Category: Covid-19

At the outset of 2020, the world looked on as China grappled with an outbreak that seemed be spiraling out of control.

Two months later, the situation is markedly different. After aggressive testing and quarantine efforts, Chinas outbreak of Novel Coronavirus (COVID-19) appears to be leveling off.

Now, numerous countries around the world are in the beginning stages of managing their own outbreaks. March 15th, 2020, marked a significant statistical milestone for this, as confirmed cases of COVID-19 outside of China surpassed the Chinese total.

The tracker above, by Our World in Data, charts the trajectory of the growing number of countries with more than 100 confirmed cases of COVID-19. As the number of new infections reported around the world continues to grow, which countries are winning the battle against COVID-19, and which are still struggling to slow the rate of infection?

Whats Your National Infection Trajectory?

As of publishing time, 39 countries have passed the threshold of 100 confirmed cases, with many more countries on the cusp. By comparing infection trajectories from the 100 case mark, were able to see a clearer picture of how quickly the virus is spreading within various countries.

A rapid doubling rate can spell big trouble, as even countries with advanced healthcare systems can become overwhelmed by the sheer number of cases. This was the case in the Lombardy region of Italy, where hospitals were overloaded and an increasing number of medical staff are under quarantine after testing positive for the virus. Nearly 10% of COVID-19 patients in Lombardy required intensive care, which stretched resources to their breaking point.

Other countries are looking to avoid this situation by flattening the curve of the pandemic. In other words, preventing and delaying the spread of the virus so that large portions of the population arent sick at the same time.

A rapid doubling rate can spell big trouble, as even countries with advanced healthcare systems can become overwhelmed by the sheer number of cases.

Image: Drew Harris, CDC

While all the countries on this tracker are united behind a common goal stamping out COVID-19 as soon as possible each country has its own approach and unique challenges when it comes to keeping their population safe. Of course, countries that are just beginning to experience exponential growth in case numbers have the benefit of learning from mistakes made elsewhere, and adopting ideas that are proving successful at slowing the rate of infection.

Many jurisdictions are implementing some or all of these measures to help flatten the curve:

The following chart explains why this last measure is critical to limiting the spread of the virus.

The more people, the higher the risk.

Image: J.S. Weitz

In scenario B above, which assumes just 20,000 active cases of COVID-19 in the U.S., theres nearly a 50% chance an infected person will be attending a 10,000 person conference or sporting event. This is precisely the reason why temporary limits on crowd size are popping up in many jurisdictions around the world.

Direct losses due to canceled tech conferences alone, such as SXSW and the Electronic Entertainment Expo, have already surpassed the $1 billion mark, but despite the short-term economic pain of cancellations and decreased entertainment spending, the costs of business-as-usual could be incalculable.

License and Republishing

World Economic Forum articles may be republished in accordance with our Terms of Use.

Written by

Nick Routley, Creative Director & Writer, Visual Capitalist

This article is published in collaboration with Visual Capitalist.

The views expressed in this article are those of the author alone and not the World Economic Forum.

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Which countries are flattening the curve of COVID-19 infections? - World Economic Forum

There's "currently no scientific evidence establishing a link between ibuprofen and worsening of COVID19," the European Medicines Agency advised Wednesday. REKINC1980/Getty Images hide caption

There's "currently no scientific evidence establishing a link between ibuprofen and worsening of COVID19," the European Medicines Agency advised Wednesday.

Updated March 19 at 12:08 p.m. ET

Over the past few days, social media has lit up with reports, picked up by some media outlets, that taking drugs like ibuprofen to ease COVID-19 symptoms could actually worsen the progress of the illness.

But most infectious disease experts say there's no good scientific evidence at this point to support that claim.

The furor was sparked by a tweet by the French health minister, Olivier Vran, over the weekend. He warned people not to take nonsteroidal anti-inflammatory drugs, or NSAIDS a category of pain relievers and fever reducers that includes ibuprofen because some French COVID-19 patients had experienced serious side effects. The warning was also included in a bulletin from the French health ministry, which counseled that patients should instead use acetaminophen, the generic name for Tylenol.

But the European Medicines Agency issued a statement Wednesday saying that while it is monitoring the situation, there's "currently no scientific evidence establishing a link between ibuprofen and worsening of COVID19."

Dr. Carlos del Rio, a professor of infectious diseases and global health at Emory University's Department of Medicine, agrees. "I think the minister of health of France is wrong [in] prohibiting the use of ibuprofen based on limited data," he says.

The World Health Organization is looking into the matter, says spokesperson Christian Lindmeier, "but after a rapid review of the literature, [the WHO] is not aware of published clinical or population-based data on this topic." A few media outlets have reported that WHO is now advising against using ibuprofen to treat fevers in patients with COVID-19 symptoms, but Lindmeier tells NPR that's not true.

"Based on currently available information, WHO does not recommend against the use of of ibuprofen," the WHO stated on its official Twitter account, adding, "'We are also consulting with physicians treating COVID-19 patients and are not aware of reports of any negative effects of ibuprofen, beyond the usual known side effects that limit its use in certain populations."

The questions about ibuprofen's safety for COVID-19 patients seem to have stemmed, in part, from a letter published in The Lancet last week hypothesizing the ways various medications could, perhaps, increase the risk of infection with the coronavirus. Research has shown that the virus attaches itself to cells in the lungs by way of an enzyme angiotensin-converting enzyme 2 (ACE2). The Lancet commentary suggested that taking ibuprofen might increase the number of ACE2 receptors on a cell, which could make someone taking the drug more vulnerable to infection.

But just because you have more ACE2 receptors doesn't mean you're more susceptible to infection, says Rachel Graham, a virologist at the University of North Carolina Gillings School of Global Public Health. She's one of the researchers who discovered how the coronavirus binds to cells.

"You can have low levels of ACE2 and still be susceptible," Graham says. What's more, she adds, the evidence that taking ibuprofen increases these receptors is almost nonexistent.

"This is why we have clinical trials to inform our medical decision-making," rather than relying on a few anecdotal cases, says Dr. Krutika Kuppalli, an infectious disease physician and fellow with the Johns Hopkins University Center for Health Security. Kuppalli says she doesn't see the Lancet letter as a reason to avoid ibuprofen for COVID-19, though she always tells her patients to use Tylenol for fever "because its mechanism is thought to affect the temperature regulating center of the brain."

Dr. Angela Rogers, a pulmonologist at the Stanford University Medical Center and chair of its intensive care unit's COVID-19 task force, notes that Tylenol is the go-to medication for patients who are sick enough to be hospitalized for any infection. That's because these patients are at higher risk of damage to internal organs, including kidneys. And kidney damage can be a side effect of ibuprofen for some patients who use it long-term in higher doses, says Rogers, whose research focuses on the kind of acute respiratory distress experienced by the most severe COVID-19 cases.

Of course Tylenol, like any medicine, isn't risk-free either; Rogers notes that acetaminophen can cause serious liver damage in high doses. In low doses, though, she says, Tylenol is "very effective" for reducing fever and "very safe."

As for what Rogers would advise for patients who are treating symptoms of COVID-19 at home?

"We don't have a lot of evidence in this disease in general," she says. Like the other physicians and scientists NPR spoke with, Rogers emphasizes that any evidence that ibuprofen exacerbates the coronavirus disease is faint at best. That said, "If people have no liver disease and it makes them feel a little bit more secure to start with Tylenol first, that might be a reasonable way to do it."

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Concerns About Ibuprofen And COVID-19 Are Overblown, Most Experts Say : Shots - Health News - NPR

If you have a cough, fever, or shortness of breath, how can you tell if youve got Covid-19, a common cold, the ordinary flu, or a bad case of the worries? Should you get tested? When should you seek medical care and when should you just stay home?

Two of us (M.H. and M.W.) are primary care doctors who have received numerous calls from concerned patients with symptoms such as cough, fevers, or shortness of breath. Those calls prompted us with the help of several colleagues to develop a simple self-triage tool to help individuals decide when to treat their symptoms safely at home and when to seek medical help. One of the most important things each of us can do during the ongoing pandemic is to free up medical providers to concentrate on the seriously ill.

First the good news: The vast majority perhaps 80% or more of people who come down with Covid-19, especially those under 50, will suffer symptoms that are no more serious than a bad cold or a mild flu and will be better within two weeks. There is no need to seek testing or go to a doctors office. A test result wont change your medical care because there is no treatment at this time other than the usual recommendations for any cold or flu: drink plenty of liquids, rest, stay home, and try over-the-counter remedies. (A test will, however, alert you to be extra careful not to infect others.)

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In some people, though, Covid-19 is a more serious illness, particularly among the elderly and those with chronic conditions. Thats why the current outbreak must be taken so seriously.

Our team at the Gehr Family Center for Health Systems Science and Innovation at the Keck School of Medicine of USC, in partnership with Akido Labs, developed a triage tool to help guide patients. Its available online for anyone to use. This tool will help most people effectively manage mild and moderate symptoms of Covid-19 at home.

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We have also compiled the general advice and tips for self-care at home below.

Although the news reports about Covid-19 are alarming, reports from China, Italy, the U.S., and elsewhere indicate that for most people, infection with the novel coronavirus is on par with getting the flu. These steps can help you know if you need formal medical care and, if not, how to care for yourself safely at home.

Know when to seek medical care. The reasons to seek immediate care today are no different than they were before the Covid-19 outbreak. The severe symptoms listed in the table below suggest that you need medical attention. Otherwise, if you have a fever and cough or other cold or flu symptoms, but are otherwise healthy, are under age 60, arent having difficulty breathing, and dont feel seriously ill, youre better off caring for yourself at home.

Severe symptoms that suggest the need for medical attention (please note that this is not intended to be a comprehensive list, but provides general guidance)

Dont go straight to a doctors office or urgent care. Start by calling a medical advice line or a telemedicine option instead. Its wise these days to stay away from crowded places, and that includes emergency departments, hospitals, doctors offices, urgent care centers, and clinics unless you are seriously ill. These are places where you could pick up the coronavirus if you dont have it, or spread your batch to other people.

Many health plans have 800 numbers with nurses or doctors on call to answer questions by phone, as do some doctors offices. Look at your insurance card and make the call. Some clinics are conducting video visits, also known as telemedicine. If you call an advice line first, you can often get the guidance you need without spreading infection or unnecessarily exhausting yourself.

Save testing for those sick enough to need hospitalization. Testing for Covid-19 will not change your medical care because there is no treatment available or necessary for mild symptoms. (People with serious symptoms, such as difficulty breathing, should get supportive care in the hospital.) Tests are currently in short supply and are being prioritized for those who have severe symptoms or who have been exposed to someone diagnosed with Covid-19. If you do not fall into one of those two categories, resist the urge to request testing unless public health officials encourage you to get tested for tracking purposes. (We know as we write this that the indications for testing may loosen in the days ahead as testing supplies increase.)

Practice self-care. Viral infections are dehydrating. Drink plenty of liquids. Pedialyte and soups that contain salt are helpful, as are plain water, tea, juice, and soda. Drink enough so your urine is its normal pale color and you produce as much urine as you usually put out. Note: Not urinating normally is a sign you may need medical attention. If you have special dietary restrictions due to diabetes, kidney disease, heart failure, or other condition, get medical advice by phone or email about the fluids that are best for you.

Some over-the-counter medications may help. As anyone who has experienced a cold knows, over-the-counter remedies tend to provide only limited relief, and some may have side effects such as dry mouth, drowsiness, and raised blood pressure. Try flushing out your nose and sinuses with saline solution. Fever-reducers and pain medications such as Tylenol (acetaminophen) can help, and honey can be an effective cough remedy. There is anecdotal evidence that non-steroidal anti-inflammatory medications like ibuprofen or naproxen may make Covid-19 worse, though more research is needed.

If you have one or more chronic medical conditions, seek telephone advice from an expert to make sure you choose a treatment that is safe for you.

Dont ask for antibiotics. Antibiotics do not work for viral illnesses like Covid-19. They also often cause side effects such as nausea, diarrhea, and rashes.

Get plenty of rest. Infections stress the body. Lots of rest including sleep will help keep your immune system strong so it can devote itself to ridding your body of the virus.

Separate yourself from others to prevent the virus from spreading. If you have the symptoms of a cold or the flu, play it safe and act as if you have Covid-19. Wear a face mask when in a room with others and if you must leave the house. Avoid close interactions with others for 14 days.

Follow the advice of public health authorities. Even for those who arent ill, social distancing will avoid fueling this pandemic. Please heed the advice of your local officials.

This is a scary moment in history. No one should be faulted for feeling anxious. Most people with viral illnesses including Covid-19 can be cared for effectively in their own homes without seeking formal medical care and will recover within two weeks. But its also important to know when to seek expert care.

We hope that our simple tool for self-triage and general advice and tips for self-care at home can ease some of the anxiety. and help you take the best care of yourself and your loved ones without putting yourself or others at unnecessary risk.

Michael Hochman, M.D., is a primary care physician, associate professor of clinical medicine at the Keck School of Medicine of USC, and director of the Gehr Family Center for Health Systems Science and Innovation at Keck. Michael D. Wang, M.D., is a professor of clinical medicine at Keck and director of inpatient programs for the schools Department of Medicine. Katy Butler is a journalist, essayist, and author who writes extensively about health topics. The authors acknowledge the essential contributions of Arek Jibilian, M.D., Carolyn Kaloostian, M.D., Anjali Mahoney, M.D., Rishi Mehta, M.D., Pieter Cohen, M.D., and Chris Hendel for reviewing this material and helping develop the triage tool.

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Think you might have Covid-19? Try this self-triage tool first - STAT

When a new virus like the novel coronavirus appears and starts infecting people, one critical asset in the fight against it is blood from people who were sick and then recovered. These blood samples can help scientists understand how the immune system responds to it, and can help in the search for therapies to treat the disease.

Thats why, this week, the Vaccine Research Center at the National Institutes of Health put out a call looking for blood donations from people who had COVID-19 and are now healthy.

Analysis of blood samples can give researchers information about if and how people develop protective antibodies after an infection. The immune system usually produces antibodies, which can bind to and deactivate viruses, during and after a viral infection. Those antibodies provide an infected person a level of protection from the virus in the future theyre unlikely to be infected again because their bodys new antibodies will stop the virus.

The initial steps are to follow individuals who have recovered and have a way to measure their antibody response, says Darrell Triulzi, director of the Division of Transfusion Medicine at the University of Pittsburgh Medical Center.

Scientists want to understand how strong the immune response to a novel coronavirus infection is, and how well that response protects people against the virus in the future. They also need to know how long the protection lasts. Long-term research on SARS patients, for example, shows that the protective immune cells were no longer present in some people six years after they were sick.

Preliminary research (that hasnt yet been published) on COVID-19 patients shows that they do produce high levels of antibodies, which virologists say is a sign people wouldnt get sick from the virus a second time. Another still unpublished study on monkeys found that they developed antibodies after they were infected with the novel coronavirus, and they didnt get sick a second time if they were exposed to the virus again. It indicates that infection results in protective immunity against SARS-CoV, at least in the short term, Angela Rasmussen, a research scientist at the Center for Infection and Immunity at the Columbia University Mailman School of Public Health, wrote in an email to The Scientist.

But more research is still needed to understand if the antibodies actually provide therapeutic benefit, Triulzi says.

Scientists also turn to the blood of patients who have recovered from COVID-19 as a possible stopgap treatment for the most at-risk people. Because their blood plasma is presumably full of protective substances like antibodies, if its injected into sick people, it may help them fight off disease. Its an old strategy and dates back as far as the 1918 Spanish flu outbreak in the United States, when doctors reported that it helped reduce the number of deaths in seriously ill patients. Recently, its been used on an experimental basis to treat people with MERS, H1N1, and Ebola.

In Ebola it seemed effective, and all we have are case reports right now for COVID-19, Triulzi says. At a press briefing, Stephen Hahn, commissioner of the Food and Drug Administration, said that the agency was evaluating it. Its a possible treatment, he said.

The treatment is risky, though, and there are always concerns that the use of plasma could make any subsequent infection with the virus in question worse. It would likely only be a temporary measure until more refined treatments became available. But the benefits may outweigh the risks for health care workers or older people who are more likely to become seriously ill if they were infected with the virus.

Just because blood can help researchers study COVID-19, though, doesnt mean that the blood of people who are or have been infected is generally dangerous, Triulzi noted. An infectious virus wouldnt linger in someones blood for a long time after theyre sick, so its not a concern for blood banks or people receiving blood transfusions. Transmission by blood has not been reported and is unlikely, he says.

And during a pandemic like this one, its more important than ever for healthy people to donate blood if theyre able. Donation drives have been cancelled left and right. Yet the need for blood continues, he says. There isnt a risk of getting the coronavirus from the donation process. And we still need the blood.

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Blood from recovered COVID-19 patients is a key resource for scientists - The Verge

In the whirlwind of news about the novel coronavirus pandemic, it can be hard to figure out whats a scam or rumor and whats vital information. The ways in which the COVID-19, the disease caused by the novel coronavirus, has transformed the way we work and keep ourselves entertained already feels unreal.

To understand why theres so much misinformation out there for example, that the virus was purposely created in a lab The Verge spoke with John Cook, a cognitive science researcher at George Mason University and one of the authors of a new Conspiracy Theory Handbook. A big fan of acronyms, Cook came up with a handy one to recognize when you or someone you know might be headed down a conspiracy theory rabbit hole and how to inoculate ourselves and others against it.

This interview has been lightly edited for length and clarity.

Why are you publishing this handbook now? Why should we be thinking about conspiracy theories at a time like this?

We had [the release of the handbook] planned for April, you know, and usually, Im not that organized that I happen to have something done a month early. But once we just saw all the conspiracy theories and the misinformation flying around about the novel coronavirus, and that it was actively directly endangering the public, we thought, We need to make this information accessible to people. Theres no point waiting a month if its ready to go now.

Is there one conspiracy theory youre really concerned about?

You have politicians in the US pushing the conspiracy theory that the coronavirus was bioengineered by a Chinese lab. And then you had retaliation to that. You had Chinese officials pushing the conspiracy theory that the US bioengineered the virus. We talked about this in the book, that there are tactical conspiracy theories. Theyre not always just a guy with a tinfoil hat in his basement talking on his laptop. It can be actual governments intentionally constructing conspiracy theories for strategic reasons. And so when you have governments pushing out all these conspiracy theories, theyre quite distracting. Its not what we need when we need governments all working together to address a global pandemic like this.

Why are those particular conspiracy theories harmful?

So when you have conspiracy theories spreading around, one of the things it does is it erodes public trust in institutions, particularly government institutions and medical institutions, who provide accurate information. One way that that can cause damage is then the public doesnt follow the advice that comes from these institutions. So if you have the CDC advising the public to maintain social distancing, dont gather in public events, dont go to restaurants, dont go to concerts or pubs. People are distrusting that advice because it comes from a mainstream institution, then the conspiracy theories are now distracting. And that has direct implications because people start behaving in ways that not only endanger themselves but endanger the public in general.

Twenty-nine percent of Americans believe the virus was created in a lab, according to new data from the Pew Research Center. Why has the conspiracy theory about the virus being engineered in labs become so popular?

In the handbook, we talk about different conditions that make the public more vulnerable to conspiracy theories, more likely to gravitate toward them. And I think the two that are really applicable to this situation is the feeling of powerlessness and coping with threat.

When people feel vulnerable, believing in conspiracy theories gives them more of a feeling of control. It seems almost counterintuitive because why would imagining that this is secret conspirators in a lab generating a virus, why does that make people feel more in control? Because at least thats an explanation. And if the explanation is just random things happen in nature; people dont like randomness. We prefer to have causal explanations. We prefer to have meaning in the way that we understand what happens in the world. And so conspiracy theories offer meaning. Were more vulnerable to them when we feel powerless, when we feel threatened and we need to get a sense of control.

How do you debunk theories like this when you come across them?

Theres a range of different solutions that we list in the handbook. And I think that the general principle that an ounce of prevention is worth a pound of cure applies. Its better to inoculate people preemptively against conspiracy theories rather than trying to go in afterward and undo the damage. Its easier to inoculate people against getting infected by a conspiracy theory, rather than trying to convince the conspiracy theorists that the conspiracy theory is not true.

But also when you do address conspiracy theories, do it in a way that doesnt reinforce or promote them. Basically, inoculation is delivering misinformation in a weakened form by explaining how it cant be true and explaining what the facts are instead. For example, with the conspiracy theory that the novel coronavirus was created in a lab, scientists have found that it has natural origins.

If your goal is to convince conspiracy theorists, then an empathetic approach is necessary just to have a genuine dialogue.

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How to debunk COVID-19 conspiracy theories - The Verge

At long last, heres an actually useful purpose for Twitters blue-check verification mark: Twitter last night announced that it is mobilising the badge system to help surface and signal more authoritative and verified voices that can provide credible updates on the topic of the coronavirus, and made a general call out for people that are experts to get all of their information up to date including associating the word addresses with their accounts to speed up this process.

This is the latest move from Twitter in what has been an ongoing effort to clear its platform of false information and the harmful spread of it as the pandemic increasingly takes its grip on the world.

The blue check mark was always intended to help steer people to know when they looking at more authentic voices or the official accounts for high-profile people or organizations, although its also been a huge vanity metric for many people, and so has often had a taint of the more ridiculous side of Twitter (the one where people also obsess over like and retweet counts). So harnessing it for a truly useful purpose is a great move.

Its also one that is linking up with other efforts online: yesterday Google launched an updated search experience that includes a carousel of Twitter accounts Tweeting information related to the pandemic. This will help Twitter and Google populate that in a more informative and dynamic way.

If you are an expert who would like to use Twitter to broadcast more effective messages to the public, please read on. And if you are an authority who is not affiliated with one of the authorities working on fighting and managing the coronavirus outbreak, hold tight as Twitter said it will also be working on how to more quickly verify you, too.

Twitter said it is working with global health authorities these include organizations like the WHO, the CDC, state health authorities and recognized academic institutions to identify not just these organizations own accounts but those of experts affiliated with them. While it has it has already Verified hundreds of accounts, there are many more to verify, but the process is being slowed down by people not having all of their information in order. (Essentially these are some of the usual requirements for verification, applied specifically now to coronavirus experts.)

Specifically, Twitter said that experts needed to make sure that the email address that a person has associated with their Twitter account is their work emails. Instructions on how to do that here.

Then, Twitter said that a persons bio needs to include references and a link to the place where they are working, and ideally that the page they are linking to also includes a reference back to the Twitter account (if its a link to a bio page). Instructions on how to update your profile here.

And accounts that are looking for verification, it goes without saying, have to follow the officialTwitter Rules (which cover things like no harassment, impersonation accounts and so on), and specifically as it relates to coronavirus and COVID-19, Twitters guidance for that.

Twitter had, predictably, what looked like hundreds of responses to its Tweets on this subject, both from people simply saying, Hey, what about me? Can I get verified today for my birthday?! and those saying they also should be verified because of their authoritative position on COVID-19. Going about how to do the latter with accuracy will be a much bigger challenge that Twitter is still working out. Were also considering a way to take public suggestions, but first are reviewing the suggestions we have from global public health authorities and partners, it concluded.

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Twitter prioritizes blue-check verifications to confirm experts on COVID-19 and the novel coronavirus - TechCrunch

The worlds most vulnerable people could be last in line for support to deal with the coronavirus outbreak, experts have warned.

Countries already dealing with humanitarian and refugee crises face a struggle to find the resources to deal with the pandemic by the time it reaches them, specialists said in a webinar hosted by the New Humanitarian news agency on Thursday.

Protective equipment and resources for testing are already a concern for China and Europe, but a third wave could leave developing countries with weakened health systems in a worse position even though most currently have a relatively small number of cases.

Experts working with refugees, on humanitarian responses and in global health warned that the international community needs to begin working closely with governments around the world to help the most vulnerable.

I dont think were quite ready yet for the fights that are coming over limited supplies of personal protective equipment, limited supplies of vaccines and limited supplies of therapeutics, said Jeremy Konyndyk, senior policy fellow at the Center for Global Development in Washington DC.

When the first 100m doses of the vaccines come out, its going to be a big fight over who gets those, and its going to be very important that [they dont] just go to those who can afford them.

Africa has had about 600 cases, compared with thousands in many individual European countries. But the World Health Organization chief, Tedros Adhanom Ghebreyesus, said more testing was needed across the continent.

Africa should wake up, my continent should wake up, said Tedros.

But with testing limited in much of the world, including the UK, developing countries faced a major challenge, said Karl Blanchet, director of the Geneva-based Centre for Education and Research in Humanitarian Action.

Testing has to happen, it is the priority. The problem is low-income countries are probably arriving on the third wave, after China, after Europe. Access to tests is going to be problematic, said Blanchet.

While many richer countries were currently focused on their own populations and economies, the humanitarian community would have to look at changing the way it works, said the experts, by investing in the strengthening of worldwide public health systems rather than focusing on single-issue campaigns.

This is not just about providing services in a refugee site or a conflict-affected area, this is really about the fundamental of health systems and about health-seeking and health-protecting behaviour across entire countries, said Konyndyk. That is not something that we in the humanitarian sector are always terribly well set up for.

Konyndyk said the sector would have to work more with governments and local organisations, who have the trust of the communities with which they work.

Virginie Lefvre, programme and partnerships coordinator with the Lebanese NGO Amel Association, said she was already seeing examples of local workers leading the way.

The locally-led response, the community-based initiatives are working despite the fear. All those workers are afraid as we can understand, because they have been exposed, she said.

Lefvre praised such workers for quickly setting up mobile clinics and using technology to communicate with people.

We have good locally-led responses, but it needs to be better coordinated with other actors in-country and at the international level, she added.

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World's most vulnerable in 'third wave' for Covid-19 support, experts warn - The Guardian

Virginia Hospital Center in Arlington, VA demonstrates how its drive-thru collection process for COVID-19 testing works. USA TODAY

Drive-thrucoronavirus testing sites are popping up across the country in states including Delaware, New York,Massachusetts and Texas. Over the next few days,47 of these sites will be set up in approximately 12 states, testing czarBrett Giroir told reporters at a press conference earlier this week.

In Virginia, a hospital has helped set up a temporarydrive-thrucoronavirus testing siteat a county-owned property across from Washington-Liberty High School.

The site opened Wednesday to collect samples from Arlington residents, Arlington County Government employees and Arlington Public Schools employees, and patients of VHC Medical Staff who are experiencing symptoms of COVID-19.

Before arriving on site, patients must make an appointment with their physician to get a doctor's orders for testing. Once they have that, they must call the Virginia Hospital Center's scheduling line to make an appointment for drive-thrutesting. Drive-thrutesting is only for patients who have symptoms like a fever, chills, cough, or shortness of breath. Otherwise, they will be turned away.

What can you expect when you actually pull up for testing? Here's a step-by-step look at what the processis like for patientsin Virginia.

Virginia Hospital technician speaks to people through closed windows of their car as they drive up seeking testing for the COVID-19 on Wednesday, March 18, 2020.(Photo: Jack Gruber)

When patients arrive at the site,they are guided by road signs directing them to keep their windows up and follow a series of cones. At their first checkpoint, individuals speaking to them through bullhorns ask to see confirmation of their doctor's orders and appointment time.

Once that is confirmed, they pull forward into a white tent where the head of the VHC's lab uses a microphone to remind them to keep their window up and asks how many people in the car will be getting tested.

Patients are then asked to hold their photo ID and insurance card, if they have one, up to the window for a picture.

A label is then printed for their sample as the patient drives through to the next tent. There, a lab technician asks them to roll their window down just a crack, tilt their head back and the back of their throat is swabbed. Patients can then roll up their window and drive off.

The sample is put into a sterile container and sent to a lab, where a chemical is used to pull the cells off the swab and turn the sample into a liquid form. That liquid is then put into a machine that goes through hot and cold cycles to make multiple copies of the virus ribonucleic acid, which carries genetic information. The machine looks to match the persons RNA with the coronavirus RNA to determine a positive or negative result.

What to expect when you get a coronavirus test: Stay calm, don't wiggle and it will take just 10 seconds

If there are no lines, the drive-thru process takes about 10minutes, according to Melody Dickerson, VHC's senior vice president and chief nursing officer. Patients can expect test results in five to seven business days.

"People will often ask, you know, 'what should I do while Im waiting for my test result'and 'what should I do if I find out that Im positive' and the answer is really the same: Stay home," Dickerson said. "Quarantine yourself, stay away from your loved ones and making sure you do frequent cleaning of all your solid surfaces."

Dickerson said that when the testing site opened Wednesday, they were able to test about 60 people. On Thursday, 24 patients had made appointments, though she expects that number to rise. She addedthat about 100 people had left messages on their scheduling line's answering machine, which they plan to turn off.

"This morning we made the decision to go from 6 tests per hour to 10 tests per hour," Dickerson said Thursday."If we can add more tests, then we will add more tests. We just want to make sure we dont overwhelm the staff."

Many who arrived for tests were turned away for not having all the proper requirements. One of those people was David Juras,58.Juras came to get a test for his 19-year-old daughter, Olivia, who had just gotten home from Scotland, where students at her school were sick.

When he arrived Thursday with an order from his daughter's pediatrician, he was turned away because he didn't have an appointment.He said he was frustratedthat he saw only one car drive through the site ashe sat in his car on hold waiting to make an appointment.

Contributing: Jorge Ortiz

Follow N'dea Yancey-Bragg on Twitter @NdeaYanceyBragg

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Read or Share this story: https://www.usatoday.com/story/news/health/2020/03/20/drive-thru-coronavirus-testing-step-step-look-what-expect/2873324001/

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Going to a drive-thru COVID-19 testing site? Here's a step-by-step look at what to expect - USA TODAY

NEWARK Social distancing measures took a dramatic but expected step on Saturday with Gov. Phil Murphy ordering all non-essential businesses closed. They have until 9 p.m. to comply.

The announcement came as New Jersey's death toll from the novel coronavirus reached 16 and the number of COVID-19 cases topped 1,327.

The disruptions, which are leading to massive unemployment claims, could last weeks, if not months, Murphy said.

The order taking effect 9 p.m. March 21 prohibits gatherings of any kind no weddings, no funerals, no in-person business meetings which previously had been limited to 50 people.

The order essentially requires that the state's 9 million residents remain home, although they're allowed to walk or run outside as long as they can maintain a safe distance from others.

The order comes with long list of exceptions. And while Murphy asked all businesses to have their employees to work from home whenever possible, he noted that construction, manufacturing, logistics, shipping and trucking work would continue.

Medical facilities such as doctors offices, hospitals, dentist offices, long-term care facilities, physical therapy offices and other medical offices also remain open.

There is no travel ban but people should try to stay home between 8 p.m. and 5 a.m. unless they're commuting or have a reasonable reason to be out.

Retailers also are allowed to continue their businesses online.

Murphy said the choices have been to take action or "let the virus run its course" and "ultimately pay a huge price in fatalities and sickness and pay an enormous economic price."

"Our job collectively is to flatten the curve, break the back of that curve as aggressively and preemptively as possible. That comes with economic pain, enormous economic pain But at the end of the day, we will get through this. We know that," Murphy said during a news briefing Saturday at Rutgers University-Newark.

"While the economy pain is significant now, we will save many lives, we will keep a lot of people healthy and frankly, at the end of the day, the economic pain related to what we're doing will be a lot less consequential than if we had let this virus run amok."

The lobbying organization representing businesses and industry in the state said Saturday that the understand "the need to put public health first in confronting a global pandemic with uncertain reach."

"There is much guidance for which businesses are or are not included as essential,' but we still anticipate much confusion, requiring further detail and guidance," Michelle Siekerka, president and CEO of the New Jersey Business & Industry Association said in a written statement.

"While we recognize the pain many of our businesses are experiencing, we are pleased to see our manufacturers and other essential sectors remain in operation to continue their work during this challenging time, particularly those who make health-based products relevant to the coronavirus response."

Grocery stores and retailers offering foods

Convenience stores

Food banks

Restaurants that can provide take-out or delivery

Farmer's markets and farms that sell directly to customers

Pharmacies

Marijuana dispensaries

Medical supply stores

Liquor stores

Banks and financial institutions

Gas stations

Auto mechanics

Car dealerships for auto maintenance and repair

Pet supply stores

Hardware and home improvement stores

Vehicle rental locations

Laundromats and dry cleaners

Stores that principally sell supplies for children under 5 years

Pet stores and veterinary service locations

Printing and office supply shops

Mail and delivery stores

Businesses that require employees to be on site "should operate with the minimal number of on-site employees as possible to ensure critical operations can continue." Examples of such employees include cashiers or store clerks, construction workers, utility workers, repair workers, warehouse workers, lab researchers, IT maintenance workers, janitorial and custodial staff and certain administrative staff.

Murphy on Saturday also said that nannies and housekeepers would be considered necessary workers.

In addition to Saturday's order closing all non-essential retail, Murphy during the week had already taken steps to close certain retailers and services. Schools were closed this week and moved to online and remote learning. Murphy is keeping daycare centers open because he said essential workers who can't work from home need a place to leave their children.

Local police departments have been ticketing violators.

"If folks are monkeying around, we will take action," Murphy said Saturday.

Restaurants and bars that cannot provide take-out or delivery

Shopping malls except for restaurants with separate entrances

Gatherings of individuals such as parties, celebrations, or other social events, are cancelled. CDC guidance defines a gathering to include conferences, large meetings, parties, festivals, parades, concerts, sporting events, weddings, and other types of assemblies

All recreational and entertainment businesses including casinos; racetracks; gyms and fitness centers

Entertainment centers such as movie theaters, performing arts centers, concert venues, and nightclubs

Personal-care businesses such as barbershops; hair salons; spas; nail and eyelash salons; tattoo parlors; massage parlors; tanning salons

Public and private social clubs.

Businesses that believe that they should be included on the list of essential establishments should reach out to the superintendent of the State Police.

Murphy also signed an order invalidating any county or municipal restrictions that conflict with his order.

Counties and municipalities are allowed to make further restrictions on online marketplaces for arranging or offering lodging and on public parks.

Sergio Bichao is deputy digital editor at New Jersey 101.5. Send him news tips: Call 609-359-5348 or email sergio.bichao@townsquaremedia.com.

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NJ COVID-19 shutdown: Here's what's closed and allowed to open - New Jersey 101.5 FM Radio

South Koreans are famously nonchalant about North Korean nuclear weapons. Bewilderingly to the rest of us, they keep calm and carry on whenever Pyongyang threatens to turn Seoul into a sea of fire. The South Korean approach to Covid-19 could not have been more different.

On 16 January, the South Korean biotech executive Chun Jong-yoon grasped the reality unfolding in China and directed his lab to work to stem the viruss inevitable spread; within days, his team developed detection kits now in high demand around the world.

There has been a general consensus in South Korea to trust in and respect the advice coming from doctors and scientists

Meanwhile, the South Korean government assumed the virus would hit. Experience with the 2003 Sars epidemic proved useful: existing governmental units in the ministries of health, welfare and foreign affairs, regional municipalities and the presidents office were mobilised. As a result, South Korea has been effective in controlling the nations mortality rate not through travel bans but instead through widespread rigorous quarantine measures and testing, now even exporting domestically produced test kits such as the 51,000 diagnostic products sent this week to the United Arab Emirates.

Most importantly, South Korea immediately began testing hundreds of thousands of asymptomatic people, including at drive-through centres. South Korea employed a central tracking app, Corona 100m, that publicly informs citizens of known cases within 100 metres of where they are. Surprisingly, a culture that has often rebelliously rejected authoritarianism has embraced intrusive measures.

On 17 March, a temporary provision entailed a small subsidy of 454,900 South Korean won (313) a month to cover basic living expenses. The same funding is available to those who are self-isolating, regardless of whether they test positive for the virus. Its not hugely generous, but provides subsistence for those whose lives are upended by necessary measures such as the ministry of educations closure of schools.

Other nations would be wise to copy the South Korean model: on 29 February, 700 people tested positive in the primary South Korean outbreak city of Daegu. By 15 March, 41 new cases were reported there.

There is, however, no time for complacency. As expected, based on the continued lack of immunity in the population, on 18 March, the number of cases began rising again, with Seoul now bracing for the worst.

From 16 March, South Korea started to screen all people arriving at airports, Koreans included. South Koreans have universal health care, double the number of hospital beds compared to Organisation for Economic Cooperation and Development (OECD) norms (and triple that of the UK), and are accustomed to paying half what Americans pay for similar medical procedures. At this historic juncture, there has been a general consensus to trust in and respect the advice coming from doctors and scientists.

But it hasnt all been smooth sailing: church officials south of Seoul were revealed to have sprayed salt water into parishioners mouths on the false premise it would stave off the infection. Worse, no one disinfected the bottles nozzle, and 46 people from the congregation have already tested positive. Also, despite South Koreas laudable healthcare apparatus, foreigners living in the country underscore disparities. With no Chinese allowed signs on numerous businesses and restaurants, some fear seeking medical advice.

The South Korean model is not without costs. In pre-pandemic days, the nations Oscar-winning film Parasite presciently showed the world how the rich can survive by working from home while their children enjoy the comfort of remote learning without worrying about food. These cultural imbalances are not unique to South Korea. Wealthy, independent schools are sending children home equipped with computers, books and musical instruments for remote learning, a situation being partially offered by state-run institutions, if at all.

In cities such as New York where there is now widespread community transmission of Covid-19 it is likely too late to follow the South Korean model. Efforts need to be focused elsewhere, including a wartime-like mobilisation to vastly increase the production of personal protective equipment for healthcare workers and the ventilator machines needed to treat the critically ill.

Oscars in hand, Bong Joon-ho, the director of Parasite, charmed the world on 10 February: I will drink until next morning, thank you. A week later, back in Seoul and well before most governments had woken up to the serious challenge they faced, he had already changed his tone, promising to wash [his] hands from now on, and participate in this movement to defeat coronavirus.

Alexis Dudden is professor of history at the University of Connecticut. Andrew Marks is a doctor and chair of physiology at Columbia University

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South Korea took rapid, intrusive measures against Covid-19 and they worked - The Guardian