wwww

Large cohort studies worldwide will examine long-term damage from Covid-19. An important reason for caution is that long-term consequences such as increased dementia or the risk of depression can only be recognized in about 10 years. 2002 SarsCov-1 also had long-term consequences

This good study from Sydney suggests that Covid-19 is much more contagious in autumn and winter due to less moisture (not cold). The cause is the drier air. It reduces drops and aerosols. There is also an interior stay

A very (!) Astonishing result, but shown in a robust study. Blood group A about 50% higher risk of severe course Covid-19. Twice the risk as blood group 0. Blood group B in between. Since immune response depends on blood type, that makes sense

COVID-19 in Japan Relative to the United States and Europe, the number of infections and deaths in Japan has been small At the same time, the number of deaths in many other parts of East Asia has also been low. Taiwan, in particular, has succeeded in keeping the number of fatal cases to a minimum Reasons for Taiwan’s success: •As a consequence of its experience with SARS and other contagious disease outbreaks,Taiwan’s level of preparedness was higher than Japan’s •Taiwan has fewer visitors from the United States and Europe than Japan does, and it was quicker to restrict inbound travel in response to the pandemic. (Feb. 6: banned visitors from mainland China. March 19: banned entry of all foreign travelers) *Japan began restricting visitors from Hubei Province, China, on Feb. 1, but it remained open to travelers from Italy, Germany, France and most other parts of Europe until March 27. It banned entry from the United States, Britain and the rest of China on April 3 Why has the number of COVID-19 cases and deaths been comparatively low in Japan? A number of reasons have been suggested for Japan’s relatively small number of infections and deaths. The most widely discussed include: •Easy access to medical care under the national health insurance system •Generally high quality of medical care, even in rural areas, with hospitals supported by a national network of local public health centers (hokenjo) •The Japanese public’s high standard of hygiene, willingness to comply with government requests, and other cultural traits and lifestyle habits At the same time, two important factors have not received due attention. They are: 1.Early detection of transmission waves 2.Cluster-based approach Early detection and delay of outbreak peak Japan detected the first wave of COVID-19 infections from China at an early stage, leading to a more gradual transmission curve that allowed Japan to delay the peak of the outbreak and to buy time to prepare. The US and Europe, by contrast, suffered rapid early surges The “Three Cs” Based on analysis of the shared characteristics of clusters, Japan developed a concept called the “ThreeCs” to denote high-risk places and situations • Closed spaces • Crowded places • Close-contact settings The public was asked to avoid the Three-Cs; awareness of the term became widespread The concept has been expanded to “Three Cs Plus,”which includes behaviors suchas loud talking and singing State of emergency A monitoring system using indicators such as the virus’ reproduction number had been put in place to detect early signs of a surge in infections A state of emergency was declared on April 7 for three reasons •Early signs of a surge in infections were detected, through close monitoring •Strain on the health care system was growing •The cluster-based approach was reaching its limits (human resources, etc.) due to increased case volume Public cooperation was vital. Changes in behavior helped stem the tide of new cases The effective reproduction number remained below 1 during the state of emergency Testing in Japan Compared with other countries, Japan has performed fewer PCR tests for the virus. Its testing has focused on high-risk groups and people associated with suspected clusters At the peak of the outbreak in early April, timely testing was not always available to those who needed it, due to limited capacity.This was an issue thatJapan is now addressing Despite such issues, Japan’s testing infrastructure has been adequate from a public health perspective •Japan’s testing has been appropriate to the scale of the outbreak. It has conducted more tests per infection and per death than many other countries •With the exception of the peak period of the outbreak, the percentage of positive results has been lower than in other countries. Low positive rates are an indicator of sufficient testing, according to the WHO Testing going forward As Japan eases restrictions and seeks to resume social and economic activity, while preparing for possible new outbreaks, the following goals should be considered in testing policy: •Laboratory testing that identifies cases at an early stage(prodrome and mild symptoms), to facilitate timely medical treatment and the prevention of further infections •Faster laboratory testing with shorter waits between consultations and tests •Use of antigen-detecting rapid diagnostic tests (RDTs). RDTs are less sensitive than PRC tests, but they are quicker, easier and can identify high viral loads, which may help detect especially infectious cases. RDTs could be particularly useful for preventing outbreaks in hospitals, nursing homes and other high-risk settings Conclusion Citizens’ cooperation has been vital to slowing the spread of the virus while preventing the healthcare system from becoming overwhelmed A focused, cluster-based response and avoidance of the “Three Cs” helped control the spread of COVID-19, especially in the early stage of the outbreak This is no time for complacency. Latent transmission chains can surface at any time, and new types of clusters could develop in the future The decline in the number of new cases should be taken as an opportunity to prepare for a potential next wave Japan has learned a lot, and while there is still much to understand, it should share its experiences with the world and actively participate in the global pandemic response https://www.mhlw.go.jp/content/10900000/000635891.pdf https://www.mhlw.go.jp/content/10900000/000615287.pdf Guidelines for lifting state of emergency: https://www.mhlw.go.jp/content/10900000/000635890.pdf

, That is exactly where we now stand. Many doubt the justice of our country, and with good reason. Black people see the repeated violation of their rights without an urgent and adequate response from American institutions. We know that lasting justice will only come by peaceful means. Looting is not liberation, and destruction is not progress. But we also know that lasting peace in our communities requires truly equal justice. The rule of law ultimately depends on the fairness and legitimacy of the legal system. And achieving justice for all is the duty of all. This will require a consistent, courageous, and creative effort. We serve our neighbors best when we try to understand their experience. We love our neighbors as ourselves when we treat them as equals, in both protection and compassion. There is a better way — the way of empathy, and shared commitment, and bold action, and a peace rooted in justice. I am confident that together, Americans will choose the better way.

https://www.nytimes.com/2020/05/29/health/coronavirus-transmission-dose.html It’s Not Whether You Were Exposed to the Virus. It’s How Much. The pathogen is proving a familiar adage: The dose makes the poison. When experts recommend wearing masks, staying at least six feet away from others, washing your hands frequently and avoiding crowded spaces, what they’re really saying is: Try to minimize the amount of virus you encounter. A few viral particles cannot make you sick — the immune system would vanquish the intruders before they could. But how much virus is needed for an infection to take root? What is the minimum effective dose? A precise answer is impossible, because it’s difficult to capture the moment of infection. Scientists are studying ferrets, hamsters and mice for clues but, of course, it wouldn’t be ethical for scientists to expose people to different doses of the coronavirus, as they do with milder cold viruses. For SARS, also a coronavirus, the estimated infective dose is just a few hundred particles. For MERS, the infective dose is much higher, on the order of thousands of particles. The new coronavirus, SARS-CoV-2, is more similar to the SARS virus and, therefore, the infectious dose may be hundreds of particles, Dr. Rasmussen said. Generally, people who harbor high levels of pathogens — whether from influenza, H.I.V. or SARS — tend to have more severe symptoms and are more likely to pass on the pathogens to others. But in the case of the new coronavirus, people who have no symptoms seem to have viral loads — that is, the amount of virus in their bodies — just as high as those who are seriously ill, according to some studies. And coronavirus patients are most infectious two to three days before symptoms begin, less so after the illness really hits. Some people are generous transmitters of the coronavirus; others are stingy. So-called super-spreaders seem to be particularly gifted in transmitting it, although it’s unclear whether that’s because of their biology or their behavior. On the receiving end, the shape of a person’s nostrils and the amount of nose hair and mucus present — as well as the distribution of certain cellular receptors in the airway that the virus needs to latch on to — can all influence how much virus it takes to become infected. A higher dose is clearly worse, though, and that may explain why some young health care workers have fallen victim even though the virus usually targets older people. ... People may take in virus by touching a contaminated surface and then putting their hands on their nose or mouth. But “this isn’t thought to be the main way the virus spreads,” according to the Centers for Disease Control and Prevention. That form of transmission may require millions more copies of the virus to cause an infection, compared to inhalation. Coughing, sneezing, singing, talking and even heavy breathing can result in the expulsion of thousands of large and small respiratory droplets carrying the virus. “It’s clear that one doesn’t have to be sick and coughing and sneezing for transmission to occur,” said Dr. Dan Barouch, a viral immunologist at Beth Israel Deaconess Medical Center in Boston. Larger droplets are heavy and float down quickly — unless there’s a breeze or an air-conditioning blast — and can’t penetrate surgical masks. But droplets less than 5 microns in diameter, called aerosols, can linger in the air for hours. “They travel further, last longer and have the potential of more spread than the large droplets,” Dr. Barouch said. Three factors seem to be particularly important for aerosol transmission: proximity to the infected person, air flow and timing. ... Recently, Dutch researchers used a special spray nozzle to simulate the expulsion of saliva droplets and then tracked their movement. The scientists found that just cracking open a door or a window can banish aerosols. Observations from two hospitals in Wuhan, China, published in April in the journal Nature, determined much the same thing: more aerosolized particles were found in unventilated toilet areas than in airier patient rooms or crowded public areas. ... Apart from avoiding crowded indoor spaces, the most effective thing people can do is wear masks, all of the experts said. Even if masks don’t fully shield you from droplets loaded with virus, they can cut down the amount you receive, and perhaps bring it below the infectious dose. “This is not a virus for which hand washing seems like it will be enough,” Dr. Rabinowitz said. “We have to limit crowds, we have to wear masks.”

https://covid.idmod.org/data/Stochasticity_heterogeneity_transmission_dynamics_SARS-CoV-2.pdf Stochasticity and heterogeneity in the transmissiondynamics of SARS-CoV-2

Prof Drosten je juce pricao o klasterima u podcastu. (negde od sredine): https://www.ndr.de/nachrichten/info/44-Coronavirus-Update-Die-rote-Murmel-kontrollieren,podcastcoronavirus216.html ima deo o statistici pricao je o neravnomernom sirenju virusa, gde npr. od 9 inficiranih svako zarazi po jednog, a deseti zarazi 10 ljudi. U zavisnosti kad se taj deseti pojavi u nizu zavisi koliko treba virusu da krene rapidno da se siri. Pa je onda dao primercic kako bi mogla da se razvija epidemija. Skraceno to bi recimo ovako nekako izgledalo: prve sedmice jedan zarazeni zarazi jednog, taj u roku od narednih 7 dana zarazi narednog, pa onda taj naredni zarazi jednog, dok se onda jedne od tih sedmica ne pojavvi taj "deseti" zarazeni koji ce da zarazi 10 novih. Tu sad krece rapidno povecavanje broja inficiranih. Skraceno to bi nekako ovako izgledalo (ako izbacim sedmice kada jedan zarazeni zarazi samo jednog narednog): 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 1 10 19 28 55 100 190 370 703 1333 2530 4807 9127 17335 32932 1 10 9 9 25 50 90 170 333 633 1200 2277 4327 8215 15602 10 9 10 10 100 200 370 700 1330 2530 4800 9120 17330 10 10 10 10 10 10 10 prvi red su recimo sedmice/generacija drugi red je porast broja inficiranih a ispod je kako druge sedmice taj jedan superspreader zarazi 10 pa trece sedmice od tih 10, njih 9 ce svaki zaraziti samo po jednog, ali ce taj deseti da zarazi narednih deset, sto daje 19 zarazenih i tako iz sedmice u sedmicu: na svakih 9 koji zaraze po jednog dodje jedan superspreader koji zarazi deset novih. (znaci, prvi red ovde su oni koji zaraze samo po jednog narednog, a red ispod su superspreaderi) Vrlo brzo upadamo u eksponencijalni rast broja zarazenih.

https://science.sciencemag.org/content/368/6493/808 Case clustering emerges as key pandemic puzzle

U tom dodatnom tekstu pise da Danska jos uvek pregovara s Svedskom, da ce mozda dozvoliti samo ljudima iz nekih delova Svedske da dodju u goste (ne znam kako bi ovo izveli).

One exception to the rule is Kågeskolan in Skellefteå where a teacher died and 25% of the staff (18 people) tested positive. None of the pupils were tested. The school closed for a small while - due to lack of staff, not because of a quarantine. Another member of school staff died in Danderyd. No one was tested, no one was quarantined. A 51-year-old member of school staff died in Nacka. I read about it in this Finnish article and have heard about it from the families in the school. A cleaner in a school in Kungsholmen died of COVID-19. No tests, no quarantine. I've heard about it from a parent. A 66-year-old teacher died of COVID-19 in Botkyrka. I've read about in Twitter and in FB.

https://www.purelivingproperties.com/ref-PLP03038_villa-sierra+blanca-marbella+golden+mile.html

Denmark will reopen its borders, closed in the Corona crisis, from June 15 to tourists from Germany, Norway, Iceland and Scandinavia. This was announced by Prime Minister Mette Frederiksen in Copenhagen. https://www.thelocal.dk/20200529/denmark-and-norway-open-borders-for-eachothers-tourists