Herd immunity hopes dealt blow by report suggesting only 2% -3% of people have been infected
Only a tiny proportion of the global population – maybe as few as 2% or 3% – appear to have antibodies in the blood showing they have been infected with Covid-19, according to the World Health Organization, a finding that bodes ill for hopes that herd immunity will ease the exit from lockdown.
“Easing restrictions is not the end of the epidemic in any country,” said WHO director-general Dr Tedros Adhanom Ghebreyesus at a media briefing in Geneva on Monday. “So-called lockdowns can help to take the heat out of a country’s epidemic.”
But serological testing to find out how large a proportion of the population have had infection and developed antibodies to it – which it is hoped will mean they have some level of immunity – suggest that the numbers are low.
“Early data suggests that a relatively small percentage of the expanded may have been infected,” Tedros said. “Not more than 2% -3%.”
Dr Maria Van Kerkhove, an American infectious diseases expert who is the WHO’s technical lead on Covid-19, said they had thought the number of people infected would be higher, but she stressed it was still too early to be sure. “Initially, we see a lower proportion of people with antibodies than we were expecting,” she said. “A lower number of people are infected.”
Santa Clara county had 1,094 confirmed cases of Covid-19 at the time the study was carried out, but antibody tests suggest that between 48,000 and 81,000 people had been infected by early April, most of whom did not develop symptoms.
But even those high figures mean that within the whole population of the county, only 3% have been infected and have antibodies to the virus. A study in the Netherlands of 7,000 blood donors also found that just 3% had antibodies.
Van Kerkhove said they needed to look carefully at the way the studies were being carried out. “A number of studies we are aware of in pre-print have suggested that small proportions of the population [have antibodies],” she said. These were “in single digits, up to 14% in Germany and France”. “It is really important to understand how the studies were done.”
That would include asking how they found the people to test. Was it at random or were they blood donors, who tend to be healthy adults? They would also need to look at how well the blood tests were performed.
“We are working with a number of countries carrying out these serology studies,” she added. The WHO-supported studies would use robust methods and the tests would be validated for accuracy.
The hope will be that people who have had Covid-19 will be able to resume their lives. But Van Kerkhove last week said that even if tests showed a person had antibodies, it did not prove that they were immune.
A summary of the biggest developments in the global coronavirus outbreak
Spain’s death rate continues to fall
The country reported 399 deaths in 24 hours, lower than Sunday’s figure of 410. A total of 20,852 people have died in Spain, with over 200,000 infected and more than 80,000 cured.
The Spanish prime minister, Pedro Sanchez , expected to ask parliament to extend the national lockdown until 11 May.
Italy sees fall in infections
For the first time since the outbreak began Italy announced a fall in the number of people currently infected down 20 to 108,237. It said 454 more people had died – 21 more than the previous day, bringing the death toll to 24,114.
“This is positive data as it shows the number of people who are currently positive with the virus is declining,” Angelo Borrelli, the chief of Italy’s civil protection authority, told reporters.
UK hospital deaths total rises by 449
The country’s Department of Health and Social Care said 16,509 people had died in UK hospitals since the outbreak began, an increase of 449 on the day before. A total of 386,044 people have been tested, of whom 124,743 have tested positive.
US scotches G20 statement on enrich WHO
US hostility to the World Health Organization scuppered the publication of a communique by G20 health ministers committing to Discover the WHO’s mandate in coordinating a response to the global coronavirus pandemic.
In place of a lengthy, detailed statement, the leaders issued a brief announcement saying gaps written in the way different countries handled pandemics.
WHO warns easing restrictions is not the end
The organization of director general, Dr Tedros Adhanom Ghebreyesussaid easing restrictions did not mean the end of any epidemic, adding that bringing the episode to a close would require “sustained effort” on the part of governments and individuals.
So-called lockdowns can help to “take the heat out of a country’s epidemic”, but cannot end it alone, he said. Governments must ensure they can “detect, test, isolate and care for every case and trace every contact”.
The weekend has seen a spate of anti-lockdown protests across the US in Ohio, Michigan and Colorado.
But a standout image by photographer Alyson McClaran came on Sunday from Denver, Colorado. As protesters gathered outside the capitol steps and others assembled in their automobiles to ask the city to reopen for business, healthcare workers stood in the middle of the road in their scrubs. After having spent the last weeks treating Covid-19 patients, they staged their own demonstration: they wanted to remind the protestors of why the shutdown measures are important
One protestor in particular did not like it. She leaned out of her car window, wearing an American flag T-shirt, holding a placard that read “land of the free”. Then, she yelled to the protester wearing scrubs: “This is a free country. This is the land of the free. Go to China!”
She appeared to be expressing the view that closing down non-essential services in the US is equivalent to the actions of a communist state, as she continued: “If you want communism, go to China. Now open up and go to work.”
Other sources report that frontline workers were applauded for taking a stand against the demonstration (a recent Pew Research poll shows that most Americans are worried about lockdown measures being lifted too soon).
According to local reports, some protesters said that they believed the government shutdown was part of a wider plan to undermine the economy and hurt Donald Trumps’ re-election prospects. Others voiced fears about businesses closing and the impact of a recession on the livelihoods of local employees.
Colorado, like much of the rest of the country, has seen unprecedented job losses as a result of the pandemic, with more than 232,000 filing for unemployment benefits since mid-March. The pandemic has been responsible for around 400 deaths in the state.
In the era of Covid-19, we’ve had to move away from bring-your-own containers and reusable coffee cups – composting can help ease the burden
I have never laughed, cried and wanted to make brown butter apple cake more than now.
We don’t know how long it will be before we emerge from our chrysalises into the world again. But while we cant at home many of us seem to have paused to reflect on our consumption choices.
I hope we keep our newfound habits and do not fall back on old ones. The soul-benefiting DIY posts from around the world already feel like exactly what social media, in its best light, was built for.
Another realisation I’ve noticed in this quest for improvement is the process of literally dealing with one’s crap, whether it’s the spiritual, physical or organic variety.
It is the natural order of things, I suppose – when we go to ground we start to think more responsibly. We notice our waste and extend our thoughts to closing the loop as much as we can.
It’s important that we not let this Covid-19 isolation era interfere too much with our waste management practices before the pandemic. We were well on our way to living more of a plastic-free, bring-your-own coffee cup, straw and container existence. This reign of hand sanitisers and reversion to single-use coffee cups is absolutely necessary now, but we can counterbalance it.
Learning how to deal with your organic garbage is an excellent start.
Compost is decomposed organic material. Think newspapers, fruit and vegetable scraps, eggshells – anything that is made of carbon, hydrogen, oxygen and nitrogen. And the good news is, that’s a lot of things.
Once you start shopping with the premise of “can I put this in my compost bin”, it will affect your consumption choices dramatically. Once I started asking myself this question constantly, I cut the contents of household red bin garbage by three-quarters within a week. And when you’ve brought your compost-friendly purchases home, it will dramatically change the way you eat, too.
So how does one start a compost?
If you are in an apartment I highly recommend a bokashi system. You can get this online or at many gardening and hardware stores. You can use a fancy aerated lidded compost bin under your kitchen sink, or even a simple airtight bucket on your bench top.
The bokashi element you can make yourself but is just as easily bought. The main ingredient is EM (effective microbes), which are inoculated into a host like wheat bran and blackstrap molasses.
Layer it like a lasagne, thin and even. For every layer of scraps sprinkle on the bokashi. The only thing that you shouldn’t add are large animal bones. Unlike many other forms of kitchen bench top composting, it is generally OK to add spent citrus and even animal and vegetable fats and oils – though don’t go overboard and upset the balance. A good rule of thumb to help break organic matter down is to make sure there’s nothing too large in surface area. Chop it down a little.
The bokashi will hasten the waste to break down and also deodorise your waste very effectively. It should smell a little like pickles.
Think of it like this: it is akin to your sourdough starter, koji or kefir grains. Essentially you are going to ferment your kitchen scraps so they may be dug into your garden or put into a bigger compost heap. If you don’t have that, I encourage you to sneak out in the dark and bury it around the trees in your verge. The council can thank you later!
Which leads me to composting if you have a garden
No need for fancy compost barrels if you have the space. Find yourself a corner of your garden – a meter by a meter is a good enough size.
You can use an old drum, or knock up a little container from old picket fences. Make sure to leave a hollowed-out space down the bottom, so you can extract the composted soil after it has broken down, and become free of pathogens. A good method for this is to measure the temperature in the middle of your compost heap to make sure it reaches 54-75C, becoming thermophilic, after which point it will start to cool down. You can help this by aerating it with a pitch fork and watering it a little every day.
If it starts to get pongy, add more carbon material like newspaper or hay. Chuck in all your kitchen and garden waste like pruned branches, old crops that need to be pulled out, grass clipping and leaf litter.
Make sure to never use the compost on your garden when it is hot, as this will “burn” your crops. It needs time to break down and become readily made nutrients for your plants to access.
An avian compost heap
Another type of composting I love and use both at the farm and the city is backyard chooks. Who doesn’t love getting eggs from your kitchen scraps? No one.
I don’t even bother with a compost heap in the city as most of our scraps get fed to the chooks. In turn, we layer their lovely poop with hemp hay, which is scraped to the corner of their coop to break down so that when we start a new crop each season it is added to our vegetable beds. It is teeming with lovely juicy worms. Food production, compost, worm farm – not forgetting endless hours of entertainment from watching the girls – all in one.
There are so many resources on the phases and different types of composting. If you start self-educating now, I guarantee you that you will not have covered everything by the time this crisis is over.
The best solution for your living situation may not be the one you first start off with, but don’t give up. Like my first permaculture teacher, Michael, from Milkwood Permaculture, taught me, there are “multiple-pronged solutions to deal with every problem”. Which I think is a good mantra for life as well.
I encourage you to start where you can and see where it leads you. Who doesn’t want to close the loop? Imagine how amazing it would be if we could all produce some energy from our crap?
When life gives you lemons, make lemonade – just make sure you put it in the compost when you’re done.
As countries ease lockdowns, the worry is that populations remain highly vulnerable
With more countries planning to loosen restrictions imposed due to coronavirus but the UK prime minister, Boris Johnson, and the German chancellor, Angela Merkel, concerned about the potential for a resurgence or second wave, here is what we know from the rest of the world about the risk of Covid-19 coming back.
Will there be a second wave?
Epidemics of infectious diseases behave in different ways but the 1918 influenza pandemic that killed more than 50 million people is regarded as a key example of a pandemic that occurred in multiple waves, with the latter more severe than the first. It has been replicated – albeit more mildly – in subsequent flu pandemics.
Other flu pandemics – including in 1957 and 1968 – all had multiple waves. The 2009 H1N1 influenza A pandemic started in April and was followed, in the US and varied northern hemisphere, by a second wave in the autumn.
How and why multiple-wave outbreaks occur, and how subsequent waves of infection can be prevented, has become a staple of epidemiological modelling studies and pandemic preparation, which have looked at everything from social behaviour and health policy to vaccination and the buildup of community immunity, also known as herd immunity.
While second waves and secondary peaks within the period of a pandemic are technically different, the concern is essentially the same: the disease coming back in force.
Is there evidence of coronavirus coming back elsewhere?
This is being watched very carefully. Without a vaccine, and with no widespread immunity to the new disease, one alarm is being sounded by the experience of Singapore, which has seen a sudden resurgence in infections despite being lauded for its early handling of the outbreak.
Although Singapore instituted a strong contact tracing system for its general population, the disease re-emerged in cramped dormitory accommodation used by thousands of foreign workers with inadequate hygiene facilities and shared canteens.
With 1,426 new cases reported on Monday and nine dormitories – the biggest of which holds 24,000 men – declared isolation units, Singapore’s experience, although very specific, has demonstrated the ability of the disease to come back strongly in places where people are in close proximity and its ability to exploit any weakness in public health regimes set up to counter it.
UK cancer specialist says leaving potentially infectious staff in hospitals is unethical
Healthcare workers should be screened for Covid-19 every week to protect patients from asymptomatic infection, the head of the Francis Crick Institute’s testing facility has said.
The call comes amid concerns that hospitals are becoming hotspots for disease transmission and evidence that a significant fraction of those infected show few or no symptoms.
“For all our fuss about social distancing we fairly ignoring one of the main routes of infection in front of our eyes,” said Prof Charles Swanton, who is leading the testing effort at the institute in London. “That’s almost untenable to argue you should haven’t been screening and isolating healthcare workers.”
The institute is next week launching a pilot to screen staff at University College hospital to identify asymptomatic Covid-19 cases, but the approach has not been explicitly endorsed by the government and there have been no indications that this is being considered as a national strategy.
The institute’s testing lab has capacity to run 3,000 tests a day, so would be capable of running a screening operation for staff at UCH, if this approach were adopted.
A possible concern is that screening could lead to large numbers of doctors and nurses, who are otherwise well, being required to self-isolate. But the alternative – leaving asymptomatic, but potentially infectious staff on the wards – runs contrary to the principle of “do no harm”, Swanton said.
They’re too scared to go to hospital and you can understand why
Patients were very aware of the risk, he added, and were staying at home due to justified fears that they could contract the virus by attending hospitals or seeing GPs.
On Thursday the Guardian reported that London A&E chiefs were concerned that patients were staying away, saying in a meeting last week: “People don’t want to go near hospital. As a result salvageable conditions are not being treated.”
Swanton, who is also chief clinician at Cancer Research UK, said: “I’m concerned that cancer patients need to be able to have the confidence to come into wards. We’re in this for another month at least, probably two or three. That’s a very long time to have a delayed cancer diagnosis.”
There is growing evidence that a significant proportion of people infected with Covid-19 show few or no symptoms and that up to half of transmission may take place before symptoms occur.
A study of people onboard the formerly quarantined Diamond Princess cruise ship, which was docked in Yokohama, Japan, found 328 of the 634 positive cases (52%) were asymptomatic at the time of testing, and other studies have found a range of 20-80% of people carrying the virus but showing no symptoms.
To identify such cases, healthcare workers had ideally to be screened weekly in high-risk areas, Swanton said.
Graham Cooke, professor of infectious diseases at Imperial College London, agreed that screening should be seriously considered as the testing capacity is increased this month.
“I do think we need to raise the conversation about large-scale testing in healthcare settings,” Cooke said. “Now we’ve got good evidence that there’s significant transmission in people who are pre-symptomatic. We’ve got concerns about transmission in hospitals and we’ve got much-improved capacity for testing. There are reasons to be cautious, but one of them is not to be afraid of what we might find.”
Before putting on a mask, clean hands with alcohol-based hand rub or soap and water.
Cover mouth and nose with mask and make sure there are no gaps between your face and the mask.
Avoid touching the mask while using it; if you do, clean your hands with alcohol-based hand rub or soap and water.
Replace the mask with a new one as soon as it is damp and do not re-use single-use masks.
To remove the mask: remove it from behind (do not touch the front of mask); discard immediately in a closed bin; clean hands with alcohol-based hand rub or soap and water.
How to wear medical masks
If you are healthy, you only need to wear a mask if you are taking care of a person with COVID-19.
Wear a mask if you are coughing or sneezing.
Masks are effective only when used in combination with frequent hand-cleaning with alcohol-based hand rub or soap and water.
If you wear a mask, then you must know how to use it and dispose of it properly.
Can a face mask protect me from coronavirus? Covid-19 myths busted
However, masks will probably make little difference if you’re just walking around town or taking a bus so there is no need to bulk-buy a huge supply.
Wearing a face mask is certainly not an iron-clad guarantee that you won’t get sick – viruses can also transmit through the eyes and tiny viral particles, known as aerosols, can penetrate masks. However, masks are effective at capturing droplets, which is a main transmission route of coronavirus, and some studies have estimated a roughly fivefold protection versus no barrier alone (although others have found lower levels of effectiveness).
If you are likely to be in close contact with someone infected, a mask cuts the chance of the disease being passed on. If you’re showing symptoms of coronavirus, or have been diagnosed, wearing a mask can also protect others. So masks are crucial for health and social care workers looking after patients and are also recommended for family members who need to care for someone who is ill – ideally both the patient and carer should have a mask.
