I’m the head of a medical school. But doctors like me are going back to the frontline – The Guardian

There has been a lot of public debate over the last few weeks over the role scientists are playing during the coronavirus crisis. In the space of just a few weeks, the likes of Chris Whitty, chief medical officer for England, and Patrick Vallance, the governments chief scientific adviser, have become household names.

As Covid-19 spreads around the world, scientists are taking a prominent role in advancing public knowledge about the virus by advising world leaders, providing expert comment in the media and urgently researching new ways of tackling the pandemic. We are lucky here in the UK: the scientists we have at the moment are as good as it gets. Whitty is a professor of epidemiology this is what he does.

But as this crisis deepens the role of researchers will become even more fundamental as many are now being called upon to join the NHS frontline. Thankfully, we understand within the community that research can go on hold. Whats more, much of it has to because of social distancing.

We have taken the decision to release all our clinical staff from academic and research responsibilities at UCL, where I am head of the medical school, as part of a national effort to staff hospitals. These are medically trained staff, who work across the faculties of population health, medical, life, brain and engineering sciences. I expect we will see the same measures enacted soon nationwide. The medical community needs to do everything possible in response to this epidemic.

In nearly 35 years as a doctor, the coronavirus pandemic is like nothing I have witnessed a global crisis, which will likely overload the health service in every country if it hasnt already done so. By this, I mean, health services will be overwhelmed by the demand put on them by the number of patients requiring treatment. I fear we have to see doctors and nurses working double, or even triple shifts. Many, themselves, will of course get sick, and will have to self-isolate, further compounding the problem.

My work at UCL requires me to look after the largest group of biomedical scientists in Europe. Two weeks ago, I started a regular, albeit occasional, clinical service as a consultant respiratory physician at Londons University College hospital alongside this. I always enjoy leaving the desk work behind and returning to my roots as a clinician. As things progress, I am in no doubt that I will spend more and more time on the frontline.

My first week working in the wards was unremarkable. But by week two last week everything had changed. The ward became eerily quiet. Very few patients were referred to the respiratory team as we prepared for the expected influx of patients infected with the Covid-19 virus. Patients were moved to different wards or different hospitals, personal protective equipment arrived and the infectious diseases team grew overnight.

Then, the patients with Covid-19 started to arrive. As expected some were well, some poorly and new unexpected challenges emerged. Can a patient who is a contact of a patient with Covid-19 have an MRI scan? How can we get a patient home if their carer(s) are unwilling to look after them?

We live in unprecedented times, at least for my generation of 50-something doctors. We are three-four weeks behind Italy and the full force of the pandemic is about to break in the UK which it is thought will not peak until mid-June. The horrific images that we see from Italy are likely to play out here. Of course I might get ill myself, but this is a challenge faced by everybody. Ideally, I hope I will be fine, but if I get it, I get it. I will self-isolate and hope I am fine.

The demand for beds and intensive care facilities, the difficult decisions with limited resources and the pressure on staff, will all build over the coming weeks and months. I have heard that many colleagues have offered to volunteer and have received numerous positive messages from our hospital colleagues. The government has said it will provide training for anyone who feels it is necessary.

Our senior students will also be given the opportunity to help and dozens of other highly skilled scientists working in our labs with relevant transferable skills will also be freed up. But UCL is not mandating this, it will be down to individual choice.

Whatever may happen over the coming weeks and months, I have never been so pleased that we have a joined-up public health structure, a top down NHS, dedicated and loyal staff from across the clinical field and the brightest and best-informed people advising the government on the way forward. Everyone is now stepping up in this new healthcare environment: health professionals doing what they do best. We are professionals, this is what we do. This is our moment. We have to step up and deliver.

Prof David Lomas is vice provost (health), UCL and head of UCL medical school

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I'm the head of a medical school. But doctors like me are going back to the frontline - The Guardian

Expert advice and tips from Warwick Medical School on how to look after our wellbeing and mental health during the coronavirus pandemic – Warwick…

Looking after our wellbeing and mental health is vital in difficult times. Fear and anxiety can suppress our immune system, so finding ways to be kind to ourselves and others while we deal with the spread of COVID19 will boost our immune system and help fight infection explains Sarah Stewart-Brown, professor of public health and expert in mental wellbeing from Warwick Medical School.

As schools close, some shops shelves become empty and many people go into voluntary self-isolation, most of us are focusing on how to manage in this very different world and there is not much headspace to think about what happens next. One unspoken view many of us are hanging on to that if we self-isolate for a week or so the problem will pass and all will be well. That is very comforting, but likely to be overly simplistic.

What tends to happen with viruses is that we develop immunity or we succumb. The proportions recovering or dying depend on how dangerous the virus is. Rhinoviruses cause symptoms of the common cold and are only hazardous to the very sick, the very old or sometimes very small babies. The proportions are different with Ebola virus. If a virus is circulating in the population all the time, people get sick, get immune and recover, or succumb at a steady state and health services can cope with caring for those who get very sick and need intensive or palliative care. We are used to this happening and take for granted that people who are very elderly or sick could die in this way.

New virus no immunity

When the level of immunity in the population is high it is difficult for a virus to circulate because it only meets people who are immune and cannot spread from person to person. At that point the population is said to have herd immunity. Viruses circulate freely in day nurseries amongst children who have not met them before and so there is no herd immunity. New viruses like Covid-19 create the mayhem we are currently experiencing because at the beginning of the outbreak no-one has immunity and the virus has a lot of choice about whom it spreads to. Hand washing, binning tissues, and self-isolation reduce the rate of spread.

Not everyone who meets viruses gets symptoms. If the immune system is working well and the dose is small it is possible to develop immunity without disease the technical term is sero-conversion. This is the principle that is exploited in the development and administration of vaccines. At present, because we do not have population testing, we do not know what proportion of the population is meeting Covid-19, sero-converting and not getting symptoms. We do not even know what proportion of people self-isolating with fevers and coughs have symptoms caused by Covid-19 rather than one of the many other viruses that cause these symptoms. The government announced yesterday that they will be stepping up their testing programme and so these facts will emerge before too long. Until they do we will not be able to calculate accurate sickness or mortality rates from Covid-19 because we do not have an accurate denominator.

The UK Governments strategy aims to slow the spread of the virus rather than prevent it altogether. It is unlikely that spread can be prevented until there is a vaccine and that could take 18 months. The reason why this helps is that our health services will not be overwhelmed with demand to provide life-saving support to the small proportion of people who meet this virus and become very seriously ill. If we slow the rate fewer people will need this help at any one time. The aim of this policy is to enable herd immunity to develop in a controlled way because that is the only way we can bring this outbreak to a close until a vaccine emerges.

Fear suppresses the immune system

Understanding this matters because it means that we are better able to protect ourselves.

And it suggests that alongside following all governments advice to help slow the spread of the virus, the most important thing we should be doing is boosting our immune systems. Doubtless supplements and herbs which are thought to boost immunity are flying off the shelves at the moment for that reason, but they may or may not work.

What is not widely appreciated by the public and what is not being said by the government because the research is not widely known and accepted by the medical profession is that an important dampener of the immune system is fear and panic. It is likely for example that the Spanish flu after the First World War was so dangerous, and particularly to young men, because the level of PTSD post traumatic stress disorder in the population was very high. We dont know this for sure and will not be able to find out in retrospect but given what we now know about fear and the immune system that is very likely.

There is plenty of fear about at the moment and not much being offered in the way of advice and support about how to calm the nervous system. Many people know ways to do this intuitively: listening to music, singing, walking in green spaces. Others have been taught in mindfulness groups or Yoga classes or a myriad of other approaches like Emotional Freedom Technique (EFT or tapping). For most of these approaches there is scientific evidence to show that they work calm the nervous system, that they enhance learning and creativity and boost the immune response. One approach with an evidence base not much known about is visualisation of the immune system functioning under self-hypnosis. Ensuring you have enough sleep is another evidenced way of enhancing immunity.

Many people have already learnt one of more of these skills. People who have this knowledge and skill should be using their skills now and practicing as much as they can. Some people prefer to learn in groups, others individually, some self-directed on line and some from teachers. It is difficult for teachers to teach these skills to others now that groups are closed, but it is possible for those who know how to do them to practice themselves. And on-line classes and webinars are appearing for many of these approaches. Some practitioners are also teaching one to one on skype. There are also Apps which can be downloaded. Some children are being taught some of these skills at school in programmes like .B. Now that they are going to be at home all the time perhaps they might be able to show these to their parents.

Positive social contact is protective technology can help

One area of research which is not being much talked about at the moment is that positive social connectedness is an important enhancer of the immune system is. People who are getting together to create WhatsApp groups in their local communities or setting up organisations like CovidMutualAid probably know, intuitively, that it is important to counter the inadvertent fear of others that is created when we are asked to keep away from other people.

Self-isolation when we are ill, at risk of illness or just plain frightened, cuts us off from the beneficial effects of other human beings. Undoubtedly social media and internet connectedness can fill that gap to some extent and we should all be exploiting those resources now. And for those of us self-isolating at home with friends or family, trying to ensure that relationships are positive and supportive is important. At the same time we need to remember that it is difficult to learn new skills when anxious or afraid. So the elderly who are not connected into social media already may need help to do so.

If we do not develop herd immunity to this virus because the isolation policy suppresses rather than controls the spread, then the outbreak will re-emerge as restrictions are lifted and we will see more peaks in the infection. That is why the government did not close schools straight away. Controlled exposure is a good public health policy. If we add to this as many activities which boost immunity as possible we will increase the number of people who develop immunity without illness or only a mild infection. There will then be a substantial number of people who can keep services running and look after those who are getting ill as the outbreak comes to a close and we all get back to normal.

Top Tips for boosting natural resistance to viral infections

- Take notice of how you feel

- Be kind to yourself and others have patience

- Stay in touch with people who calm you down. Use the telephone or social media. Avoid those who make you anxious

- Regulate your nervous system for a period of time each day with things that work for you. People are different and not everything works for everyone.

- Meditating or doing mindfulness practice

- Mindful movement like Yoga or Tai Chi something that gets you out of your mind into your body

- Getting enough sleep - ideally 8 or more hours

- Get effective sleep - good sleep hygiene practices include: no screens before bed or in the bedroom, no caffeine, alcohol or heavy meals in the evenings. Keep your bedroom dark and cool

- Self-hypnosis and guided imagery visualising your immune system functioning effectively

- Emotional Freedom Technique or tapping

- Listening to or making music especially singing

- Walking in green spaces or near water

If these arent possible other things that are known to reduce stress are:

- Noticing the unusual and positive things that have happened in the day and recalling them before sleep.

Written by Sarah Stewart-Brown, professor of public health and expert in mental wellbeing from Warwick Medical School.

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Expert advice and tips from Warwick Medical School on how to look after our wellbeing and mental health during the coronavirus pandemic - Warwick...

Medical Training Must Include Education in Abortion Care. Here’s Where to Start. – Ms. Magazine

As Congress formulated an emergency bill to alleviate the effects of COVID-19 last week,abortion rights and access arose as an issue, delaying negotiations.

For me, the issue is personal: I am a medical student and future abortion provider. I am also the daughter of a former provider whose practice was threatened by protesters and life was changed by an abortion. My reproductive health traininghowever it is impacted by the national health crisis of COVID-19will not be complete without this critical education in abortion care.

While applying to Obstetrics and Gynecology (Ob-Gyn) residency this year, I learned that abortion care training varies widely across residencies.

A survey of Ob-Gyn applicants across the country found that55 percent of medical students rated abortion training as an important factor. However,over a third of Ob-Gyn residency directors reported abortion training was not a routinepart of their residency.

Furthermore, only22 percent of residency directorsreported Ob-Gyn residents had adequate surgical abortion training. This means nearly four in five Ob-Gyn programs provide inadequate abortion trainingin spite of theAmerican College of Obstetrics and Gynecologys recommendation.

The process of applying to residency is a dizzying experience even without considering training in abortion care. We must determine which training environment, location and people to commit 80 hours per week for four years to while coordinating rotations, accommodations and interviews. Then, we rank our choices and an algorithm matches us with a residency.

Unfortunately, state-level abortion restrictions add an additional challenge for residency programs and applicants.Nine states passed legislation banning or restricting abortionearlier in pregnancylast yearbefore the fetus can survive independentlyincluding Georgia.

Although afederal judge blocked the ban on nearly all abortion care from going into effect, the legal battle continues. Restrictive abortion laws will further limit in-state abortion training opportunities.

Abortion restriction will widen health care disparities and may reduce provider access for pregnancy care. Sinceover half of physicians practice in the state they completed their residency, states with restrictive abortion laws will struggle to employ physicians who want to offer abortion in their practice.

On top of this, were in the midst of a national maternal mortality crisis, and Georgia reports some of the worst pregnancy outcomes of any state. Black women die of pregnancy related causes ata rate three times higher than white women and will bedisproportionately affected by abortion restrictions.

When thinking about abortion, I remember the difficult decisions my patients faced. While caring for these patients, I felt the heaviness of the choice in my chest. However, this is also a necessary choice. I fear that some day, I may not be able to offer this option to my patients.

I also wonder what I would do if I became unexpectedly pregnant during my medical training. If I desired an abortion, how far would I travel if my state restricted it? What if I had a serious medical condition, or was low-income or had lower access to care? The answers are unknowable. Sincealmost half of pregnancies in the U.S. are unplanned, these questions are painfully relevant to all of us.

I am unequivocally in support of the right to choose what care to access in pregnancy. If we care about the improvement and prolongation of life, then we must protect the life of every pregnant person by ensuring both abortion access and pregnancy care.

Anyone who becomes pregnant must have access to compassionate, timely, affordable abortion careregardless of state of residence. A healthcare provider must also deliver patient-centered care without fearing for their life or liberty.

There are several avenues for increasing abortion training. First and foremost, abortion training should be routine for Ob-Gyn and Family Medicine residentsas isrecommended by American College of Obstetrics and Gynecology. Since only 6 percent of abortions occur in academic centers, residencies could better incorporate community settings into training programs.

Residencies in states with restrictive laws should also partner with abortion-providing institutions across state lines. Additionally, we shouldtrain other health professionalsto provide certain abortion services in order to further expand access.

This next year will be exhilarating and terrifying as I assume the role of a doctor amidst a national health crisis brought by COVID-19. I hope to support my patients while synthesizing knowledge and staying well. Access to abortion training or care need not be among my considerations.

It is time once again to speak up and defend the basic liberty of control over our own bodies, and those of our loved ones and patients during this trying time.

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Medical Training Must Include Education in Abortion Care. Here's Where to Start. - Ms. Magazine

As COVID-19 battle escalates, U of T students offer busy health-care workers help on the home front – News@UofT

In the week leading up to the declaration of the COVID-19 pandemic, as it became clear the virus would have a wide-ranging impact, four students at the University of Torontos Faculty of Medicine found themselves searching for a way to help.

Knowing the toll the outbreak would take on the health-care system, the students Jordynn Klein,Daniel Lee, Tingting Yan and Orly Bogler organized their peersto babysit, fetch groceries and carry out other domestic tasksfor health-care workers and hospital support staff who are increasingly at risk of being stretched to the limit.

Daniel and I reached out to some members of our class to see if they would be interested in designing some kind of initiative to help health-care workers who are on the front line, Kleinsays.

Within an hour of putting the call out on Twitter, they had dozens of responses from students who wanted to help in any way possible.

The initiative quickly grew larger than the four medical school students could handle themselves, so they recruited other students in medicine and nursing to help co-ordinate the effort. As of Wednesday, the organizers had signed up over 240 volunteers and have received requests for help from more than 130 health-care workers.Students sign up to volunteer using one online form, while health-care providers fill out another form to ask for help. Already, volunteers have been dispatched all across the Greater Toronto Area.

Nelson Saddler, a second-year medical student, has been putting in six to eight hours per day driving around town in his Hyundai SUV fetching groceries or babysitting. On Wednesday, he did three grocery drop-offs, picking up chicken breasts, fruits and vegetables and salt-and-vinegar potato chips for busy health-care staff.

These health-care workers are trying to keep us safe and treat our community, he told U of T News over the phone. The only way they can keep doing that is by being supported by all of us with the little things like groceries, pet careso they can focus.

Many parents have asked the students for help taking care of their kidsnow that school has been cancelled to promote social distancing, or because grandparents can no longer look after their grandkids because the elderly are at higher risk of serious illness from COVID-19.

Weve been receiving a lot of gratitude from those folks for offering some stopgap coverage for them so they can be at work and not worry about whos going to take care of their child while theyre taking care of other people, Kleinsays.

Nelson Saddler, a second-year medical student at U of T, gets groceries for busy health-care staff duringthe novel coronavirus outbreak (photo by Nick Iwanyshyn)

Before even launching their initiative, the students thought hard about what precautions the volunteers should take so that they didnt inadvertently make the problem worse. Students arent allowed to volunteer if they have been out of the country in the last 14 days, or if they have been in contact with anyone who has. They cant volunteer if theyre involved in high-risk work such as screening patients in an emergency room. And they cant sign up if they are experiencing any upper-respiratory symptoms, according to Lee. As an added safety measure, the organizers assign a single volunteer per family to limit exposure. (U of T News also took precautions while reporting this story by interviewing and photographing the students from a safedistance or over the phone.)

The U of T students say they are in touch with more than a dozen medical students at other Canadian universities who are interested in launching their own volunteer network. I think in a way eyes are on us, says Lee, adding that the U of T students are the only ones who have so farconnected volunteers with families.

Meanwhile, Kleinsays students from Case Western Reserve University in Cleveland, Ohio and New York University have also reached out.

Yan, a first-year medical student, says that seeing how the medical community is responding to the crisis has strengthened her resolve to join the profession. People are in the midst of a crisis and [yet they] are able to rush in and help as best they can and [be] really brave and generous and caring, she says.

Bogler, a fourth-year student whose residency in internal medicine is supposed to begin in July, says she felt a pull to help front-line workers. I was very motivated to get this off the ground, to ensure our year collectively contributes to the cause, she says.

For Klein, whohas spent much of the last few days fielding calls and answering emails, the way the medical community has responded to the outbreak has been inspiring.

If theres one thing that we had reinforced over the course of this initiative, its that bravery is doing what you think is right, especially when youre scared," the second-year student says. To go in and feel that fear, and go in and do it anyway because you know its the right thing to do.

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As COVID-19 battle escalates, U of T students offer busy health-care workers help on the home front - News@UofT

Chloroquine May Fight Covid-19and Silicon Valleys Into It – WIRED

The chatter about a promising drug to fight Covid-19 started, as chatter often does (but science does not), on Twitter. A blockchain investor named James Todaro tweeted that an 85-year-old malaria drug called chloroquine was a potential treatment and preventative against the disease caused by the new coronavirus. Todaro linked to a Google doc hed cowritten, explaining the idea.

Plus: How can I avoid catching it? Is Covid-19 more deadly than the flu? Our in-house Know-It-Alls answer your questions.

Though nearly a dozen drugs to treat coronavirus are in clinical trials in China, just oneremdesivir, an antiviral that was in trials against Ebola and the coronavirus MERSis in full-on trials in the US. Nothing has been approved by the Food and Drug Administration. So a promising drug would be greatand even better, chloroquine isnt new. Its use dates back to World War II, and its derived from the bark of the chinchona tree, like quinine, a centuries-old antimalarial. That means the drug is now generic and is relatively cheap. Physicians understand it well, and theyre allowed to prescribe it for anything they want, not just malaria.

Todaros tweet got thousands of likes. The engineer/tech world picked up the idea. The widely-read blog Stratechery linked to Todaros Google document; Ben Thompson, the blogs editor, wrote that he was wholly unqualified to comment but that the anecdotal evidence favored the idea. Echoing the document, Thompson wrote that the paper was written in consultation with Stanford Medical School, the University of Alabama at Birmingham medical school, and National Academy of Sciences researchersnone of which is exactly true. (More on that in a bit.) One of Todaros coauthors, a lawyer named Gregory Rigano, went on Fox News to talk about the concept. Tesla and SpaceX CEO Elon Musk tweeted about it, citing an explanatory YouTube video from a physician whos been doing a series of coronavirus explainers. To be fair, Musk wasnt all-in on the idea absent more data, though he wrote that hed received a life-saving dose of chloroquine for malaria.

Its the definition of big if true. Part of the story of Covid-19, of the coronavirus SARS-CoV-2, is that it is novel. Humans dont have any immunity to it. Theres no vaccine, no drug approved to treat it. But if a drug did existif a cheap, easy drug can stave off the worst, ventilator-requiring, sometimes-fatal complications of coronavirus infection, or maybe prevent that infection in the first place, what are we all socially isolating for, like suckers?

That ifas the saying goesis doing a lot of work. The Covid-19 pandemic is causing, reasonably, a worldwide freak-out as scientists and policymakers race to find solutions, not always competently or efficiently. Its the kind of thing that rankles the engineer-disruptor mindset. Surely this must be an easily solved problem thats primarily the fault of bureaucracy, regulation, and people who dont understand science. And maybe the first two things are true. The third thing, though, is where the risks hide. Silicon Valley lionizes people who rush toward solutions and ignore problems; science is designed to find solutions by identifying those problems. The two approaches are often incompatible.

What happened here, specifically, is that Rigano sought Todaro out. Todaros tweet identified Rigano as being affiliated with Johns Hopkins; Riganos LinkedIn profile says hes on leave from a masters degree program there in bioinformatics, and has been an advisor to a program at Stanford called SPARK, which does translational drug discoveryfinding new uses and applications for approved drugs. I have a very unique background at the crossroads of law and science, Rigano tells me. I have been working with large pharmaceutical companies, universities, biotechs, and nonprofits in the development of drugs and medical products. He says those contacts told him about the use of chloroquine against Covid-19 in China and South Korea, so he started reading up on it.

(Johns Hopkins did not return a request for comment; a spokesperson for Stanford Medical School emails: Stanford Medicine, including SPARK, wasnt involved in the creation of the Google document, and weve requested that the author remove all references to us. In addition, Gregory Rigano is not an advisor with Stanford School of Medicine and no one at Stanford was involved in the study.)

It turns out that people have been pitching chloroquine as an antiviral for years. In the early 1990s researchers proposed it as an adjunct to early protease inhibitor drugs to help treat HIV/AIDS. A team led by Stuart Nichol, the head of the Special Pathogens Unit at the Centers for Disease Control and Prevention, published a paper in 2005 saying that the drug was effective against primate cells infected with SARS, the first big respiratory coronavirus to affect humans. Thats an in vitro test, not live animalsjust cells.

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Chloroquine May Fight Covid-19and Silicon Valleys Into It - WIRED

Coronavirus Live Updates: Hospitals on Both Sides of the Atlantic Struggle as Cases Climb – The New York Times

The peace agreement in Afghanistan, already stalled by delays in the release of Taliban prisoners and by a political stalemate in Kabul, is increasingly being defined and constricted by the coronavirus crisis.

The U.S. peace envoy, Zalmay Khalilzad, fired off a series of Twitter posts this week that cited the coronavirus as both an impediment to negotiations and a reason to urgently resolve political differences.

Its time for Afghans to compromise, one of Mr. Khalilzads posts read. In another, he wrote, coronavirus makes prisoner releases urgent.

Mr. Khalilzad also acknowledged that disruptions triggered by coronavirus measures have made face-to-face negotiations increasingly difficult.

Coronavirus and the resulting travel restrictions likely requires virtual engagement now, he wrote.

Already, President Ashraf Ghani, 70, is spending time in self-imposed isolation in his private residence at the palace complex in Kabul. The palace Facebook site posted photos of Mr. Ghani alone at home, conferring with cabinet ministers and aides by video link.

Reporting and research were contributed by Raphael Minder, Megan Specia, Marc Santora, Elisabetta Povoledo, Aurelien Breeden, Melissa Eddy, Edward Wong, David E. Sanger, David D. Kirkpatrick, Sui-Lee Wee, Katrin Bennhold, Richard Prez-Pea, Tim Arango, Jill Cowan, Emily Cochrane, Jim Tankersley, Alan Rappeport, Maya Salam, David Zucchino, Isabella Kwai and Dan Barry.

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Coronavirus Live Updates: Hospitals on Both Sides of the Atlantic Struggle as Cases Climb - The New York Times

Stopping Contagion With Science at UM: A Look Back – University of Michigan Health System News

Right now in hospitals around the world, health care professionals taking care of patients with COVID-19 are going to great lengths to protect themselves and other patients from the coronavirus that causes the disease.

They might not realize it, but some of the techniques theyre using date back more than 100 years, when hospitals adopted the aseptic technique for inpatient care.

The idea that infections didnt spread via some mysterious process in the air, but rather through contact with something that a sick person had touched, was still a novel one in the late 19th and early 20th centuries.

In fact, it was still called the germ theory of disease because medical science hadnt yet discovered the true causes of most infectious diseases and their complications, and medical professionals hadnt yet understood their own role in transmitting disease.

Emerging science

Even though bacteria were being studied in research laboratories at the University of Michigan and elsewhere by the late 1800s, viruses were still years away from being seen and understood by anyone.

Not to mention the fact that antibiotics, antiviral medications and modern vaccines were decades away from being developed by university scientists and drug companies.

But the growing realization that touch could transfer disease helped drive new developments in hospitals for people with contagious illnesses in the early 20th century. It ushered in special processes that health care workers and trainees had to follow, and research showing that these steps could reduce disease.

Those changes are still considered best practice today: thorough hand-washing by clinicians as they moved between patients; covering the clothes of patient-care staff with a new gown every time they entered contagious patients rooms and taking it off when they left; and sterilizing or disposing of everything a contagious patient touches.

In August 1914, the University of Michigan opened its first facility designed specifically for this kind of care: a24-bed Contagious Hospital, on the site where a main Medical School building now stands.

It had an ingenious design, created entirely for infection prevention. Each room held two patients, and had two doors: one that opened into a central hallway, for doctors, nurses, cleaning staff and medical trainees to pass through, and one that opened onto a porch that wrapped around the entire building.

The porch door allowed the patients bed to be wheeled through without passing other patients when they entered or left the hospital. It also allowed them to be taken out on the porch for some fresh air, which was considered to have healing properties. And large windows allowed medical students to stand on the porch as their professors discussed the care inside.

It started in a shack

U-M had actually opened its first contagious disease facility in 1897, in a shack that had served as the former hospital laundry. It stood a short distance away from the main Catherine Street hospitals.

But after smallpox ravaged the city of Ann Arbor in 1908, and patients overflowed into a hastily retrofitted house, the city offered money to build a new facility if the university would provide the land and staff.

It wasnt big 40 feet by 100 feet. But the Contagious Hospitals three stories even had living quarters upstairs for nurses, complete with a dining room and living room. The lower level included a large area for sterilization equipment, as well as a morgue.

The design, and the techniques the nurses, doctors, maids, janitors and medical students were trained to use, were inspired by trips to other hospitals that U-M medical leaders David Cowie, M.D. and Reuben Peterson, M.D., and a lead nurse had taken.

They especially focused on care at the city hospital in Providence, Rhode Island, which had been patterned on similar hospitals in London and Paris. There, patients with different diseases were cared for in separate buildings. But U-M and Ann Arbor couldnt afford that.

Safety and efficiency

Petersondescribed the hospital in the Journal of the Michigan State Medical Society a few months before the building opened.He described how the aseptic technique itself could make it possible for patients with different diseases to be cared for in the same facility.

And as Cowie wrote in 1916 in the Transactions of the Clinical Society of the University of Michigan, the aseptic technique supports the idea that the very great majority of contagious and infectious diseases are communicated from one individual to another, or from one place to another, by means of direct or indirect contact. In other words, the infected person has come either in direct contact with the patient or with something that has, directly or indirectly, touched him, Cowie wrote. If this idea can be proved to be correct or adequate, at once a great economic factor has been introduced into contagious hospital work.

One nurse could take care of multiple patients, so long as she (and in those days, they were all women) washed thoroughly and changed gowns in between.

In essence, the new hospital, and others like it, used the same approach for inpatient care that surgical teams had recently started using in their operating rooms.

Previously, surgical infection prevention had focused on fumigating the air in the room with chemicals before an operation, which Peterson recalled doing as a medical student. But as evidence grew of the role of touch, hospitals switched to making sure that everything that came in contact with the patients open surgical site was sterile going in, and disposed of or sterilized afterward.

At U-M and other sites, that same new concept came to inpatient care. Besides handwashing and gowning, the dishes that patients used at the new hospital were sterilized before and after use, as were clothes and bedding. Staff walked on cocoa-fiber mats saturated with mercuric chloride as they left, to keep from bringing infection out on their shoes. Staff couldnt eat on the clinical levels of the building. Cases of cross-infection among the patients were carefully traced.

Early success

Even while the new hospital was under construction, the team used the technique in the Palmer Ward for children, and showed that a case of chicken pox could be contained to the original patient without sickening other children.

Before, there had regularly been outbreaks of disease in both the adult and pediatric hospitals that required quarantining of entire areas after one patients infection spread to others. In 1911 alone, the Palmer Ward had been cordoned off for five months for a quarantine, and all but the most urgent surgical area had been stopped for a month.

In the first 11 months after the Contagious Hospital opened, its teams cared for 223 patients, most of them with chicken pox, mumps, scarlet fever, diphtheria and acute tonsillitis.

Only one trainee caught scarlet fever, but no others -- including the maids and janitor -- got sick.

And no quarantines were necessary in the main hospitals after the aseptic technique began being used there.

When the deadly influenza of 1918 hit Ann Arbor on September 23, after a soldier who had traveled from epidemic-stricken Massachusetts was admitted to the hospital, the aseptic tactics were well in use.

The U-M hospital admitted 130 other influenza patients in less than two months, even though half the doctors at the Medical School had been called up to military duty in World War I at the time. Only 13 of those hospitalized died. A report to the U-M Board of Regents in 1919 also noted that only five U-M students had died of the flu despite being in the highest-risk age group.

A long legacy

Even as the influenza pandemic raged, Dr. Cowie was fitting in research along with caring for patients. He studied what the infection was doing to patients adrenal glands, and tried injections of epinephrine and dead typhus bacteria on those with influenza-related pneumonia.

Though neither approach had a great effect, the research-based approach continued.

As Cowie wrote in a 1942 history of the Department of Pediatrics and Communicable Diseases, Immunizations of all kinds are made in this division of the clinic, not only for the patients but for the entire personnel of the University Hospital. These immunizations consist of vaccinations against smallpox, typhoid fever, diphtheria, and whooping cough, the giving of antitoxins, of immune serums, and of immune blood transfusions, and the carrying out of desensitizations of various kinds for those who are allergic. The Contagious Hospital laboratories employ a fulltime chemist and a full-time bacteriologist.

The Contagious Hospital continued to serve patients until 1956, around the time when the Division of Infectious Disease was formally created in the Department of Internal Medicine and intensive care units were proliferating in major hospitals.

Research on the prevention of cross-contamination of patients, and the protection of health care workers from occupational infectious hazards, has come a long way including a large body of work by U-M and VA Ann Arbor researchers. But the legacy of that first evidence-based facility lives on in some of the precautions taken today.

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Stopping Contagion With Science at UM: A Look Back - University of Michigan Health System News

Research Associate – Bristol Medical School job with UNIVERSITY OF BRISTOL | 200491 – Times Higher Education (THE)

Research Associate

Job number ACAD104526Division/School Bristol Medical SchoolContract type Fixed Term ContractWorking pattern Full timeSalary 33,797 - 38,017 per annumClosing date for applications 29-Mar-2020

The University of Bristol is seeking a Research Associate to work with Dr Foster and team developing new therapeutic agents for diabetic kidney disease. This project is funded by an MRC Confidence in Concepts award. The primary aim is to lead to larger translational grant applications and industry investment to carry this therapy to the clinic.

The role will include tissue culture work with glomerular endothelial cells and in vitro expression systems. mRNA and protein quantification will be carried out in the form of qPCR, Western blotting and ELISAs. Mouse models of type 1 diabetes will be used (Streptozotocin). In vivo techniques such as urine collection, i.v. injection, blood extraction and cardiac perfusion will be carried out. An ex vivo glomerular albumin permeability assay will be used on glomeruli isolated from mouse kidneys.

For informal queries, please contact Becky Foster - 0117 331 3165, Becky.Foster@bristol.ac.uk

We welcome applications from all members of our community and are particularly encouraging those from diverse groups, such as members of the LGBT+ and BAME communities, to join us.

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Research Associate - Bristol Medical School job with UNIVERSITY OF BRISTOL | 200491 - Times Higher Education (THE)

Medical Student Organizing in the Time of COVID-19 – Pager Publications, Inc.

On Friday, March 13, my medical school canceled our classes.

I remember looking at the screen for a full minute, then searching for a loophole can we volunteer in the clinics? before concluding there wasnt one. As a third-year medical student, everything seemed to have fallen away Step 2 CS, away rotations, a planned infectious disease rotation in Thailand with nothing in its place. Nothing can be frightening, but it can also be an opportunity.

During medical school, I have become increasingly aware of how childcare needs put pressure on parents especially women in medicine. I have seen my peers struggle to balance didactic or clinical responsibilities with the needs of their families, and thats just with the usual demands of training. In a pandemic, with multiple school and day care closures, its completely unworkable.

Working with other medical students at Oregon Health & Science University, and with others all across the country, we have developed an initiative designed to match students with health care workers in a longitudinal one-to-one relationship to adhere to social distancing guidelines and provide necessary services such as childcare, petsitting, and errands. The initiative is still growing and changing into its final form, and its too early to say what that will be, but it has already helped our health care workers feel supported and made our community stronger.

Here are a few tips for anyone who would like to develop a similar initiative at their institution:

Image credit: hold | cancel (CC BY-NC 2.0)bywootam

Contributing Writer

Oregon Health & Science University

Emily is a third year medical student at Oregon Health & Science University in Portland, Oregon class of 2021. In 2015, she graduated from Reed College with a Bachelor of Arts in biology-psychology. She enjoys hiking, gardening, and experimenting with food preservation techniques in her free time. After graduating medical school, Emily would like to pursue a career in developmental and behavioral pediatrics.

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Medical Student Organizing in the Time of COVID-19 - Pager Publications, Inc.

Understanding what works: How the coronavirus is being beaten back – STAT

With Europe and the United States locked in deadly battle with the coronavirus that causes Covid-19, a number of countries that were hit early by the virus are doing a far better job of beating it back.

China, which is now diagnosing more cases in returning travelers than in people infected at home, reported no new domestically acquired cases on Wednesday, for the first time in more than two months. South Korea, which had an explosive outbreak that began in February, is aggressively battering down its epidemic curve. Singapore, Hong Kong, and Taiwan have together reported only about 600 cases.

Those successes have been bought by a layering of what are known as non-pharmaceutical initiatives including social distancing and travel restrictions aimed at severing chains of transmission to keep the virus from going into an exponential growth cycle.

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None of the other countries has been as aggressive as China, which put tens of millions of people into forced quarantine for weeks. And these other locales have not all adopted an across-the-board checklist of measures. While kids in Hong Kong havent been in school since late January, class continues in Singapore.

Heres a look at some of the techniques these governments employed, and how they stack up to steps being taken in the United States as well as the United Kingdom, which has come under heavy scrutiny for its approach, fairly or not.

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The island city-state was one of the first places to ban incoming flights from the Chinese city of Wuhan, where the virus originated. And it placed people coming into the country from countries affected by Covid-19 into mandatory quarantine.

Singapore has seen its numbers gradually tick up. But it hasnt had an explosion of cases, likely because it has aggressively tracked where the virus was circulating. Of the 345 cases it has recorded, 124 have recovered and 221 are considered active cases. It has not yet recorded a death.

Singapore has done everything right, said David Heymann, who led the World Health Organizations response to the 2003 SARS outbreak and now teaches infectious diseases epidemiology at the London School of Hygiene and Tropical Medicine. Theyve been openly communicating every day on whats going on. And theyve made it clear to the population and the population understands that they are not only to protect themselves but protect others.

Health authorities have severed several transmission chains, tracking down people who have been in contact with a known case and ordering them into home quarantine. They are checked twice daily to see if they developed a fever.

Mass gatherings were canceled. Schools have not been closed, though students go through temperature screening to enter. So does anyone entering most buildings or restaurants.

Heymann, who was in Singapore recently to lecture at Duke-NUS Medical School, said at the start of each class, a picture would be taken of the classroom, so that if any student became ill, there would be a record of who had been in close contact with him or her. So theres all kinds of innovations and measures going on, he told STAT.

Singapore also quickly developed a much-needed serology test a blood test used to look for antibodies in blood that are a sign of previous infection. Getting a handle on how many people have been infected is critical to understanding how deadly this virus really is, experts stress. Authorities in Singapore actually used the serology test in late February to find the source of a cluster of cases in a church group.

Hong Kong, like Taiwan and Singapore, bears deep psychological scars from the 2003 SARS outbreak. Hong Kong had the most cases of the disease outside of mainland China and people there remember the trauma that came with it.

So do their public health leaders, who have prepared for disruptive infectious diseases outbreaks in the years since SARS and the 2009 H1N1 flu pandemic. People take respiratory health hygiene seriously, routinely wearing surgical masks in public if they are sick to prevent spread to others.

These places were better equipped to face an outbreak of the new coronavirus than many others, Ben Cowling, a professor of infectious diseases epidemiology, and Wey Wen Lim, a graduate student in infectious disease epidemiology at the University of Hong Kong, wrote in a recent opinion piece in the New York Times.

Hong Kong responded very quickly within days of Chinas Dec. 31 announcement that it was finding unusual cases of pneumonia. Doctors were told to report any patient who had influenza-like illness and a travel history to Wuhan. Borders crossings into China were closed first some, then all.

Schools and universities havent been open since the Lunar New Year, on Jan. 23, though online learning has replaced classroom teaching in some circumstances.

Hong Kong has been testing for the virus, aggressively trying to locate cases. People have been urged to telework if possible and to practice social distancing.

Gabriel Leung, dean of medicine at the University of Hong Kong, said measures have largely worked, but the toll is high. And both he and Cowling are concerned people are starting to let down their guard.

I think we are already beginning to see a little bit of response fatigue among the people, Leung said, noting it has become apparent over the past couple of weeks. You see that people are beginning to mix again, theyre beginning to come out again, because its been two months already. So how do you still keep alert and keep this up? There is only so much that any population would be able to tolerate.

Taiwan didnt move initially to cut off air travel with Wuhan, as Singapore did. But doctors boarded incoming flights with temperature scanners looking for people who were unwell. Later it did ban most flights from China.

Mass gatherings were not banned, but were discouraged. The government controlled the distribution and pricing of medical masks, Cowling and Lim wrote. Stiff fines up to more than $30,000 were threatened for people who violated home quarantine orders.

All of these places are coupling aggressive testing strategies to identify cases, with isolation, contact tracing and sometimes quarantine of at-risk people, said Caitlin Rivers, an assistant professor of epidemiology at the Johns Hopkins Center for Health Security, speaking of Singapore, Taiwan, Hong Kong, and South Korea. And they have also layered on community mitigation strategies, school closures and other closures. So what I take away from that is that its important to layer these strategies to try to accommodate both of them.

Rivers tried to look at whether the measures were being successful at driving down new infection rates by pulling up data on other types of communicable infections, both respiratory illnesses, diarrheal diseases, and conjunctivitis. In a short analysis she posted on Twitter, Rivers noted that rates of these other infections declined after stringent social distancing practices were put into place.

The things that are also spread through close contact have fallen dramatically, and so that tells me its individual-level social distancing behavior that is contributing to the control, she said.

Indeed, the Republic of Korea has had a different trajectory than Hong Kong, Taiwan, and Singapore.

The new coronavirus took root in a large and closely knit religious sect, a development that led to an explosive outbreak, which the other three have not experienced. As of Wednesday South Korea has reported just over 8,400 cases and 91 deaths.

But whereas Western countries that have reached numbers like those see daily and every larger rises in their case counts, South Koreas outbreak curve has been beaten back. From a one-day high of 909 new cases on Feb. 29, South Korea has seen its daily case count rise by as few as 74 cases on Monday. That swung back up, though, on Thursday to 152.

The country is testing aggressively more than a quarter of a million people had been tested by March 15, Foreign Minister Kang Kyung-wha told the BBC recently.

Testing is central because that leads to early detection. It minimizes further spread and it quickly treats those found with the virus, she said, suggesting early detection and treatment may explain why South Koreas death rate is lower than other places with large numbers of cases.

South Korea introduced drive-through testing, allowing people to be checked for disease without even leaving their vehicles. Travelers returning from abroad have to provide contact information and report their health status for 14 days after their return via a mobile app, the South Korea CDC website reports.

It has recommended Koreans refrain from international travel at this time and urged people to avoid large gatherings and church services. Companies have been encouraged to allow workers who are able to work from home.

Many epidemiologists and mathematical modelers who have been plotting the possible trajectory of this pandemic think there is no choice but to try some of the serious social distancing measures other countries have taken.

But Marc Lipsitch, an infectious diseases epidemiologist at Harvards T.H. Chan School of Public Health, said the possibility of containment stopping spread through rigorous tracing of all contacts of known cases is not realistic. That window has closed, he said.

I think one thing to learn from those experiences is that whats appropriate when an epidemic is small and mostly ascertained is not appropriate when an epidemic is large and mostly not ascertained, he said.

I would say put in place as intense as possible social distancing and get the messaging from the White House consistent with that, Lipsitch said. Right away, everywhere, with the short-term goal of trying to reduce the demand on the health care system.

Any universities still in session should send students home, especially those living in dormitories which are one step away from cruise ships in terms of density and poor ventilation, he said.

Lipsitch said time is limited to make a difference.

The data that we just assembled from Wuhan about the timing and magnitude of the peak demand for critical care shows first that it can very quickly even without that many people being infected compared to the whole population exceed per capita bed capacity in the United States, Lipsitch said.

He noted there was a four-week lag between the shutdown of Wuhan and the overwhelming of critical care units. So if you wait till you see a problem, then you have another month of agony, at least.

It appeared that was the kind of message Britain was not heeding.

There was a huge controversy late last week when it seemed like the country intended to simply allow enough people to become infected so that the population would develop herd immunity.

Adam Kucharski, an associate professor of infectious diseases epidemiology at the London School of Hygiene and Tropical Medicine, said it was never the governments plan to drive toward herd immunity; rather, there was an acknowledgment that might be what happens because the virus could be so hard to control.

Its not been an aim to get everyone infected as soon as possible. Its more this really tough situation weve got where the options we have are probably not going to be able to fully control this in the long term, Kucharski said.

The country has now taken a swing toward the types of early and aggressive social distancing methods other countries are trying to implement. The government is urging people with even mild symptoms to self-isolate; but Kucharski worried that message was going unheard in the din about herd immunity.

The country, he said, was trying to save some of the more difficult measures really stringent social distancing approaches that are hard to sustain over time for closer to when they are needed.

It makes sense to use them, given that theyre short-term measures, use them when theyve got the most impact, Kucharski said. You cant shut down your country for months.

Rivers suggested that was a risky approach. I think thats a difficult thing to time. My recommendations for the U.S. context at least, is to begin social distancing measures early, she said.

In the United States, a tepid early response marked by a prolonged delay in ramping up testing and a White House that initially seemed intent on playing down the scale of the threat has given way to a war footing.

This week the White House urged Americans to embrace social distancing by not taking part in gatherings of more than 10 people. In a number of communities, restaurants are closed to all but takeout or delivery service. Some states have closed schools. The country is on edge.

But with large-scale testing capacity still coming up to speed, it remains unclear how deeply the virus has embedded itself into the country, and whether the measures people and their local, state, and national governments are trying to adopt can slow the coronavirus progress.

It is also unclear how long communities can sustain the dramatic lifetime changes that appear to be needed to slow the viruss spread.

Right now people are approaching this if they are basically sheltering in place for a Minneapolis blizzard, lasting two or three days. And thats the mindset that they have. Where, in fact, we need to look at this like a coronavirus winter, where were only in the first weeks of what could be a long season, warned Michael Osterholm, director of the University of Minnesotas Center for Infectious Diseases Research and Policy.

This could last easily many months. And we need to make our actions proportional to the risk in the community or else we run the risk of people just getting tired of them when that particular community has not seen increased transmission of the virus.

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Understanding what works: How the coronavirus is being beaten back - STAT

Medical education in 2020: How we got here, where we’re headed – American Medical Association

More than a century ago, medical education in the U.S. was plagued by lax admission standards, unscientific protocols and shallow curricula. Several catalyzing events standardized American medical education, grounding it in protocols of scientific research and greatly boosting physician quality. A webinar explores the role of the AMA in these movements and outlines how the medical education system can further transform its approach to the betterment of public health.

The webinar, The AMA and medical education: How did we get here, and where are we going?, was produced by the AMA Accelerating Change in Medical Education initiative and featured speakers from the AMAs senior medical education staff.

One of the earliest milestones in the improvement of U.S. medical education was, in fact, the founding of the AMA, in 1847, with the goals of setting standards for ethics and medical education. Later, in 1904, the AMA established its Council on Medical Education, which began rating medical schools as a way to measure quality. One of its first outputs was a survey of 160 medical schools, which found only about half deserved an acceptable rating. Dozens later went out of business.

The council also played a key role in Abraham Flexners landmark 1910 report, Medical Education in the United States and Canada, which found huge variations in curricula and served as a wakeup call to the medical profession to standardize its education processes. By 1915, the standards advocated by the AMA Council on Medical Education had largely been adopted.

For the next hundred years or so, howeverdespite changing demographics, economics and technologythe curriculum and culture of medical education changed little. In 2013, in an effort to stimulate innovation, the AMA created the Accelerating Change in Medical Education initiative, which, over the next seven years, made $30 million in grants to 32 medical schools to jumpstart curricular and process changes and disseminate ideas. Thirty-seven schools now take part in the effort.

In 2019, the AMA launched its Reimagining Residency initiative, which has provided $15 million in five-year grants to eight projects to address the lack of continuity between medical school and residency, close gaps in preparation for residency and practice, and find new ways to support well-being for trainees.

Join the AMA at the inaugural GME Innovations Summit, Oct. 56, in Sacramento.

The presenters noted several areas in which educators, students and other stakeholders should expect the AMA to continue driving change in medical education:

Diversity of trainees. Health outcomes in underserved communities are improved when physicians are more representative of populations who live there. The AMA has numerous member groups that provide opportunities for members to influence policymaking, including the AMA Medical Student Section, the AMA Minority Affairs Section, the AMA Women Physicians Section and the AMA Advisory Committee on LGBTQ Issues.

Best practices in health systems science. Drawing on the AMA Health Systems Science textbook, medical schools across the U.S. have begun implementing this third pillar of medical education. A second edition will be published later this year. The AMA Health Systems Science Academy provides faculty, research and curriculum development resources.

Policy changes to support systemwide change. The recent change of the United States Medical Licensing Examination Step 1 exam from a three-digit score to pass-fail grading is one example of successful national efforts.

Coaching. The Accelerating Change in Medical Education Consortium has released It Takes Two: A Guide to Being a Good Coachee, a handbook focusing on what learners need to know to get the most out of a coaching relationship, as well as a corresponding text, Coaching in Medical Education: A Faculty Handbook, which provides a coaching framework and other tools for educators.

Lifelong learning. A new handbook from the AMA, Master Adaptive Learner, is an instructor-focused guide highlighting models for training future physicians to develop adaptive skills and utilize them throughout their careers.

Slides and an audio recording of the webinar are available in the Resources section of the AMA Accelerating Change in Medical Education digital community (registration required).

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Medical education in 2020: How we got here, where we're headed - American Medical Association

WHO Recommends Avoiding Ibuprofen to Treat COVID-19 Symptoms – Futurism

This weekend, a report by the French Ministry of Health claimed that the use of ibuprofen the active ingredient in Advil and other anti-inflammatory drugs could worsen the symptoms of COVID-19, the deadly disease caused by coronavirus sweeping the entire globe right now.

In light of a letter published in the journal The Lancet advising against the use of ibuprofen, Frances health minister Olivier Veran tweeted on Saturday that in case of fever, take paracetamol [commonly known as Tylenol] If you are already taking anti-inflammatory drugs, ask your doctors advice.

On Tuesday, the World Health Organization followed suit and is officially recommending against taking ibuprofen to treat symptoms of COVID-19 at least until further notice. WHO spokesman Christian Lindmeier told reporters that experts were looking into this to give further guidance, as quoted by Science Alert.

In the meantime, we recommend using rather paracetamol, and do not use ibuprofen as a self-medication, Lindmeier said. Thats important.

Before the WHOs recommendation, Reckitt Benckiser (RB), producer of the popular ibuprofen drug Nurofen, said that there still was no evidence to support forgoing the over-the-counter drug (and its also worth noting that RB has an interest in promoting its own product).

Appropriate use of ibuprofen and paracetamol is still currently being recommended by most European health authorities as part of the symptomatic treatment of COVID-19, the company wrote in a statement. RB is not aware of any evidence that ibuprofen adversely impacts the outcome in patients suffering from COVID-19 infection.

We do not currently believe there is any proven scientific evidence linking over-the-counter use of ibuprofen to the aggravation of COVID-19, the statement read.

Other experts agree the speculation is baseless at least for now.

Its all anecdote, and fake news off the anecdotes, Garret FitzGerald, chair of the department of pharmacology at the University of Pennsylvania told The New York Times, also before the WHOs recommendation. Thats the world we are living in.

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WHO Recommends Avoiding Ibuprofen to Treat COVID-19 Symptoms - Futurism

After the Coronavirus, Some Patients Face Ongoing Lung Damage – Futurism

While most patients who caught COVID-19 ended up making a full recovery, some are dealing with long-term effects of the coronavirus.

In an analysis of 12 patients who recovered from the SARS-CoV-2 coronavirus, doctors at the Hong Kong Hospital Authority (HKHA) found that several of them now have reduced lung capacity, according to Business Insider.

They gasp if they walk a bit more quickly, Owen Tsang, medical director of the HKHAs Infectious Disease Center, said in a press conference. Some patients might have around a drop of 20 to 30 percent in lung function.

After scanning the patients lungs, doctors saw signs of organ damage.

Thats far too small a sample size to declare that COVID-19 necessarily causes long-term damage, but it could be a warning sign that doctors should keep an eye out for potential complications.

Its not yet clear how applicable these results are to the outbreak at large or most other patients hit by the disease.

But even on its own, its a troubling sign that more severe cases of COVID-19 could lead to more medical problems in the long run, even after patients have kicked the virus itself.

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After the Coronavirus, Some Patients Face Ongoing Lung Damage - Futurism

This Virtual Library in Minecraft Gives a Voice to Censored Journalists – Futurism

As governments around the globe crack down on journalistic freedom and censor their national press, Reporters Without Borders is working to deliver uncensored news to the public through an unlikely channel: an enormous library housed inside the popular block-building video game Minecraft.

Even in the most restrictive countries where news is censored across the web like Chinas crackdown on the spread of information surrounding the COVID-19 pandemic citizens can now receive their news by loading Minecraft and flipping through the virtual bookshelves of The Uncensored Library.

Inside, you can find articles and information about the journalists that are being censored in their own countries, said Robert-Jan Blonk, senior interactive producer atproduction company MediaMonks, which helped build the library, in an interview with Fast Company. We share these stories through the books that live in that library, and people can just openly read them, because even in the countries where these journalists are from, youre able to play Minecraft.

The massive digital library which contains more than 12.5 million Minecraft blocks, and took 24 builders from 16 different countries over 250 hours to design and build houses real articles written by five journalists from censored countries including Russia, Mexico, Egypt, Vietnam, and Saudi Arabia, providing unblocked news to readers through a savvy internet loophole.

Even if government censors try to hack and delete the library, multiple other server hosts in other countries are prepared to take over and protect it, according to Fast Company.

Inside the library, which also received design help from design studio BlockWorks and creative agency DDB Germany, is a giant circular rotunda showcasing flags from countries around the world, off of which branch wings of the library organized by country. Readers and gamers can simply download the game and map, walk their characters into the Russia wing, pick up a book, and read an article from grani.ru, a blocked site in Russia that reports on the government and protests in the country.

Journalist Hatice Cengiz, fiance to Saudi Arabian journalist Jamal Khashoggi who was assassinated by the Saudi government worked with the developers to help include her late partners censored articles in the game. Articles also appear from other journalists: Nguyen Van Dai, who was exiled from Vietnam, Javier Valdez, who was murdered in Mexico, Mada Masr in Egypt, and Yulia Berezovskaia in Russia.

Announced on the World Day Against Cyber Censorship, the projects goal is to not only provide access to censored journalism, but to bring awareness to the threats to the freedom of press worldwide, as well as the draconian treatment of censored journalists whove stood up to their governments.

This is such a unique way of bringing attention to censorship, Blonk told FastCo. We hope that with so many players and so many people that we basically bring this problem up again. People die because theyre being censored.

Read More: This beautiful library in Minecraft lets people access the work of censored journalists from anywhere [Fast Company]

More on censorship: China Censored Info About Growing Pandemic on Social Media

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This Virtual Library in Minecraft Gives a Voice to Censored Journalists - Futurism

An Overwhelmed Italian Hospital Is 3D Printing Replacement Parts – Futurism

A hospital in Brescia, Italy, which is near one of the regions hit hardest by the coronavirus outbreak, is reportedly turning to 3D-printed replacement parts in order to keep its intensive care unit running.

Specifically, the hospital needed extra valves for ventilator devices sooner than its usual supplier could send them, according to 3D Printing Media Network. So on Friday, it called in local 3D printing companies that were able to design and manufacture the valves on-site.

As a result, ten patients were treated with a ventilator that night, 3DPMN reports. Without the valves, their severe COVID-19 cases may have gone untreated in the overwhelmed hospital.

Since then, more companies have 3D printed dozens more of the valves in a bid to keep the hospital well-stocked for the foreseeable future, according to 3DPMN. Cristian Fracassi, the technician who made the first ten, posted on Facebook that hes working on making another hundred for the hospital.

There were people in danger of life, and we acted, Fracassi wrote, as translated by Metro. Period. Now, with a cold mind, lets think. Firstly, dont call us, as some have, heroes. Sure, people were about to die, but we only did our duty. Refusing would not have been a cowardly act, but murderous.

Stanotte si va a dormire sapendo di aver fatto qualcosa di utiledomani la consegna. Un grazie speciale ad Alessandro

Posted by Cristian Fracassi onSaturday, March 14, 2020

Each one of those parts corresponds to an individual patient who needs intensive care and can now be oxygenated in the hospital, illustrating just how dire the outbreak situation can get as small parts break or find themselves in short supply.

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An Overwhelmed Italian Hospital Is 3D Printing Replacement Parts - Futurism

The Second Man to Walk on the Moon Has Some Quarantine Advice – Futurism

Berger Time

When Ars Technica senior space reporter Eric Berger asked Buzz Aldrin, the second man to have walked the Moon in 1969, what he would do while practicing social distancing during the coronavirus outbreak, Aldrin had some choice words: Lying on my ass and locking the door.

Aldrin is familiar with the concept of spending time in quarantine. After the Apollo 11 Command Module landed, he, along with commander Neil Armstrong and module pilot Michael Collins, had to spend three long weeks in quarantine to make sure no nasty bugs from space could spread on our planet.

The three men were first moved to the Mobile Quarantine Facility, a converted Airstream trailer pretty tight quarters for three adults. They were then airlifted to a secure building called the Lunar Receiving Laboratory. Years later, once the Moon was proven to be barren of life, NASA discontinued this practice after Apollo 14.

When Berger asked Aldrin for some advice for the millions of people currently self-isolating at home, the now 90-year-old former astronaut reminisced of his own time in quarantine. Well, Mike Collins and I used to exercise and jog a little bit around the hallway.

Aldrin also questioned if his and his teams temporary home was really capable of holding microbes in.

We looked at this one crack in the floor, and there were ants crawling in and out, Aldrin said.

Most of the rest of his time, he said, was spent doing paperwork.

READ MORE: Buzz Aldrin has some advice for Americans in quarantine [Ars Technica]

More on quarantine: As Coronavirus Rages, Elon Musk Refuses to Close Tesla Factory

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The Second Man to Walk on the Moon Has Some Quarantine Advice - Futurism

NEXT: Futurists Create Images of the Future, Not Predictions – columbusunderground

Given the state of the world right now, it did not seem appropriate to discuss the future when the present is hanging so heavy over us.This month, Id like to reflect on what it means to be a futurist, especially when presented with the opportunity to assess your own work.

As a futurist, I am not in the prediction business. I do not believe that precise prediction is possible, except in exceptional cases and usually when discussing simple systems.I can predict that it will be cold in Columbus next January, but that is not the kind of prediction most people are interested in hearing about. Most systemsespecially systems involving human beingsare what is known as complex adaptive systems. Even if we understand every individual part of the system, in complex systems the interactions of these parts are such that we cannot predict the behavior of the system as a whole. At best, we can only posit possible behaviors (plural) the system might exhibit.

Futurists explore the possible behaviors of complex adaptive systems.We try to anticipate whats next and to think through possibilities and implications of various scenarios, to better prepare us for what might come. This has led me to re-read one of my columns from two years ago, which is posted here.

Some aspects of the scenario seem to be unfolding as I imagined. I wrote:

It is possible that, in America, another response to the crisis would be a WWII-like, all-hands-on-deck, public pandemic mobilization campaign. That citizens would set aside the partisan squabbles that are causing so much dysfunction in American public life, and instead work together to combat a common, indiscriminate, external foe, something like what happened (briefly) after 9/11.

Other aspects are unfolding differently than I had originally imagined. For example, my column was about an influenza outbreak, not coronavirus. And there are some facets of the unfolding crisis that are still to be determined:

A global pandemic today would surely mean restrictions on travel, with national governments throwing up all sorts of barriers to outsiders entering a country, which could accelerate global trends toward nationalism and Us First-ism. Global trade would certainly be impacted, with a recession or depression a distinct possibility.

A simple overview of what I wrote two years ago might lead to a simple headline, like Futurist gets it right.Two years ago, I was writing about one scenario with an indeterminate probability of actually occurring. Having imagined the possibility, we can still be shocked by events, certainly, but perhaps not surprised.

David Staley is Director of the Humanities Institute and a professor at The Ohio State University. He is host of the Voices of Excellence podcastand host ofCreativeMornings Columbus.

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NEXT: Futurists Create Images of the Future, Not Predictions - columbusunderground

Idris Elba Says He Tested Positive for the Coronavirus – Futurism

Golden Globe-winning actor Idris Elba announced on Twitter this afternoon that he has tested positive for the SARS-CoV-2 coronavirus, which causes the disease COVID-19.

Elba known for his roles in everything from The Wire to the Marvel Cinematic Universe seems to be in good spirits. Hes the highest-profile celebrity to come forward with a coronavirus diagnosis since Tom Hanks announced that hed caught the bug last week.

Elba said in the short clip that he got tested after he realized he had been in proximity with someone else whod tested positive for the virus. Commentators have pointed out that Elba attended an event last week with Sophie Trudeau, the wife of the Canadian prime minister, who also tested positive for the virus.

To his credit, Elba seems to be using the diagnosis to spread sound advice to the public. In the clip, he advocated for staying out of public spaces, frequent hand-washing, and above all, for anyone who tests positive to quarantine themselves for a two-week period.

Look, this is serious, Elba said. This is the time to think about social distancing, washing your hands. Beyond that, there are people out there who arent showing symptoms, and that could easily spread it.

Other celebrities rushed to offer solace and advice.

Elba also closed the clip with some timeless advice.

Stay positive, he said at the end of the video. And dont freak out.

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Idris Elba Says He Tested Positive for the Coronavirus - Futurism

The Rich Are Trying to Buy Their Own Ventilators, in Case Everything Collapses – Futurism

Buried in an alarming New York Times story about a looming shortage of lifesaving ventilators is this horrifying detail (emphasis ours):

For days, [exec of ventilator maker Ventec Chris] Kiple said, he has been getting nonstop phone calls from frantic hospital administrators, governors offices and other government officials looking for more machines. Hes even received inquiries from a number of wealthy individuals hoping to buy their own personal ventilators, a fallback plan in case the American hospital system buckles.

Thats right the rich are so worried that the medical system will collapse under the strain of the runaway outbreak that theyre buying up ventilators, in case they happen to get so sick that they need them.

Unspoken in the Times is a brutal implication. Most of those jetsetters wont even need the ventilators, since most COVID-19 cases are mild enough that they dont require hospitalization. And that means that each ventilator obtained as a backup plan for a terrified plutocrat wont end up in a health care facility meaning a patient, or multiple patients, could die.

In a lesser crisis, snapping up livesaving medical supplies would be just gauche. But experts are almost certain, according to the Times, that theres going to be a critical shortage of ventilators as the disease continues to spread.

The reality is there is absolutely not enough, Hamilton Medical CEO Andreas Wieland told the Times. We see that in Italy, we saw that in China, we see it in France and other countries.

The phenomenon of rich scoundrels snapping them up is even more troubling when you compare it to the selfless efforts of others to get more ventilators into the medical system.

In Italy, for instance, local business are helping 3D print parts to keep ventilators running. A swathe of open source efforts have cropped up to try to build DIY ones. Even the enigmatic Elon Musk has offered to use his resources at Tesla to build some.

Hopefully the rich wont find a way to hoard those too.

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The Rich Are Trying to Buy Their Own Ventilators, in Case Everything Collapses - Futurism

Experts: Vaping Could Make Coronavirus Infection More Severe – Futurism

Scientists say its reasonable to assume that smoking or vaping could make COVID-19 symptoms more severe once infected, according to Scientific American.

To be clear, a direct link has yet to be investigated by researchers but theres plenty of evidence that smoking or vaping suppress immune function in the lungs and trigger inflammation.

Scientists have also found that more severe COVID-19 cases were associated with chronic lung conditions which in turn is linked to smokers and vapers as well. Some preliminary studies in China have found links between more severe COVID-19 cases and a history of smoking, but its too early to draw conclusions as many of them still await peer review.

All these things make me believe that we are going to have more severe casesespecially [in] people who are [long-term] smokers or vapers, said Melodi Pirzada, chief of pediatric pulmonology at NYU Winthrop Hospital on Long Island, to Scientific American.

Theres a very coordinated series of events that take place when you do become infected with a virus, associate professor of microbiology and immunology at the University of North Carolina Ray Pickles told Scientific American. I think once you start perturbing this sequence of events in any which way or direction, thats when things can go awry.

Scientists have found plenty of evidence for smoking being a risk factor for influenza. The link to vaping, however, is definitely less clear on the matter. Mice studies have found a link between e-cigarette aerosol lowering the chances of surviving influenza A, a common influenza virus.

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Experts: Vaping Could Make Coronavirus Infection More Severe - Futurism