New Coronavirus News from 7 Oct 2020b

Take virus 'super seriously', WHO envoy warns [RTE.ie, 7 Oct2020]

Dr David Nabarro said Covid-19 is not a mild disease

The World Health Organization's Special Envoy on Covid-19 has urged people to "take the virus super seriously right now" and treat it with respect.

Dr David Nabarro said Covid-19 is not a mild disease and not more trivial than the flu and one in 50 people who contract the virus have long-term affects.

Speaking on RTÉ's Today with Claire Byrne, Dr Nabarro said "circuit breakers" do reduce the number of cases, but if such a move is going to be made, then other measures, such as building up testing capacity, need to be put in place at the same time.

That way when the "circuit breaker" is released, there is not a sudden rise in cases that cannot be managed, he said.

When asked about the decision to ban indoor dining, he said he suspects the decision to focus on the hospitality industry is because there is evidence emerging that these are places where transmission is occurring.

He added that Ireland has some of the best infectious disease experts in the world and urged the public to listen to them.

Dr Nabarro also said that despite the number cases rising in Europe, it is not being accompanied by a rapid rise in deaths and there are various reasons for this, including the protection of vulnerable people, while people with Covid have much better treatments.

When asked about comments made by US President Donald Trump urging people "not to be afraid of the virus", he said he personally wished that leaders would not make those kind of comments.

Meanwhile, the number of confirmed cases of Covid-19 in hospitals remains relatively stable, according to the latest figures.

There are 156 people with Covid-19 in hospital as of 8am today. This is an increase from 142 people just 12 hours before, at 8pm yesterday.

The number of people with the coronavirus in intensive care is 24.

According to overnight Health Service Executive data, Tallaght University Hospital in Dublin has the most confirmed cases with 23 patients.

There are 14 patients with Covid-19 at St James's Hospital, 12 at the Mater and 12 at Letterkenny University Hospital; 11 at Beaumont and ten cases each at both Connolly Hospital Blanchardstown and Midland Regional Hospital Mullingar.

Overall, the hospital system has 27 adult ICU beds free and there are a total of 278 adult ICU beds open and staffed.

It compares with 422 critical care beds open and staffed on 7 May.

The positivity rate for Covid-19 tests has increased to 3.9 in the last seven days.

Massive investment in Covid strategy urged

A respiratory consultant at the Bon Secours Hospital in Cork said Ireland's Covid strategy needs massive investment in healthcare and should not be based on implementing lockdowns to prevent the hospital system from imploding.

Speaking on RTÉ's Today with Claire Byrne, Oisin O'Connell said Covid-19 has a natural tendency to resurge with human interaction and as with any exponential curve, ultimately it can lead to the overwhelming of the hospital system.

He said there is now "a once in a lifetime opportunity" to fix hospital capacity issues and to adequately resource beds, staff and community follow-up programmes .

Dr O'Connell said the national strategy needs to "think of this as a longer-term war" that requires a cohesive three, five and seven-year strategy with appropriate resource allocation and budgeting for that longer term.

'It's like a parasite' [CNN, 7 Octp 2020]

By Gianluca Mezzofiore, Katie Polglase, Tim Lister, Frederik Pleitgen, Natalie Croker and Sergio Hernandez

How a dangerous virtual cult is going global

In a small town in northern Germany, the local yacht club isn't what it used to be. Many of the members -- mostly middle-aged men -- have been sucked into the conspiracy theories of the QAnon movement: that the coronavirus is a hoax perpetrated by secret elites and that President Donald Trump will save the world from the machinations of the "deep state."

They've also embraced other themes that circulate among QAnon followers in Germany: displaying the flag of the pre-war German Reich, which is popular among neo-Nazis, and the false belief that German Chancellor Angela Merkel used to be a spy for the East German security service and will soon be arrested.

These conspiracy theories and many more, which have spread across social media rapidly this year, led Facebook to take drastic action to curb the impact of QAnon on its platforms. On Tuesday the social media giant announced it would "remove any Facebook Pages, Groups and Instagram accounts representing QAnon, even if they contain no violent content."

Facebook said it is "removing content accordingly, but this work will take time and need to continue in the coming days and weeks."

As part of a wide-ranging investigation into the dramatic growth of QAnon accounts outside the United States, CNN recently sent Facebook details of dozens of groups and pages that embraced QAnon conspiracy theories. Facebook said it would investigate them and had begun removing some pages.

Among the pages that may be removed in the coming weeks are several of the German yacht club's members, which CNN is not publicizing, and which had devolved into a cocktail of QAnon falsehoods.

The son of one member, who asked not to be named to protect his family from further media attention, said his father had begun by believing the coronavirus pandemic was a plot and might "spiral down into even weirder conspiracy theories."

He told CNN that, at one point, yacht club members raised the flag of the neo-Nazi Reichsburger movement. Reichsburger followers deny the Holocaust happened and have picked up on a number of QAnon themes. They joined a Berlin protest against lockdowns in August, which was also attended by some of the yacht club's members.

QAnon goes global

QAnon began life as a uniquely American phenomenon. In October 2017, an anonymous user describing themselves as Q (which is a level of US security clearance) posted on the message board 4chan. These messages, often cryptic riddles, would become known as "Q drops." They featured conspiracy theories about the Mueller investigation into Russian interference in the 2016 US election and much else.

Their popularity has grown ever since.

CNN has explored hundreds of social media accounts in tracking the explosive growth of QAnon internationally, a virtual cult that has created a dilemma for platforms such as Facebook and Twitter. Among those examined were nearly 180 Facebook groups and pages that espoused QAnon themes, all of them from outside the US and the majority in Europe or Latin America. Within Europe, Germany, Italy, France and the United Kingdom had the highest engagement with QAnon.

Combined, the QAnon-related Facebook pages and groups reviewed by CNN logged a total of at least 12.8 million interactions between the beginning of the year and the last week of September.

Almost all that activity happened since March, when the coronavirus pandemic spread quickly across Europe.

Facebook began tackling QAnon in August, when it embarked on a process of removing accounts that discussed potential violence.

It said Tuesday: "We removed over 1,500 Pages and Groups for QAnon containing discussions of potential violence and over 6,500 Pages and Groups tied to more than 300 Militarized Social Movements. But we believe these efforts need to be strengthened when addressing QAnon."

Among the falsehoods published and discussed in these groups and on these pages are claims that secret cabals are involved in widespread trafficking and torture of children, that 5G mobile phone masts cause cancer and that political elites are using the pandemic to monitor and control people.

For example, in Britain a Facebook group dedicated to stopping the rollout of 5G had almost 60,000 members before the social network deleted the account in April.

These disparate themes swirl together with anti-Semitic tropes and fascist insignia. Besides the Reichsflag, the flag of the 1930s British Union of Fascists appeared at one London event that attracted QAnon followers. Many QAnon followers and far-right groups are united in the belief that an end-of-times confrontation between forces of evil and good is at hand. 

The pandemic boost

CNN's tracking of QAnon engagement through CrowdTangle -- a Facebook tool that shows likes and shares for content across social media -- showed a remarkable increase as the coronavirus pandemic took hold across both Europe and Latin America.

This echoes research by the Institute for Strategic Dialogue. It found that from October 2017 to June 2020, 69,475,451 million tweets, 487,310 Facebook posts and 281,554 Instagram posts mentioned QAnon-related hashtags and phrases. And it said: "a clear trend exists showing a notable increase in conversation volumes coinciding with periods when lockdowns were issued in response to the Covid-19 pandemic in March 2020."

In July, internet trust tool NewsGuard identified "448,760 followers or members" of European QAnon groups in social media it analyzed. That's an indication of the scale of Facebook's task in removing QAnon content.

Matthias Poehlmann, a cult specialist with a German evangelical church, said people "search for conspiracy theories that are supposed to offer clarity about the secret plan of the 'deep state' because the coronavirus pandemic has caused a feeling in many of a loss of control."

"Many also believe that they are being left behind, that they don't have a say in political decisions. And as is usually the case with conspiracy theories, they also react to a longing for simple answers," Poehlmann said.

A survey by polling group Kieskompas of 8,000 adults in the Netherlands in August found that 10% believed one or more coronavirus-related conspiracy theories and nearly 6% thought a Covid-19 vaccine would include an implant so their movements can be tracked.

In Germany dozens of small Telegram groups of self-described "Corona rebels" have sprung up. The number of followers of Qlobal Change -- one of the main QAnon Telegram channels in Germany -- rose from 20,000 before the coronavirus crisis to more than 120,000 in September, according to research by Josef Holnburger, a data scientist at the University of Hamburg.

It is a splintered, chaotic landscape. QAnon has no structure, no leadership. It is bound together by a few hashtags -- such as #SaveTheChildren and #Wherewegoonewegoall, also known as #WWG1WGA 
"Everyone can contribute to this story with his or her own conspirac
y theory ... it is almost like a building kit where you can link one conspiracy theory to the next," Poehlmann said.

The rabbit hole

Viktor  -- who didn't want to use his real name because he's concerned about harassment -- was an early convert to the conspiracy theories that gave birth to QAnon. A Russian in his mid-twenties living in Germany, he stumbled across what became known as PizzaGate, which baselessly claimed that a Washington, DC pizzeria was a hub for child trafficking masterminded by Hillary Clinton.

"I don't know how I got hooked," he told CNN from Munich, where he is a software developer. The PizzaGate conspiracy led him down one rabbit hole after another, feeding an antipathy towards feminist, liberal and LGBTQ activists, he said.

Viktor says that as he became more embroiled with QAnon so he became angrier  -- "ready to explode ... it poisons day-to-day life to the point you can no longer maintain healthy relationships."

"Conspiracy replaces your personality. It's like a parasite on top of you, you talk about conspiracy, not building personal connections," he told CNN.

An American woman living in Ireland who asked not to be named for fear of further disrupting her family, contacted CNN about her 38-year-old son, who lives in the UK and became absorbed in QAnon theories. She had turned to a Reddit message board called QAnon Casualties for support.

"My son is a brilliant man who has become an idiot," she told CNN, adding that he cut her off from her grandchildren. When she contracted Covid-19, he dismissed it as a cold.

She thinks the "lockdown and work from home" fed into his behavior. "It does feel like they've been abducted somehow. It's a cult."

Anti-Semitic traffic

Never far away from QAnon pages are anti-Semitic conspiracies and tropes. Billionaire philanthropist George Soros and the Rothschild dynasty are frequent targets. QAnon followers sometimes refer to the Protocols of the Elders of Zion, a fake document from the early 20th century purporting to be a record of secret meetings in which Jews plotted to control the world.

In the UK, the Community Security Trust, a charity that tackles anti-Semitism, says conspiracy theories featured in 218 anti-Semitic incidents recorded between January and July of this year. One-hundred and seventy spoke of Jewish power and influence in global politics, a common theme among QAnon followers.

Dave Rich, director of policy at the Trust, told CNN: "The anti-Semitism isn't necessarily explicit in a lot of these sort of Q discourses, and it isn't necessarily what drives it, but all the tropes are there if you want to see them."

Ruben Gerczikow, vice president of the European Union of Jewish Students, said he has noticed that online "sometimes people are referring that I am part of this global conspiracy."
"I am the perfect enemy basically," he told CNN. Gerczikow said his organization had warned the Jewish community in Germany to stay away from protests against lockdown restrictions.
Taking to the streets

As lockdowns have eased, these tropes and many other QAnon theories have appeared on the streets -- especially in Germany, Italy and the UK -- in a different and more disturbing guise.
Nearly 40,000 people attended a Berlin rally at the end of August to protest against lockdown and mask mandates but also the "deep state." The event was notable for the number of far-right groups that joined in (like the Reichsburger) and for its adulation of President Trump.
In a video message, Austrian far-right activist Martin Sellner told the protesters they could mobilize a "broad, patriotic mass" to fight the "grand strategy" of global elites. Members of the Reichsburger tried to force their way into the German parliament, a symbolic act meant to recall the Nazis' burning of the Reichstag.

Poehlmann says the Berlin protest was "the call for the strong man who is fighting and working against the establishment. Trump is idolized as the savior, more or less, who is leading the battle against the deep state."

The rally made waves online. One German QAnon-related page, "Freiheit ist das Recht, anderen zu sagen, was sie nicht hören wollen" ("Freedom is the right to tell others what they don't want to hear"), amassed 1.3 million views of Facebook Lives around the protest. And a banner asking Trump to "make Germany great again" was liked more than 16,400 times on Instagram.
Last weekend, another rally took place in Konstanz, southern Germany, attended by several thousand people.

One of the speakers at the event, Traugott Ickeroth, told CNN: "I read the Q drops regularly, this Q is very intelligent and it seems that he knows the future, he's very exact."

Another QAnon sympathizer at the rally, who did not want to give his name, said he was "not the typical" Q follower. "There are some good things they're posting, many things that came out as true, but I wouldn't say I'm a blind Q follower," he told CNN. "Many things have been right that they've said ... several things they've predicted came true."

Some observers believe fringe far-right groups are grafting themselves onto QAnon groups to give themselves a greater profile.

The Jewish Students Union in Germany says the anti-lockdown protests have become an "oasis of well-being" for neo-Nazis, anti-Semites and other far-right groups. According to Josef  Holnburger at the University of Hamburg, Reichsburger's following grew from 10,000 to about 100,000 subscribers across online platforms in the first four months of 2020 alone.

In Italy, the far-right  Forza Nuova has latched onto QAnon's momentum, working with the cult's followers to organize a protest in Rome in August. Some figures in the right-wing party Lega, like Patrizia Rametta in Sicily, have embraced QAnon ideas and revived the Protocols of Zion conspiracy.

But it's not solely the right that has propagated themes popular among QAnon followers. Sara Cunial, an independent member of the Italian parliament who used to represent the populist Five Star Movement, claimed in the Italian parliament in May that philanthropist Bill Gates was behind a vaccination drive aimed at "absolute domination over human beings reduced to guinea pigs and slaves." 

Videos supporting her gained almost 1,730,000 views on YouTube in only two days, and three of them received nearly 600,000 interactions on Facebook, according to the Atlantic Council's Digital Forensic Research Lab. The hashtag #IoStoConSaraCunial ("I Stand With Sara Cunial") gained 5 million impressions on Twitter within 48 hours.

Facebook later noted on the video of Cunial speaking that "independent fact-checkers say that this information has no basis in fact."

Real consequences

Some might dismiss the QAnon phenomenon as the online paranoia of a tiny minority, but it's had and still has real-world consequences. In December 2016, a 28-year old man from North Carolina fired three shots at the DC pizza restaurant supposedly at the heart of the PizzaGate conspiracy.

QAnon has since lured in thousands of people genuinely concerned about the real rise in abuse and pedophilia reported by child protection agencies, an increase they associate with the impact of the pandemic.

In the UK the National Society for the Prevention of Cruelty to Children told CNN that the issue of sexual abuse of children is an "incredibly emotive issue" and whipping it up can lead to vigilante action.

"We can't protect children by fueling a moral panic," said NSPCC's Andy Burrows.

Burrows told CNN that social media platforms "have been exploited and built services without an understanding of how they could lead to mischief increasing."

A film called "UK's Hidden Shadows" claiming child abuse by secret elites in Britain has surpassed 500,000 YouTube views.

Several groups that combat child abuse say it has disrupted their work. KidSafe, an international charity devoted to keeping children safe, said QAnon "associate their message of hate and bigotry with well-known, well-regarded organizations."

"That strategy threatens to diminish our identities, tarnish our reputations and harm our good works," KidSafe said.

Few QAnon accounts or groups explicitly call for violence, though plenty abuse and harass journalists who report on the phenomenon.

However, some who become obsessed with conspiracy theories are prone to violence. In a 2019 internal memo, the FBI said that involvement with QAnon could "occasionally induce both groups and individual extremists" to "carry out criminal or violent acts."

In February this year Tobias Rathjen shot dead nine people at two shisha bars in immigrant areas of the German city of Hanau before killing himself. The 43-year-old extremist left behind a rambling screed that combined racism with a lot of the themes circulated by QAnon, but he didn't specifically mention QAnon. 

One reason that QAnon is so hard to track is its diffusion across so many online platforms.
Graphika, which analyzes social media networks and how they evolve, told CNN that it had migrated to mainstream platforms quickly after starting out at the fringe on Gab, 4chan and 8chan, unfiltered websites that are popular with extremist groups. QAnon followings now populate all the main platforms: Twitter, Facebook, YouTube, TikTok and Reddit. 

The major social media platforms have begun taking action against QAnon. Twitter said it had removed some 7,000 QAnon-associated accounts in July.

On September 30, Facebook announced it was "prohibiting anyone on our platform from running ads that praise, support or represent militarized social movements and QAnon."

Even so, the tech companies are struggling to keep up with the proliferation of conspiracy theories and incitement pushed by QAnon followers in multiple languages around the world.

It's obviously a tough call to delete or restrict accounts that appear to campaign against child trafficking. But Facebook has decided that because QAnon followers use hashtags like #savethechildren, it would "direct people to credible child safety resources when they search for certain child safety hashtags."

Thousands of QAnon followers have migrated to the less-regulated space of Telegram.

Oliver Janich -- a self-described German libertarian who lives in the Philippines -- has been promoting QAnon for nearly three years. In one video he asked: "Who is Q? Trump's secret agent?" He began this year with 40,000 subscribers on Telegram. By late September, he had 140,000.

A former television journalist, Eva Herman, who has become an icon of QAnon in Germany, had 141,000 members on her Telegram channel at the end of September. She has promoted several themes popular among QAnon followers. A YouTube discussion in May between Herman and the German singer Xavier Naidoo, who also embraced QAnon theories, garnered nearly 1 million views.

QAnon followers often create back-up accounts to avoid being shut down. "Instead of having one big group that the platforms might be able to delete, they spread out and formed local groups," Holnburger said.

Miro Dittrich, who tracks far-right extremism at the Berlin-based Amadeu-Antonio-Foundation, likens QAnon to a mushroom. "The roots of a mushroom grow and grow. And whenever there's a crisis, the blooming of mushrooms gets activated."

Compounding the problem is the lack of obvious avenues for  QAnon followers to "detox" or for people to seek advice on coping with family members seduced by QAnon. Christoph Grotepass at Sekten-Info NRW, a counseling service in Germany, told CNN that "roughly a quarter to a third of the inquiries regarding conspiracy narratives explicitly refer to QAnon." Inquiries from relatives concerned about conspiracy narratives "have already more than doubled compared to the whole last year," Grotepass added.

Viktor  -- the Russian living in Germany -- endured a long struggle to escape QAnon. But when he did, he went back to Reddit and volunteered to help. 

"I want to contribute to other people about my experience to help them, I hope it's like a vaccine," he said.

But combating QAnon is a formidable task. Facebook said Tuesday that even as it had removed some content supporting violence, "we've seen other QAnon content tied to different forms of real world harm, including recent claims that the [US] west coast wildfires were started by certain groups."

"Additionally, QAnon messaging changes very quickly and we see networks of supporters build an audience with one message and then quickly pivot to another," Facebook added.

That echoes CNN's investigation: as an online phenomenon QAnon mutates with incredible speed across a range of seemingly unconnected themes -- all of them potent falsehoods.

How CNN reported this story

For this story, CNN created a data set of public Facebook groups and pages that publish QAnon theories across the globe. We excluded US QAnon sites because we sought to focus on QAnon's presence beyond the United States.

We based our data on a list of pages and groups compiled by Marc-André Argentino, a PhD candidate at Concordia University and an associate fellow at the Global Network on Extremism & Technology who has researched QAnon. CNN spoke with Argentino to discuss his methodology for vetting QAnon Facebook pages and groups and expanded his dataset to show a more comprehensive set of QAnon sites based on the set of rules outlined below.

To expand Argentino's data, we searched on Facebook and on CrowdTangle, a Facebook-owned platform that tracks public engagement with social media sites, for groups and pages with names that included "QAnon" or alternate spellings (such as "CueAnon"), or with a clear connection to the conspiracy theory.

We categorized pages and groups by geographical origin using the information listed in the page or group's "About" section and links on the Facebook page/group. If that was missing, we looked at the page or group administrator's listed location and the most prevalent language used on the page/group. When the information on origin was entirely missing or conflicting, we excluded those pages and groups. We also included pages and groups surfaced by CrowdTangle's suggestion tool and included ones with QAnon in their names or with at least three pieces of QAnon-related content.

To estimate the growth and the number of interactions with each page we used CrowdTangle, a Facebook-owned platform that tracks public engagement with social media sites. We chose to view the data over a range from December 29, 2020 to September 20, 2020. Our engagement figures may include automated activity from fraudulent accounts, which we were unable to identify and exclude. It is unclear how prevalent it is on Facebook.

Our data may not be exhaustive as Facebook has continued to remove pages and groups from its platform that demonstrate support for QAnon. Meanwhile, new groups and pages are continuously being set up. We also could not include private groups in our searches and our searches may not have captured every QAnon-related page or group. This dataset therefore provides a snapshot of large QAnon groups and pages from across the world without necessarily reflecting the full picture.

How to prevent the next COVID-19: Start with biodefense [Fast Company, 7 Oct 2020]

BY ZLATI MEYER

At the Fast Company Innovation Festival this week, experts laid out what we can do to prevent the next COVID-19 from ever happening.

The world is still in the midst of the COVID-19 pandemic, but a group of people is already thinking about the next global disease—and how to be ready.

According to experts in biological defense and epidemiology who spoke at the Fast Company Innovation Festival today, the tools needed include investment (both from the government and public-private partnerships, such as working with the philanthropic community); an early-warning system to prevent epidemics before they start spreading; incentives for industry to be involved; and creating and maintaining the infrastructure needed to tackle such a disease again.

“Clearly, this is a national security threat that will be dominant in the 21st century,” said Andrew Weber, a senior fellow at the Council on Strategic Risks and and the former assistant secretary of defense for nuclear, chemical, and biological defense programs. “For only about $15-$20 million a year over the next 5 to 10 years, we can eliminate the biological weapons threats as well as infectious diseases, but it has to be part of our national security effort and a priority.”

The pharmaceutical industry needs to be motivated to be involved, explained Megan Murray, professor of global health at Harvard Medical School, who researches using the BCG tuberculosis vaccine to reduce the severity of COVID-19. These companies take on risk when producing vaccines, so the answer might lay in working with the government and academia too.

She pointed to the importance of having logistics in place—from cold storage for vaccines to making dose packages in more manageable sizes—and working with other countries. In the case of zoonotic diseases, which jump from animals to humans, such as COVID-19, there’s an additional issue, because that tends to happen in places where people and wilderness are close by.

“For Ebola, that happened in Guinea,” Murray said. “For the Nipah virus, it happened in Malaysia. For the first SARS, we don’t know how it actually got to southern China.”

She added that the best defense against such diseases is finding them early. “We need global surveillance, including these rural areas, which right now have very little in terms of healthcare,” Murray said.

How to prevent the next COVID-19: Start with biodefense [Fast Company, 7 Oct 2020]

BY ZLATI MEYER

At the Fast Company Innovation Festival this week, experts laid out what we can do to prevent the next COVID-19 from ever happening.

The world is still in the midst of the COVID-19 pandemic, but a group of people is already thinking about the next global disease—and how to be ready.

According to experts in biological defense and epidemiology who spoke at the Fast Company Innovation Festival today, the tools needed include investment (both from the government and public-private partnerships, such as working with the philanthropic community); an early-warning system to prevent epidemics before they start spreading; incentives for industry to be involved; and creating and maintaining the infrastructure needed to tackle such a disease again.

“Clearly, this is a national security threat that will be dominant in the 21st century,” said Andrew Weber, a senior fellow at the Council on Strategic Risks and and the former assistant secretary of defense for nuclear, chemical, and biological defense programs. “For only about $15-$20 million a year over the next 5 to 10 years, we can eliminate the biological weapons threats as well as infectious diseases, but it has to be part of our national security effort and a priority.”

The pharmaceutical industry needs to be motivated to be involved, explained Megan Murray, professor of global health at Harvard Medical School, who researches using the BCG tuberculosis vaccine to reduce the severity of COVID-19. These companies take on risk when producing vaccines, so the answer might lay in working with the government and academia too.

She pointed to the importance of having logistics in place—from cold storage for vaccines to making dose packages in more manageable sizes—and working with other countries. In the case of zoonotic diseases, which jump from animals to humans, such as COVID-19, there’s an additional issue, because that tends to happen in places where people and wilderness are close by.

“For Ebola, that happened in Guinea,” Murray said. “For the Nipah virus, it happened in Malaysia. For the first SARS, we don’t know how it actually got to southern China.”

She added that the best defense against such diseases is finding them early. “We need global surveillance, including these rural areas, which right now have very little in terms of healthcare,” Murray said.

Coronavirus: over 1,000 new cases in a day in Switzerland [Le News, 7 Oct 2020]

On 7 October 2020, the Federal Office of Public Health (FOPH) reported 1,077 new cases of SARS-CoV-2 infection over 24 hours.

The latest daily infection figure, which is 2.6 time the daily number a week ago. represents a significant jump in daily infections.

Switzerland’s 7-day rolling average daily new infection number has jumped from 312 to 632 in a week.

In addition, the rate of positivity – the percentage of tests coming back positive – has risen since last week. Last Thursday it was 4.44%. Today it was 7.12%.

Currently, Zurich and Geneva are showing the steepest rises in new cases. In Zurich, the 7-day rolling average number of daily new cases has more than doubled over the last week from 53 to 131. The most recent daily figure was 183. The growth in average 7-day new daily case numbers shows a similar trend in Geneva where it has jumped from 40 to 75 over a week. The most recent daily figure in Geneva was 133.

In Vaud, Switzerland’s most recent new infection hotspot, the 7-day rolling average has not changed over the recent week. It remains at 85 cases per day. The most recent daily figure in Vaud was 98 new cases.

Alain Berset, Switzerland’s interior minster, called on the population to pull together and respect social distancing and hygiene to avoid further restrictions and closures.

Didier Trono, a virus and genetics expert at EPFL, warned in an interview on RTS radio that if the public doesn’t return to the routines adopted in spring there is a risk of ending up in the same situation as Madrid or Marseille.

Over the last week a further 13 people in Switzerland died after being infected by the SARS-CoV-2 virus.

The scars of Long Covid [New Statesman, 7 Oct 2020]

BY LAURA SPINNEY

What scientists are discovering about the mysterious long-term effects of coronavirus.

Loss of muscular energy was one of the earliest symptoms,” wrote Dr Jamieson, “and convalescents have been more struck by their astonishing lack of strength than by anything else.” He noted sluggish pulses and instances of “mental aberration” persisting far into convalescence. For some the aberration took the form of delirium, for others apathy and depression.

Jamieson was working in a hospital on New Zealand’s South Island during the 1918 flu pandemic. His testimony was one of many compiled by historian Geoffrey Rice in That Terrible Time: Eye-witness Accounts of the 1918 Influenza Pandemic in New Zealand, published on the centenary of that disaster. As I read them now, ten months into a new pandemic, there are recurring themes that leap out: “The men get down and very weak and don’t appear able to rally”; “My mother recovered but she had angina and died some years later from a heart attack”; “She was never the same girl again”; “I never regained my usual health”.

The lingering symptoms were not confined to New Zealand. They were reported globally, just as they are today in the context of a different disease, Covid-19. In 2020, they have been bundled together under the label “Long Covid”. Though the symptoms differ, there are eerie echoes of the Spanish flu, and in both cases the symptoms are bewilderingly diverse. In the case of Long Covid, says Birmingham-based sufferer Claire Hastie, they include such oddities as arthritic-like pains, phantom smells and bodily vibrations. She knows because in early May she set up the Long Covid Support Group on Facebook – one of many such online groups – so that fellow sufferers could share their symptoms at a time when the medical world had little to say about them. “Groups like ours can validate that you’re not going completely mental and that other people are also living this,” she says.

There is little hard data on the “Long Flu” of 1918, but only a minority of those who caught Spanish flu seem to have been affected. Though it’s too early to say, the same is presumed to be true of Long Covid. Still, given the many millions who have already been infected by Sars-CoV-2 – the virus that causes Covid-19 – even a small minority could amount to substantial misery, not to mention social and economic fallout. “My hypothesis is that there is a subset of the human population that will unfortunately be wrecked by Covid-19,” says Carlos Bustamante, who studies population genomics at Stanford University in California, and is one of many scientists trying to tease out the who, what and why of Long Covid.

One definition of Long Covid is “not recovering [for] several weeks or months following the start of symptoms that were suggestive of Covid, whether you were tested or not”. Some medics have complained that this is too vague to be useful. Others point to the importance of labelling the condition – first so that those suffering from it can be taken seriously and treated, and second so that it can be studied and, eventually, parsed into the different post-Covid-19 syndromes that it almost certainly comprises.
***
Long Covid outlasts the presence of Sars-CoV-2 in the body, at least at detectable levels. Probably its most common manifestation is fatigue and breathlessness. “I used to cycle 13 miles a day on my commute and now I use a wheelchair if I need to leave the house,” says Hastie. The fatigue may last for weeks or months, but in most cases it improves eventually. When it doesn’t, a patient’s condition may come to resemble chronic fatigue syndrome (CFS) – itself regarded as a suite of conditions whose causes are unclear. No one yet knows how long Long Covid can last, or whether there are forms of it that will only emerge years or decades from now. One thing does seem clear, however: “The virus affects the whole body,” says Michael Zandi, a neurologist at University College London (UCL) who is studying Covid’s effects on the brain.

This comes as no surprise to Debby van Riel, a virologist at Erasmus University in Rotterdam, the Netherlands. For years, in human cells grown in petri dishes, in animal models and in patients, she has observed the ravages flu causes beyond the respiratory tract. She has seen them with the aggressive H5N1 “bird” flu that until last year was considered a leading candidate for the cause of the next pandemic; with the H1N1 “swine” flu that caused the mini pandemic of 2009; and – alongside her colleague Emmie de Wit, who works in a high-level biosafety lab in Montana – with the virus that caused the mother of all pandemics, in 1918.
Earlier this year, Van Riel switched her attention to Sars-CoV-2, and saw that – though it behaves differently from flu – it, too, has effects beyond the respiratory tract. “At least in its severe form, we should consider Covid-19 a systemic disease,” she says.

It’s early days for understanding exactly what it does in the rest of the body, however. As Zandi notes, many patients with apparently non-Covid-19-related conditions such as stroke and heart attacks tended to stay away from hospitals in the spring, so the full clinical picture is only emerging gradually. Nevertheless, a preliminary survey he and others conducted of neurological patients over five weeks in April indicated that Covid-19 infection was associated with a range of conditions, including stroke and various forms of brain inflammation. One particularly common condition was acute disseminated encephalomyelitis, which damages white matter in the brain and spinal cord and can lead to symptoms including impaired vision and muscle weakness – even paralysis. There was no correlation between this complication and the severity of respiratory symptoms.

Evidence is accumulating that, in an unknown but probably small proportion of cases, infection with Sars-CoV-2 can cause damage to the lungs, heart, blood vessels, intestine and kidneys too. How it does so is not clear. Van Riel is testing two hypotheses: that the virus itself spreads to other tissues, and that it triggers a damaging inflammatory response that reaches those tissues via the blood. Others are exploring different theories, for example that it causes blood to become “stickier” and that circulating clots do the damage (interestingly, anecdotal reports from 1918 highlighted the unusually thick, dark blood of flu patients). It’s not yet possible to choose between these theories – though there are tantalising clues in favour of each – and there may be more than one mechanism at work. There is another outstanding question, Van Riel says: “Is [the generalised damage] virus specific, or is it a consequence of any very severe respiratory disease?”

Since recovery from damage to the brain and heart, in particular, can take months, many researchers view Covid-19 as an opportunity to study the long-term effects of viruses prospectively, and possibly shed light on refractory mysteries such as CFS in the process.
Contact-tracing apps, if they ever hit their stride, could help – but only if the data they gather can be linked to primary care records, which poses privacy problems. “The population cohorts in which this country is a world leader will also be like gold dust,” says the psychiatrist Simon Wessely of King’s College London. The Covid-19 Symptom Study that King’s is coordinating is an example of these, but to date Wessely feels cohort studies have focused too much on hospitalised patients. Patients who never go to hospital – including many Long Covid sufferers – need more studies of their own.

The NHS and other socialised healthcare systems are ideally placed to mount such studies, because of their federated record-keeping, but US researchers aren’t sitting idle. Carlos Bustamante is involved in research that will follow 10,000 Covid-19-positive individuals – both adults and children – over two years. One question he hopes it will answer is how a person’s genetic make-up shapes their experience of the disease, including whether it is short or long. He is particularly interested in multisystem inflammatory syndrome in children (MIS-C), a rare paediatric complication of Covid-19 that involves inflammation in many tissues, the symptoms of which include headache, vomiting, abdominal pain and fatigue. “MIS-C is the canary in the coal mine to teach us about Long Covid,” he says.
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For the best part of a decade, researchers at Stanford have been following hundreds of children with a mysterious condition called paediatric acute-onset neuropsychiatric syndrome (Pans), in which they suddenly – sometimes from one day to the next – develop neuropsychiatric symptoms including obsessive-compulsive behaviour and eating disorders.
The cause of Pans is unknown, but one theory is that it is triggered by a transient infection in children who are genetically predisposed to it. One line of evidence for this is the relatively high prevalence of Pans-like syndromes in countries such as Venezuela that also have high rates of infectious diseases such as dengue and Zika. Another is the similarities that Bustamante is seeing in the genetic profiles of children with MIS-C and Pans: “Covid-19 is a once-in-a-lifetime opportunity to study post-infectious sudden onset neuropsychiatric disease,” he says.

One of the enduring mysteries of the 1918 flu is whether it was the cause of a subsequent pandemic of encephalitis lethargica (EL), a form of brain inflammation that is thought to have affected a million people worldwide in the early 1920s. Of those, roughly a third died, a third recovered and a third went on – years later – to develop a form of Parkinsonism. (It was some of these latter patients that the neurologist Oliver Sacks wrote about in his 1973 bestseller Awakenings.) Genetic material from the flu virus has never been found in tissue taken from the brains of EL patients post-mortem, but that doesn’t mean it wasn’t there. Modern methods of detection may simply not be sensitive enough to detect it. And as Van Riel points out, the virus itself may not have to invade the brain to damage it (it could just trigger a damaging immune response there).

The historical example of EL has prompted some scientists to ask if Sars-CoV-2 could also have very long-term effects on the brain. Though he admits it will be tough to get the funding, John Hardy, a geneticist who studies neurodegenerative disease at UCL, would like the cohort studies now under way to address that question by following Covid-19 patients for several decades. He thinks that if they did they might shed light on a theory that he and others are pursuing: that chronic, low-level inflammation pushes a brain protein called tau to form the abnormal tangles inside brain cells that are associated with neurodegenerative diseases such as Alzheimer’s and Parkinson’s.

Collectively called tauopathies, these diseases include some rare ones that have caused generations of neurologists to scratch their heads because of their inexplicable localisation in space. One is Guam disease, which has all but vanished from the eponymous Micronesian island after causing more than half a century of misery there; another is nodding syndrome in east Africa. Guam disease resembles amyotrophic lateral sclerosis, the disease that afflicted physicist Stephen Hawking, while nodding syndrome is described as a form of epilepsy, but both have much in common with post-encephalitic Parkinsonism.

Could they have been triggered by geographically circumscribed epidemics of infectious disease in the past, that might themselves have gone unreported? Hardy thinks it’s possible, and that Covid-19 is a chance to investigate the infection-as-trigger hypothesis. “We need to look out for Covid tangle disease in about 30 years’ time,” he says.

Others warn against drawing too many historical parallels with what is, after all, a novel disease. “We have to tread carefully,” says Wessely, “and not assume that previous knowledge, either from other post-viral or post infective syndromes, automatically applies to Covid-19.”

While research attempts to elucidate which historical parallels do hold, if any, he believes that the care of Long Covid patients – like that of CFS patients – should remain broad. Doctors need to provide general advice and symptomatic relief where possible, and above all listen and show kindness.

For her part, Claire Hastie would like to see public health messaging around Covid-19 change to acknowledge a category of sufferers who have remained for too long in the shadows – and who potentially cover a much broader demographic than those who end up in intensive care. “People don’t realise that you are not immune no matter how healthy or fit or young you are,” she says. “None of those are protections against this.”