In coming Chamber of Commerce president Jean-Pierre Leignadier (l) and President Cortizo (r) at the Chamber’s installation of new officers ceremony. Photo by the Presidencia.
What’s “conservative” anymore?
There are so many things that might be said about the narrow social base with whom President Cortizo consults over major policy initiatives, the realities of a country in which informal micro-enterprises are the vast majority of business but are not recognized as such, and political stances that have hardened over the years.
The Panama Chamber of Commerce, Industry and Agriculture (CCIAP) is what it is, a generally known quantity. Their basic orientation is for the prosperity of their member businesses and for continuity of the established social order. In that sense they can be called “conservative,” even when they hobnob with a president whose party is a member of the Socialist International.
Might today’s Chamber be far away from the principles of the old Colombian Conservatives, basically a large landowners’ party in alliance with the Catholic Church? Perhaps. We could get into historical roots and interregnums, and semantic debates.
What was the gist of what Mr. Leignadier had to say? On common ground with most of Panamanian society, he opined that our legal system is bad for business and needs to change. The country’s leftist organizations and leaders would all say that, too. When it comes to proposals for change, the ground begins to fragment, but we all know what has to end.
Like so many of us, Leignadier feels the losses of this harsh quarantine. He was not railing against the man who ordered it, the president, who was in the room. “Every day that passes without starting up the economy,” the new Chamber president said, “affects the possibility of sustaining thousands of jobs.” He correctly noted that both businesses and individuals are being hurt.
But Leignadier called for caution in the reopening of businesses in Panama. He warned against magic solutions to economic problems. His organization has consulted with the government on plans to slowly get public activity, economic and otherwise, restarted in Panama.
The Chamber’s caution is in marked contrast with the reckless dismissal of all facts that goes under the brand name of conservatism in the United States. Gunman threatening the government to throw all medical caution to the wind, as happens up there, is nothing that any Panamanian business leader, nor any business-oriented politician, is about to condone.
Down here the conservatives want to actually conserve something. Up there conservatives are a smash and grab mob who don’t much care about the society and republic they leave behind.
Small-c conservative Panamanian business leaders may call way too many dibs for most citizens’ liking. But at least they have the sense to know that a work force and a consumer market devastated by mass death and illness is no way to conserve very much that’s worth having.
Violence, in reality, defends no right and no one.
Mohandas K. Gandhi
Bear in mind…
Winston Churchill would kill his own mother just so he could use her skin to make a drum to beat his own praises.
Margot Asquith
There are only two families in the world, the Haves and the Have Nots.
Miguel de Cervantes Saavedra
There ain’t no answer. There ain’t gonna be any answer. There never has been an answer. That’s the answer.
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Una de las grandes interrogantes sobre el uso del ADN en el agua de mar para hacer listas de especies es si proviene de un sitio específico o si ha flotado desde otro lugar. En este estudio, los investigadores pudieron distinguir diferentes hábitats marinos utilizando solo ADN. Aquí los científicos descubrieron que los manglares tenían la mayor cantidad de biodiversidad. Foto por Elaine Shen.
Smithsonian usa ADN para distinguir
hábitats marinos tropicales en Panamá
por STRI
Investigadores de seis universidades y museos se reunieron en el Instituto Smithsonian de Investigaciones Tropicales (STRI) y descubrieron ADN de casi 9000 distintos tipos de animales en las aguas de la Bahía de Almirante y sus alrededores en la provincia de Bocas del Toro de Panamá. Apostaron por una técnica poderosa no solo para identificar especies en peligro de extinción e invasoras, sino también para monitorear los cambios ambientales en la Bahía. El equipo demostró que podían distinguir la diferencia entre cinco hábitats diferentes basados en minúsculos trozos de ADN que flotaban en el agua de mar. ¡No solo detectaron muchos de los peces en el mar, sino que también detectaron miles de invertebrados marinos, microbios e incluso un ratón!
“Por lo general, los estudios marinos se centran en un grupo: peces, invertebrados o microbios”, comentó Matthieu Leray, becario postdoctoral en STRI, que lidera un proyecto más amplio para comparar organismos marinos en los océanos Caribe y Pacífico de Panamá. “En esta investigación tratamos de observar todos los grupos de animales simultáneamente. Una razón por la que podríamos hacer eso es porque la fauna marina de Bocas del Toro es relativamente conocida”.
Compararon cinco hábitats diferentes (manglares, lechos de pastos marinos, fondos arenosos, arrecifes de coral y muelles de botes) de la manera tradicional (un buzo nada y registra todos los peces que ve) y también recolectando ADN ambiental (eADN) en muestras de agua de cada hábitat.
Elaine Shen, ex pasante de licenciatura de la Universidad de Rice, escribió el artículo resultante en Informes científicos basados en su proyecto de investigación de pasantías de verano.
“Espero que esto inspire a otros estudiantes universitarios a solicitar fondos para investigación y pasantías remuneradas que parecen estar fuera de su alcance, pero que en realidad son alcanzables. Me hizo creer que, si estás dispuesto a trabajar, todo es posible”. Elaine, ahora estudiante de doctorado en la Universidad de Rhode Island, espera pacientemente a que termine la cuarentena para partir a Indonesia a trabajar en su investigación doctoral utilizando las mismas técnicas de ADN en un área donde se sabe mucho menos.
El ADN en el agua de mar proviene de lo que los animales dejan: excremento, piel y células sanguíneas, escamas y moco.
Los genetistas determinan y comparan la secuencia de nucleótidos en cada cadena de ADN. Imagine un collar de perlas de diferentes colores. Cada secuencia única (patrón de colores) se denomina unidad taxonómica operativa (OTU). Al comparar estos patrones con las secuencias de ADN de las especies recolectadas anteriormente, descubren qué especies estaban en cada muestra de agua. Debido a que el Smithsonian tiene una estación marina en Bocas del Toro, aprovecharon una enorme base de datos de 6,500 especies que los científicos han registrado durante las últimas dos décadas, así como varias otras herramientas como una guía virtual de Peces del Gran Caribe, disponible como aplicación para iPhone.
En total, encontraron 23,123 OTU diferentes. 8,781 de estos eran animales multicelulares. Y de estos, pudieron identificar alrededor de 800 especies. Los peces representaron menos del uno por ciento del total, según los resultados de eADN. De todos los OTU que podrían coincidir con especies conocidas, solo se informó previamente del 40 por ciento. Eso significa que cientos de nuevas especies esperan ser descubiertas.
Aunque los buzos que realizaron el estudio visual tradicional observaron un total estimado de 7 millones de peces, el número total de especies en sus listas fue de solo 97. La técnica de eADN, que requiere menos mano de obra, encontró 43 especies adicionales.
Al comparar el ADN del agua de mar, pudieron distinguir entre manglares y sitios de pastos marinos, entre arrecifes y sitios arenosos y entre sitios que estaban en la bahía y sitios expuestos a condiciones de océano abierto. Los manglares fueron los más diversos, seguidos de los lechos de pastos marinos, aguas abiertas (muestras de muelles), fondos arenosos y arrecifes de coral. Aunque los arrecifes pueden albergar a los animales más llamativos… peces de colores brillantes y anémonas de mar, estos otros hábitats albergan animales discretos que aún no se han identificado.
“Nuestro hallazgo de que el eADN recolectado de distintos hábitats fue diferente es importante”, comentó Leray. “No existe una herramienta mágica para estudiar la biodiversidad marina. A las personas les ha preocupado que el ADN en el agua de mar pueda moverse y no representar un hábitat en particular. El ADN dura de 8 horas a un día, por lo que puede moverse en cierta medida, pero demostramos que era específico de un hábitat dado”.
“Eso fue realmente lo mejor de nuestro proyecto”, comentó Bryan Nguyen, miembro del Museo Nacional de Historia Natural en Washington. “Debido a que podríamos mostrar diferencias entre hábitats, descubrimos algo nuevo sobre eADN que será útil en el futuro a medida que monitoreamos diversos paisajes marinos. También nos enseñó el valor del uso de eADN y métodos visuales. Cada técnica le brinda diferentes partes de la imagen. Con ambos, obtienes una vista mucho más completa”.
Referencia: Nguyen BN, Shen EW, Seemann J, Correa AMS, ODonnell JL, Altieri AH, Knowlton N, Crandall, KA, Egan SP, McMillan WO, Leray M. 2020. Environmental DNA survey captures patterns of fish and invertebrate diversity across a tropical seascape. Scientific Reports. https://doi.org/10.1038/s41598-020-63565-9
Aunque muchos hábitats de las aguas poco profundas en Bocas del Toro estaban cerca uno del otro, estos albergaban distintos conjuntos de organismos que impulsaban patrones de biodiversidad dentro de ellos. Foto por Elaine Shen.
La investigación ambiental de ADN captura patrones de la diversidad de peces y invertebrados del paisaje marino tropical. Usando eADN, descubrimos que las comunidades animales se distinguían entre los hábitats adyacentes y descubrimos más diversidad de peces que por medio de las observaciones.
De izq. a der.: Elaine Shen, Will Wied y la Dra. Janina Seemann en el campo recolectando muestras. Mientras Elaine tomaba muestras de agua, Will y la Dr. Seemann inspeccionaron las comunidades de peces en cada sitio. Foto por Elaine Shen.
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Strangely enough, navigating the world with mental illness has oddly prepared me for quarantine.
I’ve got social anxiety. I crave human connection, and I also fear it, so I spent years avoiding people while desperately lonely.
You know what it looked like? A lot like quarantine.
In recent years, I’ve started making friends, joining groups, and participating in activities. Before that, I had friends, but I spent a lot of time alone. During quarantine, I find myself going back to what I did during those years — and based on the shortages of garden supplies and bread flour, the rest of the country is joining me at it.
Here’s what I did in my 20s and early 30s: I read everything, blogged, wrote, hiked, backpacked, did jigsaw puzzles, played online card games, knit, made jewelry, cooked, baked, dehydrated, fermented, sprouted, canned, pickled, foraged, gardened, built a chicken coop, raised chickens, and learned botany, herbalism, and photography, plus very brief failed attempts at quilting, crochet, pottery, and basketry.
I stopped doing those things as my mental health improved because I had other, more fulfilling activities to take their place, like having friends. Now that I’m stuck at home, I made sourdough starter, began fermenting kombucha, planted a garden, tried new recipes, and stocked up on mason jars.
It’s a bit jarring that the old me is making a return, but I also realized: I know how to do this because I’ve done it before. Keeping myself busy with solo hobbies sustained me by giving my life meaning and purpose for years when I could not get those things in other ways. It’s no different in quarantine.
I didn’t immediately jump to bread-baking when quarantine started. Honestly, my initial reaction to life as we know it shutting down felt like my initial reaction when I learned my brother died 12 years ago, albeit on a much smaller magnitude.
First, numbness — and action. Then, about a week later, all of the emotions hit and I was capable of nothing but watching Netflix and napping. Thanks to therapy, I’ve also got a lot of practice working through feeling like the world is about to end, because I feel that way all the time anyway.
Step one: Let myself feel how I’m feeling and seek out human connection. Don’t judge myself. Do what feels good. Find pleasure where I can. Accept that I might not be as productive or achieve as much as I’d hoped pre-pandemic.
I think during those weeks I was simply working through fear, uncertainty, and disappointment. The only thing I forced myself to do was take a walk most days.}Step two: I didn’t intend for this to happen, but I found an online cooking class, then I bought some seeds, and before long I was keeping busy with hobbies. I still did not pressure myself about productivity.
Step three: Productivity on actual work. I wasn’t sure I’d get to this place, but I did. I’m financially stable, healthy, and I live alone. After six weeks with only a cat and some sourdough starter for company, I found inspiration to get to work on my dissertation.
I’ve seen competing memes online about whether now is the time to better ourselves by learning Italian and taking up woodworking or it’s just time to survive. I think it’s both, because hobbies can help with survival.
What it isn’t time for is judging ourselves for lack of productivity. Whatever your survival strategy is, do that. Feel proud of yourself for getting through this — don’t beat yourself up for not getting through it better.
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People are reluctant to speak ab out suicide, men more so than women. Graphic by The People Speak!
Preventable, but not if it’s unspeakable
by Eric Jackson
Notwithstanding hype about what a happy society we are, Panama usually has an annual suicide rate of about 3.5 per 100,000. That’s about 150, but we can reasonably expect that it’s more. There are always uncertainties, and social mores will sometimes, for example when somebody dies of a drug overdose, tip a close call about suicide or accident toward the latter for the sake of sparing the surviving family some unwanted notoriety.
As if it’s the family’s fault. But in some way, might it be?
There are hereditary conditions that raise the risks of individuals killing themselves. Top among these are chronic depression, in its unipolar and bipolar forms.
A lot of suicides, especially among older folks, are motivated by fear of becoming a burden on family or society.
There are hellishly dysfunctional families or relationships, which may to some people make suicide look like a reasonable exit strategy — or twisted means of revenge.
Grinding poverty, especially with anticipation that it will shortly become worse, like the deterioration from hunger to homelessness, is often a factor.
And then, as any competent jailer knows, confinement will drive certain people in the direction of self-destruction.
In Panama, and around the planet, there is a pandemic and there are harsh quarantine measures to control it. Those on the front lines here are not releasing hard numbers — it would be difficult to do so even if they had any great desire to do so — but there is a ready admission by people in the know that the isolation of quarantine is exacting a mental health toll.
Should we be alarmed about the toll of those who know the most about the situation? Panama’s physicians and nurses, through their unions and professional associations, are complaining that the numbers of their profession who are affected by the COVID-19 crisis are being withheld from them. Juana Herrera, the mental health director for the Ministry of Health (MINSA), did, however, tell TVN that health care workers are at the moment especially vulnerable to mental health problems because of the stress of their jobs.
At Santo Tomas Hospital, chief of psychiatry Marcell Iván Penna Franco put it this way to La Critica:
The frequency of suicides or suicide attempts at this time is because we are in a situation that’s extremely irregular and totally new. … [People have] no way to deal with confinement stress.
For most people in Panama, certainly. But epidemics, wars and natural disasters that cause some of the similar conditions are well enough known in the world. World Heath Organization director-general Tedros Adhanom Ghebreyesus cites a typical situation:
Social isolation, fear of contagion, and loss of family members is compounded by distress caused by loss of income and often of employment.
From the start of Panama’s coronavirus quarantine, mental health issues and related problems were counted as likely challenges. It’s part of the reason why the “stay at home ” order was accompanied by a dry law, a special hotline for domestic violence and separate men’s and women’s shopping times that would likely give women an excuse to be outside of an abusive man’s presence long enough to report or seek help for the problem.
MINSA set up a special mental health hotline — 169, extension 2. The regular 911 emergency operators were advised to look for signs of mental disturbance and especially suicidal thoughts among those who contacted them. In our culture women are about twice as likely to ask for mental health services, and men are particularly reluctant to admit to suicidal thoughts. A tactful transfer to the right professional becomes a critical part of an emergency operator’s job these days.
So how bad is the situation? These days, especially in a gringo community that notoriously has people who believe in “alternative facts” and wild conspiracy theories, the lack of hard numbers will be take as proof of a sinister plot by which “they” can “control you.” There actually ARE control motives: the authorities don’t want people to batter other members of their households, riot in the streets, loot the closest mini-super or commit suicide. These are hard times and some sort of morale management is seen as a necessity to keep society from collapsing under all the stress.
So how hard is this work? One figure that MINSA did share with La Estrella: in the first week of May, the 169, extension 2 mental health hotline took 281 calls. The state of the mental health professionals who took those calls? That, MINSA does not say. It should not be a shock if many of them were exhausted, some may have been physically ill, and some were fighting off mental demons of their own.
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And for people who live like this? Archive photo by Eric Jackson.
Panamanians are part of worldwide
efforts to answer hard questions
by Eric Jackson
“MINSA reiterates to the population to continue implementing measures such as … constant handwashing … which are efficient weapons to eradicate COVID-19.”
Ministry of Health appeal to the public
In the best of situations, medicine is not an exact science. People are not a fungible mass. That same strain of pathogenic microbe can infect two people who by most social measures are similar, and one gets the sniffles while the other dies. See enough of that, examine the cases closely enough, from enough different angles of inquiry, and profiles that are predictive and medically useful may emerge. All of the useful inquiries may not be by medical doctors.
A hot question of the moment — probably the key to whether there can be a COVID-19 vaccine — is whether and to what extent there is an acquired immunity.
Along one line of investigation, starting in April desperate doctors trying to save the lives of critically ill patients began to do something they had heard about from other places. The infused blood plasma from people who had become sick with the new coronavirus and recovered. The plasma would contain various antibodies, some of which might kill or slow the reproduction of the offending coronavirus. They didn’t actually know much about which antibody was which, but the hunch was that the treatment might work.
So did it? Records were kept, anecdotally it seemed to have helped in some cases, such that in this country the transfusions continue is cases where physicians think them indicated. Meanwhile in research labs more than hospital wards, scientists work on separating and identifying the various antibodies. What these do are studied. The world may be on lockdown but the Internet is still up, so treating physicians and researchers are constantly comparing notes across most sorts of borders.
Probably closer than a vaccine are mixtures of mass produced antibodies that would attack and hinder the coronavirus, holding it to a standstill before it can kill the patient. Not a preventive, not a cure as such, but like the anti-retroviral cocktails that can keep an HIV infection from becoming full-blown aids, there is the prospect of a lifeline to the infected.
The coronavirus-stricken USS Theodore Roosevelt, docked in Guam. US Pacific Fleet photo.
INDICASAT, the Institute for Scientific Research and High Technology Services, is a little-known Panamanian office created in 2002 for the promotion of science but since then largely neglected by politicians with attitudes ranging from a dependence on foreigners to do any serious scientific field, to a general lack of curiosity, to fear of the disruptions that a scientifically literate population might bring to established economic interests.
José Loaiza is a staff scientist at INDICASAT and were that all, he might be stuck in an organizational chart backwater. But his interests, his vocation and his networks of collaborators cross all sorts of organizational and disciplinary boundaries. He’s a professor of entomology — the study of insects and arachnids — at the University of Panama. He’s a research associate at the Smithsonian Tropical Research Institute (STRI). His interests go well beyond his subdivision of biology, spilling into the earth sciences and the social sciences into an interdisciplinary study of diseases, their vectors and their dynamics in changing environments. Along with professors from the University of Oklahoma and Johns Hopkins University, he has just published an article that asks more questions than it answers and will surely send a small army of scientists into the field.
Of concern are reports from China and South Korea about how the virus thrives in the gastro-intestinal track, and in excreted human feces. It will live and reproduce in human sewage.
What might that mean in a region where a lot of people have no running water, or no regular access to clean water at all? The inquiry gets into social statistics, facts about infrastructures, ecological studies and data on other medical phenomena that may suggest similarities with COVID-19 infection routes.
Some of the reports from other regions that attracted the interest of Loaiza and his colleagues here go to the heart of perhaps the heaviest COVID-19 mystery of them all. Is there any such thing as acquired immunity to this?
Out of Wuhan, out of South Korea, out of the crew of the stricken USS Theodore Roosevelt, we get reports of people who had been sick, then tested negative, then got sick again.
Does that mean that there is no immunity, or at least wasn’t for these individuals? Or does it mean that the viruses actually never went away, that they may have left the sinuses which were tested but they held out in the guts,, and perhaps in other organs?
Yes, this pandemic arrived on the scene and mostly presented itself as a respiratory infection. Now, however, we know that the new coronavirus disease attacks the kidneys, the heart, the brain and the digestive system as well as the lungs, sinuses and throat.
So do the sinus swabs give false negatives when the infection is hiding out in the intestines? Or do people fully eliminate their infections but remain vulnerable to re-infecting themselves? Perhaps, reinfecting by using a privy instead of a bathroom with modern plumbing? Perhaps, wiping themselves after a bowel movement and thinking themselves clean enough, but unable to do a proper job of it for lack of running water?
Lingering and hiding infections versus recurring infections is a question with major implications in the search for a vaccine.
Infected feces raise many sorts of environmental health questions. If the sewers of some Panama City neighborhood overflow onto the streets, can someone who steps in it become infected by the coronavirus? If a rainstorm overflows a rural privy and the diluted excrement makes its way into a watershed, does somebody bathing or drinking downstream run the risk of an infection from that?
The public health implications that ought to be tracked down and tested grow from just about any question that is answered. This expanding research is going on all over the world. Including here, at The Crossroads of The World.
During this quarantine Claro has increased the cost of Internet service for The Panama News by at least six-fold. To help with that, there are two things you might do:
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World Health Organization Director-General Tedros Adhanom Ghebreyesus. UN photo.
With determination to triumph over this common threat
by Dr. Tedros, PhD
My sisters and brothers,
As you know, this year is the International Year of the Nurse and the Midwife.
This Assembly was intended to be a moment of recognition for the incredible contribution that nurses and midwives make every day, in every country.
The pandemic has robbed us of that opportunity. But it has only served to illustrate why nurses, midwives and all health workers are so important.
Nurses and midwives have been on the frontlines of the fight against COVID-19, putting themselves in harm’s way. Many have made the ultimate sacrifice in service of humanity.
Last month, WHO published the first State of the World’s Nursing report.
It shows that the world is facing a shortfall of six million nurses to achieve and sustain universal health coverage.
But it also provides a roadmap for governments to invest in nursing, to fill that gap and progress towards universal health coverage. Health for all.
Now more than ever, the world needs nurses and midwives.
Please join me, wherever you are, in standing to show your appreciation for these true health heroes.
Here, in 1958 in La Chorrera, the WHO assisted the Government of Panama to strengthen rural health services and to develop effective methods of health administration suited to the social, economic and cultural needs of the population. Nurse Ethel Springer is helping to update the skills of rural midwife Dona Lola, 73 years old, by practicing umbilical cord severance on a rag doll. WHO photo.
We have come together as the nations of the world to confront the defining health crisis of our time.
We come in grief for those we have lost.
We come with concern for those still fighting for their lives.
We come with determination to triumph over this common threat.
And we come with hope for the future.
The world has confronted several pandemics before. This is the first caused by a coronavirus.
This a dangerous enemy, with a dangerous combination of features: this virus is efficient, fast, and fatal.
It can operate in the dark, spread silently if we’re not paying attention, then suddenly explode if we aren’t ready. And moves like a bushfire.
We have seen the same pattern repeated in cities and countries the world over.
We must treat this virus with the respect and attention it deserves.
More than fpur-and-a-half million cases of COVID-19 have now been reported to WHO, and more than 300,000 people have lost their lives.
But numbers don’t even begin to tell the story of this pandemic.
Each loss of life leaves a scar for families, communities and nations.
The health impacts of the pandemic extend far beyond the sickness and death caused by the virus itself.
The disruption to health systems threatens to unwind decades of progress against maternal and child mortality, HIV, malaria, tuberculosis, noncommunicable diseases, mental health, polio and many other of the most urgent health threats.
And yet this is so much more than a health crisis.
Lives and livelihoods have been lost or upended.
Hundreds of millions of people have lost their jobs.
Fear and uncertainty abound.
The global economy is headed for its sharpest contraction since the Great Depression.
The pandemic has brought out the best – and worst – of humanity: Fortitude and fear; solidarity and suspicion; rapport and recrimination.
This contagion exposes the fault lines, inequalities, injustices and contradictions of our modern world.
It has highlighted our strengths, and our vulnerabilities.
Science has been hailed and scorned.
Nations have come together as never before, and geopolitical divisions have been thrown into sharp relief.
We have seen what is possible with cooperation, and what we risk without it.
The pandemic is a reminder of the intimate and delicate relationship between people and planet.
Any efforts to make our world safer are doomed to fail unless they address the critical interface between people and pathogens, and the existential threat of climate change that is making our earth less habitable.
For all the economic, military and technological might of nations, we have been humbled by this very small microbe.
If this virus is teaching us anything, it’s humility. Time for humility.
Six months ago, it would have been inconceivable to most that the world’s biggest cities would fall eerily quiet; that shops, restaurants, schools and workplaces would be closed; that global travel would grind to a standstill; that simply shaking hands could be life-threatening.
Terms once used only by epidemiologists, like “reproduction number,” “physical distancing” and “contact tracing” have become common parlance.
In less than five months, the pandemic has encircled the globe.
All countries have faced challenges in coming to grips with this virus, rich and poor, large and small.
Low-income countries, small island developing states and those suffering from violence and conflict are trying to confront this threat in the most challenging of circumstances.
How do you practice physical distancing when you live in crowded conditions?
How do you stay at home when you have to work to feed your family?
How do you practice hand hygiene when you lack clean water?
Some countries are succeeding in preventing widespread community transmission.
“Some have issued stay-at-home orders and imposed severe social restrictions to suppress community transmission.
Some are still bracing for the worst.
And some are now assessing how to ease the restrictions that have exacted such a heavy social and economic toll.
WHO fully understands and supports the desire of countries to get back on their feet and back to work.
It’s precisely because we want the fastest possible global recovery that we urge countries to proceed with caution.
Countries that move too fast, without putting in place the public health architecture to detect and suppress transmission, run a real risk of handicapping their own recovery.
Early serology studies are painting a consistent picture: even in the worst-affected regions, the proportion of the population with the tell-tale antibodies is no more than 20 percent, and in most places, less than 10 percent.
In other words: the majority of the world’s population remains susceptible to this virus.
The risk remains high and we have a long road to travel.
Over the past few months, we have learned an enormous amount about how to prevent infections and save lives.
But there is no single action that has made the difference.
Not testing alone. Not contact tracing alone. Not isolation, quarantine, hand hygiene or physical distancing alone.
The countries that have done well have done it all.
This is the comprehensive approach that WHO has called for consistently.
There is no silver bullet. There is no simple solution. There is no panacea. There is no one-size-fits-all approach.
It takes hard work, fidelity to science, learning and adapting as you go, and difficult decisions, of course.
But there are many common components that must be part of every national strategy:
A whole-of-government and whole-of-society response that engages and empowers people and communities to keep themselves and others safe;
The commitment and capacity to find, isolate, test and care for every case, and trace and quarantine every contact;
And special attention to vulnerable groups like people living in nursing homes, refugee camps, prisons and detention centers.
Military chaplains gather at the Holyoke Soldiers Home in Massachusetts, where dozens of veterans died as COVID-19 swept through the facility. Massachusetts Air National Guard photo.
Since day one, WHO has stood shoulder-to-shoulder with countries in these darkest of hours.
WHO sounded the alarm early, and we sounded it often.
We notified countries, issued guidance for health workers within 10 days, and declared a global health emergency — our highest level of alert — on the 30th of January. At the time, there were less than 100 cases and no deaths outside China.
We have provided technical guidance and strategic advice, based on the latest science and experience.
We have supported countries to adapt and implement that guidance.
We have shipped diagnostics, personal protective equipment, oxygen and other medical supplies to more than 120 countries.
We have trained more than 2.6 million health workers, in 23 languages.
We have driven research and development, through the Solidarity Trial.
We have called for equitable access to vaccines, diagnostics and therapeutics through the ACT Accelerator.
We have informed, engaged and empowered people.
We have fought the infodemic, combating myths with reliable information.
And we have called consistently for the two essential ingredients for conquering this virus: national unity and global solidarity.
Uh huh. A vast conspiracy to “control you” by creating an epidemic. A sinister plot involving the world’s nearly 200 governments, some of them at war with one another. Some of the alleged conspirators hate each other, and if they could control you would have you do very different things. But in a world of “alternative facts,” paranoia sells. Such is the nature of the infodemic.
We all have lessons to learn from the pandemic.
Every country and every organization must examine its response and learn from its experience.
WHO is committed to transparency, accountability and continuous improvement. For us, change is a constant.
In fact, the existing independent accountability mechanisms are already in operation, since the pandemic started.
The Independent Oversight Advisory Committee has today published its first report on the pandemic, with several recommendations for both the Secretariat and Member States.
In that spirit, we welcome the proposed resolution before this Assembly, which calls for a step-wise process of impartial, independent and comprehensive evaluation.
To be truly comprehensive, such an evaluation must encompass the entirety of the response by all actors, in good faith.
So, I will initiate an independent evaluation at the earliest appropriate moment to review experience gained and lessons learned, and to make recommendations to improve national and global pandemic preparedness and response.
But one thing is abundantly clear. The world must never be the same.
We do not need a review to tell us that we must all do everything in our power to ensure this never happens again.
Whatever lessons there are to learn from this pandemic, the greatest failing would be to not learn from them, and to leave the world in the same vulnerable state it was before.
If there is anything positive to come from this pandemic, it must be a safer and more resilient world.
This is not a new message.
Reviews after SARS, the H1N1 pandemic and the West African Ebola epidemic highlighted shortcomings in global health security, and made numerous recommendations for countries to address those gaps.
Some were implemented; others went unheeded.
The SARS outbreak gave rise to the revision of the International Health Regulations, in 2005.
The H1N1 pandemic saw the creation of the Pandemic Influenza Preparedness Framework.
And the Ebola outbreak of 2014 and 15 led to the establishment of the Pandemic Emergency Financing Facility, the WHO Emergencies Program and the Independent Oversight Advisory Committee.
The world doesn’t need another plan, another system, another mechanism, another committee or another organization.
It needs to strengthen, implement and finance the systems and organizations it has – including WHO. Many leaders who have spoken today have raised these issues: implementing, supporting WHO, and financing.
The world can no longer afford the short-term amnesia that has characterized its response to health security for too long.
The time has come to weave together the disparate strands of global health security into an unbreakable chain – a comprehensive framework for epidemic and pandemic preparedness.
The world does not lack the tools, the science, or the resources to make it safer from pandemics. What is has lacked is the sustained commitment to use the tools, the science and the resources it has.
That must change, and it must change today.
Today I am calling on all nations to resolve that they will do everything it takes to ensure that the 2020 coronavirus pandemic is never repeated.
I am calling on all nations to invest in strengthening and implementing the many tools at our disposal – especially the global treaty that underpins global health security: the International Health Regulations.
To be successful, we must all commit to mutual ownership and accountability.
One way to do that, proposed by the Africa Group last year, is through a system of universal periodic review, in which countries agree to a regular and transparent review of each nation’s preparedness.
South Africa’s President Cyril Ramaphosa attend the online 2020 World Health Assembly. The novel coronavirus pandemic is so severe it was considered too dangerous to gather the world’s health and political authorities in one place. South African government photo.
Since my election at this assembly three years ago, I have made a priority of transforming WHO into an organization that is agile and responsive, focused on outcomes and impact.
Two years ago, I presented – and this Assembly approved – the cornerstone of our transformation: WHO’s 13th General Program of Work.
At its heart are the ambitious “triple billion” targets:
1 billion more people enjoying better health and well-being.
1 billion more people benefiting from universal health coverage;
And 1 billion more people better protected from health emergencies.
These are the targets that the world has set itself to achieve by 2023, to get on track and stay on track for the Sustainable Development Goals.
The WHO Results Report, launched today, provides a comprehensive picture of what WHO, its Member States and partners have achieved in the past two years.
On healthy populations, we’ve made important progress to improve the air people breathe, the food they eat, the water they drink, the roads they use, and the conditions in which they live and work are the most important, actually, in bringing health.
On universal health coverage, the world came together last year to endorse the political declaration on UHC – an unprecedented commitment to the ideal of health for all.
We have expanded access to prevention, testing and treatment for HIV, tuberculosis, malaria, hepatitis C, hypertension, diabetes, cancer and more.
And to keep the world safe, WHO has investigated and, when necessary, responded to more than 900 events in 141 countries.
That includes coordinating a huge and complex response to the Ebola outbreak in the Democratic Republic of the Congo, complicated by violence, a mobile population and a weak health system.
All of these efforts have been supported by an increased focus on science, evidence and data.
In the coming year, we will launch the WHO Academy to provide training for millions more health workers around the world.
And the WHO Foundation will be launched in the next few weeks, to broaden WHO’s donor base.
I am proud of the progress WHO has made in these and many other areas. However, much work remains to be done.
Even before COVID-19, the world was off track for the SDGs.
The pandemic threatens to set us back even further.
It exploits and exacerbates existing gaps in gender equality, poverty, hunger and more.
Already we have seen the impact of the pandemic on immunization campaigns and many other essential health services.
But the challenges we face cannot be an excuse to abandon hope of achieving the “triple billion” targets or the SDGs.
On the contrary, they must serve as motivation to redouble our efforts, and to work aggressively in pursuit of the healthier, safer, fairer world we all want.
Although COVID-19 is rightly the focus of the world’s attention now, we must not lose focus on sustaining and accelerating other initiatives that have saved millions of lives in recent years – like the work of Gavi, the Vaccine Alliance.
Over the past 20 years, Gavi has supported countries to vaccinate 760 million children, preventing more than 13 million deaths.
Gavi has set an ambitious goal to immunize 300 million more children with 18 vaccines by 2025.
We call on the global community to support Gavi’s upcoming replenishment, hosted by the UK, to ensure that it is fully funded for this life-saving work.
For the time being, the new normal. Photo cc fromwww.vperemen.com (Russia) .
Last week, my friend Dr Suwit from Thailand sent me a message. This is what he said:
“Actually, COVID has demonstrated how WHO’s “triple billion” goals are interconnected.
“Universal health coverage plays big roles in the COVID response in many countries.
“And healthy lives mean less deaths from COVID.”
I couldn’t agree more.
COVID-19 is not just a global health emergency, it is a vivid demonstration of the fact that there is no health security without resilient health systems, or without addressing the social, economic, commercial and environmental determinants of health.
More than ever, the pandemic illustrates why investing in health must be at the center of development. I will repeat this: More than ever, the pandemic illustrates why investing in health must be at the center of development.
We’re learning the hard way that health is not a luxury; it’s a necessity. It is a necessity.
Health is not a reward for development; it is a prerequisite.
Health is not a cost; it’s an investment.
Health is a pathway to security, prosperity and peace.
My brothers and sisters,
40 years ago, the nations of the world came together under the banner of WHO to rid the world of smallpox.
They showed that when solidarity triumphs over ideology, anything is possible.
The COVID-19 pandemic is posing a similar threat – not just to human health, but to the human spirit.
We have a long road ahead in our struggle against this virus.
The pandemic has tested, strengthened and strained the bonds of fellowship between nations.
But it has not broken them.
The COVID-19 pandemic is asking us two fundamental questions:
What sort of world do we want?
And what sort of WHO do we want?
The answer to the first question will determine the answer to the second.
Now more than ever, we need a healthier world.
Now more than ever, we need a safer world.
Now more than ever, we need a fairer world.
Healthy, safe and fair.
And now more than ever, we need a stronger WHO.
There is no other way forward but together.
During this quarantine Claro has increased the cost of Internet service for The Panama News by at least six-fold. To help with that, there are two things you might do:
1: Send money to the The Panama News Internet number, which is 62757611, via Ding at https://www.ding.com/
2. Buy Claro prepaid phone cards, scratch off the covering on the code numbers and email those numbers to fund4thepanamanews@gmail.com
To fend off hackers, organized trolls and other online vandalism, our website comments feature is switched off. Instead, come to our Facebook page to join in the discussion.
Durante esta cuarentena Claro ha aumentado el costo del servicio de Internet para The Panama News en por menos seis veces. Para ayudar específicamente con eso, hay dos cosas que puede hacer:
1: Envíe dinero al número de Internet de The Panama News, que es 62757611, a través de Ding en https://www.ding.com/es
2. Compra Claro tarjetas telefónicas prepagas, raspe la cubierta de los números de código y envíe esos números por correo electrónico a fund4thepanamanews@gmail.com
To fend off hackers, organized trolls and other online vandalism, our website comments feature is switched off. Instead, come to our Facebook page to join in the discussion.
Para defendernos de los piratas informáticos, los trolls organizados y otros actos de vandalismo en línea, la función de comentarios de nuestro sitio web está desactivada. En cambio, ven a nuestra página de Facebook para unirte a la discusión.
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These announcements are interactive. Click on them for more information.
Estos anuncios son interactivos. Toque en ellos para seguir a las páginas de web.
Noted health expert Q says it’s OK — it MUST be true.
Understandable but nonetheless troubling: Facebook’s ban on in-person events
by David Greene — Electronic Frontier Foundation (EFF)
We’re closely watching how Facebook enforces its newly-announced policy that limits speech by users who are organizing public protests. This policy is deserving of special attention since it effects free expression on two levels: the organization of the protest itself, and the speech about it. This new policy adds to Facebook’s overall content moderation burden at a time when the company is already unable to keep up with user reports and appeals. One of the great benefits of Facebook is that it is a powerful and affordable organizing tool — therefore, the potential consequences of this policy are serious.
The new policy, first reportedbyjournalists, has been added to Facebook’s COVID-19 Policy Updates & Protections Page. Of the policy, Facebook writes:
Under our coordinating harm policy, we’re removing content that:
Advocates for in-person meetings or events against government health guidance. This does not include discussion and debate of public policy or proposed new guidance from policymakers and elected officials.
Coordinates in-person events or gatherings that encourage people with COVID-19 to join.
Although we understand Facebook’s motivations here, this policy is troubling for several reasons.
First, as with all content removal decisions, Facebook has still not fully implemented the Santa Clara Principles, and is currently failing to provide sufficient avenues to appeal removal decisions.
Second, under the best circumstances, content moderation is extremely difficult to do well. It’s full of tricky context, huge grey areas, and impossible line-drawing. Facebook moderates a ton of content — the result of which is hugely problematic, and not for lack of effort. When it comes to complexity, this policy is no different, and indeed, may be even more difficult to implement fairly and consistently.
We had initially hoped Facebook would base these decisions on an objective measure like state or local law; Facebook had previously said they were consulting with local governments and “unless government prohibits the event during this time, we allow it to be organized on Facebook.”
But the written policy Facebook has adopted uses instead the hazier standard of “government health guidance,” which seems to incorporate gatherings that are discouraged though not legally prohibited. Granted, even relying on law would involve a thousand difficult decisions. But laws at least aim for some level of precision. Under US law, for example, laws that restrict First Amendment-protected activity like protests must meet an even higher level of precision: complete limits on gatherings, irrespective of content, must be justified by an important governmental interest and leave open ample means of communication; limits on some but not all gatherings, including those that disfavor expressive gatherings like protests, likely have to be proven to be necessary and the least speech restrictive alternative to advancing a critical public interest. But guidelines, being hortatory and unenforceable, do not.
But even if such standards were precise, the task Facebook has burdened itself with is daunting. There are thousands of these guidelines in the US alone — and thousands more worldwide — with many variations among them. What is permissible in one town may, because of slight variations in the guidelines, be impermissible in the next town over.
And compounding this and every content moderation-related problem now is the increased use of automated decision-making. As we’ve previously written, the current uptick in automated content moderation is understandable given the circumstances, but nevertheless troubling — and must be treated as a temporary measure to be rolled back as soon as it’s safe for moderators to return to work.
Realistically, Facebook is probably mostly targeting events that specifically urge the flouting of social distancing rules, that specifically call for prohibited crowding and defiance of public health measures. Perhaps they wrote their policy to be fastidiously viewpoint-neutral, wanting to avoid, rightfully, a policy that banned only protests against shelter-in-place rules. They seem to try to address this by including an explanation that the policy does not restrict “discussion and debate of public policy or proposed new guidance from policymakers and elected officials.” But if this is the case, we should also be concerned by the existence of a broadly written policy when they envision only limited enforcement.
COVID-19 is compounding content moderation impossibilities in numerous ways. This Events Policy is another one, and it is sure to result in mistakes and angry users. That’s why we recommend that companies roll back any policy changes made in light of COVID-19.
During this quarantine Claro has increased the cost of Internet service for The Panama News by at least six-fold. Used to be, one could go to one of their offices and load the chip in the wireless modem for $15 plus tax and get 30 days of service. Loading that amount in the chip using cards according to the instructions that come through a cell phone, you get just a few days of service. To help keep The Panama News online in the face of that, there are two things you might do:
1: Send money do the The Panama News Internet number, which is 62757611, via Ding athttps://www.ding.com/
2. Buy Claro prepaid phone cards, scratch off the covering on the code numbers and email those numbers tofund4thepanamanews@gmail.com
To fend off hackers, organized trolls and other online vandalism, our website comments feature is switched off. Instead, come to our Facebook page to join in the discussion.
The first coronaviruses known to infect humans were discovered more than half a century ago – so why are there no vaccines against these viruses? Should we be optimistic that an effective vaccine will be developed now?
SARS-CoV-2, the recently discovered coronavirus that causes COVID-19, is similar enough to other coronaviruses, so scientists make predictions about how our immune system might deal with it. But its novelty warrants its own careful study. Similar to Sars and Mers that cause severe acute respiratory syndrome, the novel coronavirus has emerged from animals and can cause damage to the lungs and sometimes other organs.
Why don’t we have a vaccine against other human coronaviruses? The emergence of Sars and Mers, in 2002 and 2012 respectively, were either quashed relatively quickly or affected small numbers of people. Despite the interest from keen virologists, there was no economic incentive to develop a vaccine for these diseases as they posed a small threat at the time. Virologists with an interest in coronaviruses were struggling to secure funding for their research.
In contrast, COVID-19 has caused huge disruption around the world. As a result, at least 90 vaccines are under development, withsome already in human trials.
How a vaccine works
A vaccine gives our body a harmless flavor of the virus, alerting the immune response to generate antibodies and/or cellular immunity (T cells) ready to fight the infection. The idea is that we can then deploy a ready-made defense system next time we encounter the virus, and this spares us from severe symptoms. We know that most people who have recovered from COVID-19 have detectable antibodies in their blood.
We don’t know if these antibodies are fully protective, but a vaccine still has the potential to elicit powerful neutralizing antibodies and scientists will evaluate these following vaccination. Researchers will also look for potent T cell responses in the blood of vaccinated people. These measurements will help scientists predict the efficacy of the vaccine, and will be available before a vaccine is approved.
The best way to evaluate a vaccine, of course, is to judge how well it protects people from infection. But exposing vulnerable groups to the virus is far too risky, so most vaccines will be tested in younger people with no underlying health problems. There are ethical considerations for deliberately infecting a healthy person with a potentially dangerous virus for a vaccine trial, and these need to be considered carefully.
In the course of a pandemic, a vaccinated volunteer may become infected with the novel coronavirus, especially if they are a healthcare worker. It will take time to gather data on protection following infection and compare them to people that received a placebo vaccine.
Vaccine challenges
The ideal vaccine should protect everyone and cause lifelong defenses with a single dose. It would be quick to produce, affordable, easy to administer (nasal or oral administration) and wouldn’t need refrigeration, so non-specialists can distribute it to hard-to-reach parts of the world. In reality, we don’t fully understand how to produce a vaccine that induces long-lived protective immunity for different viruses. For some infections, we need to administer booster vaccinations.
Ageing comes with a tired immune system that struggles to respond to vaccination, and this is also the case for people with weakened immune systems, so it is difficult to protect the most vulnerable. Therefore, vaccination programs that protect over 80% of the population can reduce the incidence of virus spreading and protect the vulnerable by proxy, through herd immunity. Currently, the percentage of people who may have had COVID-19 in different parts of the world varies, but this is hard to estimate because of test availability.
Scientists test and confirm a vaccine’s safety before it is approved. We appreciate that in some viral infections, existing antibodies from an earlier infection with the same type of virus can cause more severe disease. However, there is no strong evidence for any adverse effects of antibodies for SARS-CoV-2 infection.
Within reach
Here are some reasons to be optimistic. One, this virus can be cured. Unlike some viruses such as HIV that embed their genome in our own and make fresh copies of themselves after immune elimination, we know that SARS-CoV-2 is unable to persist in this way.
Two, most infected patients develop antibodies and there is evidence of virus-specific T cell responses. Although we don’t know if these responses are protective yet, these are precisely the responses that can lead to immunological memory, the cornerstone of vaccination. Vaccine products will be refined and enriched to induce more potent immune responses than natural infection.
Three, coronaviruses mutate slower than viruses such as influenza, and we know from Sars and Mers that antibodies can persist for at least one to two years following recovery. This is good news for an effective vaccine that may not require updating for quite some time.
There are more reasons to be upbeat. Scientists are testing several approaches so there is a higher probability of success, and pharmaceutical companies have been engaged early, scaling up production and working out logistics for distribution even before there is evidence the vaccine will work. This is worth the investment because resources can be quickly repurposed for the most promising vaccines following the first clinical trials.
A coronavirus vaccine is within our reach, and it is our best hope to stem transmission and generate herd immunity to protect the most vulnerable. Taking away its hosts for replication, we can eradicate this virus from the human population just as vaccination previously eradicated smallpox.
During this quarantine Claro has increased the cost of Internet service for The Panama News by at least six-fold. Used to be, one could go to one of their offices and load the chip in the wireless modem for $15 plus tax and get 30 days of service. Loading the chips using cards according to the instructions that come through a cell phone, you get just a few days of service. To help specifically with that, there are two things you might do:
1: Send money do the The Panama News Internet number, which is 62757611, via Ding at https://www.ding.com/
2. Buy Claro prepaid phone cards, scratch off the covering on the code numbers and email those numbers to fund4thepanamanews@gmail.com
To fend off hackers, organized trolls and other online vandalism, our website comments feature is switched off. Instead, come to our Facebook page to join in the discussion.
