Monthly Archives: July 2020

Revaluing the Oceans – Architecture – e-flux – E-Flux

Posted: July 27, 2020 at 4:23 am

The oceans throughout history provided seemingly inexhaustible fish for people brave and skillful enough to exploit them. Whenever fish catches declined, fishers would sail farther and farther from home to meet their needs.1 Nowadays the entire global ocean is accessible. Large factory ships and the magic of refrigeration have allowed fishers to venture out for months or years, and more efficient and diverse ways of fishing have increased catches with little care or understanding about the incremental reduction of fish stocks.2 Before the middle of the twentieth century, no one but a few scientists worried about how long the bounty could last, until suddenly, everything began to collapse. Mini wars over fishing rights between Iceland and the United Kingdom in the 1960s and 1970s, along with increasingly protective measures by other nations, led to the unilateral establishment of exclusive economic zones (EEZs) to keep foreign fishers away, the legitimacy of which were formally recognized in 1982 under the auspices of the United Nations Convention of the Law of the Sea. Yet even still, as in Newfoundland, fisheries kept collapsing, with tragic consequences for entire communities.

The great majority of fisheries data come from coastal ecosystems including estuaries, marsh and mangrove wetlands, seagrass meadows, kelp forests, and coral reefs. In spite of great differences in their inhabitants, the dominant predators in each of these environments were historically large animals, including some combination of killer whales, sharks, seals, crocodiles, predatory fishes like tunas and sharks, and seabirds.3 Nowadays, however, most of these animals are so severely depleted as to be ecologically extinct. Humans have taken their place as the dominant predators at almost all trophic levels above the zooplankton.4 There is even a major fishery for krill in Antarctica, which are critically important for the survival of whales, without the necessary ecological data for an adequate stock assessment to know what is sustainable.5

Biomass of groundfish and sharks has been diminished by an order of magnitude in the northwest Atlantic.6 Similar depredations have affected coral reefs, kelp forests, estuaries and coastal seas, and the high seas.7 Many fisheries biologists originally claimed that the depletions of fish stocks were overstated, but a detailed assessment by the US National Research Council strongly supported the original claims.8 It is now generally accepted that two-thirds of global fisheries are overfished and getting worse, while many of the remaining, better-managed fisheries are not yet sufficiently recovered to be economically viable.9

Global fish catches are declining in spite of increased capacity supported by misguided government subsidies that only accentuate the problem.10 The greatest losses are for large-scale industrial fisheries, whereas artisanal catches appear to be more sustainable. Risks of biological extinction are also increasing for large animals.11 Caribbean Monk seals have already been lost, and their Hawaiian and Mediterranean counterparts are gravely threatened.12 Killer whales are rapidly diminishing globally, especially those species that depend on highly specific overfished prey like salmon.13 Caribbean sea turtles have declined in abundance 100-fold, and Caribbean crocodiles are threatened to endangered throughout most of their range.14 Sharks are globally threatened with losses of numerous species exceeding 90% or more.15

The oceans have long been the terminal point for our garbage, excrement, and chemicals. Coastal pollution most obviously began in the stench of estuaries like New York Harbor, which by the nineteenth century had become serious hazards to human health.16 Soon afterwards, entire semi-enclosed seas like the Baltic and Adriatic seas, Chesapeake Bay, and embayments of the Mississippi Delta were so polluted by excess nutrients and organic matter that oxygen levels declined, and fish kills were commonplace.17 More recently, the industrial pollution of toxic chemicals and greenhouse gases from burning fossil fuels have extended to the farthest reaches of the oceans and the atmosphere, poisoning tuna and swordfish with mercury and littering the oceans with plastic.18

There are currently more than 500 coastal hypoxic dead zones worldwide that are largely due to massive increases in nutrient runoff from intensive agriculture made possible by cheap nitrogen fertilizer manufactured from petroleum.19 Excess nitrogen runoff fuels population explosions of phytoplankton far beyond the capacity of zooplankton and other suspension feeders to consume them. As a result, the excess phytoplankton die and sink to the seafloor where they are metabolized by microbes, a process that consumes most or all of the oxygen in bottom waters. Animals including fisheries species that cannot swim away die from asphyxia, except for a very few species that can survive in extremely low oxygen conditions.

The structural integrity of coastal marine habitats, from the tropics to the temperate zone, is dependent on the abundance of a small number of structurally dominant species of mangroves, saltmarshes, seagrasses, kelps, and reef corals that stabilize sediments and provide critical shoreline protection from storms.20 They are also important sites of carbon deposition and sequestration, and are important nursery habitats for fisheries.21 Coastal development and climate change effectively kills the environment, reducing biological structural stability and complexity. Global losses have been alarming, reaching 50% for mangroves and 30% for seagrasses.22 Global declines in living coral cover on reefs is also highly variable but commonly exceeds 50% throughout the Caribbean and Indo-Pacific.23

Other increasingly widespread forms of anthropogenic habitat change are more immediately destructive in reducing habitat complexity and biodiversity.24 The most damaging include dynamite fishing on coral reefs to harvest the fish that float to the surface; seabed trawling for shrimp, scallops, and groundfish that transforms biodiverse underwater forests into depauperate level bottoms of mud; and deep seafloor mining that, if it is allowed to proceed, will inevitably destroy seafloor ecosystems for decades and possibly centuries.25 Container ship traffic is also increasing almost exponentially and carries the double risk of fatal collisions with endangered whales and sound pollution that is dangerous for all cetaceans.26 Seismic oil and gas exploration causes even more severe sound pollution that can cause mass mortalities of whales and dolphins.27

Introductions of exotic species are also increasing due to expanding ship traffic, which discharge ever-increasing volumes of ballast water that contain larval stages of invertebrates, fishes, plankton, and pathogens.28 While the data are mostly circumstantial, the first mass mortality of the sea urchin Diadema antillarum occurred next to the Caribbean entrance of the Panama Canal, and the first widespread outbreaks of coral diseases in the Caribbean were recorded from nearby Colombia and adjacent Netherlands Antilles.29 Coral diseases are exacerbated by global warming, but these first Caribbean disease outbreaks occurred two decades before the first reports of coral bleaching due to extreme warming events.30 Introductions also occur due to deliberate or accidental release from aquaria, as with the Indo-Pacific lionfish that has devasted native fish populations of the Caribbean.31

Farmed salmon bones preserved in a laboratory in collaboration with palaeontologists at the University of Bergen, Norway. Michelle-Marie Letelier,Outline for The Bonding (Still #3), 2017. 16mm film transferred to HD. Image courtesy of the artist.

Impacts of climate change due to the burning of fossil fuels are also both direct and indirect, including rising average temperatures, extreme heating events, declining oxygen, ocean acidification, disease outbreaks, and intensification of extreme storms.32 Sea surface temperatures are rising globally, but disproportionately, with the greatest increases in polar seas and semi-enclosed basins in the temperate zones, such as the Gulf of Maine. The latitudinal limits of myriad species are rapidly increasing in response, as in the case of the Humboldt squid, whose northern limit shifted from southern California to the Gulf of Alaska in just a few decades due to a combination of climate change and overfishing that reduced the abundance of predators.33 Most species range shifts are more gradual but pervasive, with great implications for fisheries.34 For example, optimal conditions for Atlantic and Barents Sea cod are moving northward out of traditional fishing grounds and into different international jurisdictions, further exacerbating the consequences of historical overfishing.35 Tropical reef corals are also migrating towards higher latitudes, most strikingly along the southwest coast of Australia, where kelp forests are dying off and being replaced by subtropical species including reef corals.36

As oceans continue to warm, species characteristic of colder polar conditions have nowhere else to migrate and are at risk of extinction. Arctic species and entire ecosystems are increasingly threated by the loss of summer sea ice.37 Populations of polar bears, which historically fed on seals captured at breathing holes, are plummeting, and starving bears are showing up around human settlements where they forage on garbage and potentially whatever else.38 Other effects on polar food webs are still poorly understood, but the collapse of Antarctic krill, for example, would have grave impacts on the baleen whales that feed upon them.39

Global warming is also causing increases in the magnitude and frequency of extreme heating events wherein sea surface temperatures may rise 2 to 3C above normal maxima in just a few months.40 Consequences for reef corals can be catastrophic.41 Healthy reef corals exist in symbiosis with the dinoflagellates within their tissues that are critical to coral nutrition and calcification.42 Extreme heat breaks down this symbiosis, whereby corals evict the symbiont (which leaves them ghostly white, hence bleached). This is commonly fatal to the corals unless symbiosis is reestablished within a matter of weeks. Mass bleaching events are increasingly frequent and severe, raising questions about the very survival of coral reefs. The most recent extreme example was in 20152016 when most corals along the northern Great Barrier Reef bleached and died, and similar mass bleaching and mortality occurred across the Pacific.43 Another example is the enormous blob of hot water that appeared in the northeast Pacific in 2014 that was associated with collapses in species abundance and outbreaks of diseases.44

Climate change also sets off a cascading series of indirect effects that magnify its impact. The impact of coral diseases has greatly increased, especially in connection with mass bleaching events.45 Outbreaks of coral diseases are especially impactful on polluted reefs and those where overfishing has resulted in population explosions of fleshy algae, which have been shown experimentally to increase the vulnerability of corals to disease.46 In contrast, disease outbreaks are comparatively rare on unpolluted reefs in marine protected areas with abundant grazing fishes. Lobsters along the northeast coast of North America are also more vulnerable to shell wasting disease as waters warm, effectively wiping out the fishery in Long Island Sound.47

Oxygen concentrations are declining in the open ocean because warming surface waters makes them lighter, which in turn slows down the vertical mixing of the oceans; a runaway process that decreases the rate of oxygen transport to the deep sea and upwelling of nutrients to the sea surface.48 The process is especially striking in the equatorial Pacific, and in the Arctic ocean where the cover of summer sea ice is rapidly decreasing.49 Sea ice is highly reflective, dispersing heat back into the atmosphere, whereas seawater absorbs heat and sets up a positive feedback that is effectively irreversible. Reduced nutrient upwelling and declining oxygen are strongly associated with decreases in open ocean productivity, which is the basis for high seas fisheries.50

The ocean is also becoming more acidic. Solution in seawater of increasing atmospheric levels of carbon dioxide has resulted in a global reduction in ocean pH of 0.1 units over the past century.51 The biologic consequences of acidification are still poorly understood and controversial, but could affect the reproduction, physiology, growth, and development of a wide variety of plants and animals. The most obvious impacts are on organisms that form their skeletons of calcium carbonate, which is more easily dissolved under more acidic conditions. This is already affecting shellfish aquaculture industries in the state of Washington, where pH has been steadily declining.52 Aquaculturists have been forced to raise vulnerable juvenile clams and oysters under less acidic conditions in aquaria on land before placing them in the ocean.53 Reef corals are also vulnerable to increasing acidity. Corals grown under present-day more acidic conditions grew 15% more slowly than corals where pH was maintained at historically less acidic conditions.54

Bird watchers were pioneers in the early rise of the conservation movement, with organizations such as the Audubon Society fighting to stop the slaughter of herons and egrets for womens hats.55 Similarly, its not just important for tourism that increasing numbers of people pay good money to see whales up close in the wild and increasingly to SCUBA dive with sharks.56 Besides the thrill of witnessing their power and grace, whale and shark watchers learn about the lives and behavior of these animals and how they fit into ocean ecosystems which, in turn, leads to increased support for their protection.

Horror at the slaughter of whales was a major factor in the establishment of the International Whaling Commission in 1946 which, despite persistent opposition from a few countries, has resulted in dramatic recoveries of most whale species.57 In addition to the ethical issues inherent in the mass slaughter of such animals, we now know that the great whales were once (and increasingly are now again) vitally important ecosystem engineers, as predators of massive amounts of fish and invertebrates, prey for other large predators, highly mobile reservoirs of carbon and nutrients, and as carcasses, sources of energy and habitat in the deep sea.58

Similar public concerns about the loss of other marine mammals were a driving factor in the enactment of the United States Marine Mammal Protection Act in 1972, which prohibits the killing, harm, harassment, or collection of any marine mammal in US territorial waters or by US citizens anywhere else. It also forbids the importation of any marine mammal products or parts. Populations of most marine mammals have varyingly recovered, although their comparative success is strongly associated with their life histories, habitat requirements, and geographic range.59 The depletion of essential forage fish due to overfishing also inhibits their recovery.60 One obvious manifestation of success is the greatly increased abundance of seals along the east and west coasts of the US, where their activities and real or perceived impacts on fisheries are not always welcome. Their rebound has also led to increases in great white sharks near shore, restoring a degree of balance to marine food webs while generating new questions about perceived risks to humans and potential impacts on endangered species.61

Increased tourist revenues have also led to the banning of shark fishing on coral reefs by entire nations because the sharks are vastly more lucrative alive than dead. Economic analysis for the government of Palau demonstrated that diver tourism provides 39% of the countrys total GDP, and that 21% of divers come principally to dive with sharks. The approximately 100 sharks in prime shark dive sites are each worth about US$180,000 per year in tourist revenue, or US$1.9 million during their lifetimes, versus about $110 for their fins and meat.62 Shark diving is a burgeoning global industry that is not without its environmental concerns, although if it is done responsibly, the net conservation value appears to be generally positive.63

New studies of the remarkable behavior and migrations of ocean species are also increasing public support for increased protections.64 The electronic tagging of thousands of individuals of different species of Pacific whales, seabirds, seaturtles, tunas and other large fish, and sharks has revealed striking transoceanic migrations of some species versus others that move much smaller distances.65 Bluefin tuna, for example, move back and forth across the Atlantic and Pacific, hanging out for up to a year or more in the same general location before moving on.66 In contrast, eastern Pacific great white sharks move back and forth between the California coast where they feed on burgeoning seal populations and an area of deep ocean halfway between Baja California and Hawaii dubbed the White Shark Caf, where they feed on vertically migrating fishes and invertebrates.67 Over 200 of these sharks have been tagged and followed for up to twenty years.68

Wild salmon eggs at Arna Sport Fishermens Association, Norway. Michelle-Marie Letelier,Outline for The Bonding (Still #5), 2017. 16mm film transferred to HD. Image courtesy of the artist.

Marine protected areas (MPAs) are an increasingly popular and effective conservation strategy for biodiversity and habitat protection when effectively financed, administered, and enforced.69 Unprotected paper parks, however, can do more harm than good by lulling people into thinking everything is fine when it is not.70 MPAs are also controversial from the perspective of fisheries management, with some arguing that MPAs are the most effective tool available versus those who believe that other management tools such as catch shares and gear restrictions are more effective in most cases than simple area closures.71

Cabo Pulmo in the southern Sea of Cortez is one of the most spectacular success stories of an effectively enforced MPA.72 Although it was severely overfished at the time, Cabo Pulmo was designated as a Mexican marine national park in 1995 on the basis of its coral populations. Protections did not become effective until local villagers self-organized to enforce the entire park as a no-take area in the late 1990s. Fish biomass was less than one metric ton per hectare in 1999, comparable to other unprotected areas or paper parks throughout the Gulf of California. Subsequent to the villagers protection, biomass increased over the following ten protected years to about 4.5 metric tons, while all other areas failed to increase. Biomass and diversity have fluctuated since 2009, in large part due to the community evolving towards a more natural composition that includes greater populations of schooling fishes as well as more abundant corals. The greatest potential threat to Cabo Pulmo is its notorious success, which attracts burgeoning numbers of tourists and development.

A network of nine well enforced no-take MPAs and two partial-take MPAs was established around four of the northern Channel Islands off the coast of California in 2003 and revisited ten years later.73 The biomass of preferred fisheries species approximately doubled within MPAs at three of the four islands, but non-targeted species showed little response. The biomass of targeted species outside the reserves also increased by about one quarter, possibly because of a spillover effect. Similar results were obtained the Cowcod Conservation Areas established in the southern Channel Islands in 2001, where abundances of six of eight targeted species and four of seven non-targeted rockfish species increased regionally from 1998 to 2013.74 Rising temperatures during the study are a complicating factor. Nevertheless, 75% of targeted species but none of the non-targeted species increased inside compared to outside of the MPAs while controlling for environmental factors.

The establishment of very large marine protected areas within exclusive economic zones has increased the area of ocean within MPAs to only 3.5%, about half of which are under strong protection.75 Meanwhile, most ocean ecosystems are hemorrhaging, as major fishing fleets continue to expand their global operations.76 This may be changing, however, as the international community finally begins to seriously consider international governance of the high seas defined as areas beyond national jurisdictions. The first major achievement in this was the agreement to establish the worlds largest marine protected area by the twenty-five-national-member Commission for the Conservation of Antarctic Marine Living Resources.77 The agreement protects all wildlife and bans fishing for overfished krill and Patagonian and Antarctic Toothfish in 600,000 square miles in the Ross Sea for thirty-five years. Much more will have to be done, however, to preserve populations around Antarctica where these species are threatened by overfishing and rapid climate change and have ripple effects on the marine mammals and penguins that depend upon them.

The scientific case for closing the high seas to fisheries is strong. Nearly 98% of global seafood production comes from the exclusive economic zones (EEZs) of individual nations and aquaculture. What does come from the high seas is mostly luxury species such as tuna and billfishes, yet their commercial value is even less.78 Moreover, most high seas fisheries are heavily dependent on government subsidies by a small number of wealthy countries that can afford the enormous costs.79 Closure of the high seas to fishing would therefore have great economic and social benefits in addition to environmental protections of fish stocks and the long-distance migration routes of marine megafauna.80 Most compellingly, the overwhelming majority of high seas fishery species are also major components of fisheries within national EEZs, which means that closure of the high seas to fishing would produce a vast MPA where commercially important species could prosper, reproduce, and spill over into EEZs whose potential catches would increase.81 Further advantages would include simplification of policing the rampant problem of pirate fishing and transfers at sea.82

While commonly overshadowed by bad news, concerted actions to reduce pollution and protect keystone species have resulted in many recoveries of marine populations and ecosystems.83 The installation of modern sewage systems and the reduction in nutrient runoff have varyingly improved water quality, reduced excess planktonic productivity and toxic algal blooms, and restored seagrass meadows, salt marshes, and fisheries in estuaries around the world.84 These efforts demonstrate that even greater progress could be achieved in stabilizing coastal ecosystems if adequate measures are taken to eliminate or greatly reduce pollutant runoff, and most importantly agricultural nutrients.85 Serious efforts to do so have not yet materialized, however, because farmers dont have to pay for what they pollute. There is also a problem of scale in semi-enclosed seas like the Baltic because nutrient buildups in sediments are already so great that simply reducing nutrient runoff may not suffice.

Banning the use of fish pots around Bermuda in 1990, where fish populations had collapsed due to overfishing, resulted in rapid rebounding of fish populations dominated by schools of large parrotfish.86 Since then, abundances have remained high except for the large predatory fish that remain overfished. Coral populations also have steadily increased due to the control of algal populations by the abundant parrotfish. Caribbean coral reefs are generally extremely overfished, but the few places where both fishing and pollution are effectively controlled uniquely support high coral abundance.

Detail of farmed salmon scales, Norway. Michelle-Marie Letelier,Outline for The Bonding (Still #2), 2017. 16mm film transferred to HD. Image courtesy of the artist.

Despite important accomplishments, comprehensive policies are lacking to address the unsustainability of the modern economy that is driving ecosystem collapses and threatening human wellbeing.87 Nature is a complex system, and much of that system as we knew it is irreversibly breaking down.88 Environmental perturbations in one place almost inevitably have repercussions down the line, be it agricultural pollution in the US cornbelt causing the dead zone in the Gulf of Mexico or the effects of runoff and overfishing on outbreaks of disease affecting reef corals. Huge energy and investment in projects to restore populations of corals in Florida and on the Great Barrier Reef are making much progress in terms of the technical details of raising, breeding, and growing corals, but they are also absurdly expensive and small scale, not to mention that putting the corals back into the same nutrient polluted environments and expecting them to somehow survive is folly. More fundamentally, they are bandaids to address the symptoms of ocean decline rather than addressing the fundamental root causes of the ocean crisis: global warming, overfishing, and land-based pollution.89

The most encouraging development towards adapting to and managing these realities is that large scale efforts to decarbonize the global economy are beginning to gain traction despite political intransigence, not least because, in addition to its obvious advantages for human health and the environment, green energy is financially a better option than heavily subsidized fossil fuels.90 California, the fifth largest global economy, is committed to be carbon neutral by 2045 and is well on track, and electric cars are becoming a more practical alternative to gasoline and diesel. The outstanding question is how rapidly opposition can be overcome to speed things up and take actions on the appropriate scales.

This paper is adapted from a presentation at the University of Utah submitted to Island Press. The author is grateful to Jennifer Jacquet for her helpful review of the manuscript.

Oceans in Transformation is a collaboration between TBA21Academy and e-flux Architecture within the context of the eponymous exhibition at Ocean Space in Venice by Territorial Agency and its manifestation on Ocean Archive.

Jeremy Jackson is Senior Scientist Emeritus at the Smithsonian Institution and Professor of Oceanography Emeritus at the Scripps Institution of Oceanography.

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How to stop China completing its takeover of the South China Sea – The Strategist

Posted: at 4:23 am

China appears to be accelerating its campaign to control the South China Sea and the Senkaku Islands in the East China Sea. Beijing does itself no favours with the highly ambiguous nature of its claims in the region. Its internationally condemned nine-dash line sometimes appears to be delineating its claims to the island features within it. More ominously, Beijing sometimes insinuates the line as a maritime delineation, carving out sovereign control of the sea itself as well as the airspace above it.

Chinas ongoing militarisation of many artificial features in disputed waters is well known. A less well known, but highly consequential implication of this militarisation is the vastly increased capacity it gives China to project power not only to control the reefs and rocks of the South China Sea, but, in the future, to assert control over the high seas and airspace above it. Beijing is vocal about its opposition to innocent passage and other military activities within its 200-nautical mile exclusive economic zones.

Beijing has tried hard to keep its dispute resolution efforts focused on bilateral negotiations between itself and the various claimants, effectively fracturing a united response by ASEAN. Pushback in the region is only now beginning. Chinas sweeping claims also impact many countries that lie far beyond the shores of the South China Sea. The US, Japan, Australia, India and many others around the world have critical interests in using the sea directly for economic, scientific and military purposes. More urgently, maintaining an open and free system of movement through the high seasand in the future, in outer spaceis of critical importance.

The decisive rejection of Chinas claims in the South China Sea by an arbitral tribunal under the UN Convention on the Law of the Sea in 2016 only accelerated Beijings continued bad-faith efforts to construct features, militarise them, and extend administrative control over others presence and activities to the furthest reaches of the nine-dash line. In fact, the ruling decisively rejects both Chinas claims to many rocks and maritime features and the idea that these islands can generate territorial seas and exclusive economic zones.

This studied strategic ambiguity by China (on display on other fronts as well) should encourage the international community to confront an alternative and altogether darker explanation for Beijings behaviourthat it is building forces and positions in the region so that over the long term it can assert sovereign authority over the South China Sea.

This interpretation of Chinas actions, though difficult to accept, should be considered as a possibility in military and strategic planning efforts around the world with an eye towards avoiding this worst-case outcome. It is important to remember that the scope and scale of Chinas claims are unprecedented in international law and have no real analogue anywhere else on earth. An unwillingness to confront this scenario risks ceding Beijing permanent control over economic and military activities over a large and critical section of the worlds oceansand beyond.

The South China Sea is a third larger than the Mediterranean Sea and more than twice as large as the Gulf of Mexico. Acknowledging Chinas sweeping claims to sovereignty over this massive space would increase the possibility of a future international environment in which ever larger portions of the global commons are cut off and controlled by individual nations.

Either the international community believes in maintaining a free and open global commons and protects international law or it doesnt. If it doesnt, then Chinas potential annexation of this vast space will guarantee similar claims over the worlds oceans. To foreclose on this future will require an active and aggressive response by the widest grouping of states possible. Regardless of how individual claims over the various land features in the South China Sea are resolved, the entire globe has a stake in free and open access to the region.

For this reason, the US, along with all major allies and partners, should explicitly link Chinas own access to the global commons with its behaviour in the South China Sea. Washingtons announcement of its rejection of Beijings maritime claims, underscored by the US Navy dual aircraft carrier strike group exercises in the region, is a good beginning. However, operations in the South China Sea play to Chinas strengths. The US and the widest range of allies and partners in the international community should begin to articulate and apply escalating administrative and technical restrictions globally on Chinese shipping, air travel and transport in and through exclusive economic zones around the world by participating countries.

Restrictions on economic and military transit and scientific exploration should be pre-planned and scalable so that they are similar to Chinese moves in the South China Sea. These allied grey zone competitive activities could be problematic for Beijing; they would drastically increase the cost and complication of accessing the Indo-Pacific region and beyond. For example, contiguous US, Japanese and Philippine zones restrict direct Chinese access to the Western Pacific. This possibility should be communicated to Beijing should it attempt to assert sovereign control in the South China Sea through force.

Securing the highest degree of freedom and access throughout the global commons should be the ultimate goal of this international effort. Focused and reciprocal restrictions on China throughout the exclusive economic zones of the world should be coupled with strong assurances that they remain open for participating nations. Moreover, these restrictions on China should be easily and quickly reversible. When Beijing comes to its senses on the use of the South China Sea, its access to the global maritime commons should be both restored and encouraged.

Although this strategic approach to countering Beijings most aggressive designs in the South China Sea appears to be rather drastic, like-minded nations around the world should be prepared to deliver a decisive shock to Beijings calculations about any gains it may achieve by limiting access to the South China Sea and rejecting the free use of the global commons more generally. Even hinting that a global response on this scale is possible should concentrate minds in Beijing on their strong and growing dependence on the global commons to reach their much vaunted centenary goals. Together, allied nations should encourage China to support an open and free global commons today in the South China Sea.

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Fisheries Subsidies Reform Could Reduce Overfishing and Illegal Fishing, Case Studies Find – The Pew Charitable Trusts

Posted: at 4:22 am

Overfishing is one of the greatest threatsto ocean health, yet for decades many governments have paid subsidies to their fishing fleets, helping them fish beyond levels that are biologically sustainable. Its time to end these harmful subsidies, some of which even support illegal fishing activities. Now, new case studies show that World Trade Organization (WTO) measures to end those harmful payments could help local fishers while increasing global catch.

Not all fisheries subsidies are harmful. Some, for example, might help artisanal fishers survive a lean season, and those payments should be maintained. But studies show that governments are spending $22.2 billion per year on payments that encourage overfishing. These subsidies, paid to help offset the costs of vessel fuel, upgrades, port renovations, and other expenses, enable primarily industrial fleets to fish farther from shore and longer than they otherwise would. A June 2018 study found that without government subsidies, as much as 54% of the present high-seas fishing grounds would be unprofitable.

Fortunately, the global community has recognized this problem and the need to address it: The United Nations Sustainable Development Goal 14 Target 6, which U.N. member governments agreed to in 2015, tasks the WTO with crafting an agreement to end harmful fisheries subsidies. WTO members were on track to finalize this deal at a June meeting but have postponed that conference due to COVID-19.

The new case studies provide the first practical evidence of how curbing subsidy-driven overfishing would improve fishery sustainability and benefit local fishers, their families, and their communities.

To produce the studies, the International Institute for Sustainable Development commissioned researchers to examine fish stock exploitation levels, governance regimes, revenue from landings, income from subsidies, and operating costs in three fisheries: shrimp in Latin America, sardinella in West Africa, and southern longline tuna in the Pacific. The researchers were then asked to examine the economic impacts of possible WTO disciplines, and options for managing these impacts.

Broadly, the studies found that reforming harmful fisheries subsidies could lead to higher yields for local fishers, which in turn could help provide more stable jobs, raise fishers incomes, reduce poverty, and improve food security in local communities.

Incomplete or inadequate reporting often allows governments to obscure the nature of their subsidy programs, creating challenges in evaluating their true impacts. But if governments commit to increased transparency and more complete notifications to the WTO of their subsidy programs, analysts and observers will gain a far better understanding of the potential effects of any new policy.

Here are some of the specific findings from the case studies.

In the Latin American shrimp fisheries:

Key takeaway: WTO disciplines could help artisanal fisheries compete with industrial vessels that may not be profitable without subsidies. Fuel and vessel maintenance subsidies represented 20% to 50% of income for industrial vessels in Mexico and Nicaragua, for example.

In the West African sardinella fishery:

Key takeaway: WTO disciplines could limit the harmful subsidies contributing to the overcapacity and overfishing of sardinella for both sectors. These subsidies cover the costs of fuel, certain capital costs, and access to other countries waters, as well as contribute to allowing illegal, unreported, and unregulated (IUU) fishing, mostly by foreign vessels. Previous studies have estimated that West African fishers are losing up to $2.3 billion in revenue each year due to IUU fishing in the region.

In the western and central Pacific longline tuna fishery:

Key takeaway: Though the impact of WTO disciplines would likely vary in different parts of the fishery, ending subsidies that contribute to overfishing and overcapacity could reduce the overall fishing effort and allow for Pacific island countries to better develop their domestic fishing industries.

WTO members still have a chance to reach a trade deal that could realize unprecedented benefits for the ocean. While new WTO measures might require transition periods to help vulnerable fishers mitigate potential short-term impacts of subsidy removal, meaningful subsidy prohibitions, coupled with improved fisheries management at the national level, could improve economic and environmental conditions in fisheries around the world.

The new case studies show that subsidy reform would improve ocean health and help fishing fleets operate sustainably far into the future.

Isabel Jarrettis a manager and Reyna Gilbert is a senior associate with The Pew Charitable Trusts project to reduce harmful fisheries subsidies.

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Coronavirus disease 2019 – Wikipedia

Posted: at 4:21 am

Infectious respiratory disease caused by severe acute respiratory syndrome coronavirus 2

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).[9] It was first identified in December 2019 in Wuhan, Hubei, China, and has resulted in an ongoing pandemic.[10][11] The first confirmed case has been traced back to 17 November 2019 in Hubei.[12] As of 27 July 2020, more than 16.2million cases have been reported across 188 countries and territories, resulting in more than 648,000 deaths. More than 9.4million people have recovered.[8]

Common symptoms include fever, cough, fatigue, shortness of breath, and loss of smell and taste.[13][5][6][14] While the majority of cases result in mild symptoms, some progress to acute respiratory distress syndrome (ARDS) possibly precipitated by cytokine storm,[15] multi-organ failure, septic shock, and blood clots.[16][17][18] The time from exposure to onset of symptoms is typically around five days, but may range from two to fourteen days.[5][19]

The virus is primarily spread between people during close contact,[a] most often via small droplets produced by coughing,[b] sneezing, and talking.[6][20][22] The droplets usually fall to the ground or onto surfaces rather than travelling through air over long distances.[6][23] Transmission may also occur through smaller droplets that are able to stay suspended in the air for longer periods of time.[24] Less commonly, people may become infected by touching a contaminated surface and then touching their face.[6][20] It is most contagious during the first three days after the onset of symptoms, although spread is possible before symptoms appear, and from people who do not show symptoms.[6][20] The standard method of diagnosis is by real-time reverse transcription polymerase chain reaction (rRT-PCR) from a nasopharyngeal swab.[25] Chest CT imaging may also be helpful for diagnosis in individuals where there is a high suspicion of infection based on symptoms and risk factors; however, guidelines do not recommend using CT imaging for routine screening.[26][27]

Recommended measures to prevent infection include frequent hand washing, maintaining physical distance from others (especially from those with symptoms), quarantine (especially for those with symptoms), covering coughs, and keeping unwashed hands away from the face.[7][28][29] The use of cloth face coverings such as a scarf or a bandana has been recommended by health officials in public settings to minimise the risk of transmissions, with some authorities requiring their use.[30][31] Health officials also stated that medical-grade face masks, such as N95 masks, should be used only by healthcare workers, first responders, and those who directly care for infected individuals.[32][33]

There are no vaccines nor specific antiviral treatments for COVID-19.[6] Management involves the treatment of symptoms, supportive care, isolation, and experimental measures.[34] The World Health Organization (WHO) declared the COVID19 outbreak a public health emergency of international concern (PHEIC)[35][36] on 30 January 2020 and a pandemic on 11 March 2020.[11] Local transmission of the disease has occurred in most countries across all six WHO regions.[37]

Fever is the most common symptom of COVID-19,[13] but is highly variable in severity and presentation, with some older, immunocompromised, or critically ill people not having fever at all.[39][40] In one study, only 44% of people had fever when they presented to the hospital, while 89% went on to develop fever at some point during their hospitalization.[41]

Other common symptoms include cough, loss of appetite, fatigue, shortness of breath, sputum production, and muscle and joint pains.[13][1][5][42] Symptoms such as nausea, vomiting, and diarrhoea have been observed in varying percentages.[43][44][45] Less common symptoms include sneezing, runny nose, sore throat, and skin lesions.[46] Some cases in China initially presented with only chest tightness and palpitations.[47] A decreased sense of smell or disturbances in taste may occur.[48][49] Loss of smell was a presenting symptom in 30% of confirmed cases in South Korea.[14][50]

As is common with infections, there is a delay between the moment a person is first infected and the time he or she develops symptoms. This is called the incubation period. The typical incubation period for COVID19 is five or six days, but it can range from one to fourteen days[6][51] with approximately ten percent of cases taking longer.[52][53][54]

An early key to the diagnosis is the tempo of the illness. Early symptoms may include a wide variety of symptoms but infrequently involves shortness of breath. Shortness of breath usually develops several days after initial symptoms. Shortness of breath that begins immediately along with fever and cough is more likely to be anxiety than COVID-19. The most critical days of illness tend to be those following the development of shortness of breath.[55]A minority of cases do not develop noticeable symptoms at any point in time.[56] These asymptomatic carriers tend not to get tested, and their role in transmission is not fully known.[57][58] Preliminary evidence suggested they may contribute to the spread of the disease.[59] In June 2020, a spokeswoman of WHO said that asymptomatic transmission appears to be "rare", but the evidence for the claim was not released.[60] The next day, WHO clarified that they had intended a narrow definition of "asymptomatic" that did not include pre-symptomatic or paucisymptomatic (weak symptoms) transmission and that up to 41% of transmission may be asymptomatic. Transmission without symptoms does occur.[56]

COVID19 is a new disease, and many of the details of its spread are still under investigation.[6][20][22] It spreads easily between peopleeasier than influenza but not as easily as measles.[20] People are most infectious when they show symptoms (even mild or non-specific symptoms), but may be infectious for up to two days before symptoms appear (pre-symptomatic transmission).[22] They remain infectious an estimated seven to twelve days in moderate cases and an average of two weeks in severe cases.[22] People can also transmit the virus without showing any symptom (asymptomatic transmission), but it is unclear how often this happens.[6][20][22] A June 2020 review found that 4045% of infected people are asymptomatic.[61]

COVID-19 spreads primarily when people are in close contact and one person inhales small droplets produced by an infected person (symptomatic or not) coughing, sneezing, talking, or singing.[22][62] The WHO recommends 1 metre (3ft) of social distance;[6] the US Centers for Disease Control and Prevention (CDC) recommends 2 metres (6ft).[20]

Transmission may also occur through aerosols, smaller droplets that are able to stay suspended in the air for longer periods of time.[24] Experimental results show the virus can survive in aerosol up to three hours.[63] Some outbreaks have also been reported in crowded and inadequately ventilated indoor locations where infected persons spend long periods of time (such as restaurants and nightclubs).[64] Aerosol transmission in such locations has not been ruled out.[24] Some medical procedures performed on COVID-19 patients in health facilities can generate those smaller droplets,[65] and result in the virus being transmitted more easily than normal.[6][22]

When the contaminated droplets fall to floors or surfaces they can, though less commonly, remain infectious if people touch contaminated surfaces and then their eyes, nose or mouth with unwashed hands.[6] On surfaces the amount of viable active virus decreases over time until it can no longer cause infection,[22] and surfaces are thought not to be the main way the virus spreads.[20] It is unknown what amount of virus on surfaces is required to cause infection via this method, but it can be detected for up to four hours on copper, up to one day on cardboard, and up to three days on plastic (polypropylene) and stainless steel (AISI 304).[22][66][67] Surfaces are easily decontaminated with household disinfectants which destroy the virus outside the human body or on the hands.[6] Disinfectants or bleach are not a treatment for COVID19, and cause health problems when not used properly, such as when used inside the human body.[68]

Sputum and saliva carry large amounts of virus.[6][20][22][69] Although COVID19 is not a sexually transmitted infection, direct contact such as kissing, intimate contact, and fecaloral routes are suspected to transmit the virus.[70][71] The virus may occur in breast milk, but it's unknown whether it's infectious and transmittable to the baby.[72][73]

Estimates of the number of people infected by one person with COVID-19, the R0, have varied. The WHO's initial estimates of R0 were 1.42.5 (average 1.95), however an early April 2020 review found the basic R0 (without control measures) to be higher at 3.28 and the median R0 to be 2.79.[74]

Severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) is a novel severe acute respiratory syndrome coronavirus, first isolated from three people with pneumonia connected to the cluster of acute respiratory illness cases in Wuhan.[75] All features of the novel SARS-CoV-2 virus occur in related coronaviruses in nature.[76]Outside the human body, the virus is destroyed by household soap, which bursts its protective bubble.[26]

SARS-CoV-2 is closely related to the original SARS-CoV.[77] It is thought to have an animal (zoonotic) origin. Genetic analysis has revealed that the coronavirus genetically clusters with the genus Betacoronavirus, in subgenus Sarbecovirus (lineage B) together with two bat-derived strains. It is 96% identical at the whole genome level to other bat coronavirus samples (BatCov RaTG13).[46] In February 2020, Chinese researchers found that there is only one amino acid difference in the binding domain of the S protein between the coronaviruses from pangolins and those from humans; however, whole-genome comparison to date[when?] found that at most 92% of genetic material was shared between pangolin coronavirus and SARS-CoV-2, which is insufficient to prove pangolins to be the intermediate host.[78]

The lungs are the organs most affected by COVID19 because the virus accesses host cells via the enzyme angiotensin-converting enzyme 2 (ACE2), which is most abundant in type II alveolar cells of the lungs.[79] The virus uses a special surface glycoprotein called a "spike" (peplomer) to connect to ACE2 and enter the host cell.[80] The density of ACE2 in each tissue correlates with the severity of the disease in that tissue and some have suggested decreasing ACE2 activity might be protective,[81][82][unreliable medical source?] though another view is that increasing ACE2 using angiotensin II receptor blocker medications could be protective.[83] As the alveolar disease progresses, respiratory failure might develop and death may follow.[82][unreliable medical source?]

SARS-CoV-2 may also cause respiratory failure through affecting the brainstem as other coronaviruses have been found to invade the central nervous system (CNS). While virus has been detected in cerebrospinal fluid of autopsies, the exact mechanism by which it invades the CNS remains unclear and may first involve invasion of peripheral nerves given the low levels of ACE2 in the brain.[84][85][unreliable medical source?]

The virus also affects gastrointestinal organs as ACE2 is abundantly expressed in the glandular cells of gastric, duodenal and rectal epithelium[86] as well as endothelial cells and enterocytes of the small intestine.[87][unreliable medical source?]

The virus can cause acute myocardial injury and chronic damage to the cardiovascular system.[88] An acute cardiac injury was found in 12% of infected people admitted to the hospital in Wuhan, China,[44] and is more frequent in severe disease.[89][unreliable medical source?] Rates of cardiovascular symptoms are high, owing to the systemic inflammatory response and immune system disorders during disease progression, but acute myocardial injuries may also be related to ACE2 receptors in the heart.[88] ACE2 receptors are highly expressed in the heart and are involved in heart function.[88][90] A high incidence of thrombosis (31%) and venous thromboembolism (25%) have been found in ICU patients with COVID19 infections, and may be related to poor prognosis.[91][unreliable medical source?][92][unreliable medical source?] Blood vessel dysfunction and clot formation (as suggested by high D-dimer levels) are thought to play a significant role in mortality, incidences of clots leading to pulmonary embolisms, and ischaemic events within the brain have been noted as complications leading to death in patients infected with SARS-CoV-2. Infection appears to set off a chain of vasoconstrictive responses within the body, constriction of blood vessels within the pulmonary circulation has also been posited as a mechanism in which oxygenation decreases alongside the presentation of viral pneumonia.[93][bettersourceneeded]

Another common cause of death is complications related to the kidneys.[93][bettersourceneeded] Early reports show that up to 30% of hospitalized patients both in China and in New York have experienced some injury to their kidneys, including some persons with no previous kidney problems.[94]

Autopsies of people who died of COVID19 have found diffuse alveolar damage (DAD), and lymphocyte-containing inflammatory infiltrates within the lung.[95][unreliable medical source?]

Although SARS-CoV-2 has a tropism for ACE2-expressing epithelial cells of the respiratory tract, patients with severe COVID19 have symptoms of systemic hyperinflammation. Clinical laboratory findings of elevated IL-2, IL-7, IL-6, granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon- inducible protein 10 (IP-10), monocyte chemoattractant protein1 (MCP-1), macrophage inflammatory protein 1- (MIP-1), and tumour necrosis factor- (TNF-) indicative of cytokine release syndrome (CRS) suggest an underlying immunopathology.[44]

Additionally, people with COVID19 and acute respiratory distress syndrome (ARDS) have classical serum biomarkers of CRS, including elevated C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer, and ferritin.[96]

Systemic inflammation results in vasodilation, allowing inflammatory lymphocytic and monocytic infiltration of the lung and the heart. In particular, pathogenic GM-CSF-secreting T-cells were shown to correlate with the recruitment of inflammatory IL-6-secreting monocytes and severe lung pathology in COVID19 patients.[citation needed] Lymphocytic infiltrates have also been reported at autopsy.[95][unreliable medical source?]

The WHO has published several testing protocols for the disease.[98] The standard method of testing is real-time reverse transcription polymerase chain reaction (rRT-PCR).[99] The test is typically done on respiratory samples obtained by a nasopharyngeal swab; however, a nasal swab or sputum sample may also be used.[25][100] Results are generally available within a few hours to two days.[101][102] Blood tests can be used, but these require two blood samples taken two weeks apart, and the results have little immediate value.[103] Chinese scientists were able to isolate a strain of the coronavirus and publish the genetic sequence so laboratories across the world could independently develop polymerase chain reaction (PCR) tests to detect infection by the virus.[10][104][105] As of 4April2020[update], antibody tests (which may detect active infections and whether a person had been infected in the past) were in development, but not yet widely used.[106][107][108] Antibody tests may be most accurate 23 weeks after a person's symptoms start.[109] The Chinese experience with testing has shown the accuracy is only sixty to seventy percent.[110] The US Food and Drug Administration (FDA) approved the first point-of-care test on 21 March 2020 for use at the end of that month.[111] The absence or presence of COVID-19 signs and symptoms alone is not reliable enough for an accurate diagnosis.[112]

Diagnostic guidelines released by Zhongnan Hospital of Wuhan University suggested methods for detecting infections based upon clinical features and epidemiological risk. These involved identifying people who had at least two of the following symptoms in addition to a history of travel to Wuhan or contact with other infected people: fever, imaging features of pneumonia, normal or reduced white blood cell count, or reduced lymphocyte count.[113]

A study asked hospitalised COVID19 patients to cough into a sterile container, thus producing a saliva sample, and detected the virus in eleven of twelve patients using RT-PCR. This technique has the potential of being quicker than a swab and involving less risk to health care workers (collection at home or in the car).[69]

Along with laboratory testing, chest CT scans may be helpful to diagnose COVID19 in individuals with a high clinical suspicion of infection but are not recommended for routine screening.[26][27] Bilateral multilobar ground-glass opacities with a peripheral, asymmetric, and posterior distribution are common in early infection.[26] Subpleural dominance, crazy paving (lobular septal thickening with variable alveolar filling), and consolidation may appear as the disease progresses.[26][114]

In late 2019, the WHO assigned emergency ICD-10 disease codes U07.1 for deaths from lab-confirmed SARS-CoV-2 infection and U07.2 for deaths from clinically or epidemiologically diagnosed COVID19 without lab-confirmed SARS-CoV-2 infection.[115]

Few data are available about microscopic lesions and the pathophysiology of COVID19.[116][117] The main pathological findings at autopsy are:[citation needed]

A COVID-19 vaccine is not expected until 2021 at the earliest.[127] The US National Institutes of Health guidelines do not recommend any medication for prevention of COVID19, before or after exposure to the SARS-CoV-2 virus, outside the setting of a clinical trial.[128][129] Without a vaccine, other prophylactic measures, or effective treatments, a key part of managing COVID19 is trying to decrease and delay the epidemic peak, known as "flattening the curve".[123] This is done by slowing the infection rate to decrease the risk of health services being overwhelmed, allowing for better treatment of current cases, and delaying additional cases until effective treatments or a vaccine become available.[123][126]

Preventive measures to reduce the chances of infection include staying at home, wearing a mask in public, avoiding crowded places, keeping distance from others, washing hands with soap and water often and for at least 20 seconds, practising good respiratory hygiene, and avoiding touching the eyes, nose, or mouth with unwashed hands.[130][131][132][133]

The US Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) recommend individuals wear non-medical face coverings in public settings where there is an increased risk of transmission and where social distancing measures are difficult to maintain.[134][30][135] This recommendation is meant to reduce the spread of the disease by asymptomatic and pre-symtomatic individuals and is complementary to established preventive measures such as social distancing.[30][136] Face coverings limit the volume and travel distance of expiratory droplets dispersed when talking, breathing, and coughing.[30][136] Many countries and local jurisdictions encourage or mandate the use of face masks or cloth face coverings by members of the public to limit the spread of the virus.[137][138][139][140]

Masks are also strongly recommended for those who may have been infected and those taking care of someone who may have the disease.[141] When not wearing a mask, the CDC recommends covering the mouth and nose with a tissue when coughing or sneezing and recommends using the inside of the elbow if no tissue is available.[131] Proper hand hygiene after any cough or sneeze is encouraged.[131]

Social distancing strategies aim to reduce contact of infected persons with large groups by closing schools and workplaces, restricting travel, and cancelling large public gatherings.[142] Distancing guidelines also include that people stay at least 6 feet (1.8m) apart.[143] After the implementation of social distancing and stay-at-home orders, many regions have been able to sustain an effective transmission rate ("Rt") of less than one, meaning the disease is in remission in those areas.[144]

The CDC also recommends that individuals wash hands often with soap and water for at least 20 seconds, especially after going to the toilet or when hands are visibly dirty, before eating and after blowing one's nose, coughing or sneezing. The CDC further recommends using an alcohol-based hand sanitiser with at least 60% alcohol, but only when soap and water are not readily available.[131] For areas where commercial hand sanitisers are not readily available, the WHO provides two formulations for local production. In these formulations, the antimicrobial activity arises from ethanol or isopropanol. Hydrogen peroxide is used to help eliminate bacterial spores in the alcohol; it is "not an active substance for hand antisepsis". Glycerol is added as a humectant.[145]

Those diagnosed with COVID19 or who believe they may be infected are advised by the CDC to stay home except to get medical care, call ahead before visiting a healthcare provider, wear a face mask before entering the healthcare provider's office and when in any room or vehicle with another person, cover coughs and sneezes with a tissue, regularly wash hands with soap and water and avoid sharing personal household items.[32][146]

Sanitizing of frequently touched surfaces is also recommended or required by regulation for businesses and public facilities; the United States Environmental Protection Agency maintains a list of products expected to be effective.[147]

On 7 July 2020, the WHO said in a press conference that it will issue new guidelines about airborne transmission in settings with close contact and poor ventilation.[148]

For health care professionals who may come into contact with COVID-19 positive bodily fluids, using personal protective coverings on exposed body parts improves protection from the virus.[149] Breathable personal protective equipment improves user-satisfaction and may offer a similar level of protection from the virus.[149] In addition, adding tabs and other modifications to the protective equipment may reduce the risk of contamination during donning and doffing (putting on and taking off the equipment).[149] Implementing an evidence-based donning and doffing protocol such as a one-step glove and gown removal technique, giving oral instructions while donning and doffing, double gloving, and the use of glove disinfection may also improve protection for health care professionals.[149]

People are managed with supportive care, which may include fluid therapy, oxygen support, and supporting other affected vital organs.[150][151][152] The CDC recommends those who suspect they carry the virus wear a simple face mask.[32] Extracorporeal membrane oxygenation (ECMO) has been used to address the issue of respiratory failure, but its benefits are still under consideration.[citation needed][153] Personal hygiene and a healthy lifestyle and diet have been recommended to improve immunity.[154] Supportive treatments may be useful in those with mild symptoms at the early stage of infection.[155]

The WHO, the Chinese National Health Commission, and the United States' National Institutes of Health have published recommendations for taking care of people who are hospitalised with COVID19.[128][156][157] Intensivists and pulmonologists in the US have compiled treatment recommendations from various agencies into a free resource, the IBCC.[158][159]

The severity of COVID19 varies. The disease may take a mild course with few or no symptoms, resembling other common upper respiratory diseases such as the common cold. Mild cases typically recover within two weeks, while those with severe or critical diseases may take three to six weeks to recover. Among those who have died, the time from symptom onset to death has ranged from two to eight weeks.[46]

Children make up a small proportion of reported cases, with about 1% of cases being under 10 years and 4% aged 1019 years.[22] They are likely to have milder symptoms and a lower chance of severe disease than adults. In those younger than 50 years the risk of death is less than 0.5%, while in those older than 70 it is more than 8%.[166][167][168] Pregnant women may be at higher risk of severe COVID19 infection based on data from other similar viruses, like severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), but data for COVID19 is lacking.[169][170] According to scientific reviews smokers are more likely to require intensive care or die compared to non-smokers,[171][172] air pollution is similarly associated with risk factors,[172] and obesity contributes to an increased health risk of COVID-19.[172][173][174]

A European multinational study of hospitalized children published in The Lancet on June 25, 2020 found that about 8% of children admitted to a hospital needed intensive care. Four of those 582 children (0.7%) died, but the actual mortality rate could be "substantially lower" since milder cases that did not seek medical help were not included in the study.[175]

Most of those who die of COVID19 have pre-existing (underlying) conditions, including hypertension, diabetes mellitus, and cardiovascular disease.[220] The Istituto Superiore di Sanit reported that out of 8.8% of deaths where medical charts were available, 97% of people had at least one comorbidity with the average person having 2.7 diseases.[221] According to the same report, the median time between the onset of symptoms and death was ten days, with five being spent hospitalised. However, people transferred to an ICU had a median time of seven days between hospitalisation and death.[221] In a study of early cases, the median time from exhibiting initial symptoms to death was 14 days, with a full range of six to 41 days.[222] In a study by the National Health Commission (NHC) of China, men had a death rate of 2.8% while women had a death rate of 1.7%.[223] In 11.8% of the deaths reported by the National Health Commission of China, heart damage was noted by elevated levels of troponin or cardiac arrest.[47] According to March data from the United States, 89% of those hospitalised had preexisting conditions.[224]

Most critical respiratory comorbidities according to the CDC, are: moderate or severe Asthma, pre-existing COPD, pulmonary fibrosis, cystic fibrosis.[225] Current evidence stemming from meta-analysis of several smaller research papers, also suggest that smoking can be associated with worse patient outcomes.[226][227] When someone with existing respiratory problems is infected with COVID-19, they might be at greater risk for severe symptoms.[228] COVID-19 also poses a greater risk to people who misuse opioids and methamphetamines, insofar as their drug use may have caused lung damage.[229]

Complications may include pneumonia, acute respiratory distress syndrome (ARDS), multi-organ failure, septic shock, and death.[10][16][230][231] Cardiovascular complications may include heart failure, arrhythmias, heart inflammation, and blood clots.[232]

Approximately 2030% of people who present with COVID19 have elevated liver enzymes reflecting liver injury.[233][129]

Neurologic manifestations include seizure, stroke, encephalitis, and GuillainBarr syndrome (which includes loss of motor functions).[234] Following the infection, children may develop paediatric multisystem inflammatory syndrome, which has symptoms similar to Kawasaki disease, which can be fatal.[235][236]

Concerns have been raised about long-term sequelae of the disease. The Hong Kong Hospital Authority found a drop of 20% to 30% in lung capacity in some people who recovered from the disease, and lung scans suggested organ damage.[237] This may also lead to post-intensive care syndrome following recovery.[238]

It is unknown (as of April 2020) if past infection provides effective and long-term immunity in people who recover from the disease.[needs update][239][240] Some of the infected have been reported to develop protective antibodies, so acquired immunity is presumed likely, based on the behaviour of other coronaviruses.[241] Cases in which recovery from COVID19 was followed by positive tests for coronavirus at a later date have been reported.[242][243][244][245] However, these cases are believed to be lingering infection rather than reinfection,[245] or false positives due to remaining RNA fragments.[246] An investigation by the Korean CDC of 285 individuals who tested positive for SARS-CoV-2 in PCR tests administered days or weeks after recovery from COVID-19 found no evidence that these individuals were contagious at this later time.[247] Some other coronaviruses circulating in people are capable of reinfection after roughly a year.[248][249]

The virus is thought to be natural and has an animal origin,[76] through spillover infection.[250] The first known human infections were in China. A study of the first 41 cases of confirmed COVID19, published in January 2020 in The Lancet, reported the earliest date of onset of symptoms as 1December 2019.[251][252][253] Official publications from the WHO reported the earliest onset of symptoms as 8December 2019.[254] Human-to-human transmission was confirmed by the WHO and Chinese authorities by 20 January 2020.[255][256] According to official Chinese sources, these were mostly linked to the Huanan Seafood Wholesale Market, which also sold live animals.[257] In May 2020, George Gao, the director of the Chinese Center for Disease Control and Prevention, said animal samples collected from the seafood market had tested negative for the virus, indicating that the market was the site of an early superspreading event, but it was not the site of the initial outbreak.[258] Traces of the virus have been found in wastewater that was collected from Milan and Turin, Italy, on 18 December 2019.[259]

There are several theories about where the very first case (the so-called patient zero) originated.[260] According to an unpublicised report from the Chinese government, the first case can be traced back to 17 November 2019; the person was a 55-year old citizen in the Hubei province. There were four men and five women reported to be infected in November, but none of them were "patient zero".[12] By December 2019, the spread of infection was almost entirely driven by human-to-human transmission.[161][261] The number of coronavirus cases in Hubei gradually increased, reaching 60 by 20 December[262] and at least 266 by 31 December.[263] On 24 December, Wuhan Central Hospital sent a bronchoalveolar lavage fluid (BAL) sample from an unresolved clinical case to sequencing company Vision Medicals. On 27 and 28 December, Vision Medicals informed the Wuhan Central Hospital and the Chinese CDC of the results of the test, showing a new coronavirus.[264] A pneumonia cluster of unknown cause was observed on 26 December and treated by the doctor Zhang Jixian in Hubei Provincial Hospital, who informed the Wuhan Jianghan CDC on 27 December.[265] On 30 December, a test report addressed to Wuhan Central Hospital, from company CapitalBio Medlab, stated an erroneous positive result for SARS, causing a group of doctors at Wuhan Central Hospital to alert their colleagues and relevant hospital authorities of the result. That evening, the Wuhan Municipal Health Commission issued a notice to various medical institutions on "the treatment of pneumonia of unknown cause".[266] Eight of these doctors, including Li Wenliang (punished on 3January),[267] were later admonished by the police for spreading false rumours, and another, Ai Fen, was reprimanded by her superiors for raising the alarm.[268]

The Wuhan Municipal Health Commission made the first public announcement of a pneumonia outbreak of unknown cause on 31 December, confirming 27 cases[269][270][271]enough to trigger an investigation.[272]

During the early stages of the outbreak, the number of cases doubled approximately every seven and a half days.[273] In early and mid-January 2020, the virus spread to other Chinese provinces, helped by the Chinese New Year migration and Wuhan being a transport hub and major rail interchange.[274] On 20 January, China reported nearly 140 new cases in one day, including two people in Beijing and one in Shenzhen.[275] Later official data shows 6,174 people had already developed symptoms by then,[276] and more may have been infected.[277] A report in The Lancet on 24 January indicated human transmission, strongly recommended personal protective equipment for health workers, and said testing for the virus was essential due to its "pandemic potential".[278][279] On 30 January, the WHO declared the coronavirus a public health emergency of international concern.[277] By this time, the outbreak spread by a factor of 100 to 200 times.[280]

On 31 January 2020, Italy had its first confirmed cases, two tourists from China.[281] As of 13 March 2020, the WHO considered Europe the active centre of the pandemic.[282] On 19 March 2020, Italy overtook China as the country with the most deaths.[283] By 26 March, the United States had overtaken China and Italy with the highest number of confirmed cases in the world.[284] Research on coronavirus genomes indicates the majority of COVID-19 cases in New York came from European travellers, rather than directly from China or any other Asian country.[285] Retesting of prior samples found a person in France who had the virus on 27 December 2019[286][287] and a person in the United States who died from the disease on 6February 2020.[288]

On 11 June 2020, after 55 days without a locally transmitted case,[289] Beijing reported the first COVID-19 case, followed by two more cases on 12 June.[290] By 15 June, 79 cases were officially confirmed.[291] Most of these patients went to Xinfadi Wholesale Market.[289][292]

Several measures are commonly used to quantify mortality.[293] These numbers vary by region and over time and are influenced by the volume of testing, healthcare system quality, treatment options, time since the initial outbreak, and population characteristics such as age, sex, and overall health.[294]

The death-to-case ratio reflects the number of deaths divided by the number of diagnosed cases within a given time interval. Based on Johns Hopkins University statistics, the global death-to-case ratio is 4.0% (648,913/16,262,481) as of 27 July 2020.[8] The number varies by region.[295]

Other measures include the case fatality rate (CFR), which reflects the percent of diagnosed individuals who die from a disease, and the infection fatality rate (IFR), which reflects the percent of infected individuals (diagnosed and undiagnosed) who die from a disease. These statistics are not time-bound and follow a specific population from infection through case resolution. Many academics have attempted to calculate these numbers for specific populations.[296]

Outbreaks have occurred in prisons due to crowding and an inability to enforce adequate social distancing.[297][298] In the United States, the prisoner population is aging and many of them are at high risk for poor outcomes from COVID19 due to high rates of coexisting heart and lung disease, and poor access to high-quality healthcare.[297]

Total confirmed cases over time

Infection fatality rate (or infection fatality ratio) is distinguished from case fatality rate. The case fatality rate ("CFR") for a disease is the proportion of deaths from the disease compared to the total number of people diagnosed with the disease (within a certain period of time). The infection fatality ratio ("IFR"), in contrast, is the proportion of deaths among all the infected individuals. IFR, unlike CFR, attempts to account for all asymptomatic and undiagnosed infections.

Our World in Data states that, as of 25 March 2020, the infection fatality rate (IFR) for coronavirus cannot be accurately calculated.[301] In February, the World Health Organization reported estimates of IFR between 0.33% and 1%.[302][303] On 2July, The WHO's Chief Scientist reported that the average IFR estimate presented at a two-day WHO expert forum was about 0.6%.[304][305]

The CDC estimates for planning purposes that the infection fatality rate is 0.65% and that 40% of infected individuals are asymptomatic, suggesting a fatality rate among those who are symptomatic of 1.08% (.65/60) (as of 10 July).[306][307] According to the University of Oxford Centre for Evidence-Based Medicine (CEBM), random antibody testing in Germany suggested a national IFR of 0.37% (0.12% to 0.87%).[308][309][310] To get a better view on the number of people infected, as of April2020[update], initial antibody testing had been carried out, but peer-reviewed scientific analyses had not yet been published.[311][312] On 1May antibody testing in New York City suggested an IFR of 0.86%.[313]

Firm lower limits of infection fatality rates have been established in a number of locations such as New York City and Bergamo in Italy since the IFR cannot be less than the population fatality rate. As of 10July, in New York City, with a population of 8.4million, 23,377 individuals (18,758 confirmed and 4,619 probable) have died with COVID-19 (0.28% of the population).[314] In Bergamo province, 0.57% of the population has died.[315]

Early reviews of epidemiologic data showed greater impact of the pandemic and a higher mortality rate in men in China and Italy.[316][1][317] The Chinese Center for Disease Control and Prevention reported the death rate was 2.8 percent for men and 1.7 percent for women.[318] Later reviews in June 2020 indicated that there is no significant difference in susceptibility or in CFR between genders.[319][320] One review acknowledges the different mortality rates in Chinese men, suggesting that it may be attributable to lifestyle choices such as smoking and drinking alcohol rather than genetic factors.[321] Sex-based immunological differences, lesser prevalence of smoking in women and men developing co-morbid conditions such as hypertension at a younger age than women could have contributed to the higher mortality in men.[322] In Europe, 57% of the infected people were men and 72% of those died with COVID-19 were men.[323] As of April 2020, the US government is not tracking sex-related data of COVID-19 infections.[324] Research has shown that viral illnesses like Ebola, HIV, influenza and SARS affect men and women differently.[324]

In the US, a greater proportion of deaths due to COVID-19 have occurred among African Americans.[326] Structural factors that prevent African Americans from practicing social distancing include their concentration in crowded substandard housing and in "essential" occupations such as public transit and health care. Greater prevalence of lacking health insurance and care and of underlying conditions such as diabetes, hypertension and heart disease also increase their risk of death.[327] Similar issues affect Native American and Latino communities.[326] According to a US health policy non-profit, 34% of American Indian and Alaska Native People (AIAN) non-elderly adults are at risk of serious illness compared to 21% of white non-elderly adults.[328] The source attributes it to disproportionately high rates of many health conditions that may put them at higher risk as well as living conditions like lack of access to clean water.[329] Leaders have called for efforts to research and address the disparities.[330]

In the U.K., a greater proportion of deaths due to COVID-19 have occurred in those of a Black, Asian, and other ethnic minority background.[331][332][333] Several factors such as poverty, poor nutrition and living in overcrowded properties, may have caused this.[citation needed]

During the initial outbreak in Wuhan, China, the virus and disease were commonly referred to as "coronavirus" and "Wuhan coronavirus",[334][335][336] with the disease sometimes called "Wuhan pneumonia".[337][338] In the past, many diseases have been named after geographical locations, such as the Spanish flu,[339] Middle East Respiratory Syndrome, and Zika virus.[340]

In January 2020, the World Health Organisation recommended 2019-nCov[341] and 2019-nCoV acute respiratory disease[342] as interim names for the virus and disease per 2015 guidance and international guidelines against using geographical locations (e.g. Wuhan, China), animal species or groups of people in disease and virus names to prevent social stigma.[343][344][345]

The official names COVID19 and SARS-CoV-2 were issued by the WHO on 11 February 2020.[346] WHO chief Tedros Adhanom Ghebreyesus explained: CO for corona, VI for virus, Dfor disease and 19 for when the outbreak was first identified (31 December 2019).[347] The WHO additionally uses "the COVID19 virus" and "the virus responsible for COVID19" in public communications.[346]

After the initial outbreak of COVID19, misinformation and disinformation regarding the origin, scale, prevention, treatment, and other aspects of the disease rapidly spread online.[348][349][350]

The pandemic has had many impacts on global health beyond those caused by the COVID-19 disease itself. It has led to a reduction in hospital visits for other reasons. There have been 38% fewer hospital visits for heart attack symptoms in the United States and 40% fewer in Spain.[351] The head of cardiology at the University of Arizona said, "My worry is some of these people are dying at home because they're too scared to go to the hospital."[352] There is also concern that people with strokes and appendicitis are not seeking timely treatment.[352] Shortages of medical supplies have impacted people with various conditions.[353] In several countries there has been a marked reduction of spread of sexually transmitted infections, including HIV, attributable to COVID-19 quarantines and social distancing measures.[354][355] Similarly, in some places, rates of transmission of influenza and other respiratory viruses significantly decreased during the pandemic.[356][357][358] The pandemic has also negatively impacted mental health globally, including increased loneliness resulting from social distancing.[359]

Humans appear to be capable of spreading the virus to some other animals. A domestic cat in Lige, Belgium, tested positive after it started showing symptoms (diarrhoea, vomiting, shortness of breath) a week later than its owner, who was also positive.[360] Tigers and lions at the Bronx Zoo in New York, United States, tested positive for the virus and showed symptoms of COVID19, including a dry cough and loss of appetite.[361] Minks at two farms in the Netherlands also tested positive for COVID-19.[362]

A study on domesticated animals inoculated with the virus found that cats and ferrets appear to be "highly susceptible" to the disease, while dogs appear to be less susceptible, with lower levels of viral replication. The study failed to find evidence of viral replication in pigs, ducks, and chickens.[363]

In March 2020, researchers from the University of Hong Kong have shown that Syrian hamsters could be a model organism for COVID-19 research.[364]

No medication or vaccine is approved with the specific indication to treat the disease.[365] International research on vaccines and medicines in COVID19 is underway by government organisations, academic groups, and industry researchers.[366][367] In March, the World Health Organisation initiated the "Solidarity Trial" to assess the treatment effects of four existing antiviral compounds with the most promise of efficacy.[368] The World Health Organization suspended hydroxychloroquine from its global drug trials for COVID-19 treatments on 26 May 2020 due to safety concerns. It had previously enrolled 3,500 patients from 17 countries in the Solidarity Trial.[369] France, Italy and Belgium also banned the use of hydroxychloroquine as a COVID-19 treatment.[370]

There has been a great deal of COVID-19 research, involving accelerated research processes and publishing shortcuts to meet the global demand. To minimise the harm from misinformation, medical professionals and the public are advised to expect rapid changes to available information, and to be attentive to retractions and other updates.[371]

There is no available vaccine, but various agencies are actively developing vaccine candidates. Previous work on SARS-CoV is being used because both SARS-CoV and SARS-CoV-2 use the ACE2 receptor to enter human cells.[372] Six vaccination strategies are being investigated. Four of these, as of early July 2020, are being tested in clinical trials.[373] First, researchers aim to build a whole virus vaccine. The use of such inactive virus aims to elicit a prompt immune response of the human body to a new infection with COVID19. A second strategy, subunit vaccines, aims to create a vaccine that sensitises the immune system to certain subunits of the virus. In the case of SARS-CoV-2, such research focuses on the S-spike protein that helps the virus intrude the ACE2 enzyme receptor. A third strategy is that of the nucleic acid vaccines (DNA or RNA vaccines, a novel technique for creating a vaccination). Fourthly, scientists are attempting to use viral vectors to deliver the SARS-CoV-2 antigen gene into the cell.[374] These can be replicating or non-replicating. As of early July 2020, only non-replicating viral vectors are in clinical trials. Viral vectors in clinical trials include Chimpanzee Adenovirus 63,[374] Adenovirus type-5,[373] and Adenovirus type-26.[375] Scientists are also working to develop an attenuated COVID-19 vaccine and a COVID-19 vaccine using virus-like particles, but these are still in preclinical research.[373] Experimental vaccines from any of these strategies would have to be tested for safety and efficacy.[376]

Antibody-dependent enhancement has been suggested as a potential challenge for vaccine development for SARS-COV-2, but this is controversial.[377]

At least 29 Phase IIIV efficacy trials in COVID19 were concluded in March 2020, or scheduled to provide results in April from hospitals in China.[378][379] There are more than 300 active clinical trials underway as of April 2020.[129] Seven trials were evaluating already approved treatments, including four studies on hydroxychloroquine or chloroquine.[379] Repurposed antiviral drugs make up most of the research, with nine PhaseIII trials on remdesivir across several countries due to report by the end of April.[378][379] Other candidates in trials include vasodilators, corticosteroids, immune therapies, lipoic acid, bevacizumab, and recombinant angiotensin-converting enzyme 2.[379]

The COVID19 Clinical Research Coalition has goals to 1) facilitate rapid reviews of clinical trial proposals by ethics committees and national regulatory agencies, 2) fast-track approvals for the candidate therapeutic compounds, 3) ensure standardised and rapid analysis of emerging efficacy and safety data and 4) facilitate sharing of clinical trial outcomes before publication.[380][381]

Several existing medications are being evaluated for the treatment of COVID19,[365] including remdesivir, chloroquine, hydroxychloroquine, lopinavir/ritonavir, and lopinavir/ritonavir combined with interferon beta.[368][382] There is tentative evidence for efficacy by remdesivir, and on 1May 2020, the United States Food and Drug Administration (FDA) gave the drug an emergency use authorization for people hospitalized with severe COVID19.[383] Phase III clinical trials for several drugs are underway in several countries, including the US, China, and Italy.[365][378][384]

There are mixed results as of 3 April 2020 as to the effectiveness of hydroxychloroquine as a treatment for COVID19, with some studies showing little or no improvement.[385][386] One study has shown an association between hydroxychloroquine or chloroquine use with higher death rates along with other side effects.[387][388] A retraction of this study by its authors was published by The Lancet on 4June 2020.[389] The studies of chloroquine and hydroxychloroquine with or without azithromycin have major limitations that have prevented the medical community from embracing these therapies without further study.[129] On 15 June 2020, the FDA updated the fact sheets for the emergency use authorization of remdesivir to warn that using chloroquine or hydroxychloroquine with remdesivir may reduce the antiviral activity of remdesivir.[390]

In June, initial results from a randomised trial in the United Kingdom showed that dexamethasone reduced mortality by one third for patients who are critically ill on ventilators and one fifth for those receiving supplemental oxygen.[391] Because this is a well tested and widely available treatment this was welcomed by the WHO that is in the process of updating treatment guidelines to include dexamethasone or other steroids.[392][393] Based on those preliminary results, dexamethasone treatment has been recommended by the National Institutes of Health for patients with COVID-19 who are mechanically ventilated or who require supplemental oxygen but not in patients with COVID-19 who do not require supplemental oxygen.[394]

A cytokine storm can be a complication in the later stages of severe COVID19. There is preliminary evidence that hydroxychloroquine may be useful in controlling cytokine storms in late-phase severe forms of the disease.[395]

Tocilizumab has been included in treatment guidelines by China's National Health Commission after a small study was completed.[396][397] It is undergoing a PhaseII non-randomised trial at the national level in Italy after showing positive results in people with severe disease.[398][399] Combined with a serum ferritin blood test to identify a cytokine storm (also called cytokine storm syndrome, not to be confused with cytokine release syndrome), it is meant to counter such developments, which are thought to be the cause of death in some affected people.[400][401][402] The interleukin-6 receptor antagonist was approved by the Food and Drug Administration (FDA) to undergo a PhaseIII clinical trial assessing its effectiveness on COVID19 based on retrospective case studies for the treatment of steroid-refractory cytokine release syndrome induced by a different cause, CAR T cell therapy, in 2017.[403] To date,[when?] there is no randomised, controlled evidence that tocilizumab is an efficacious treatment for CRS. Prophylactic tocilizumab has been shown to increase serum IL-6 levels by saturating the IL-6R, driving IL-6 across the blood-brain barrier, and exacerbating neurotoxicity while having no effect on the incidence of CRS.[404]

Lenzilumab, an anti-GM-CSF monoclonal antibody, is protective in murine models for CAR T cell-induced CRS and neurotoxicity and is a viable therapeutic option due to the observed increase of pathogenic GM-CSF secreting T-cells in hospitalised patients with COVID19.[405]

The Feinstein Institute of Northwell Health announced in March a study on "a human antibody that may prevent the activity" of IL-6.[406]

Transferring purified and concentrated antibodies produced by the immune systems of those who have recovered from COVID19 to people who need them is being investigated as a non-vaccine method of passive immunisation.[407][408] The safety and effectiveness of convalescent plasma as a treatment option requires further research.[408] This strategy was tried for SARS with inconclusive results.[407] Viral neutralisation is the anticipated mechanism of action by which passive antibody therapy can mediate defence against SARS-CoV-2. The spike protein of SARS-CoV-2 is the primary target for neutralizing antibodies.[409] It has been proposed that selection of broad-neutralizing antibodies against SARS-CoV-2 and SARS-CoV might be useful for treating not only COVID-19 but also future SARS-related CoV infections.[409] Other mechanisms, however, such as antibody-dependent cellular cytotoxicity and/or phagocytosis, may be possible.[407] Other forms of passive antibody therapy, for example, using manufactured monoclonal antibodies, are in development.[407] Production of convalescent serum, which consists of the liquid portion of the blood from recovered patients and contains antibodies specific to this virus, could be increased for quicker deployment.[410]

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COVID-19 Daily Update 7-26-20 – 10 AM – West Virginia Department of Health and Human Resources

Posted: at 4:21 am

TheWest Virginia Department of Health and Human Resources (DHHR) reports as of 10:00 a.m., on July 26,2020, there have been 259,669 total confirmatory laboratory results receivedfor COVID-19, with 5,887 total cases and 103 deaths.

In alignment with updated definitions fromthe Centers for Disease Control and Prevention, the dashboard includes probablecases which are individuals that have symptoms and either serologic (antibody)or epidemiologic (e.g., a link to a confirmed case) evidence of disease, but noconfirmatory test.

CASESPER COUNTY (Case confirmed by lab test/Probable case):Barbour (28/0), Berkeley (589/19), Boone (70/0), Braxton (8/0), Brooke(47/1), Cabell (272/9), Calhoun (5/0), Clay (17/0), Doddridge (2/0), Fayette(114/0), Gilmer (14/0), Grant (40/1), Greenbrier (81/0), Hampshire (56/0),Hancock (81/4), Hardy (50/1), Harrison (159/1), Jackson (153/0), Jefferson(275/5), Kanawha (671/12), Lewis (24/1), Lincoln (46/2), Logan (86/0), Marion(154/4), Marshall (97/1), Mason (41/0), McDowell (14/1), Mercer (84/0), Mineral(94/2), Mingo (91/2), Monongalia (801/16), Monroe (18/1), Morgan (24/1),Nicholas (22/1), Ohio (230/0), Pendleton (27/1), Pleasants (6/1), Pocahontas(39/1), Preston (97/22), Putnam (139/1), Raleigh (126/4), Randolph (201/4),Ritchie (3/0), Roane (14/0), Summers (4/0), Taylor (38/1), Tucker (8/0), Tyler(11/0), Upshur (33/2), Wayne (173/2), Webster (3/0), Wetzel (40/0), Wirt (6/0),Wood (212/10), Wyoming (15/0).

As case surveillance continues at thelocal health department level, it may reveal that those tested in a certaincounty may not be a resident of that county, or even the state as an individualin question may have crossed the state border to be tested.

Pleasenote that delays may be experienced with the reporting of information from thelocal health department to DHHR.

Please visit thedashboard at http://www.coronavirus.wv.gov for more detailed information.

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Moderna to receive another $472 million from US for COVID-19 vaccine efforts – ModernHealthcare.com

Posted: at 4:21 am

Biotech company Moderna Inc. on Sunday announced up to $472 million in additional federal funding for development of a COVID-19 vaccine. This is in addition to $483 million Moderna has already received from the Biomedical Advanced Research and Development Authority. The Cambridge, Mass.-based company is believed to be the frontrunner in the race to market a vaccine to combat the coronavirus, which has killed nearly 650,000 people worldwide.

"Following discussions with the U.S. Food and Drug Administration (FDA) and consultations with Operation Warp Speed over the past several months, the company has decided to conduct a significantly larger Phase 3 clinical trial, leaving a gap in BARDA funding that will be closed by this contract modification," a press release on Sunday stated. "Under the terms of the revised contract, BARDA is expanding their support of the company's late stage clinical development of mRNA-1273, including the execution of a 30,000 participant Phase 3 study in the U.S."

Phase 3, a randomized, placebo-controlled trial is expected to include approximately 30,000 participants. The total value of the award is now approximately $955 million, according to the company.

"Encouraged by the Phase 1 data, we believe that our mRNA vaccine may aid in addressing the COVID-19 pandemic and preventing future outbreaks," Moderna CEO Stphane Bancel said in a statement.

Moderna shares have soared more than 270% this year.

"Working together with collaborators like NIH, the Company hopes to achieve a shared goal that the participants in the COVE study are representative of the communities at highest risk for COVID-19 and of our diverse society," according to the press release.

The Company remains on track to be able to deliver approximately 500 million doses per year, and possibly up to 1 billion doses per year.

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COVID-19 Daily Update 7-24-20 – 5 PM – West Virginia Department of Health and Human Resources

Posted: at 4:21 am

TheWest Virginia Department of Health and Human Resources (DHHR) reports as of 5:00 p.m., on July 24,2020, there have been 253,040 total confirmatory laboratory results receivedfor COVID-19, with 5,695 total cases and 103 deaths.

In alignment with updated definitions fromthe Centers for Disease Control and Prevention, the dashboard includes probablecases which are individuals that have symptoms and either serologic (antibody)or epidemiologic (e.g., a link to a confirmed case) evidence of disease, but noconfirmatory test.

CASESPER COUNTY (Case confirmed by lab test/Probable case):Barbour (28/0), Berkeley (585/19), Boone (69/0), Braxton (8/0), Brooke(42/1), Cabell (248/9), Calhoun (5/0), Clay (17/0), Fayette (111/0), Gilmer(14/0), Grant (37/1), Greenbrier (81/0), Hampshire (55/0), Hancock (80/4),Hardy (49/1), Harrison (152/1), Jackson (153/0), Jefferson (273/5), Kanawha (641/12),Lewis (24/1), Lincoln (36/2), Logan (66/0), Marion (148/4), Marshall (94/1),Mason (38/0), McDowell (13/1), Mercer (79/0), Mineral (87/2), Mingo (79/2),Monongalia (797/15), Monroe (17/1), Morgan (24/1), Nicholas (22/1), Ohio(217/0), Pendleton (27/1), Pleasants (6/1), Pocahontas (39/1), Preston (94/21),Putnam (132/1), Raleigh (119/4), Randolph (201/4), Ritchie (3/0), Roane (12/0),Summers (4/0), Taylor (37/1), Tucker (8/0), Tyler (11/0), Upshur (33/2), Wayne(173/2), Webster (3/0), Wetzel (41/0), Wirt (6/0), Wood (209/11), Wyoming(15/0).

As case surveillance continues at thelocal health department level, it may reveal that those tested in a certaincounty may not be a resident of that county, or even the state as an individualin question may have crossed the state border to be tested.Such is thecase of Greenbrier, Lincoln, Monroe and Upshur counties in this report.

Pleasenote that delays may be experienced with the reporting of information from thelocal health department to DHHR.

Please visit thedashboard at http://www.coronavirus.wv.gov for more detailed information.

Additional report:

To increase COVID-19 testing opportunities, the Governor's Office,the Herbert Henderson Office of Minority Affairs, WV Department of Health andHuman Resources, WV National Guard, local health departments, and communitypartners today provided free COVID-19 testing for residents in counties withhigh minority populations and evidence of COVID-19 transmission.

Todays testing resulted in 250 individuals tested in BrookeCounty. Please note these are considered preliminary numbers.

Testing will be held tomorrow in Brooke and Logan counties inthese locations.

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Missouri health officials call for ‘aggressive actions’ as COVID-19 cases rise – ABC News

Posted: at 4:21 am

Missouri health officials are urging residents to take "aggressive actions" following nearly a week in which daily COVID-19 cases have reached four figures.

On Sunday, the state had its sixth straight day of more than 1,000 new cases, with 1,218. A four-day streak of record-breaking numbers of new cases peaked at 1,652 on Friday.

There are 41,927 total confirmed cases of COVID-19 in Missouri and 1,197 deaths, according to the state health department. The seven-day rolling average of positive tests is 8.8%.

Covid-19 testing site at the Walmart Supercenter in Joplin, Missouri, July 2, 2020.

"We're trending up," Dr. Randall Williams, director of the state's health department, said Wednesday at Missouri Gov. Mike Parson's coronavirus briefing. The 1,000-plus numbers likely represent community transmission, primarily among 20- and 30-year-olds, Williams said.

The average age of those contracting COVID-19 has been steadily declining, according to the Missouri Department of Health and Senior Services. As of Sunday, the average age of a COVID-19 patient in the state is 43; the seven-day rolling average is 40.

Daily hospitalization data on the state's COVID-19 dashboard has not been updated since July 12, though Williams said those numbers are also "trending up." The lag in reporting is due to a change in how data is collected, after the White House switched data collection from the CDC to a private firm earlier this month. As a result, the Missouri Hospital Association said it has been left "in the dark" and unable to access state data.

Williams said he expects to have updated hospitalization figures this week.

Missouri started reopening its economy on May 4, with the governor allowing the state to fully reopen starting June 16. There is no statewide mask mandate, though several local jurisdictions, including St. Louis County and Kansas City, Missouri, have issued their own orders as COVID-19 cases have started to rise in recent weeks.

The Missouri Hospital Association is also among a coalition of eight state organizations urging residents to "mask up" amid the increase, pointing to recommendations from the Centers for Disease Control and Prevention to wear cloth face coverings in public to help limit the spread of COVID-19.

"Missouri's stay-at-home order helped reduce transmission of the virus. However, with many regions of the state opening, Missouri's transmission rates have been rising," the association said in a statement. "Missourians can protect themselves, their families and members of the community by wearing a mask when in public and when in contact with at-risk individuals."

In a grim letter to the public released Friday, several health officials in the Kansas City region, including two in Missouri, urged residents to take steps to limit the spread of the disease due to recent data that suggests they are "losing the battle with COVID-19," the letter said.

"We are extremely concerned that hospitalizations will continue to escalate in the coming weeks and months, and that the uncontrolled spread of COVID-19 will lead to increasing ventilator use and deaths," said the letter, which stressed mask-wearing indoors and when social distancing is not possible. "This is our best option right now for protecting our friends, families, neighbors and the economy."

One oft-cited example of the value of mask-wearing happened right in Missouri: After two symptomatic hairdressers potentially exposed 140 customers to COVID-19 in May, the county health department determined that no new cases were linked to the Springfield salon. Both hairstylists and all clients were wearing face coverings at the time, officials said.

The hardest-hit county in Missouri is its most populous one: St. Louis. As of Sunday, the county had about a quarter of the state's COVID-19 cases, with 10,995, based on state data. During the first two weeks of July, the average number of new COVID-19 cases more than doubled, according to a July 23 report from the St. Louis County Health Department. Hospitalizations increased by 73% during that period, it found. The overall testing positivity rate has been gradually climbing since mid-June, the report stated.

With a record numbers of new cases in recent days, county officials have warned they are considering reimposing restrictions. At a coronavirus briefing on Friday, St. Louis County Executive Sam Page said that the county would start "talking about restrictions" when daily hospital admissions hit 40. That number has been hovering around there in recent days. On Sunday, the St. Louis Metropolitan Pandemic Task Force reported daily new hospitalizations at 36, down from 40 on Thursday. The seven-day moving average of new hospitalizations was 40 on Sunday, continuing an upward trend in the county.

"We're in a difficult place right now, and we do need to be taking some aggressive actions as a community to turn the curve around," task force head Dr. Alex Garza said Friday at a coronavirus briefing. "We have a lot of transmission in our community. It is still being driven by our younger population."

Last week, the county announced that it would be pausing youth summer league competitions, such as games and scrimmages, due to rising cases among children ages 10-19.

"While the risk of transmission during competitive youth sports games is most likely low, all of the activities surrounding the games increase the likelihood of spreading the virus. This includes teams, coaches and parents gathering before, during and after games and practices, carpooling and other activities associated with participating in sports teams, especially if proper mitigation practices are not in place," the St. Louis County Department of Public Health, the St. Louis Sports Medicine COVID-19 Task Force and the city of St. Louis said in a joint statement released Thursday. The guidelines only apply to summer sports, officials said.

Garza stressed "decisive actions," such as mask-wearing, social distancing and not congregating in large groups, to help reduce the curve and keep hospital admissions down in the region.

In a confluence of COVID-19 concerns, one recent outbreak in the state has been tied to a large gathering of young people. The Jackson County Health Department said on Friday it had traced five cases of the virus to a July 10 high school party attended by anywhere from 100 to 200 students.

The department is recommending that all those who attended get tested for the virus. Under the county's current guidelines, gatherings are limited to 100 people.

Tune into ABC at 1 p.m. ET and ABC News Live at 4 p.m. ET every weekday for special coverage of the novel coronavirus with the full ABC News team, including the latest news, context and analysis.

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North Dakota’s active COVID-19 cases surpass 1000 for first time – Grand Forks Herald

Posted: at 4:21 am

North Dakota's 1,025 active cases reported July 26 represent the first time the state has reached quadruple-digits in that figure. Last Sunday at this time, the state had 784 active cases. Before mid-July, the state's previous high point for active cases was 671 on May 21.

As of Sunday, Bismarck's Burleigh County leads the state with 249 active cases, marking a 42% increase from last Sunday's total of 175. Cass County, the state's most populous area, has 138 active cases, down 18% from a week ago. Grand Forks County added a dozen active cases over the past week. Statewide, active cases rose 29% in the past week.

The department reported 141 new virus cases in the state Sunday. Of those, 34 were in the Bismarck area of Burleigh County, 29 were in the Fargo area of Cass County and 21 were in Grand Forks County.

Benson County west of Devils Lake added 10 new cases while Mandan's Morton and Minot's Ward counties both reported eight new cases. Dickinson's Stark County recorded seven new infections. Barnes, Emmons, McKenzie, McLean, Mountrail, Pembina, Ramsey, Richland, Sioux, Steele, Stutsman, Wells and Williams counties each added five or fewer new cases.

The state reported 4,718 new tests Sunday. The Department of Health processed an average of 4,511 tests each day over the past week. Five new virus patients have been hospitalized, and 42 are currently hospitalized in the state.

For the third consecutive day, North Dakota deaths attributed to COVID-19 held at 99. Eighty-seven deaths list COVID-19 as the primary cause of death, while 12 others list the virus as a secondary cause.

North Dakota ranks ninth in the nation in per-capita testing, ahead of current hot-spot states Arizona, Florida and Texas, according to Johns Hopkins University's Coronavirus Resource Center. The state reports a 4.01% positivity rate among the 146,479 unique individuals tested. John Hopkins reports the state's positivity rate at 6.5%.

The state has recorded the eighth-fewest cases of COVID-19 and sixth-fewest deaths caused by the virus, according to data from the Centers for Disease Control and Prevention.

Nationwide, the CDC reports 4,099,310 cases of the virus and 145,013 deaths.

As a public service, weve opened this article to everyone regardless of subscription status. If this coverage is important to you, please consider supporting local journalism by clicking on the subscribe button in the upper righthand corner of the homepage.

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Hurricane’s Fallout Batters Texas As The Region Confronts A COVID-19 Spike – NPR

Posted: at 4:21 am

Hurricane Hanna is the first hurricane of the 2020 Atlantic hurricane season. NASA/NRL hide caption

Hurricane Hanna is the first hurricane of the 2020 Atlantic hurricane season.

Updated at 5:15 a.m. ET Sunday

South Texas is braced for flooding after Hurricane Hanna began battering the state. The first hurricane of the season made landfall twice Saturday as a Category 1 storm.

The first landfall happened at around 5 p.m. about 15 miles north of Port Mansfield, which is about 130 miles south of Corpus Christi, according to the National Weather service. The second landfall took place nearby in eastern Kenedy County. The storm arrived with maximum sustained winds of 90 mph.

Forecasters early Sunday downgraded Hanna to a tropical storm. But Chris Birchfield, a meteorologist with the National Weather Service in Brownsville, told The Associated Press that residents needed to remain alert. Hanna's winds weakened, but the storm's real threat remained heavy rainfall.

"We're not even close to over at this point," Birchfield added. "We're still expecting catastrophic flooding."

The storm is expected to bring heavy rainfall to Texas' southern coast with the potential for "life-threatening flash flooding," according to the National Weather Service.

The center warned of storm surges as high as 5 feet along Texas' southern coast and said the upper coasts of Texas and Louisiana could expect 3-5 inches of rain. Isolated tornadoes could also appear.

Texas Gov. Greg Abbott said earlier in the week that the Texas Division of Emergency Management was preparing teams to help communities affected by the storm. He urged residents in the region to avoid roads that flood and listen to local warnings.

On Saturday, prior to the storm making landfall, Abbott issued a disaster declaration and said he had requested an emergency declaration from President Trump and FEMA.

"As Hurricane Hanna approaches, the Lone Star State is taking swift action to support the communities in the path of the storm," Abbott said. "We are closely monitoring the situation and working with local officials to help ensure they have the resources they need to keep Texans safe. I urge Texans in the region to take all necessary precautions and follow the guidance of local officials. I ask our fellow Texans to keep these communities in their prayers as they brace for this storm."

The city of Corpus Christi in Nueces County, which is already dealing with a spike in confirmed coronavirus cases, was among the communities bracing on Saturday for Hanna's arrival. On Friday, Nueces County reported 175 new cases of the coronavirus and five deaths. Of the county's 129 COVID-19 deaths, 119 of them have come in July, according to the Corpus Christi Caller-Times.

Ahead of the storm's landfall, the city closed at least one drive-through testing site through Tuesday, according to The Texas Tribune.

As Hurricane Hanna approaches, Corpus Christi Mayor Joe McComb said he felt certain that the region is prepared to handle both the storm and the pandemic.

"Don't feel like since we've been fighting COVID for five months that we're out of energy or we're out of gas. We're not. We can do these two things together and we're going to win both of them. And so, we'll get through this," McComb told The Associated Press.

But McComb's comments also reflected the realities of the pandemic as he urged residents to take masks with them if they have to evacuate and stay with others.

"We don't want to expose anyone during this storm. ... Even when you're in the house, I recommend wearing a mask if you're in crowded conditions" McComb told The Texas Tribune.

To the south of Corpus Christi in Cameron County, Judge Eddie Trevio told the AP that if families are evacuated to shelters, there are plans in place to make sure they are socially distanced from one another.

As the storm continues to make its path in south Texas, two other storms are being watched closely. Hurricane Douglas is in the Pacific and is expected to either pass nearby or over the main Hawaiian islands sometime Sunday. The National Hurricane Center warned of a "triple threat of hazards," including heavy rainfall and flooding, damaging winds and dangerously high surf.

Farther to the east and south of the Gulf of Mexico, Tropical Storm Gonzalo was downgraded to a depression Saturday afternoon. The system brought gusty wind to the southern Windward Islands on Saturday morning. The National Hurricane Center also warned of heavy rainfall with the potential for "life-threatening flash flooding" in the area.

Earlier this year, forecasters from the National Oceanic and Atmospheric Administration predicted an above-average hurricane season with at least three to six major hurricanes in 2020.

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Hurricane's Fallout Batters Texas As The Region Confronts A COVID-19 Spike - NPR

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