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Obese adults will be put on a ‘soup and shakes’ diet



For the residents along Indonesia’s Cisadane River, the coronavirus has brought not just deadly disease, but also a deluge of medical waste: a constant stream of syringes, face masks and hazmat suits floating by.

The double threat for those who depend on the 86-mile-long river to bathe and wash their clothes comes as Indonesia has struggled to contain Covid-19, now with the highest death toll in Southeast Asia, and in the past week almost 3,000 new infections a day.

As the virus has spread, medical waste had been piling up at Tangerang’s Cipeucang landfill. Then in May its walls collapsed, sending tons of garbage straight into the Cisadane’s khaki green waters.

“I still worry to be honest, but I have to wash here,” local resident Eka Purwanti, 36, told Reuters, as she did her laundry in the river, and children played on the riverbank, “I hope nothing will happen, although I know it’s a deadly disease.”





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why this was a disaster ten years in the making


There would have been no demand for masks, visors or droplet repellent PPE. Mass testing and track and trace systems would have been next to worthless. And there would have been no need for lockdown.

Why? Because an influenza pandemic would have been unstoppable. Just as was shown by Excercise Cygnus in 2016 when ministers simulated a flu pandemic, many tens of thousands would have died but there would have been nothing much to do, other than bury the dead.

This is the narrative pushed by Jeremy Hunt, the former Health Secretary, and Sally Davies, the former chief medical officer, who were responsible for Britain’s pandemic planning, but it will never survive the scrutiny of the public inquiry to come.

As epidemiologists like Prof Francois Balloux, director of the Genetics Institute at University College London, have pointed out, past pandemic strains of influenza and SARS-CoV-2 are extraordinarily similar. Both are droplet spread, if anything Covid spreads faster than influenza, both cause asymptomatic infections and both have similar infection fatality rates.

“SARS-CoV-2 behaves in most ways like a pandemic influenza strain,” wrote Prof Balloux in a recent Twitter thread. “The only major epidemiological difference between COVID 19 and flu pandemics is the age risk distribution, with influenza being highly dangerous to young children in addition to the elderly. At this stage, COVID 19 is really ‘like pandemic flu’, but not like ‘seasonal endemic flu'[which is much less lethal]”.

Mr Lesh says the real problem in Whitehall was “failure of imagination” and a ­misjudgment about society’s  tolerance for risk.

He said: “The thinking was, as with previous pandemics and Excercise Cygnus, you would let it run through and manage the deaths. They thought people’s tolerance for risk was higher, and that people would also be far less tolerant of social distancing measures.”

“If they looked at the SARS outbreak for example, my guess is they thought we would never accept that sort of mitigation in the west. So in some ways, you could say it was a benign assumption – that western publics would not be willing to make the sacrifices of the relatively more collectivist societies of Asia”.

Group think and western ­exceptionalism were certainly part of the problem but, as Mr Davies points out it was money too. The Institute for Government’s report on the pandemic finds that “failures in planning and funding cuts meant public services were not well prepared to handle the coronavirus crisis”.

Years of austerity overseen by former chancellor George Osborne saw the NHS protected but the capacity of its sister public health services dramatically cut.

“The Treasury is very effective at controlling spending but has historically been less good at understanding what it is getting for its money”, said Mr Davies.

“Also, the priority of governments since 2010 has been to keep tax as low as they can and – within public spending – to focus on efficiency over resilience.

“Those are perfectly reasonable political judgments to make, but clearly that has come back to bite us.”

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How do coronavirus home antibody tests work, and how do I get one?



The Elecsys laboratory-based test requires a blood sample to be taken by a health professional. Blood serums are obtained, to which reagents are added, and then examined in machines known as cobas e analysers, already widely installed in NHS labs across the country.

The development of an accurate antibody test is seen as key to helping Britain get back to work.

Scientists believe people who produce antibodies after having coronavirus may develop immunity to catching the virus again, making them safe to return to work.

Dr Ron Daniels, a consultant in critical care at University Hospitals Birmingham NHS Foundation Trust, says: “If you test positive for antibodies, it’s likely you have a degree of immunity. We’re not sure for how long, and how much, so you shouldn’t stop [social] distancing, but best guess it is likely to be partially protective for at least a few months.”

The Government had previously hoped to roll out millions of antibody tests, but supplies from China failed to pass sensitivity and specificity tests. 

Ministers will attempt to recoup taxpayers’ money spent on the fingerprick tests after an Oxford University trial found they returned inaccurate results.

That failure was a significant setback because it had been hoped the antibody tests would show who had already built up immunity, therefore offering a swifter route out of lockdown.

In April, however, Professor Karol Sikora, a private oncologist and Dean of Medicine at the University of Buckingham, validated a test kit using samples from staff at his clinics, which were then verified by a private lab.

Around 6 per cent of staff were found to have had the virus but, crucially, under-40s who had tested positive came back negative, suggesting the test may not be useful for the wider population. 

Siemens Healthineers, a German diagnostics and medical imaging firm, also announced on April 23 that it was producing an antibody blood test to identify past coronavirus infections.

The blood tests were expected to be available to large labs by late May, the company said, adding that it would be able to provide more than 25 million tests per month from June thanks to an upgrade to its manufacturing site in Massachusetts.

Another antibody test being pioneered by Oxford University could be available by the end of May, according to Professor John Newton, the UK’s national testing co-ordinator.

What is an antigen test?

An antigen test detects the presence (or absence) of an antigen, not antibodies. An antigen is a structure within a virus that triggers the immune system’s response to fight off the infection. It can be detected in blood before antibodies are made.

An antigen test is effective because it can take a few days for the immune system to build enough antibodies to be detected in a test, however, antigens can be detected almost immediately after infection. So, in theory, the test can tell much sooner whether someone has the virus.

Antigen tests are used to diagnose HIV, malaria and flu. 



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Donald Trump clashes with reporters



A group of California prisoners tried to infect themselves in a futile bid to win freedom, a senior police official said on Monday.

Inmates at a facility in Castaic, north of Los Angeles, were filmed sharing a disposable cup and sniffing a used face mask while crowded together.

“Somehow, there was some mistaken belief among the inmate population that if they tested positive, that there was a way to force our hand and somehow release more inmates out of our jail environment – and that’s not going to happen,” said county sheriff Alex Villanueva.

Some 21 prisoners tested positive in the prison section where the video was shot “as a result of the behaviour”, he added.

The activity came to light as prison officials investigated a broader spike in Covid-19 cases behind bars, with nearly 40 percent of those incarcerated in Los Angeles County now in quarantine.





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UK deaths soar past 8,000 as 866 recorded in last 24 hours in England alone



The Philippines has banned doctors, nurses and other health workers from leaving the country to work overseas in a bid to throw more resources at its own coronavirus outbreak, reports Patrick Sawer.

With the pandemic threatening to overwhelm Phillipine’s fragile healthcare system the Government says it requires all available medics and support staff to remain in the country.

Thousands of health professionals leave the Phillipine to work overseas, many travelling to the UK to work in NHS and private hospitals and in social care.

More than 30,000 doctors, nurses and medical technicians left the Philippines in 2010, according to the latest available data.

But the country has one of the lowest ratios of doctors per population in the region, leaving it ill prepared to cope with the coronavirus pandemic.

The Philippine Overseas Employment Administration has now barred healthcare professionals travelling to work abroad for the duration of the nation’s state of emergency.

The ban covers 14 jobs defined as “mission critical”, including doctors, nurses, microbiologists and pharmacists.

It also includes hospital equipment repair technicians, nursing assistants and laboratory technicians, all of whose skills “reflect the primary function of the organization without which mission critical work cannot be completed and which skills are internally developed and require extensive training, thus, not easily replaceable,” states the order.

The Philippines had 4,076 coronavirus cases as of Thursday, with deaths reaching 203. More than 200 health workers have been infected, with at least a dozen dying from the virus.

According to the World Health Organization there are only six doctors for every 10,000 people in the Philippines, compared to Singapore’s ratio of almost 23 and Malaysia at 15.36.





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