1:15 PM 7/14/2020 - Covid-19 and global Real Estate Market - Google Search - Selected Posts: The Disease X-19

1:15 PM 7/14/2020 - Covid-19 and global Real Estate Market - Google Search - Selected Posts: The Disease X-19

“The greatest griefs are those we cause ourselves.” – from “Oedipus Rex” – The Disease X-19

The Hypothesis of the Disease X-19 as the New Abwehr Intelligence Operation and the new type of the combined Biological – Informational Warfare 

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Covid-19-Review

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Michael Novakhov - SharedNewsLinks
Covid-19 and global Real Estate Market - Google Search
6:49 AM 7/14/2020 - Disease X-19 News Review In Brief
mikenov on Twitter: Despite the official ASF story, the virus has been used as a bio-weapon in the past. The Mystery of the African swine fever in China and Asia fxstreet.com/analysis/the-m
"Despite the official ASF story, the virus has been used as a bio-weapon in the past." The Mystery of the African swine fever in China and Asia fxstreet.com/analysis/the-m
11:39 AM 7/14/2020 - "Echizen Maru" appears to be a telling name
11:39 AM 7/14/2020 - "Echizen Maru" appears to be a telling name
Buenos Aires Times | 57 sailors onboard fishing ship in Ushuaia test positive for Covid-19
COVID-19 researchers sum up the Tsunami of information
Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review | Critical Care Medicine | JAMA
Google Alert - Coronavirus and US Military: Japan traces new coronavirus outbreak linked to Tokyo theatre
Google Alert - covid-19 in daily mail: Mystery as 57 Argentine fishermen test positive for coronavirus despite spending 35 days at sea ...
Mystery as 57 Argentine fishermen test positive for coronavirus after 35 days at sea
8:07 AM 7/14/2020 - "Pass the SALT!!!" The Mystery of the African swine fever in China and Asia | Swine Fever Is Killing Vast Numbers Of Pigs In China : The Salt : NPR | Pig feed with African Swine Fever Virus (ASFV) is a BIOWEAPON - Google Search
The Mystery of the African swine fever in China and Asia
Swine Fever Is Killing Vast Numbers Of Pigs In China : The Salt : NPR
Pig feed with African Swine Fever Virus (ASFV) is a BIOWEAPON - Google Search
Infectious Dose of African Swine Fever Virus When Consumed Naturally in Liquid or Feed - Volume 25, Number 5May 2019 - Emerging Infectious Diseases journal
African swine fever virus, or ASFV, transmission through feed for pigs - Google Search
Certain feed additives may be effective tools against ASF
african swine fever - Google Search
African Swine Fever continues to grow worldwide | News
Google Alert - covid-19 and pork: African Swine Fever continues to grow worldwide
6:33 PM 7/13/2020 - Hypothetically, the mass infections with Sars-Cov-2 in Dutch (and probably other) Mink and their ability to transmit it to humans, indicate that the similar situation may exist in genetically close to them various river rats and sewer rats. They have to be tested! - M.N.
6:07 PM 7/13/2020 - Minks culled in Netherlands
minks culled in netherlands - Google Search

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Michael Novakhov - SharedNewsLinks
Covid-19 and global Real Estate Market - Google Search
Michael_Novakhov shared this story . Search Results Web results Coronavirus (COVID-19) real estate implications | JLL Research www.us.jll.com trends-and-insights covid-19-global... <a href="http://www.us.jll.com" rel="nofollow">www.us.jll.com</a> trends-and-insights covid-19-global... Cached Apr 19, 2020 - The COVID-19 pandemic is now a truly global phenomenon with 2.6 billion ... In the real estate sector, we can see that the pandemic has ... Global Real Estate Rental Market Report 2020-30: COVID-19 ... www.businesswire.com news home Global-Real-E... <a href="http://www.businesswire.com" rel="nofollow">www.businesswire.com</a> news home Global-Real-E... Cached Jun 2, 2020 - Global Real Estate Rental Market Report 2020-30: COVID-19 Impact & Recovery - <a href="http://ResearchAndMarkets.com" rel="nofollow">ResearchAndMarkets.com</a>. June 02, 2020 04:42 AM Eastern ... Global Real Estate Markets 2020-2030: COVID-19 ... www.businesswire.com news home Global-Real-E... <a href="http://www.businesswire.com" rel="nofollow">www.businesswire.com</a> news home Global-Real-E... Cached May 13, 2020 - The global real estate market is expected to grow from $2,673.1 billion in 2019 to $2,696.7 billion in 2020, rising at a compound annual growth ... Understanding COVID-19's impact on the real estate sector ... www2.deloitte.com about-deloitte articles covid-19 <a href="http://www2.deloitte.com" rel="nofollow">www2.deloitte.com</a> about-deloitte articles covid-19 Cached As the effects of COVID-19 are felt around the world, real estate companies are being ... Understanding COVID-19's impact on the global real estate sector
6:49 AM 7/14/2020 - Disease X-19 News Review In Brief
Michael_Novakhov shared this story from Covid-19-Review. Is COVID-19 the dreaded 'Disease X' scientists warned us about? _______________________________________________________________________ Disease X-19 News Review In Brief | On RSS Dog http://feed.informer.com/digests/A9MXEJ3CMQ/feeder.rsshttp://feed.informer.com/digests/A9MXEJ3CMQ/feeder.atom__________________________________________ » Disease X-19 Regions from Michael_Novakhov (8 sites)
mikenov on Twitter: Despite the official ASF story, the virus has been used as a bio-weapon in the past. The Mystery of the African swine fever in China and Asia fxstreet.com/analysis/the-m
Michael_Novakhov shared this story from Covid-19 Review: The Pandemic As The Bio-Info-Weapon The Disease X-19. “Despite the official ASF story, the virus has been used as a bio-weapon in the past.” The Mystery of the African swine fever in China and Asia fxstreet.com/analysis/the-m… Posted by mikenov on Tuesday, July 14th, 2020 11:50am  mikenov on Twitter
"Despite the official ASF story, the virus has been used as a bio-weapon in the past." The Mystery of the African swine fever in China and Asia fxstreet.com/analysis/the-m
Michael_Novakhov shared this story from mikenov on Twitter. "Despite the official ASF story, the virus has been used as a bio-weapon in the past." The Mystery of the African swine fever in China and Asia fxstreet.com/analysis/the-m Posted by mikenov on Tuesday, July 14th, 2020 11:50am
11:39 AM 7/14/2020 - "Echizen Maru" appears to be a telling name
Michael_Novakhov shared this story from Covid-19-Review. 11:39 AM 7/14/2020 Echizen Maru - GS "Echizen Maru" appears to be a telling name.  Icky Zen - (Signature:) Ma Ru (Mother Russia).  These are the Japanese name, and the (Japanese? electronics) company owns this ship.   Apparently, the Russian-Jewish Mafia (TOC), very likely in company with the GRU and the other involved parties, are quite interested in buying up the beautiful and
11:39 AM 7/14/2020 - "Echizen Maru" appears to be a telling name
Michael_Novakhov shared this story from Covid-19-Review. 11:39 AM 7/14/2020 Echizen Maru - GS "Echizen Maru" appears to be a telling name.  Icky (or "экий") (City)Zen - (Signature:) Ma Ru (Mother Russia).  These are the Japanese name, and the (Japanese? electronics) company owns this ship.   Apparently, the Russian-Jewish Mafia (TOC), very likely in company with the GRU and the other involved parties, are quite interested in buying up the beautiful and strategically located fishing and resort town of Ushuaia's Real Estate, for the Russian "new rich" or for their (Mafia and GRU) agents. They say, you can see the Antarctica from there, and that's what they train their gaze on. This detail adds some more grist on the mill. Was the infected rat conveniently placed on this ship? _______________________________________________ Saved, Shared Stories, Tweets | Page | In Brief - Page | on RSS Dog In 250 Posts | ____________________________________________________________________________ Saved and Shared Stories from Michael_Novakhov (3 sites)  Michael Novakhov - SharedNewsLinks: Buenos Aires Times | 57 sailors onboard fishing ship in Ushuaia test positive for Covid-19 Saved Stories - None: Google Alert - COVID-19 Outbreak In fish and seafood Industry: Fishing Communities Constrained by COVID-19 Michael Novakhov - SharedNewsLinks: COVID-19 researchers sum up the Tsunami of information Michael Novakhov - SharedNewsLinks: Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review | Critical Care Medicine | JAMA Saved Stories - None: Google Alert - sars cov 2: COVID-19 researchers sum up the Tsunami of information Saved Stories - None: Google Alert - covid-19 in meat plants: Half of Covid-positive workers in meat plant were asymptomatic, reports show Saved Stories - None: Google Alert - coronavirus immunity: Ex-Harvard Medical School faculty member warns COVID-19 herd immunity is 'wishful thinking' Saved Stories - None: Google Alert - covid-19 in daily mail: Pub coronavirus cluster grows to 28 as fears grow Sydney will be forced back into lockdown Saved Stories - None: Google Alert - coronavirus in nursing homes: NY Senate, Assembly to hold hearings on coronavirus impact, including nursing homes Saved Stories - None: Google Alert - covid-19 neurological symptoms: This doctor caught coronavirus at a meeting about coronavirus. Then it nearly killed him. Saved Stories - None: Google Alert - CoronaVirus as Biological Weapon: E-voices, July 14, 2020 Saved Stories - None: Google Alert - coronavirus cardiac symptoms: Silent hypoxia in patients with SARS CoV-2 infection before hospital discharge Michael Novakhov - SharedNewsLinks: Google Alert - Coronavirus and US Military: Japan traces new coronavirus outbreak linked to Tokyo theatre Saved Stories - None: Google Alert - Coronavirus and US Military: Japan traces new coronavirus outbreak linked to Tokyo theatre Saved Stories - None: Google Alert - Coronavirus and US Military: COVID-19 flare-ups at US overseas bases spark concerns among local communities Saved Stories - None: Google Alert - sars cov 2: Researchers stabilize the closed SARS-CoV-2 spike trimer Saved Stories - None: Google Alert - coronavirus on twitter: Japan says coronavirus adds to security threat by China Saved Stories - None: Google Alert - sars cov 2: Antibodies and immune responses are preferentially being generated against the wrong parts of ... Saved Stories - None: Google Alert - coronavirus and mafia: 'Fear City: New York vs. The Mafia' Trailer: Netflix Docuseries Details the Mob's Stranglehold on the ... Saved Stories - None: Google Alert - coronavirus new york: New York City Reports No COVID Deaths in 24 Hours | Voice of America - English Saved Stories - None: Google Alert - covid-19 in daily mail: Ten-year-old boy is among ELEVEN Australians infected with coronavirus on a single flight from ... Feed Integration by RSS Dog. Saved and Shared Stories from Michael_Novakhov (3 sites)  Michael Novakhov - SharedNewsLinks: Buenos Aires Times | 57 sailors onboard fishing ship in Ushuaia test positive for Covid-19 Michael_Novakhov shared this story .
Buenos Aires Times | 57 sailors onboard fishing ship in Ushuaia test positive for Covid-19
Michael_Novakhov shared this story . An Argentine fishing boat that had been at sea for 35 days returned to land when some of its 61 crew showed symptoms of the new coronavirus, Tierra del Fuego Province's Health Ministry reported on Monday. Reports later that evening from local outlets said that 57 of the crew members had tested positive for Covid-19. The Ushuaia 24 news portal said that all of them remain isolated on the ship, the Etchizen Maru, and that they would not be allowed to disembark. Only medical personnel would be allowed to board, it added. The incident has attracted attention since prior to setting sail the 60 crew members had completed 14 days of mandatory quarantine in a hotel in Ushuaia, and before that they had been swabbed with a negative result, according to a statement from the Tierra del Fuego health portfolio, in the southern tip. "It is difficult to establish how the contagion of this crew was, since in these 35 days they have not had contact with land and the supply is made only when leaving the port of Ushuaia," said Alejandra Alfaro, the director of the province's Atención Temprana de Salud centre. He explained that they are studying "what the chronology of symptoms has been like within the crew to establish the contagion timeline."  Leandro Ballatore, chief of infectology at the Ushuaia Regional Hospital, warned that "it is a case that escapes all the description that appears in the publications, because such a long incubation period is not described anywhere." The Etchizen Maru returned to the port of Ushuaia when the first crew-members began showing symptoms of Covid-19 onboard, so the emergency protocol was activated and the crew was placed in mandatory isolation on board the vessel. "We cannot yet explain how the symptoms appear. It is somewhat striking, but we are handling five hypotheses that we have to finish evaluating to establish what happened," said Ballatore, a member of the province's Emergency Operations Committee. The Argentine Naval Prefecture maintains a security cordon around the boat to prevent "nobody getting on or off without permission," said Alfaro. The Etchizen Maru belongs to a firm called Pesantar, a part of the New San group, one of the main manufacturers of electronic products in the province. Argentina exceeded 100,000 coronavirus cases on Sunday, with fatalities totalling 1,859 to date. Around 95 percent of infections have occured in the Buenos Aires Metropolitan Area, with a population of 14 million out of 44 million Argentines. Domestic tourism re-opened in Tierra del Fuego in late June, after more than a month of no new cases. Since the start of the pandemic, there have been only 141 cases and one death in the province. Of those infected, only five still have the virus, as of Friday. TIMES/AFP
COVID-19 researchers sum up the Tsunami of information
Michael_Novakhov shared this story from The Medical News. The severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) infection leading to COVID-19 is a raging pandemic across the world at present. It has infected 13 million and killed 571,000 individuals around the world as of today. The infection was first reported in Wuhan, Hubei Province of China in late December 2019. Now, a group of researchers from the Netherlands, United Kingdom, Australia, and the United States has collaborated in a review of what is currently known about the disease. Their study titled, Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19) - A Review, was published the JAMA Network on July 10, 2020. Need for this review There is a so-called Tsunami of scientific research and information as well as evidence regarding SARS-CoV-2 infection and COVID-19 disease. The virus and the course of the disease are new to the scientific world, as is its pathophysiology and course. The infection typically leads to severe respiratory and hematological complications in some individuals who require hospitalization. Due to this sudden rise in hospitalizations, there is a sudden overwhelming of the health care system leading to several public health problems. There is a rise in the number of patients with COVID-19 admitted with severe pneumonia, and some develop unexplained multi-organ failure, wrote the researchers. This review was undertaken to summarize the currently available evidence regarding the pathology, person-to-person transmission, diagnosis, and management of COVID-19. How was the data gathered? For this study, the team looked at all available evidence and scientific literature on the infection and the disease on various scientific databases such as PubMed, LitCovid, bioRxiv, medRxiv, ClinicalTrials.gov, the Chinese Clinical Trial Registry, and the International Clinical Trials Registry Platform. They searched for papers with keywords coronavirus, severe acute respiratory syndrome coronavirus 2, 2019-nCoV, SARS-CoV-2, SARS-CoV, MERS-CoV, and COVID-19 for all studies that were published between January 1, 2002, and June 15, 2020. What was found? The following were the different observations from the available scientific literature. The team wrote: COVID-19 pathophysiology The researchers wrote that the novel coronavirus is a single-stranded RNA virus, and the common viruses in this family include 229E, OC43, NL63, and HKU1. They explained that this SARS-CoV-2 is the third coronavirus that has led to an outbreak of human disease over the past two decades. The first was severe acute respiratory syndrome (SARS) that originated in Foshan, China, in an outbreak in 2002-2003 SARS-CoV pandemic. The second outbreak was due to the Middle East respiratory syndrome (MERS) that began in the Arabian peninsula in 2012. This new virus has a diameter of 60 nm to 140 nm and distinctive spikes, ranging from 9 nm to 12 nm. It looks like a solar corona wrote the researchers. They added that bats are found to the natural reservoir for SARS-CoV-2, and pangolins could be intermediate hosts before humans are infected. How does the human host respond to COVID-19? The infection with SARS-CoV-2 typically begins when the virus invades the epithelial cells of the nose and bronchi. The viral structural spike (S) protein binds to the angiotensin-converting enzyme 2 (ACE2) receptor. The host cell contains an enzyme called the type 2 transmembrane serine protease (TMPRSS2) that breaks down the ACE2 and activates the SARS-CoV-2 S protein that allows entry of the virus into the host cell. Both ACE2 and TMPRSS2 are found in the lung cells. This infection leads to the lowering of the lymphocytes, especially T-lymphocytes, and there is a viral inflammatory response. ACE inhibitor and angiotensin receptor blocker medications use for hypertension have not found to raise the risk of infection and severe COVID-19 or deaths. As the infection progresses in the lungs, it leads to inflammation, and there is a rise in monocytes and neutrophils. This leads to inflammatory infiltration that manifests as ground-glass opacities on computed tomographic imaging. There is also overt lung edema leading to early-phase acute respiratory distress syndrome (ARDS). As the disease progressively worsens, there is an activation of the coagulation factors and clotting factors that are rapidly consumed. Studies have shown that nearly 80 percent of those who died of COVID-19 develop diffuse intravascular coagulation. There are thrombocytopenia and development of clots and its complications such as deep venous thrombosis, pulmonary embolism, and thrombotic arterial complications (e.g., limb ischemia, ischemic stroke, myocardial infarction), the team wrote. Some of these patients develop sepsis and multi-organ failure. Transmission of the infection The available data suggests the SARS-CoV-2 infection spread via droplets generated when an infected person talks, coughs, or sneezes. The team wrote that exposure to a person who is infected for over 15 minutes within 6 feet distance and brief exposure to those patients who are coughing and have other symptoms is associated with a greater risk of transmission. The infection can also be transmitted via viruses left on surfaces. Small droplets containing the virus left suspended in air can also lead to transmission, they wrote. The risk of transmission of the virus from the mother to her unborn baby (vertical transmission) has not yet been reported. The infection is commonly seen in the third trimester, and there have been no deaths in the mothers, and the newborn babies of infected mothers have also fared well, they wrote. Prevention The transmission of the infection can be prevented by wearing masks especially N95 respirators and surgical masks and maintaining a distance of at least 6 feet. Repeated hand washing and the use of alcohol-based sanitizers are recommended. Common symptoms and lab and imaging findings The common symptoms among those who are hospitalized include fever, dry cough, shortness of breath, headache, weakness, runny nose, anosmia or loss of smell, loss of taste, etc. There is a lowering of lymphocyte count, raised inflammatory markers such as ESR and C reactive protein, ferritin, TNF-alfa, Interleukins 1 and 6. There is an abnormality in prothrombin time (prolonged), low platelet count, elevated D dimer, and low fibrinogen. On radiographic images, there is infiltration on both lungs in the lower lobes that appears as ground-glass opacities on chest CT scan. Diagnosis and management Diagnosis of the infection is made by testing the samples from nasopharyngeal secretions using polymerase chain reaction (PCR). At present, there is no specific drug that can effectively cure COVID-19. Treatment thus is primarily supportive and symptomatic. Remdesivir a drug used against Ebola infection, has found to reduce the time for recovery significantly. Other drugs that are being used wrote the researchers, include antivirals (e.g., remdesivir, favipiravir) antibodies (e.g., convalescent plasma, hyperimmune immunoglobulins) anti-inflammatory agents (dexamethasone, statins) targeted immunomodulatory therapies (eg, tocilizumab, sarilumab, anakinra, ruxolitinib) anticoagulants (eg, heparin) antifibrotics (eg, tyrosine kinase inhibitors) The team also found that evidence suggests the benefits of prophylactic treatment with subcutaneous low molecular weight heparin in all hospitalized patients with COVID-19. Conclusions The team wrote in conclusion, Many aspects of transmission, infection, and treatment remain unclear. Advances in prevention and effective management of COVID-19 will require basic and clinical investigation and public health and clinical interventions. They wrote that as of now, no vaccine is available to prevent SARS-CoV-2, but around 120 candidates are in development around the world. Journal reference: Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review. JAMA. Published online July 10, 2020. doi:10.1001/jama.2020.12839, https://jamanetwork.com/journals/jama/fullarticle/2768391
Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review | Critical Care Medicine | JAMA
Michael_Novakhov shared this story from JAMA Current Issue. Importance  The coronavirus disease 2019 (COVID-19) pandemic, due to the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a worldwide sudden and substantial increase in hospitalizations for pneumonia with multiorgan disease. This review discusses current evidence regarding the pathophysiology, transmission, diagnosis, and management of COVID-19. Observations  SARS-CoV-2 is spread primarily via respiratory droplets during close face-to-face contact. Infection can be spread by asymptomatic, presymptomatic, and symptomatic carriers. The average time from exposure to symptom onset is 5 days, and 97.5% of people who develop symptoms do so within 11.5 days. The most common symptoms are fever, dry cough, and shortness of breath. Radiographic and laboratory abnormalities, such as lymphopenia and elevated lactate dehydrogenase, are common, but nonspecific. Diagnosis is made by detection of SARS-CoV-2 via reverse transcription polymerase chain reaction testing, although false-negative test results may occur in up to 20% to 67% of patients; however, this is dependent on the quality and timing of testing. Manifestations of COVID-19 include asymptomatic carriers and fulminant disease characterized by sepsis and acute respiratory failure. Approximately 5% of patients with COVID-19, and 20% of those hospitalized, experience severe symptoms necessitating intensive care. More than 75% of patients hospitalized with COVID-19 require supplemental oxygen. Treatment for individuals with COVID-19 includes best practices for supportive management of acute hypoxic respiratory failure. Emerging data indicate that dexamethasone therapy reduces 28-day mortality in patients requiring supplemental oxygen compared with usual care (21.6% vs 24.6%; age-adjusted rate ratio, 0.83 [95% CI, 0.74-0.92]) and that remdesivir improves time to recovery (hospital discharge or no supplemental oxygen requirement) from 15 to 11 days. In a randomized trial of 103 patients with COVID-19, convalescent plasma did not shorten time to recovery. Ongoing trials are testing antiviral therapies, immune modulators, and anticoagulants. The case-fatality rate for COVID-19 varies markedly by age, ranging from 0.3 deaths per 1000 cases among patients aged 5 to 17 years to 304.9 deaths per 1000 cases among patients aged 85 years or older in the US. Among patients hospitalized in the intensive care unit, the case fatality is up to 40%. At least 120 SARS-CoV-2 vaccines are under development. Until an effective vaccine is available, the primary methods to reduce spread are face masks, social distancing, and contact tracing. Monoclonal antibodies and hyperimmune globulin may provide additional preventive strategies. Conclusions and Relevance  As of July 1, 2020, more than 10 million people worldwide had been infected with SARS-CoV-2. Many aspects of transmission, infection, and treatment remain unclear. Advances in prevention and effective management of COVID-19 will require basic and clinical investigation and public health and clinical interventions. The coronavirus disease 2019 (COVID-19) pandemic has caused a sudden significant increase in hospitalizations for pneumonia with multiorgan disease. COVID-19 is caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 infection may be asymptomatic or it may cause a wide spectrum of symptoms, such as mild symptoms of upper respiratory tract infection and life-threatening sepsis. COVID-19 first emerged in December 2019, when a cluster of patients with pneumonia of unknown cause was recognized in Wuhan, China. As of July 1, 2020, SARS-CoV-2 has affected more than 200 countries, resulting in more than 10 million identified cases with 508000 confirmed deaths (Figure 1). This review summarizes current evidence regarding pathophysiology, transmission, diagnosis, and management of COVID-19. We searched PubMed, LitCovid, and MedRxiv using the search terms coronavirus, severe acute respiratory syndrome coronavirus 2, 2019-nCoV, SARS-CoV-2, SARS-CoV, MERS-CoV, and COVID-19 for studies published from January 1, 2002, to June 15, 2020, and manually searched the references of select articles for additional relevant articles. Ongoing or completed clinical trials were identified using the disease search term coronavirus infection on ClinicalTrials.gov, the Chinese Clinical Trial Registry, and the International Clinical Trials Registry Platform. We selected articles relevant to a general medicine readership, prioritizing randomized clinical trials, systematic reviews, and clinical practice guidelines. Coronaviruses are large, enveloped, single-stranded RNA viruses found in humans and other mammals, such as dogs, cats, chicken, cattle, pigs, and birds. Coronaviruses cause respiratory, gastrointestinal, and neurological disease. The most common coronaviruses in clinical practice are 229E, OC43, NL63, and HKU1, which typically cause common cold symptoms in immunocompetent individuals. SARS-CoV-2 is the third coronavirus that has caused severe disease in humans to spread globally in the past 2 decades.1 The first coronavirus that caused severe disease was severe acute respiratory syndrome (SARS), which was thought to originate in Foshan, China, and resulted in the 2002-2003 SARS-CoV pandemic.2 The second was the coronavirus-caused Middle East respiratory syndrome (MERS), which originated from the Arabian peninsula in 2012.3 SARS-CoV-2 has a diameter of 60 nm to 140 nm and distinctive spikes, ranging from 9 nm to 12 nm, giving the virions the appearance of a solar corona (Figure 2).4 Through genetic recombination and variation, coronaviruses can adapt to and infect new hosts. Bats are thought to be a natural reservoir for SARS-CoV-2, but it has been suggested that humans became infected with SARS-CoV-2 via an intermediate host, such as the pangolin.5,6 The Host Defense Against SARS-CoV-2 Early in infection, SARS-CoV-2 targets cells, such as nasal and bronchial epithelial cells and pneumocytes, through the viral structural spike (S) protein that binds to the angiotensin-converting enzyme 2 (ACE2) receptor7 (Figure 2). The type 2 transmembrane serine protease (TMPRSS2), present in the host cell, promotes viral uptake by cleaving ACE2 and activating the SARS-CoV-2 S protein, which mediates coronavirus entry into host cells.7 ACE2 and TMPRSS2 are expressed in host target cells, particularly alveolar epithelial type II cells.8,9 Similar to other respiratory viral diseases, such as influenza, profound lymphopenia may occur in individuals with COVID-19 when SARS-CoV-2 infects and kills T lymphocyte cells. In addition, the viral inflammatory response, consisting of both the innate and the adaptive immune response (comprising humoral and cell-mediated immunity), impairs lymphopoiesis and increases lymphocyte apoptosis. Although upregulation of ACE2 receptors from ACE inhibitor and angiotensin receptor blocker medications has been hypothesized to increase susceptibility to SARS-CoV-2 infection, large observational cohorts have not found an association between these medications and risk of infection or hospital mortality due to COVID-19.10,11 For example, in a study 4480 patients with COVID-19 from Denmark, previous treatment with ACE inhibitors or angiotensin receptor blockers was not associated with mortality.11 In later stages of infection, when viral replication accelerates, epithelial-endothelial barrier integrity is compromised. In addition to epithelial cells, SARS-CoV-2 infects pulmonary capillary endothelial cells, accentuating the inflammatory response and triggering an influx of monocytes and neutrophils. Autopsy studies have shown diffuse thickening of the alveolar wall with mononuclear cells and macrophages infiltrating airspaces in addition to endothelialitis.12 Interstitial mononuclear inflammatory infiltrates and edema develop and appear as ground-glass opacities on computed tomographic imaging. Pulmonary edema filling the alveolar spaces with hyaline membrane formation follows, compatible with early-phase acute respiratory distress syndrome (ARDS).12 Bradykinin-dependent lung angioedema may contribute to disease.13 Collectively, endothelial barrier disruption, dysfunctional alveolar-capillary oxygen transmission, and impaired oxygen diffusion capacity are characteristic features of COVID-19. In severe COVID-19, fulminant activation of coagulation and consumption of clotting factors occur.14,15 A report from Wuhan, China, indicated that 71% of 183 individuals who died of COVID-19 met criteria for diffuse intravascular coagulation.14 Inflamed lung tissues and pulmonary endothelial cells may result in microthrombi formation and contribute to the high incidence of thrombotic complications, such as deep venous thrombosis, pulmonary embolism, and thrombotic arterial complications (eg, limb ischemia, ischemic stroke, myocardial infarction) in critically ill patients.16 The development of viral sepsis, defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, may further contribute to multiorgan failure. Transmission of SARS-CoV-2 Infection Epidemiologic data suggest that droplets expelled during face-to-face exposure during talking, coughing, or sneezing is the most common mode of transmission (Box 1). Prolonged exposure to an infected person (being within 6 feet for at least 15 minutes) and briefer exposures to individuals who are symptomatic (eg, coughing) are associated with higher risk for transmission, while brief exposures to asymptomatic contacts are less likely to result in transmission.25 Contact surface spread (touching a surface with virus on it) is another possible mode of transmission. Transmission may also occur via aerosols (smaller droplets that remain suspended in air), but it is unclear if this is a significant source of infection in humans outside of a laboratory setting.26,27 The existence of aerosols in physiological states (eg, coughing) or the detection of nucleic acid in the air does not mean that small airborne particles are infectious.28 Maternal COVID-19 is currently believed to be associated with low risk for vertical transmission. In most reported series, the mothers' infection with SARS-CoV-2 occurred in the third trimester of pregnancy, with no maternal deaths and a favorable clinical course in the neonates.29-31 Box Section Ref ID Box 1. TRANSMISSION, SYMPTOMS, AND COMPLICATIONS OF CORONAVIRUS DISEASE 2019 (COVID-19) Transmission17 of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurs primarily via respiratory droplets from face-to-face contact and, to a lesser degree, via contaminated surfaces. Aerosol spread may occur, but the role of aerosol spread in humans remains unclear. An estimated 48% to 62% of transmission may occur via presymptomatic carriers. Common symptoms18 in hospitalized patients include fever (70%-90%), dry cough (60%-86%), shortness of breath (53%-80%), fatigue (38%), myalgias (15%-44%), nausea/vomiting or diarrhea (15%-39%), headache, weakness (25%), and rhinorrhea (7%). Anosmia or ageusia may be the sole presenting symptom inapproximately3% of individuals with COVID-19. Common laboratory abnormalities19 among hospitalized patients include lymphopenia (83%), elevated inflammatory markers (eg, erythrocyte sedimentation rate, C-reactive protein, ferritin, tumor necrosis factor-α, IL-1, IL-6), and abnormal coagulation parameters (eg, prolonged prothrombin time, thrombocytopenia, elevated D-dimer [46% of patients], low fibrinogen). Common radiographic findings of individuals with COVID-19 include bilateral, lower-lobe predominate infiltrates on chest radiographic imaging and bilateral, peripheral, lower-lobe ground-glass opacities and/or consolidation on chest computed tomographic imaging. Common complications18,20-24 among hospitalized patients with COVID-19 include pneumonia (75%); acute respiratory distress syndrome (15%); acute liver injury, characterized by elevations in aspartate transaminase, alanine transaminase, and bilirubin (19%); cardiac injury, including troponin elevation (7%-17%), acute heart failure, dysrhythmias, and myocarditis; prothrombotic coagulopathy resulting in venous and arterial thromboembolic events (10%-25%); acute kidney injury (9%); neurologic manifestations, including impaired consciousness (8%) and acute cerebrovascular disease (3%); and shock (6%). Rare complications among critically ill patients with COVID-19 include cytokine storm and macrophage activation syndrome (ie, secondary hemophagocytic lymphohistiocytosis). The clinical significance of SARS-CoV-2 transmission from inanimate surfaces is difficult to interpret without knowing the minimum dose of virus particles that can initiate infection. Viral load appears to persist at higher levels on impermeable surfaces, such as stainless steel and plastic, than permeable surfaces, such as cardboard.32 Virus has been identified on impermeable surfaces for up to 3 to 4 days after inoculation.32 Widespread viral contamination of hospital rooms has been documented.28 However, it is thought that the amount of virus detected on surfaces decays rapidly within 48 to 72 hours.32 Although the detection of virus on surfaces reinforces the potential for transmission via fomites (objects such as a doorknob, cutlery, or clothing that may be contaminated with SARS-CoV-2) and the need for adequate environmental hygiene, droplet spread via face-to-face contact remains the primary mode of transmission. Viral load in the upper respiratory tract appears to peak around the time of symptom onset and viral shedding begins approximately 2 to 3 days prior to the onset of symptoms.33 Asymptomatic and presymptomatic carriers can transmit SARS-CoV-2.34,35 In Singapore, presymptomatic transmission has been described in clusters of patients with close contact (eg, through churchgoing or singing class) approximately 1 to 3 days before the source patient developed symptoms.34 Presymptomatic transmission is thought to be a major contributor to the spread of SARS-CoV-2. Modeling studies from China and Singapore estimated the percentage of infections transmitted from a presymptomatic individual as 48% to 62%.17 Pharyngeal shedding is high during the first week of infection at a time in which symptoms are still mild, which might explain the efficient transmission of SARS-CoV-2, because infected individuals can be infectious before they realize they are ill.36 Although studies have described rates of asymptomatic infection, ranging from 4% to 32%, it is unclear whether these reports represent truly asymptomatic infection by individuals who never develop symptoms, transmission by individuals with very mild symptoms, or transmission by individuals who are asymptomatic at the time of transmission but subsequently develop symptoms.37-39 A systematic review on this topic suggested that true asymptomatic infection is probably uncommon.38 Although viral nucleic acid can be detectable in throat swabs for up to 6 weeks after the onset of illness, several studies suggest that viral cultures are generally negative for SARS-CoV-2 8 days after symptom onset.33,36,40 This is supported by epidemiological studies that have shown that transmission did not occur to contacts whose exposure to the index case started more than 5 days after the onset of symptoms in the index case.41 This suggests that individuals can be released from isolation based on clinical improvement. The Centers for Disease Control and Prevention recommend isolating for at least 10 days after symptom onset and 3 days after improvement of symptoms.42 However, there remains uncertainty about whether serial testing is required for specific subgroups, such as immunosuppressed patients or critically ill patients for whom symptom resolution may be delayed or older adults residing in short- or long-term care facilities. The mean (interquartile range) incubation period (the time from exposure to symptom onset) for COVID-19 is approximately 5 (2-7) days.43,44 Approximately 97.5% of individuals who develop symptoms will do so within 11.5 days of infection.43 The median (interquartile range) interval from symptom onset to hospital admission is 7 (3-9) days.45 The median age of hospitalized patients varies between 47 and 73 years, with most cohorts having a male preponderance of approximately 60%.44,46,47 Among patients hospitalized with COVID-19, 74% to 86% are aged at least 50 years.45,47 COVID-19 has various clinical manifestations (Box 1 and Box 2). In a study of 44672 patients with COVID-19 in China, 81% of patients had mild manifestations, 14% had severe manifestations, and 5% had critical manifestations (defined by respiratory failure, septic shock, and/or multiple organ dysfunction).48 A study of 20 133 individuals hospitalized with COVID-19 in the UK reported that 17.1% were admitted to high-dependency or intensive care units (ICUs).47 Box Section Ref ID Box 2. COMMONLY ASKED QUESTIONS ABOUT CORONAVIRUS DISEASE 2019 (COVID-19) How is severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) most commonly transmitted? SARS-CoV-2 is most commonly spread via respiratory droplets (eg, from coughing, sneezing, shouting) during face-to-face exposure or by surface contamination. What are the most common symptoms of COVID-19? The 3 most common symptoms are fever, cough, and shortness of breath. Additional symptoms include weakness, fatigue, nausea, vomiting, diarrhea, changes to taste and smell. How is the diagnosis made? Diagnosis of COVID-19 is typically made by polymerase chain reaction testing of a nasopharyngeal swab. However, given the possibility of false-negative test results, clinical, laboratory, and imaging findings may also be used to make a presumptive diagnosis for individuals for whom there is a high index of clinical suspicion of infection. What are current evidence-based treatments for individuals with COVID-19? Supportive care, including supplemental oxygen, is the main treatment for most patients. Recent trials indicate that dexamethasone decreases mortality (subgroup analysis suggests benefit is limited to patients who require supplemental oxygen and who have symptoms for >7 d) and remdesivir improves time to recovery (subgroup analysis suggests benefit is limited to patients not receiving mechanical ventilation). What percentage of people are asymptomatic carriers, and how important are they in transmitting the disease? True asymptomatic infection is believed to be uncommon. The average time from exposure to symptoms onset is 5 days, and up to 62% of transmission may occur prior to the onset of symptoms. Are masks effective at preventing spread? Yes. Face masks reduce the spread of viral respiratory infection. N95 respirators and surgical masks both provide substantial protection (compared with no mask), and surgical masks provide greater protection than cloth masks. However, physical distancing is also associated with substantial reduction of viral transmission, with greater distances providing greater protection. Additional measures such as hand and environmental disinfection are also important. Although onlyapproximately25% of infected patients have comorbidities, 60% to 90% of hospitalized infected patients have comorbidities.45-49 The most common comorbidities in hospitalized patients include hypertension (present in 48%-57% of patients), diabetes (17%-34%), cardiovascular disease (21%-28%), chronic pulmonary disease (4%-10%), chronic kidney disease (3%-13%), malignancy (6%-8%), and chronic liver disease (<5%).45,46,49 The most common symptoms in hospitalized patients are fever (up to 90% of patients), dry cough (60%-86%), shortness of breath (53%-80%), fatigue (38%), nausea/vomiting or diarrhea (15%-39%), and myalgia (15%-44%).18,44-47,49,50 Patients can also present with nonclassical symptoms, such as isolated gastrointestinal symptoms.18 Olfactory and/or gustatory dysfunctions have been reported in 64% to 80% of patients.51-53 Anosmia or ageusia may be the sole presenting symptom inapproximately3% of patients.53 Complications of COVID-19 include impaired function of the heart, brain, lung, liver, kidney, and coagulation system. COVID-19 can lead to myocarditis, cardiomyopathy, ventricular arrhythmias, and hemodynamic instability.20,54 Acute cerebrovascular disease and encephalitis are observed with severe illness (in up to 8% of patients).21,52 Venous and arterial thromboembolic events occur in 10% to 25% in hospitalized patients with COVID-19.19,22 In the ICU, venous and arterial thromboembolic events may occur in up to 31% to 59% of patients with COVID-19.16,22 Approximately 17% to 35% of hospitalized patients with COVID-19 are treated in an ICU, most commonly due to hypoxemic respiratory failure. Among patients in the ICU with COVID-19, 29% to 91% require invasive mechanical ventilation.47,49,55,56 In addition to respiratory failure, hospitalized patients may develop acute kidney injury (9%), liver dysfunction (19%), bleeding and coagulation dysfunction (10%-25%), and septic shock (6%).18,19,23,49,56 Approximately 2% to 5% of individuals with laboratory-confirmed COVID-19 are younger than 18 years, with a median age of 11 years. Children with COVID-19 have milder symptoms that are predominantly limited to the upper respiratory tract, and rarely require hospitalization. It is unclear why children are less susceptible to COVID-19. Potential explanations include that children have less robust immune responses (ie, no cytokine storm), partial immunity from other viral exposures, and lower rates of exposure to SARS-CoV-2. Although most pediatric cases are mild, a small percentage (<7%) of children admitted to the hospital for COVID-19 develop severe disease requiring mechanical ventilation.57 A rare multisystem inflammatory syndrome similar to Kawasaki disease has recently been described in children in Europe and North America with SARS-CoV-2 infection.58,59 This multisystem inflammatory syndrome in children is uncommon (2 in 100000 persons aged <21 years).60 Diagnosis of COVID-19 is typically made using polymerase chain reaction testing via nasal swab (Box 2). However, because of false-negative test result rates of SARS-CoV-2 PCR testing of nasal swabs, clinical, laboratory, and imaging findings may also be used to make a presumptive diagnosis. Diagnostic Testing: Polymerase Chain Reaction and Serology Reverse transcription polymerase chain reactionbased SARS-CoV-2 RNA detection from respiratory samples (eg, nasopharynx) is the standard for diagnosis. However, the sensitivity of testing varies with timing of testing relative to exposure. One modeling study estimated sensitivity at 33% 4 days after exposure, 62% on the day of symptom onset, and 80% 3 days after symptom onset.61-63 Factors contributing to false-negative test results include the adequacy of the specimen collection technique, time from exposure, and specimen source. Lower respiratory samples, such as bronchoalveolar lavage fluid, are more sensitive than upper respiratory samples. Among 1070 specimens collected from 205 patients with COVID-19 in China, bronchoalveolar lavage fluid specimens had the highest positive rates of SARS-CoV-2 PCR testing results (93%), followed by sputum (72%), nasal swabs (63%), and pharyngeal swabs (32%).61 SARS-CoV-2 can also be detected in feces, but not in urine.61 Saliva may be an alternative specimen source that requires less personal protective equipment and fewer swabs, but requires further validation.64 Several serological tests can also aid in the diagnosis and measurement of responses to novel vaccines.62,65,66 However, the presence of antibodies may not confer immunity because not all antibodies produced in response to infection are neutralizing. Whether and how frequently second infections with SARS-CoV-2 occur remain unknown. Whether presence of antibody changes susceptibility to subsequent infection or how long antibody protection lasts are unknown. IgM antibodies are detectable within 5 days of infection, with higher IgM levels during weeks 2 to 3 of illness, while an IgG response is first seenapproximately 14 days after symptom onset.62,65 Higher antibody titers occur with more severe disease.66 Available serological assays include point-of-care assays and high throughput enzyme immunoassays. However, test performance, accuracy, and validity are variable.67 A systematic review of 19 studies of 2874 patients who were mostly from China (mean age, 52 years), of whom 88% were hospitalized, reported the typical range of laboratory abnormalities seen in COVID-19, including elevated serum C-reactive protein (increased in >60% of patients), lactate dehydrogenase (increased in approximately 50%-60%), alanine aminotransferase (elevated in approximately 25%), and aspartate aminotransferase (approximately 33%).24 Approximately 75% of patients had low albumin.24 The most common hematological abnormality is lymphopenia (absolute lymphocyte count <1.0×109/L), which is present in up to 83% of hospitalized patients with COVID-19.44,50 In conjunction with coagulopathy, modest prolongation of prothrombin times (prolonged in >5% of patients), mild thrombocytopenia (present in approximately 30% of patients) and elevated D-dimer values (present in 43%-60% of patients) are common.14,15,19,44,68 However, most of these laboratory characteristics are nonspecific and are common in pneumonia. More severe laboratory abnormalities have been associated with more severe infection.44,50,69 D-dimer and, to a lesser extent, lymphopenia seem to have the largest prognostic associations.69 The characteristic chest computed tomographic imaging abnormalities for COVID-19 are diffuse, peripheral ground-glass opacities (Figure 3).70 Ground-glass opacities have ill-defined margins, air bronchograms, smooth or irregular interlobular or septal thickening, and thickening of the adjacent pleura.70 Early in the disease, chest computed tomographic imaging findings in approximately 15% of individuals and chest radiograph findings in approximately 40% of individuals can be normal.44 Rapid evolution of abnormalities can occur in the first 2 weeks after symptom onset, after which they subside gradually.70,71 Chest computed tomographic imaging findings are nonspecific and overlap with other infections, so the diagnostic value of chest computed tomographic imaging for COVID-19 is limited. Some patients admitted to the hospital with polymerase chain reaction testingconfirmed SARS-CoV-2 infection have normal computed tomographic imaging findings, while abnormal chest computed tomographic imaging findings compatible with COVID-19 occur days before detection of SARS-CoV-2 RNA in other patients.70,71 Supportive Care and Respiratory Support Currently, best practices for supportive management of acute hypoxic respiratory failure and ARDS should be followed.72-74 Evidence-based guideline initiatives have been established by many countries and professional societies,72-74 including guidelines that are updated regularly by the National Institutes of Health.74 More than 75% of patients hospitalized with COVID-19 require supplemental oxygen therapy. For patients who are unresponsive to conventional oxygen therapy, heated high-flow nasal canula oxygen may be administered.72 For patients requiring invasive mechanical ventilation, lung-protective ventilation with low tidal volumes (4-8 mL/kg, predicted body weight) and plateau pressure less than 30 mg Hg is recommended.72 Additionally, prone positioning, a higher positive end-expiratory pressure strategy, and short-term neuromuscular blockade with cisatracurium or other muscle relaxants may facilitate oxygenation. Although some patients with COVID-19related respiratory failure have high lung compliance,75 they are still likely to benefit from lung-protective ventilation.76 Cohorts of patients with ARDS have displayed similar heterogeneity in lung compliance, and even patients with greater compliance have shown benefit from lower tidal volume strategies.76 The threshold for intubation in COVID-19related respiratory failure is controversial, because many patients have normal work of breathing but severe hypoxemia.77 Earlier intubation allows time for a more controlled intubation process, which is important given the logistical challenges of moving patients to an airborne isolation room and donning personal protective equipment prior to intubation. However, hypoxemia in the absence of respiratory distress is well tolerated, and patients may do well without mechanical ventilation. Earlier intubation thresholds may result in treating some patients with mechanical ventilation unnecessarily and exposing them to additional complications. Currently, insufficient evidence exists to make recommendations regarding earlier vs later intubation. In observational studies,approximately8% of hospitalized patients with COVID-19 experience a bacterial or fungal co-infection, but up to 72% are treated with broad-spectrum antibiotics.78 Awaiting further data, it may be prudent to withhold antibacterial drugs in patients with COVID-19 and reserve them for those who present with radiological findings and/or inflammatory markers compatible with co-infection or who are immunocompromised and/or critically ill.72 Targeting the Virus and the Host Response The following classes of drugs are being evaluated or developed for the management of COVID-19: antivirals (eg, remdesivir, favipiravir), antibodies (eg, convalescent plasma, hyperimmune immunoglobulins), anti-inflammatory agents (dexamethasone, statins), targeted immunomodulatory therapies (eg, tocilizumab, sarilumab, anakinra, ruxolitinib), anticoagulants (eg, heparin), and antifibrotics (eg, tyrosine kinase inhibitors). It is likely that different treatment modalities might have different efficacies at different stages of illness and in different manifestations of disease. Viral inhibition would be expected to be most effective early in infection, while, in hospitalized patients, immunomodulatory agents may be useful to prevent disease progression and anticoagulants may be useful to prevent thromboembolic complications. More than 200 trials of chloroquine/hydroxychloroquine, compounds that inhibit viral entry and endocytosis of SARS-CoV-2 in vitro and may have beneficial immunomodulatory effects in vivo,79,80 have been initiated, but early data from clinical trials in hospitalized patients with COVID-19 have not demonstrated clear benefit.81-83 A clinical trial of 150 patients in China admitted to the hospital for mild to moderate COVID-19 did not find an effect on negative conversion of SARS-CoV-2 by 28 days (the main outcome measure) when compared with standard of care alone.83 Two retrospective studies found no effect of hydroxychloroquine on risk of intubation or mortality among patients hospitalized for COVID-19.84,85 One of these retrospective multicenter cohort studies compared in-hospital mortality between those treated with hydroxychloroquine plus azithromycin (735 patients), hydroxychloroquine alone (271 patients), azithromycin alone (211 patients), and neither drug (221 patients), but reported no differences across the groups.84 Adverse effects are common, most notably QT prolongation with an increased risk of cardiac complications in an already vulnerable population.82,84 These findings do not support off-label use of (hydroxy)chloroquine either with or without the coadministration of azithromycin. Randomized clinical trials are ongoing and should provide more guidance. Most antiviral drugs undergoing clinical testing in patients with COVID-19 are repurposed antiviral agents originally developed against influenza, HIV, Ebola, or SARS/MERS.79,86 Use of the protease inhibitor lopinavir-ritonavir, which disrupts viral replication in vitro, did not show benefit when compared with standard care in a randomized, controlled, open-label trial of 199 hospitalized adult patients with severe COVID-19.87 Among the RNA-dependent RNA polymerase inhibitors, which halt SARS-CoV-2 replication, being evaluated, including ribavirin, favipiravir, and remdesivir, the latter seems to be the most promising.79,88 The first preliminary results of a double-blind, randomized, placebo-controlled trial of 1063 adults hospitalized with COVID-19 and evidence of lower respiratory tract involvement who were randomly assigned to receive intravenous remdesivir or placebo for up to 10 days demonstrated that patients randomized to receive remdesivir had a shorter time to recovery than patients in the placebo group (11 vs 15 days).88 A separate randomized, open-label trial among 397 hospitalized patients with COVID-19 who did not require mechanical ventilation reported that 5 days of treatment with remdesivir was not different than 10 days in terms of clinical status on day 14.89 The effect of remdesivir on survival remains unknown. Treatment with plasma obtained from patients who have recovered from viral infections was first reported during the 1918 flu pandemic. A first report of 5 critically ill patients with COVID-19 treated with convalescent plasma containing neutralizing antibody showed improvement in clinical status among all participants, defined as a combination of changes of body temperature, Sequential Organ Failure Assessment score, partial pressure of oxygen/fraction of inspired oxygen, viral load, serum antibody titer, routine blood biochemical index, ARDS, and ventilatory and extracorporeal membrane oxygenation supports before and after convalescent plasma transfusion status.90 However, a subsequent multicenter, open-label, randomized clinical trial of 103 patients in China with severe COVID-19 found no statistical difference in time to clinical improvement within 28 days among patients randomized to receive convalescent plasma vs standard treatment alone (51.9% vs 43.1%).91 However, the trial was stopped early because of slowing enrollment, which limited the power to detect a clinically important difference. Alternative approaches being studied include the use of convalescent plasma-derived hyperimmune globulin and monoclonal antibodies targeting SARS-CoV-2.92,93 Alternative therapeutic strategies consist of modulating the inflammatory response in patients with COVID-19. Monoclonal antibodies directed against key inflammatory mediators, such as interferon gamma, interleukin 1, interleukin 6, and complement factor 5a, all target the overwhelming inflammatory response following SARS-CoV-2 infection with the goal of preventing organ damage.79,86,94 Of these, the interleukin 6 inhibitors tocilizumab and sarilumab are best studied, with more than a dozen randomized clinical trials underway.94 Tyrosine kinase inhibitors, such as imatinib, are studied for their potential to prevent pulmonary vascular leakage in individuals with COVID-19. Studies of corticosteroids for viral pneumonia and ARDS have yielded mixed results.72,73 However, the Randomized Evaluation of COVID-19 Therapy (RECOVERY) trial, which randomized 2104 patients with COVID-19 to receive 6 mg daily of dexamethasone for up to 10 days and 4321 to receive usual care, found that dexamethasone reduced 28-day all-cause mortality (21.6% vs 24.6%; age-adjusted rate ratio, 0.83 [95% CI, 0.74-0.92]; P<.001).95 The benefit was greatest in patients with symptoms for more than 7 days and patients who required mechanical ventilation. By contrast, there was no benefit (and possibility for harm) among patients with shorter symptom duration and no supplemental oxygen requirement. A retrospective cohort study of 201 patients in Wuhan, China, with confirmed COVID-19 pneumonia and ARDS reported that treatment with methylprednisolone was associated with reduced risk of death (hazard ratio, 0.38 [95% CI, 0.20-0.72]).69 Thromboembolic prophylaxis with subcutaneous low molecular weight heparin is recommended for all hospitalized patients with COVID-19.15,19 Studies are ongoing to assess whether certain patients (ie, those with elevated D-dimer) benefit from therapeutic anticoagulation. A disproportionate percentage of COVID-19 hospitalizations and deaths occurs in lower-income and minority populations.45,96,97 In a report by the Centers for Disease Control and Prevention of 580 hospitalized patients for whom race data were available, 33% were Black and 45% were White, while 18% of residents in the surrounding community were Black and 59% were White.45 The disproportionate prevalence of COVID-19 among Black patients was separately reported in a retrospective cohort study of 3626 patients with COVID-19 from Louisiana, in which 77% of patients hospitalized with COVID-19 and 71% of patients who died of COVID-19 were Black, but Black individuals comprised only 31% of the area population.97,98 This disproportionate burden may be a reflection of disparities in housing, transportation, employment, and health. Minority populations are more likely to live in densely populated communities or housing, depend on public transportation, or work in jobs for which telework was not possible (eg, bus driver, food service worker). Black individuals also have a higher prevalence of chronic health conditions than White individuals.98,99 Overall hospital mortality from COVID-19 is approximately 15% to 20%, but up to 40% among patients requiring ICU admission. However, mortality rates vary across cohorts, reflecting differences in the completeness of testing and case identification, variable thresholds for hospitalization, and differences in outcomes. Hospital mortality ranges from less than 5% among patients younger than 40 years to 35% for patients aged 70 to 79 years and greater than 60% for patients aged 80 to 89 years.46 Estimated overall death rates by age group per 1000 confirmed cases are provided in the Table. Because not all people who die during the pandemic are tested for COVID-19, actual numbers of deaths from COVID-19 are higher than reported numbers. Although long-term outcomes from COVID-19 are currently unknown, patients with severe illness are likely to suffer substantial sequelae. Survival from sepsis is associated with increased risk for mortality for at least 2 years, new physical disability, new cognitive impairment, and increased vulnerability to recurrent infection and further health deterioration. Similar sequalae are likely to be seen in survivors of severe COVID-19.100 Prevention and Vaccine Development COVID-19 is a potentially preventable disease. The relationship between the intensity of public health action and the control of transmission is clear from the epidemiology of infection around the world.25,101,102 However, because most countries have implemented multiple infection control measures, it is difficult to determine the relative benefit of each.103,104 This question is increasingly important because continued interventions will be required until effective vaccines or treatments become available. In general, these interventions can be divided into those consisting of personal actions (eg, physical distancing, personal hygiene, and use of protective equipment), case and contact identification (eg, test-trace-track-isolate, reactive school or workplace closure), regulatory actions (eg, governmental limits on sizes of gatherings or business capacity; stay-at-home orders; proactive school, workplace, and public transport closure or restriction; cordon sanitaire or internal border closures), and international border measures (eg, border closure or enforced quarantine). A key priority is to identify the combination of measures that minimizes societal and economic disruption while adequately controlling infection. Optimal measures may vary between countries based on resource limitations, geography (eg, island nations and international border measures), population, and political factors (eg, health literacy, trust in government, cultural and linguistic diversity). The evidence underlying these public health interventions has not changed since the 1918 flu pandemic.105 Mathematical modeling studies and empirical evidence support that public health interventions, including home quarantine after infection, restricting mass gatherings, travel restrictions, and social distancing, are associated with reduced rates of transmission.101,102,106 Risk of resurgence follows when these interventions are lifted. A human vaccine is currently not available for SARS-CoV-2, butapproximately 120 candidates are under development. Approaches include the use of nucleic acids (DNA or RNA), inactivated or live attenuated virus, viral vectors, and recombinant proteins or virus particles.107,108 Challenges to developing an effective vaccine consist of technical barriers (eg, whether S or receptor-binding domain proteins provoke more protective antibodies, prior exposure to adenovirus serotype 5 [which impairs immunogenicity in the viral vector vaccine], need for adjuvant), feasibility of large-scale production and regulation (eg, ensuring safety and effectiveness), and legal barriers (eg, technology transfer and licensure agreements). The SARS-CoV-2 S protein appears to be a promising immunogen for protection, but whether targeting the full-length protein or only the receptor-binding domain is sufficient to prevent transmission remains unclear.108 Other considerations include the potential duration of immunity and thus the number of vaccine doses needed to confer immunity.62,108 More than a dozen candidate SARS-CoV-2 vaccines are currently being tested in phase 1-3 trials. Other approaches to prevention are likely to emerge in the coming months, including monoclonal antibodies, hyperimmune globulin, and convalscent titer. If proved effective, these approaches could be used in high-risk individuals, including health care workers, other essential workers, and older adults (particularly those in nursing homes or long-term care facilities). This review has several limitations. First, information regarding SARS CoV-2 is limited. Second, information provided here is based on current evidence, but may be modified as more information becomes available. Third, few randomized trials have been published to guide management of COVID-19. As of July 1, 2020, more than 10 million people worldwide had been infected with SARS-CoV-2. Many aspects of transmission, infection, and treatment remain unclear. Advances in prevention and effective management of COVID-19 will require basic and clinical investigation and public health and clinical interventions. Accepted for Publication: June 30, 2020. Corresponding Author: W. Joost Wiersinga, MD, PhD, Division of Infectious Diseases, Department of Medicine, Amsterdam UMC, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands (w.j.wiersinga@amsterdamumc.nl). Published Online: July 10, 2020. doi:10.1001/jama.2020.12839 Conflict of Interest Disclosures: Dr Wiersinga is supported by the Netherlands Organisation of Scientific Research outside the submitted work. Dr Prescott reported receiving grants from the US Agency for Healthcare Research and Quality (HCP by R01 HS026725), the National Institutes of Health/National Institute of General Medical Sciences, and the US Department of Veterans Affairs outside the submitted work, being the sepsis physician lead for the Hospital Medicine Safety Continuous Quality Initiative funded by BlueCross/BlueShield of Michigan, and serving on the steering committee for MI-COVID-19, a Michigan statewide registry to improve care for patients with COVID-19 in Michigan. Dr Rhodes reported being the co-chair of the Surviving Sepsis Campaign. Dr Cheng reported being a member of Australian government advisory committees, including those involved in COVID-19. No other disclosures were reported. Disclaimer: This article does not represent the views of the US Department of Veterans Affairs or the US government. 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Docherty  AB, Harrison  EM, Green  CA,  et al; ISARIC4C investigators.  Features of 20133 UK patients in hospital with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study.    BMJ . 2020;369:m1985. doi: 10.1136/bmj.m1985PubMedGoogle ScholarCrossref 48.  The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19)China, 2020.    China CDC Weekly . 2020;2:10. Google Scholar 49. Grasselli  G, Zangrillo  A, Zanella  A,  et al; COVID-19 Lombardy ICU Network.  Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy.    JAMA . 2020;323(16):1574-1581. doi: 10.1001/jama.2020.5394 ArticlePubMedGoogle ScholarCrossref 51. Lechien  JR, Chiesa-Estomba  CM, De Siati  DR,  et al.  Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study.    Eur Arch Otorhinolaryngol . 2020;277(8):2251-2261. doi: 10.1007/s00405-020-05965-1PubMedGoogle ScholarCrossref 57. Götzinger  F, Santiago-García  B, Noguera-Julián  A, Lanaspa  M, Lancella  L, Carducci  FIC.  COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study.    Lancet Child Adolesc Health . Published online June 25, 2020. doi: 10.1016/S2352-4642(20)30177-2PubMedGoogle Scholar 59. Whittaker  E, Bamford  A, Kenny  J,  et al.  Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2.    JAMA . Published online June 8, 2020. doi: 10.1001/jama.2020.10369 ArticlePubMedGoogle Scholar 63. Kucirka  LM, Lauer  SA, Laeyendecker  O, Boon  D, Lessler  J.  Variation in false-negative rate of reverse transcriptase polymerase chain reaction-based SARS-CoV-2 tests by time since exposure.    Ann Intern Med . Published online May 13, 2020. doi: 10.7326/M20-1495PubMedGoogle Scholar 64. Williams  E, Bond  K, Zhang  B, Putland  M, Williamson  DA.  Saliva as a non-invasive specimen for detection of SARS-CoV-2.    J Clin Microbiol . Published online April 21, 2020. doi: 10.1128/JCM.00776-20PubMedGoogle Scholar 65. Guo  L, Ren  L, Yang  S,  et al.  Profiling early humoral response to diagnose novel coronavirus disease (COVID-19).    Clin Infect Dis . Published online March 21, 2020. doi: 10.1093/cid/ciaa310PubMedGoogle Scholar 66. Zhao  J, Yuan  Q, Wang  H,  et al.  Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019.    Clin Infect Dis . Published online March 28, 2020. doi: 10.1093/cid/ciaa344PubMedGoogle Scholar 67. Bond  K, Nicholson  S, Hoang  T, Catton  M, Howden  B, Williamson  D. Post-Market Validation of Three Serological Assays for COVID-19. Office of Health Protection, Commonwealth Government of Australia; 2020. 76. Hager  DN, Krishnan  JA, Hayden  DL, Brower  RG; ARDS Clinical Trials Network.  Tidal volume reduction in patients with acute lung injury when plateau pressures are not high.    Am J Respir Crit Care Med . 2005;172(10):1241-1245. doi: 10.1164/rccm.200501-048CPPubMedGoogle ScholarCrossref 78. Rawson  TM, Moore  LSP, Zhu  N,  et al.  Bacterial and fungal co-infection in individuals with coronavirus: a rapid review to support COVID-19 antimicrobial prescribing.    Clin Infect Dis . Published online May 2, 2020. doi: 10.1093/cid/ciaa530PubMedGoogle Scholar 81. Magagnoli  J, Narendran  S, Pereira  F,  et al. Outcomes of hydroxychloroquine usage in United States veterans hospitalized with COVID-19.  MedRxiv . Preprint posted June 5, 2020. doi: 10.1016/j.medj.2020.06.001 82. Mahévas  M, Tran  VT, Roumier  M,  et al.  Clinical efficacy of hydroxychloroquine in patients with covid-19 pneumonia who require oxygen: observational comparative study using routine care data.    BMJ . 2020;369:m1844. doi: 10.1136/bmj.m1844PubMedGoogle ScholarCrossref 91. Li  L, Zhang  W, Hu  Y,  et al.  Effect of convalescent plasma therapy on time to clinical improvement in patients with severe and life-threatening COVID-19: a randomized clinical trial.    JAMA . Published online June 3, 2020. doi: 10.1001/jama.2020.10044 ArticlePubMedGoogle Scholar 93. Brouwer  PJM, Caniels  TG, van der Straten  K,  et al.  Potent neutralizing antibodies from COVID-19 patients define multiple targets of vulnerability.    Science . Published online June 15, 2020. doi: 10.1126/science.abc5902 . PubMedGoogle Scholar 95. Horby  P, Lim  WS, Emberson  J, Mafham  M, Bell  J,  et al. Effect of dexamethasone in hospitalized patients with COVID-19: preliminary report.  medRxiv . 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Google Alert - Coronavirus and US Military: Japan traces new coronavirus outbreak linked to Tokyo theatre
Michael_Novakhov shared this story from Disease X-19 and Security from Michael_Novakhov (10 sites). ... with plans to reopen a runway at one of the country's biggest airports, even as infections persist in major cities, rural areas and U.S. military bases.  Google Alert - Coronavirus and US Military
Google Alert - covid-19 in daily mail: Mystery as 57 Argentine fishermen test positive for coronavirus despite spending 35 days at sea ...
Michael_Novakhov shared this story from Disease X-19 Publications from Michael_Novakhov (5 sites). The Echizen Maru fishing trawler returned to port after some of its crew began exhibiting symptoms typical of COVID-19, the health ministry for the ...  Google Alert - covid-19 in daily mail
Mystery as 57 Argentine fishermen test positive for coronavirus after 35 days at sea
Michael_Novakhov shared this story from News | Mail Online. Mystery as 57 Argentine fishermen test positive for coronavirus despite spending 35 days at sea and testing negative before they left Echizen Maru fishing vessel left port in Ushuaia, southern Argentina, 35 days ago It returned after several sailors fell ill; 57 out of 61 are positive for coronavirus Scientists are baffled because ship had no contact with land while it was gone  Sailors all tested negative and had 14-day quarantine before voyage began  By Afp Published: | Updated: Argentina is trying to solve a medical mystery after 57 sailors were infected with the coronavirus after 35 days at sea, despite the entire crew testing negative before leaving port. The Echizen Maru fishing trawler returned to port after some of its crew began exhibiting symptoms typical of COVID-19, the health ministry for the southern Tierra del Fuego province said Monday. According to the ministry, 57 sailors, out of 61 crew members, were diagnosed with the virus after undergoing a new test. Copy link to paste in your message Doctors are trying to work out how 57 out of 61 sailors on board this fishing vessel caught coronavirus, after they spent 35 days at sea and tested negative before they left However, all of the crew members had undergone 14 days of mandatory quarantine at a hotel in the city of Ushuaia.  Prior to that, they had negative results, the ministry said in a statement. Two of the other sailors have tested negative, and two others are awaiting test results, the province's emergency operations committee said. Two sailors were hospitalized. 'It's hard to establish how this crew was infected, considering that for 35 days, they had no contact with dry land,' said Alejandra Alfaro, the director of primary health care in Tierra del Fuego. 'Supplies were only brought in from the port of Ushuaia.' A team was examining 'the chronology of symptoms in the crew to establish the chronology of contagion,' she said. Copy link to paste in your message Argentina now has more than 100,000 cases of coronavirus with 1,859 deaths from the disease (pictured, a mask-wearing woman in Buenos Aires) The head of the infectious diseases department at Ushuaia Regional Hospital, Leandro Ballatore, said he believed this is a 'case that escapes all description in publications, because an incubation period this long has not been described anywhere.' 'We cannot yet explain how the symptoms appeared,' said Ballatore. The crew was placed in isolation on board the ship and returned to the port of Ushuaia. Argentina exceeded 100,000 total cases on Sunday, and the death toll rose to 1,859. The majority of infections are in the Buenos Aires area. 'The worst has yet to come': World Health Organization warning Loaded: 0% Progress: 0% 0:00 LIVE Advertisement Share or comment on this article:
8:07 AM 7/14/2020 - "Pass the SALT!!!" The Mystery of the African swine fever in China and Asia | Swine Fever Is Killing Vast Numbers Of Pigs In China : The Salt : NPR | Pig feed with African Swine Fever Virus (ASFV) is a BIOWEAPON - Google Search
Michael_Novakhov shared this story from Covid-19-Review. 8:07 AM 7/14/2020 - "Pass the SALT!!!"  Pig feed with African Swine Fever Virus (ASFV) is a BIOWEAPON - Google Search African swine fever virus, or ASFV, transmission through feed for pigs - Google Search Swine Fever Is Killing Vast Numbers Of Pigs In China : The Salt : NPR (Pass the SALT!!! - Munich Cluster - Reuters) The Mystery of the African swine fever in China and Asia | Swine Fever Is Killing Vast Numbers Of Pigs In China : The Salt : NPR | Pig feed with African Swine Fever Virus (ASFV) is a BIOWEAPON - Google Search Infectious Dose of African Swine Fever Virus When Consumed Naturally in Liquid or Feed - Volume 25, Number 5May 2019 - Emerging Infectious Diseases journal African swine fever virus, or ASFV, transmission through feed for pigs - Google Search Certain feed additives may be effective tools against ASF african swine fever - Google Search African Swine Fever continues to grow worldwide | News Google Alert - covid-19 and pork: African Swine Fever continues to grow worldwide 6:33 PM 7/13/2020 - Hypothetically, the mass infections with Sars-Cov-2 in Dutch (and probably other) Mink and their ability to transmit it to humans, indicate that the similar situation may exist in genetically close to them various river rats and sewer rats. They have to be tested! - M.N. Pig feed with African Swine Fever Virus (ASFV) is a BIOWEAPON _____________________________________________
The Mystery of the African swine fever in China and Asia
Michael_Novakhov shared this story . The costly and deadly African swine fever is penalizing food security in China and more than half a dozen Asian countries. Despite the official ASF story, the virus has been used as a bio-weapon in the past. The suppression of such bio-threats requires multipolar cooperation. On August 20, Agriculture Secretary William Dar confirmed the BAI report on the growing death rate of pigs raised by farmers in their backyards. The Philippines is tightening bio-security awaiting lab results. Along with Myanmar, Philippines may prove the most recent target of the Asian swine fever (ASF). The virus is already present in six Asian countries: Cambodia, China, DPR Korea, Lao PDR, Mongolia and Vietnam. Current losses represent more than 10% of the total pig population in China, Vietnam and Mongolia, respectively. But how did the African swine fever (ASF) outbreak start? The official ASF narrative The ASF is a devastating hemorrhagic fever of pigs with mortality rates close to 100 percent. It causes major economic losses, threatens food security and limits pig production in affected countries. There is no vaccine against the virus. It persistently infects its natural hosts, warthogs, bush pigs, and soft ticks, which likely act as a vector with no disease signs. Historically, the first African swine fever outbreak took place in Kenya in 1907. The first spread of ASF outside Africa was to Portugal in 1957, presumably as a result of waste from airline flights being fed to pigs near Lisbon airport. Outbreaks of ASF were reported subsequently in other European countries.   Cuba was the first country in the Caribbean region to report infection with ASF in 1971. It was believed to have been introduced from Spain. ASF was further reported in the late 1970s in several Caribbean island countries and in Brazil 1978. Presumably, it was introduced from Spain or Portugal through food waste carried by transcontinental flights. After a decade or more relative quiet, the ASF in 2007 spread to Georgia in the Caucasus and thereafter widely to neighboring countries, including Armenia, Azerbaijan and several territories in Russia. After another decade of quiet, the number of ASF outbreaks suddenly soared after September 2018, especially in China, although it had not been detected in China or Asia before. Since then, over 2.8 million hogs have been culled globally due to ASF, although according to the World Organization for Animal Health (OIE). Industry observers believe the actual number is much higher. Thats the conventional wisdom, which implies that ASF remained restricted to Africa until the late 50s. In reality, ASF had arrived in North America already in the early 1950s, when Fort Terry, a US biowarfare facility in Plum Island New York, housed seven deadly virus strains. ASF in biological warfare After World War II experimentation, U.S. biological warfare was launched for offensive purposes. During the Cold War, ASF attracted great interest among anti-animal viruses, such as foot and mouth disease and cattle plague. By 1954, according to biowarfare historians, three viruses were available as agents for the destruction of food-bearing animals, including ASF. Between the mid-1960s and late 90s, Cuba accused the United States of 10 biological warfare attacks following serious infectious disease outbreaks. None were proven conclusively, but several probably occurred. In 1971, pigs in Havana hog farm were diagnosed with ASF virus, which spread and caused half a million pigs to be slaughtered. Cuba suffered food shortage. The UN labeled the outbreak the "most alarming event" of 1971. In 1977, the investigative journalists of Newsday, a Long Island daily, reported the virus was delivered from a US army base in the Panama Canal Zone; the site of joint Army-CIA covert operations in Latin America and the Caribbean. Reportedly, anti-Castro saboteurs, backed by the CIA, had introduced ASF into Cuba six weeks before the outbreak to destabilize the economy. US Army denied involvement. Nevertheless, Norman Covert, historian of Fort Detrick, Maryland the center of US biowarfare from the mid-50s to late 60s - has said that CIA had access to these laboratories. Later, a CIA document confirmed that biological warfare was used in efforts to destabilize Cuba. Such efforts did not end with the Cold War. In 2000, neoconservatives behind the Bush administration flirted with the idea of politically useful ethnic bioweapons. That led Russia in 2007 to ban all exports of human bio samples. In October 2018, Russian Defense Ministry claimed that the spread of viral diseases from Georgia, including African swine fever since 2007, could be connected to a US lab network. In the area, more than 70 Georgians had died in mysterious conditions, which Moscow attributed to US toxins or bioweapons. Russia believed bio agents violated the prohibition of biological weapons. The lab network is part of the Cooperative Biological Engagement Program (CBEP), which is funded by Pentagons Cooperative Threat Reduction Agency (DTRA). The CBEP labs are located in 25 countries, particularly in Eastern Europe, and the Middle East, Africa and Southeast Asia, including Philippines. As Pentagon denied that US was developing biological weapons in the labs, Vladimir Shamanov, head of Russias State Duma Defense Committee, called for a comprehensive evaluation suggesting joint inspections. Yet, these multilateral demands have been ignored. In its 2020 multimillion-dollar budget, the DTRA characterizes the program in Asia by its biosecurity functions, but also as the partner of choice in a region competing against Chinese influence. So while virus outbreaks operate across borders, multilateral cooperation is shunned for geopolitics. How did ASF spread in China and Asia Some speculate that secrecy and misguided incentives might have fueled the crisis in China. But possible reasons for the accelerated ASF spread do not explain its source, timing or strain. In August 2018, the first ASF outbreak was reported in Shenyang, northeast China. The ASF viral sequence in China seems to be highly homologous to that of the Georgia 2007 strain. So it is speculated that ASF came to China via Russia or Eastern Europe from the areas that remain the crux of the US-Russian biowarfare debate. What is certain is that the ASF is a major threat to Chinese and Asian biosafety. China has the largest swine population in the world, with 690 million pigs in 2017. Thats almost half of the worlds pork production. Already nearly 5 million pigs in Asia have died or been culled because of the spread of ASF. In addition to the geographic source of the virus, the timing is intriguing. In China, the ASF spread began in parallel with the US trade war after mid-2018. As a result, US pork sales to China were over three times pricier last spring than during the same period a year before, despite the US retaliatory tariffs. There is still another odd anomaly. In a new study, Chinese medical researchers identified the ASFV strain but conclude that it differs from reported ASF virus strains in China in 2018. The way to resolve the ASF oddities, including the spread of information and disinformation, is to build on international multipolar biological arms control; that is, the 1925 Geneva Protocol, the 1972 Biological and Toxin Weapons Convention (BWC) and the 1993 Chemical Weapons Convention (CWC). But that would require multilateralism, which the Trump administration abhors. The economic costs and existential risks associated with biological threats should outweigh the current mistrust among major powers. This commentary is based on Dr Steinbocks fully-referenced research note on the African swine fever outbreaks worldwide. Dr. Dan Steinbock is the founder of Difference Group and has served at the India, China and America Institute (US), Shanghai Institute for International Studies (China) and the EU Center (Singapore).
Swine Fever Is Killing Vast Numbers Of Pigs In China : The Salt : NPR
Michael_Novakhov shared this story from Food : NPR. Pigs are seen in a hog pen in Linquan county in central China's Anhui province in July. The number of pigs in China is falling rapidly due to an epidemic of African Swine Fever. Barcroft Media/Barcroft Media via Getty Images hide caption toggle caption Barcroft Media/Barcroft Media via Getty Images Pigs are seen in a hog pen in Linquan county in central China's Anhui province in July. The number of pigs in China is falling rapidly due to an epidemic of African Swine Fever. Barcroft Media/Barcroft Media via Getty Images An epidemic of African Swine Fever is sweeping through China's hog farms, and the effects are rippling across the globe, because China is a superpower of pork. Half of the world's pigs live in China or at least they did before the epidemic began a year ago. "Every day, we hear of more outbreaks," says Christine McCracken, a senior analyst at RaboResearch, which is affiliated with the global financial firm Rabobank. McCracken and her colleagues now estimate that by the end of 2019, China's production of pork could be cut in half. "That's roughly 300 million to 350 million pigs lost in China, which is almost a quarter of the world's pork supply," she says. "It's a massive number." (This measures the reduction in pigs slaughtered annually, which is roughly twice the number of animals in China's swine herd at any one time.) The estimate, McCracken says, is based on information from her company's clients in China, which include meat packers, companies that sell animal feed, and animal health experts. African Swine Fever is not the same as "swine flu." This disease is harmless to humans. It can spread through contaminated pork products or the clothes of people working with infected pigs. It does not travel through the air, but it's long-lived and hard to get rid of which Chinese farmers are learning the hard way. "They've had a hard time repopulating herds," McCracken says. "It's hard to decontaminate a facility in a short amount of time. Generally, it takes at least six months, sometimes three years, to decontaminate a site." Up to now, Chinese consumers still are finding enough pork to buy. McCracken says that's mainly because many farmers slaughtered their herds early, out of fear of infection. In the past month or so, however, supplies have started to run short, and pork prices are now rising sharply in China. In fact, people around the world are now starting to feel the effects. With fewer pigs, China is importing less soy meal to feed them. That alone has been enough to push down global prices for soybeans, which means less money for farmers in Brazil and the U.S. The effect on soybean prices may turn out to be modest. According to a preliminary analysis by Amani Elobeid, an economist at Iowa State University, and Miguel Carriquiry, at the University of the Republic in Uruguay, a 30% cut in China's pork production could reduce the price of soy meal by 3 to 5%. In an email to NPR, however, they noted that the analysis "is VERY preliminary and should be used with caution." The growing Chinese pork shortage is good news, though, for pork producers in the rest of the world: China is now starting to import more pork, driving up prices. McCracken says the epidemic is still going strong. "It's really hard to see how this is going to end," she says. "Though at some point there will just be better, more 'biosecure' facilities that have less of a chance of getting the virus." African Swine Fever is present in wild pigs in Europe. European pork producers have managed to protect their commercial herds from infection through careful precautions, preventing any potentially contaminated food or clothing from entering the facilities where pigs live. Almost half the pigs in China, on the other hand, came from hundreds of thousands of small, backyard operations, which have been particularly hard-hit by the epidemic. If those farms can't protect their animals from infection, they may not survive.
Pig feed with African Swine Fever Virus (ASFV) is a BIOWEAPON - Google Search
Michael_Novakhov shared this story . The Mystery of the African swine fever in China and Asia www.fxstreet.com analysis the-mystery-of-the-afric... <a href="http://www.fxstreet.com" rel="nofollow">www.fxstreet.com</a> analysis the-mystery-of-the-afric... Cached Aug 26, 2019 - Despite the official ASF story, the virus has been used as a bio-weapon in the past. The suppression of such bio-threats requires multipolar ...
Infectious Dose of African Swine Fever Virus When Consumed Naturally in Liquid or Feed - Volume 25, Number 5May 2019 - Emerging Infectious Diseases journal
Michael_Novakhov shared this story . African swine fever virus (ASFV) is an emerging threat to swine production in North America and Europe. During the past decade, ASFV has spread into Eastern Europe and Russia (1,2) and most recently into China (3,4) and Belgium (5). Disease caused by ASFV is characterized by severe disseminated hemorrhage, and case-fatality rates approach 100% (6). The virus is a member of the Asfarviridae family and is the only known vectorborne DNA virus (7). Challenges to disease control include the lack of available vaccines and the potential for ASFV to become endemic in feral swine and ticks (8). Because no effective vaccine or treatment exists, preventing ASFV introduction is the primary goal of disease-free countries. Mitigation strategies during an African swine fever (ASF) outbreak are centered around restricting pig movement and conducting large-scale culling of infected herds. It is estimated that the introduction of ASFV into the United States would cost producers >$4 billion in losses (9). Historical outbreaks, including the introduction of ASFV into the Caucasus region in 2007 and subsequent spread into Russia, have been attributed to feeding contaminated pork products (1) or direct contact with pigs (10). ASFV survives in meat and blood at room temperature for several months (11,12) and is resistant to temperature and pH extremes (13). Molecular characterization of the more recent ASFV incursions into China (4) and Siberia (14) demonstrate similarity in viral isolates to the Georgia 2007 strain of ASFV. These outbreaks have occurred in herds separated by thousands of kilometers (15). For example, ASFV spread 2,100 km from the city Shenyang in northern China to the city Wenzhou, south of Shanghai, in 3 weeks (16). Also, an ASFV incursion has been reported recently in a large-scale, high-biosecurity farm in Romania (17). Contaminated water from the Danube River has been implicated in introducing ASF onto the 140,000-pig breeding farm (18). Contaminated feed as a transmission vehicle for introducing transboundary animal diseases onto high-biosecurity swine operations has been recognized as a major risk factor since the introduction of porcine epidemic diarrhea virus into the United States in 2013 (1924). The lesson learned from porcine epidemic diarrhea virus underscores the need to quantitate the risk that feed plays in the introduction of other transboundary animal diseases. Nonetheless, data defining the risk for ASFV transmission through feed or feed ingredients are limited. In 2014, the introduction and spread of ASFV in Latvia was associated with the feeding of virus-contaminated fresh grass or crops to naive pigs (25). Furthermore, recent work has demonstrated that ASFV survives in feed ingredients, such as conventional soybean meal, organic soybean meal, soy oil cake, and choline, under conditions simulating trans-Atlantic shipment from Eastern Europe to the United States (21). These reports suggest that the spread of ASFV might be attributed to less-recognized transmission routes, such as feed or water. ASFV can be transmitted experimentally through several routes, including intramuscularly, oronasally, or through direct contact (6). In many of the studies on oronasal transmission, however, ASFV was placed directly in the mouth or on the tonsils. The infectious dose of ASFV in plant-based feed or liquid consumed naturally is lacking; moreover, nothing has been reported regarding ASFV Georgia 2007 transmission in feed. Although field-based epidemiologic reports provide information suggesting routes of transmission, they provide little information about infectious dose. Thus, our objectives were to 1) define the relationship between infection probability and dose, 2) identify the minimum infectious dose (MID) or lowest dose required to result in ASFV infection of >1 pig, and 3) identify the median infectious dose (ID50) or dose required to result in ASFV infection of 50% of pigs for ASFV Georgia 2007 when consumed naturally in contaminated feed or liquid. ASFV Inoculum Preparation We used an ASFV Georgia 2007/1 isolate (2) for this study. Viral stocks were created from spleen tissue collected from pigs during acute infection with ASFV Georgia 2007 (26). We minced splenic tissue and passed it through a cell strainer in the presence of phosphate-buffered saline (PBS) supplemented with penicillin/streptomycin and fungizone. We centrifuged the suspension at 4,000 × g for 30 min and stored the supernatant at 4°C. We then resuspended the pellet in sterile PBS with antibiotics and antimycotics and obtained additional virus by 3 freeze-thaw cycles. The suspension was centrifuged and clarified supernatant stored at 4°C. For virus titration, we collected porcine alveolar macrophages (PAMs) by using lung lavage of 35-week-old pigs. We cultured PAMs for 2 days in RPMI media supplemented with 10% fetal bovine serum and antibiotics in a 37°C 5% CO2 incubator. We then prepared 10-fold serial dilutions of virus in triplicate and added the dilutions to PAMs in a 96-well plate. After 3 days at 37°C, cells were fixed by using 80% acetone for 10 min. Cells were stained using a p30 monoclonal antibody (27) diluted 1:6,000. We incubated the plate at 37°C for 1 h and washed it 3 times with PBS. Bound antibody was detected by using a goat-anti mouse antibody (AlexaFluor 488; Thermo Fisher Scientific, https://www.thermofisher.comExternal Link) diluted 1:400 and incubated for 1 h at 37°C. We observed stained cells under an inverted fluorescence microscope (Evos FL; Thermo Fisher Scientific) and calculated the log10 50% tissue culture infectious dose per milliliter (TCID50/mL) according to the method of Reed and Muench (28). We made dilutions of the clarified ASFV Georgia 2007 splenic homogenate by using RPMI media, with doses ranging from 100 TCID50 to 108 TCID50 added to a final volume of 100 mL RPMI or 100 g complete feed. The feed was a typical corn soybean mealbased diet formulated to be nutritionally adequate according to the National Research Council recommendations for pigs weighing 1025 kg (29). The diet did not contain any animal-based feed ingredients. For mixing virus with feed, we allowed 10 mL of virus to absorb onto 100 g of feed in a 500 mL wide-mouth high-density polyethylene round bottle (Nalgene, Thermo Fisher Scientific) for 30 s before homogenization by rolling and gently mixing the bottle by hand. Animals and Housing The use of pigs and viruses in research was performed in accordance with the Federation of Animal Science Societies Guide for the Care and Use of Agricultural Animals in Research and Teaching and the US Department of Agricultures Animal Welfare Act and Animal Welfare Regulations. The research was approved by the Kansas State University Institutional Animal Care and Use Committee and the Institutional Biosafety Committee. We obtained 84 crossbred pigs (average age, 51.8 + 2.2 days) from a single high-health commercial source. Pigs were housed in 3 identical 66 m2 rooms at the Kansas State University Biosecurity Research Institute and maintained under Biosafety Level 3 agriculture containment conditions. Rooms were environmentally controlled, and complete exchange of air occurred 14.5 times/hour in each room. Pigs were maintained individually in 1.9 m2 pens, and each pen was separated by >1.5 m in the room. The stainless-steel pens were raised and contained slotted fiberglass flooring. Three sides of the pen were solid, with a fourth side consisting of bars and a gate. All efforts were made to prevent aerosol spread of virus. Negative control pigs were maintained in the room as a means to monitor the potential for cross-contamination between pens. Experimental Design We adapted the experimental design and approach for determining the median infectious dose of ASFV Georgia 2007 from previous work on porcine reproductive and respiratory syndrome virus (30,31). We conducted 7 replicates for both liquid and feed, each composed of 6 pigs for liquid and 6 pigs for feed. In each replicate for feed or liquid, we administered 5 pigs a specific dose of ASFV; 1 pig served as the negative control. An adaptive study design was incorporated throughout the course of the experiment to result in the most precise estimate of the ID50 while maximizing the information gained from the trial (32,33). The most likely ID50 was based on a review of the available literature (3440). We used this information to identify the initial infectious dose tested of 103 TCID50 for liquid and 104 TCID50 for feed. After completion of the first replicate, we used the continual reassessment method to update the ID50 estimate (32,33). The results of each replicate were used to select dosages for subsequent replicates; in general, this process resulted in liquid doses decreasing and feed doses increasing after the initial replicates were completed. All replicates and pig numbers for each dose are shown in Table 1. For drinking, pigs consumed ASFV mixed in a 100-mL volume of RPMI media. Liquid was provided through a gravity-fed restricted-flow nipple drinker (Arato 76 Piglet Drinker; Ag Works International, http://www.agworksintl.comExternal Link) attached to an adjustable galvanized wall bracket (1.3 cm × 61 cm pipe; SMB Manufacturing, https://www.smbmfg.comExternal Link). If pigs became averse to drinking from a nipple, liquid medium was placed in a small stainless-steel bowl for pigs to drink. For feeding, pigs consumed ASFV mixed in a 100-g volume of complete feed provided in a 23-cm stainless-steel creep feeder (Vittetoe Inc., http://www.vittetoe.comExternal Link). Infectious titers of each virus dilution were back-titrated on PAMs by endpoint titration assay (TCID50/mL) to confirm accurate dosing. Negative control pigs received the same volumes of sterile media or complete feed without virus. Pigs were acclimated to the drinkers or feeders for 34 days before ASFV inoculation. During this acclimation period, water and feed (drinking) or feed alone (feeding) were withheld for 1014 hours before liquid media or feed was offered. Pigs were monitored during the drinking or eating process. Once pigs had consumed the specified volume of liquid or feed, pigs were given unrestricted access to feed and water until the next withholding period. After acclimation, 5 pigs in each replicate were offered the same substrate containing a specific dose of ASFV followed by unrestricted access to feed and water. We evaluated the pigs for clinical signs of ASF twice daily and collected blood from each pig at 0 and 5 days postinoculation (dpi). Pigs showing clinical signs before 5 dpi were humanely euthanized, and blood and tissues were collected. The remaining pigs were humanely euthanized on 5 dpi, and complete necropsies were performed. We determined infection status on the basis of real-time PCR detection of ASFV in the serum or spleen and virus isolation from the spleen. We constructed dose-response curves and calculated ID50, as described further in this article. ASFV PCR We extracted nucleic acid from serum or splenic homogenate by using the MagMAX-96 Viral RNA Isolation Kit (Thermo Fisher Scientific). For nucleic acid isolation, we combined 50 μL of sample with 20 μL of Bead mix (containing lysis/binding solution, carrier RNA, and 100% isopropanol) on a U-bottom 96-well plate. Cells were lysed by using 130 μL lysis/binding solution and mixed for 5 minutes on a shaker. The beads were captured on a magnetic stand and washed twice using 150 μL Wash Solution 1 and 2 with a final elution volume of 50 μL. We performed PCR amplification of p72 according to King et al. (41). The primer and probe mixture was commercially synthesized by using PrimeTime Mini qPCR Assay (IDT Technologies, https://www.idtdna.comExternal Link): probe (5-[6-FAM]- CCA CGG GAG ZEN GAA TAC CAA CCC AGT G-3-[IBFQ]), sense primer (5-CTG CTC ATG GTA TCA ATC TTA TCG A-3), and anti-sense primer (5-GAT ACC ACA AGA TCR GCC GT-3). The 15 μL PCR mixture consisted of 10 μL 2X iTaq Universal Probes Supermix (Bio-Rad Laboratories, http://www.bio-rad.comExternal Link), 1 μL 1X PrimeTime Mini (500 nM primers and 250 nM probe), and 4 μL nuclease-free water. We dispensed this mastermix into a Hard-Shell optical 96 well reaction plate (Bio-Rad Laboratories), added DNA samples, and briefly centrifuged the plate to remove air bubbles. We then performed real-time PCR on a CFX96 Real-Time System (Bio-Rad Laboratories) under the following conditions: 95°C for 2 min, followed by 45 cycles of 94°C for 30 s, 58°C for 1 min, and 60°C for 30 s. We performed data analysis by using CFX96 software and reported results as cycle threshold values. Data Analysis We assessed infectivity by using 3 diagnostic methods (PCR of spleen, PCR of serum, and virus isolation of spleen), which resulted in 3 binary response variables (i.e., positive or negative) for each individual pig. We categorized ASFV infection as positive if >1 diagnostic test indicated evidence of infection. We analyzed all binary responses simultaneously to account for imperfect test agreement (4244). Without assuming a functional form for the relationship between dose and probability of infection, we used a constrained spline regression model. The constraints used were limited to the assumptions that infection probability increases as dose increases and that the relationship is continuous. We used a constrained regression spline within a Bayesian hierarchical model to estimate the infection probability at each dose for a single exposure based on the results of the 3 diagnostic methods. On the basis of the single exposure, we also modeled repeated exposures, assuming repeated exposures are independent events. Thus, we calculated the infection probability for multiple exposures as 1 (1 p)q, where p is the single-exposure infection probability and q is the number of exposures. Repeated exposures can be viewed interactively online (https://trevorhefley.shinyapps.io/asfvExternal Link). We used previously described algorithms for statistical model implementation (45,46) by using the cgam package in R (47). We have provided a tutorial with the computational details, annotated computer code to assist readers implementing similar models, and the necessary code to reproduce results and figures related to the analysis (Appendix). Top A summary of the infection results is shown in Table 2. A total of 68 pigs were included in the study. No evidence of ASFV infection was detected in the 14 negative control pigs. Therefore, adequate biosecurity was maintained throughout the study. Of the 32 pigs with evidence of ASFV infection, 16 (50%) were positive on virus isolation and PCR of spleen, 8 (25%) were positive on virus isolation of spleen alone, and 8 (25%) were positive on all 3 tests. The 34 pigs in the feeding trial consumed the 100 g of feed in a mean + SD of 14.8 + 5.5 min (minimum 7 min, maximum 30 min). For the liquid trial, the 34 pigs consumed the 100 mL of ASFV-inoculated media in a mean + SD of 21.1 + 18.2 min (minimum 3 min, maximum 63 min). A small number of pigs (3/34 [8.8%]) averse to the restricted-flow nipples consumed media from a bowl. Figure 1 Figure 1. Estimated liquid (blue line) and feed (black line) infection probability at different oral doses of ASFV based on experimental data to determine the infectious dose of ASFV when consumed naturally. Data... Overall, the probability of infection increased as the dose increased for both feed and liquid (Figure 1). Reported as the lowest dose required to result in ASFV infection of >1 pig, the MID after liquid consumption was 100 TCID50, whereas 104 TCID50 was the MID required to result in infection after consumption of contaminated complete feed. For a single exposure, liquid had a higher infection probability compared with feed at doses up to 107.5 TCID50 where the 95% CIs overlap (Figure 1, panel A). At the highest dose tested in liquid (104 TCID50), 100% of pigs were infected with ASFV; in contrast, no feed dose resulted in a 100% infection rate in this experiment. Figure 2 Figure 2. African swine fever virus (ASFV) ID50 distribution in a study determining the infectious dose of ASFV when consumed naturally in liquid or feed. For liquid, ID50 was 101.0, and for feed,... When multiple exposures are considered, the infection probability increases at all dose levels for both liquid and feed (Figure 1, panels B and C). By 10 exposures with liquid, the probability of infection increases to near 1 at the lowest dose of 1 TCID50 ASFV. For feed with multiple exposures, we observed an increase in the width of the 95% CI at the lower dosages, indicating that with repeated exposures, the uncertainty in the infection probability increased. This result was attributable to fewer pigs being infected with lower doses and the lower infection probability for a single exposure. The distribution of plausible doses that could produce infection in 50% of pigs is shown in Figure 2. The ID50 was 101.0 (95% CI 100102.3) for liquid and 106.8 (95% CI 104.6108+) for feed. Top Our study confirms the efficient transmission of ASFV by the oral route in liquid and feed lacking contaminated pork products and provides quantitative data for the Georgia 2007 strain. Early studies indicated a minimum dose of 105 50% hemadsorption doses (HAD50) of ASFV KWH/12 was required to cause infection when administered orally in milk (38). Later, Howey et al. (35) determined the infectious potential of 3 doses of ASFV Malawi 1983 delivered intraoropharyngeally to commercial pigs. Although a low dose of 102 HAD50 did not induce infection (0/2), moderate (104 HAD50) and high (106 HAD50) doses were sufficient to cause infection in 100% of the pigs (4/4) (35). More recently, a study demonstrated that even lower doses of a contemporary ASFV isolate related to ASFV Georgia 2007 was capable of inducing infection. Specifically, Pietschmann et al. (34) showed that oronasal doses as low as 3 and 25 hemadsorption units of ASFV Armenia 2008, when delivered in 2 mL of splenic suspension, caused infection in wild boar. Increased susceptibility was demonstrated in wild boar described as weak with poor condition (34). In our study, we confirmed the high infectivity of ASFV Georgia 2007 through liquid by the oral route. Of note, the pigs in our study consumed the contaminated liquid naturally through drinking and were considered healthy and robust. Productive infection resulted in almost 40% of the pigs exposed to an ASFV liquid inoculum containing as little as 1 TCID50. The low infectious dose of ASFV through natural liquid consumption should be considered as a possible factor in the spread of ASF through water, consistent with the epidemiologic evidence linking the Danube River with ASF spread in Romania (18). ASFV delivered through liquid by the oronasal or intraoropharyngeal route might result in infection because of virus exposure of the nasopharynx, including the tonsils, or of the gastrointestinal tract. Because of the high stability of ASFV in a wide range of pH values (from 4 to 10) (13), survival in the acidic gastric environment is possible but unlikely. More likely is that liquid medium provides an ideal substrate for virus contact with the tonsils, where primary virus replication occurs after natural exposure to ASFV (38). Reports documenting experimental ASFV infection through contaminated feed involve consumption of tissues from infected animals. As early as 1954, it was reported that transmission of ASFV by oral feeding required a minimum dose of 105 (40). Parker et al. failed to infect pigs with homogenized tissues from warthogs containing 103.7106.1 HAD50 of ASFV administered in solid feed (37). In contrast, Colgrove et al. (39) successfully infected domestic pigs by adding 50 g of minced spleen and liver from an infected pig to solid feed. Each gram of tissue contained 107.0107.5 HAD50 of ASFV isolate Hinde WH II (39). Our experimental studies using the contemporary isolate Georgia 2007 show that ASFV infection through the consumption of plant-based feed requires a higher dose compared with liquid. Compared with liquid media, feed might stimulate salivary proteases that degrade virus integrity. Furthermore, the feed matrix might inhibit tonsillar contact, reducing virus exposure to lymphoid and epithelial tissues before gastrointestinal entry (36). Despite the higher MID in feed compared with liquid observed in this study, we hypothesize that feed might actually pose a higher risk compared with water sources in modern swine production systems. Feed delivery is a high-frequency event, and feed production is highly centralized; thus, contaminated feed can be easily distributed across a substantial number of pig farms. Pigs would also likely consume the contaminated feed in higher volumes (>100 g) and at higher frequencies (>1 exposure) than what was tested in our study. The likelihood of productive infection after consumption of ASFV-contaminated complete feed increases significantly after 3 or 10 exposures (Figure 1, panels B, C). Therefore, despite infection after consumption of ASFV in contaminated feed being a lower-probability event compared with liquid, the high frequency of exposure might make feed a more important risk factor for transmission. Adding to this risk is the fact that highly centralized feed mills use ingredients from a global distribution supply chain. For example, inventory from a midwestern US swine farm indicated feed ingredients originating from 12 countries in North America, Asia, and Europe (S.S. Dritz, unpub. data, 2018 Sep 6). As of February 2019, ASFV had spread to a high-biosecurity farm in Romania (17) and had been detected in pig herds located in >25 provinces of China, including the capital Beijing (48), with thousands of kilometers separating affected herds. How ASFV is moving across such vast areas within the largest pork-producing country in the world is unknown; however, movement of the virus within feed or feed ingredients should be considered. The results of our study demonstrate that ASFV can be easily transmitted orally through natural consumption of both liquid and feed, supporting the potential role of feed in the emergence of this virus in new pig populations throughout the world. Top Dr. Niederwerder is an assistant professor of virology in the Department of Diagnostic Medicine/Pathobiology at Kansas State University, Manhattan, Kansas. Her research interests are in the pathogenesis, prevention, and control of emerging and endemic viral diseases of swine. Top The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
African swine fever virus, or ASFV, transmission through feed for pigs - Google Search
Michael_Novakhov shared this story . Search Results Web results Infectious Dose of African Swine Fever Virus When Consumed ... wwwnc.cdc.gov eid article 18-1495_article wwwnc.cdc.gov eid article 18-1495_article Cached Feb 13, 2019 - In 2014, the introduction and spread of ASFV in Latvia was associated with the feeding of virus-contaminated fresh grass or crops to naive pigs ... by MC Niederwerder - Cited by 40 - Related articles PEOPLE ALSO SEARCH FOR Transmission routes of African swine fever virus to domestic pigs veterinaryrecord.bmj.com content <a href="http://veterinaryrecord.bmj.com" rel="nofollow">veterinaryrecord.bmj.com</a> content Abstract. African swine fever (ASF) is a major threat to the pig industry in Europe. ... feed, as the main transmission routes of ASF virus (ASFV) to domestic pigs. by C Guinat - 2016 - Cited by 106 - Related articles PEOPLE ALSO SEARCH FOR Assessing the risk of African swine fever virus (ASFV ... www.pork.org research assessing-risk-african-swine... <a href="http://www.pork.org" rel="nofollow">www.pork.org</a> research assessing-risk-african-swine... Cached Taken together, this study provides evidence that ASFV can be easily transmitted orally through contaminated liquid and feed when consumed naturally, with higher doses required for infection in complete feed, and provides additional information supporting the potential role of feed in ASFV transmission. The Risk of Infection by African Swine Fever Virus in ... www.frontiersin.org articles fvets.2019.00486 full <a href="http://www.frontiersin.org" rel="nofollow">www.frontiersin.org</a> articles fvets.2019.00486 full Cached Jan 9, 2020 - The Risk of Infection by African Swine Fever Virus in European Swine Through ... The riskiest pathway for ASFV transmission to pigs was the ... to swill feeding with contaminated food waste, it became endemic in the Iberian ... by RA Taylor - 2020 - Cited by 3 - Related articles African Swine Fever - The Center for Food Security and Public ... www.cfsph.iastate.edu Factsheets pdfs african_swi... <a href="http://www.cfsph.iastate.edu" rel="nofollow">www.cfsph.iastate.edu</a> Factsheets pdfs african_swi... Cached Similar PDF Jun 18, 2019 - The spread of ASFV is facilitated by a number of factors, including its persistence for long periods in uncooked pork products, which may be fed to pigs in food scraps (pig swill), and its ability to become established in wild or feral suids. by PA Suum - Related articles
Certain feed additives may be effective tools against ASF
Michael_Novakhov shared this story from FeedNavigator RSS. ASF has been spreading rapidly, threatening pork production and human food security worldwide.  The study from the K-State research team, headed by Megan Niederwerder, assistant professor of diagnostic medicine and pathobiology in the College of Veterinary Medicine, was published in the journal Transboundary and Emerging Diseases.  The team said the paper provides the first evidence that feed additives may be effective tools against the virus, that chemical feed additives may potentially serve as mitigants for reducing the risk of ASFV introduction and transmission through feed. "Over the last two years, ASF is estimated to be responsible for the death of at least 25% of the world's pig population due to the emergence of the virus within China and subsequent spread to over 10 other Asian countries," Niederwerder said. "In 2019, we published the first report of African swine fever virus, or ASFV, transmission through the natural consumption of plant-based feed. Our subsequent work has focused on mitigation of ASFV in feed through the use of chemical feed additives and heat treatment, she added. Niederwerder and her team examined two different classes of liquid feed additives, including a medium-chain fatty acid-based additive and a formaldehyde-based additive, for efficacy against ASF virus in cell culture and in feed ingredients. In general, the scientists observed that both chemical additives demonstrated evidence of reducing the virus infectivity, with data supporting dose-dependent efficacy. The study lead said there are currently no commercially available vaccines and no effective treatments that can be administered to pigs for ameliorating disease caused by the virus. Thus, control of ASF is focused on biosecurity measures to prevent the introduction of the virus into negative countries or negative farms and regions within a positive country. The other method of containment would involve large-scale culling of infected or high-risk animals to contain the spread of the virus. "Our new research reports novel data evaluating the efficacy of feed additives on inactivating ASFV in an in vitro cell culture model and a feed ingredient transoceanic shipment model," Niederwerder said. "This will provide valuable information to the swine industry with regards to mitigating the risk of potential routes for introduction and transmission of ASFV through feed and ingredients." The K-State study was funded by a grant from the Swine Health Information Center and the State of Kansas National Bio and Agro-defense Facility Fund. While she said the results of the study are promising, Niederwerder emphasized the need for a multifaceted approach to reducing the risk of ASF virus in feed, including sourcing ingredients from countries without the virus when possible, applying holding times to high-risk ingredients, and implementing consistent biosecurity protocols at the feed mill. Source: Transboundary and Emerging Diseases DOI: https://doi.org/10.1111/tbed.13699 Title: Mitigating the risk of African swine fever virus in feed with antiviral chemical additives Authors: MC. Niederwerder, S. Dee, DG Diel, A MM. Stoian  LA Constance, M Olcha, V. Petrovan, G. Patterson, AG CinoOzuna, R RR Rowland
african swine fever - Google Search
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African Swine Fever continues to grow worldwide | News
Michael_Novakhov shared this story from norfolkdailynews.com - RSS Results in wjag/news of type article. DES MOINES, IA - COVID-19 dominates the news, but National Pork Board senior vice president of science and technology Dr. David Pyburn says agriculture cannot forget about African Swine Fever. Advertisement Pyburn says ASF has continued to expand its territory globally. About five to six months ago it moved into Greece, but it looks like they might get it under control. "We also saw a couple of months ago it moved into India as well, so another country that has now been declared positive for the virus. In the countries of the Philippines, China, Vietnam, those Asian countries, we continue to see it expanding its territory within those countries and continues to affect more herds in those countries. They do not have it under control." Advertisement Pyburn says even in that Eastern European area and in Poland as well, theyve seen continued ASF expansion. He says they continue to talk with Customs and Border Protection, because thats the first line of defense in making sure ASF doesnt come to the U.S. Advertisement
Google Alert - covid-19 and pork: African Swine Fever continues to grow worldwide
Michael_Novakhov shared this story from Disease X-19 Epidemiology from Michael_Novakhov (39 sites). DES MOINES, IA - COVID-19 dominates the news, but National Pork Board senior vice president of science and technology Dr. David Pyburn says ...  Google Alert - covid-19 and pork
6:33 PM 7/13/2020 - Hypothetically, the mass infections with Sars-Cov-2 in Dutch (and probably other) Mink and their ability to transmit it to humans, indicate that the similar situation may exist in genetically close to them various river rats and sewer rats. They have to be tested! - M.N.
Michael_Novakhov shared this story from Covid-19-Review. Hypothetically, the mass infections with Sars-Cov-2 in Dutch (and probably other) Mink and their ability to transmit it to humans, indicate that the similar situation may exist in genetically close to them various river rats and sewer rats. They have to be tested! - M.N. | 6:33 PM 7/13/2020  ________________________________ Blogs from Michael_Novakhov _______________________________________________________________ Blogs from Michael_Novakhov (24 sites)  Covid-19-Review: 6:07 PM 7/13/2020 - Minks culled in Netherlands Covid-19-Review: The Disease X-19 - Michael Novakhov | 7.13.20 Covid-19-Review: 12:39 PM 7/13/2020 - Coronavirus: 169 new cases in Italy, deaths up by 13 - Disease X-19 News Review In Brief Covid-19-Review: 11:36 AM 7/13/2020 - Coronavirus rate growing fast in US military: Defense Department, World News | Hundreds of Army and Air Force Recruits Have Tested Positive for COVID-19 Since March Saved Stories - Blogs: 9:35 AM 7/13/2020 - Selected Posts: The Disease X-19: Introductions and early spread of SARS-CoV-2 in France | bioRxiv Saved Stories - Blogs: 5:57 PM 7/12/2020 - WHO team commands China to search origin of coronavirus - Mike Nova's Shared NewsLinks Review In 250 Brief Posts Covid-19-Review: 5:57 PM 7/12/2020 - WHO team commands China to sea... covid-19-review.blogspot.com/2020/07/557-pm Covid-19-Review: 9:35 AM 7/13/2020 - Selected Posts: The Disease X-19: Introductions and early spread of SARS-CoV-2 in France | bioRxiv Saved Stories - Blogs: 7:11 AM 7/13/2020 - Superspreading: environment or individuals? - Google Search 13/07/20 06:42 from Disease X-19 from Michael_Novakhov Covid-19-Review: 7:11 AM 7/13/2020 - Superspreading: environment or individuals? - Google Search 13/07/20 06:42 from Disease X-19 from Michael_Novakhov Covid-19-Review: 5:57 PM 7/12/2020 - WHO team commands China to search origin of coronavirus - Mike Nova's Shared NewsLinks Review In 250 Brief Posts Covid-19-Review: 4:41 PM 7/12/2020 - Russia has developed world's first Covid-19 vaccine, British, German, Chinese, and other Studies state that the Immunity falls sharply within the first two to several months and the reinfections are seen. Covid-19-Review: 3:40 PM 7/12/2020 - White supremacist violence in the U.S. is on the rise, with a sharp increase in deadly incidents over the last five years. Covid-19-Review: 3:12 PM 7/12/2020 - Wuhan scientists 'defecting to West' as FBI gathers evidence coronavirus pandemic WAS caused by an accidental leak Covid-19-Review: 11:58 AM 7/12/2020 - 'A multisystem disease': How coronavirus affects the entire body The FBI News Review: 7:54 AM 7/12/2020 - The Covid-19 Pandemic Cyberattacks: Is there a significant increase, and are these attacks a part of the Bio-Info-Warfare package? | Hospitals see rise in patient data hacking attacks during COVID-19 The FBI News Review: 6:59 AM 7/12/2020 - North Korea's Military Can Kill a Lot of People Covid-19-Review: 5:53 PM 7/11/2020 - Disease X-19 - News Review Covid-19-Review: 5:17 PM 7/11/2020 - News - rats in nyc Covid-19-Review: 3:06 PM 7/11/2020 - Vice versa: rats caused the Pandemic! Rat population was amplified deliberately & globally as the tool & vector of the future Pandemic. | Rats and the COVID-19 pandemic: Early data on the global emergence of rats in response to social distancing | medRxiv Covid-19-Review: 10:27 AM 7/11/2020 - Young Adults Now Make Up Most Of Chicago's New Coronavirus Cases Covid-19-Review: 10:20 AM 7/11/2020 - US covid-19 rates and rat populations by zip codes: is there an association? - M.N. 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Search Results Web results Coronavirus is killing the Dutch mink industry <a href="http://www.nationalgeographic.com" rel="nofollow">www.nationalgeographic.com</a> animals 2020/06 co... <a href="http://www.nationalgeographic.com" rel="nofollow">www.na... » Thousands of mink to be culled after SARS-CoV-2 found on 23rd farm 13/07/20 17:48 from Mike Nova's Shared Newslinks Michael_Novakhov shared this story . The Dutch government revealed on Monday that the 23rd mink farm in the country showed positive test results for novel coronavirus SARS-CoV-2. The farm houses two thousand female mink and their litters... » Sars-Cov-2 existed since 2013 - University of Calgary research - Google Search 13/07/20 15:51 from Mike Nova's Shared Newslinks Michael_Novakhov shared this story . SARS-CoV-2 has been evolving for at least 7 years <a href="http://www.news-medical.net" rel="nofollow">www.news-medical.net</a> news SARS-CoV-2-has-bee... <a href="http://www.news-medical.net" rel="nofollow">www.news-medical.net</a> news ... » The Disease X-19 - Michael Novakhov | 7.13.20 13/07/20 14:41 from Mike Nova's Shared Newslinks Michael_Novakhov shared this story from Covid-19-Review. The Disease X-19 - 7.13.20 Update Covid-19 Review: The Pandemic As The Bio-Info-Weapon - The Disease X-19 I respectfully recommend to WHO and the Scientific Community to rename Co... » The importance of multiparasitism: examining the consequences of co-infections for human and animal health | SpringerLink 13/07/20 13:41 from Mike Nova's Shared Newslinks Michael_Novakhov shared this story . » Hantavirus : What are the chances of having both hantavirus and coronavirus infection in same human in china ? 13/07/20 13:39 from Mike Nova's Shared Newslinks Michael_Novakhov shared this story . Hantavirus : What are the chances of having both hantavirus and coronavirus infection in same human in china ? "Hantaviruses in the Americas are known as New World hantaviruses and may cause hantavi... » Multiple Co-infections of Rodents with Hantaviruses, Leptospira, and Babesia in Croatia 13/07/20 13:38 from Mike Nova's Shared Newslinks Michael_Novakhov shared this story . Abstract Hantaviruses, Leptospira spp., and Babesia spp. are rodent-borne pathogens present worldwide. We studied multiple co-infections of small rodents in Croatia with all three pathogens. Twenty-ei... » Covid-19 and hantavirus as coinfections of the pandemic - Google Search 13/07/20 13:35 from Mike Nova's Shared Newslinks Michael_Novakhov shared this story . 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NEW YORK CITY (WABC) -- New York City marked its first 24-hour period without a COVID-19 related death for the first time since the pandemic began, but officials are growing concerned a... » US coronavirus: Coronavirus cases continue to surge, reaching nearly 1 out of every 100 American 13/07/20 13:19 from Mike Nova's Shared Newslinks Michael_Novakhov shared this story . At least 35 states are seeing a rise in new cases compared to the previous week, according to Johns Hopkins University data. Both local and state leaders in the US have said in recent weeks new cases ...
6:07 PM 7/13/2020 - Minks culled in Netherlands
Michael_Novakhov shared this story from Covid-19-Review. 6:07 PM 7/13/2020 - minks culled in netherlands Covid-19-Review ____________________________________________________  Audio News: | VOA Newscasts | NPR News Now |  NPR News Now On RSS Dog |  Michael Novakhov SharedNewsLinks In Brief | Trump Investigations News In Brief | Trump Investigations on RSS Dog | Michael Novakhov SharedNewsLinks | on RSS Dog  Michael Novakhov - SharedNewsLinks minks culled in netherlands - Google Search minks culled in netherlands - Google Search Thousands of mink to be culled after SARS-CoV-2 found on 23rd farm Sars-Cov-2 existed since 2013 - University of Calgary research - Google Search The Disease X-19 - Michael Novakhov | 7.13.20 The importance of multiparasitism: examining the consequences of co-infections for human and animal health | SpringerLink Hantavirus : What are the chances of having both hantavirus and coronavirus infection in same human in china ? Multiple Co-infections of Rodents with Hantaviruses, Leptospira, and Babesia in Croatia Covid-19 and hantavirus as coinfections of the pandemic - Google Search covid-19 - Google Search COVID NYC Update: New York City reports no COVID deaths, but new concerns about infection rates US coronavirus: Coronavirus cases continue to surge, reaching nearly 1 out of every 100 American 12:39 PM 7/13/2020 - Coronavirus: 169 new cases in Italy, deaths up by 13 - Disease X-19 News Review In Brief 11:36 AM 7/13/2020 - Coronavirus rate growing fast in US military: Defense Department, World News | Hundreds of Army and Air Force Recruits Have Tested Positive for COVID-19 Since March Google Alert - coronavirus in new york post: New Yorkers fear second coronavirus wave with worst yet to come Google Alert - sars cov 2: Vietnam now has 16 people positive for SARS-CoV-2 Google Alert - CoronaVirus as Biological Weapon: Is it true that Corona is a biological weapon and not some random virus? Coronavirus rate growing fast in US military: Defense Department, World News Hundreds of Army and Air Force Recruits Have Tested Positive for COVID-19 Since March Google Alert - Coronavirus and US Military: Hundreds of Army and Air Force Recruits Have Tested Positive for COVID-19 Since March Google Alert - Coronavirus and US Military: Coronavirus rate growing fast in US military: Defense Department Covid-19-Review: 9:35 AM 7/13/2020 Selected Posts: The Disease X-19: Introductions and early spread of SARS-CoV-2 in France | bioRxiv 9:35 AM 7/13/2020 - Selected Posts: The Disease X-19: Introductions and early spread of SARS-CoV-2 in France | bioRxiv Google Alert - sars cov 2: Coronavirus: Immunity to Covid-19 can vanish in months, study suggests 9:35 AM 7/13/2020 - Selected Posts: The Disease X-19: Introductions and early spread of SARS-CoV-2 in France | bioRxiv Feed Integration by RSS Dog.  _____________________________________________
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Covid-19 and global Real Estate Market - Google Search
Michael_Novakhov shared this story . Search Results Web results Coronavirus (COVID-19) real estate implications | JLL Research www.us.jll.com trends-and-insights covid-19-global... <a href="http://www.us.jll.com" rel="nofollow">www.us.jll.com</a> trends-and-insights covid-19-global... Cached Apr 19, 2020 - The COVID-19 pandemic is now a truly global phenomenon with 2.6 billion ... In the real estate sector, we can see that the pandemic has ... Global Real Estate Rental Market Report 2020-30: COVID-19 ... www.businesswire.com news home Global-Real-E... <a href="http://www.businesswire.com" rel="nofollow">www.businesswire.com</a> news home Global-Real-E... Cached Jun 2, 2020 - Global Real Estate Rental Market Report 2020-30: COVID-19 Impact & Recovery - <a href="http://ResearchAndMarkets.com" rel="nofollow">ResearchAndMarkets.com</a>. June 02, 2020 04:42 AM Eastern ... Global Real Estate Markets 2020-2030: COVID-19 ... www.businesswire.com news home Global-Real-E... <a href="http://www.businesswire.com" rel="nofollow">www.businesswire.com</a> news home Global-Real-E... Cached May 13, 2020 - The global real estate market is expected to grow from $2,673.1 billion in 2019 to $2,696.7 billion in 2020, rising at a compound annual growth ... Understanding COVID-19's impact on the real estate sector ... www2.deloitte.com about-deloitte articles covid-19 <a href="http://www2.deloitte.com" rel="nofollow">www2.deloitte.com</a> about-deloitte articles covid-19 Cached As the effects of COVID-19 are felt around the world, real estate companies are being ... Understanding COVID-19's impact on the global real estate sector

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THE REAL COUP WAS IN 2016 | THE PSYCHOANALYSIS OF INTELLIGENCE OPERATIONS

The real Coup was in 2016, and it was performed by the corrupt, pro neo-Nazi oriented, Abwehr bought and subverted, the Rightist wing of the GOP, the Broidy-Manafort ring in its latest reincarnation; and by the other alumni of the Abwehr Law School, a.k.a. Roy Cohn’s Law Firm: Little Duce Giuliani, “dirty trickster” Roger Stone, and their circles, climbing and clawing their ways to Power and Money. And apparently, some officers of the New York Branch of the FBI were their ideological and operational “stormtroopers”. Search the Anthony Weiner sexting affair scandal as FBI operation, much under-researched, under-investigated, and under-publicized. 
If only a part of all these legitimate and well based suspicions and accusations against the New York branch of the FBI are proven or sufficiently demonstrated, this question would be quite legitimate: Was at least a part of the NY FBI branch corrupt, rotten, in Trump’s pocket, and under possible influences of the foreign agents? 

Investigate the “STORMTROOPERS” – the alleged “pro-Trumpists” within the NY branch of the FBI, and look into the general health of the whole branch. 

Investigate James Kallstrom and others! 

Investigate the Abwehr – Roy Cohn Law School and all its “graduates”. 

Investigate the political corruption in both parties. Investigate the corruption and failures within the FBI, and their root causes. The proof is in the pudding, sadly but undeniably. 

Michael Novakhov | 7:38 AM 11/26/2019 – Post Link

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The Psychoanalysis of Intelligence Operations And the Diagnostic Signs and Features of Abwehr Operations – Preliminary Web Review By Michael Novakhov

Psychoanalysis of Intelligence Operations – 11.17.19

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(PDF) The Role of Psychoanalytic Knowledge in CIA’s ARTICHOKE and MKULTRA Documents During the Years 1947-1963: Use and Misuse of Psychoanalytic Techniques

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Check out C-SPAN’s Impeachment Inquiry Page: https://www.c-span.org/impeachment | 

Post Link | C-SPAN has launched a new web page, c-span.org/impeachment, devoted to Congress’ impeachment inquiry into President Donald Trump. The goal is to provide one-stop shopping for all of C-SPAN’s coverage of the inquiry, including the latest Hill tweets, various news conferences and hearings, and the Trump Administration’s response. 

» Saved Stories – None: C-SPAN Launches Impeachment Coverage Page
22/10/19 07:34 from Saved Stories from Michael_Novakhov (1 sites)
C-SPAN has launched a new web page, c-span.org/ impeachment , devoted to Congress’ impeachment inquiry into President Donald Trump. The goal … Saved Stories – None

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Saved Stories – In 50 Brief Posts | In 250 Brief Posts | On RSS Dog | 

» Saved Stories - None: Google Alert - COVID-19 Outbreak In fish and seafood Industry: Fishing Communities Constrained by COVID-19
14/07/20 10:16 from Saved Stories from Michael_Novakhov (1 sites)
The COVID - 19 pandemic, which has seemingly affected every sphere of ... These disruptions include a complete shut-down of some fisheries , ... the fisheries sector – has provided little help to the sector since the outbreak began. Goog...

» Saved Stories - None: Google Alert - sars cov 2: COVID-19 – researchers sum up the “Tsunami” of information
14/07/20 10:10 from Saved Stories from Michael_Novakhov (1 sites)
The severe acute respiratory syndrome coronavirus 2 ( SARS CoV - 2 ) infection leading to COVID-19 is a raging pandemic across the world at present. Google Alert - sars cov 2 Saved Stories - None

» Saved Stories - None: Google Alert - covid-19 in meat plants: Half of Covid-positive workers in meat plant were asymptomatic, reports show
14/07/20 10:09 from Saved Stories from Michael_Novakhov (1 sites)
The report shows that while there was significant Covid - 19 infection among meat plant workers, many did not have severe symptoms of the disease, ... Google Alert - covid-19 in meat plants Saved Stories - None

» Saved Stories - None: Google Alert - coronavirus immunity: Ex-Harvard Medical School faculty member warns COVID-19 herd immunity is 'wishful thinking'
14/07/20 10:09 from Saved Stories from Michael_Novakhov (1 sites)
People can become immune to certain viruses after surviving infection or being vaccinated. Typically, at least 70 percent of a population must be ... Google Alert - coronavirus immunity Saved Stories - None

» Saved Stories - None: Google Alert - covid-19 in daily mail: Pub coronavirus cluster grows to 28 as fears grow Sydney will be forced back into lockdown
14/07/20 10:08 from Saved Stories from Michael_Novakhov (1 sites)
Pub coronavirus cluster grows to 28 as fears grow Sydney will be forced back into lockdown. By Brittany Chain For Daily Mail Australia 22:05 EDT 13 Jul ... Google Alert - covid-19 in daily mail Saved Stories - None

» Saved Stories - None: Google Alert - coronavirus in nursing homes: NY Senate, Assembly to hold hearings on coronavirus impact, including nursing homes
14/07/20 10:07 from Saved Stories from Michael_Novakhov (1 sites)
On August 3 and August 10, state lawmakers will discuss the rate of coronavirus infections and the number of deaths in residential health care facilities  ... Google Alert - coronavirus in nursing homes Saved Stories - None

» Saved Stories - None: Google Alert - covid-19 neurological symptoms: This doctor caught coronavirus at a meeting about coronavirus. Then it nearly killed him.
14/07/20 10:07 from Saved Stories from Michael_Novakhov (1 sites)
Over the next month, the coronavirus dragged Lewis to the brink of death. ... to diagnosis his own delirium during a check-up with a neurologist . Google Alert - covid-19 neurological symptoms Saved Stories - None

» Saved Stories - None: Google Alert - CoronaVirus as Biological Weapon: E-voices, July 14, 2020
14/07/20 10:06 from Saved Stories from Michael_Novakhov (1 sites)
It's a biological weapon you are wielding, plain and simple. ... “Nothing has changed except for the 135,000 deaths caused by the coronavirus . Google Alert - CoronaVirus as Biological Weapon Saved Stories - None

» Saved Stories - None: Google Alert - coronavirus cardiac symptoms: Silent hypoxia in patients with SARS CoV-2 infection before hospital discharge
14/07/20 10:05 from Saved Stories from Michael_Novakhov (1 sites)
Researchers conducted a 6 MWT in 26 discharge-ready COVID -19 patients without chronic pulmonary disease or cardiac failure. They tested heart  ... Google Alert - coronavirus cardiac symptoms Saved Stories - None

» Saved Stories - None: Google Alert - Coronavirus and US Military: Japan traces new coronavirus outbreak linked to Tokyo theatre
14/07/20 10:02 from Saved Stories from Michael_Novakhov (1 sites)
... with plans to reopen a runway at one of the country's biggest airports, even as infections persist in major cities, rural areas and U.S. military bases. Google Alert - Coronavirus and US Military Saved Stories - None

» Saved Stories - None: Google Alert - Coronavirus and US Military: COVID-19 flare-ups at US overseas bases spark concerns among local communities
14/07/20 10:00 from Saved Stories from Michael_Novakhov (1 sites)
TOKYO/SEOUL, July 14 (Xinhua) -- The recent COVID -19 flare-ups at several U.S. overseas military bases have sparked concerns among local ... Google Alert - Coronavirus and US Military Saved Stories - None

» Saved Stories - None: Google Alert - sars cov 2: Researchers stabilize the closed SARS-CoV-2 spike trimer
14/07/20 09:59 from Saved Stories from Michael_Novakhov (1 sites)
The target of much of this study is the spike (S) protein of severe acute respiratory syndrome coronavirus 2 ( SARS - CoV - 2 ), a trimeric component of the ... Google Alert - sars cov 2 Saved Stories - None

» Saved Stories - None: Google Alert - coronavirus on twitter: Japan says coronavirus adds to security threat by China
14/07/20 09:58 from Saved Stories from Michael_Novakhov (1 sites)
As evidence, a Japanese Defense Ministry official noted a Chinese Foreign Ministry official had posted on Twitter in March accusing U.S. military of ... Google Alert - coronavirus on twitter Saved Stories - None

» Saved Stories - None: Google Alert - sars cov 2: Antibodies and immune responses are preferentially being generated against the wrong parts of ...
14/07/20 09:58 from Saved Stories from Michael_Novakhov (1 sites)
Several serologic tests have been developed to help diagnose the presence of the severe acute respiratory syndrome coronavirus 2 ( SARS - CoV - 2 ), ... Google Alert - sars cov 2 Saved Stories - None

» Saved Stories - None: Google Alert - coronavirus and mafia: 'Fear City: New York vs. The Mafia' Trailer: Netflix Docuseries Details the Mob's Stranglehold on the ...
14/07/20 09:57 from Saved Stories from Michael_Novakhov (1 sites)
New York was becoming a playground for organized crime, and five mafia ... THE MAFIA sheds light on how the mafia's control of unions, high-rise ... by attending school in person next month while coronavirus continues to rage. Google Ale...

» Saved Stories - None: Google Alert - coronavirus new york: New York City Reports No COVID Deaths in 24 Hours | Voice of America - English
14/07/20 09:57 from Saved Stories from Michael_Novakhov (1 sites)
New York City, once the center of the U.S. COVID -19 outbreak, has had its first 24-hour period with no coronavirus deaths. "This disease is far from ... Google Alert - coronavirus new york Saved Stories - None

» Saved Stories - None: Google Alert - covid-19 in daily mail: Ten-year-old boy is among ELEVEN Australians infected with coronavirus on a single flight from ...
14/07/20 09:57 from Saved Stories from Michael_Novakhov (1 sites)
Ten-year-old boy is among ELEVEN Australians infected with coronavirus on a single flight from the UK. By Charlotte Karp For Daily Mail Australia 00:49 ... Google Alert - covid-19 in daily mail Saved Stories - None

» Saved Stories - None: Google Alert - coronavirus in israel: Israel's lightning response to a frightening pandemic
14/07/20 09:56 from Saved Stories from Michael_Novakhov (1 sites)
Israel's response to the coronavirus pandemic is much like Israeli society – fast, fascinating, and full of heart. In my conversations with leading Israeli  ... Google Alert - coronavirus in israel Saved Stories - None

» Saved Stories - None: Google Alert - Coronavirus and cyber attacks: Australian enterprises facing more cyber attacks
14/07/20 09:56 from Saved Stories from Michael_Novakhov (1 sites)
According to VMware Carbon Black's 2020 Australia cyber attack ... have also been targeted by cyber attackers amid the ongoing Covid -19 pandemic. Google Alert - Coronavirus and cyber attacks Saved Stories - None

» Saved Stories - None: Google Alert - covid rash: Okinawa in bind over tight-lipped US military on COVID-19 cases
14/07/20 09:55 from Saved Stories from Michael_Novakhov (1 sites)
A recent rash of COVID -19 cases among U.S. military personnel in Okinawa left the prefectural government scrambling to persuade notoriously ... Google Alert - covid rash Saved Stories - None

» Saved Stories - None: Google Alert - Coronavirus in health care workers: Congress must address mental health needs of medical workers
14/07/20 09:54 from Saved Stories from Michael_Novakhov (1 sites)
... medical workers for their heroic efforts to save victims of the coronavirus . ... and other health professionals who are fighting the COVID -19 pandemic. Google Alert - Coronavirus in health care workers Saved Stories - None

» Saved Stories - None: Google Alert - covid-19 in daily mail: Mystery as 57 Argentine fishermen test positive for coronavirus despite spending 35 days at sea ...
14/07/20 09:27 from Saved Stories from Michael_Novakhov (1 sites)
The Echizen Maru fishing trawler returned to port after some of its crew began exhibiting symptoms typical of COVID - 19 , the health ministry for the ... Google Alert - covid-19 in daily mail Saved Stories - None

» Saved Stories - None: Google Alert - Coronavirus dermatological symptoms: New way of detecting corona: By the skin
14/07/20 09:26 from Saved Stories from Michael_Novakhov (1 sites)
Even small changes on the skin can serve as markers to detect many undiagnosed or hidden internal diseases. Skin signs of Covid -19. Chandigarh- ... Google Alert - Coronavirus dermatological symptoms Saved Stories - None

» Saved Stories - None: Google Alert - coronavirus vaccine: Fact Check – Why Russia's Coronavirus Vaccine Does Not Signal an End to COVID-19 Pandemic?
14/07/20 09:26 from Saved Stories from Michael_Novakhov (1 sites)
Coronavirus ( COVID-19 ) vaccine developed by Russia has been all over the media. With more than 13 million cases, 575,000 deaths globally, the ... Google Alert - coronavirus vaccine Saved Stories - None

» Saved Stories - None: Google Alert - Coronavirus and HIV: Drop in HIV, TB testing since COVID-19 lockddown
14/07/20 09:25 from Saved Stories from Michael_Novakhov (1 sites)
Health Minister Zweli Mkhize says it's concerning to see a reduction in tests for non- COVID -19 related illnesses. HIV testing, blood tests Getty Images. Google Alert - Coronavirus and HIV Saved Stories - None

» Saved Stories - None: Google Alert - coronavirus in israel: Israeli Data Show School Openings Were a Disaster That Wiped Out Lockdown Gains
14/07/20 09:24 from Saved Stories from Michael_Novakhov (1 sites)
JERUSALEM— Israel's unchecked resurgence of COVID -19 was propelled by the abrupt May 17 decision to reopen all schools, medical and public ... Google Alert - coronavirus in israel Saved Stories - None

» Saved Stories - None: Google Alert - Coronavirus and US Military: US Virus Updates: Japan Criticizes US Military's Virus Policy; 10 States Surpass 100K Cases
14/07/20 09:23 from Saved Stories from Michael_Novakhov (1 sites)
Okinawa Gov. Denny Tamaki has criticized the U.S. military for a lack of transparency regarding the coronavirus , saying it has caused concern among ... Google Alert - Coronavirus and US Military Saved Stories - None

» Saved Stories - None: Google Alert - Covid toes and fingers: Symptoms of coronavirus: Fever, tiredness and dizziness among the warning signs you could have ...
14/07/20 09:23 from Saved Stories from Michael_Novakhov (1 sites)
... loss of taste or smell, a rash or discoloured fingers or toes . Others become infected but don't develop any symptoms and don't feel unwell — in short, ... Google Alert - Covid toes and fingers Saved Stories - None

» Saved Stories - None: Google Alert - new york times on coronavirus: Face Masks Will Be Mandatory in Shops in England
14/07/20 09:22 from Saved Stories from Michael_Novakhov (1 sites)
... over mandating face coverings to stop the spread of the coronavirus , the government of Prime Minister Boris Johnson was expected to announce on ... Google Alert - new york times on coronavirus Saved Stories - None

» Saved Stories - None: Google Alert - Coronavirus on Yahoo News: Coronavirus updates: Miami is now epicenter of COVID-19 pandemic, says doctor
14/07/20 09:22 from Saved Stories from Michael_Novakhov (1 sites)
This news followed last week's announcement that Russia is looking resume international air travel in mid July. Russia confirmed 6,248 new coronavirus  ... Google Alert - Coronavirus on Yahoo News Saved Stories - None

» Saved Stories - None: Google Alert - Covid toes and fingers: This is what you should take into account if you have Covid-19 and you will be treated at home
14/07/20 09:22 from Saved Stories from Michael_Novakhov (1 sites)
... and pains, nasal congestion, headache, conjunctivitis, sore throat, diarrhea, loss of taste or smell and rashes or color changes in the fingers or toes . Google Alert - Covid toes and fingers Saved Stories - None

» Saved Stories - None: Google Alert - new york times on coronavirus: The Stunning Sweep of the Coronavirus Through the Rio Grande Valley
14/07/20 09:20 from Saved Stories from Michael_Novakhov (1 sites)
“I love you,” the message flashed, over and over. Edgar Sandoval is a reporter on the Metro desk at The New York Times , where he covers ... Google Alert - new york times on coronavirus Saved Stories - None

» Saved Stories - None: Google Alert - Covid-19: Genetic factors: Why We're Losing the Battle With Covid-19
14/07/20 09:20 from Saved Stories from Michael_Novakhov (1 sites)
It looked as if his county might succeed in controlling the coronavirus outbreak. ... Cutting-edge gene therapies are curing rare genetic disorders, and new ... Think of the factors that determine a society's health as a pyramid, Frieden...

» Saved Stories - None: Google Alert - Covid-19: genetic studies: COVID-19 and American Identity
14/07/20 09:18 from Saved Stories from Michael_Novakhov (1 sites)
In the current COVID - 19 crisis, we hear whispers that America can only ... Studies estimate that the total number of coronavirus cases globally could have ... human-to-human transmission as late as January and withheld viral genetic &n...

» Saved Stories - None: Google Alert - covid-19 and pork: African Swine Fever continues to grow worldwide
14/07/20 06:53 from Saved Stories from Michael_Novakhov (1 sites)
DES MOINES, IA - COVID - 19 dominates the news, but National Pork Board senior vice president of science and technology Dr. David Pyburn says ... Google Alert - covid-19 and pork Saved Stories - None

» Saved Stories - None: Google Alert - coronavirus in new york post: New Yorkers fear second coronavirus wave with worst yet to come
13/07/20 10:51 from Saved Stories from Michael_Novakhov (1 sites)
Sign up for our special edition newsletter to get a daily update on the coronavirus pandemic. Most New Yorkers think the worst of the coronavirus is yet to ... Google Alert - coronavirus in new york post Saved Stories - None

» Saved Stories - None: Google Alert - new york times on coronavirus: Global Coronavirus Cases Rise Above 13 Million
13/07/20 10:50 from Saved Stories from Michael_Novakhov (1 sites)
(Reuters) - Global coronavirus infections passed 13 million on Monday, ... The United States reported a daily global record of 69,070 new infections on ... Google Alert - new york times on coronavirus Saved Stories - None

» Saved Stories - None: Google Alert - coronavirus origins: Coronavirus Live Updates: Trump Aides Target Fauci
13/07/20 10:50 from Saved Stories from Michael_Novakhov (1 sites)
Coronavirus Live Updates: Trump Aides Target Fauci ... number of cases with unknown origins and clusters linked to housing estates, homes for older ... Google Alert - coronavirus origins Saved Stories - None

» Saved Stories - None: Google Alert - coronavirus origins: WHO experts in China for COVID-19 research cooperation: FM spokesperson
13/07/20 10:49 from Saved Stories from Michael_Novakhov (1 sites)
BEIJING, July 13 (Xinhua) -- Two WHO experts have arrived in China for cooperation on researching the origin of the COVID-19 virus, Foreign Ministry ... Google Alert - coronavirus origins Saved Stories - None

» Saved Stories - None: Google Alert - Sars-Cov-2 origins: What you need to know about coronavirus on Monday, July 13
13/07/20 10:48 from Saved Stories from Michael_Novakhov (1 sites)
What you need to know about coronavirus on Monday, July 13. By Eliza Mackintosh, CNN. Updated 7:09 AM ET, Mon July 13, 2020. Google Alert - Sars-Cov-2 origins Saved Stories - None

» Saved Stories - None: Google Alert - Sars-Cov-2 origins: Asian Americans Facing High COVID-19 Case Fatality
13/07/20 10:47 from Saved Stories from Michael_Novakhov (1 sites)
In San Francisco, a steady trend in coronavirus ( COVID-19 ) deaths has ... became the first state to publicly report case data by Asian national origin . Google Alert - Sars-Cov-2 origins Saved Stories - None

» Saved Stories - None: Google Alert - coronavirus origins: US Grapples With Pandemic as Origins Are Traced in China
13/07/20 10:47 from Saved Stories from Michael_Novakhov (1 sites)
The United States was grappling with the worst coronavirus outbreak in the world on Monday, as Florida shattered the national record for a state's ... Google Alert - coronavirus origins Saved Stories - None

» Saved Stories - None: Google Alert - Latest coronavirus news: Explained: Why Russian Covid-19 vaccine is far from ready
13/07/20 10:47 from Saved Stories from Michael_Novakhov (1 sites)
A report by the TASS news agency of Russia on July 10 said the phase I ... here to join our channel (@ieexplained) and stay updated with the latest . Google Alert - Latest coronavirus news Saved Stories - None

» Saved Stories - None: Google Alert - sars cov 2: Vietnam now has 16 people positive for SARS-CoV-2
13/07/20 10:46 from Saved Stories from Michael_Novakhov (1 sites)
Hanoi [Vietnam], July 13 (VNA/ANI): Vietnam had only 16 people positive for the novel coronavirus ( SARS - CoV - 2 ) by 6 pm on July 13, according to the ... Google Alert - sars cov 2 Saved Stories - None

» Saved Stories - None: Google Alert - CoronaVirus as Biological Weapon: Is it true that Corona is a biological weapon and not some random virus?
13/07/20 10:45 from Saved Stories from Michael_Novakhov (1 sites)
The viral content on media/social media runs the gambit (is all over the place). There are many well informed bits of information; and a lot of ... Google Alert - CoronaVirus as Biological Weapon Saved Stories - None

» Saved Stories - None: Google Alert - coronavirus and mafia: Get Out
13/07/20 10:32 from Saved Stories from Michael_Novakhov (1 sites)
In the fall, the structures will host classes and student activities, while reducing health risks — since the coronavirus spreads less easily outdoors. Google Alert - coronavirus and mafia Saved Stories - None

» Saved Stories - None: Google Alert - coronavirus and mafia: Dirty money: How the Mafia plundered Italy's public health system
13/07/20 10:31 from Saved Stories from Michael_Novakhov (1 sites)
Dirty money: How the Mafia plundered Italy's public health system ... system has left many of the region's hospitals deeply vulnerable to coronavirus . Google Alert - coronavirus and mafia Saved Stories - None

» Saved Stories - None: Google Alert - Coronavirus and US Military: Coronavirus rate growing fast in US military: Defense Department
13/07/20 10:31 from Saved Stories from Michael_Novakhov (1 sites)
The number of COVID -19 cases in the military has grown twice the rate of growth in the US , according to the US data. There have also been three new ... Google Alert - Coronavirus and US Military Saved Stories - None

» Saved Stories - None: Google Alert - coronavirus criminal investigations: Pangolin scale seizures jumped 10 times between 2014 and 2018: UN report
13/07/20 10:30 from Saved Stories from Michael_Novakhov (1 sites)
There is a need for stronger criminal justice systems and improved ... from the COVID -19 crisis, we cannot afford to ignore wildlife crime,” she said. Google Alert - coronavirus criminal investigations Saved Stories - None

» Saved Stories - None: Google Alert - Coronavirus and US Navy: How HMS Queen Elizabeth avoided a Covid-19 outbreak
13/07/20 10:30 from Saved Stories from Michael_Novakhov (1 sites)
The US Navy's USS Theodore Roosevelt saw an outbreak that led to the death of one sailor, the firing of the ship's commanding officer, and ultimately ... Google Alert - Coronavirus and US Navy Saved Stories - None

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