• Climate Change Is Rewiring the Network of Animal Viruses - The Atlantic

    For the world’s viruses, this is a time of unprecedented opportunity. An estimated 40,000 viruses lurk in the bodies of mammals, of which a quarter could conceivably infect humans. Most do not, because they have few chances to leap into our bodies. But those chances are growing. Earth’s changing climate is forcing animals to relocate to new habitats, in a bid to track their preferred environmental conditions. Species that have never coexisted will become neighbors, creating thousands of infectious meet-cutes in which viruses can spill over into unfamiliar hosts—and, eventually, into us. Many scientists have argued that climate change will make pandemics more likely, but a groundbreaking new analysis shows that this worrying future is already here, and will be difficult to address. The planetary network of viruses and wildlife “is rewiring itself right now,” Colin Carlson, a global-change biologist at Georgetown University, told me. And “while we thought we understood the rules of the game, again and again, reality sat us down and taught us: That’s not how biology works.”

    In 2019, Carlson and his colleague Greg Albery began creating a massive simulation that maps the past, present, and future ranges of 3,100 mammal species, and predicts the likelihood of viral spillovers if those ranges overlap. The simulation strained a lot of computing power; “every time we turn it on, an angel dies,” Carlson told me. And the results, which have finally been published today, are disturbing. Even under the most optimistic climate scenarios, the coming decades will see roughly 300,000 first encounters between species that normally don’t interact, leading to about 15,000 spillovers wherein viruses enter naive hosts.

    The Anthropocene, an era defined by humanity’s power over Earth, is also an era defined by viruses’ power over us—a Pandemicene. “The moment to stop climate change from increasing viral transmission was 15 years ago,” Carlson said. “We’re in a world that’s 1.2 degrees warmer [than preindustrial levels], and there is no backpedaling. We have to prepare for more pandemics because of it.”

    Southeast Asia will also be especially spillover-prone because it’s home to a wide range of bats. Flight gives bats flexibility, allowing them to react to changing climates more quickly than other mammals, and to carry their viruses farther. And bats in Southeast Asia are highly diverse, and tend to have small ranges that don’t overlap. “You shake that like a snowglobe and you get a lot of first encounters,” Carlson said.

    Such events will also be problematic elsewhere in the world. In Africa, bats are probably the natural reservoirs for Ebola. Thirteen species could potentially carry the virus, and as global warming forces them to disperse, they’ll encounter almost 3,700 new mammal species, leading to almost 100 spillovers. So far, the biggest Ebola outbreaks have occurred in West Africa, but Carlson said that within decades, the disease could easily become a bigger problem for the continent’s eastern side too. “And that’s emblematic of everything,” he told me: Every animal-borne disease will likely change in similarly dramatic ways.

    And spillovers that initially occur between other mammals could someday affect us: The original SARS virus hopped from bats to humans via civets, and HIV reached us from monkeys via chimpanzees and gorillas. For an animal virus to jump into humans, geography, biological compatibility, and other factors must line up in just the right way. Each event is unlikely: Imagine playing Russian roulette using a gun with a million chambers. But as the climate changes, we’re loading more of those chambers with bullets, and pulling the trigger more frequently.

    The revelations are “so large and heavy to behold that even as we were writing them, we didn’t want to,” Carlson said. But despite every attempt that he and Albery made to naysay their own work, the simulation kept spitting out the same results. They confirm that three of our greatest existential threats—climate change, pandemics, and the sixth mass extinction of wildlife—are really intertwined parts of the same mega-problem. To tackle it, “we need atmospheric scientists talking to ecologists talking to microbiologists talking to demographers,” Rachel Baker, whose research at Princeton focuses on climate and disease, told me.

    But pandemics are inherently unpredictable, and no amount of prevention will fully negate their risk. The world must be ready to meet the viruses that slip through the net. That means fortifying public health and health-care systems, strengthening social safety nets, and addressing all the weaknesses of the pre-COVID normal that made the world so vulnerable to the current pandemic and will leave it susceptible to the next. The world, in its desire to move past COVID, is already forgetting the lessons of the recent past, and perhaps assuming that a generation-defining crisis will occur only once a generation. “But no, all of this could happen again tomorrow,” Carlson said. And “if this many viruses are undergoing host jumps this much,” multiple pandemics could strike together.

    #Pandémies #Changement_climatique #Virus #Pandémicène

  • Higher Ed, We’ve Got a Morale Problem — And a Free T-Shirt Won’t Fix It

    Let’s say, hypothetically, that it’s been a difficult start to the fall semester for many of us who work as staff and faculty on college campuses in America.

    Perhaps we allowed ourselves the faintest glimmer of hope for better working conditions compared to last year, only to be met by sterile emails enforcing inflexible personnel policies, signs about “masking up” on campus as hoards of unmasked fans descend on football stadiums, and pressures to pantomime normalcy for students when our own lives feel far from normal.

    Maybe we have experienced a cruel deja vu, once again juggling hours of Zoom meetings with the needs of our unvaccinated children as the delta variant courses through schools and day care centers. Let’s say we’re not just physically and emotionally depleted, but we question whether our institutions have our best interests at heart. We might wonder if we can still enact our values in higher education, given our employers’ leadership and decision-making.

    Hypothetically speaking.

    Assuming that some part of the scenario above sounds vaguely familiar, college leaders may be casting about for ways to lift their employees’ spirits. More than a few, it seems, have turned to gimmicks that have little chance of meaningfully moving the dial on morale. That’s because the root of many morale issues in higher education run deep enough that a free T-shirt will feel shallow and even insulting.

    Morale can absolutely be improved in higher education, but it requires the type of sustained attention necessary to shift organizational culture. Leaders need to be ready to put in the work, starting with admitting there is a morale problem and actively listening to what staff and faculty are saying.
    From Burnout to Demoralization

    There was considerable discussion last fall about burnout among college staff and faculty. I wrote about how college leaders should prepare for a wave of burnout as the pandemic brewed a potent blend of constant work and worry. Recently, I’ve seen an increasing number of stories about workers who aren’t just exhausted. They are fed up.

    Stories have chronicled boycotts of in-person teaching, protests and die-ins to demand mask and vaccine mandates, faculty senate resolutions, and even faculty members walking away from jobs. I’ve heard from several colleagues at multiple institutions that morale is the lowest they have ever seen. People in higher education are using a new word to describe their experience: “demoralized.”

    Doris A. Santoro, a professor at Bowdoin College who wrote a book on teacher demoralization, has explained that teachers of all kinds are facing stressors during the pandemic that put them at heightened risk for burnout and demoralization. But she also draws clear distinctions between the two. Whereas burnout happens when teachers are entirely depleted, demoralization “happens when teachers are consistently thwarted in their ability to enact the values that brought them to the profession.” Anne Helen Peterson and John Warner have also written eloquently about demoralization and how it differs from burnout.

    Suffice it to say, demoralization suggests an ethical indictment of organizations, professions and society broadly. We still often talk about burnout (and its solutions) at the individual level, but we refer to demoralization among a group, like workers at a particular company or in an entire profession. In fact, many definitions of “morale” focus on collective sentiments, equating it to esprit de corps. Low morale, like demoralization, means a group is struggling to maintain belief in an institution or goal, especially when times get tough. As such, it provides a stronger push for people thinking about leaving their jobs. If burnout means driving while drowsy, demoralization means seeking the nearest off-ramp.
    What Has Changed This Fall?

    How did we get from burnout to demoralization in a year? In truth, the delta variant didn’t suddenly trigger demoralization. These issues predate the pandemic and have long co-existed. And, of course, the feeling isn’t universal. But it does seem like wading through another semester of Pandemic University—or, more accurately, through the ways that policymakers and college leaders responded to the pandemic—shattered many people’s fragile defenses. While writing this piece, I received many emails and messages about why morale is low at their institutions or why they left higher education, and a few themes surfaced.

    There’s a pervasive frustration that leaders didn’t learn any lessons from last year. It’s almost as if last year didn’t happen at all, or leaders are exercising a sort of selective amnesia about the trauma of the past 18 months. In practice, this manifests in zealously pursuing Normal Fall™ regardless of employees’ concerns and worsening public health indicators. Relatedly, many people feel that leaders simply aren’t listening, aren’t taking questions about fall plans in meetings, or aren’t transparently answering the questions they received. Values-based conflict emerged as staff and faculty sought compassion and thoughtful answers in the face of elevated risk and instead heard: “Everything’s fine!”

    Low compensation, of course, was frequently mentioned. A recent article in The Chronicle of Higher Education included results from a survey showing that 88 percent of respondents believed uncompetitive salaries are a top reason people leave college student affairs jobs. While staff and faculty may have previously tolerated inadequate pay, the equation changed significantly with the addition of excessive work demands and the possibility of serious illness. The fact that many leaders continued to ask employees to work under these conditions without additional compensation felt exploitative.

    Another reason for low morale is inadequate staffing. As people have left jobs, institutions have faced vacancies they haven’t been able to fill or fill fast enough. Or they simply haven’t ever hired enough people to do the work well. Sociologists Laura Hamilton and Kelly Nielsen described the pervasive and purposeful under-staffing of institutions in their book “Broke” as the austerity-driven goal of “tolerable suboptimization,” with workers “toiling under exceptionally high workloads with little relief in sight.” For many staff and faculty, the combination of low pay and ballooning workloads reveals institutions care little for employee wellbeing.

    Norms within the higher education profession aren’t helping matters. As Margaret Sallee, who recently edited a book on sustainable careers in student affairs, told me, “I’ve been so concerned about the ways that student affairs eats its people up. I think it’s been exacerbated by the pandemic … but, I hate to say it, I think it’s gotten worse in the last three months.” The profession normalizes working long hours to support students, and many senior student affairs leaders “are stuck in a rut of how we used to do things and how we’ve always done things.” Sallee attributes some of the low morale this year to disappointment after it looked like the field may shift away from these “ideal worker” norms: “Instead I just see this knee-jerk reaction to going back to how it was.”

    There are also tensions surfacing between different categories of university employees. Some workers have had autonomy to decide what was best for them and their families, while others have not. And some staff, in particular, are tired of having their expertise ignored. That’s what I heard when I spoke to a staff member at a rural community college who asked to not be named to protect their job. “Staff have degrees, they have expertise, they are publishing and doing these things that are just completely ignored by faculty,” the staff member explained. “It’s just really hard to be constantly dismissed.” They likened higher education to a class system: “I don’t have academic freedom. I don’t have any type of protection … I think that has become more apparent with the pandemic, being told who is ‘essential,’ who has to be on campus.”

    This staff member and their colleagues have been sending each other job ads: “There are data analyst jobs I could do and easily make double what I’m making.” But what bothers them about staff leaving is the sense that nobody cares. “We see a lot of ‘quit lit’ from faculty. We don’t see it often from staff, mainly because staff just disappear.”
    Gimmicks Won’t Get It Done

    Just as there were college leaders genuinely worried about burnout, there are leaders who want to do something about low morale. Too frequently, however, the solutions they devise don’t match the magnitude of the problems or initiate the long-term, cultural changes many employees desire.

    When I expressed my worry that many college leaders won’t put in the work to address low morale, my Twitter followers filled my mentions with examples of small tokens of appreciation or one-time events. It was clear they found many of these gifts or programs to range from comically unhelpful to infuriating. In no particular order, these examples included: a credit to the performing arts center, tickets to a football game, free ice cream, raffles for gift cards, a coupon to the coffee shop, food trucks, and free hats and T-shirts.

    To be clear, I don’t imagine most leaders believe these efforts will fix everything. They know what they have asked of staff and faculty during the pandemic, and they want to recognize that effort. However, they may not fully appreciate how these initiatives can trivialize concerns and have the opposite effect of what they intended.

    How Leaders Can Start to Improve Morale

    There are some obvious answers to higher education’s morale problem. People want compensation that reflects the realities of their labor and the value they bring to the institution. They also want their departments and units to be properly staffed to meet expectations and serve students well. This last point bears repeating: Students’ success is inextricably linked to staff and faculty working conditions. You don’t get the former without investing in the latter.

    It’s true that raises and adding new positions are huge expenses for most institutions, but that doesn’t make them impossible. Just as important, the price tag doesn’t prevent leaders from making a commitment and a plan. Leaders should tell staff and faculty that increasing pay is a priority, even if it takes time to implement, then develop a plan to analyze workload issues across the institution and create a timeline for addressing them. Knowing there is movement toward adequate pay and equitable workloads is more meaningful for many staff and faculty than a dozen thank-you emails.

    I’ve heard of a few other low-cost ideas. For example, leaders should think about their communication choices. I suggest they excise “return to normal” from their vocabulary, stop worshipping at the altar of “in-person” instruction and activities, and feel comfortable admitting when morale is low. Josie Ahlquist, an expert on digital leadership in higher education, recently wrote that leaders should give up on messages imbued with “toxic positivity” and consider instead a position of “critical hope.”

    I asked her about this in an interview, and she explained: “Leaders in the past could just be performative or hide behind, ‘I’m fundraising, attending big football games, and it’s all good.’ And we haven’t had ‘all good.’ To say ‘everything’s fine’ isn’t being emotionally connected.”

    She drew inspiration from professor Jessica Riddell, who wrote that many leaders have leaned on toxic positivity in their responses to the pandemic. By putting on a constantly cheery facade that brooks no dissent, leaders have silenced “candid and uncomfortable conversations.” On the other hand, critical hope acknowledges that we are in the midst of a radical transformation and welcomes complexity and discomfort as cornerstones of a process to reimagine higher education.

    Given how many people have told me they feel ignored, I can’t recommend enough the power of giving staff and faculty platforms to speak—and then listening to them. In practice, this means collecting perspectives and questions, then providing complete and transparent responses. It means bringing important campus decisions to shared governance bodies for deliberative discussion, rather than seeking “input” after the decisions have already been made. Ahlquist stressed the value of being accessible, whether it’s blocking off time for anyone in the campus community to meet, doing listening tours, or allowing people to send direct messages via social media. Even small efforts like these can help employees feel seen.

    I spoke with Terisa Riley, chancellor of the University of Arkansas at Fort Smith, after learning she asked a student affairs group on Facebook for ideas to improve staff wellbeing. “I’m a real active social listener, which will sometimes drive people crazy,” she explained. Although initially some people were suspicious of her engagement on multiple social media sites, Riley maintains it helps her get to the bottom of frustrations, note complaints, and collaborate with colleagues to find solutions.

    Listening isn’t enough to completely prevent departures. “We’ve started to face some of the turnover that we’ve been reading about,” Riley explained. But she is keenly aware that “other industries are much more flexible, they understand that the human being doesn’t divorce the family or responsibilities they have when they walk through the door at 8 a.m.”

    She’s a firm believer that higher education needs to do a better job of managing its talent. And that might mean leaders need to give people the ability to individually renegotiate their working conditions. As Riley put it: “If someone is thinking that leaving is their only option, I say, ‘Please don’t let it be. Can we talk through what you personally think you need to be here? I’ll try to help meet your needs, I want to hear from you personally.’ Because I only have 1,000 employees. I can work with all of them if I need to do it.”

    Importantly, this approach doesn’t treat workers as expendable. Colleges have a bad track record of operating as if there will be an endless supply of people who want to work at them. I think that’s both factually and ethically wrong—it’s also a terrible approach to attracting and retaining highly-skilled workers, many of whom are, at this very moment, perusing job ads.

    The simple truth is that while morale can tank quickly, rebuilding it takes time and sustained energy. And it’s harder still to rebuild as the pandemic continues. But I wouldn’t be writing this if I didn’t have my own critical hope that the “business as usual” systems and decisions that got us here can be transformed for the better. Save the T-shirts for another day and start building the type of organizational culture that staff and faculty can believe in again.


    #burn-out #démoralisation #enseignement (pas pas que...) #ESR #université #facs #valeurs #moral

    ping @_kg_

  • Wie hilfesuchende Kinder während der Pandemie allein gelassen werden

    Jonas* ist ein junger Mann, 19 Jahre alt. Gesund. Kräftig. Er hat tiefe Augenringe. Nicht vom Feiern. Er sitzt in seinem Kinderzimmer. In den vergangenen Monaten war er oft hier. Lange. Er streicht sich mit der Hand über die Haare. „Ich habe während der Pandemie starke Depressionen bekommen. Wären meine Freunde nicht für mich da gewesen, wäre ich jetzt nicht hier“, sagt er. Jonas dachte an Selbstmord.

    Jonas heißt eigentlich anders. Er möchte lieber anonym bleiben. Der Schüler hat zwei Leben gelebt: eins vor der Pandemie und eins während der Pandemie. Vor der Pandemie hat er sich gerne mit seinen Freunden und Freundinnen getroffen, ist zum Kampfsport gegangen und wollte nach der Schule soziale Arbeit oder Psychologie studieren. Doch im März 2020 schlossen zum ersten Mal die Schulen, der Unterricht fand nur noch digital statt, Jonas verlor sein soziales Leben: „Alles, wovon ich Energie geschöpft habe, war plötzlich nicht mehr da.“ Der Schüler kam mit dem Homeschooling nicht klar. Seine Noten verschlechterten sich. Er wurde dieses Jahr nicht zum Abitur zugelassen.

    Seit der Pandemie spielt sich sein Alltag fast nur noch in seinem Zimmer ab. Seit einigen Monaten leidet der Schüler an starken Depressionen. Doch professionelle Hilfe bekommt er nicht. Im Februar versuchte er, einen Termin bei einem Psychiater zu bekommen, weil er Selbstmordgedanken hatte. Am Telefon wurde ihm gesagt, dass der nächste Termin im Juli sei. Daraufhin wandte Jonas sich an die Schulpsychologin, mit der er sich ein paar Mal traf. Das Reden half ihm zwar, sagt er. Aber sie habe ihm nichts Neues sagen können, was er nicht schon wusste: „Dass sogar eine Schulpsychologin nicht weiterhelfen konnte, war sehr heftig für mich. Ich bin einer Machtlosigkeit ausgesetzt und ich kann nichts dagegen tun.“ Alles was ihm gut tue, könne er momentan nicht machen.

    Die Kinder- und Jugendhilfe ist während der Pandemie stark eingeschränkt

    Für diese Recherche hat CORRECTIV mit mehreren Schülern und Schülerinnen gesprochen. Sie teilten ihre persönlichen Geschichten, wie es ihnen seit Beginn der Pandemie geht und mit welchen Schwierigkeiten sie zu kämpfen haben. Zudem sprach CORRECTIV mit weiteren Familienangehörigen, Heimen und Beratungsstellen. Das Ergebnis der Recherche: Für notleidende Kinder und Jugendliche steht das Hilfesystem seit der Pandemie fast still. Termine für Therapien und Beratungen sind kaum zu bekommen und Kontrollinstanzen wie Schule und Kita fallen weg.

    Schon im Februar berichtete CORRECTIV, wie dutzende Jugendämter in NRW seit Beginn der Pandemie nur noch in dringenden Fällen Hausbesuche machten. Jetzt zeigt sich: Die Kinder- und Jugendhilfe ist stark zurückgegangen. Für hilfesuchende Kinder und Jugendliche kann das im Extremfall lebensbedrohlich werden.

    Was ein Extremfall bedeuten kann, zeigen die Statistiken der Polizei. Diese Woche wurde in Berlin eine Sonderauswertung der polizeilichen Kriminalstatistik vorgestellt. Daraus geht hervor, dass 2020 sexuelle Gewalt gegen Kinder zugenommen hat. Demnach stieg die Zahl der Misshandlung Schutzbefohlener um zehn Prozent. Der Kindesmissbrauch stieg um 6,8 Prozent im Vergleich zum Vorjahr. Die Statistik erfasst alle Taten, die bei der Polizei gemeldet werden. Die Dunkelziffer ist laut der Sonderauswertung wahrscheinlich viel höher.

    Dazu kommt: Kindern und Jugendlichen geht es grundsätzlich seit Beginn der Pandemie schlechter als vorher. Das zeigt eine Studie von den Universitäten Hildesheim, Frankfurt und Bielefeld, in der rund 3400 Jugendliche zwischen 15 und 19 Jahren befragt wurden. Demnach fühlen sich viele Jugendliche aufgrund der Pandemie einsam, verunsichert und überfordert.
    Ein funktionierendes Hilfesystem kann Kindern das Leben retten

    Wie wichtig gerade jetzt ein funktionierendes Unterstützungssystem für hilfesuchende Kinder und Jugendliche ist, zeigt der Fall von Mira. Die heute 25-Jährige hat das Zusammenleben mit ihrer gewalttätigen Mutter unter großen Leiden überlebt. Sie erinnert sich noch sehr gut an ihre Kindheit. Auch heute muss sie vieles noch verarbeiten: „Wenn ich mal eine schlechte Note auf dem Zeugnis hatte, hat meine Mutter zugeschlagen. Sie hat mich dabei im schlimmsten Fall am Nacken gepackt, sodass ich nicht weglaufen konnte“, erzählt Mira.

    Irgendwann kam für die damals 17-Jährige der Punkt, an dem sie nicht mehr konnte: „Ich dachte mir, ich komme hier entweder raus oder ich bringe mich selber um“, sagt sie. Ihre Hoffnung, dass sich ihre Mutter ändern würde, hatte sie aufgegeben. Doch einfach das Jugendamt von zu Hause aus anrufen ging nicht. Ihre Mutter kontrollierte die Telefonrechnungen. Einmal rief sie die Telefonseelsorge an. Ihre Mutter habe die Anrufe auf der Rechnung gesehen. „Sie ist völlig ausgerastet und hat mich geschlagen“, erzählt sie. Deswegen war es wichtig, dass sie in die Schule gehen und mit einem Lehrer darüber sprechen konnte. Der Lehrer reagierte sofort, die damals 17-Jährige wurde von dem Jugendamt in Obhut genommen.

    Während der Corona-Pandemie wäre das kaum möglich gewesen. Es fehlen wichtige Kontrollinstanzen wie Schulen oder Kitas. So werden Kinder und Jugendliche nur noch eingeschränkt wahrgenommen, Gewalt und Missbrauch schwerer erkannt. Der Präsident des deutschen Kinderschutzbundes, Heinz Hilgers, sagt, dass viele Fälle häufig nicht gesehen werden: „Trotz der erhöhten Gewaltbelastung in den Familien ist die Zahl der Inobhutnahmen nicht gestiegen, denn der Kontakt zu den Familien ist erschwert.“

    Beratungsgespräche werden abgesagt

    Sara* ist auch eine hilfesuchende Jugendliche, die sich noch kurz vor dem ersten Lockdown in ein Heim retten konnte. Die 17-Jährige wurde zu Hause von ihrem älteren Bruder geschlagen. Weil sie noch minderjährig ist, bleibt auch sie anonym. Sara erzählt: „Als mein Bruder herausgefunden hat, dass ich einen Freund habe, ist er komplett ausgerastet.“ Die Eltern sind machtlos gegenüber dem gewalttätigen Bruder. Ihr Vater versteht bis heute nicht, wieso die Schülerin seit über einem Jahr in einem Heim lebt und nicht zuhause. Er gab ihr zu verstehen, dass sie übertreibt.

    Im Februar 2020 erzählt die 17-Jährige ihren Freundinnen in der Schule, dass ihr Bruder sie geschlagen hat. Ihre Freundinnen ermutigen sie, sich einem Lehrer anzuvertrauen. Dann ging alles sehr schnell. Das Jugendamt reagiert sofort und nimmt die Schülerin in Obhut. Das war rund drei Wochen vor dem ersten Lockdown. Seitdem lebt Sara in einem Heim.

    Doch mit der Inobhutnahme verschwinden die Probleme nicht. Das erste Heim, in das die Schülerin kommt, sei dreckig gewesen und sie habe sich dort nicht wohlgefühlt. Eine „Horror-Inobhutnahme“, sagt Sara. Doch die Schülerin braucht Hilfe und vor allem ein stabiles Umfeld. Im Sommer 2020 kann sie das Heim verlassen, weil in einem sogenannten Hilfeplangespräch mit dem Jugendamt besprochen wird, was mit Sara passiert. Sie entscheidet sich für ein anderes Heim, in dem sie jetzt seit fast einem Jahr lebt und sich wohlfühlt.

    Dass Sara ein Hilfeplangespräch bekam und in ein anderes Heim ziehen konnte, ist keine Selbstverständlichkeit während der Pandemie. Denn die sogenannten Hilfeplangespräche wurden laut einer CORRECTIV-Recherche in einigen nordrhein-westfälischen Jugendämtern entweder verschoben oder ganz abgesagt. Eigentlich sollen sie regelmäßig stattfinden, dabei sprechen der betroffene Jugendliche, eine Fachkraft und das Jugendamt über die Zukunft des Jugendlichen und können aktuelle Konflikte thematisieren.

    Kinder und Jugendliche, die Hilfe von außen suchen, brauchen Heime, in denen sie sich wohlfühlen und in denen sie ihre Traumata und ihre Probleme bewältigen können. Genau diese Schutzorte sind durch die Pandemie stark belastet.
    Keine Therapie, schwierige Betreuung: Traumatisierte und hilfesuchende Kinder leiden stärker durch die Pandemie

    Ein Heim, in dem Kinder und Jugendliche vor Gewalt und Missbrauch Schutz finden können, ist das St. Vincenz Jugendhilfe Zentrum in Dortmund. Hier können sie durch verschiedene Angebote ein normales Leben führen. Doch auch an diesem Beispiel zeigt sich, wie stark die Pandemie die Arbeit in dem Heim belastet hat.

    Melanie Mohr arbeitet seit rund 15 Jahren als Sozialarbeiterin in der Wohngruppe. Sie erzählt, dass die Kinder und Jugendlichen extrem frustriert sind: „Ein Jugendlicher von uns ist biologisch ein Mädchen, möchte aber als Junge leben, heißt, er ist transsexuell. Wäre Corona nicht gewesen, hätte der Junge eine stabilere Psyche und könnte dadurch ein geregelteres Leben führen.“ Weil seine Behandlung aber teilweise während der Pandemie abgebrochen worden sei, sei er stark depressiv geworden. Das größte Problem sei vor allem, dass es schwieriger geworden sei, Termine bei Therapeuten zu bekommen. Mohr sagt: „Die Jugendlichen, die sich sowieso schon schlecht gefühlt haben, fühlen sich jetzt noch schlechter, weil es kaum ergänzende Maßnahmen gibt. Die Entwicklungen der Kinder sind stagniert.“

    Das größte Problem der stationären Jugendhilfe sei die große Belastung, erzählt Heinz Hilgers vom deutschen Kinderschutzbund: „Die Heime sind eigentlich so aufgebaut, dass die Kinder zur Schule gehen. Durch die Pandemie sind die Schulen aber teilweise geschlossen und auch ergänzende Unterstützungen sind erschwert. Das müssen die Mitarbeiter und Mitarbeiterinnen in den Heimen selber versuchen aufzufangen“, sagt Hilgers. Er findet, dass die Kinder- und Jugendhilfe in den ganzen Diskussionen rund um die Pandemie kaum Beachtung gefunden hat.

    Familienhilfe: Vertrauen durch persönliche Gespräche aufbauen

    Nachdem die damals 17-jährige Mira von ihrer gewalttätigen Mutter weg konnte, hat sie später angefangen Pädagogik zu studieren. Die heute 25-Jährige schaut besorgt auf die Kinder- und Jugendhilfe während der Pandemie: „Familienhilfe ist nicht einfach. Man kann nicht einfach ein Telefonat führen und direkt mit dem betroffenen Kind Vertrauen aufbauen. Ich habe das am eigenen Leib gespürt.“ Wenn Mira über ihre Kindheit spricht, weiß sie, dass ihr das Hilfesystem das Leben gerettet hat. Sie erzählt, dass sie niemals in der Gegenwart ihrer Mutter Außenstehenden gesagt hätte, dass sie geschlagen wird. Die Angst war zu groß. Über die Erlebnisse konnte sie erst mit einem Lehrer sprechen, dem sie vertraute.

    Persönliche Gespräche sind für hilfesuchende Kinder und Jugendliche sehr wichtig. Doch gerade diese Möglichkeiten sind durch die Pandemie stark eingeschränkt. Die Beratungsstelle „Gegenwind“ aus Bottrop setzt sich dafür ein, dass Kinder und Jugendliche vor sexuellem Missbrauch geschützt werden. Seit dem ersten Lockdown bietet die Beratungsstelle telefonische Beratungen an. Doch das lief am Anfang nicht so gut. Doris Wagner, Mitbegründerin von „Gegenwind“, erzählt: „Die telefonische Beratung lief im ersten Lockdown sehr schleppend an. Wir haben uns große Sorgen um Kinder gemacht, die nicht mehr raus konnten und somit nicht mehr im Blickfeld waren. Die Kinder waren sehr schlecht zu erreichen.“ Das Problem sei vor allem die Kommunikation gewesen. Viele Betroffene hätten gar nicht gewusst, dass Hilfe auch unter Pandemie-Bedingungen möglich war.

    Jugendliche leben während der Corona-Pandemie zwischen Hoffnung und Verzweiflung

    Die Kinder- und Jugendhilfe ist lebensnotwendig. Mira weiß das nur zu gut: „Wäre Corona in meiner Jugend da gewesen, wäre ich wahrscheinlich nicht am Leben, weil ich das nicht überstanden hätte.“ Fast zehn Jahre, nachdem sie ihre gewalttätige Mutter durch das Jugendamt verlassen konnte, hat sie ihrem damaligen Lehrer eine Nachricht geschrieben: „Ich glaube, ihm war gar nicht bewusst, dass er damals mein Leben gerettet hat. Ich wollte mich einfach bei ihm bedanken.“

    Wenn Sara, die von ihrem Bruder geschlagen wurde, an ihre Zukunft denkt, dann wirkt sie hoffnungsvoll. Sie will die Zeit in dem Heim nutzen, ein gutes Abitur ablegen und vielleicht Polizistin oder Sozialarbeiterin werden. „Weil diese Berufsgruppen Menschen vor Gewalt schützen“, sagt die Schülerin. Wenn Sie an Zuhause denkt, dann hat sie noch die Gewalt im Kopf, die sie noch nicht verarbeitet hat. In dem Heim findet sie trotz der Corona-Pandemie Schutz und Hilfe.

    Jonas, der unter starken Depressionen leidet, wirkt mit Blick auf seine Zukunft hoffnungslos. Weil er sein Abitur nicht bestanden hat, muss er Umwege gehen. Aktuell sucht er nach einem Platz für ein freiwilliges soziales oder ökologisches Jahr, um sein Fachabitur zu machen. Er kann aber auch nicht sagen, wie er seine Depression bewältigen soll. Der 19-Jährige weiß nur, dass seit Beginn der Pandemie einiges falsch gelaufen ist: „Es wurde nicht auf das Wohlergehen der Kinder und Jugendlichen geschaut.“

    *Name geändert

    #pandemic #covid #children #youth #lockdown #Germany #depression #suicidal_thoughts #life-threatening #support #violence #domestic_violence #child_abuse #sexualized_violence #isolation #social_system #therapy


  • K : The Overlooked Variable That’s Driving the Pandemic - The Atlantic

    There’s something strange about this #coronavirus #pandemic. Even after months of extensive research by the global scientific community, many questions remain open.

    Why, for instance, was there such an enormous death toll in northern Italy, but not the rest of the country? Just three contiguous regions in northern Italy have 25,000 of the country’s nearly 36,000 total deaths; just one region, Lombardy, has about 17,000 deaths. Almost all of these were concentrated in the first few months of the outbreak. What happened in Guayaquil, Ecuador, in April, when so many died so quickly that bodies were abandoned in the sidewalks and streets?* Why, in the spring of 2020, did so few cities account for a substantial portion of global deaths, while many others with similar density, weather, age distribution, and travel patterns were spared? What can we really learn from Sweden, hailed as a great success by some because of its low case counts and deaths as the rest of Europe experiences a second wave, and as a big failure by others because it did not lock down and suffered excessive death rates earlier in the pandemic? Why did widespread predictions of catastrophe in Japan not bear out? The baffling examples go on.

    I’ve heard many explanations for these widely differing trajectories over the past nine months—weather, elderly populations, vitamin D, prior immunity, herd immunity—but none of them explains the timing or the scale of these drastic variations. But there is a potential, overlooked way of understanding this pandemic that would help answer these questions, reshuffle many of the current heated arguments, and, crucially, help us get the spread of COVID-19 under control.

    By now many people have heard about R0—the basic reproductive number of a pathogen, a measure of its contagiousness on average. But unless you’ve been reading scientific journals, you’re less likely to have encountered k, the measure of its dispersion. The definition of k is a mouthful, but it’s simply a way of asking whether a virus spreads in a steady manner or in big bursts, whereby one person infects many, all at once. After nine months of collecting epidemiological data, we know that this is an overdispersed pathogen, meaning that it tends to spread in clusters, but this knowledge has not yet fully entered our way of thinking about the pandemic—or our preventive practices.

    The now-famed R0 (pronounced as “r-naught”) is an average measure of a pathogen’s contagiousness, or the mean number of susceptible people expected to become infected after being exposed to a person with the disease. If one ill person infects three others on average, the R0 is three. This parameter has been widely touted as a key factor in understanding how the pandemic operates. News media have produced multiple explainers and visualizations for it. Movies praised for their scientific accuracy on pandemics are lauded for having characters explain the “all-important” R0. Dashboards track its real-time evolution, often referred to as R or Rt, in response to our interventions. (If people are masking and isolating or immunity is rising, a disease can’t spread the same way anymore, hence the difference between R0 and R.)

    Unfortunately, averages aren’t always useful for understanding the distribution of a phenomenon, especially if it has widely varying behavior. If Amazon’s CEO, Jeff Bezos, walks into a bar with 100 regular people in it, the average wealth in that bar suddenly exceeds $1 billion. If I also walk into that bar, not much will change. Clearly, the average is not that useful a number to understand the distribution of wealth in that bar, or how to change it. Sometimes, the mean is not the message. Meanwhile, if the bar has a person infected with COVID-19, and if it is also poorly ventilated and loud, causing people to speak loudly at close range, almost everyone in the room could potentially be infected—a pattern that’s been observed many times since the pandemic begin, and that is similarly not captured by R. That’s where the dispersion comes in.

    There are COVID-19 incidents in which a single person likely infected 80 percent or more of the people in the room in just a few hours. But, at other times, COVID-19 can be surprisingly much less contagious. Overdispersion and super-spreading of this virus are found in research across the globe. A growing number of studies estimate that a majority of infected people may not infect a single other person. A recent paper found that in Hong Kong, which had extensive testing and contact tracing, about 19 percent of cases were responsible for 80 percent of transmission, while 69 percent of cases did not infect another person. This finding is not rare: Multiple studies from the beginning have suggested that as few as 10 to 20 percent of infected people may be responsible for as much as 80 to 90 percent of transmission, and that many people barely transmit it.

    This highly skewed, imbalanced distribution means that an early run of bad luck with a few super-spreading events, or clusters, can produce dramatically different outcomes even for otherwise similar countries. Scientists looked globally at known early-introduction events, in which an infected person comes into a country, and found that in some places, such imported cases led to no deaths or known infections, while in others, they sparked sizable outbreaks. Using genomic analysis, researchers in New Zealand looked at more than half the confirmed cases in the country and found a staggering 277 separate introductions in the early months, but also that only 19 percent of introductions led to more than one additional case. A recent review shows that this may even be true in congregate living spaces, such as nursing homes, and that multiple introductions may be necessary before an outbreak takes off. Meanwhile, in Daegu, South Korea, just one woman, dubbed Patient 31, generated more than 5,000 known cases in a megachurch cluster.

    Unsurprisingly, SARS-CoV, the previous incarnation of SARS-CoV-2 that caused the 2003 SARS outbreak, was also overdispersed in this way: The majority of infected people did not transmit it, but a few super-spreading events caused most of the outbreaks. MERS, another coronavirus cousin of SARS, also appears overdispersed, but luckily, it does not—yet—transmit well among humans.

    This kind of behavior, alternating between being super infectious and fairly noninfectious, is exactly what k captures, and what focusing solely on R hides. Samuel Scarpino, an assistant professor of epidemiology and complex systems at Northeastern, told me that this has been a huge challenge, especially for health authorities in Western societies, where the pandemic playbook was geared toward the flu—and not without reason, because pandemic flu is a genuine threat. However, influenza does not have the same level of clustering behavior.

    We can think of disease patterns as leaning deterministic or stochastic: In the former, an outbreak’s distribution is more linear and predictable; in the latter, randomness plays a much larger role and predictions are hard, if not impossible, to make. In deterministic trajectories, we expect what happened yesterday to give us a good sense of what to expect tomorrow. Stochastic phenomena, however, don’t operate like that—the same inputs don’t always produce the same outputs, and things can tip over quickly from one state to the other. As Scarpino told me, “Diseases like the flu are pretty nearly deterministic and R0 (while flawed) paints about the right picture (nearly impossible to stop until there’s a vaccine).” That’s not necessarily the case with super-spreading diseases.

    Nature and society are replete with such imbalanced phenomena, some of which are said to work according to the Pareto principle, named after the sociologist Vilfredo Pareto. Pareto’s insight is sometimes called the 80/20 principle—80 percent of outcomes of interest are caused by 20 percent of inputs—though the numbers don’t have to be that strict. Rather, the Pareto principle means that a small number of events or people are responsible for the majority of consequences. This will come as no surprise to anyone who has worked in the service sector, for example, where a small group of problem customers can create almost all the extra work. In cases like those, booting just those customers from the business or giving them a hefty discount may solve the problem, but if the complaints are evenly distributed, different strategies will be necessary. Similarly, focusing on the R alone, or using a flu-pandemic playbook, won’t necessarily work well for an overdispersed pandemic.

    Hitoshi Oshitani, a member of the National COVID-19 Cluster Taskforce at Japan’s Ministry of Health, Labour and Welfare and a professor at Tohoku University who told me that Japan focused on the overdispersion impact from early on, likens his country’s approach to looking at a forest and trying to find the clusters, not the trees. Meanwhile, he believes, the Western world was getting distracted by the trees, and got lost among them. To fight a super-spreading disease effectively, policy makers need to figure out why super-spreading happens, and they need to understand how it affects everything, including our contact-tracing methods and our testing regimes.

    There may be many different reasons a pathogen super-spreads. Yellow fever spreads mainly via the mosquito Aedes aegypti, but until the insect’s role was discovered, its transmission pattern bedeviled many scientists. Tuberculosis was thought to be spread by close-range droplets until an ingenious set of experiments proved that it was airborne. Much is still unknown about the super-spreading of SARS-CoV-2. It might be that some people are super-emitters of the virus, in that they spread it a lot more than other people. Like other diseases, contact patterns surely play a part: A politician on the campaign trail or a student in a college dorm is very different in how many people they could potentially expose compared with, say, an elderly person living in a small household. However, looking at nine months of epidemiological data, we have important clues to some of the factors.

    In study after study, we see that super-spreading clusters of COVID-19 almost overwhelmingly occur in poorly ventilated, indoor environments where many people congregate over time—weddings, churches, choirs, gyms, funerals, restaurants, and such—especially when there is loud talking or singing without masks. For super-spreading events to occur, multiple things have to be happening at the same time, and the risk is not equal in every setting and activity, Muge Cevik, a clinical lecturer in infectious diseases and medical virology at the University of St. Andrews and a co-author of a recent extensive review of transmission conditions for COVID-19, told me.

    Cevik identifies “prolonged contact, poor ventilation, [a] highly infectious person, [and] crowding” as the key elements for a super-spreader event. Super-spreading can also occur indoors beyond the six-feet guideline, because SARS-CoV-2, the pathogen causing COVID-19, can travel through the air and accumulate, especially if ventilation is poor. Given that some people infect others before they show symptoms, or when they have very mild or even no symptoms, it’s not always possible to know if we are highly infectious ourselves. We don’t even know if there are more factors yet to be discovered that influence super-spreading. But we don’t need to know all the sufficient factors that go into a super-spreading event to avoid what seems to be a necessary condition most of the time: many people, especially in a poorly ventilated indoor setting, and especially not wearing masks. As Natalie Dean, a biostatistician at the University of Florida, told me, given the huge numbers associated with these clusters, targeting them would be very effective in getting our transmission numbers down.

    Overdispersion should also inform our contact-tracing efforts. In fact, we may need to turn them upside down. Right now, many states and nations engage in what is called forward or prospective contact tracing. Once an infected person is identified, we try to find out with whom they interacted afterward so that we can warn, test, isolate, and quarantine these potential exposures. But that’s not the only way to trace contacts. And, because of overdispersion, it’s not necessarily where the most bang for the buck lies. Instead, in many cases, we should try to work backwards to see who first infected the subject.

    Because of overdispersion, most people will have been infected by someone who also infected other people, because only a small percentage of people infect many at a time, whereas most infect zero or maybe one person. As Adam Kucharski, an epidemiologist and the author of the book The Rules of Contagion, explained to me, if we can use retrospective contact tracing to find the person who infected our patient, and then trace the forward contacts of the infecting person, we are generally going to find a lot more cases compared with forward-tracing contacts of the infected patient, which will merely identify potential exposures, many of which will not happen anyway, because most transmission chains die out on their own.

    The reason for backward tracing’s importance is similar to what the sociologist Scott L. Feld called the friendship paradox: Your friends are, on average, going to have more friends than you. (Sorry!) It’s straightforward once you take the network-level view. Friendships are not distributed equally; some people have a lot of friends, and your friend circle is more likely to include those social butterflies, because how could it not? They friended you and others. And those social butterflies will drive up the average number of friends that your friends have compared with you, a regular person. (Of course, this will not hold for the social butterflies themselves, but overdispersion means that there are much fewer of them.) Similarly, the infectious person who is transmitting the disease is like the pandemic social butterfly: The average number of people they infect will be much higher than most of the population, who will transmit the disease much less frequently. Indeed, as Kucharski and his co-authors show mathematically, overdispersion means that “forward tracing alone can, on average, identify at most the mean number of secondary infections (i.e. R)”; in contrast, “backward tracing increases this maximum number of traceable individuals by a factor of 2-3, as index cases are more likely to come from clusters than a case is to generate a cluster.”

    Even in an overdispersed pandemic, it’s not pointless to do forward tracing to be able to warn and test people, if there are extra resources and testing capacity. But it doesn’t make sense to do forward tracing while not devoting enough resources to backward tracing and finding clusters, which cause so much damage.

    Another significant consequence of overdispersion is that it highlights the importance of certain kinds of rapid, cheap tests. Consider the current dominant model of test and trace. In many places, health authorities try to trace and find forward contacts of an infected person: everyone they were in touch with since getting infected. They then try to test all of them with expensive, slow, but highly accurate PCR (polymerase chain reaction) tests. But that’s not necessarily the best way when clusters are so important in spreading the disease.

    PCR tests identify RNA segments of the coronavirus in samples from nasal swabs—like looking for its signature. Such diagnostic tests are measured on two different dimensions: Are they good at identifying people who are not infected (specificity), and are they good at identifying people who are infected (sensitivity)? PCR tests are highly accurate for both dimensions. However, PCR tests are also slow and expensive, and they require a long, uncomfortable swab up the nose at a medical facility. The slow processing times means that people don’t get timely information when they need it. Worse, PCR tests are so responsive that they can find tiny remnants of coronavirus signatures long after someone has stopped being contagious, which can cause unnecessary quarantines.

    Meanwhile, researchers have shown that rapid tests that are very accurate for identifying people who do not have the disease, but not as good at identifying infected individuals, can help us contain this pandemic. As Dylan Morris, a doctoral candidate in ecology and evolutionary biology at Princeton, told me, cheap, low-sensitivity tests can help mitigate a pandemic even if it is not overdispersed, but they are particularly valuable for cluster identification during an overdispersed one. This is especially helpful because some of these tests can be administered via saliva and other less-invasive methods, and be distributed outside medical facilities.

    In an overdispersed regime, identifying transmission events (someone infected someone else) is more important than identifying infected individuals. Consider an infected person and their 20 forward contacts—people they met since they got infected. Let’s say we test 10 of them with a cheap, rapid test and get our results back in an hour or two. This isn’t a great way to determine exactly who is sick out of that 10, because our test will miss some positives, but that’s fine for our purposes. If everyone is negative, we can act as if nobody is infected, because the test is pretty good at finding negatives. However, the moment we find a few transmissions, we know we may have a super-spreader event, and we can tell all 20 people to assume they are positive and to self-isolate—if there are one or two transmissions, there are likely more, exactly because of the clustering behavior. Depending on age and other factors, we can test those people individually using PCR tests, which can pinpoint who is infected, or ask them all to wait it out.

    Scarpino told me that overdispersion also enhances the utility of other aggregate methods, such as wastewater testing, especially in congregate settings like dorms or nursing homes, allowing us to detect clusters without testing everyone. Wastewater testing also has low sensitivity; it may miss positives if too few people are infected, but that’s fine for population-screening purposes. If the wastewater testing is signaling that there are likely no infections, we do not need to test everyone to find every last potential case. However, the moment we see signs of a cluster, we can rapidly isolate everyone, again while awaiting further individualized testing via PCR tests, depending on the situation.

    Unfortunately, until recently, many such cheap tests had been held up by regulatory agencies in the United States, partly because they were concerned with their relative lack of accuracy in identifying positive cases compared with PCR tests—a worry that missed their population-level usefulness for this particular overdispersed pathogen.

    To return to the mysteries of this pandemic, what did happen early on to cause such drastically different trajectories in otherwise similar places? Why haven’t our usual analytic tools—case studies, multi-country comparisons—given us better answers? It’s not intellectually satisfying, but because of the overdispersion and its stochasticity, there may not be an explanation beyond that the worst-hit regions, at least initially, simply had a few unlucky early super-spreading events. It wasn’t just pure luck: Dense populations, older citizens, and congregate living, for example, made cities around the world more susceptible to outbreaks compared with rural, less dense places and those with younger populations, less mass transit, or healthier citizenry. But why Daegu in February and not Seoul, despite the two cities being in the same country, under the same government, people, weather, and more? As frustrating at it may be, sometimes, the answer is merely where Patient 31 and the megachurch she attended happened to be.

    Overdispersion makes it harder for us to absorb lessons from the world, because it interferes with how we ordinarily think about cause and effect. For example, it means that events that result in spreading and non-spreading of the virus are asymmetric in their ability to inform us. Take the highly publicized case in Springfield, Missouri, in which two infected hairstylists, both of whom wore masks, continued to work with clients while symptomatic. It turns out that no apparent infections were found among the 139 exposed clients (67 were directly tested; the rest did not report getting sick). While there is a lot of evidence that masks are crucial in dampening transmission, that event alone wouldn’t tell us if masks work. In contrast, studying transmission, the rarer event, can be quite informative. Had those two hairstylists transmitted the virus to large numbers of people despite everyone wearing masks, it would be important evidence that, perhaps, masks aren’t useful in preventing super-spreading.

    Comparisons, too, give us less information compared with phenomena for which input and output are more tightly coupled. When that’s the case, we can check for the presence of a factor (say, sunshine or Vitamin D) and see if it correlates with a consequence (infection rate). But that’s much harder when the consequence can vary widely depending on a few strokes of luck, the way that the wrong person was in the wrong place sometime in mid-February in South Korea. That’s one reason multi-country comparisons have struggled to identify dynamics that sufficiently explain the trajectories of different places.

    Once we recognize super-spreading as a key lever, countries that look as if they were too relaxed in some aspects appear very different, and our usual polarized debates about the pandemic are scrambled, too. Take Sweden, an alleged example of the great success or the terrible failure of herd immunity without lockdowns, depending on whom you ask. In reality, although Sweden joins many other countries in failing to protect elderly populations in congregate-living facilities, its measures that target super-spreading have been stricter than many other European countries. Although it did not have a complete lockdown, as Kucharski pointed out to me, Sweden imposed a 50-person limit on indoor gatherings in March, and did not remove the cap even as many other European countries eased such restrictions after beating back the first wave. (Many are once again restricting gathering sizes after seeing a resurgence.) Plus, the country has a small household size and fewer multigenerational households compared with most of Europe, which further limits transmission and cluster possibilities. It kept schools fully open without distancing or masks, but only for children under 16, who are unlikely to be super-spreaders of this disease. Both transmission and illness risks go up with age, and Sweden went all online for higher-risk high-school and university students—the opposite of what we did in the United States. It also encouraged social-distancing, and closed down indoor places that failed to observe the rules. From an overdispersion and super-spreading point of view, Sweden would not necessarily be classified as among the most lax countries, but nor is it the most strict. It simply doesn’t deserve this oversize place in our debates assessing different strategies.

    Although overdispersion makes some usual methods of studying causal connections harder, we can study failures to understand which conditions turn bad luck into catastrophes. We can also study sustained success, because bad luck will eventually hit everyone, and the response matters.

    The most informative case studies may well be those who had terrible luck initially, like South Korea, and yet managed to bring about significant suppression. In contrast, Europe was widely praised for its opening early on, but that was premature; many countries there are now experiencing widespread rises in cases and look similar to the United States in some measures. In fact, Europe’s achieving a measure of success this summer and relaxing, including opening up indoor events with larger numbers, is instructive in another important aspect of managing an overdispersed pathogen: Compared with a steadier regime, success in a stochastic scenario can be more fragile than it looks.

    Once a country has too many outbreaks, it’s almost as if the pandemic switches into “flu mode,” as Scarpino put it, meaning high, sustained levels of community spread even though a majority of infected people may not be transmitting onward. Scarpino explained that barring truly drastic measures, once in that widespread and elevated mode, COVID-19 can keep spreading because of the sheer number of chains already out there. Plus, the overwhelming numbers may eventually spark more clusters, further worsening the situation.

    As Kucharski put it, a relatively quiet period can hide how quickly things can tip over into large outbreaks and how a few chained amplification events can rapidly turn a seemingly under-control situation into a disaster. We’re often told that if Rt, the real-time measure of the average spread, is above one, the pandemic is growing, and that below one, it’s dying out. That may be true for an epidemic that is not overdispersed, and while an Rt below one is certainly good, it’s misleading to take too much comfort from a low Rt when just a few events can reignite massive numbers. No country should forget South Korea’s Patient 31.

    That said, overdispersion is also a cause for hope, as South Korea’s aggressive and successful response to that outbreak—with a massive testing, tracing, and isolating regime—shows. Since then, South Korea has also been practicing sustained vigilance, and has demonstrated the importance of backward tracing. When a series of clusters linked to nightclubs broke out in Seoul recently, health authorities aggressively traced and tested tens of thousands of people linked to the venues, regardless of their interactions with the index case, six feet apart or not—a sensible response, given that we know the pathogen is airborne.

    Perhaps one of the most interesting cases has been Japan, a country with middling luck that got hit early on and followed what appeared to be an unconventional model, not deploying mass testing and never fully shutting down. By the end of March, influential economists were publishing reports with dire warnings, predicting overloads in the hospital system and huge spikes in deaths. The predicted catastrophe never came to be, however, and although the country faced some future waves, there was never a large spike in deaths despite its aging population, uninterrupted use of mass transportation, dense cities, and lack of a formal lockdown.

    It’s not that Japan was better situated than the United States in the beginning. Similar to the U.S. and Europe, Oshitani told me, Japan did not initially have the PCR capacity to do widespread testing. Nor could it impose a full lockdown or strict stay-at-home orders; even if that had been desirable, it would not have been legally possible in Japan.

    Oshitani told me that in Japan, they had noticed the overdispersion characteristics of COVID-19 as early as February, and thus created a strategy focusing mostly on cluster-busting, which tries to prevent one cluster from igniting another. Oshitani said he believes that “the chain of transmission cannot be sustained without a chain of clusters or a megacluster.” Japan thus carried out a cluster-busting approach, including undertaking aggressive backward tracing to uncover clusters. Japan also focused on ventilation, counseling its population to avoid places where the three C’s come together—crowds in closed spaces in close contact, especially if there’s talking or singing—bringing together the science of overdispersion with the recognition of airborne aerosol transmission, as well as presymptomatic and asymptomatic transmission.

    Oshitani contrasts the Japanese strategy, nailing almost every important feature of the pandemic early on, with the Western response, trying to eliminate the disease “one by one” when that’s not necessarily the main way it spreads. Indeed, Japan got its cases down, but kept up its vigilance: When the government started noticing an uptick in community cases, it initiated a state of emergency in April and tried hard to incentivize the kinds of businesses that could lead to super-spreading events, such as theaters, music venues, and sports stadiums, to close down temporarily. Now schools are back in session in person, and even stadiums are open—but without chanting.

    It’s not always the restrictiveness of the rules, but whether they target the right dangers. As Morris put it, “Japan’s commitment to ‘cluster-busting’ allowed it to achieve impressive mitigation with judiciously chosen restrictions. Countries that have ignored super-spreading have risked getting the worst of both worlds: burdensome restrictions that fail to achieve substantial mitigation. The U.K.’s recent decision to limit outdoor gatherings to six people while allowing pubs and bars to remain open is just one of many such examples.”

    Could we get back to a much more normal life by focusing on limiting the conditions for super-spreading events, aggressively engaging in cluster-busting, and deploying cheap, rapid mass tests—that is, once we get our case numbers down to low enough numbers to carry out such a strategy? (Many places with low community transmission could start immediately.) Once we look for and see the forest, it becomes easier to find our way out.

  • Turkey finally releases epidemic figures: coronavirus epicenter in Istanbul-Al monitor
    “Another 79 people died in the last 24 hours, bringing the death toll to 356 people, Health Minister Fahrettin Koca said. Another 2,456 people tested positive and the country now has 18,135 confirmed cases, he said.”


  • Turkish Medical Association: Covid-19 Spread All Around Turkey due to Government’s Mistakes-
    “As the coronavirus has spread all around Turkey because of the government’s mistakes in containing the disease, it has now lost the opportunity to implement a country-wide quarantine, according to the Turkish Medical Association”


  • #Coronavirus_Capitalism” : Naomi Klein’s Case for Transformative Change Amid Coronavirus Pandemic

    Author, activist and journalist Naomi Klein says the coronavirus crisis, like earlier ones, could be a catalyst to shower aid on the wealthiest interests in society, including those most responsible for our current vulnerabilities, while offering next to nothing to most workers and small businesses. In 2007, Klein wrote “The Shock Doctrine: The Rise of Disaster Capitalism.” Now she argues President Trump’s plan is a pandemic shock doctrine. In a new video for The Intercept, where she is a senior correspondent, Klein argues it’s vital for people to fight for the kind of transformative change that can not only curb the worst effects of the current crisis but also set society on a more just path.

    AMY GOODMAN: Today we spend much of the hour looking at the economic impact of the coronavirus pandemic, what some are calling coronavirus capitalism. Soon we’ll be joined by Nobel Prize-winning economist Joseph Stiglitz, whose new book is People, Power and Profits: Progressive Capitalism for an Age of Discontent. But first we begin with a new video by author and activist Naomi Klein, produced by The Intercept. In 2007, Klein wrote The Shock Doctrine: The Rise of Disaster Capitalism. Now she argues Trump’s plan is a pandemic shock doctrine, but it’s not the only way forward. The video opens with this quote from economist Milton Friedman, who says, “Only a crisis — actual or perceived — produces real change. When that crisis occurs, the actions that are taken depend on the ideas that are lying around.”

    NAOMI KLEIN: “Ideas that are lying around.” Friedman, one of history’s most extreme free market economists, was wrong about a whole lot, but he was right about that. In times of crisis, seemingly impossible ideas suddenly become possible. But whose ideas? Sensible, fair ones, designed to keep as many people as possible safe, secure and healthy? Or predatory ideas, designed to further enrich the already unimaginably wealthy while leaving the most vulnerable further exposed? The world economy is seizing up in the face of cascading shocks.

    TEDROS ADHANOM GHEBREYESUS: COVID-19 can be characterized as a pandemic.

    GEORGE STEPHANOPOULOS: In the wake of the coronavirus crisis, stocks have stopped trading on Wall Street after a 7% drop.

    KRISTINA PARTSINEVELOS: This is a historical day, the biggest drop we’ve seen since that crash in 1987.

    ELAINE QUIJANO: The drop was spurred by a growing oil price war as the market was already weakened by coronavirus fears.

    PRESIDENT DONALD TRUMP: Yeah, no, I don’t take responsibility at all.

    NAOMI KLEIN: In the midst of this widespread panic, corporate lobbyists of all stripes are of course dusting off all the ideas they had lying around. Trump is pushing a suspension of the payroll tax, which could bankrupt Social Security, providing the excuse to cut it or privatize it completely — an idea that has been lying around for very long time.

    PRESIDENT GEORGE W. BUSH: A worker, at his or her option, ought to be allowed to put some of their own money in a — you know, in a private savings account.

    NAOMI KLEIN: Lying around on both sides of the aisle.

    SEN. JOE BIDEN: When I argued if we should freeze federal spending, I meant Social Security, as well. I meant Medicare and Medicaid.

    NAOMI KLEIN: And then, there are the ideas being floated to bail out some of the wealthiest and most polluting sectors in our economy.

    PRESIDENT DONALD TRUMP: We are working very closely with the cruise line industry, likewise with the airline industry. They’re two great industries, and we’ll be helping them through this patch.

    NAOMI KLEIN: Bailouts for fracking companies, not to mention cruise ships, airlines and hotels, handouts which Trump could benefit from personally. Which is a big problem because the virus isn’t the only crisis we face. There’s also climate disruption, and these industries that are getting rescued with our money are the ones driving it. Trump has also been meeting with the private health insurers.

    PRESIDENT DONALD TRUMP: We’re meeting with the top executives of the health insurance companies.

    NAOMI KLEIN: The very ones who have made sure that so many Americans can’t afford the care they need. And what are the chances they don’t have their hands out? It seems like the whole pandemic is getting outsourced.

    BRIAN CORNELL: Well, Mr. President, thank you for inviting us here today, along with our colleagues from Walmart and Walgreens and our partners at CVS. Normally you’d view us as competitors, but today we’re focused on a common competitor. And that’s defeating the spread of the coronavirus.

    NAOMI KLEIN: The Fed’s first move was to pump $1.5 trillion into the financial markets, with more undoubtedly on the way. But if you’re a worker, especially a gig worker, there’s a very good chance you’re out of luck. If you do need to see a doctor for care, there’s a good chance no one’s going to help you pay if you aren’t covered. And if you want to heed the public health warnings to stay home from work, there’s also a chance that you won’t get paid. Of course, you still need to pay your rent and all of your debts — medical, student, credit card, mortgage. The results are predictable. Too many sick people have no choice but to go to work, which means more people contracting and spreading the virus. And without comprehensive bailouts for workers, we can expect more bankruptcies and more homelessness down the road.

    Look, we know this script. In 2008, the last time we had a global financial meltdown, the same kinds of bad ideas for no-strings-attached corporate bailouts carried the day, and regular people around the world paid the price. And even that was entirely predictable. Thirteen years ago, I wrote a book called The Shock Doctrine: The Rise of Disaster Capitalism, described a brutal and recurring tactic by right-wing governments. After a shocking event — a war, coup, terrorist attack, market crash or natural disaster — they exploit the public’s disorientation, suspend democracy, push through radical free market policies that enrich the 1% at the expense of the poor and middle class.

    But here is what my research has taught me. Shocks and crises don’t always go the shock doctrine path. In fact, it’s possible for crisis to catalyze a kind of evolutionary leap. Think of the 1930s, when the Great Depression led to the New Deal.

    PRESIDENT FRANKLIN ROOSEVELT: The only thing we have to fear is fear itself.

    NAOMI KLEIN: In the United States and elsewhere, governments began to weave a social safety net, so that the next time there was a crash, there would be programs like Social Security to catch people.

    PRESIDENT FRANKLIN ROOSEVELT: The right of every family to a decent home, the right to adequate medical care and the opportunity to achieve and enjoy good health.

    NAOMI KLEIN: Look, we know what Trump’s plan is: a pandemic shock doctrine, featuring all the most dangerous ideas lying around, from privatizing Social Security to locking down borders to caging even more migrants. Hell, he might even try canceling elections. But the end of this story hasn’t been written yet. It is an election year. And social movements and insurgent politicians are already mobilized. And like in the 1930s, we have a whole bunch of other ideas lying around.

    SEN. BERNIE SANDERS: Do we believe that everybody should be entitled, as a right, to healthcare?


    DOMINIQUE WALKER: We will not stop organizing and fighting until all unhoused folks who want shelter have shelter.

    REP. ILHAN OMAR: Canceling student debt.

    REP. RO KHANNA: It makes so much sense that if you’re sick, that you should not be penalized where you don’t have an income.

    NAOMI KLEIN: Many of these ideas were dismissed as too radical just a week ago. Now they’re starting to seem like the only reasonable path to get out of this crisis and prevent future ones.

    ELIZABETH COHEN: Now, here’s something that helps explain the difference between the testing situation in South Korea and the U.S. The South Korea, like European countries and Canada, has universal single-payer insurance. And that means that it’s easier to mobilize, and also people know what to do. There is pretty much one answer for how to get testing. The U.S. is a patchwork of countless different systems, and so you can’t say, “Here’s exactly the steps that every American should take in order to get tested.”

    NAOMI KLEIN: And with Washington suddenly in the giant stimulus business, this is precisely the time for the stimulus that many of us have been talking about for years.

    REP. ALEXANDRIA OCASIO-CORTEZ: Today is the day that we truly embark on a comprehensive agenda of economic, social and racial justice in the United States of America.

    NAOMI KLEIN: It’s called the Green New Deal. Instead of rescuing the dirty industries of the last century, we should be boosting the clean ones that will lead us into safety in the coming century. If there is one thing history teaches us, it’s that moments of shock are profoundly volatile. We either lose a whole lot of ground, get fleeced by elites and pay the price for decades, or we win progressive victories that seemed impossible just a few weeks earlier. This is no time to lose our nerve. The future will be determined by whoever is willing to fight harder for the ideas they have lying around.

    AMY GOODMAN: That’s author and activist Naomi Klein of The Intercept. The video ends with Milton Friedman’s quote: “Only a crisis — actual or perceived — produces real change. When that crisis occurs, the actions that are taken depend on ideas that are lying around. That, I believe, is our basic function: to develop alternatives to existing policies, to keep them alive and available until the politically impossible becomes politically inevitable.”

    This is Democracy Now!, democracynow.org, The War and Peace Report. When we come back, Nobel Prize-winning economist Joe Stiglitz. Stay with us.


    AMY GOODMAN: That’s Spanish pianist Alberto Gestoso, performing the Titanic theme song, “My Heart Will Go On,” for his quarantined neighbors in Barcelona. He was on his balcony. Spain has had more than 3,400 cases of the coronavirus in the last 24 hours. Now at least 17,000 people are infected, and that’s only what is known without widespread testing.

    #Naomi_Klein #stratégie_du_choc #pandémie #coronavirus #covid-19 #épidémie #capitalisme #pandemic_shock_doctrine

  • What happens to freedom of movement during a pandemic ?

    Restrictions are particularly problematic for those who need to move in order to find safety, but whose elementary freedom to move had been curtailed long before the Covid-19 outbreak.

    The severe consequences of the Covid-19 pandemic dominate headlines around the globe and have drawn the public’s attention unlike any other issue or event. All over the world, societies struggle to respond and adapt to rapidly changing scenarios and levels of threat. Emergency measures have come to disrupt everyday life, international travel has largely been suspended, and many state borders have been closed. State leaders liken the fight against the virus to engaging in warfare – although it is clear that the parallel is misleading and that those involved in the “war” are not soldiers but simply citizens. The situation is grim, and it would be a serious mistake to underestimate the obvious danger of infection, loss of life, the collapse of health services and the economy. Nonetheless, there is a need to stress that this phase of uncertainty entails also the risk of normalising ‘exceptional’ policies that restrict freedoms and rights in the name of crisis and public safety - and not only in the short term.

    “Of all the specific liberties which may come into mind when we hear the word “freedom””, philosopher Hannah Arendt once wrote, the “freedom of movement is historically the oldest and also the most elementary.” However, in times of a pandemic, human movements turn increasingly into a problem. The elementary freedom to move is said to be curtailed for the greater good, particularly for the elderly and others in high-risk groups. (Self-)confinement appears key – “inessential” movements and contact with others are to be avoided. In China, Italy and elsewhere, hard measures have been introduced and their violation can entail severe penalties. Movements from A to B need (state) authorisation and unsanctioned movements can be punished. There are good reasons for that, no doubt. Nevertheless, there is a need to take stock of the wider implications of our current predicament.

    In this general picture, current restrictions on movement are problematic for people who do not have a home and for whom self-quarantine is hardly an option, for people with disability who remain without care, and for people, mostly women, whose home is not a safe haven but the site of insecurity and domestic abuse. Restrictions are also particularly problematic for those whose elementary freedom to move had been curtailed long before the Covid-19 outbreak but who need to move in order to find safety. Migrants embody in the harshest way the contradictions and tensions surrounding the freedom of movement and its denial today. It is not surprising that in the current climate, they tend to become one of the first targets of the most restrictive measures.
    Migrant populations who moved, or still seek to move, across borders without authorisation in order to escape danger are subjected to confinement and deterrence measures that are legitimized by often spurious references to public safety and global health. Discriminatory practices that segregate in the name of safety turn those at risk into a risk. “We are fighting a two-front war”, Hungary’s Prime Minister Viktor Orban declared, “one front is called migration, and the other one belongs to the coronavirus, there is a logical connection between the two, as both spread with movement.” The danger of conflating the declared war on the pandemic with a war on migration is great, and the human costs are high. Restrictive border measures endanger the lives of vulnerable populations for whom movement is a means of survival.

    About two weeks ago, it was documented that the Greek coastguard opened fire on migrants trying to escape via the Aegean Sea and the land border between Turkey and Greece. Some people died while many were injured in a hyperbolic deployment of border violence. The European reaction, as embodied in the person of European Commission president Ursula von der Leyen, was to refer to Greece as Europe’s “shield”. About a week ago, it was uncovered that a migrant boat with 49 people on board which had already reached a European search and rescue zone was returned to Libya through coordinated measures taken by the EU border agency Frontex, the Armed Forces of Malta, and Libyan authorities. In breach of international law and of the principle of non-refoulement, the people were returned to horrid migrant camps in Libya, a country still at war. With no NGO rescuers currently active in the Mediterranean due to the effects of the Coronavirus, more than 400 people were intercepted at sea and forcibly returned to Libya over the past weekend alone, over 2,500 this year.

    Such drastic migration deterrence and containment measures endanger the lives of those ‘on the move’ and exacerbate the risk of spreading the virus. In Libyan camps, in conditions that German diplomats once referred to as “concentration-camp-like”, those imprisoned often have extremely weakened immune systems, often suffering from illnesses like tuberculosis. A Coronavirus outbreak here would be devastating. Doctors without Borders have called for the immediate evacuation of the hotspot camps on the Greek Islands, highlighting that the cramped and unhygienic conditions there would “provide the perfect storm for a COVID-19 outbreak”. This is a more general situation in detention camps for migrants throughout Europe and elsewhere, as it is in ‘regular’ prisons worldwide.

    Together with the virus, a politics of fear spreads across the world and prompts ever-more restrictive measures. Besides the detrimental consequences of curtailing the freedom to move already experienced by the most vulnerable, the worry is that many of these measures will continue to undermine rights and freedoms even long after the pandemic has been halted. And yet, while, as Naomi Klein notes, “a pandemic shock doctrine” may allow for the enactment of “all the most dangerous ideas lying around, from privatizing Social Security to locking down borders to caging even more migrants”, we agree with her that “the end of this story hasn’t been written yet.”

    The situation is volatile – how it ends depends also on us and how we collectively mobilize against the now rampant authoritarian tendencies. All around us, we see other reactions to the current predicament with new forms of solidarity emerging and creative ways of taking care of “the common”. The arguments are on our side. The pandemic shows that a global health crisis cannot be solved through nationalistic measures but only through international solidarity and cooperation – the virus does not respect borders.

    Its devastating effects strengthen the call to universal health care and the value of care work, which continues to be disproportionately women’s work. The pandemic gives impetus to those who demand the right to shelter and affordable housing for all and provides ammunition to those who have long struggled against migrant detention camps and mass accommodations, as well as against migrant deportations. It exposes the ways that the predatory capitalist model, often portrayed as commonsensical and without alternatives, provides no answers to a global health crisis while socialist models do. It shows that resources can be mobilized if the political will exists and that ambitious policies such the Green New Deal are far from being ‘unrealistic’. And, the Coronavirus highlights how important the elementary freedom of movement continues to be.
    The freedom of movement, of course, also means having the freedom not to move. And, at times, even having the freedom to self-confine. For many, often the most vulnerable and disenfranchised, this elementary freedom is not given. This means that even during a pandemic, we need to stand in solidarity with those who take this freedom to move, who can no longer remain in inhumane camps within Europe or at its external borders and who try to escape to find safety. Safety from war and persecution, safety from poverty and hunger, safety from the virus. In this period in which borders multiply, the struggle around the elementary freedom of movement will continue to be both a crucial stake and a tool in the fight against global injustice, even, or particularly, during a global health crisis.


    #liberté_de_circulation #liberté_de_mouvement #coronavirus #épidémie #pandémie #frontières #virus #mobilité #mobilité_humaine #migrations #confinement #autorisation #restrictions_de_mouvement #guerre #guerre_aux_migrants #guerre_au_virus #danger #fermeture_des_frontières #pandemic_shock_doctrine #stratégie_du_choc #autoritarisme #solidarité #solidarité_internationale #soins_de_santé_universels #universalisme #nationalisme #capitalisme #socialisme #Green_New_Deal #immobilité #vulnérabilité #justice #Sandro_Mezzadra #Maurice_Stierl

    via @isskein
    ping @karine4

  • Regular soap is extremely effective at deactivating viruses.

    Regular soap is extremely effective at deactivating viruses.

    #coronavirus #COVID19 #information #pandemic

    The hydrophobic tails of the soap molecules disrupt the structure of the lipid casing and destroy it.