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In a documentary produced and broadcast by us entitled Covid-19: Fighting a Pandemic, the environmental problem of coronavirus transmission in closed environments is studied with reference to the micro-droplets exhaled by people.
See the extract of the video Covid-19: Fighting a Pandemic in Attached Documents.
In the fight against the coronavirus pandemic, a new research reveals how tiny droplets carrying the virus can remain in the air for some time.

The Infection Routes are:
  • Contact with object that has virus on it;
  • Inhaling droplets emitted by sneezes and coughs.
During an interview, Kazuhiro Tateda, President at The Japanese Association for Infectious Disease, declare: “It seems transmissions are happening during conversations and even when people are standing a certain distance apart. These cases can’t be explained by ordinary droplet infection. We think infection comes from micrometer particles. This transmission mechanism can be called micro-droplet infection.”

So, how does this take places?
With a group of researchers an experiment has been made. The team would track particles in the air using laser and a high sensitivity camera. This technology allows to detect droplets as small as 0.1 micrometer wide. During the experiment we can see micro-droplet floating in the air, both when a person sneezes and during a conversation.

Kazuhiro Tateda say that “Micro-droplets carry many viruses. We produce them when we talk loudly or breathe heavily. People around us inhale them, and that’s how the virus spreads. We’re beginning to see this risk now.”
The risk of infection through micro-droplet becomes even greater in a close space with poor ventilation.

Another experiment is made in a room with ten people with a person that sneezes. The macro droplets go down to the ground after 1 minute, while the micro droplets continue to float in the air also after 20 minutes.

Masashi Yamakawa, Associate Professor at the Kyoto Institute of Technology declare that “If the air isn’t flowing, the micro-droplets won’t move, and since they can’t move on their own, they stay in place for some time.”
Opening windows and increasing air circulation is believed to be effective.

“What’s important is to create two openings and do this at least once an hour; That lowers the risk of infection considerably, Kazuhiro Tateda say.
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Should more of us wear face masks to help slow the spread of coronavirus?
This question is to be assessed by a panel of advisers to the World Health Organization (WHO).
The group will weigh up research on whether the virus can be projected further than previously thought; a study in the US suggests coughs can reach 6m and sneezes up to 8m.
The panel's chair, Prof David Heymann, told BBC News that the new research may lead to a shift in advice about masks.
The former director at the WHO explained: "The WHO is opening up its discussion again looking at the new evidence to see whether or not there should be a change in the way it's recommending masks should be used."

What is the current advice?
The WHO recommends keeping a distance of at least 1m from anyone coughing or sneezing to avoid the risk of infection.
It says people who are sick and show symptoms should wear masks. But it advises that healthy people only need to wear them if they are caring for others suspected of being infected or if they themselves are coughing or sneezing.

It emphasises that masks are only effective if combined with frequent hand-washing and used and disposed of properly.
The UK, along with other countries including the US, advises that social distancing should mean staying at least 2m apart.
This advice is based on evidence showing that viruses can only be transmitted while carried within drops of liquid.
The understanding is that most of those drops will either evaporate or fall to the ground near to the person who released them.

So what does the new research say?
Researchers at the Massachusetts Institute of Technology (MIT) in Cambridge, US, used high-speed cameras and other sensors to assess precisely what happens after a cough or sneeze.
They found that an exhalation generates a small fast-moving cloud of gas that can contain droplets of liquid of varying sizes - and that the smallest of these can be carried in the cloud over long distances.
The study - conducted in laboratory conditions - found that coughs can project liquid up to 6m away and that sneezes, which involve much higher speeds, can reach up to 8m away.

What are the implications?
The scientist who led the study, Prof Lydia Bourouiba of MIT, told me that she is concerned about the current concept of "safe distances".
"What we exhale, cough or sneeze is a gas cloud that has high momentum that can go far, traps the drops of all sizes in it and carries them through the room," she said.
"So having this false idea of safety at one to two metres, that somehow drops will just fall to the ground at that distance is not based on what we have quantified, measured and visualised directly."

Does this change the advice about masks?
Prof Bourouiba's view is that in certain situations, especially indoors in poorly ventilated rooms, wearing masks would reduce the risks.
For example, when facing someone who's infected, masks could help divert the flow of their breath and its load of virus away from your mouth.
"Flimsy masks are not going to protect from inhaling the smallest particulates in the air because they do not provide filtration," Prof Bourouiba said.
"But they would potentially divert the cloud that is being emitted with high momentum to the side instead of forward."

What do the WHO advisers think?
According to Prof Heymann, the new research from MIT and other institutions will be evaluated because it suggests that droplets from coughs and sneezes could be projected further than originally thought.
He said that if the evidence is supported, then "it might be that wearing a mask is equally as effective or more effective than distancing."
But he adds a warning that masks need to be worn properly, with a seal over the nose. If they become moist, Prof Heymann explained, then particles can pass through. People must remove them carefully to avoid their hands becoming contaminated.
He adds that masks need to be worn consistently.
"It's not on to wear a mask and then decide to take it off to smoke a cigarette or eat a meal - it must be worn full time," he said.
The panel, known as the Strategic and Technical Advisory Group for Infectious Hazards, is due to hold its next virtual meeting in the next few days.
A spokesperson for Public Health England said there was little evidence of widespread benefit from wearing masks outside clinical settings.
"Facemasks must be worn correctly, changed frequently, removed properly, disposed of safely and used in combination with good universal hygiene behaviour in order for them to be effective.
"Research also shows that compliance with these recommended behaviours reduces over time when wearing facemasks for prolonged periods."

Aren't countries changing their advice on masks anyway?
Long popular in many countries in Asia, masks are now being assessed for public use by the US Centers for Disease Control (CDC).
In Austria, the police now wear them and anyone dealing with the police will have to wear one too. Supermarkets there will insist that customers do too.
A once-rare sight in Europe is becoming more common, and new advice from the WHO would accelerate that change.
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The areas most affected by Covid-19 are, at present, three: Wuhan in China; the Po Valley and particularly Lombardy in Italy; New York in the United States of America. The correlation is easy: there are three areas with a high rate of pollution, therefore the coronavirus Sars-CoV-2 spreads especially in areas where the air is full of substances such as nitrogen oxides or particles such as PM10 and PM2.5.
Pandemic and air pollution therefore seem to go hand in hand.
But it is so? Fabio Zampieri interviewed by Federica d’Auria has already mentioned how the relationship between infectious diseases and the environment is very close. Now let's try to investigate more specifically. What is the relationship between air pollution and the spread of Covid-2019?
The first general answer is that we know little about it and that, as Fabrizio Bianchi (director of the Environmental Epidemiology Unit of the CNR of Pisa) and Fabio Cibella (epidemiologist of the CNR of Palermo) explain, published on Sunday 29 March in the scientific journal BMJ (British Medical Journal) it is necessary to investigate quickly. Because understanding how things go between spreading the virus can serve not only to explain, but also to act in real time.
But let's start from this factual observation: even if the classic media and above all the social media talk a lot about it and even if there have been announcements of the beginning of in-depth studies, from the scientific point of view we do not yet know with sufficient detail definition what the relationship is between air pollution and Sars-CoV-2.
There are three areas of greatest interest. The first concerns the reduction of air pollution in areas subject to lockdown (or isolation), starting right from the region of Hubei, that of the city of Wuhan, in China and from Lombardy in Italy. Satellite measurements - for example from the Copernicus Atmosphere Monitoring Service (CAMS) - show a sharp decrease in the concentration of nitrogen dioxide (NO2, a strong indicator of air pollution) both in China and on the Po Valley. In the Hubei region, due to the lockdown, particulate matter has decreased between 20% and 30% in recent weeks compared to December. Air pollution kills about one million people a year in China alone. So, it is calculated, the reduction detected in these first three months of 2020 has (but it is better to use the conditional, it would have) saved the lives of 4,000 children and 73,000 adults.
A reduction of similar air pollutants has also been detected, as we have said, in northern Italy. As reported by the astrophysicist Patrizia Caraveo on the Sunday of the Sole24Ore, the Sentinel 5P satellite of the European Space Agency (ESA) has obtained similar results for Italy and has detected a decrease in pollutants also in New York, Los Angeles, San Francisco and Seattle. An increase in mortality from air pollution can therefore be expected, also in Italy and the United States. But in order to be sure of this, epidemiologists and statisticians must be pronounced.
In any case, even if this were verified, we can neither applaud the Convid-2019 nor diminish our effort to counter it by staying at home. We must drastically decrease air pollution and its consequences regardless of Sars-Cov-2.
In China there has also been a decrease in carbon dioxide emissions, the main greenhouse gas (or climate-altering as experts like to call them). Excellent news. But we must not confuse between a global pollutant that does not directly attack our health, such as carbon dioxide, and local pollutants, such as NO2 and particulates that directly attack our health and, in particular, the respiratory tract.
A second point of attention in the articulated SARS-CoV-2 tar report and air pollution concerns the ability of the particulates to be a carrier and a booster, or to transport the virus. According to this hypothesis, the pollution in three high-rate areas in particulate pollution such as Wuhan, Lombardy and New York could be explained, therefore, not only by the direct transmission from man to man, but by the transport of the virus on microparticles. If true, the virus would prove to be much more subtle than you think and even more "smart" than many of its brothers. This possibility must be investigated. But, as Bianchi and Cibella recall, so far there is no scientific proof that particulate matter is a career a coronavirus booster.
Now let's reason by hypothesis, without any claim of scientific solidity. But if air pollution and particulate matter in particular had a direct connection - cause-effect type - we would have to solve two small or large anomalies. The first is that - to date, we never hope - the coronavirus has not dramatically spread to the most polluted cities in the world, which are not European and North American ones and, as much as it wants a cliché, not even the Chinese ones. The most polluted cities in the world (from an air point of view) are mainly in India, then in Pakistan, in many countries of Southeast Asia and, also, in Africa. Lagos, in Nigeria, with its 16 million inhabitants and passes is among them. Well, we repeat, to date the spread of the virus in India, Pakistan, Southeast Asia and Africa has not reached the spread it has had in Hubei, northern Italy and New York.
Second small anomaly, the hypothesis that pollution is the direct cause of the spread does not explain why Spain and in particular the area of ​​Madrid has a virus spread rate comparable to that of Lombardy. In the Iberian peninsula, however high, the air pollution rate is significantly lower than the Po Valley.
These correlations, of course, are purely abstract. They could be completely misleading. There is a need, once again, for an accurate scientific evaluation, which is not there. Therefore, prudence in proposing any type of hypothesis. For now we do not know with sufficient detail definition how the virus works. Of course there is only that it is transmitted from man to man. And therefore, we fully agree with the invitation of the scientific and political authorities: we are at home.
The third point that is worth investigating (also and above all because it has tangible effects on prevention and treatment) is the indirect correlation between lethality and air pollution. There is no doubt: an immense consolidated scientific literature, as Fabio Zampieri also reminded us, has shown that air pollution makes us more susceptible to virus infections. The main reason is that it makes our immune system weaker. This can at least partially explain the high lethality of Sars-CoV-2 in Lombardy and in the northern part of Emilia-Romagna. Those who have been breathing polluted air for years found themselves in a situation of greatest weakness when they were attacked by the virus.
This does not, however, take away the apparent high lethality in this part of the country is, in fact, apparent. And that the absolute number of deaths (with an average age of around 80 and a large majority with one or more diseases on the shoulders) is due to a much higher number of infected than that revealed by the tests.
One day, hopefully not too far, we will know.
For now we record the words of Fabrizio Bianchi: "Even if one day we will demonstrate that atmospheric particulate matter is Sars-Cov-2's booster career, we must not pass the belief that the cause of Covid-19 is pollution". What is certain is that air pollution "remains a powerful killer of other diseases and is a predisposer to Covid-19, increases susceptibility to the virus". And equally certain is that the origin and spread of this new pathogen "is in turn the effect of unsustainable development".
Ultimately: the relationship between the environment and Sars-CoV-2 exists, but it is very complex and complex. And most importantly, it still needs to be investigated. As soon as possible.
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We are only at the beginning of this crisis, in all of its dimensions, and particularly on the economic and social fronts. Many sectors, such as tourism, transportation and entertainment, will only recover in a very long time; many jobs will be destroyed. In contrast, other sectors are insufficiently developed and cruelly lacking in production. Therefore, we must act now to give the economy a new direction and to harness new engines of development.
This is true everywhere in the world, and particularly in Europe, which produces a large number of goods and services that will be less needed for a long time to come. Furthermore, Europe has lost an essential part of its sovereignty in sectors that many are now discovering to be key; because Brussels has put the mantra of competition ahead of the requirements of autonomy.
The European Union is not yet equal to these new challenges. And it is normal: health is not a Community policy as defined by Member States; and the Union's budget is limited to one percent of GDP. And yet, with these meagre resources, and though taken by surprise, the current leaders of the Union, in particular the Commission and the Central Bank, are performing miracles. National governments are also doing a lot, in a more fragmented manner.
As such, the federalists have rightly come up with an old idea, Eurobonds, which would enable the European Union to support Member States that have difficulty obtaining low-interest financing.
This proposal has led to, once again, deep division between the countries of the South (this time, France rightly lined up beside them), and the others, not at all determined to finance the less prosperous states. Among the most vehement, we find the Germans and the Dutch; either because they do not want to give their populist oppositions an opening; or because populist parties are already members of the ruling coalition.
In fact, this is an outdated debate. And we have to think quite differently about the issues before us.
Firstly, because the European Central Bank now has the means and the intention to act as guarantor of a decrease in the yield spread of the loan to each Member State; secondly, because governments are very active in supporting their own businesses; and thirdly, because the European Investment Bank (EIB) and other European instruments, including the European Safe Bond (ESB), are about to enter the fray.
It is an opportunity to change the paradigm and think about a completely different solution, which would not just be financial but also political in the noblest sense. A solution that would make it possible to strengthen solidarity between the Member States, get the economy moving again, and resolve the problems of sovereignty.
To achieve this, the Union would have to equip itself with the means to regain its autonomy in the key sectors of tomorrow's world, those that I call the "industries of life": health, food, hygiene, water, housing, digital, energy, education, research, distribution, environmental protection, security, information and a few others. We cannot continue to depend on non-European suppliers in these essential sectors; and we will have to accept paying more for these products and services, as a price for our autonomy. This will create jobs to compensate for those lost elsewhere, and new sources of profitable investment.
One way of initiating this policy, which can only be a common one, would be for the European Union to issue a massive loan, (for example, an initial amount of 200 billion euros). But not a so-called “coronabond,” which would aim to finance the entire economy, but rather a "lifebond,” (a "life eurobond,” which could also be called a "sovereign bond"), which would only finance life industries (and the conversion of less essential industries to these sectors), to ensure the autonomy of the Union.
These resources would be managed on the model of what is being prepared, albeit at a slow pace, for a Europe of Defence. An ad hoc institution would decide on the rules for the distribution of this funding among the various countries and companies, on the basis of tender offers, as massively and rapidly as possible. Even the countries that are most reluctant to show European solidarity would have a selfish interest in this.
We urgently need to take action; to get out of the shock and emergency; to show that there is light at the end of the tunnel. And to move forward.
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There’s no question the United States missed the opportunity to get ahead of the novel coronavirus. But the window for making important decisions hasn’t closed. The choices we and our leaders make now will have an enormous impact on how soon case numbers start to go down, how long the economy remains shut down and how many Americans will have to bury a loved one because of COVID-19.
Our foundation has been working to slow the outbreak for several months. To date, we’ve invested $105 million in efforts to create new therapeutics, expand access to testing, and limit the virus’s impact here in Seattle.
As a result of this work, I’ve spoken with experts and leaders in Washington and across the country. It’s become clear to me that we must take three steps.

First, we need a consistent nationwide approach to shutting down. Despite urging from public health experts, some states and counties haven’t shut down completely. In some states, beaches are still open; in others, restaurants still serve sit-down meals.
This is a recipe for disaster. Because people can travel freely across state lines, so can the virus. The country’s leaders need to be clear: Shutdown anywhere means shutdown everywhere. Until the case numbers start to go down across America—which could take 10 weeks or more—no one can continue business as usual or relax the shutdown. Any confusion about this point will only extend the economic pain, raise the odds that the virus will return, and cause more deaths.

Second, the federal government needs to step up on testing. Far more tests should be made available. We should also aggregate the results so we can quickly identify potential volunteers for clinical trials and know with confidence when it’s time to return to normal. There are good examples to follow: New York state recently expanded its capacity to more than 25,000 tests per day.
There’s also been some progress on more efficient testing methods, such as the self-swab developed by the Seattle Coronavirus Assessment Network, which allows patients to take a sample themselves without possibly exposing a health worker. I hope this and other innovations in testing are scaled up across the country soon.
Even so, demand for tests will probably exceed the supply for some time, and right now, there’s little rhyme or reason to who gets the few that are available. As a result, we don’t have a good handle on how many cases there are or where the virus is likely headed next, and it will be hard to know if it rebounds later. And because of the backlog of samples, it can take seven days for results to arrive when we need them within 24 hours.
This is why the country needs clear priorities for who is tested. First on the list should be people in essential roles such as health-care workers and first responders followed by highly symptomatic people who are most at risk of becoming seriously ill and those who are likely to have been exposed.
The same goes for masks and ventilators. Forcing 50 governors to compete for lifesaving equipment—and hospitals to pay exorbitant prices for it—only makes matters worse.

Finally, we need a data-based approach to developing treatments and a vaccine. Scientists are working full speed on both; in the meantime, leaders can help by not stoking rumors or panic buying. Long before the drug hydroxychloroquine was approved as an emergency treatment for COVID-19, people started hoarding it, making it hard to find for lupus patients who needed it to survive.
We should stick with the process that works: Run rapid trials involving various candidates and inform the public when the results are in. Once we have a safe and effective treatment, we’ll need to ensure that the first doses go to the people who need them most.
To bring the disease to an end, we’ll need a safe and effective vaccine. If we do everything right, we could have one in less than 18 months—the fastest a vaccine has ever been developed. But creating a vaccine is only half the battle. To protect Americans and people around the world, we’ll need to manufacture billions of doses.
Without a vaccine, developing countries are at even greater risk than wealthy ones, because it’s even harder for them to do physical distancing and shutdowns. The further down the income ladder people live, the more important it is that they go to work every day just to feed their family.
If they live in the poorest parts of sub-Saharan Africa or India, staying home simply isn’t an option. Even if they do stay home, they can’t just wall themselves off from their neighbors; in slums, the houses are packed together so closely that there’s no way to keep your distance. All the work that rich countries are doing now to develop vaccines will save lives in those places, too.
We can get a head start on manufacturing all of the doses we’ll need now by building the facilities where these vaccines will be made. Because many of the top candidates are made using unique equipment, we’ll have to build facilities for each of them, knowing that some won’t get used. Private companies can’t take that kind of risk, but the federal government can. It’s a great sign that the administration made deals this week with at least two companies to prepare for vaccine manufacturing. I hope more deals will follow.
In 2015, I urged world leaders in a TED Talk to prepare for a pandemic the same way they prepare for war—by running simulations to find the cracks in the system. As we’ve seen this year, we have a long way to go. But I still believe that if we make the right decisions now, informed by science, data, and experience of medical professionals, we can save lives and get the country back to work.
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As the coronavirus continues its march around the world, governments have turned to proven public health measures, such as social distancing, to physically disrupt the contagion. Yet, doing so has severed the flow of goods and people, stalled economies, and is in the process of delivering a global recession. Economic contagion is now spreading as fast as the disease itself.
This didn’t look plausible even a few weeks ago. As the virus began to spread, politicians, policy makers, and markets, informed by the pattern of historical outbreaks, looked on while the early (and thus more effective and less costly) window for social distancing closed. Now, much further along the disease trajectory, the economic costs are much higher, and predicting the path ahead has become nearly impossible, as multiple dimensions of the crisis are unprecedented and unknowable.
In this uncharted territory, naming a global recession adds little clarity beyond setting the expectation of negative growth. Pressing questions include the path of the shock and recovery, whether economies will be able to return to their pre-shock output levels and growth rates, and whether there will be any structural legacy from the coronavirus crisis.
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Higher public debt levels will become an economic feature and be accompanied by private debt cancellation

The coronavirus pandemic is a human tragedy of potentially biblical proportions. Many today are living in fear of their lives or mourning their loved ones. The actions being taken by governments to prevent our health systems from being overwhelmed are brave and necessary. They must be supported. But those actions also come with a huge and unavoidable economic cost. While many face a loss of life, a great many more face a loss of livelihood. Day by day, the economic news is worsening. Companies face a loss of income across the whole economy. A great many are already downsizing and laying off workers. A deep recession is inevitable. The challenge we face is how to act with sufficient strength and speed to prevent the recession from morphing into a prolonged depression, made deeper by a plethora of defaults leaving irreversible damage. It is already clear that the answer must involve a significant increase in public debt. The loss of income incurred by the private sector — and any debt raised to fill the gap — must eventually be absorbed, wholly or in part, on to government balance sheets. Much higher public debt levels will become a permanent feature of our economies and will be accompanied by private debt cancellation. It is the proper role of the state to deploy its balance sheet to protect citizens and the economy against shocks that the private sector is not responsible for and cannot absorb. States have always done so in the face of national emergencies. Wars — the most relevant precedent — were financed by increases in public debt. During the first world war, in Italy and Germany between 6 and 15 per cent of war spending in real terms was financed from taxes. In Austria-Hungary, Russia and France, none of the continuing costs of the war were paid out of taxes. Everywhere, the tax base was eroded by war damage and conscription. Today, it is by the pandemic’s human distress and the shutdown. The key question is not whether but how the state should put its balance sheet to good use. The priority must not only be providing basic income for those who lose their jobs. We must protect people from losing their jobs in the first place. If we do not, we will emerge from this crisis with permanently lower employment and capacity, as families and companies struggle to repair their balance sheets and rebuild net assets. Employment and unemployment subsidies and the postponement of taxes are important steps that have already been introduced by many governments. But protecting employment and productive capacity at a time of dramatic income loss requires immediate liquidity support. This is essential for all businesses to cover their operating expenses during the crisis, be they large corporations or even more so small and medium-sized enterprises and self-employed entrepreneurs. Several governments have already introduced welcome measures to channel liquidity to struggling businesses. But a more comprehensive approach is needed. While different European countries have varying financial and industrial structures, the only effective way to reach immediately into every crack of the economy is to fully mobilise their entire financial systems: bond markets, mostly for large corporates, banking systems and in some countries even the postal system for everybody else. And it has to be done immediately, avoiding bureaucratic delays. Banks in particular extend across the entire economy and can create money instantly by allowing overdrafts or opening credit facilities. Banks must rapidly lend funds at zero cost to companies prepared to save jobs. Since in this way they are becoming a vehicle for public policy, the capital they need to perform this task must be provided by the government in the form of state guarantees on all additional overdrafts or loans. Neither regulation nor collateral rules should stand in the way of creating all the space needed in bank balance sheets for this purpose. Furthermore, the cost of these guarantees should not be based on the credit risk of the company that receives them, but should be zero regardless of the cost of funding of the government that issues them. Companies, however, will not draw on liquidity support simply because credit is cheap. In some cases, for example businesses with an order backlog, their losses may be recoverable and then they will repay debt. In other sectors, this will probably not be the case. Such companies may still be able to absorb this crisis for a short period of time and raise debt to keep their staff in work. But their accumulated losses risk impairing their ability to invest afterwards. And, were the virus outbreak and associated lockdowns to last, they could realistically remain in business only if the debt raised to keep people employed during that time were eventually cancelled. Either governments compensate borrowers for their expenses, or those borrowers will fail and the guarantee will be made good by the government. If moral hazard can be contained, the former is better for the economy. The second route is likely to be less costly for the budget. Both cases will lead to governments absorbing a large share of the income loss caused by the shutdown, if jobs and capacity are to be protected. Public debt levels will have increased. But the alternative — a permanent destruction of productive capacity and therefore of the fiscal base — would be much more damaging to the economy and eventually to government credit. We must also remember that given the present and probable future levels of interest rates, such an increase in government debt will not add to its servicing costs. In some respects, Europe is well equipped to deal with this extraordinary shock. It has a granular financial structure able to channel funds to every part of the economy that needs it. It has a strong public sector able to co-ordinate a rapid policy response. Speed is absolutely essential for effectiveness. Faced with unforeseen circumstances, a change of mindset is as necessary in this crisis as it would be in times of war. The shock we are facing is not cyclical. The loss of income is not the fault of any of those who suffer from it. The cost of hesitation may be irreversible. The memory of the sufferings of Europeans in the 1920s is enough of a cautionary tale. The speed of the deterioration of private balance sheets — caused by an economic shutdown that is both inevitable and desirable — must be met by equal speed in deploying government balance sheets, mobilising banks and, as Europeans, supporting each other in the pursuit of what is evidently a common cause.
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Japan is considering using Avigan, an anti-influenza medication developed by a unit of Fujifilm Holdings Corp., to treat patients of the novel coronavirus, health minister Katsunobu Kato said Saturday.

“We will do everything we can,” Kato said on a TV program, noting that there is no established treatment for COVID-19 yet. The drug is also known as Favipiravir.

“We hear from overseas that some (drugs) among those that have been used against influenza may be useful,” he said.

Kato told reporters his ministry will check how effective flu drugs are at fighting the disease and, if necessary, make it possible for many medical institutions to administer them to patients.

He also said the government will disclose a basic policy on how to deal with the outbreak as soon as Tuesday. The policy will be based on one Japan already has in place for a novel influenza, according to government officials.

Avigan, developed by Fujifilm Toyama Chemical Co., has been stocked in Japan as a flu drug but is viewed as having the potential to treat other diseases, including Ebola and a tick-borne illness.

As some studies have pointed to the possibility of it causing fetal abnormalities in animals, pregnant women are advised to not use the medication.
So far, about 750 people have tested positive for the pneumonia-causing coronavirus in Japan. But most of the people infected with the virus, which spread from Wuhan, China, were on the quarantined Diamond Princess cruise ship docked in Yokohama.

Japanese authorities are said to be using the drug in clinical trials of coronavirus patients who have mild or moderate symptoms, but the results are not as effective if patients with more severe symptoms are to be treated.

South Korea, the country that praises itself for how it is treating the epidemic and suggested as a model in Italy, will not use the drug Avigan because it was deemed not effective and above all unsafe following tests on animals that would have proved harmful to the fetus. Here's what Korean sites report:

"The anti-viral drug developed by the Fujifilm Holdings Corp. has emerged as one of the potential drugs in the race to find an effective treatment for COVID-19 as there is currently no specific treatment.

The Ministry of Food and Drug Safety said it has decided not to import Avigan after a team of infectious disease experts here ruled there is not enough clinical data to prove the drug's efficacy.

Avigan was approved as a backup drug for reemergent influenza in Japan in 2014. However, it has not been used to treat regular flu because several animal studies showed potential fetal damage. "

For some time in Italy there has been talk of the Avigan antiviral drug and it is not a novelty at all. In fact, this drug was used in 2015 at Spallanzani in Rome as an experimental treatment against Ebola, given the emergency, but still recommending further research at the time.

Recently, in fact, it was mentioned on March 18, 2020 in The Guardian, the Chinese medical authorities seen in the Japanese drug Avigan, an efficacy against the new coronavirus. According to Zhang Xinmin, an official from the Chinese Ministry of Science and Technology, the drug has a high degree of safety and is effective in the treatment.

In order for a drug to enter the market in Italy, and in Europe, it must be subjected to adequate controls and studies. In this case, exceptionally, we want to speed up the pace.

"In this sense, there is already an open road with the immediate green light in Italy for all possible promising therapies. The Italian Medicines Agency (AIFA) has in fact activated, in collaboration with Ema, the European regulatory body of medicines, a fast track, a fast process that allows, in case data on new drugs effective to combat Covid-19 come to light, to approve their use in hospitals in a few hours. The requirements are the availability of data on the safety of the use in humans, "recalls Aifa at Adnkronos Salute.
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Contribution to the reflection on the Coronavirus
.I would like to report a beautiful reflection signed by a friend named Raffaella, originally from Bassano del Grappa, who deals with family Constellations , a psychological method practiced all over the world.
. With modesty and respect for what is happening in these days, now weeks, in light of the recent measures to declare all of Italy in the "red" area, I would like to offer my thoughts on this.
It is not easy for me to express a position or feeling in this difficult moment, without the fear of speaking out of turn or simplifying events that deeply affect the lives of all people, especially those who are sick and have lost their Dear.
Therefore, I would like to submit my reflection on tiptoe, in full respect of everyone's life, offering a different reflection which, I repeat again, underlies, embraces and respects the gravity of these moments.
These days I have read everything and more on various websites and in the various messages that I have received via Messenger and / or Whatsapp. Too much information is confusing and everything can be true or false as far as we know, since we really don't have access to the scientific data of what this virus really is. I stick only to a feeling felt in the circle of healing meditation activated in these days, in which I felt the need to integrate the virus into the world and not to exclude it. To this was added a further feeling, arrived talking this morning with a friend who had sent me a prayer (received in turn). In this the virus was intimated: "disappear, out of here, I don't accept you".
As a primary feeling I thought there was something wrong and I said to myself that, in psychoanalytic terms and in the eyes of the teachings of BERT (BERT HELLINGER, creator of the Family Constellations, who died at the age of 94 in Bischofswiesen in 2019, editor's note), what is denied, finds more and more strength to act and be noticed.
Paradoxically, if it is true that this virus was created in the laboratory, (but I do not dare to say an opinion on it) if it is a creature of man, the virus acts as an abandoned child, an illegitimate child, excluded and therefore the immune system (of humanity - the family that created it) does not recognize it and rejects it.
But beyond these conjectures that I cannot prove, I am connected to the disease as a representative of an excluded person. The virus goes out into the world in search of a father and mother or family from which it has been removed. It does not belong, perhaps it still represents a different consciousness.
So I did a blind constellation with three people tonight. I didn't tell anyone of them who they represented. I staged a representative of Coronavirus, one for the immune system and the third for humanity. In looking at the Coronavirus, the representative of the immune system felt very tired and collapsed to the ground, the representative of humanity was afraid and that of the Coronavirus was sad, he looked at the representative of the immune system with supplicant eyes.
.I then had the immune system representative say, "I see you, you belong.", Towards the virus and the situation changed - the virus breathed a sigh of relief, the immune system felt better and slowly took come on, humanity has gone to the immune system.
The representative of the immune system said that with this sentence he felt much better, "fuller", the virus was relaxed because he had been seen and humanity said he was better, he could observe the world with less fear.
Scientifically, Coronavirus is something new that we humans are not yet ready for, our immune system does not recognize and fight so that it does not have the antibodies to beat it. Immunity, on the other hand, is built from the memory of antibodies that activate each time that same virus occurs. The immune system and healing are memory.My reflection is therefore this: if the immune system says to the virus : YOU BELONG, this sentence gives strength to the system because by integrating it, it recognizes it as something that is familiar. What is fought, in truth, belongs. and belonging awakens the memory of the antibody.
Through the sentence and the inclusion, the system acts as if the memory of silent antibodies is reactivated and awakens by "remembering" something already known.
.I recognize that it may seem paradoxical or too superficial. I am not a doctor, nor a biologist, but I have only observed how the phrase "you belong" was the basis for building immunity.
. We do not fight what is present and integrated, we fight what we do not know.
The basis for getting out is inclusion, if each of us takes a moment of silence and looks at the virus internally with love, with a sense of acceptance, as if it were inside a glass, despite the pain, anger, bitterness , always inwardly he whispers to him: "YOU BELONG", then and only then does confidence come and diminish, move back, fear eases. Good life?
. .
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Community Voting
  • Does climate change affect the transmission of coronavirus?
  • Does air pollution increase the risk of getting coronavirus? Does it make symptoms worse?
  • Will warmer weather slow the spread of coronavirus?
  • How likely are we to see infectious disease spread as a result of climate change?
  • Why are emerging infectious diseases on the rise?
  • Is the U.S. government doing enough to prevent the spread of infectious diseases? What more can we be doing?
  • What actions can we take to prevent future outbreaks?
  • Climate change and global health policy are largely treated as separate issues by the public and media. Do we need to adjust our thinking?
  • COVID-19 is killing people now and climate change is killing people now. The scale of actions to combat them are starkly different. Why?
5 1 Votes
Community Voting
Today is World Water Day , a moment to remind us that every drop of this precious resource is very important and that we must all do our part to protect the environment.
I would also like to take this opportunity to highlight an update on the current situation. Times of uncertainty such as these have never been seen before, and in these contingencies carrying on certain values is an act of great importance: precisely for this reason the main priorities are health and safety at work, for employees and for those who love the Levi's brand.
Levi's, for example, monitors daily and wishes to comply with the provisions of the local authorities, therefore has decided to close its stores in Italy. The site remains active as always.
There are still many things we don't know, but we are certain that we will overcome this situation together, practicing kindness, keeping healthy and staying connected to each other.

Take care of yourself and keep relationships with those you love alive, even if only virtually.

The Levi's® team hopes for water savings of up to about 90%, for the production of its jeans yarns (skirts, shirts, trousers, etc ...).
The jeans we love, made using less water.Water
Levi's has achieved a water saving of 3 billion liters. And he's not done yet.
His goal: By 2021, 80% of Levi's® jeans will be produced with Water
Now it's your turn to make a difference. A pair of jeans can consume up to 3,800 liters of water during its life cycle, and 23% of it depends on how you take care of denim.
They will now extend the return period to 60 days to allow the customer to fully experience the quality of the jeans.
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Community Voting
The coronavirus emergency risks having short and long-term social and economic effects on various production sectors: the priorities in this situation are to improve skills and quality.

The moment is difficult, the situation is constantly evolving and the choices of the Italian government are not always clear, which remain more cause for concern in the entire national economic system. It remains complicated to imagine what the real consequences of coronavirus will be in our country, both economically and socially: let's try to analyze the situation and understand what the future prospects could be after the emergency.
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Community Voting

Chloroquine and hydroxychloroquine have been found to be efficient on SARS-CoV-2, and reported to be efficient in Chinese COV-19 patients. We evaluate the role of hydroxychloroquine on respiratory viral loads.

Patients and methods
French Confirmed COVID-19 patients were included in a single arm protocol from early March to March 16th, to receive 600mg of hydroxychloroquine daily and their viral load in nasopharyngeal swabs was tested daily in a hospital setting. Depending on their clinical presentation, azithromycin was added to the treatment. Untreated patients from another center and cases refusing the protocol were included as negative controls. Presence and absence of virus at Day6-post inclusion was considered the end point.

Six patients were asymptomatic, 22 had upper respiratory tract infection symptoms and eight had lower respiratory tract infection symptoms.
Twenty cases were treated in this study and showed a significant reduction of the viral carriage at D6-post inclusion compared to controls, and much lower average carrying duration than reported of untreated patients in the literature. Azithromycin added to hydroxychloroquine was significantly more efficient for virus elimination.

Despite its small sample size our survey shows that hydroxychloroquine treatment is significantly associated with viral load reduction/disappearance in COVID-19 (Coronavirus) patients and its effect is reinforced by azithromycin.
5 1 Votes
Community Voting
  • Governments, central banks and the WHO will not defeat coronavirus alone; the private sector must play a key role.
  • As companies respond to COVID-19, business leaders who back moral statements with practical action will stand out.
  • Protecting employees and redeploying their unique capabilities to meet society’s immediate needs could build more loyal workforces and public good will while helping to fight a global crisis.
The many layers to the COVID-19 crisis are unfolding in front of our eyes. Our political leaders, financial institutions and global governance structures are being severely tested. Their job is made all the harder by low levels of public trust and broken social contracts in many parts of the world.
Many countries are bracing themselves should their health services buckle as services have in those countries already badly affected. Despite the many wonderful acts of charity being witnessed in communities in lockdown, we know imminent hardship will take a toll on social cohesion.
As the limits on our go-to crisis-management tools become clear, it is increasingly apparent that we need the private sector to join the coronavirus front line. There’s a reason the White House has asked Walmart and others to help with drive-thru testing and Downing Street wants manufacturers to shift production lines to building ventilators. Governments, central banks and the WHO will not defeat this disease alone.
Responsible capitalism, which seeks to move corporate culture beyond shareholder primacy, now faces its biggest test yet. Today’s CEOs are knee-deep in invidious choices as they attempt to absorb losses, steady cashflow and balance the competing needs of their investors, customers, staff and suppliers. There are no firm answers, just best judgements and countless unknowns over supply chains, volatile markets and the impact of travel bans and social distancing. It will be impossible to keep everyone happy.
Yet, perhaps, there is opportunity too. In recent years we have seen that employees and consumers increasingly reward businesses that use their powers for good. Companies which uphold clear values to advance a bigger societal mission regularly exhibit stronger financial performance. We saw this clearly at Unilever during my 10 years as CEO when putting purpose at the heart of our business model delivered a 300% shareholder return. As companies respond to coronavirus, false virtuousness will be easy to spot. Business leaders who back moral statements with practical action will stand out.
Firstly, some businesses can redeploy their unique capabilities to meet society’s immediate needs. Think war-time effort: Luxury goods giant LVMH is producing hand sanitizer in its perfume factories, for use in French hospitals; Johnson & Johnson has donated a million surgical masks to Chinese health workers; IKEA is helping to kit-out hospitals in affected areas. These acts will not be forgotten by their recipients and will build good will among the wider public for a long time to come.
Secondly, responsible firms will do everything possible to protect their people, meaning employees, customers and supply chains. Promoting health and safety is priority number one; next is trying to mitigate the financial impact, especially for staff on precarious contracts. Microsoft has agreed to keep paying regular wages to the hourly workers who support their campus, even if hours reduce. UK supermarket Morrisons has just launched a hardship fund for employees facing difficulties as a result of the virus. Others are following suit, some by initiating paid sick leave. While governments can and must provide support to families, it is foolish to hope that overstretched national exchequers can do all the heavy lifting. If our societies are to emerge from the turmoil as strong as possible, it will be essential for businesses to do their bit.
Easier said than done. It is always tempting to ensure your investors get paid first. But long-sighted firms who balance this demand with providing real help to other groups will see immense benefits in the months and years ahead.
These companies will build more resilient and more loyal workforces, better positioned to weather a prolonged economic storm. All but the hardest-hit large firms should be able to protect vulnerable workers through dedicated schemes and guaranteed minimum income, including those people unable to perform their duties because of sickness or through no fault of their own. Doing everything possible to insulate supply chains, especially extending credit where needed, is not only ethically right but is in companies’ enlightened self-interest. The fewer businesses that go to the wall, the better for the overall health of the economy and our eventual recovery.
None of this is revolutionary. The last decade has seen a growing movement towards longer-term, multistakeholder business models. And it’s obvious that most businesses can’t thrive in faltering economies. But don’t underestimate the siege mentality that will be gripping many boardrooms and the powerful instinct to protect profits, even if compassion and humanity are the cost.
The greatest business leaders will, by contrast, play a longer game to serve the societies which host them in this moment of great need, offering people security and stability as an antidote to panic and fear. Employees above all will expect this. This extraordinary and overwhelming crisis demands more of our top executives as they help lead our response. The best will advance the interests of others knowing that it makes us all better off.
Nobel prize winner Wangari Maathai said that, in the course of history, there comes a time when humanity is called upon to shift to a new level of consciousness, to reach a higher moral ground. For C-suites everywhere, that time is now.
5 1 Votes
Community Voting
Good afternoon everybody and thank you very much for coming.
I’ve just chaired a meeting of the government’s emergency committee including ministers from Scotland, Wales and Northern Ireland.
And it’s clear that coronavirus, COVID-19, continues and will continue to spread across the world and our country over the next few months. We’ve done what can be done to contain this disease and this has bought us valuable time.
But it is now a global pandemic.
And the number of cases will rise sharply and indeed the true number of cases is higher - perhaps much higher - than the number of cases we have so far confirmed with tests.
I’ve got to be clear, we’ve all got to be clear, that this is the worst public health crisis for a generation.
Some people compare it to seasonal flu. Alas, that is not right. Owing to the lack of immunity, this disease is more dangerous.
And it’s going to spread further and I must level with you, level with the British public, many more families are going to lose loved ones before their time. And the Chief Scientific Adviser will set out the best information we have on that in a moment.
But as we’ve said over the last few weeks, we have a clear plan that we are now working through.
And we are now moving to the next phase in that plan.
Because this is now not just to attempt to contain the disease as far as possible, but to delay its spread and thereby minimise the suffering. If we delay the peak even by a few weeks, then our NHS will be in a stronger state as the weather improves and fewer people suffer from normal respiratory diseases, more beds are available and we’ll have more time for medical research.
We can also act to stretch the peak of the disease over a longer period so that our society is better able to cope.
The Chief Medical Officer will set out our lines of defence. We have to deploy these at the right time to maximise their effect. The most important task will be to protect our elderly and most vulnerable people during the peak weeks when there is the maximum risk of exposure to the disease and when the NHS will be under the most pressure. So the most dangerous period is not now but some weeks away depending on how fast it spreads.
Today therefore we are moving forward with our plan. From tomorrow, if you have coronavirus symptoms, however mild – either a new continuous cough or a high temperature – then you should stay at home for at least 7 days to protect others and help slow the spread of the disease.
We advise all those over 70 and those with serious medical conditions against going on cruises and we advise against international school trips.
At some point in the next few weeks, we are likely to go further and if someone in a household has those symptoms, we will be asking everyone in the household to stay at home. We are not introducing this yet for reasons Sir Patrick will explain, but I want to signal now that this is coming down the track.
We are considering the question of banning major public events such as sporting fixtures. The scientific advice as we’ve said over the last couple of weeks is that banning such events will have little effect on the spread.
But there is also the issue of the burden that such events can place on public services. So we’re discussing these issues with colleagues in all parts of the United Kingdom and will have more to say shortly about the timing of further action in that respect.
At all stages, we have been guided by the science, and we will do the right thing at the right time.
We are not - repeat not - closing schools now. The scientific advice is that this could do more harm than good at this time. But we are of course keeping this under review and this again may change as the disease spreads. Schools should only close if they are specifically advised to do so. And that remains our advice.
There is no escaping the reality that these measures will cause severe disruption across our country for many months.
The best scientific advice is that this will help us slow the disease and save lives. There will be detailed information available on the NHS website and from 111 online. But I want to stress something that is very important in the wake of what we’re saying this afternoon – I urge people, who think in view of what we’re saying about their potential symptoms that they should stay at home, not to call 111 but to use the internet for information if they can.
I also want at this stage to speak directly to older people. Because this disease is particularly dangerous for you, for older people, even though the vast majority this will be a mild to moderate illness, I know that many people will be very worried. And I think we should all be thinking about our elderly relatives, the more vulnerable members of their family, our neighbours, and everything we can do to protect them over the next few months. We’re going to need to mobilise millions of people to help and support each other. And I just want to you to know that the government will do all we can to help you and your family during this period. We’re not just going to be as you saw yesterday supporting the economy during this period, we will be providing money and many other forms of support, and helping communities to support each other.
And as we have done over the last few weeks, we will continue to provide, as soon as we have it, as much clear scientific and medical information as we can.
So I’d like to end by repeating the two important messages, with which you will have become familiar – it is still vital, perhaps more vital than ever – that we remember to wash our hands.
And lastly of course even if things seem tough now, just to remember, that we will get through this, this country will get through this epidemic, just as it has got through many tougher experiences before if we look out for each other and commit wholeheartedly to a full national effort.
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Community Voting
Politicians, Community Leaders and Business Leaders: What Should You Do and When?
With everything that’s happening about the Coronavirus, it might be very hard to make a decision of what to do today. Should you wait for more information? Do something today? What?
Here’s what I’m going to cover in this article, with lots of charts, data and models with plenty of sources:
  • How many cases of coronavirus will there be in your area?
  • What will happen when these cases materialize?
  • What should you do?
  • When?
When you’re done reading the article, this is what you’ll take away:
The coronavirus is coming to you.
It’s coming at an exponential speed: gradually, and then suddenly.
It’s a matter of days. Maybe a week or two.
When it does, your healthcare system will be overwhelmed.
Your fellow citizens will be treated in the hallways.
Exhausted healthcare workers will break down. Some will die.
They will have to decide which patient gets the oxygen and which one dies.
The only way to prevent this is social distancing today. Not tomorrow. Today.
That means keeping as many people home as possible, starting now.
As a politician, community leader or business leader, you have the power and the responsibility to prevent this.
You might have fears today: What if I overreact? Will people laugh at me? Will they be angry at me? Will I look stupid? Won’t it be better to wait for others to take steps first? Will I hurt the economy too much?
But in 2–4 weeks, when the entire world is in lockdown, when the few precious days of social distancing you will have enabled will have saved lives, people won’t criticize you anymore: They will thank you for making the right decision.
Ok, let’s do this.
4 1 Votes
Community Voting
French, French, my dear compatriots,
For the past few weeks, our country has been facing the spread of a virus, Covid-19, which has affected several thousand of our compatriots. I have, of course, this evening, before anything else, an emotional and warm thought for the families and loved ones of our victims. This epidemic which affects all continents and strikes all European countries is the most serious health crisis that France has experienced in a century. In the overwhelming majority of cases, Covid-19 is safe, but the virus can have very serious consequences, especially for those of our compatriots who are elderly or affected by chronic diseases such as diabetes, obesity or cancer.
2 1 Votes
Community Voting
Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study.
Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described.

In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death.

191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days.
The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future.
Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Other Authors
Fei Zhou, MD †, Ting Yu, MD †, Ronghui Du, MD †, Guohui Fan, MS †, Ying Liu, MD †, Zhibo Liu, MD †, Jie Xiang, MS †, Yeming Wang, MD, Bin Song, MS, Xiaoying Gu, PhD, Lulu Guan, MD, Yuan Wei, MS, Hui Li, MD, Xudong Wu, MS, Jiuyang Xu, MD, Shengjin Tu, MD, Yi Zhang, MD
5 1 Votes
Community Voting
WHO is deeply concerned by the alarming levels of the coronavirus spread, severity & inaction, & expects to see the number of cases, deaths & affected countries climb even higher. Therefore, we made the assessment that COVID19 can be characterized as a pandemic.

This is the first pandemic caused by a coronavirus.
We cannot say this loudly enough, or clearly enough, or often enough: all countries can still change the course of this pandemic. This is the first pandemic that can be controlled.
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Community Voting
  • The containment and treatment of infectious diseases like Covid-19 are highly dependent on individual decision-making.
  • Individuals are not always rational and will balance the perceived benefits of making contact against the perceived cost of the disease.
  • The most effective response to outbreaks, such as Coronavirus, will take these behavioural insights, including the impact of panic on individual decision-making, into account.
Infectious diseases have shaped economics for centuries – think about the Black Death, plague, cholera, Spanish flu and SARS. The new coronavirus (Covid-19) will most probably be added to this list and become part of our collective memory as an event that shaped societies and economies.
To most people, experts and non-experts in the field, the economic risks and consequences of outbreaks, pandemics and epidemics are clear and tangible: the cost for health systems, disruption and reduction in labour productivity, decreased trade and decline in travel and tourism, to name just a few. However, if one had to look at news titles and pictures shared across the globe, one would identify a fundamental multiplier factor: panic – a level of distress beyond the “toilet paper panic” seen in Hong Kong, Singapore or, more recently, in Italy.
Epidemic risk management is by itself a highly complex task, where sets of measures need to be put in place and coordinated at local, national and international levels in order to minimize health and economic consequences. This complex and monumental task does not benefit from panic or extreme worry among citizens; this should be controlled and reduced as much as possible. Even Italy’s Prime Minister Giuseppe Conte first asked the public to “stop the panic”, then to act responsibly, when scenes of hundreds fleeing Milan surfaced – living proof that there is more to be understood and more that can be done in managing health (and many other) shocks
One helpful set of tools are “behavioural insights”, a collection of contributions from various disciplines of behavioural sciences (such as behavioural economics, social and cognitive psychology and anthropology), that can be used to inform public policy.
Public health is a public good and as any economist would tell you, this is always problematic. A public good is defined as a good from which everybody can benefit, even those who have not contributed to its creation (the so-called “free riders”). Normally, health decisions for non-communicable diseases are self-contained and personal (eating healthily, exercising, stopping smoking, going to a screening exam in order to avoid or detect disease).
Infectious diseases are a notable exception as individual decision-making is no longer self-contained or personal, but rather becomes a community matter. If you are contagious and do not protect others or are healthy and do not protect yourself, for example, you could be co-responsible for an outbreak becoming a pandemic.
In other words, when facing infection control interventions, individual behaviour is critical not only for the self but for society as a whole.
If individuals were entirely rational, the management of any communicable disease would be easy and straightforward: prevention, protection and containment would be implemented effortlessly and efficiently.
Unfortunately, we are not rational as experts used to think, but instead, use mental shortcuts which affect how we perceive most aspects of infectious diseases. The limits to human rationality are further exacerbated under strenuous conditions, such as fear.
It is clear that, when public health authorities have to face outbreaks, the Achilles heel is a proper understanding and representation of “real” human behaviour in policies and interventions. Getting people to cooperate towards the goal of containment (self-imposed quarantines, washing hands, limiting travel and gatherings), reducing number of free-riders (hand-sneezers, employees going to work even if sick) to a minimum and avoiding extreme risk perceptions (panic and dismissal) is as important as closing schools and increasing the number of beds in intensive care.
Nevertheless, this is not a trivial task and behavioural experts can explain why. For example, the likelihood of infections and associated health risks can be over or underestimated. People find it very difficult to process representations of risk, especially if these are expressed in odds, percentages and probabilities, but also when these are represented with adjectives (such as “rare”, “common” or “minor”), owing to the inherent ambiguity of these words. This leads to divergent interpretations, often very far from the intent of the communicators.
Furthermore, people are subject to the availability heuristic (the tendency to rely on immediate examples), an unconscious mental shortcut that can be highly misleading in the estimation of the probability of an event. In other words, if you have been bombarded by sensationalist news titles and powerful images of Coronavirus and then must face its threat, these images will come to mind first and will serve as an unconscious shortcut for your decision-making.
Italians, like many others around the world, have since early January been exposed to images of unhygienic wildlife markets, bat soup, face masks, hazmat suits, quarantined ships and other apocalyptic scenes. It is not surprising that when a little village in Lombardy was singled out for an outbreak of the Coronavirus most northern Italians felt a surge in panic and the sudden need to stockpile pasta and tomato sauce. Our subconscious has been fed with danger warnings for weeks and our mental shortcuts, so important for the survival of the fittest in the past, have worked just as intended, but not in the ways needed for the common good.
The issue is not just the content of message communicating a risk (hint: graphic information is generally best), but also involves the timing, medium and messenger. For example, if trust in the government is low, it will also be low in information delivered by governmental medical experts.
When the risk is overestimated the situation can be perceived as extreme and panic might set in. This can lead to instances where individuals ignore social conventions and tend to act in an extremely selfish way, such as looting. On the other hand, in extreme conditions people also tend to act extremely altruistically, helping others in chivalrous ways or punishing those who selfishly take advantage of the situation, for example, reporting price gouging to the authorities.
Panic doesn’t just set in because of risk (mis)perceptions, however, but also because individuals perceive a lack of escape routes. Lockdowns and quarantines represent exactly that: the closing down of an escape route. People fleeing Wuhan before it was put under lockdown, but also those who escaped quarantine by picking locks or running away in the middle of the night from red zones in Italy, did not see the measures as a fundamental instrument to eliminate their ability to carry and transmit the disease (a public good), but as a costly limitation to their freedom. The individual cost of anti-social behaviour (quarantines, maintaining a distance from others) is often considered too high, especially if it requires separation from loved ones.
When it comes to economics, in cases such as outbreaks of coronavirus, individuals balance the perceived benefits from making contact against the perceived cost of the disease and this affects transmission rates. The behaviour of some can expedite the disease’s spread, while the actions of others can slow epidemics. Once we acknowledge the power of individual behaviour in epidemics taking behavioural insights into account will not be a choice but a necessity.
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Community Voting
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Creative Fashion!22/03/2020Discussion
3231Coronavirus e imprese: i settori in crisi e le opportunità per crescere
L’emergenza coronavirus rischia di avere effetti sociali ed economici a breve e lungo termine su ... read more >>
1 Nicola Testa
Smart Economy!21/03/2020Discussion
3230Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open- label non-randomized clinical trial

Chloroquine and hydroxychloroquine have been found to be efficient on ... read more >>
1 Didier RaoultDefeat the Coronavirus!21/03/2020Discussion51
3229How responsible businesses can step forward to fight coronavirus
  • Governments, central banks and the WHO will not defeat coronavirus alone; the private sector must ... read more >>
1 Paul Polman
Smart Economy!20/03/2020Discussion51
3228Statement on coronavirus, by UK Prime Minister
Good afternoon everybody and thank you very much for coming.
I’ve just chaired a meeting of the ... read more >>
1 Boris Johnson
Defeat the Coronavirus!14/03/2020Discussion
3227Coronavirus: Why You Must Act Now
Politicians, Community Leaders and Business Leaders: What Should You Do and When?
With everything ...
1 Tomas Pueyo
Defeat the Coronavirus!13/03/2020Discussion41
3226Coronavirus : Proposition pour faire face à la plus grave crise sanitaire depuis un siècle
Françaises, Français, mes chers compatriotes,
Depuis quelques semaines, notre pays fait face à ... read more >>
1 Emmanuel Macron
Defeat the Coronavirus!13/03/2020Discussion21
3225Risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China
Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a ... read more >>
1 Hua ChenDefeat the Coronavirus!13/03/2020Discussion51
3223COVID19 can be characterized as a pandemic.
WHO  is deeply concerned by the alarming levels of the coronavirus spread, severity & inaction, & ... read more >>
1 Tedros Adhanom Ghebreyesus
Defeat the Coronavirus!12/03/2020Discussion
3222Coronavirus: our reaction
  • The containment and treatment of infectious diseases like Covid-19 are highly dependent on ... read more >>
1 Marianna Baggio
Defeat the Coronavirus!11/03/2020Discussion