 per cent of asymptomatic positive cases.

Making things even more complicated, a May 13 study in Annals of Internal Medicine from researchers at the Johns Hopkins Bloomberg School of Public Health in Baltimore, found that test timing is also essential to getting an accurate result.

Lead study author Dr. Lauren Kucirka, a medical resident at Johns Hopkins Medicine, said testing too early after exposure to the virus substantially raises the risk of a false negative.

“If you have someone who has been exposed and they’ve started to develop symptoms, it probably makes sense to wait a few days before testing,” Kucirka said.

Her study found that three days after the onset of symptoms is when the test is most likely valid.

But besides issues with how and when test samples are collected, questions are also being raised about the quality of the diagnostic tests themselves.

CREATING A FALSE SENSE OF SECURITY

The biggest problem with that is you create a false sense of security. Even if samples are collected perfectly, at the ideal time, the tests could turn up incorrect results. A commentary published in April in Mayo Clinic Proceedings criticised the reliance on PCR tests, saying that even when tests are 90 per cent accurate, that still leaves a substantial number of false test results.

The article’s co-author, Dr Priya Sampathkumar, an infectious disease specialist at the Mayo Clinic, used California as an example in a statement. If the entire population of 40 million people were tested, there would be 2 million false negative results. Even if only 1 per cent of the population was tested, there would be 20,000 false negatives.

“The biggest problem with that is you create a false sense of security,” Wells said.

Another type of COVID-19 diagnostic test, Abbott Labs’ popular ID NOW point-of-care test, has also come under fire in recent weeks, after the FDA issued an alert that it may not always be accurate.

QUICK TEST MAY NOT BE ACCURATE

The test, which uses a method different from PCR, called isothermal nucleic acid amplification, can deliver results in five to 13 minutes. It’s used by doctors across the country and touted by the White House as what’s used to test President Donald Trump and other staffers.

One small study by NYU Langone Health found that the test returned false negatives for nearly 50 per cent of certain samples that a rival test had found to be positive. The study has not yet been peer-reviewed.

In response, Abbott last week released interim data on several of its own studies finding that accuracy was significantly better, in some cases nearly 100 per cent, especially when performed in patients who were tested early after their onset of symptoms.

But anecdotal reports have also found issues with accuracy, leading some of the nation’s largest medical centres to stop or never even start using it.

I think that any test, even if not entirely accurate, is better than none. Remember, in January, COVID-19 wasn’t on our radar, there was no such thing as lockdowns or social distancing. That’s why it’s important that we all social distance, follow the public health advice in place, and do our bit to stop this pandemic in its tracks.

CORONAVIRUS SYMPTOMS OFTEN LINGER BEFORE WORSENING

As doctors around the world diagnose and care for a growing number of people with COVID-19, distinct patterns are emerging, giving clues about how the illness manifests itself in patients.

Very often, people start off with minor physical complaints — slight cough, headache, low-grade fever — that gradually worsen.

“Patients tend to have symptoms for about a week before either getting better, or getting really sick," said Dr. Joshua Denson, a pulmonary medicine and critical care physician at Tulane Medical Centre in New Orleans.

Denson, who estimated he’s treated 15 to 20 patients with the coronavirus, described that first phase of the illness as “a slow burn.”

Other doctors are seeing similar progression.

“It seems like there's a period of time where the body is trying to sort out whether it can beat this or not,” said Dr. Ken Lyn-Kew, a pulmonologist in the critical care department at National Jewish Health, a hospital in Denver.

“We’re learning about this disease as it’s happening, minute-by-minute.”

PATIENTS FEEL BETTER, THEN OFTEN DETERIORATE QUICKLY

Sometimes, patients start to feel better before their health quickly deteriorates. “That’s what we’re seeing with these patients who get a lot worse,” Lyn-Kew said. “They’re doing OK, and then all of a sudden they’re really fatigued, a lot more shorter of breath and having chest pains.”

In North Carolina, Dr. Christopher Ohl has also seen rapid, unexpected development of severe symptoms.

“They say, ‘Hey, you know, I think I’m getting over this,’ and then within 20 to 24 hours, they’ve got fevers, severe fatigue, worsening cough and shortness of breath,” said Ohl, an infectious disease expert and professor of medicine at the Wake Forest School of Medicine in Winston-Salem, North Carolina. “Then they get hospitalized.”

Susan Kane said she noticed her husband, Chris, developed a nagging cough after arriving home from a business trip to Florida late last month. Chris Kane, 55, had no reason to suspect the cough was anything more than a minor cold.

STARTED OFF AS A LITTLE DRY COUGH

Kane was a non-smoker and had no underlying health conditions. “It started off as just a little bit of a dry cough,” said Susan Kane, who lives in Snohomish County, Washington. “He didn’t have any other symptoms but this crazy cough.”

But over the next few days, her husband’s cough grew worse.

“It ramped up, and then it was coughing and choking and just gasping for air.”

A week later, he was diagnosed with coronavirus and hospitalised at Providence Regional Medical Center in Everett, Washington.

“He was really sick,” Susan Kane said. “They put him on oxygen right away.”

Kane eventually recovered after being given an experimental treatment.

Though severe coronavirus cases have been reported among younger and middle-aged adults, doctors say older adults, the elderly and those with chronic health conditions seem to be most at risk for the sudden decline.

CRITICAL ILL PATIENTS HAVE OTHER UNDERLYING CONDITIONS

Denson said nearly all of his most critically ill patients have a combination of three specific underlying medical problems: obesity, high blood pressure and type 2 diabetes.

The ability to compare notes on patients is useful to doctors who have been thrust into figuring out a brand new virus

“We don’t have a nice COVID-19 textbook to go back to,” Lyn-Kew said. “We’re learning about this disease as it’s happening, minute-by-minute.”

But while severe cases and even deaths occur, they’re not the norm.

Some critically ill patients who have needed mechanical ventilation in the intensive care unit have been able to come off the oxygen eventually and get better. And overall, data on coronavirus cases from China and Europe have shown that more than 80 per cent of patients have a mild form of the illness and recover.

Still, doctors said, those most at risk for complications should pay attention to any new symptoms that pop up, even after they start to feel better.

“Be aware of what's going on,” Ohl said. “If your symptoms start to get worse after you’ve been feeling better, then you need to contact your doctor. That’s probably something that doctors need to treat in an emergency,” he said.

MEME OF THE DAY

This was shared with me on Instagram by Sandy who lives just outside London. She and John are good friends going back quite a while. It sort of reminds me about the story: How many therapists does it take to change a lightbulb? One – but the lightbulb must really want to change. Thanks for sharing…

TAKING STOCK

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

So, the London market is closed on Saturdays and Sundays, with trading resuming on Monday.

I’ve had a very positive week, increasing the value of my portfolio by roughly £1,000 in just four days of trading. I don’t see any reason to alter for now, but Diageo, the drinks distiller, is starting to slip and I may cut if loose if it falls significantly again on Monday.

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 stocks I can buy, just as long as I can afford them.

This is how things stand after last week’s trading:

Net worth £14,422.88

Ocado, 100 shares: £2191.00

Diageo, 100 shares: £2790.50

Avast, 1,000 shares: £5030.00

PowerHouse, 1200 shares: £4356.00

Cash in hand: £55.38

£ gain on last trading day: £977.50

% Gain overall: 44.2 per cent

£ Gain overall: £4,422.88

COVIDIOTS, YOBS AND GOONS

Here’s my daily collection that proves covidiots missed a lot of classroom time by sitting outside the principal’s office for too long.

DID A COVIDIOT GET AWAY WITH MURDER IN KILLING OF UK STATION WORKER?

No further action will be taken in relation to the death of a railway ticket office worker who contracted COVID-19 after being spat at while on duty, the British Transport Police (BTP) have said.

Belly Mujinga, 47, fell ill with the virus days after a man who said he had COVID-19 spat and coughed at her and a colleague at Victoria station. She died on 5 April.

In a statement, BTP said senior detectives had concluded “there is no evidence to substantiate any criminal offences having taken place, and the tragic death of Belly Mujinga was not a consequence of this incident”.

As a result, the matter will not be referred to the Crown Prosecution Service.

BTP said detectives had conducted “extensive inquiries” which included reviewing CCTV footage of the incident and speaking to witnesses.

NATIONAL OUTCRY IN UK FOR MORE PROTECTIVE EQUIPMENT

Mujinga’s death sparked a national outcry and a call for more protection for transport workers, with Boris Johnson condemning the incident. “The fact that she was abused for doing her job is utterly appalling,” he said during prime minister’s questions.

The UK transport secretary, Grant Shapps, said the case was a criminal matter, not about staff having more protective equipment.

The transport union TSSA called on the government to extend the coronavirus compensation scheme for health and care workers to the families of transport workers who had lost their lives.

DCI Sam Blackburn said: “I know the loss of Belly has moved so many people, and I can assure you we have done everything we can to provide answers for her family.

“As a result of our inquiries, we can now be confident that this incident did not lead to Belly’s tragic death.

“Our thoughts remain with her family and we will continue to support them as they come to terms with the loss of their much-loved mother and wife.”

DEPUTY MAYOR OF LIVERPOOL IS A COVIDIOT

Beware: There are covidiots at every level of government in the UK – not just advising the Prime Minister.

Liverpool’s deputy mayor has temporarily stepped down after video footage emerged of a gathering in her garden during the strictest phase of the coronavirus lockdown.

The Labour councillor Lynnie Hinnigan told the Liverpool Echo that the event for her 50th birthday was not a party, and that she had stayed away from family and friends.

Video clips, which appear to have been uploaded on to Instagram on May 9, show 12 people gathered in Hinnigan’s garden, where a large number of chairs are laid out and bunting and balloons adorn the fences.

The Labour party said she had “voluntarily and temporarily” stepped down from her duties while the event being investigated.

Current lockdown measures, which were eased on 13 May, stipulate that only two people from different households can meet in outdoor settings – such as parks – as long as they stay more than 2 metres apart.

AND A TORY MP ADMITS TO COVIDIOCY

The news of Hinnigan’s gathering comes after a series of political figures were accused of acting against public health advice.

On Thursday, Peter Gibson, the Conservative MP for Darlington, said he made a 400-kilometre journey on a train home while experiencing coronavirus symptoms in March, before the nationwide lockdown. He said he was advised to make the trip home by the MPs’ coronavirus helpline.

Hinnigan, who became one of three deputies to the Liverpool mayor Joe Anderson in 2018, told the Echo the event in her garden had been secretly arranged by her daughter, and family and friends had only come to drop off gifts.

“I really wasn’t aware that it was happening, it was genuinely a surprise,” she said. “Everyone is finding lockdown hard, not seeing family and friends, but everyone should still follow the rules, stay alert, stay safe and socially distance, which is exactly what I told my daughter and the reason I never left the house.

“I am sorry if this has hurt anyone as it was never mine or my daughter’s intention. Many other families in our city have struggled throughout this period, we still need to follow the guidance until we can meet face to face again.”

COVIDIOT HINNIGAN MOVES ASIDE FOR NOW

In a statement, councillor Ruth Bennett, the chief whip of the Liverpool Labour group, said: “We have received emails regarding Lynnie Hinnigan and can confirm that she is being investigated.

“In the meantime, she has, in agreement with the mayor, voluntarily and temporarily stepped down from her council roles with immediate effect during the investigation into her actions.”

Richard Kemp, the leader of Liverpool city council’s Liberal Democrat opposition, called for Hinnigan to resign. He said on Twitter: “Those of us in public life must set an example not find excuses.”

Earlier this month, the Liverpool Labour councillors Barry and Joann Kushner were referred to party whips after an image emerged of them relaxing with family members at their home in Allerton on the same day as the gathering in Hinnigan’s garden.

On Thursday, Barry Kushner was suspended from his duties for two months by the Liverpool Labour group over the incident.

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