Coronavirus Sars-CoV-2/Covid-19 Megathread

[Sheilbh]

I agree Sheilbh, once it was out the issue became how to put measures in place to live with that reality.  That is where Trump not only failed completely but did and continues to do active harm.

Yeah, and I actually think his focus on border closures, banning flights from China etc was possibly harmful because it distracted from everything else that needed to happen. It's exactly the sort of measure Trump loves: loud, attention-grabbing, "decisive". And, like most of them, woefully ineffective.

[Syt]

Vienna is at over 1,000 active cases for the first time since April, trending steadily upwards since July. Hospitalizations and fatalities are going up only very slightly, though.

[Sheilbh]

We need to smash Facebook

Facebook funnelling readers towards Covid misinformation - study
Research findings undermine firm's claims it is cracking down on inaccurate news
Emma Graham-Harrison and Alex Hern
Published on Wed 19 Aug 2020 11.00 BST

Websites spreading misinformation about health attracted nearly half a billion views on Facebook in April alone, as the coronavirus pandemic escalated worldwide, a report has found.

Facebook had promised to crack down on conspiracy theories and inaccurate news early in the pandemic. But as its executives promised accountability, its algorithm appears to have fuelled traffic to a network of sites sharing dangerous false news, campaign group Avaaz has found.

False medical information can be deadly; researchers led by Bangladesh's International Centre for Diarrhoeal Disease Research, writing in The American Journal of Tropical Medicine and Hygiene, have directly linked a single piece of coronavirus misinformation to 800 deaths.

Pages from the top 10 sites peddling inaccurate information and conspiracy theories about health received almost four times as many views on Facebook as the top 10 reputable sites for health information, Avaaz warned in a report.

The report focused on Facebook pages and websites that shared large numbers of false claims about coronavirus. The pages and sites covered a variety of different backgrounds, including alternative medicine, organic farming, far-right politics and generalised conspiracies.

It found that global networks of 82 sites spreading health misinformation over at least five countries had generated an estimated 3.8bn views on Facebook over the last year. Their audience peaked in April, with 460m views in a single month.

"This suggests that just when citizens needed credible health information the most, and while Facebook was trying to proactively raise the profile of authoritative health institutions on the platform, its algorithm was potentially undermining these efforts," the report said.

A relatively small but influential network is responsible for driving huge amounts of traffic to health misinformation sites. Avaaz identified 42 "super-spreader" sites that had 28m followers generating an estimated 800m views.

A single article, which falsely claimed that the American Medical Association was encouraging doctors and hospitals to over-estimate deaths from Covid-19, was seen 160m times.

This vast collective reach suggested that Facebook's own internal systems are not capable of protecting users from misinformation about health, even at a critical time when the company has promised to keep users "safe and informed".

"Avaaz's latest research is yet another damning indictment of Facebook's capacity to amplify false or misleading health information during the pandemic," said British MP Damian Collins, who led a parliamentary investigation into disinformation.

"The majority of this dangerous content is still on Facebook with no warning or context whatsoever ... The time for [Facebook CEO, Mark] Zuckerberg to act is now. He must clean up his platform and help stop this harmful infodemic."

According to a second research paper, published in The American Journal of Tropical Medicine and Hygiene, the potential harm of health disinformation is vast. Scanning media and social media reports from 87 countries, researchers identified more than 2,000 claims about coronavirus that were widely circulating, of which more than 1,800 were provably false.

Some of the false claims were directly harmful: one, suggesting that pure alcohol could kill the virus, has been linked to 800 deaths, as well as 60 people going blind after drinking methanol as a cure. "In India, 12 people, including five children, became sick after drinking liquor made from toxic seed Datura (ummetta plant in local parlance) as a cure to coronavirus disease," the paper says. "The victims reportedly watched a video on social media that Datura seeds give immunity against Covid-19."

Beyond the specifically dangerous falsehoods, much misinformation is merely useless, but can contribute to the spread of coronavirus, as with one South Korean church which came to believe that spraying salt water could combat the virus.

"They put the nozzle of the spray bottle inside the mouth of a follower who was later confirmed as a patient before they did likewise for other followers as well, without disinfecting the sprayer," an official later said. More than 100 followers were infected as a result.

"National and international agencies, including the fact-checking agencies, should not only identify rumours and conspiracies theories and debunk them but should also engage social media companies to spread correct information," the researchers conclude.

Among Facebook's tactics for fighting disinformation on the platform has been giving independent fact-checkers the ability to put warning labels on items they consider untrue.

Zuckerberg has said fake news would be marginalised by the algorithm, which determines what content viewers see. "Posts that are rated as false are demoted and lose on average 80% of their future views," he wrote in 2018.

But Avaaz found that huge amounts of disinformation slips through Facebook's verification system, despite having been flagged up by factcheck organisations.

They analysed nearly 200 pieces of health misinformation which were shared on the site after being identified as problematic. Fewer than one in five carried a warning label, with the vast majority – 84% – slipping through controls after they were translated into other languages, or republished in whole or part.

"These findings point to a gap in Facebook's ability to detect clones and variations of fact-checked content – especially across multiple languages – and to apply warning labels to them," the report said.

Two simple steps could hugely reduce the reach of misinformation. The first would be proactively correcting misinformation that was seen before it was labelled as false, by putting prominent corrections in users feeds.

Recent research has found corrections like these can halve belief in incorrect reporting, Avaaz said. The other step would be to improve the detection and monitoring of translated and cloned material, so that Zuckerberg's promise to starve the sites of their audiences is actually made good.

A Facebook spokesperson said: "We share Avaaz's goal of limiting misinformation, but their findings don't reflect the steps we've taken to keep it from spreading on our services. Thanks to our global network of fact-checkers, from April to June, we applied warning labels to 98m pieces of Covid-19 misinformation and removed 7mpieces of content that could lead to imminent harm. We've directed over 2bn people to resources from health authorities and when someone tries to share a link about Covid-19, we show them a pop-up to connect them with credible health information."

[Sheilbh]

Really interesting piece on declining fatality rate in the UK - and speaking to a friend who works in the NHS and said that the number of people who need to go to hospital is also down:

Britain's coronavirus death rate is down, but the unanswered question is why
Charlotte Summers
Some have suggested we're now successfully treating Covid-19, or that 'herd immunity' has finally arrived. Neither is true
Published on Fri 14 Aug 2020 08.00 BST

Why has the mortality rate for coronavirus decreased in the UK? The Intensive Care National Audit and Research Centre has analysed data from more than 10,000 patients admitted to intensive care units in England, Wales and Northern Ireland, and shown that the 28-day mortality of patients admitted to ICU has fallen from 43.5% before the April peak to 34.5% after the peak – a decrease of nine percentage points.

Some have suggested this may be due to "herd immunity" or that over time we have learned how to successfully treat this disease. But there's scant evidence to support these claims. So what's going on?

Emerging data suggests that some people who have not been exposed to Sars-Cov-2 have a type of white blood cell (T cell) that recognises the virus because it has previously been exposed to other coronaviruses, such as the common cold. Whether these cross-reactive T cells prevent or lessen the impact of infection in people with coronavirus is not yet known. It's an intriguing preliminary finding, but there's currently no evidence that we have herd immunity in the UK.

Studies have consistently shown that fewer than 20% of the UK population have antibodies to coronavirus in their blood, and we don't fully understand the mechanisms by which our immune systems deal with this new virus effectively.

The term herd immunity is ill-defined and unhelpful. It suggests that we can now relax our adherence to measures such as social distancing and facial coverings. But this is no time for complacency. We're heading towards a winter that will probably be challenging, and we all need to continue to do our part in reducing viral transmission. The most likely contributor to decreased mortality is the same reason we've seen a reduction in the number of Covid cases: the UK population has adhered to social distancing, wearing face coverings, working from home and regular hand hygiene.

Have we got better at treating Covid-19? As much as I would like to say yes, my answer is "not sure". Many clinical management approaches have been proposed for coronavirus, such as hydroxychloroquine, non-invasive ventilation and vitamin supplements, and many have suggested that given the pressing need for treatments, we should use these as soon as possible. This has resulted in patients across the globe being administered therapies for which there is little evidence of benefit.

During the pandemic there has been immense pressure to circumvent our usual pathways for safely discovering treatments. In the face of a devastating disease, the desire to act quickly to find new interventions is unsurprising. The controversy surrounding hydroxychloroquine is a good example of this. Despite increasing evidence that the drug is not effective in the treatment of people who have developed Covid-19, or in preventing the development of the disease in people exposed to the virus, people in countries such as Brazil and the US continue to receive this therapy.

There have also been many questions about the optimum way to support people who are having difficulty breathing. Many people have declared their approach to be the correct one, but there is currently little evidence suggesting that non-invasive ventilation is superior to invasive mechanical ventilation when treating patients with severe cases of Covid-19.

The use of unproven therapies outside clinical trials should concern us all, and has been actively discouraged by the UK's chief medical officers. There is no drug or therapy that does not have side-effects or adverse consequences, so every time we take this approach, patients are being exposed to risk in the absence of evidence.

Worse, every time we administer an unproven therapy outside a clinical trial, we are wasting an opportunity to learn something that may help save many lives. Evidence suggests that patients enrolled in randomised clinical trials, or who are treated in hospitals with high levels of research activity, have better clinical outcomes than those who are not.

There are many coronavirus therapies that are currently going through rigorous clinical trials. The National Institute for Health Research-funded Recovery trial has recruited more than 12,000 hospitalised patients with Covid-19 since March, and has already provided evidence that the anti-inflammatory dexamethasone improves survival in hospitalised patients needing oxygen or mechanical ventilation, whereas the antivirals hydroxychloroquine and lopinavir-ritonavir are ineffective.

We also have evidence from clinical trials in the US that remdesivir may be an effective antiviral, as well as preliminary data that inhaled interferon-beta-1a might be of benefit, a finding that now needs confirming in large clinical trials, and the Recovery-RS trial is seeking to determine the best way to support the breathing of patients with Covid-19.

During a pandemic, people look for certainty. But science doesn't work like that. We raise hypotheses, we test them, we refine them, and we repeat the process. This takes time, and although we are making astonishing progress during the coronavirus pandemic, much uncertainty remains. Facts are merely things that have yet to be proven untrue, and people who say they know the answers but can't provide evidence should be treated with scepticism.

At the moment, we can't be certain why the mortality associated with Covid-19 has fallen in the UK, but there are many people working on understanding why, and on making it fall still further. In the meantime, we all need to continue doing our best to reduce viral transmission while this important work is still going on.

• Dr Charlotte Summers is a lecturer in intensive care medicine at the University of Cambridge

[viper37]

A combination of all factors.

Since we now know who's more at risk, these people are extra careful and limit their movements even more than the others.  That surely helps.

[The Larch]

Apparently contact tracers in Castilla la Mancha are having lots of trouble with an outbreak in a town in the region that has had already three of them, as it seems to come from a brothel, and nobody is willing to admit to being a patron there. 

[Sheilbh]

Really interesting row emerging over local lockdown in Oldham.

For background Oldham is a town with a large British-Asian (I think mainly Pakistani and Bengali) community, that has a history of community tensions. There were race riots there in the early 2000s. I think community cohesion's got a lot better since then, but it's still a bit shaky. It's also quite a poor town and the definition of post-industrial - at its peak Oldham produced more cotton than France and Germany combined, but now it's got a fair share of abandoned run down mills etc.

Anyway there has been an outbreak in Oldham, last week figures were at 100/100k and while there's no hard and fast trigger for local lockdown the apparoach seems to be if it's sustained at over 50/100k (I think to avoid locking down a council area after, say, an outbreak in a meat packing plant).  This week it's down to 85/100k. There are now talks that Oldham is about to be locked down like Leicester which will obviously hurt economically.

But what's really interesting is that Oldham Council and Greater Manchester Council are pushing back and basically saying infections are falling because of the measures they've taken locally. So locally they've been doing hyper-targeted door knocking campaigns, texting etc for messaging purposes and also doing backwards contact tracing. And the other point they make is that all of this they've identified the spread as happening in and between households (some of this has been in the Asian community, others have been house parties), not in the businesses that will be shut down. They also note that a lot of the household spread is with people who wouldn't be locked down (and never were in the first place) - public transport workers, taxi workers, food delivery, essential retail etc. The council have also said there's a real risk of civil disorder in a lock down because the far-right online have noticed this and really been saying this is all the fault of Asians and there's been increasing community tensions around this which might boil over if lockdown is imposed.

It may not aply everywhere but Oldham and Greater Manchester want to carry on with what they've been doing and, they argue, this could be an alternative to really strict, really broad local lockdown so may allow for a more nuanced approach when infections rise elsewhere. The flipside of this is that apparently the Health Secretary's made up his mind that they need to go into lockdown and it's probably not the time for a nuanced approach in the run-up to schools re-opening.

Edit: The other interesting point is this would be the first local lockdown in a council area like Oldham. Leicester is basically a city surrounded by countryside. It's a relatively contained area. Oldham is a town and a borough within greater Manchester - it's caught between light and dark, the west side is directly next to Manchester, while the east side looks out onto the moors. There are streets where one side is Oldham the other is Rochdale or Manchester, and lots of people who live there work in jobs in other boroughs/areas in Manchester and the North-West. So it's interesting because I've no idea how local lockdown would work in a more-or-less urban borough...

[garbon]

https://www.theguardian.com/society/2020/aug/20/deaf-people-mask-wearing-lipreading

I'm Deaf. When mask-wearing came along, I had to rebuild my world

Since mask-wearing began, my world has disappeared. I was born partially deaf, and masks prevent me from lipreading and using facial cues to communicate.

I'm not alone. Over 460 million people worldwide have disabling hearing loss according to the World Health Organization. So how are people who are d/Deaf (lower case refers to the physical condition of deafness, capital D refers to the Deaf community) or hard of hearing surviving mask mandates?

It also makes me wonder, is my mask less safe because of my disability?

The most common mask on the market right now is the ear band, with loops to slip over ears. But not everyone has two ears and some people who are hard of hearing also have difficulty wearing these masks. "They get tangled up in the tubes of my hearing aid," said Jannie Marshall in Ohio, retired from providing services to developmentally disabled adults. "It's hell to put masks on, wear them, take them off with hearing aids," said Meg Day, a poet and assistant professor at Franklin Marshall College in Pennsylvania. "Your hearing aids go flying if you're not careful ... The [mask] elastic has to sit perfectly to not interfere with the hearing aid's microphone."

You can attach masks with paperclips or even plastic toys in the back of the head. But ear band masks are not designed to be worn this way, and the fit is very tight, creating tension and headaches. When I tried them, the paperclips got caught in my hair.

The best solution I found are "ear-savers," strips with toggles to attach mask loops, originally designed for essential workers. It's not a perfect solution, or a fast one. I have to look in a mirror to ensure the best fit. I have to delegate all door-answering – anything that requires a mask quickly – to my partner, who is hearing. Most of us already panic at unannounced visits during the pandemic, but for people who are hard of hearing, the extra stress is a considerable burden.

The likelihood of me not understanding a masked stranger is high. Callie Adair, a graduate student in social work, told me that "masks make everyone sound more muffled, so even my good hearing days become bad hearing days if I have to go out".

Evan Adair, an MBA student and Callie's spouse, says that masks "turned my life around 180 degrees". Both Callie and Evan use smartphone notepad features to help communicate with strangers, but not everyone has this technology – or the patience to use it.

"People get frustrated because they're unprepared to communicate via text or paper and pen, so they remove their mask. It's scary," Day said. "Every encounter is charged."

A common occurrence in my experience is that people don't assume a young-looking person could be hard of hearing. And when I don't respond, they respond in anger.

"Maintaining social distancing in stores is hard when we can't hear you coming up behind us," Callie Adair said. Hearing strangers can mistake a d/Deaf or hard of hearing person's silence for permission to enter their space.

To get a head start on those situations, I purchased buttons on Etsy with messages such as: Your mask prevents me from reading your lips. Please be patient. But I do worry about issues of safety and vulnerability in announcing my disability to strangers, including the potential for mistreatment, even abuse. d/Deaf and hard of hearing people are more likely than hearing people to be sexually assaulted or experience other violence.

Along with buttons, there is now a market on Etsy for "hearing aid masks" that wrap or tie around the head. One seller, when I reached out to her, told me: "You are the exact reason I have been custom-making masks."

There are also several kinds and brands of masks with see-through centers, designed to assist in lipreading and American Sign Language (ASL utilizes more than just the hands but the entire body, including facial expressions).

These masks are not without issues. "They fogged up immediately and stuck to your lips and looked, well, kind of scary," Day said about a vinyl mask. Day prefers ClearMask, a deaf-cofounded company, whose masks are entirely clear, have straps, and a foam seal.

And although some workers are taking the initiative on their own to wear masks with clear centers to assist people, they're in the minority. I've never seen a mask like that in real life – not on retail workers in my neighborhood, not on medical personnel.

"It's kind of pointless that I have an entire box of these [clear masks] when I'm not the one who needs to be wearing them," Day said. "My dentist needs a box and my colleagues need a box. Other folks need to play a part in providing access."

"One thing I really wish the hearing society would know and understand is that communication difficulty increased during the pandemic, and there is nothing we can do to fix it," Evan Adair said.

As a hard of hearing person, I have never felt more lonely than during mask-mandates. At the same time, I believe hearing people are realizing how much we all rely on facial, physical and other cues to get by. "My heart goes out to everyone who is restricted now and is suffering in isolation. I'm accustomed to it," Marshall said.

A good reminder for hearing people at all times, not only during a pandemic, is don't just use your voice to announce your presence – wave, make eye contact. Be open to communicating in different ways with strangers. Realize that not everyone may be exactly like you. And maybe ask your doctors, teachers or co-workers to utilize clear masks or similar products.

When the pandemic is controlled, and the masks come off, I hope hearing people remember how much of the world revolves around community and communicating. I hope they still consider us, who deserve to be heard.

[viper37]

I've posted something like this, like, 200 pages ago, and got slammed for not being happy to wear a mask.  You're on the list too, now

[garbon]

I don't think anyone in that article suggested not wearing masks as a solution? In fact, one person noted it makes it more dangerous because when she can't understand people, they take their masks off...

[viper37]

I don't think anyone in that article suggested not wearing masks as a solution? In fact, one person noted it makes it more dangerous because when she can't understand people, they take their masks off...

There are transparent masks now.  At least, some are made in Quebec.
https://www.etsy.com/ca/listing/826630660/face-covering-with-window?ref=shop_home_active_4&frs=1&crt=1

I'm guessing there will be or there are other suppliers around the world.

[viper37]

Anyway, after a month with mandatory masks, Quebec registered a small dip for a couple days, then it started increasing again, back to the previous weeks' average, around 80-90 cases per day.
https://www.quebec.ca/en/health/health-issues/a-z/2019-coronavirus/situation-coronavirus-in-quebec/

Mask ain't doing anything good, except pissing off people and creating problems for many of us, non 110% healthy people.

[Valmy]

The only place in the world that has used masks is Quebec so I guess we have no choice but to conclude this data is solid evidence.

If you ever have surgery are you going to request nobody wears a mask since they have no effect according to this conclusive data?

[merithyn]

Anyway, after a month with mandatory masks, Quebec registered a small dip for a couple days, then it started increasing again, back to the previous weeks' average, around 80-90 cases per day.
https://www.quebec.ca/en/health/health-issues/a-z/2019-coronavirus/situation-coronavirus-in-quebec/

Mask ain't doing anything good, except pissing off people and creating problems for many of us, non 110% healthy people.

Correlation <> causation

Thankfully, there's a whole big world out there with a whole lot of data that shows that your assumptions are actually wrong.

[Razgovory]

When did viper become so anti-science?