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What is an immunity passport and could it work?
In Chile, the so-called "release certificate" would free holders from all types of quarantine or restriction.
Weeks into lockdown and with economic indicators signalling a deep global recession, governments around the world are searching for ways to get their countries back up and running.
But emerging from a cocooned state could risk a second spike of coronavirus infections as people start mixing once more. Among the measures being considered by governments including Chile, Germany, Italy, Britain and the US are immunity passports – a form of documentation given to those who have recovered from COVID-19.
In Chile, which looks set to become the first country to put such a scheme into action, the so-called "release certificate" would free holders from all types of quarantine or restriction, Chilean Health Minister Jaime Mañalich said in April.
But the idea has proved contentious, with the World Health Organization (WHO) among those voicing criticism. The root of the concern for many is the unknown degree to which past infection confers future immunity. Until it is understood whether or not people can be reinfected with the disease, and how long any immunity lasts for, the move may be premature.
In Chile's case, the certificate will expire three months after a confirmed infected person has recovered. After this point, they will be considered to have the same risk of infection as anyone else. The government hopes the certificates will encourage diagnosed individuals to report results to the health ministry.
The WHO also raises questions about the validity of results from some of the tests on the market, which it says are not sufficiently sensitive or accurate.
False positives could lead people to think that they are safe from future infection, despite never having had the disease. False negatives would also mean infected people might fail to self-isolate. Advice from the WHO is that immunity certificates may in fact risk continued transmission of the virus, and lead to people ignoring public health advice.
This could be a particular cause for concern given a number of recent studies have demonstrated that a comparatively small population has been infected so far, leaving the vast majority still vulnerable. Many countries are also bowing under the weight of the amount of testing required.
Placing a value on recovery
Some experts think enforcing two-tier restrictions on who can and cannot socialize or go to work also raises legal and practical concerns, and that it could have the adverse effect of incentivizing people to seek out infection to avoid being excluded.
And as such existing inequalities could worsen. Not least the economic divide, potentially exaggerated by some being excluded from work when others aren't.
"By replicating existing inequities, use of immunity passports would exacerbate the harm inflicted by COVID-19 on already vulnerable populations," Alexandra Phelan, a member of the Center for Global Health Science and Security at Georgetown University, writes in The Lancet. Because of this, she says, they would be ripe for corruption.
Phelan also says immunity passports could risk providing some governments with an "apparent quick fix" that could result in them failing to adopt economic policies to protect health and welfare.
Alongside advances in vaccines and creating the infrastructure to deliver them, investment in testing and tracing is seen by many as key to limiting further spread of the virus. The International Labour Organization is among the bodies that say this could play an effective role in getting people back to work.
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Health officials in China reported that a man was infected with bubonic plague, the infectious disease that caused the Black Death.
- The case was reported in the city of Bayannur, which has issued a level-three plague prevention warning.
- Modern antibiotics can effectively treat bubonic plague, which spreads mainly by fleas.
- Chinese health officials are also monitoring a newly discovered type of swine flu that has the potential to develop into a pandemic virus.
Bacteria under microscope
needpix.com<p>Today, bubonic plague can be treated effectively with antibiotics.</p><p style="margin-left: 20px;">"Unlike in the 14th century, we now have an understanding of how this disease is transmitted," Dr. Shanthi Kappagoda, an infectious disease physician at Stanford Health Care, told <a href="https://www.healthline.com/health-news/seriously-dont-worry-about-the-plague#Heres-how-the-plague-spreads" target="_blank">Healthline</a>. "We know how to prevent it — avoid handling sick or dead animals in areas where there is transmission. We are also able to treat patients who are infected with effective antibiotics, and can give antibiotics to people who may have been exposed to the bacteria [and] prevent them [from] getting sick."</p>
This plague patient is displaying a swollen, ruptured inguinal lymph node, or buboe.
Centers for Disease Control and Prevention<p>Still, hundreds of people develop bubonic plague every year. In the U.S., a handful of cases occur annually, particularly in New Mexico, Arizona and Colorado, <a href="https://www.cdc.gov/plague/faq/index.html" target="_blank">where habitats allow the bacteria to spread more easily among wild rodent populations</a>. But these cases are very rare, mainly because you need to be in close contact with rodents in order to get infected. And though plague can spread from human to human, this <a href="https://www.healthline.com/health-news/seriously-dont-worry-about-the-plague#Heres-how-the-plague-spreads" target="_blank">only occurs with pneumonic plague</a>, and transmission is also rare.</p>
A new swine flu in China<p>Last week, researchers in China also reported another public health concern: a new virus that has "all the essential hallmarks" of a pandemic virus.<br></p><p>In a paper published in the <a href="https://www.pnas.org/content/early/2020/06/23/1921186117" target="_blank">Proceedings of the National Academy of Sciences</a>, researchers say the virus was discovered in pigs in China, and it descended from the H1N1 virus, commonly called "swine flu." That virus was able to transmit from human to human, and it killed an estimated 151,700 to 575,400 people worldwide from 2009 to 2010, according to the Centers for Disease Control and Prevention.</p>There's no evidence showing that the new virus can spread from person to person. But the researchers did find that 10 percent of swine workers had been infected by the virus, called G4 reassortant EA H1N1. This level of infectivity raises concerns, because it "greatly enhances the opportunity for virus adaptation in humans and raises concerns for the possible generation of pandemic viruses," the researchers wrote.
SEAL training is the ultimate test of both mental and physical strength.
- The fact that U.S. Navy SEALs endure very rigorous training before entering the field is common knowledge, but just what happens at those facilities is less often discussed. In this video, former SEALs Brent Gleeson, David Goggins, and Eric Greitens (as well as authors Jesse Itzler and Jamie Wheal) talk about how the 18-month program is designed to build elite, disciplined operatives with immense mental toughness and resilience.
- Wheal dives into the cutting-edge technology and science that the navy uses to prepare these individuals. Itzler shares his experience meeting and briefly living with Goggins (who was also an Army Ranger) and the things he learned about pushing past perceived limits.
- Goggins dives into why you should leave your comfort zone, introduces the 40 percent rule, and explains why the biggest battle we all face is the one in our own minds. "Usually whatever's in front of you isn't as big as you make it out to be," says the SEAL turned motivational speaker. "We start to make these very small things enormous because we allow our minds to take control and go away from us. We have to regain control of our mind."
Is focusing solely on body mass index the best way for doctor to frame obesity?
- New guidelines published in the Canadian Medical Association Journal argue that obesity should be defined as a condition that involves high body mass index along with a corresponding physical or mental health condition.
- The guidelines note that classifying obesity by body mass index alone may lead to fat shaming or non-optimal treatments.
- The guidelines offer five steps for reframing the way doctors treat obesity.