The former captain of the aircraft carrier Theodore Roosevelt fired from command after sounding the alarm on an out-of-control coronavirus outbreak on board in 2020 will retire from the Navy next month, the Navy Times newspaper reported Monday.
Captain Brett Crozier, a 30-year-Navy veteran, was removed from command of the Roosevelt based in San Diego at the time following the leak of a letter he wrote to Pacific Fleet commanders in which he implored the Navy to do more to protect the crew as dozens of sailors began testing positive for COVID-19. The ship was just a couple of months into a scheduled deployment to the Western Pacific when the outbreak began. It was sidelined in Guam but sailors were still living in close quarters on board as the virus spread unabated.
Immediately after Croziers letter was made public, the Navy announced thousands of sailors would move off the ship. The next day, Crozier was fired from command.
Video of Croziers departure from the ship showed hundreds of sailors cheering their captain and chanting his name. Shortly after those videos went viral, the acting secretary of the Navy at the time, Thomas Modly, visited the ship and blasted Crozier over its public address system.
Audio of Modlys profane 15-minute speech also leaked. The acting secretary first apologized, then resigned.
Crozier was initially reassigned to a staff position at Naval Air Forces in San Diego. Crozier later told investigators he understood the risk to his career he took in writing the letter but did so to avoid a larger catastrophe.
The Roosevelt remained in Guam for two months before finishing its deployment and returning to San Diego. One Roosevelt sailor, Chief Petty Officer Thomas Thacker, died of the virus. He was the first of 92 service members 17 of them sailors to die from the virus throughout the pandemic.
Crozier is currently assigned to Strike Fighter Squadron 154 in Lemoore, Calif. He flew his last flight in an F/A-18F Super Hornet on Feb. 2, Navy Times reported.
The Roosevelt left San Diego in July to begin an 18-month retrofit in Bremerton, Wash.
Most people who die of COVID-19 first spend time in an ICU.
Early in the pandemic, about one-third of COVID-19 patients treated in intensive care died. Those figures are far better now, thoughprecise numbers aren't available.
But what we do know is that most of the survivors don't bounce back quickly.A study recently found that among Dutch people treated for COVID-19 in an ICU, 74% still had physical symptoms a year later, including weakness and muscle and joint pain. More than a quarter reported lingering mental symptoms and 16% had cognitive problems.
Read more from reporter Karen Weintraub on the experiences of COVIDpatients in the ICU here.
It's Tuesday, and this is Coronavirus Watch from the USA TODAY Network. Here's more news to know:
See our COVID-19 resource guide here. See total reported cases anddeaths here. On vaccinations: About 76% of people in the U.S. have received at least one vaccine shot, and about 64% are fully vaccinated, according to the CDC.
Cady Stanton, USA TODAY digital editor fellow, @cady_stanton
A recent study carried out by the American Conference of Governmental Industrial Hygienists (ACGIH), based on data provided by the US Centers for Disease Control and Prevention (CDC), estimates different timeframes for coronavirus contagion depending on the type of face mask a person is using. These range from 27 minutes for somebody wearing a cloth mask to up to 25 hours for someone wearing a perfectly adjusted N95 mask (the US equivalent of an FFP2 in Europe).
In a closed space, without ventilation and no masks, an infected person can pass the virus to another in 15 minutes.
A well-fitted N95 mask lets a maximum of 10% unfiltered air through. If two people are using them, infection is unlikely.
*All infection times in this infographic have been calculated in an enclosed, unventilated space with a distance of two meters between the two people.
In a closed space, without ventilation and no masks, an infected person can pass the virus to another in 15 minutes.
A well-fitted N95 mask lets a maximum of 10% unfiltered air through. If two people are using them, infection is unlikely.
*All infection times in this infographic have been calculated in an enclosed, unventilated space with a distance of two meters between the two people.
In a closed space, without ventilation and no masks, an infected person can pass the virus to another in 15 minutes.
A well-fitted N95 mask lets a maximum of 10% unfiltered air through. If two people are using them, infection is unlikely.
*All infection times in this infographic have been calculated in an enclosed, unventilated space with a distance of two meters between the two people.
In a closed space, without ventilation and no masks, an infected person can pass the virus to another in 15 minutes.
A well-fitted N95 mask lets a maximum of 10% unfiltered air through. If two people are using them, infection is unlikely.
*All infection times in this infographic have been calculated in an enclosed, unventilated space with a distance of two meters between the two people.
These masks were in short supply in the early days of the pandemic, but now that they are commonplace, scientists and health authorities have been stressing the importance of using this kind of effective protection against coronavirus, pointing out that masks made of cloth and surgical masks are not equipped with a facial seal and are loose-fitting, thereby allowing a large quantity of aerosols to escape.
In the United States, the Joe Biden administration announced in January it would distribute 400 million N95 face masks to people across the country free of charge as part of the presidents strategy to combat the spread of the more-contagious omicron variant of the coronavirus. Since December, anybody wishing to attend the theater or a concert or use public transport in Italy has been obliged to wear a face mask of this grade to be granted access. In Spain, sales of FFP2 and FFP3 masks rose by 642% between November 2021 and January 2022 according to medical material distributor Cofares, while some Spanish regions such as Andalusia and Catalonia have asked that the wearing of this type of mask be made obligatory on public transport and during visits to senior homes.
The lack of protection against Covid-19 afforded by surgical masks is due to their loose-fitting design. Masks of this type are used to contain splashes on both sides of the fabric. During a surgical procedure, for example, they prevent the patient from being contaminated by drops of saliva from the mouths of the surgeons when they are talking, while also protecting the medical personnel from blood and other fluids from the patient. Furthermore, the filters in these masks only trap particles of between three and seven microns in size. This means that bacteria and other large aerosols are retained by the mask, but other finer aerosols, such as those that transmit the coronavirus, are able to get through.
Their loose design allows for up to 50% of the air (and aerosols) that we breathe to enter and escape.
These are designed specifically to stop infectious droplets that we emit when we speak, cough and sneeze, but not to trap the air nor the possible infectious aerosols.
During their production and professional use, tests are not carried out on the fit, only on the filtering material.
*Micron: a thousandth of a millimeter
Most of the aerosols that we breathe are smaller than 3 microns. Surgical masks do not trap these, but well-fitted N95 masks do.
Their loose design allows for up to 50% of the air (and aerosols) that we breathe to enter and escape.
These are designed specifically to stop infectious droplets that we emit when we speak, cough and sneeze, but not to trap the air nor the possible infectious aerosols.
During their production and professional use, tests are not carried out on the fit, only on the filtering material.
*Micron: a thousandth of a millimeter
Most of the aerosols that we breathe are smaller than 3 microns. Surgical masks do not trap these, but well-fitted N95 masks do.
Their loose design allows for up to 50% of the air (and aerosols) that we breathe to enter and escape.
These are designed specifically to stop infectious droplets that we emit when we speak, cough and sneeze, but not to trap the air nor the possible infectious aerosols.
During their production and professional use, tests are not carried out on the fit, only on the filtering material.
Most of the aerosols that we breathe are smaller than 3 microns. Surgical masks do not trap these, but well-fitted N95 masks do.
*Micron: a thousandth of a millimeter
These are designed specifically to stop infectious droplets that we emit when we speak, cough and sneeze, but not to trap the air nor the possible infectious aerosols.
Their loose design allows for up to 50% of the air (and aerosols) that we breathe to enter and escape.
*Micron: a thousandth
of a millimeter
During their production and professional use, tests are not carried out on the fit, only on the filtering material.
Most of the aerosols that we breathe are smaller than 3 microns. Surgical masks do not trap these, but well-fitted N95 masks do.
The N95, which is considered a high-protection mask and used in the prevention of respiratory diseases, is designed to retain fine aerosols. To achieve this, such masks are better adjusted to the contours of the face and have a filter capable of trapping up to 95% of particles measuring three microns (94% in the case of the FFP2). For an FFP2 mask to meet all the regulations you have to perform 15 or 20 different tests. In the case of surgical masks, only four are carried out: filtration of bacteria, respirability, whether or not they contaminated and if they are splash-resistant, explains Jos Mara Lagarn, a researcher at the Spanish National Research Council (CSIC).
The fit of a mask and its seal are more important than the filtration efficacy of its component materials when it comes to reducing leakage on the inside of the fabric. Ensuring an optimal fit is also important with these masks, as a gap between mask and face equivalent to as little as 2% of the masks surface would allow up to 50% of air to pass through unfiltered.
Recommendations for a good fit
Beards can
impede a
good fit
The best filtration and facial seal are offered by an N95 mask (N95 in Europe) that is well fitted around the head and the neck.
A knot tied in the bands of the mask improves the fit and reduces the entry and exit of aerosols.
The best recommendation to ensure a good facial seal of a surgical mask is to use a silicone mask fitter.
Recommendations for a good fit
Beards can
impede a
good fit
The best filtration and facial seal are offered by an N95 mask (N95 in Europe) that is well fitted around the head and the neck.
A knot tied in the bands of the mask improves the fit and reduces the entry and exit of aerosols.
The best recommendation to ensure a good facial seal of a surgical mask is to use a silicone mask fitter.
Recommendations for a good fit
The best filtration and facial seal are offered by an N95 mask (N95 in Europe) that is well fitted around the head and the neck.
Beards can
impede a
good fit
A knot tied in the bands of the mask improves the fit and reduces the entry and exit of aerosols.
The best recommendation to ensure a good facial seal of a surgical mask is to use a silicone mask fitter.
Recommendations for a good fit
Beards can
impede a
good fit
A knot tied in the bands of the mask improves the fit and reduces the entry and exit of aerosols.
The best recommendation to ensure a good facial seal of a surgical mask is to use a silicone mask fitter.
The best filtration and facial seal are offered by an N95 mask (N95 in Europe) that is well fitted around the head and the neck.
Tests to measure the concentration of aerosols on the interior and exterior of masks establish the minimum fit factor required to provide effective protection at 100. A good FFP2 mask has a fit factor of over 200; a surgical mask can be as low as two, explains Santos Huertas, director of research and innovation at Spanish occupational accidents and diseases insurer Asepeyo.
The type of fastening a mask has, the researcher explains, is key to ensuring an optimal fit. Masks that fit around the ears have much lower fit factors than those that are attached around the nape of the neck and the crown of the head. However, the fit of masks that use ear supports can be improved by a cardboard or plastic hook that links both straps behind the head. Whichever type of fastening is employed, it is essential to ensure that the nose piece is correctly shaped to the wearers requirement and that the mask fits the overall shape of the users face.
N95 masks are more durable than surgical masks, which lose their efficacy after around four hours of use. A disposable mask has a useful life span of around eight hours, while reusable models can last for 30 hours. Between uses, it is important to ensure that the mask is allowed to dry out, while also checking that it is in good condition, has not been damaged in any way and that its fastenings retain their elasticity.
The maximum usage time for a reusable N95 mask is up to 40 hours, but according to the exposure to the virus, experts consulted say that they can last up to 20 days.
Low exposure to the virus
Ventilated spaces and
with few people.
* Provided that the mask remains dry
and is properly fitted.
High exposure to the virus
Hospitals and areas with high amounts
of people.
Tests carried out with high levels of virus showed that it can remain active up to 72 hours in an N95. Four N95 masks alternated every 72 hours could last up to 20 days.
The maximum usage time for a reusable N95 mask is up to 40 hours, but according to the exposure to the virus, experts consulted say that they can last up to 20 days.
Low exposure to the virus
Ventilated spaces and
with few people.
* Provided that the mask remains dry
and is properly fitted.
High exposure to the virus
Hospitals and areas with high amounts
of people.
Tests carried out with high levels of virus showed that it can remain active up to 72 hours in an N95. Four N95 masks alternated every 72 hours could last up to 20 days.
The maximum usage time for a reusable N95 mask is up to 40 hours, but according to the exposure to the virus, experts consulted say that they can last up to 20 days.
Low exposure to the virus
Ventilated spaces and
with few people.
* Provided that the mask remains dry
and is properly fitted.
High exposure to the virus
Hospitals and areas with high amounts of people.
Four N95 masks alternated every 72 hours could last up to 20 days.
Tests carried out with high levels of virus showed that it can remain active up to 72 hours in an N95.
Theres an important relationship among your nutritional status, immune health, risk of infection, and ability to recover from illness (1, 2, 3).
Poor nutrition is associated with inflammation and oxidative stress, which compromise immune health. Both inflammation and oxidative stress are elevated when you have COVID-19 (1, 2).
The World Health Organization declared the novel coronavirus a pandemic in March 2020. The viruss full name is severe acute respiratory syndrome coronavirus (SARS-CoV-2), and the illness it causes is called COVID-19 (4).
COVID-19 negatively affects nutritional status because it decreases appetite and may limit your access to nutritious foods during confinement, yet it simultaneously increases your bodys need for nutrients, such as vitamin D (3, 5, 6).
Diet and nutrition can help support your immune health if you have COVID-19, especially if you consume foods with antioxidant and anti-inflammatory properties (1, 2, 5, 6, 7).
Its important to note that this is an emerging area of research. These foods wont prevent you from contracting the novel coronavirus or cure the disease, but they have been shown to support immune health.
This article lists key nutrients, foods, and nutrition practices that may be beneficial for people who have COVID-19 or are recovering from it.
Vitamin D is the most frequently discussed micronutrient among nutrition experts for the management of COVID-19 (5).
This fat-soluble vitamin and hormone exerts an anti-inflammatory effect by suppressing overactivity of the immune system, according to newer and older research (1, 5, 8, 9).
In the body, vitamin D acts on angiotensin converting enzyme 2 (ACE2), a protein receptor found in the lungs and fat tissue (1, 7).
The novel coronavirus binds to ACE2 at the beginning of an infection, potentially leading to acute respiratory distress syndrome and severe illness in people with COVID-19 (10).
However, vitamin D interacts with the ACE2 receptors, potentially preventing the virus from binding to them, and reducing complications associated with COVID-19 (1, 10, 11).
Vitamin D may also play a protective role and support healing of damaged tissues, primarily in the lungs (10).
On average, people make approximately 80% of their vitamin D when their skin is exposed to sunlight (ultraviolet light) and get the remaining 20% from their diet (8).
As a result, taking vitamin D daily may be a good idea if youre in confinement due to COVID-19 and have little sunlight exposure (5).
However, some medications may interact with vitamin D supplements including blood thinners, which are common among people with COVID-19 as a result of the increased risk of blood clotting.
Thats why its best to speak with a healthcare professional before you start taking vitamin D supplements regularly.
Increasing your intake of vitamin D-rich foods while you have or are recovering from COVID-19 is a great way to reduce the risk of a vitamin D deficiency and potentially improve your immune response.
Here are seven foods rich in vitamin D, along with the amount of the vitamin each contains (12, 13, 14, 15, 16, 17, 18):
Wild mushrooms are a vegetarian source of vitamin D. Their levels vary depending on the type of light they were exposed to as they were growing, according to older research (19).
Vitamin D may help protect your lungs during novel coronavirus infection by disrupting viral attachment in your body. Several foods are rich in vitamin D, including cod liver oil, salmon, herring, and some wild mushrooms.
Carotenoids are antioxidants as well as pigments (red, green, yellow, and orange). Theyre found in nature in some colorful algae, bacteria, fungi, plants, fruits, and vegetables, some of which you can include in your diet (20, 21).
Of the 700 carotenoids identified in nature, only about 30 have been found in the human body. One of these is vitamin A and its precursor, beta carotene (20, 22, 23).
Vitamin A is a fat-soluble antioxidant carotenoid. It has anti-inflammatory properties, and research has shown it may be beneficial for managing pneumonia and respiratory infections (1, 24, 25, 26).
In the case of COVID-19, studies indicate that vitamin A reduces inflammation and oxidative stress, enhances the immune response, and may decrease the severity of the disease (24, 25).
Researchers think it protects the ACE2 receptors, similarly to vitamin D, and may work on several other molecular targets to combat COVID-19 (24, 25).
Some people may develop vitamin A deficiency during infections such as COVID-19, and this may actually increase the severity of the disease. If this happens, you might need to take vitamin A supplements (25).
However, drug interactions are also possible if youre taking vitamin A supplements, so make sure you speak with a healthcare professional before taking them.
Dark green leafy vegetables and organ meats, particularly liver, are rich sources of vitamin A.
Here are eight foods rich in vitamin A, along with the % of the DV per 100 grams of each (27, 28, 29, 30, 31, 32, 33, 34):
Vitamin A is a carotenoid that may help provide powerful protection against infections, including COVID-19. Food sources include liver, dark green leafy vegetables, and pigmented vegetables such as sweet potatoes and carrots.
Zinc deficiency has been associated with an increased risk of infections and poorer outcomes in those with COVID-19 (1, 35).
Zinc is regarded as one of the most important minerals. Research has shown that its antioxidant and anti-inflammatory properties may reduce the risk of heart disease, may support eye health, and are essential for immune health (36, 37, 38, 39).
In COVID-19, zinc may reduce the risk of getting a bacterial infection at the same time and decrease activity of the ACE2 receptors, which are targets of the novel coronavirus (40).
It also protects the health of the lung tissue and may be a therapeutic additional treatment for COVID-19. Studies on this are now underway (41, 42, 43, 44).
If youve received a diagnosis of zinc deficiency, your doctor may have recommended that you take zinc supplements. However, be careful not to take too much, because zinc is toxic in excess amounts. Stick to the dose your doctor recommends (45).
Here are seven foods rich in zinc, along with the % of the DV per 100 grams of each (46, 47, 48, 49, 50, 51, 52):
Zinc is an essential mineral with anti-inflammatory properties that may benefit people with COVID-19. Rich food sources include ground beef, cashews, and hemp seeds.
Omega-3 polyunsaturated fats are a category of fatty acids shown to have anti-inflammatory health benefits, including for brain health, heart disease, and rheumatoid arthritis (1, 9, 53, 54).
These omega-3 fats, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), may improve recovery in people with COVID-19 (55).
However, higher quality research in humans is needed before healthcare professionals may recommend taking it for this purpose.
Omega-3 fats reduce inflammation and the potential for the cytokine storm in COVID-19, which is hyperactivity of the immune system that causes negative symptoms.
Theyre thought to do this by becoming part of cell membranes of various tissues throughout the body and preventing the production of pro-inflammatory compounds (56).
Another potential benefit of omega-3 fats in treating those with or recovering from COVID-19 is their role in improving mood, anxiety, and depression all of which may be worsened by the novel coronavirus pandemic (57, 58).
Research is underway to determine the therapeutic role of omega-3 fats for COVID-19.
Here are eight foods rich in omega-3 fatty acids, along with the amount of omega-3s found in each. Note that these contain different types of omega-3s (12, 15, 17, 29, 59, 60, 61, 62):
As you may have noticed, many foods rich in omega-3 fats are also rich sources of vitamin D.
Omega-3 polyunsaturated fats are known for their anti-inflammatory health benefits and may help treat COVID-19. Foods rich in omega-3 fats include salmon, sardines, and chia seeds.
Vitamin C is an antioxidant vitamin that supports immune health in people of all ages (63).
Animal and human studies have found that vitamin C may reduce oxidative stress, improve endothelial function to guard against heart disease, and support recovery from the common cold (64, 65, 66).
Emerging research demonstrates that giving vitamin C to people with COVID-19 may support recovery and improvement during the disease course (44, 66, 67).
Vitamin C has a potential role in the prevention and management of pneumonia and bacterial infections such as sepsis, although some in the scientific community question its use (66, 67).
Preliminary evidence suggests that taking vitamin C may help those with COVID-19, but more studies in humans are needed (68).
Here are eight foods naturally high in vitamin C, along with the % of the DV per 100 grams of each (69, 70, 71, 72, 73, 74, 75, 76):
Vitamin C is an antioxidant vitamin that supports immune health and is known to reduce the risk of pneumonia. This nutrient shows promise as a treatment for COVID-19, and more research is currently underway.
COVID-19 negatively affects nutritional status, and a healthy, functional immune system is paramount to reducing the risk of infection and supporting recovery.
Researchers are looking with great interest at vitamin D, carotenoids, vitamin A, zinc, omega-3 fatty acids, and vitamin C to determine their potential health benefits as complementary treatments for COVID-19.
There is currently no clinical evidence that a low histamine diet is beneficial to those with or recovering from COVID-19. More research in humans is needed.
A child wears a KN95 mask for kids in Hastings-on-Hudson, New York. (Tiffany Hagler-Geard/Bloomberg via Getty Images)
Each week, we answer frequently asked questions about life during the coronavirus crisis. If you have a question youd like us to consider for a future post, email us at goatsandsoda@npr.org with the subject line Weekly Coronavirus Questions. See an archive of our FAQs here.
Do kids really need masks if theyve been vaccinated and had COVID?
Most kids who were either recently infected or vaccinated should have a strong enough immune response to protect them from getting COVID for several weeks or longer, says Dr. Abraar Karan, an infectious disease physician at Stanford University.
The combination of being vaccinated and having had COVID induces stronger immunity than just one or the other, he says in an email. Of course, if they are immunocompromised, [the decision not to mask] will be more complicated and parents should consult with their physicians.
In general, though, recent infection and vaccination makes the risk of getting COVID so low that the extra benefit of a mask is negligible, says Seema Lakdawala, an associate professor at the University of Pittsburgh School of Medicine who specializes in respiratory viruses with pandemic potential.
That could change over the next year if a new variant comes along that doesnt care very much about your recent omicron infection, says Dr. Emily Landon, an infectious disease specialist and chief hospital epidemiologist at University of Chicago Medicine.
But for now, if your vaccinated kid has recently recovered from COVID, the choice of whether to mask is up to you and your child, as long as youre not violating any mandates.
Many parents in this situation choose to keep masking their children because its part of the social contract of all of us trying to get through this together, Lakdawala says. If one kid stops wearing a mask to school, another may decide to opt out as well, she points out, since keeping track of everyone who got COVID and who is vaccinated is not feasible.
If you and your child decide to forgo masking, make sure your child is not pressuring classmates to take theirs off.
If your kid is the only one not wearing a mask and theyre trying to push other kids to not wear masks, even though it may be best for them to [mask], she says, thats not OK. So its really important to talk with your kids in mask-optional settings about not trying to influence others and to be really tolerant of what they need.
So if I really dont want my elementary school-age kids to get COVID, whats the best way to protect them?
First, get your 5- to 12-year-old vaccinated, doctors and experts say. In a study published online Wednesday, scientists in Israel found that vaccinated children were half as likely to catch COVID as their unvaccinated peers. But this protection was short-term. After about five months, the rate of infection was almost the same for vaccinated and unvaccinated teenagers.
Even as case rates are plunging in some areas, multi-layered strategies are still necessary. Lakdawala compares the situation to a battlefield.
If were at war with the virus, the vaccine is our armor, she says. That helps us from getting badly beaten. But it doesnt help us win, so we also need a mask as a shield that helps us block the virus, and then other ways to fight back like ventilation and ways to clean the air as a sword.
Parents should check whether their schools are up-to-date on their ventilation and air cleaning systems. That could include opening doors and windows at certain times of the day when classrooms are busiest, according to Lakdawala, and using portable air cleaners or a built-in air filtration system. Teachers wearing masks can also make a dent in classroom transmission. According to a study from Germany published in December, teachers wearing masks at school was a more effective strategy at reducing transmission of the virus than students wearing masks.
Everyone wants kids to be in school and learning and interacting safely, Lakdawala says. So we need to continue to think about all of the ways to reduce risk in all environments.
And what about masks for the kids?
Many experts have recommended upgrading to high-filtration respirators during the omicron surge. Indeed, these respirators (N95s, KN95s, KF94s) may be the only masks that are helpful against omicron.
N95 masks arent available for children, but KN95 and KF94s are. Such masks could help kids in situations that call for added caution. If your kids environment includes spending time with anyone at higher risk of complications from COVID, for example, keep that person in mind when making decisions about masking, advises Landon.
If their best friend has Type 1 diabetes and has been battling some infections recently or has a primary immunodeficiency and has to take immunoglobulin infusions, then your kid should be [extra careful], she says. If your kid wants to keep being friends with that kid, they need to wear a mask all the time.
But for many families, KN95s or KF94s arent a viable option. They are much more expensive than cloth or surgical masks and less reusable than cloth masks. On top of that, a child needs to wear the mask consistently to make it effective.
Sheila Mulrooney Eldred is a freelance health journalist in Minneapolis. She has written about COVID-19 for many publications, including The New York Times, Kaiser Health News, Medscape and The Washington Post. More at sheilaeldred.pressfolios.com. On Twitter: @milepostmedia.
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The tweet has stuck with me for months now: a chart of cumulative COVID-19 deaths per capita in the United States, the United Kingdom, and South Korea. The U.S. and U.K. lines rise up like mountains relative to the valley of South Korea below. Even as Omicron-related deaths have increased in South Korea more recently, the picture hasnt changed much.
South Korea kept deaths 40 times lower all the way till 75% of population fully vaccinated, the physician Vincent Rajkumar marveled on Twitter in response to the chart. This is success.
A more apt word than success might be resilience. As I have previously argued, the COVID crisis has underscored that clout in the 21st centuryan era rife with systemic threats including climate change, cyberattacks, and economic criseswill depend on a countrys ability to anticipate and absorb large-scale shocks, adapt to their disruptions, and rapidly bounce back (or even forward) from them. It will depend on resilient power. And through its response to the coronavirus so far, South Korea has emerged as a paragon of resilience governance.
South Korea hasnt proved to be the only resilient power in this period; other standouts include New Zealand and the Nordic countries. Yet South Korea is unusual in that it has not only repeatedly suppressed the spread of the virus and kept deaths to relatively low levels, but also never instituted a full lockdown. As a result, it has experienced much less economic fallout from the crisis than most other major economies. In contrast to other countries that excelled at one stage of the pandemic but struggled at others, South Korea has somehow respectably navigated every stage. After a sluggish start to its vaccine campaign, it now has one of the worlds highest vaccination rates. South Korea has also amassed soft power and diplomatic influence by providing pandemic-related assistance to other countries and establishing itself as a widely perceived model for how democracies should contend with COVID-19.
Uri Friedman: The pandemic is revealing a new form of national power
How did South Korea escape the pandemic relatively unaffected economically, with deaths at such low levels, while now vaccinating at such a high level that it has protected itself from future waves of illness and harsh lockdowns? the public-health expert Devi Sridhar recently inquired. Thats the question we should all be asking.
Below is my answer to that questionin the form of the broad lessons that other countries should learn from South Koreas achievements. These are the seven habits of highly resilient nations.
In 2015, an outbreak of Middle East respiratory syndrome (MERS), also caused by a coronavirus, tore through South Koreas hospitals and caught the government off guard. After initially failing to provide sufficient testing and transparent information about the crisis, however, officials eventually got the outbreak under control.
This history of lived resilience, as Michele Grossman, a resilience expert at Deakin University in Melbourne, Australia, once described it to me, gave the South Korean government and public confidence from the start of the SARS-CoV-2 outbreak, when others were either panicking or complacent, that they could prevent the virus from spiraling out of control. This might seem like an encouraging lesson: If resilience is born of the sort of trauma every country has experienced during this pandemic, then every country should now theoretically be primed to be more resilient in the future.
Adversity is not a sufficient condition for resilience, however. As The Atlantics Derek Thompson has written, what has set the South Korean government and people apart is their willingness to learn from that adversity and adapt their practices, policies, and institutions accordingly. South Koreas playbook for containing COVID-19rapid and widely accessible testing, sophisticated contact-tracing technology, and treatment measures such as compulsory isolation of serious casessprang from new legislation and government infrastructure developed as a direct result of MERS and other prior epidemics, such as a 2009 outbreak of H1N1 influenza.
As part of its dozens of post-MERS reforms, the government enhanced its data-collection methods and medical and laboratory facilities. It empowered the Korea Disease Control and Prevention Agency (KCDA). It identified high-priority infectious diseases, stockpiled personal protective equipment and other medical essentials, crafted a plan to disseminate supplies across the country, and conducted drills. MERS also prompted the government to develop closer relationships with biotechnology companies, which paid dividends when the novel coronavirus hit, enabling the country to quickly acquire reagents for diagnostic tests.
A December study by Bertelsmann Stiftung, which examined 29 countries in the European Union and the Organization for Economic Cooperation and Development, found that from the earliest days of the coronavirus outbreak, South Korea based its public-health interventions on scientific and socioeconomic expertise from a range of government entities. More broadly, according to the German foundation, countries that can speedily and successfully integrate expert advice into new policies, or adjust existing policies, tend to respond better to crises.
Uri Friedman: The dueling ideas that will define the 21st century
South Koreas overall COVID strategy was shaped by deference to such expertise. As Sridhar, the public-health expert, has argued, the countrys short-term focus on maximum suppression helped buy time for scientists to find a sustainable exit from the crisis through the development and approval of vaccines in 2020 and therapeutics in 2021.
Resilience depends on governments responding early and decisively to fluid realities. That, in turn, requires a commitment to Follow the data as a beacon for policy and decision making, Grossman, of Deakin University, told me.
South Korea has advanced data infrastructureincluding a cutting-edge (if also problematic, from a privacy perspective) contact-tracing systemthat enabled authorities to swiftly collect and analyze various sorts of pandemic-related data as a means of detecting early warning signs and assessing the effects of government policies. Employing its sensitive, multilevel alert system for infectious-disease risks, the government shifted its focus to economic recovery when new COVID cases dropped and shifted back to virus mitigation when cases surged again.
South Korea was one of only several countries in the Bertelsmann Stiftung study that succeeded in regularly reviewing the effectiveness of their policies, and in adapting them on an ongoing basis to rapidly changing circumstances or new knowledge, the report notes.
That achievement should not be underestimated. Real-time learning [during a crisis] is very, very difficult in the majority of countries, including nearly all of the studys front-runners, Christof Schiller, a governance expert at Bertelsmann Stiftung and a co-author of its report, told me. Korea could be an exception there.
New Zealand has been the worlds brightest star for crisis communications during the pandemic (its prime minister actually has a degree in communications), but South Korea has distinguished itself in this domain as well, consistently conveying a coherent containment strategy to its people.
As early as January 30, 2020, when the country had only five confirmed COVID cases, the government initiated twice-daily press briefings with public-health officials. It quickly issued press releases and web resources packed with data on the state of the outbreak and steps to counteract it, deployed a mobile-friendly emergency-alert system, established a 24-hour COVID hotline, and disseminated infographics on measures to avoid infection.
Here, too, the South Korean governments adherence to learning was key. The countrys Infectious Disease Control and Prevention Act, shaped by lessons from the H1N1 and MERS outbreaks, afforded the public a right to be informed about disease outbreaks and about government responses to them, note Thomas Kalinowski and Sang-young Rhyu, Bertelsmann Stiftungs South Korea experts. They explain that as a result, the government largely disclosed its actions and plans, and was transparent even about difficulties that threatened to increase public levels of frustration, such as the mask shortages in the early days of the coronavirus outbreak. In leveling with the public about these challenges, the government restored civic trust and encouraged the population to engage in a communal effort to prevent the spread of the virus.
That transparency also helped mobilize the private sector to boost South Koreas resilience by, for instance, developing mobile apps and websites that draw on government data to track mask inventories in stores or paths of viral transmission.
Writing for The Atlantic in 2020, the political scientist Francis Fukuyama argued that the most significant factor in national performance against the pandemic was whether citizens trust their leaders, and whether those leaders preside over a competent and effective state. Other scholars have since similarly discovered correlations between countries resilience to COVID-19 and their levels of trust in government and within society.
Read: Whats really behind global vaccine hesitancy
The authors of one such study of 177 countries and territories recently estimated that if the citizens of every country trusted one another at the level evident in South Korea, which ranked in the 75th percentile for this metric in their survey, the first 21 months of the global coronavirus outbreak might have produced 40 percent fewer infections.
South Korea is not a paragon of public trust in government. Nevertheless, the South Korean public has generally been willing to follow the governments pandemic guidelines, perhaps because the countrys COVID-19 response has been largely expert-led and depoliticized. In the global survey on trust that it released last month, the public-relations firm Edelman found that South Koreans trust in scientists (70 percent) and national-health authorities (56 percent) remained high relative to trust in government leaders (35 percent). Koreans also tend to be more trusting of their civil service, which has a strong culture of performance and accountability assessments, than they are of appointed or elected officials.
The Bertelsmann Stiftung study notes that South Korea was one of several more centralized countries that topped their rankings in part because national coordination efforts proved sensitive to local concerns and were thus carried out with the least friction, by through local authorities empowered to find solutions that work at the local level.
By leveraging a centralized but flexible system, the government was able to establish regional centers for disease control and prevention and rush resources, health-care workers, and public-health officials to areas reeling from surges in cases. The governments Central Disaster and Safety Countermeasures Headquartersled by the prime minister and established in February 2020held daily high-level meetings during acute periods of the pandemic to coordinate disaster response across central-government ministries and 17 provinces and major cities.
Notably, many of the countries that have proved most resilient against COVID-19 have been small nations such as New Zealand and the Nordic countries or midsize ones such as South Korea. Maybe this elaborate interplay between national and local systems is easier to pull off in such countries than in larger, more complex, and more diverse ones like the United States. A study of 116 national responses to the pandemic by the Lowy Institute in Australia last year found that countries with populations of fewer than 10 million people proved more agile than the majority of their larger counterparts. Its just one example of how traditional measures of national powermilitary spending, population size, gross domestic productdont necessarily translate into resilience.
South Koreas commitment to continuous learning, scientific expertise, and following the data extended not just to assessments of its own performance during the pandemic but also to assimilating insights from other countries grappling with the same challenges.
Resilient countries dont go it alone, Grossman explained; instead, they navigate toward and share resources; understand that their own well-being is interdependent with, and contingent upon, the well-being of the rest of the world; and act to reinforce the reciprocal relations that underwrite this recognition.
South Korea has not been perfect on this score. Kalinowski and Rhyu write that the government has remained inward-looking during the pandemic, showing a willingness to promote South Koreas successes against COVID-19 to the world but less interest in coordinating actions with international partners.
Nevertheless, the government has established travel bubbles with nearby countries and shared its COVID-19 knowledge, testing kits, and anonymized patient data with other countries and international organizations, while launching the Group of Friends of Solidarity for Global Health Security at the United Nations as a platform for countries to exchange lessons from their responses to the virus and other public-health challenges.
Derek Thompson: How Denmark decided COVID isnt a critical threat to society
The specific factors that have enabled South Korea to be resilient to COVID-19its post-MERS crisis-management system, for instancemay not help it respond resiliently to other systemic threats; South Korea performed less well on Bertelsmann Stiftungs assessments of economic, welfare-state, and democratic resilience during the coronavirus crisis.
Now that the Omicron variant is generating a substantial wave of new COVID cases in South Korea, this might also seem like an odd time to be singling out the country as a model. But the government is once again adapting, for example by ditching its celebrated pandemic playbook for a new one that focuses resources on the most at-risk COVID patients.
And, crucially, resilience is not the absence of failure. It is, instead, failure with grace, followed by robust recovery. For two years weve sought out neat success stories in the struggle with COVID. The real trick is managing vulnerabilities to avoid surrendering to shock.
Is it time to live with COVID-19? Some scientists warn of 'endemic delusion' Science Magazine
After almost 2 years, the COVID-19 pandemic continues to be an issue around the world. To date, there have been more than 414 million confirmed cases worldwide, and the illness has caused more than 5.8 million deaths.
There are currently a number of different drugs at different stages of research evaluation to test their effectiveness against SARS-CoV-2, the virus that causes COVID-19.
Part of these efforts is a research group from the University of Pennsylvania that has identified a combination of antiviral drugs to treat COVID-19. The blend includes an experimental drug called brequinar with the drugs remdesivir or molnupiravir.
Thus far, researchers have tested this combination on both human respiratory cells and in mice. They believe the results they have seen show the drug combination has the potential to become a promising treatment for COVID-19.
The results from this study appear in the scientific journal Nature.
As the name suggests, an antiviral drug combats viruses that get into the human body. Antiviral drugs can enter cells infected with a virus and make it harder for the virus to bind with those cells. Additionally, some antiviral drugs can stop a virus from genetically replicating itself. Antiviral drugs also boost the bodys natural immune system, giving it an edge in fighting off a viral infection.
Because the SARS-CoV-2 virus causes COVID-19, there are currently a number of ongoing research studies around the use of different antiviral drugs to combat the disease.
For example, a new study found a combination of two specific antivirals may help fight off SARS-CoV-2 infection. Pharmaceutical company Pfizer also released data for a new antiviral medication that received approval for use in the United Kingdom in October 2021.
In October 2020, the Food and Drug Administration (FDA) approved the antiviral drug remdesivir as the first treatment for COVID-19 for adults and children over the age of 12. The FDA originally granted an emergency use authorization (EUA) for the drug in May 2020.
Results from three clinical trials found people hospitalized with COVID-19 who received remdesivir had higher rates of symptom improvement compared with receiving a placebo or only standard of care. In January 2022, the FDA expanded the use of remdesivir to certain nonhospitalized people with COVID-19 to treat mild-to-moderate symptoms.
Remdesivir is one of the potential drug candidates researchers from the University of Pennsylvania found during their initial screening of about 18,000 drugs.
Researchers examined the drugs for antiviral activity against live SARS-CoV-2 virus inside human epithelial respiratory cells. Using this method, scientists narrowed the field down to 122 drugs that showed antiviral activity and selectivity against SARS-CoV-2.
According to principal investigator Dr. Sara Cherry, professor of pathology and laboratory medicine and director of the program for chemogenomic discovery at the University of Pennsylvania, the goal was to identify drugs with antiviral activity against SARS-CoV-2 that are active in respiratory cells. We identified a number of drugs, including a group of nucleoside analogs, which are the largest group of approved antivirals, Dr. Cherry told MNT.
Importantly, we identified the two drugs approved for COVID-19 remdesivir and molnupiravir, which is under EUA.
A nucleoside analog is a type of antiviral drug that imitates a humans natural nucleoside. A nucleoside is an organic molecule in the body comprised of a nitrogenous base and sugar. When used to deliver an antiviral medication, a nucleoside analog enters the body and is able to enter cells where there is a virus. Certain compounds within the nucleoside analog activate, causing it to become a nucleotide. Nucleotides are building blocks of the bodys genetic DNA and RNA code.
Finding nucleoside analogs, which are mimics of our nucleosides and inhibitors of our enzymes that make nucleosides, led us to the hypothesis that the combination may be more than the sum of their parts, [which] is synergistic, Dr. Cherry explained. Synergy is difficult to find, and our discovery may lead to the use of these combinations in treatments.
Additionally, Dr. Cherry said the researchers found a number of other drugs that fall into diverse classes, including drugs that inhibit a humans nucleoside biosynthesis enzymes. The nucleoside biosynthesis inhibitor Dr. Cherry refers to is the experimental drug brequinar.
According to the study, a nucleoside biosynthesis inhibitor like brequinar stops the body from producing nucleosides. This made sense because the [SARS-CoV-2] virus uses the nucleoside building blocks created by our cells to produce the viral RNA, she added. Ultimately, brequinar helps prevent the SARS-CoV-2 virus from spreading in a persons body through the use of their RNA.
Once Dr. Cherry and her team identified the antiviral drug combination they felt would be most effective brequinar plus remdesivir or molnupiravir they tested the mix on both plated human epithelial lung cells and in mice.
Within both models, scientists observed the drug combination of a nucleoside biosynthesis inhibitor with a nucleoside analog led to a significant reduction in viral replication of the SARS-CoV-2 virus.
The research team also found adding an additional antiviral called Paxlovid to the mix could provide an extra boost against the SARS-CoV-2 virus. The FDA approved Paxlovid in December 2021 as the first oral treatment for mild-to-moderate COVID-19 in children and adults over the age of 12 at a high risk of developing severe illness.
For this study, the research team focused on testing these antiviral drug combinations in cells from a humans lower respiratory tract, such as the lungs.
We found that the combination is active in a respiratory cell line, as well as in air-liquid interface cultures derived from the nasal epithelium [and] from bronchial cells, Dr. Cherry said when asked if she felt this drug therapy would also be effective in the upper respiratory tract. Therefore, we think that this will be active in the upper respiratory tract in humans.
Dr. Cherry also believes this antiviral drug combination could potentially be effective against new variants of SARS-CoV-2. Given that these drugs target RNA replication of the virus, which does not evolve rapidly, and not the Spike protein, it is likely that this combination will be active against emerging variants, she explained. Indeed, we found that the combination showed synergy against all of the variants we tested. And we are currently testing Omicron.
As for the next steps for this research, Dr. Cherry said they are currently continuing to explore the use of these drug combinations, as well as other drugs the research team identified in the screening to determine how they impact SARS-CoV-2 and if they could treat COVID-19.
Researchers also mentioned that the next step in testing these drug combinations would include testing in clinical trials.
That is of interest to Dr. Fady Youssef, a board certified pulmonologist, internist, and critical care specialist at MemorialCare Long Beach Medical Center. Dr. Youssef spoke to MNT about this study and said it is encouraging to see possibilities within combinations of these antiviral drugs.
The biggest question we have is how to identify and treat patients early in their disease state before the virus progresses and causes pneumonia, he explained. Many of the interventions we have dont perform as well when the disease has progressed, including antivirals. The most opportune time to quell a fire is the earliest time you can.
Another big question, Dr. Youssef continued, is going to be: How does this perform when applied in [humans]? This is a good precursor that theres a signal there thats worth testing. How its going to perform in [humans] is unknown and how much activity its going to have in the upper respiratory tract versus lower tract is going to depend on how it performs in human trials.
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Total vaccine doses distributed: 676,650,925
Patients who've received the first dose: 252,144,326
Patients whove received the second dose: 213,962,983
% of population fully vaccinated: 64.4%
% of infections tied to the Omicron Variant: 100%
Wales has become the first UK nation to announce it will offer COVID-19 vaccines to all five to 11-year-olds.
Health minister Eluned Morgan said she has received the "yet to be published" final advice from the Joint Committee for Vaccination and Immunisation (JCVI) on COVID-19 jabs for children aged five to 11 who are not judged to be at clinical risk.
"I have accepted this advice and thank the JCVI for scrutinising the science and evidence and setting out its advice in a careful and considered way," Baroness Morgan said.
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"Our intention, as it has been from the start of the pandemic, is to follow the clinical and scientific evidence."
She said the full JCVI advice would be published in "due course".
Delay to JCVI announcement 'perplexing'
There has been a delay to the official announcement, reportedly because of disagreements between the UK government and the JCVI - with an announcement expected on 21 February.
Facing questions in a Plenary session at the Senedd, Baroness Morgan said the delay was a "shame" and "perplexing".
"In relation to vaccination of children, the JCVI has yet to publish its report, although there are lots of clues in The Guardian and other places where there seems to have been lots of leaks come out," she said.
"It's a shame and it's perplexing to understand why that has not been published yet.
"But I have seen a copy of that advice and we will be commencing the rollout of vaccinations for five to 11-year-olds."
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'Very difficult decision'
Baroness Morgan did not lay out a timetable for when this would happen, saying: "We're not going to do that as a matter of urgency, as we did over the Christmas period. That's partly because the risk isn't as great to that cohort.
"And we're also waiting to hear from the JCVI to see whether they'll need a booster on top of the booster for older age groups in the spring."
She added: "Of course, it's likely to have been a very difficult decision for the JCVI, because generally, children have a milder illness and fewer hospitalisations.
"But, of course, they have to balance that against the prospect of missing school.
"We have to consider very different issues when it comes to the vaccination of children as young as five years old, of course, so we'll be in a position where we will expect those children to be accompanied by an adult.
"There will be a need for informed consent, but there will be an opportunity for siblings, for example, to be brought at the same time."
'No decisions' made by Westminster government
In December, the JCVI updated its guidance to suggest that children aged five to 11 who are in a clinical risk group or who are a household contact of someone who is immunosuppressed should be offered a primary course of vaccination.
At that time, the vaccine experts said further advice regarding jabs for healthy five to 11-year-olds would be issued in due course "following consideration of additional data relevant to this age group and on the Omicron variant more broadly".
The government in England is expected to make an announcement on jabs for all five to 11-year-olds next week.
"No decisions have been made by ministers on the universal offer of a COVID-19 vaccine to all five to 11-year-olds," a spokesperson said.
"We are committed to reviewing the JCVI's advice as part of wider decision-making ahead of the publication of our long-term strategy for living with COVID-19."
