With medical supplies strained by the coronavirus outbreak, health care professionals and technologists are coming together online to crowdsource repairs and supplies of critical hospital equipment. From a report: Doctors, hospital technicians and 3D-printing specialists are also using Google Docs, WhatsApp groups and online databases to trade tips for building, fixing and modifying machines like ventilators to help treat the rising number of patients with COVID-19, the disease caused by the coronavirus. The efforts come as supply shortages loom in one of the biggest challenges for health care systems around the world. "We have millions of health care workers around this country who are prepared to do battle against this virus, but I am concerned there are a couple of areas of supplies they need to fight that virus as effectively as possible," Dr. Peter Slavin, president of Massachusetts General Hospital in Boston, told NBC News, noting that protective equipment, including surgical masks and eye protection, was in particularly short supply. "We wouldn't want to send soldiers to war without helmets and armor," he said. "We don't want to do the same with our health care workers."

The American Hospital Association says COVID-19 could require the hospitalization of 4.8 million patients, 960,000 of whom would need ventilators. As the demand for the equipment surges, making timely repairs will be critical to saving lives. New York Mayor Bill de Blasio warned Friday that the city could run out of basic medical supplies in as little as two weeks. 3D printing, a relatively new and niche technology that can create everything from houses to tiny and complex structures from raw materials, has remained mostly on the fringes of the manufacturing and health care sectors. But the coronavirus has suddenly made it a crucial resource. On Thursday, Slavin called on people with 3D printers to help make protective masks for hospital staff.

UK Prime Minister Boris Johnson announced strict measures to combat the spread of the coronavirus. He says a "huge national effort" has been needed to halt the spread, adding: "there will come a moment when no health service in the world could possibly cope because there won't be enough ventilators, enough intensive care beds, enough doctors and nurses." Non-essential businesses will be closed and citizens are being ordered to stay in their homes. They can only leave for the following "very limited purposes": shopping for basic necessities; one form of exercise a day alone or with members of your household; any medical need, to provide care or to help a vulnerable person; and/or traveling to and from work, but only where this is absolutely necessary and cannot be done from home.

"That's all -- these are the only reasons you should leave your home," says Johnson. "You should not be meeting friends. If your friends ask you to meet, you should say No. You should not be meeting family members who do not live in your home. You should not be going shopping except for essentials like food and medicine -- and you should do this as little as you can. And use food delivery services where you can." The police will be able to take action through fines and dispersing gatherings. The lockdown restrictions will be looked at again in three weeks to determine if they'll be relaxed or not.

You can read the full text of Boris Johnson's address to the nation here.

India is turning to WhatsApp, the most popular app in the country, to create awareness about the coronavirus pandemic and has urged social media services to tackle the spread of misinformation on their platforms. From a report: Narendra Modi, India's Prime Minister, said on Saturday that citizens in the country can text a WhatsApp bot -- called MyGov Corona Helpdesk -- to get instant authoritative answers to their coronavirus queries such as the symptoms of the viral disease and how they could seek help. An individual is required to text +919013151515 to connect to the bot. The bot was built by Mumbai-based firm Haptik Technologies, which local telecom giant Reliance Jio acquired last year, and the information is being provided by the nation's Ministry of Health.

The number of "silent carriers" -- people who are infected by the new coronavirus but show delayed or no symptoms -- could be as high as one-third of those who test positive, according to classified Chinese government data seen by the South China Morning Post. An anonymous reader writes: That could further complicate the strategies being used by countries to contain the virus, which has infected more than 300,000 people and killed more than 14,000 globally. More than 43,000 people in China had tested positive for Covid-19 by the end of February but had no immediate symptoms, a condition typically known as asymptomatic, according to the data. They were placed in quarantine and monitored but were not included in the official tally of confirmed cases, which stood at about 80,000 at the time. Scientists have been unable to agree on what role asymptomatic transmission plays in spreading the disease. A patient usually develops symptoms in five days, though the incubation period can be as long as three weeks in some rare cases.

South Korea "has emerged as a sign of hope and a model to emulate," reported Nature earlier on Tuesday. "The country of 50 million appears to have greatly slowed its epidemic; it reported only 74 new cases today, down from 909 at its peak on 29 February." And it has done so without locking down entire cities or taking some of the other authoritarian measures that helped China bring its epidemic under control. "South Korea is a democratic republic, we feel a lockdown is not a reasonable choice," says Kim Woo-Joo, an infectious disease specialist at Korea University. South Korea's success may hold lessons for other countries — and also a warning: Even after driving case numbers down, the country is braced for a resurgence.

Behind its success so far has been the most expansive and well-organized testing program in the world, combined with extensive efforts to isolate infected people and trace and quarantine their contacts. South Korea has tested more than 270,000 people, which amounts to more than 5200 tests per million inhabitants — more than any other country except tiny Bahrain, according to the Worldometer website. The United States has so far carried out 74 tests per 1 million inhabitants, data from the U.S. Centers for Disease Control and Prevention show. South Korea's experience shows that "diagnostic capacity at scale is key to epidemic control," says Raina MacIntyre, an emerging infectious disease scholar at the University of New South Wales, Sydney. "Contact tracing is also very influential in epidemic control, as is case isolation," she says...

Legislation enacted since [2015] gave the government authority to collect mobile phone, credit card, and other data from those who test positive to reconstruct their recent whereabouts. That information, stripped of personal identifiers, is shared on social media apps that allow others to determine whether they may have crossed paths with an infected person... There are 43 drive-through testing stations nationwide, a concept now copied in the United States, Canada, and the United Kingdom. In the first week of March, the Ministry of the Interior also rolled out a smartphone app that can track the quarantined and collect data on symptoms.


"We hope our experience will help other countries control this COVID-19 outbreak," Kim tells Nature. And Reuters reports that in the five days since the article was published, South Korea has still kept new infections around a low 100 or less each day -- for 12 consecutive days -- compared with the peak of 909 new cases reported on February 29.

Reuters adds that though South Korea has experienced 8,961 cases, on Monday it reported its lowest daily number yet for new cases -- 64. And on the same day, "257 patients were released from hospitals where they had been isolated for treatment, the KCDC said.

"South Korea posted more recoveries than new infections on March 13 for the first time since its first case was confirmed on January 20."

"White House officials are asking tech companies for more insight into our social networks and travel patterns," reports Wired, noting that Facebook even "created a disease mapping tool that tracks the spread of disease by aggregating user travel patterns." And Clearview AI "says it is in talks with public officials to use its software to identify anyone in contact with people who are infected." Such efforts clash with people's expectations of privacy. Now, there's a compelling reason to collect and share the data; surveillance may save lives. But it will be difficult to draw boundaries around what data is collected, who gets to use it, and how long the collection will continue...

"What's really important is for the government to be really clear in articulating what specific public health goals it's seeking to accomplish," said Kelsey Finch, senior counsel at the Future of Privacy Forum, an industry-backed group focused on tech policy. "And how it's limiting the collection of personal data to what's necessary to achieve those very specific goals, and then making sure that there are appropriate privacy safeguards put in place before data starts to change hands...."

Some privacy scholars question whether enhanced surveillance in the name of fighting disease can be dialed back once the danger has passed. "I'm not sure that we should be making longer-term judgments, in an emergency situation, about what the right balance is right now," said Jennifer Daskal, faculty director of the Tech, Law, and Security program at American University and a former national security official in the Department of Justice. "That often doesn't work out so well." Pointing back to 9/11, when Congress granted immense surveillance powers to the federal government, Daskal said decisions made during emergency situations tend to lead to overreach...

The rapid spread of the disease has prompted even some traditional defenders of personal privacy to acknowledge the potential benefits of digital tracking. "Public policy must reflect a balance between collective good and civil liberties in order to protect the health and safety of our society from communicable disease outbreaks," the Electronic Frontier Foundation wrote in a blog post earlier this month. But, the group continued, any data collection "must be scientifically justified and ⦠proportionate to the need."

An anonymous reader writes: 57-year-old U.S. Senator Rand Paul has tested positive for the coronavirus, reports CNN, citing a tweet from the senator's Twitter account.

"He is feeling fine and is in quarantine," the tweet reports. "He is asymptomatic and was tested out of an abundance of caution due to his extensive travel and events. He was not aware of any direct contact with any infected person." Another tweet adds that "Ten days ago, our D.C. office began operating remotely, hence virtually no staff has had contact with Senator Rand Paul."

Paul plans to continue working while in quarantine, and hopes to return to the Senate after his quarantine period ends.

The Wall Street Journal reports that as the coronavirus pandemic began, America's Centers for Disease Control and Prevention "provided restrictive guidance on who should be tested."

They're basing that on archived pages on the CDC's own web site. "While agencies in other countries were advising and conducting widespread testing, the CDC, charged with setting the U.S. standard for who should be tested for the virus, kept its criteria limited." Once the CDC deferred testing evaluations to individual physicians and rolled out testing widely, early data show a surge in positive cases, so public-health officials expect a clearer picture of the epidemic's scale to emerge... Containing a virus requires identifying and isolating those who are infected, infectious-disease and public-health experts say. "If we would have had a true understanding of the extent of the disease several weeks ago, implementation of social-distancing measures could have prevented the escalation of the disease," said Neil Fishman, chief medical officer at the Hospital of the University of Pennsylvania and an infectious-disease specialist...

Initially, the CDC recommended only investigating those who had symptoms and had recently traveled to Wuhan, China, or made contact with someone who may have the virus. As the outbreak worsened, it expanded the criteria for travel history slowly, but maintained its recommendation that symptoms be present, despite some cases having mild or no symptoms.

Now, the CDC has turned over authority to physicians to determine who gets tested, but the testing rates vary widely by state.
America's response was also hampered by "a botched initial test batch," according to the article, which meant there were fewer tests available until the agency allowed private laboratories to develop tests.

America's Food and Drug Administration has approved a coronavirus test from a company called Cepheid.

It can deliver its results in about 45 minutes, "much faster than current tests that require a sample to be sent to a centralized lab, where results can take days," reports The Hill: The test has been designed to operate on any of Cepheid's more than 23,000 automated GeneXpert Systems worldwide, of which 5,000 are in the U.S., the company said. The systems are already being used to test for conditions such as HIV and tuberculosis. The systems do not require users to have specialty training to perform testing and are capable of running around the clock.

"An accurate test delivered close to the patient can be transformative" and can "help alleviate the pressure" that the COVID-19 outbreak has put on health facilities, David Persing, Cepheid's chief medical and technology officer, said in a statement.

An anonymous reader quotes a report from Motherboard: An emergency medicine physician says she and a colleague invented a way to connect four patients to a single ventilator, a hack that could significantly increase the capacity of overburdened hospitals during the coronavirus pandemic. Doctors Greg Neyman and Charelene Irvin Babcock published a pilot study of the technique in Academic Emergency Medicine in 2006. Babock is now an emergency medicine physician at a hospital in Detroit, Michigan and posted a YouTube video on March 14 describing the technique.

The technique is remarkably simple. "Four sets of standard ventilator tubing were connected to a single ventilator via two flow splitters," the study said. "Each flow splitter was constructed of three Briggs T-Tubes which included connection adapters with the valves removed." In Babock's video, she said the adapters were 22mm in size. Basically, any kind of T-shaped tube can be adapted to extend the ventilator to more than one patient. Babock's video has gone viral, and she told Motherboard in a phone interview that she put together the four way adapter set in her YouTube video in 15 minutes using supplies her hospital already had. In an interview with Motherboard, Babcock said that actually using it on coronavirus patients is a tough call, but a potentially life-saving one in a last-resort situation. "It's only been done in test lungs," she said over the phone. "But it's probably better than nothing in dire circumstances. We don't know how bad it's gonna get. [Italy] is so overwhelmed with people that will die without ventilators and they don't have enough ventilators. Sometimes trying something almost MacGyverish is better than doing nothing."

We've known about SARS-CoV-2 for only three months, but scientists can make some educated guesses about where it came from and why it's behaving in such an extreme way. From a report: The structure of the virus provides some clues about its success. In shape, it's essentially a spiky ball. Those spikes recognize and stick to a protein called ACE2, which is found on the surface of our cells: This is the first step to an infection. The exact contours of SARS-CoV-2's spikes allow it to stick far more strongly to ACE2 than SARS-classic did, and "it's likely that this is really crucial for person-to-person transmission," says Angela Rasmussen of Columbia University. In general terms, the tighter the bond, the less virus required to start an infection. There's another important feature. Coronavirus spikes consist of two connected halves, and the spike activates when those halves are separated; only then can the virus enter a host cell. In SARS-classic, this separation happens with some difficulty. But in SARS-CoV-2, the bridge that connects the two halves can be easily cut by an enzyme called furin, which is made by human cells and -- crucially -- is found across many tissues. "This is probably important for some of the really unusual things we see in this virus," says Kristian Andersen of Scripps Research Translational Institute. Further reading: How the Coronavirus Could Take Over Your Body (Before You Ever Feel It)

The Centers for Disease Control and Prevention has collaborated with Microsoft to introduce the Coronavirus Self-Checker, a tool designed to better help you understand the disease which has caused over 10,000 confirmed cases in the United States and claimed at least 187 lives. From a report: The chatbot is another step Microsoft has taken to educate the public about the viral outbreak, after developing home-testing kits, a COVID-19 tracker tool, and a $100 million donation for global coronavirus research. At the very beginning of the chat, the bot asks if you are sick or if you have been in touch with someone who is sick. The conversation cuts short if you select no, noting that this "Coronavirus Self-Checker system is for those who may be sick." Although a considerable amount of data indicates that many COVID-19 carriers are asymptomatic or presymptomatic, the bot is specifically for individuals displaying visible symptoms of the virus.

A global arms race for a coronavirus vaccine is underway. The New York Times reports: In the three months since the virus began its deadly spread, China, Europe and the United States have all set off at a sprint to become the first to produce a vaccine. But while there is cooperation on many levels -- including among companies that are ordinarily fierce competitors -- hanging over the effort is the shadow of a nationalistic approach that could give the winner the chance to favor its own population and potentially gain the upper hand in dealing with the economic and geostrategic fallout from the crisis. What began as a question of who would get the scientific accolades, the patents and ultimately the revenues from a successful vaccine is suddenly a broader issue of urgent national security. And behind the scramble is a harsh reality: Any new vaccine that proves potent against the coronavirus -- clinical trials are underway in the United States, China and Europe already -- is sure to be in short supply as governments try to ensure that their own people are the first in line.

In China, 1,000 scientists are at work on a vaccine, and the issue has already been militarized: Researchers affiliated with the Academy of Military Medical Sciences have developed what is considered the nation's front-runner candidate for success and is recruiting volunteers for clinical trials. China "will not be slower than other countries," Wang Junzhi, a biological products quality control expert with the Chinese Academy of Sciences, said Tuesday at a news conference in Beijing. The effort has taken on propaganda qualities. Already, a widely circulated photograph of Chen Wei, a virologist in the People's Liberation Army, receiving an injection of what was advertised to be the first vaccine, has been exposed as a fake, taken before a trip she made to Wuhan, where the virus began. President Trump has talked in meetings with pharmaceutical executives about making sure a vaccine is produced on American soil, to assure the United States controls its supplies. German government officials said they believed he tried to lure a German company, CureVac, to do its research and production, if it comes to that, in the United States.

As millions of Americans hunker down to slow the spread of COVID-19, U.S. broadband networks are seeing a significant spike in usage. While industry insiders say that the U.S. internet should be able to handle the strain overall, broadband availability, affordability, and slow speeds could still pose a serious problem for many housebound U.S. residents. From a report: In a blog post, Cloudflare noted that Seattle, ground zero for the U.S. coronavirus spread, has seen internet usage spike by some 40 percent. Key internet exchanges in cities like Amsterdam, London, and Frankfurt have seen a 10 to 20 percent spike in traffic since around March 9. ISPs use a number of modern network technologies to handle congestion in real time, often letting them intelligently and automatically "deprioritize" the traffic of heavy users in overloaded areas. Even then, the massive surge in usage will likely impact U.S. broadband speeds in the weeks and months to come, industry trackers say. Broadband Now, a company that tracks U.S. broadband availability and speed, told Motherboard that six of the biggest U.S. cities by population have seen little to no change in median speed test results from the past 11 weeks.

An anonymous reader quotes a report from TechCrunch: In a great example of what can happen when smart, technically-oriented people come together in a time of need, an open-source hardware project started by a group including Irish entrepreneur Colin Keogh and Breeze Automation CEO and co-founder Gui Calavanti has produced a prototype ventilator using 3D-printed parts and readily available, inexpensive material. The ventilator prototype was designed and produced in just seven days, after the project spun up on Facebook and attracted participation from over 300 engineers, medical professionals and researchers.

The prototype will now enter into a validation process by the Irish Health Services Executive (HSE), the country's health regulatory body. This will technically only validate it for use in Ireland, which ironically looks relatively well-stocked for ventilator hardware, but it will be a key stamp of approval that could pave the way for its deployment across countries where there are shortages, including low-income nations. The group behind the ventilator also recently changed the focus of their Facebook community, renaming the group from the Open Source Ventilator Project to the Open Source COVID19 Medical Supplies community. They're looking at expanding their focus to finding ways to cheaply and effectively build and validate other needed equipment, including protective gear like masks, sanitizer and protective face guards for front-line healthcare workers.

U.S. Food and Drug Administration Commissioner Stephen Hahn addressed the ongoing work of the agency in terms of its work on potential treatments and vaccines for the COVID-19 coronavirus currently spreading globally. From a report: Despite a claim early in Thursday's White House briefing on the pandemic by President Donald Trump that one proposed treatment, anti-malarial chloroquine, had already been approved by the FDA for COVID-19 treatment, Hahn said that in fact the agency is currently looking at widespread clinical trials of the drug, but it is not yet approved for that use. "In the short term, we're looking at drugs that are already approved for other indications," Dr. Hahn said.

"Many Americans have read studies and heard media reports about this drug chloroquine, which is an anti-malarial drug. It's already approved, as the president said, for the treatment of malaria [Trump had not said this, but had instead said it was now approved for COVID-19] as well as an arthritis condition. That's a drug that the president has directed us to take a closer look at, as to whether an expanded use approach to that could be done to actually see if that benefits patients. And again, we want to do that in the setting of a clinical trial, a large pragmatic clinical trial to actually gather that information and answer the question that needs to be answered." Another potential treatment which has shown signs of possible positive effect, remdesivir, was also cited by Trump as being very "near" approval for use by the FDA. Hahn clarified that in fact, while remdesivir is currently undergoing clinical trials, it's following the normal FDA process for approval for clinical medical therapeutic use in the U.S.

More than 99% of Italy's coronavirus fatalities were people who suffered from previous medical conditions, according to a study [PDF] by the country's national health authority. Reader schwit1 shares a report: The new study could provide insight into why Italy's death rate, at about 8% of total infected people, is higher than in other countries. The Rome-based institute has examined medical records of about 18% of the country's coronavirus fatalities, finding that just three victims, or 0.8% of the total, had no previous pathology. Almost half of the victims suffered from at least three prior illnesses and about a fourth had either one or two previous conditions. More than 75% had high blood pressure, about 35% had diabetes and a third suffered from heart disease.

On Monday, the Imperial College report on COVID-19 was released and the results are terrifying. For those who may not know, the Imperial College in London "has advised the government on its response to previous epidemics, including SARS, avian flu and swine flu," reports The New York Times. "With ties to the World Health Organization and a team of 50 scientists, led by a prominent epidemiologist, Neil Ferguson, Imperial is treated as a sort of gold standard, its mathematical models feeding directly into government policies."

In a series of tweets, Jeremy C. Young, Assistant Professor of History at Dixie State, summarized what the report says would happen if the U.S. does absolutely nothing. That is, if we treat COVID-19 like the flu, go about our business, and let the virus take its course. The Imperial College team plugged infection and death rates from China, Korea, and Italy into epidemic modeling software and ran a simulation... Here's what would happen: 80% of Americans would get the disease. 0.9% of them would die. Between 4 and 8 percent of all Americans over the age of 70 would die. 2.2 million Americans would die from the virus itself. It gets worse. People with severe COVID-19 need to be put on ventilators. 50% of those on ventilators still die, but the other 50% live. But in an unmitigated epidemic, the need for ventilators would be 30 times the number available in the US. Nearly 100% of these patients die.

So the actual death toll from the virus would be closer to 4 million Americans -- in a span of 3 months. 8-15% of all Americans over 70 would die. How many is 4 million people? It's more Americans than have died all at once from anything, ever. It's the population of Los Angeles. It's 4 times the number of Americans who died in the Civil War...on both sides combined. It's two-thirds as many people as died in the Holocaust. Americans make up 4.4% of the world's population. If we extrapolate these numbers to the rest of the world (warning: MOE is high here), this gives us 90 million deaths globally from COVID-19, in 3-6 months. 15 Holocausts. 1.5 times as many people as died in all of World War II. The Imperial College then ran the numbers for what would happen if countries assumed a "mitigation" strategy and "suppression" strategy. You can read the full summarized breakdown of what happens in each scenario below, but basically the mitigation strategy flattens the curve with an actual death toll at around two million deaths while the suppression strategy has the death rate in the U.S. peaking at 3 weeks with only a few thousand deaths.

You can view a screenshot of the thread below:

An anonymous reader quotes a report from The Wall Street Journal: New York City is working with the hospitality industry to possibly convert entire hotels into hospitals for patients without the novel coronavirus, in an effort to increase capacity at medical facilities as the outbreak grows. The city's emergency management commissioner, Deanne Criswell, said in an interview Wednesday that hotels could be vital as New York City needs more beds to treat those with Covid-19. The hotels would be for "those non-Covid patients who are really minor but need care," she said. It couldn't be determined how many beds would be immediately available for these patients or how much the city would pay hotels.

The city currently uses hotels for some quarantine, and could use them to house health-care workers who need places to stay, Ms. Criswell said. With the city's tourism industry hit by the virus, many hotels are now empty, she added. New York City has 1,339 confirmed cases of the virus as of Wednesday afternoon, with 10 deaths. City officials also hope to turn the Jacob K. Javits Convention Center in Manhattan into a large hospital, using federal medical stations, according to Ms. Criswell. Mayor Bill de Blasio said earlier this week the city had an additional 1,300 beds by reopening closed hospitals and other facilities, including Roosevelt Island's Coler hospital, a city hospital that was no longer in use. A recently built nursing home in Brooklyn will also be used to hold 600 beds, and two Bronx hospitals with more than 100 beds will also be available, according to Mr. de Blasio. To make more space, the city is also discharging patients that can leave hospitals, canceling elective surgeries, and building more capacity within hospitals. Earlier today, the U.S. and Canada announced it will suspend non-essential travel between the two countries to prevent the spread of the virus. This comes two days after Canada closed its borders to non-citizens with exceptions for U.S. citizens, air crews and diplomats.

The U.S. is also ordering Fannie Mae and Freddie Mac to suspend foreclosures and evictions for at least 60 days.

Hospital workers in Washington state have been making protective medical gear out of office supplies and other run-of-the-mill materials as they deal with a severe shortage of equipment needed to care for patients who may have Covid-19. From a report: Among the supplies coming in handy: clear vinyl sheets. "We are very close to being out of face shields," said Becca Bartles, executive director of infection prevention at Providence St. Joseph Health, a 51-hospital system. "Masks, we're probably a couple of days away" from running out, she said. To buy time, Providence infection control and quality experts designed prototype face-shields with off-the-shelf materials: marine-grade vinyl, industrial tape, foam and elastic. Monday night they bought supplies at craft stores and Home Depot. On Tuesday, about 20 administrative staff members at the health system's corporate headquarters volunteered to work an assembly line in a large conference room, putting together 500 home-spun face shields that were going to a hospital in Seattle that night.