Tag: union

  • BIRTH CONTROL METHODS

    BIRTH CONTROL METHODS

    The general subject of Birth Control necessarily includes the special subject of Birth Control Methods, viz., of the methods of association between husband and wife under which offspring is conceived only at such times as desired, and consequently only in the number desired.

    These methods may be grouped into three general classes, as follows:

    I. Methods of Continence (total or temporary). In the practice of the methods under this class, there is an avoidance of sexual relations between husband and wife, either continuously or for certain periods during which the liability to conception is great.

    II. Methods of Semi-Continence. In the practice of the methods under this class, there is a partial manifestation of the sexual relation accompanied by an absence of the manifestation of the procreative functions.

    III. Methods of Contraception. In the practice of the methods under this class, the usual manifestations of the sexual relation are observed, accompanied by an avoidance of the union of the male and female elements of reproduction which result in conception.

    The student of the subject of Birth Control, of course, familiarizes himself or herself with each of the several classes of methods above noted, for the purpose of understanding the characteristic distinctions between them, and the respective advantages and disadvantages of each class. In the following pages each class will be briefly considered, that the student may acquire a general understanding thereof, and may be enabled to reason intelligently concerning them. In this presentation therewill be sought a fair statement of each class, without any desire to influence the student for or against either of them.

    Continence.

    Continence (which in this special sense means the avoidance of sexual relations between husband and wife), in the strict sense, is based upon the idea that the sexual relation should not be exercised except for the purpose and intent of procreation. In the restricted usage of the term, it refers to the abstinence from sexual intercourse during stated periods in which the liability to conception is greatest.

    Rev. Sylvanus Stall, the author of several widely-read works on the subject of Sex, says of strict continence: “One theory is that the reproductive function is not to be exercised except for the purpose of procreation. * * * There are some married people, more numerous than some suppose, who have adopted the idea of uniform continence, and who call the reproductive nature into exercise for the purpose of procreation only, and who assert that the maintenance of continence secures not only the greater strength and better health, but greater happiness also. * * * While the results of our investigations do not enable us to assert that it is the true theory, we are yet prepared to say that it is worthy of thoughtful consideration. If it is possible for married people to maintain absolute continence for a period of six months or a year, it must be conceded that it would be possible to extend that time to a longer period. The maintenance of this theory would require such a degree of self-control as is far beyond the possession of the great mass of humanity. We fear, also, that there are but few, even if they entered upon a life union with such thought and intention, who would be willing to maintain their principles for any considerable period. * * * The other theory, and that which many men and women who are eminent for their learning and religious life hold to be the correct theory, is that while no one has a right to enter upon the marriage relation with the fixed purpose of evading the duty of parenthood, yet that procreation is not the only high and holy purpose which God has had in view in establishing the marriage relation, but that the act of sexual congress may be indulged in between husband and wife for the purpose of expressing their personal endearments, and for quickening those affections and tender feelings which are calculated to render home the place of blessing and good which God intended. * * * It is held by those who advocate this theory, that while it would be possible to restrict the exercise of the reproductive functions to the single purpose of procreation, yet in the great majority of instances the effort to live by that theory would generally result in marital unhappiness. * * * Due regard is not only to be paid to the perpetuity of the race, but to the well-being and perpetuity of the individual.”

    The advocates of continence, except for the purpose of procreation, advance many arguments and evidence to justify their contention that this is the only course justified by Nature and Morality. We need not present this argument here, for it is outside the particular question now under consideration. However, in all fairness and justice, there should be presented here the general outline of their argument that there is no rational basis for the widely accepted idea that abstinence from sexual relations is in any way harmful or detrimental to the health and physical well-being of the human race.

    The advocates of continence cite the cases of many continent men who have been noted for their vigor and activity; and claim that such cases also justify their claim that continence makes for the sound mind in the sound body of mankind. The following quotations from authorities will give the general spirit of this contention.

    Dr. Kellogg says: “It has been claimed by many, even physicians, and though with but a slight show of reason, that absolute continence, after a full development of the organs of reproduction, could not be maintained without a great detriment to health. It is needless to enumerate all the different arguments employed to support this position, since they are, with a few exceptions, too frivolous to mention.” Dr. Mayer says: “This position is held by men of the world, and many physicians share it. This belief appears to us erroneous, without foundation, and easily refuted. No peculiar disease nor any abridgement of the duration of life can be ascribed to such continence. * * * Health does not absolutely require that there should ever be an emission of semen, from puberty to death, though the individual live a hundred years.” Dr. Kellogg also says: “This has been amply confirmed by experiments upon animals, as well as by the experience of some of the most distinguished men who have ever lived, among whom may be mentioned Sir Isaac Newton, Kant, Paschal, Fontenaille, and Michael Angelo. These men never married, and lived continent lives. Some of them lived to be a very great age, retaining to the last their wonderful abilities. In view of this fact, there is certainly no danger.”

    Another writer has said: “The Greek athletes training for the great Olympic Games were compelled to observe strict continence, the experience being that by this course they were able to conserve their vigor and strength much better. The prize-fighters of today are compelled by their trainers to observe strict continence during the period of training. Many of the former champions who went to pieces suddenly, owe their downfall to a violation of this rule.” Another has said: “Chastity, even continence, is the prime necessity of the successful athlete.” Dr. Kellogg forcefully says: “Breeders of stock who wish to secure sound progeny will not allow the most robust stallion to associate with mares as many times during the whole season as some of these salacious human males perform a similar act within a month.”

    Dr. Warbasse has said: “Testicular fluid in the seminal vesicles, under unexciting conditions, does not require to be discharged at intervals. I have not been able to find in the studies of the physiologists that its retention is abnormal or unhygienic. * * * I do not conceive of a man suffering from the ills of continence who has been cast away on a desert island, with no immediate prospect of relief, and whose mind and hands are occupied with raising grain, catching fish for subsistence, and constructing a boat for escape. All that has been said of men may be said of women.”

    Dr. Talmey has said: “Continence, if long continued, has been claimed to be the cause of impotence. But there is no valid reason for this belief. To prove the harmfulness of continence an analogue is brought forward between the atrophy of a muscle in enforced idleness and the injury to the sex organs in enforced abstinence. But the proof is somewhat feeble. The essential organs of generation are not muscles, but glands, and who has ever heard of a tear gland atrophying for lack of crying. * * * There is no valid proof of the harmfulness of total abstinence in a healthy individual. A perfectly healthy man is never injured by abstinence. At least there is no sufficient proof that he ever was; but there are unmistakable proofs that total abstinence does not harm the individual.”

    Dr. Stockham has said: “The testes may be considered analogous to the salivary and lachrymal glands, in which there is no fluid secreted except at the demand of their respective functions. The thought of food makes the mouth water for a short time only, while the presence of food causes abundant yield of saliva. It is customary for physicians to assume that the spermatic secretion is analogous to bile, which, when once formed, must be expelled. But substitute the word ‘tears’ for bile, and you put before the mind an idea entirely different. Tears, as falling drops, are not essential to life and health. A man may be in perfect health and yet not cry once in five or even fifty years. The lachrymal fluid is ever present, but in such small quantities that it is unnoticed. Where are tears while they remain unshed? They are ever ready, waiting to spring forth when there is an adequate cause, but they do not accumulate and distress the man because they are not shed daily, weekly, or monthly. The component elements of the tears are prepared in the system, they are on hand, passing through the circulation, ready to mix and flow whenever they are needed; but if they mix, accumulate and flow without adequate cause, there is a disease of the lachrymal glands. While there are no exact analogies in the body, yet the tears and the spermatic fluids are much more closely analogous in their normal manner of secretion and use than are the bile and the semen. Neither flow of tears nor of semen is essential to life or health. Both are largely under the control of the imagination, the emotions, and the will; and the flow of either is liable to be arrested in a moment of sudden mental action.”

    Parkhurst says: “The prostatic fluid, according to Robin, is secreted at the moment of ejaculation. The remaining element of the spermatic secretion is produced, under normal circumstances, only as required, either for impregnation or for the maintenance of the affectional function. The theory that the sperm is naturally secreted only as it is required, brings it into harmony with other secretions. The tears, the saliva, and the perspiration, are always required in small quantities, and the secretion is continuous; but if required in great quantities, the secretion becomes great almost instantly. The mother’s milk is chiefly secreted just as it is required for the infant, and when not required the secretion entirely ceases; yet it recommences the moment the birth of another child makes it necessary. * * * A man accustomed to abstinence will not suffer from any accumulation of secretions, while a man whose absorbing glands have never had occasion to take up the secretions will be in trouble; just as a dairy cow which has not been milked will be in trouble, though if running wild she would never have any necessity for milking. * * * The objection that man needs physical relief from a continuous secretion is answered by the admitted fact that men not deficient in sexual vigor live for months, and probably for years, in strict abstinence, and with no physical inconvenience such as is often complained of by men who happen to be deprived of their accustomed indulgence for a week or two at a time.”

    Dr. Nystrom, the eminent Swedish writer on the subject, however, utters the following warning to those who would make hasty generalizations on the subject: “In speaking of relative abstinence or regulation and command of the sexual instinct, I warn against absolutism in this regard, and especially against the generalizing of abstinence as possible for everybody. Although abstinence during an entire lifetime does not injure certain individuals, it cannot be endured by others for some length of time without undesirable consequences. I therefore oppose the principle of absolute continence as in the main false. It may possibly be applied to a few deeply religious or philosophical persons, but not to the majority of normal people, despite good resolutions and habits. * * * We must consider the different bodily constitutions and passions—why some people without difficulty, others with the greatest difficulty, can master their feelings regarding sexual relations. * * * May those who try to better humanity in sexual respects first give their attention to the subject when well prepared with a rich experience and deep study, for otherwise they cannot give advice which can be followed, and their work should fail as being contrary to human nature.”

    Temporary Continence. Many married couples who are desirous of preventing too-frequent conception, or conception following too soon after the birth of the youngest child, practice the method of refraining from the marital sexual relations during certain periods in which conception is most likely to occur. This custom is said to be favored by those acting under the advice of their religious instructors, and who regard all methods of birth-control other than continence as sinful. Even the most orthodox objectors to birth-control as a general principle seem to regard this particular method as free from objection, providing that the married couple do not seek to entirely escape parenthood in this manner.

    This plan is based upon the well-known, and well-established physiological principle that the time immediately before the menstrual period, and still more, immediately after the period is the most favorable to conception. Impregnation is most likely to occur just after the menstrual period; while from about two weeks after the beginning of the period, to a few days before the beginning of the next period, is the time of comparative sterility when impregnation and conception are the least likely to occur. Consequently, the authorities hold that the period of from ten to fifteen days after the end of the menstruation is one peculiarly free from the probability of impregnation and conception.

    This plan of temporary continence, continuing during the period in which conception is most probable, and terminating when that period has passed each month, until the new period approaches, is followed by many married couples with the full approval of the conscience and their religious guides. In many cases the result fulfills the expectations, though as there is a considerable variation observed among different women there is no absolute certainty to the plan considered as a birth-control method—at the best it is but taking advantage of the law of probabilities, the chances being in favor of the result sought.

    Semi-Continence.

    Semi-Continence (in the sense in which the term is employed herein) consists of the abstinence from the exercise of the procreative functions, while there is a partial manifestation of the sexual relation. Under various fanciful names, backed by as many curious theories, this birth-control method is practiced by very many married couples in this and other countries.

    Among the earlier advocates of this general class of birth-control methods was Noyes, the founder of the one-time famous Oneida Community, who taught the doctrine of what he called “Male Continence.” The gist of his teaching was as follows: That the sexual relation (in its entirety) should be exercised solely for the purpose of reproduction, all else being contrary to nature. But, he held, notwithstanding this, there was possible and proper a certain degree of such physical relation which, while not opposing Nature’s laws of reproduction, yet was sufficient to afford a complete manifestation of the “affectional desire and function.” In other words, as a writer has expressed it, “that one might manifest a marked degree of sexual gratification and still remain continent, while feeling none of the irksome restraints of continence.”

    Noyes claimed that his community followed this plan with satisfactory results, the ordinary sexual relations being manifested only when reproduction was specially desired and deliberately decided upon. Noyes claimed that in this way there was no secretion of the seminal fluid, and therefore no waste of the same, and no unnatural practices such attached to the common custom of “tricking Nature” by methods of preventing impregnation and conception. Parkhurst (who, as we shall see presently, followed Noyes) objected to the Noyes plan, claiming that “it necessarily stimulates into activity the generative functions of the sexual batteries, and this not only causes a wasteful use of sperm, but diverts the sexual batteries from their affectional function, diminishing amative attraction.”

    In the year 1896, Dr. Alice B. Stockham, of Chicago, published a book called “Karezza” which has since attained an enormous sale, the leading principle of which seems to have been almost similar to that of Noyes, as above stated. The book was built around the idea previously announced by the same author in an earlier book, which she stated as follows: “By some a theory called ‘secular absorption’ is advanced. This involves intercourse without culmination.” In her book “Karezza” this author further stated: “Karezza so consummates marriage that through the power of will, and loving thoughts, the crisis is not reached, but a complete control by both husband and wife is maintained throughout the entire relation, a conscious conservation of the creative energy. * * * It is both a union on the affectional plane, and a preparation for the best possible conditions for procreation.”

    About 1882, Henry M. Parkhurst published a booklet called “Diana,” which since that time has passed through several editions, and has had a large number of readers. The principle advocated is radically different from that of Noyes or Dr. Stockham, above mentioned, although some of the writings of Dr. Stockham seem to favor the Parkhurst idea as much as the one advanced by herself. Parkhurst, as we may see by reference to a quotation from him in connection with the Noyes’ idea, did not approve of the “male continence” as taught by the latter, although he seems to have considered it a step in the right direction.

    The gist of the Parkhurst idea is expressed in the following quotations from his booklet, “Diana”: “In order to secure proper and durable relations between the sexes, it is necessary to live in harmony with the law of Alphism, that is abstinence except for procreation. But if that principle is adopted alone, no means being taken to provide for the due exercise of the sexual faculties, it will likely be abandoned or lead to a life of asceticism. In order to make Alphism practicable for ordinary men and women, another law has to be observed, that is, the law of sexual satisfaction from sexual contact; understanding by the term ‘contact’ not merely physical external contact, but using the term in its more general sense to include sexual companionship, or even correspondence, bringing the minds into mental contact. The observance of this law will lead to complete and enduring satisfaction in abstinence.

    “It is an observed fact that contact incites to activity the affectional action, * * * extending over the whole frame, and by their activities satisfies them, without calling into action the special generative function of the generative organs. And it is also an observed fact that the repression of this affectional activity naturally creates a desire for the exercise of the other; so that a true remedy for sexual intemperance is the full satisfaction of the affectional mode of activity by frequent and free sexual contact. Sexual satisfaction may be obtained by personal presence, conversation, a clasp of the hands, kissing, caressing, embracing, personal contact with or without the intervention of dress.

    “The exercise of the affectional function tends to satiety and exhaustion in the same way as all other physical or mental exercise; but if it is not carried to excess it is a permanent benefit. * * * The principle of Alphism will tend to diminish prostitution, not only by diminishing sexual intemperance, even if the principle is not at once accepted in practice to the full extent, thus diminishing the temptation of the present generation, and the hereditary temptation of future generations; but also by correcting the physiological error which has led astray so many, i. e., that total abstinence is not conducive to health, or to the highest physical pleasure, but that the ordinary physical relation is an essential feature in male existence.

    “To avoid misapprehension, these two theories should be clearly defined and the distinction between them explained. The doctrine of Alphism is confined to one principle, i. e., the law of abstinence except for procreation. Those who believe in this doctrine may be divided into different classes. Some believe in it as a matter of duty, to be enforced by precept and self-denial; and some believe in it as a matter of right, requiring no self-denial. In the latter is included the doctrine of ‘Diana,’ which may be defined as the law of sexual satisfaction from sexual contact. In other words, Dianism is Alphism as the result of sexual equilibration.”

    The general idea of Parkhurst, and those who have followed his teachings in some modified or adapted form, may be said to be based upon the following general proposition: That there is a dual function in the sexual relations, which may be stated as follows: (1) the function exercised from purely physiological causes, and which expresses the desire for the relation resulting in procreation; and (2) the function exercised from emotional causes, and which expresses what may be called the “affectional desire,” i. e., the desire for the embrace, caress, fondling, and general companionship with the loved one of the other sex.

    The first one of these phases, i. e., the reproductive function, is manifested by the lower animals as well as by man, and is elemental and primitive in character. It is often manifested by man without the accompaniment of the affectional function, and at times seems to be almost entirely divorced from the idea of high human affection. The second one of these phases, i. e., the affectional function, usually accompanied the procreative function in the human sexual relation, at least in the highest forms of that relation. But also, it may be and often is manifested independently of the procreative function by men and women of refinement. In fact, it would seem to be the form of physical attraction accompanying the very highest phase of love, particularly in women.

    It is this affectional function which is manifested by betrothed lovers in their beautiful period of mutual understanding, sympathy, and affection. It is that characteristic of the courting days which is so precious to the woman, but which is too often sadly missed by the wife after the honeymoon. It exists often before the fires of passion are kindled, and it persists often after the flame of passion has died away. It is the expression of the purest love of youth, and of the tenderest affection of age. It is this form of sexual relation, physical though it may be, that is the outgrowth of evolution in man. May it not be that in this way man has “improved upon the sexual habits of the animals”; and that when man violates the natural restrictions held sacred by animal life, and indulges in excessive sexual relations in and out of season, that he is really manifesting a degenerative tendency instead of taking an upward step on the evolutionary scale.

    There have been many excellent authorities who have held that this affectional function, and its manifestation, is far better calculated to satisfy the sexual instincts of advanced men and women than is the ordinary physical sexual relation. They claim that in the higher form of this affectional relation is to be found the secret of the joy, bliss, and happiness of the betrothed lovers, which alas! too often disappear when the other form of the relation is manifested, particularly when manifested to excess in the manner customary to so many married men. They claim that in the recognition of this fact of human life and love is to be found the secret of married happiness between wedded advanced and cultured individuals. They assert that the experience of the race, rightly considered and understood, full proves this contention.

    Edward Carpenter has the following to say on this point: “It is a matter of common experience that the unrestrained outlet of the purely physical desire leaves the nature drained of its higher love-forces. * * * There are grounds for believing in the transmutability of the various forms of the passion, and grounds for thinking that the sacrifice of a lower phase may sometimes be the only condition on which a higher and more durable phase can be attained; and that, therefore, restraint (which is absolutely necessary at times) has its compensation. Anyone who has once realized how glorious a thing love is in its essence, and how indestructible, will hardly need to call anything that leads to it a sacrifice; and he is indeed a master of life who, accepting the grosser desires as they come to his body, and not refusing them, knows how to transform them at will into the most rare and fragrant flowers of human emotion * * * Between lovers, then, a kind of hardy temperance is to be recommended—for all reasons, but especially because it lifts their satisfaction and delight in each other out of the regions of ephemeralities (which too often turn into dull indifference and satiety) into the region of more lasting things—one step nearer at any rate to the eternal kingdom.

    “How intoxicating, indeed, how penetrating—like a most precious wine—is that love which is the sexual transformed by the magic of the will into the emotional and spiritual! And what a loss, on the merest ground of prudence and the economy of pleasure, is the unbridled waste along physical channels! So nothing is so much dreaded between lovers as just this—the vulgarization of love—and this is the rock upon which marriage so often splits. There is a kind of illusion about physical desire similar to that which a child suffers from when, seeing a beautiful flower, it instantly snatches the same and destroys in a few moments the form and fragrance which attracted it. He only gets the full glory who holds back a little, and he only truly possesses who is willing if need be not to possess. * * * It must be remembered, however, that in order for a perfect intimacy between two people their physical endearment must by the nature of the case be free to each other. The physical endearment may not be the object for which they come together; but, if it is denied, its denial will bar any real sense of repose and affiance, and make their mutual association restless, vague, tentative and unsatisfied. I think, from various considerations, that, generally, even without the actual physical sex-act, there is an interchange of vital and ethereal elements—so that it may be said that there is a kind of generation taking place within each of the persons concerned, through their mutual influence on each other, as well as that more specialized generation which consists in the propagation of the race.”

    Count Tolstoi said on this subject: “The difference in organization between man and woman is not only physiological but extends also into other and moral characteristics, such as go to make manhood in man, and womanhood (or femininity) in woman. The attraction between the sexes is based not merely upon the yearning for physical union, but likewise upon that reciprocal attraction exerted by the contrasting qualities of the sexes each upon the other, manhood upon womanhood, and womanhood upon manhood. The one sex endeavors to complement itself with the other, and therefore the attraction between the sexes demands a union of spirit precisely identical with the physical union.

    “The tendency toward physical and spiritual union forms two phases of manifestation of one and the same fountain-head of desire, and they bear such intimate relations to each other that the gratification of the one inclination inevitably weakens the other. So far as the yearning for spiritual union is satisfied, to that extent the yearning for physical union is diminished or entirely destroyed; and, vice versa, the gratification of the physical desire weakens or destroys the spiritual. And, consequently, the attraction between the sexes is not only physical affinity leading to procreation, but is also the attraction of opposites for one another, capable of assuming the form of the most spiritual union in thought only, or of the most animal union, causing the propagation of children, and all those varied degrees of relationship between the one and the other. The question of upon which footing the relation between the sexes is to be established and maintained, is settled by deciding what method of union is regarded at any given time, or for all time, as good, proper, and therefore desirable. * * *

    “The nearer the union approaches the extreme physical boundary, the more it kindles the physical passions and desires, and the less satisfaction it gets; the nearer it approaches the opposite extreme spiritual boundary, the less new passions are excited and the greater is the satisfaction. The nearer it is to the first, the more destructive it is to animal energy; the nearer it approaches the second, the spiritual, the more serene, the more enjoyable and forceful is the general condition. * * * Taking into consideration the varying conditions of temperament, and above all what the contracting parties regard as good, proper, and desirable, marriage for some will approach the spiritual union, and for others the physical; but the nearer the union approaches the spiritual the more complete will be the satisfaction. The substance of what has been said is this: that the relation between the sexes have two functions, i. e., the reproductive, and the affectional; and that the sexual energy, if only it have no conscious desire to beget children, must be always directed in the way of affection and love. The manifestation which this energy assumes depends upon custom or reason; the gradual bringing of the reason into accord with the principles herein expounded, and a gradual reorganization of customs consonant with them, results in saving men from many of their passions, and giving them satisfaction for their higher sexual instincts and desires.”

    Some capable writers on the subject have held that in the practice of the methods of semi-continence, such as have been referred to in the foregoing pages of this part of the book, there may lie the danger of excessive stimulation of the sexual centres, without the safety-valve of the physical and nervous relief which follows as a natural sequence in the ordinary sexual relations. The advocates of these methods, however, reply that such objections while valid in the case of persons who practice the same only because opportunity prevents the performance of the usual physical relation, still have no true application to those who adopt these methods in a conscientious and honest manner, and who maintain the proper mental attitude toward the whole question.

    These advocates say that the mental effect upon the secretions of the body must be taken into account in all considerations of the question. They say that just as the gastric juice will begin to flow in response to the mental image or idea of food, and the mother’s milk in response to the cry of the child for food, so do the sexual secretions, direction of the circulation, and other physiological activities result from the mental pictures or idea of sexual congress. They hold that if the mind of the husband be filled with mental images of sexual congress, then there is set into operation the process of secretion of seminal fluids, and the consequent engorgement of the blood-vessels concerned therewith, which are denied the normal physiological relief, and accordingly produce bad effects upon the nervous system. But they likewise claim that if the mind of the husband entertains ideas merely of physical endearment and caress as “an end to itself,” then there is no mental incentive toward the secretion of the seminal fluids, and the constant engorgement of the blood-vessels, and no nerve force is generated—and therefore no nerve-shock is experienced by reason of frustrated manifestation and expression.

    Parkhurst says regarding the point just mentioned: “In the relations between the sexes, the question of how the association of the husband and the wife shall stimulate the affectional or generative action or sexual batteries must depend greatly upon their habits of association. We have only to accustom ourselves to associating the relation with the affectional action, by repeated repetition when the affectional action is all that is felt or thought of, in order to cultivate such habits and associations as will make the association tend to repress passional desires, by the direction of the sexual forces into the channel of affectional attraction and functioning. * * * The form of the sexual manifestation will be largely influenced, by the mind, and largely by force with these principles, and the gradual formation of habits consistent therewith, will make more and more evident their beneficial operation.”

    There is much interest now being taken by thinking people in some phases of the general subject of semi-continence, and many thoughtful and conscientious persons find in it at least the promise of a worthy and honest solution of the problem of Continence as applied to Birth Control. Such persons claim to find in this general class of Birth Control methods a happy medium between the rigid practice of absolute Continence in the marriage relations, on the one hand, and the more popular methods of Contraception, on the other hand.

    Contraception.

    We now come to the consideration of the subject of Contraception, pure and simple, the methods of which contemplate the manifestation of the usual physical sexual relations between husband and wife, accompanied by an avoidance of the union of the male and female elements of reproduction which result in conception.

    It should once more be positively emphasized that by Contraception is NOT meant Abortion. Abortion means “the premature expulsion of the human embryo or foetus; miscarriage.” Contraception, on the other hand, means simply the prevention of the union of the male and female elements of reproduction, and consequently, the preventing of the process which evolves the foetus or embryo. Contraception is prevention; abortion is destruction. There is here a difference as wide as the poles. As Dr. William J. Robinson says, in a paragraph previously quoted in this book: “In inducing abortion, one destroys something already formed—a foetus, or an embryo, a fertilized ovum, a potential human being. In prevention, however, one merely prevents chemically or mechanically the spermatozoa from coming in contact with the ovum. There is no greater sin or crime in this than there is in simple abstinence, in refraining from sexual intercourse.”

    Unfortunately for the cause of scientific Birth Control in America, the laws of the United States (and of most of the separate States) at present prevent the public dissemination by written or printed words, or by public teaching of information concerning the contraceptive methods known to all intelligent physicians and others who have made a scientific study of the subject. The conveyal of such information, in the manner stated, is made a criminal offence, subject to heavy fines and imprisonment. Though there is a strong movement underway on the part of many intelligent and earnest citizens of this country, having for its object the repeal of such prohibitive laws, and the passage of careful legislation designed to give the dissemination of such instruction a legal and certain status, under the restrictions imposed by common sense, intellectual honesty, and the best interests of the race—to place it upon the same footing as in certain advanced European countries—the fact remains that at the present time no person may give such information without subjecting himself to indictment and probable conviction as a law-breaker and enemy of society.Under the circumstances, of course, there has been, and will be, no attempts to furnish such forbidden information in this book. So long as these laws stand unrepealed on the statute books, they must be observed by all law abiding citizens.

    Dr. Wm. J. Robinson, an authority on the subject, says: “We believe that under any conditions, and particularly under our present economic conditions, human beings should be able to control the number of their offspring. They should be able to decide how many children they want to have, and when they want to have them. And to accomplish this result we demand that the knowledge of controlling the number of offspring, in other and plainer words, the knowledge of preventing undesirable conception, should not be considered a criminal offence punishable by hard labor in Federal prisons, but that it should be considered knowledge useful and necessary to the welfare of the race and of the individual; and that its dissemination should be as permissible as is the dissemination of any hygienic, sanitary or eugenic knowledge.”

    The only possible relief from the present condition is seen by careful thinkers to be in the education of the public as to the needs of the case, and the presentation of the scientific argument in favor of rational and proper Birth Control, to the end that public opinion, once seeing the truth in the case, may be sufficiently strong as to bring about a change in the present antiquated and bigoted laws. But, so long as the laws remain on the statute books, they must be observed and obeyed. Education, not Anarchy, is the true remedy.

    The following general remarks on the subject of Contraception, by Havelock Ellis, the well-known English authority of the subject of Sex in Modern Society, may perhaps prove interesting to students of the general subject: Ellis says: “Many ways of preventing conception have been devised since the method which is still the commonest was first introduced, so far as our certainly imperfect knowledge extends, by a clever Jew, Onan (Genesis, Chap. XXXVIII) whose name has since been wrongly attached to another practice with which the Mosaic record in no way associates him. There are now many contraceptive methods, some dependent on precautions adopted by the man, others dependent upon the woman, others again which take the form of an operation permanently preventing conception, and, therefore, not to be adopted save by couples who already have as many children as they desire, or else who ought never to have children at all and thus wisely adopt a method of sterilization. It is unnecessary here, even if it were otherwise desirable, to discuss these various methods in detail. It is even useless to do so, for we must bear in mind that no method can be absolutely approved or absolutely condemned. Each may be suitable under certain conditions and for certain couples, and it is not easy to recommend any method indiscriminately. We need to know the intimate circumstances of individual cases. For the most part, experience is the final test.

    “Forel compared the use of contraceptive devices to the use of eyeglasses, and it is obvious that, without expert advice, the results in either case may sometimes be mischievous or at all events ineffective. Personal advice and instruction are always desirable. In Holland nurses are medically trained in a practical knowledge of contraceptive methods, and are thus enabled to enlighten the women of the community. This is an admirable plan. Considering that the use of contraceptive measures is now almost universal, it is astonishing that there are yet so many ‘civilized’ countries in which this method of enlightenment is not everywhere adopted. Until it is adopted, and a necessary knowledge of the most fundamental facts of sexual life brought into every home, the physician must be regarded as the proper adviser. It is true that until recently he was generally in these matters a blind leader of the blind. Nowadays it is beginning to be recognized that the physician has no more serious and responsible duty than that of giving help in the difficult path of sexual life. Very frequently, indeed, even yet, he has not risen to a sense of his responsibilities in this matter. It is well to remember, however, that a physician who is unable or unwilling to give frank and sound advice in this most important department of life, is unlikely to be reliable in any other department. If he is not up to date here, he is probably not up to date anywhere.

    “Whatever may be the method adopted, there are certain conditions which it must fulfill, even apart from its effectiveness as a contraceptive, in order to be satisfactory. Most of these conditions may be summed up in one: the most satisfactory method is that which least interferes with the normal process in the act of intercourse. Every sexual act is, or should be, a miniature courtship, however long marriage may have lasted. No outside mental tension or nervous apprehension must be allowed to intrude. Any contraceptive proceeding which hastily enters the atmosphere of love immediately before or immediately after the moment of union is unsatisfactory and may be injurious. It even risks the total loss of the contraceptive result, for at such moments the intended method may be ineffectively carried out, or neglected altogether. No method can be regarded as desirable which interferes with the sense of satisfaction and relief which should follow the supreme act of loving union. No method which produces a nervous jar in one of the parties, even though it may be satisfactory to the other, should be tolerated. Such considerations must for some couples rule out certain methods. We cannot, however, lay down absolute rules, because methods some couples may find satisfactory prove unsatisfactory in other cases. Experience, aided by expert advice, is the only final criterion.

    “When a contraceptive method is adopted under satisfactory conditions, with a due regard to the requirements of the individual couple, there is little room to fear that any injurious results will be occasioned. It is quite true that many physicians speak emphatically concerning the injurious results to husband or to wife of contraceptive devices. Although there has been exaggeration, and prejudice has often been imported into this question, and although most of the injurious results could have been avoided had trained medical help been at hand to advise better methods, there can be no doubt that much that has been said under this head is true. Considering how widespread is the use of these methods, and how ignorantly they have often been carried out, it would be surprising indeed if it were not true. But even supposing that the nervously injurious effects which have been traced to contraceptive practices were a thousandfold greater than they have been reported to be—instead of, as we are justified in believing, considerably less than they are reported—shall we therefore condemn contraceptive methods? To do so would be to ignore all the vastly greater evils which have followed in the past from unchecked reproduction. It would be a condemnation which, if we exercised it consistently, would destroy the whole of civilization and place us back in savagery. For what device of man, ever since man had any history at all, has not proved sometimes injurious?

    “Every one of even the most useful and beneficial of human inventions has either exercised subtle injuries or produced appalling catastrophes. This is not only true of man’s devices, it is true of Nature’s in general. Let us take, for instance, the elevation of man’s ancestors from the quadrupedal to the bipedal position. The experiment of making a series of four-footed animals walk on their hind-legs was very evolutionary and risky; it was far more beset by dangers than is the introduction of contraceptives; we are still suffering all sorts of serious evils in consequence of Nature’s action in placing our remote ancestors in the erect position. Yet we feel that it was worth while; even those physicians who most emphasize the evil results of the erect position do not advise that we should go on all-fours. It is just the same with a great human device, the introduction of clothes. They have led to all sorts of new susceptibilities to disease and even tendencies to direct injury of many kinds. Yet no one advocates the complete disuse of all clothing on the ground that corsets have sometimes proved harmful. It would be just as absurd to advocate the complete abandonment of contraceptives on the ground that some of them have been misused. If it were not, indeed, that we are familiar with the lengths to which ignorance and prejudice may go we should question the sanity of anyone who put forward so foolish a proposition. Every great step which Nature and man have taken in the path of progress has been beset by dangers which are gladly risked because of the advantages involved. We must never loose sight of the immense advantages which Man has gained in acquiring a conscious and deliberate control of reproduction.”

    PRIVATE Sex Advice to Women By R. B. Armitage, M. D.

    For Young Wives and those who Expect to be Married.

    Views: 0

  • UK PM listened to his scientists about Covid-19, but they were slow to sound the alarm

    UK PM listened to his scientists about Covid-19, but they were slow to sound the alarm

    UK PM listened to his scientists about Covid-19, but they were slow to sound the alarm 1

    LONDON: It was early spring when British scientists laid out the bald truth to their government. It was “highly likely,“ they said, that there was now “sustained transmission” of COVID-19 in the United Kingdom.

    If unconstrained and if the virus behaved as in China, up to four-fifths of Britons could be infected and one in a hundred might die, wrote the scientists, members of an official committee set up to model the spread of pandemic flu, on March 2. Their assessment didn’t spell it out, but that was a prediction of over 500,000 deaths in this nation of nearly 70 million.

    Yet the next day, March 3, Prime Minister Boris Johnson was his cheery self. He joked that he was still shaking hands with everyone, including at a hospital treating coronavirus patients.

    “Our country remains extremely well prepared,“ Johnson said as Italy reached 79 deaths. “We already have a fantastic NHS,“ the national public health service, “fantastic testing systems and fantastic surveillance of the spread of disease.”

    Alongside him at the Downing Street press conference was Chris Whitty, the government’s chief medical adviser and himself an epidemiologist. Whitty passed on the modelling committee’s broad conclusions, including the prediction of a possible 80% infection rate and the consequent deaths. But he played them down, saying the number of people who would be infected was probably “a lot lower” and coming up with a total was “largely speculative.”

    The upbeat tone of that briefing stood in sharp contrast with the growing unease of many of the government’s scientific advisers behind the scenes. They were already convinced that Britain was on the brink of a disastrous outbreak, a Reuters investigation has found.

    Interviews with more than 20 British scientists, key officials and senior sources in Johnson’s Conservative Party, and a study of minutes of advisory committee meetings and public testimony and documents, show how these scientific advisers concluded early the virus could be devastating.

    But the interviews and documents also reveal that for more than two months, the scientists whose advice guided Downing Street did not clearly signal their worsening fears to the public or the government. Until March 12, the risk level, set by the government’s top medical advisers on the recommendation of the scientists, remained at “moderate,“ suggesting only the possibility of a wider outbreak.

    “You know, there’s a small little cadre of people in the middle, who absolutely did realise what was going on, and likely to happen,“ said John Edmunds, a professor of infectious disease modelling and a key adviser to the government, known for his work on tracking Ebola. Edmunds was among those who did call on the government to elevate the warning level earlier.

    From the outset, said Edmunds, work by scientists had shown that, with only limited interventions, the virus would trigger an “overwhelming epidemic” in which Britain’s health service was not going “to get anywhere near being able to cope with it. That was clear from the beginning.”

    But he said: “I do think there’s a bit of a worry in terms you don’t want to unnecessarily panic people.”

    Johnson, who himself has sickened with the virus, moved more slowly than the leaders of many other prosperous countries to adopt a lockdown. He has been criticised for not moving more swiftly to organise mass tests and mobilise supplies of life-saving equipment and beds. Johnson was hospitalized on April 5 and moved to intensive care the next day.

    It is too soon to judge the ultimate soundness of the UK’s early response. If history concludes that it was lacking, then the criticism levelled at the prime minister may be that, rather than ignoring the advice of his scientific advisers, he failed to question their assumptions.

    Interviews and records published so far suggest that the scientific committees that advised Johnson didn’t study, until mid-March, the option of the kind of stringent lockdown adopted early on in China, where the disease arose in December, and then followed by much of Europe and finally by Britain itself. The scientists’ reasoning: Britons, many of them assumed, simply wouldn’t accept such restrictions.

    The UK scientists were also mostly convinced – and many still are – that, once the new virus escaped China, quarantine measures would likely not succeed. Minutes of technical committees reviewed by Reuters indicate that almost no attention was paid to preparing a programme of mass testing. Other minutes and interviews show Britain was following closely a well-laid plan to fight a flu pandemic – not this deadlier disease. The scientists involved, however, deny that the flu focus ultimately made much difference.

    Now, as countries debate how to combat the virus, some experts here say, the lesson from the British experience may be that governments and scientists worldwide must increase the transparency of their planning so that their thinking and assumptions are open to challenge.

    John Ashton, a clinician and former regional director of Public Health England, the government agency overseeing healthcare, said the government’s advisers took too narrow a view and hewed to limited assumptions. They were too “narrowly drawn as scientists from a few institutions,“ he said. Their handling of COVID-19, Ashton said, shows the need for a broader approach. “In the future we need a much wider group of independent advisers.”

    Michael Cates, who succeeded Stephen Hawking as Lucasian Professor of Mathematics at Cambridge University, is leading an initiative by the Royal Society, the UK’s leading scientific body, to bring modellers in from other scientific disciplines to help understand the epidemic.

    “Without faulting anyone so far, it’s vital, where there is such a lot at stake, to throw the maximum possible light on the methods, assumptions and data built into our understanding of how this epidemic will develop,“ he told Reuters.

    In a statement to Reuters, a spokesperson for the Department of Health and Social Care said the government was delivering “a science-led action plan” to contain the outbreak. “As the public would expect, we regularly test our pandemic plans and what we learned from previous exercises has helped us to rapidly respond to COVID-19.”

    A LOW RISK TO THE PUBLIC

    When news came from China in January of a new infectious disease, Johnson had reason to believe his country was well prepared. It had some of the world’s best scientists and a well-drilled plan to deal with potentially lethal pandemics. Perhaps, some scientists say in hindsight, the plan made them slow to adapt.

    For many years, the Cabinet Office – a collection of officials who act as the prime minister’s direct arm to run the government – took the threat of pandemics seriously. Presciently, it rated pandemics as the Number 1 threat to the country, ahead of terrorism and financial crashes.

    At the centre of planning was a small group of scientists, among them Edmunds. His research group at the London School of Hygiene and Tropical Medicine runs one of the two computer modelling centres for epidemics that have mostly driven government policy. The other is at nearby Imperial College. Edmunds remembers that early in the outbreak, the data from China were sketchy, in the period “where the Chinese were trying to pretend that this wasn’t transmissible between humans.”

    Edmunds and his colleague at Imperial, Neil Ferguson, were part of an alphabet soup of committees that fed advice into the Cabinet Office machinery around the prime minister. Both were founders of the flu pandemic modelling committee, known as SPI-M, that produced the March 2 report warning of more than 500,000 deaths. This committee had met together for nearly 15 years.

    Ferguson did not respond to a request to be interviewed for this article.

    Edmunds and Ferguson were also part of NERVTAG, the New and Emerging Respiratory Virus Threats Advisory Group. Both too were members of the Scientific Advisory Group for Emergencies, known as SAGE, that advises the government in times of crisis. SAGE reports directly to Johnson and the government’s main emergency committee, COBRA.

    At first, when NERVTAG met on January 13, it studied information from China that there was “no evidence of significant human to human transmission” of the new virus, according to minutes of the meeting. The scientists agreed the risk to the UK population was “very low.”

    The evidence soon changed, but this wasn’t reflected in the official threat level. By the end of January, scientists in China began releasing clinical data. Case studies published in the British medical journal, The Lancet, showed 17% of the first 99 coronavirus cases needed critical care. Eleven patients died. Another Chinese study, in the same magazine, warned starkly of a global spread and urged: “Preparedness plans and mitigation interventions should be readied for quick deployment globally.”

    Edmunds recalled that “from about mid January onwards, it was absolutely obvious that this was serious, very serious.” Graham Medley, a professor of infectious diseases modelling at the London School and chairman of SPI-M, agreed. He said that the committee was “clear that this was going to be big from the first meeting.” At the end of January, his committee moved into “wartime” mode, he said, reporting directly into SAGE.

    Dr Jon Read, a senior lecturer in biostatistics at the University of Lancaster, also a member of SPI-M, said by the end of January it was apparent the virus had “pandemic potential” and that death rates for the elderly were brutal. “From my perspective within the sort of modelling community, everybody’s aware of this, and we’re saying that this is probably going to be pretty bad,“ he said.

    But the scientists did not articulate their fears forcefully to the government, minutes of committee meetings reveal.

    On January 21, scientists on NERVTAG endorsed the elevation of the UK risk warning from COVID-19 from “very low” to “low.” SAGE met formally for the first time the following day about the coronavirus threat. So did COBRA, which was chaired by Matt Hancock, the health secretary, who would contract the virus himself in late March. He told reporters after the meeting: “The clinical advice is that the risk to the public remains low.”

    In response to questions from Reuters, the government’s Department of Health declined to clarify how the risk levels are defined or what action, if any, they trigger. In a statement, a spokesperson said: “Increasing the risk level in the UK is a belt and braces measure which allows the government to plan for all future eventualities.”

    Two days later, China put the city of Wuhan, where the outbreak began, into a complete lockdown. Hubei, the surrounding province, would follow. But already, 17 passenger flights had flown directly from Wuhan to Britain since the start of 2020, and 614 flights from the whole of China, according to FlightRadar24, a flight-tracking service. That meant thousands of Chinese, some of them potential carriers, had come to Britain. On April 5, scientific adviser Ferguson said he estimated only one-third of infected people reaching Britain had been detected.

    As they watched China impose its lockdown, the British scientists assumed that such drastic actions would never be acceptable in a democracy like the UK. Among those modelling the outbreak, such stringent counter-measures were not, at first, examined.

    “We had milder interventions in place,“ said Edmunds, because no one thought it would be acceptable politically “to shut the country down.” He added: “We didn’t model it because it didn’t seem to be on the agenda. And Imperial (College) didn’t look at it either.” The NERVTAG committee agreed, noting in its minutes that tough measures in the short term would be pointless, as they “would only delay the UK outbreak, not prevent it.”

    That limited approach mirrored the UK’s longstanding pandemic flu strategy. The Department of Health declined a request from Reuters for a copy of its updated pandemic plan, without providing a reason. But a copy of the 2011 “UK Influenza Pandemic Preparedness Strategy 2011,“ which a spokesman said was still relevant, stated the “working presumption will be that Government will not impose any such restrictions. The emphasis will instead be on encouraging all those who have symptoms to follow the advice to stay at home and avoid spreading their illness.”

    According to one senior Conservative Party politician, who was officially briefed as the crisis unfolded, the close involvement in the response to the coronavirus of the same scientific advisers and civil servants who drew up the flu plan may have created a “cognitive bias.”

    “We had in our minds that COVID-19 was a nasty flu and needed to be treated as such,“ he said. “The implication was it was a disease that could not be stopped and that it was ultimately not that deadly.”

    While the UK was prepared to fight the flu, places in Asia like China, Hong Kong, Singapore and South Korea had built their pandemic plans with lessons learned from fighting the more lethal SARS outbreak that began in 2002, he said. SARS had a fatality rate of up to 14%. As a result, these countries, he said, were more ready to resort to widespread testing, lockdowns and other draconian measures to keep their citizens from spreading the virus.

    Scientists involved in the UK response disagree that following the government’s flu plan clouded their thinking or influenced the outbreak’s course. The plan had a “reasonable worst case” scenario as devastating as the worst predictions for COVID-19, they note.

    Mark Woolhouse, a professor of infectious diseases epidemiology at the University of Edinburgh, and a member of the SPI-M committee, said COVID-19 did behave differently than an expected pandemic flu – for example school closures proved to be far less effective in slowing the spread of the coronavirus. But, broadly, “the government has been consistently responsive to changing facts.”

    By the end of January, the government’s chief medical adviser, Whitty, was explaining to politicians in private, according to at least two people who spoke to him, that if the virus escaped China, it would in time infect the great majority of people in Britain. It could only be slowed down, not stopped. On Jan 30, the government raised the threat level to “moderate” from “low.”

    The country’s medical officers “consider it prudent for our governments to escalate planning and preparation in case of a more widespread outbreak,“ a statement said at the time. Whitty did not respond to questions from Reuters for this article.

    A TIME TO PREPARE

    On the evening of January 31, Boris Johnson sat before a fireplace in 10 Downing Street and told the nation, in a televised address: “This is the moment when the dawn breaks and the curtain goes up on a new act in our great national drama.”

    He was talking of finally delivering Brexit, or what he called “this recaptured sovereignty.” Until that moment, Johnson’s premiership had been utterly absorbed by delivering on that challenge.

    With Brexit done, Johnson had the chance to focus on other matters the following month, among them the emerging virus threat. But leaving the European Union had a consequence.

    Between February 13 and March 30, Britain missed a total of eight conference calls or meetings about the coronavirus between EU heads of state or health ministers – meetings that Britain was still entitled to join. Although Britain did later make an arrangement to attend lower-level meetings of officials, it had missed a deadline to participate in a common purchase scheme for ventilators, to which it was invited. Ventilators, vitally important to treating the direst cases of COVID-19, have fallen into short supply globally. Johnson’s spokesman blamed an administrative error.

    A Downing Street aide told Reuters that from around the end of January, Johnson concentrated his attention increasingly on the coronavirus threat, receiving “very frequent” updates at least once per day from mid February, either in person or via a daily dashboard of cases.

    In the medical and scientific world, there was growing concern about the threat of the virus to the UK. A report from Exeter University, published on February 12, warned a UK outbreak could peak within four months and, without mitigation, infect 45 million people.

    That worried Rahuldeb Sarkar, a consultant physician in respiratory medicine and critical care in the county of Kent, who foresaw that intensive care beds could be swamped. Even if disease transmission was reduced by half, he wrote in a report aimed at clinicians and actuaries in mid-February, a coronavirus outbreak in the UK would “have a chance of overwhelming the system.”

    With Whitty stating in a BBC interview on February 13 that a UK outbreak was still an “if, not a when,“ Richard Horton, a medical doctor and editor of the Lancet, said the government and public health service wasted an opportunity that month to prepare quarantine restriction measures and a programme of mass tests, and procure resources like ventilators and personal protective equipment for expanded intensive care.

    Calling the lost chance a “national scandal” in a later editorial, he would testify to parliament about a mismatch between “the urgent warning that was coming from the frontline in China” and the “somewhat pedestrian evaluation” of the threat from the scientific advice to the government.

    After developing a test for the new virus by January 10, health officials adopted a centralised approach to its deployment, initially assigning a single public laboratory in north London to perform the tests. But, according to later government statements, there was no wider plan envisaged to make use of hundreds of laboratories across the country, both public and private, that could have been recruited.

    According to emails and more than a dozen scientists interviewed by Reuters, the government issued no requests to labs for assistance with staff or testing equipment until the middle of March, when many abruptly received requests to hand over nucleic acid extraction instruments, used in testing. An executive at the Weatherall Institute of Molecular Medicine at the University of Oxford said he could have carried out up to 1,000 tests per day from February. But the call never came.

    “You would have thought that they would be bashing down the door,“ said the executive, who spoke on condition of anonymity. By April 5, Britain had carried out 195,524 tests, in contrast to at least 918,000 completed a week earlier in Germany.

    Nor was there an effective effort to expand the supply of ventilators. The Department of Health told Reuters in a statement that the government started talking to manufacturers of ventilators about procuring extra supplies in February. But it was not until March 16, after it was clear supplies could run out, that Johnson launched an appeal to industry to help ramp up production.

    Charles Bellm, managing director of Intersurgical, a global supplier of medical ventilation products based outside London, said he has been contacted by more than a dozen governments around the world, including France, New Zealand and Indonesia. But there had been no contact from the British government. “I find it somewhat surprising, I have spoken to a lot of other governments,“ he said.

    Countering such criticism, Hancock, the health minister, said the government is on track to deliver about 10,000 more ventilators in the coming weeks. One reason Britain was behind some countries on testing, he said, was the absence of a large diagnostics industry at the outbreak of the epidemic. “We didn’t have the scale.”

    GAME OVER

    It was during the school half-term holidays in February that frontline doctor Nicky Longley began to realise that early efforts to contain the disease were likely doomed.

    For weeks now, doctors and public health workers had been watching out for people with flu-like symptoms coming in from China. Longley, an infectious diseases consultant at London’s Hospital for Tropical Diseases, was part of a team that staffed a public health service helpline for those with symptoms. The plan, she said, had been to make all effort to catch every case and their contacts. And “to start with, it looked like it was working.”

    But then, bad news. First, on Wednesday the 19th of February, came the shock news from Iran of two deaths. Then, on Friday the 21st, came a death in Italy and a bloom of cases in Lombardy and Veneto regions. Britain has close links to both countries. Thousands of Britons were holidaying in Italy that week.

    “I don’t think anybody really foresaw what was happening in Italy,“ Longley said. “And I think, the minute everybody saw that, we thought: ‘This is game over now.’”

    Until then, Longley said, everyone felt “there was a chance to stamp it out” even though most were sceptical it could be done long-term. But after Iran and Italy, it was obvious containment would not work. The contact tracing continued for a while. But as the cases in London built up, and the volume of calls to the helpline mushroomed, the priority began to shift to clinical care of the serious cases. “At a certain point you have to make a decision about where you put your efforts as a workforce.”

    Edmunds noted that Iran and Italy had hardly reported a case until that point. “And then, all of sudden you had deaths recorded.” There was a rule of thumb that, in an outbreak’s early stages, for each death there were probably 1,000 cases in a community. “And so it was quite clear that there were at least thousands of cases in Italy, possibly tens of thousands of cases in Italy right then.”

    Amid the dreadful news from Italy, the scientists at NERVTAG convened by phone that Friday, 21st February. But they decided to recommend keeping the threat level at “moderate,“ where it had sat since January 30th. The minutes don’t give a detailed explanation of the decision. Edmunds, who had technical difficulties and couldn’t be heard on the call, emailed afterwards to ask the warning to be elevated to “high,“ the minutes revealed. But the warning level remained lower. It’s unclear why.

    “I just thought, are we still, we still thinking that it’s mild or something? It definitely isn’t, you know,“ said Edmunds.

    A spokesman for the government’s chief scientific adviser, Sir Patrick Vallance, didn’t directly respond to Reuters questions about the threat level. Asked whether, with hindsight, the scientists’ approach was the right one, the spokesperson said in a statement that “SAGE and advisers provide advice, while Ministers and the Government make decisions.”

    HERD IMMUNITY

    On Sunday, March 1st, Ferguson, Edmunds and other advisers spent the day with NHS public health service experts trying to work out how many hospital beds and other key resources would be needed as the outbreak exploded. By now, Italian data was showing that a tenth of all infected patients needed intensive care.

    The following day, pandemic modelling committee SPI-M produced its “consensus report” that warned the coronavirus was now transmitting freely in the UK. That Thursday, March 5, the first death in the UK was announced. Italy, which reached 827 deaths by March 11, ordered a national lockdown. Spain and France prepared to follow suit.

    Johnson held out against stringent measures, saying he was following the advice of the government’s scientists. He asserted on March 9: “We are doing everything we can to combat this outbreak, based on the very latest scientific and medical advice.”

    Indeed, the government’s Scientific Advisory Group for Emergencies, SAGE, had recommended that day, with no dissension recorded in its summary, that the UK reject a China-style lockdown. SAGE decided that “implementing a subset of measures would be ideal,“ according to a record of its conclusions. Tougher measures could create a “large second epidemic wave once the measures were lifted,“ SAGE said.

    On March 12 came a bombshell for the British public. Chris Whitty, the chief medical officer, announced Britain had moved the threat to UK citizens from “moderate” to “high.” And he said the country had moved from trying to contain the disease to trying to slow its spread. New cases were not going to be tracked at all. “It is no longer necessary for us to identify every case,“ he said. Only hospital cases would, in future, be tested for the virus. What had been an undisclosed policy was in the open: beyond a certain point, attempts to completely extinguish the virus would stop.

    The same day, putting aside his jokey self, Johnson made a speech in Downing Street, flanked by two Union Jacks and evoking the spirit of Winston Churchill’s “darkest hour” address. He warned: “I must level with you, level with the British public – more families, many more families are going to lose loved ones before their time.”

    For most Britons, it came as a shock. Several of the next day’s newspapers splashed Johnson’s words on their front pages.

    Vallance, the government’s chief scientific adviser, who chaired SAGE, said in a BBC interview on March 13 that the plan was to simply control the pace of infection. The government had, for now, rejected what he called “eye-catching measures” like stopping mass gatherings such as football games or closing schools. The “aim is to try and reduce the peak, broaden the peak, not to suppress it completely.” Most people would get the virus mildly, and this would build up “herd immunity” which, in time, would stop the disease’s progress.

    But by now, the country was rebelling. Major institutions decided to close. After players began to get infected, the professional football leagues suspended their games. As Johnson still refused to close schools and ban mass gatherings, the Daily Mirror’s banner headline, summing up a widespread feeling, asked on March 13: “Is It Enough?”

    The catalyst for a policy reversal came on March 16 with the publication of a report by Neil Ferguson’s Imperial College team. It predicted that, unconstrained, the virus could kill 510,000 people. Even the government’s “mitigation” approach could lead to 250,000 deaths and intensive care units being overwhelmed at least eight times over.

    Imperial’s prediction of over half a million deaths was no different from the report by the government’s own pandemic modelling committee two weeks earlier. Yet it helped trigger a policy turn-around, both in London and in Washington, culminating seven days later in Johnson announcing a full lockdown of Britain. The report also jarred the U.S. administration into tougher measures to slow the virus’ spread.

    Ferguson was now in isolation himself after catching the virus. Testifying by video link to a committee in Parliament, he explained why he and other scientific advisers had shifted from advocating partial social-distancing measures to warning that without a rigorous shutdown, the NHS would be overwhelmed. The reason, he said, lay in data coming out of Italy that showed large numbers of patients required critical care.

    “The revision was that, basically, estimates of the proportion of patients requiring invasive ventilation, mechanical ventilation, which is only done in a critical care unit, roughly doubled,“ he said.

    Edmunds had a different explanation for the policy shift.

    What allowed Britain to alter course, said Edmunds, was a lockdown in Italy that “opened up the policy space” coupled with new data. First came a paper by Edmunds’ own London School team that examined intermittent lockdowns, sent to the modelling committee on March 11 and validated by Edinburgh University. Ferguson’s revised Imperial research followed.

    Woolhouse, the Edinburgh professor, confirmed the sequence.

    Edmunds said these new studies together had demonstrated that if the British government imposed a lengthy period of tougher measures, perhaps relaxed periodically, then the size of the epidemic could be substantially reduced.

    Still, without a vaccine or effective treatments, it’s going to be hard to avoid a substantial part of the British population getting infected, said Edmunds. “Until you get to a vaccine, there is no way of getting out of this without certainly tens of thousands of deaths,“ he said. “And probably more than that.”

    Now subject to intense public scrutiny, the modelling teams at universities across Britain continue to work on different scenarios for how the world can escape the virus’s clutches. According to Medley, the chairman of the SPI-M pandemic modelling committee, no one now doubts, for all the initial reservations, that a lockdown was essential in Britain.

    Medley added: “At the moment we don’t know what’s going to happen in six months. All we know is that unless we stop transmission now, the health service will collapse. Yep, that’s the only thing we know for sure.” – Reuters

    UK PM listened to his scientists about Covid-19, but they were slow to sound the alarm
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  • Virtual Press Conference on COVID-19- 06 April 2020

    Virtual Press Conference on COVID-19- 06 April 2020

    Originally broadcast live on 06 April 2020, the daily press briefing on coronavirus COVID-19, direct from WHO Headquarters, Geneva Switzerland with Dr Tedros WHO Director-General, Dr Micheal Ryan, Executive Director of the Health Emergencies Programme, and Dr Maria Van Kerkhove, Technical lead, WHO Health Emergencies Programme with special guests Lady Gaga and Hugh Evans, CEO and Co-founder of Global Citizen.

    Transcript:

    Speaker key:

    TJ        Tarik Jasarevic

    TAG    Dr Tedros Adhanom Ghebreyesus

    LG       Lady Gaga

    HE       Hugh Evans

    MR      Dr Michael Ryan JA  Jamie

    MK      Dr Maria Van Kerkhove KA Kai

    KT       Kate

    IN        Innocent

    YA      Yang

    00:00:19

     

    TJ        Good evening to everyone from Geneva and WHO headquarters. Welcome to the regular press conference on COVID-19. Journalists who are online can ask their questions by clicking  raise hand if  you are
    on Zoom.  Today we have a special guest but  I will  let Dr Tedros do his opening remarks and introduce them.  Before I give  the floor  to Dr Tedros, just to remind you, we will also be sending you some news from other
    WHO offices around the world with the audio file  from this  press briefing a little  bit  later. I give  the floor  immediately to Dr Tedros.

     

    00:01:07

     

    TAG    Good morning, good  afternoon and good  evening.  The COVID-19 pandemic continues to take a heavy toll on families, communities and nations the world over but it’s also giving rise to incredible acts of generosity,
    solidarity and co-operation. We have said consistently that we’re all in this together and we can only succeed together. We need an all- of-society approach with everyone playing their part. That includes  people  in  the entertainment
    industry.

     

    Today I’m very delighted to be joined by one of the biggest names in entertainment in the world, Lady Gaga, and my friend Hugh Evans, the founder and CEO of Global Citizen.

    WHO has been working with Global Citizen for several weeks on the Together At Home concert series with artists like Chris Martin and John Legend giving free online performances.

    Now we’re working with Lady Gaga and Global Citizen to take this concept and make it even bigger through the  One World  Together  At Home virtual  global  special on Saturday 18th April. It’s now my great pleasure to invite
    Lady Gaga and Hugh Evans to say more about this very special event, One World.

    00:03:10

     

    LG       Thank you very much, Dr Tedros. Good morning, good afternoon  and good  evening to everyone who’s listening and watching. I would  like  to thank the World  Health Organization and the
    United Nations as well as Global Citizen; thank you very much, Dr Tedros and Hugh Evans, for all of your leadership in this fight against COVID-19 and thank you very much to the World Health Organization  for asking  me to collaborate 
    with  you on this special.

    We are also very grateful to all of the healthcare professionals across the country and around the world who are on the front lines during COVID-19. This  global  pandemic  is  a catastrophe. I’m so thankful to them and I’m also
    praying for those who are sick. It’s been a pleasure to partner with Global Citizen  and we’ve been working  all together  behind  the scenes to raise money for the World Health Organization.

    I would also like to send my prayers as well to people  that are losing  their  jobs  and are having a hard time feeding themselves  and their  children.  We are raising  money  for  the World Health
    Organization’s COVID-19 Solidarity  Response  Fund and seven days ago we held a  call with more than 68 corporate leaders from some of the world’s biggest and most generous companies and I asked them to join my corporate kindness
    list as there have been many corporations and philanthropists that have been very, very generous during this time.

    00:04:38

     

    Since then we have also been calling on philanthropists around the world as well and tech companies included. I’d like  to reiterate our deep gratitude  to the medical  community.  My heart is very, very aching and warm for those
    who are ER doctors as well as nurses who are sleeping in cars to make sure they don’t infect their families  or  their  patients.  What you’re doing is putting  yourselves  in  harm’s way to help the world 
    and we all salute  you and you are a triumph truly.

    I am proud to say that over the past seven days we’ve raised a total of $35 million for the Solidarity Fund. This money will [inaudible]  essential PPE, supplies  and testing kits around  the world and will help improve lab capacity
    to rapidly process tests. It will also [inaudible] research development. It is so important to think globally and to support the World Health Organization to curb the pandemic and prevent future outbreaks.

    I know Dr Tedros is particularly concerned about Africa and [inaudible]. We also need to act globally by supporting local charities  and initiatives so that the front-line health  workers in most immediate need have the resources they need
    to survive during this time. It has been an honour to help with this huge broadcast event, which will take place on April 18th, where we need to tell the stories of and celebrate the front-line community, healthcare workers and their acts of kindness.

    We will be on different networks, many networks actually and I want to [inaudible] about what we’re going to be doing. What’s very important is that two things happen for all of us; that we celebrate and we highlight the singular, kind global community
    that is arising right now. Two, we want to highlight the gravity of this historically unprecedented cultural movement and, three, we want to celebrate and encourage the power of the human spirit.

    00:06:47

    I would like to, on behalf of  the World  Health Organization  and Global  Citizen,  thank Dr Tedros as well as everyone that has donated so far. We are going to continue fundraising but I would like to also let you know that
    this broadcast special is not actually a fundraiser. We all wanted to raise the money before we went on air so when we do  air  live  on  April  18th  put your wallets away, put your credit  cards away, anything 
    away that you need to and just  sit back and enjoy the show that you all very much deserve.

    I’d like to pass this now to Hugh Evans, who’s been a wonderful partner of mine. Hugh, thank you so much and thank you, Dr Tedros.

    HE       Good morning, good afternoon,  good  evening  and thank you,  Dr Tedros  and thank you, Lady Gaga. Your Excellencies,  ladies  and gentlemen;  Lady Gaga, Dr Tedros, 
    you’ve both demonstrated extraordinary leadership at an unprecedented moment when our society is being challenged like never before and we are so thankful for your leadership. I’d like to echo Lady Gaga’s sentiment and commend the incredible acts
    of bravery demonstrated by the front-line community  health  workers around the world  and I hope  that we as a shared humanity emerge from this moment forever grateful for the work of doctors, nurses, teachers, grocery store workers and all of those who are
    the backbone of our communities.

    Global health is at the very core of the global citizen mission and we must  ensure that the world’s poorest and most  marginalised  people  have  access to resources to cope with and tackle this health crisis. Through One
    World:  Together At Home on April 18th  we’ll be calling on philanthropists, corporations and governments to fund critical global COVID-19 response efforts including distribution of resources and PPE to critical front-line healthcare
    workers.

    00:09:09

    In our partnership with the WHO and United Nations Global Citizen is committed to driving action to help ensure our global health systems are strong enough to stop a future pandemic before it happens. April 18th is going to be a moment of global unity
    connecting the world through a historic global broadcast. We are bringing together the greatest artists in the world under the passionate and extremely talented curation of Lady Gaga.

    In alphabetical order some of the artists we’ll be announcing today include Alanis Morissette, Andrea Bocelli,  Billie  Eilish,  Billy  Joe Armstrong  of Green Day, Burna Boy, Chris Martin, Sir David Beckham, Eddie Vedder,
    Sir Elton John, Finneas, Idris and Sabrina Elba, J Balvin, John Legend, Kacey Musgraves, Keith Urban, Kerry Washington,  Lang Lang,  Lizzo, Maluma, Sir Paul McCartney, Priyanka Chopra Jonas, Shah Rukh Khan, Stevie Wonder and many more to be announced over the coming weeks from all corners of the globe under the passionate and extremely talented curation of Lady Gaga.

    We’re grateful to all of you for participating and supporting this critical effort. One World Together At Home will be broadcast live on Saturday April 18th 2020 at 5:00pm PDT, 8:00pm EDT and 12:00am BST, airing on ABC, NBC, Viacom and CBS networks,
    IHeartMedia, and Bell media networks and platforms in Canada. Internationally BBC1 will run the programme on Sunday April 19th and additional  international  broadcasters include BN Media Group, Multi-Choice Group and RTE in Ireland.

    00:11:43

    The digital broadcast will celebrate and support brave community  health workers who are doing life-saving work on the front line and we’ve all seen the limitations of world leaders around this world to step up and face this extraordinary challenge 
    and we want to do our best to support the essential work of the World Health Organization, driving action and raising critical funds. Thank you again, Dr Tedros, and thank you, Lady Gaga, for your leadership.

    Thank you all.

    TJ        Thank you very much to our guests for their remarks. Dr Tedros, I guess you would like to thank them too.

    TAG    Once again I would like  to thank Lady Gaga and Hugh Evans for their  partnership. We had a call last week and I was so amazed by the energy and passion of Lady Gaga. It’s incredible commitment to humanity and that’s
    when I said, I think what she has planned can happen. It’s bringing the world together to improve awareness and to mobilise  resources to fight the pandemic so I thank her for her incredible passion and commitment  and leadership and
    also to my friend, Hugh Evans, for connecting all the dots and for his leadership.

    We all look forward to joining you for the One World: Together  At Home concert on 18th April. As the pandemic continues we recognise that individuals and governments want to do everything they can to protect themselves and others and so do we.
    We understand that some countries have recommended or are considering the use of both medical  and non-medical masks in the general population to prevent the spread of COVID-19.

    00:14:21

    First and foremost medical masks must be prioritised for health workers on the front lines  of  the response. We know medical masks can help to protect health workers but they’re in short supply globally.  We’re concerned that the mass
    use of medical  masks by the general population could exacerbate the shortage of these specialised masks for the people who need them most. In some places these shortages are putting health workers in real danger.

    In healthcare facilities WHO continues to recommend the use of medical masks, respirators and other personal protective equipment for  health workers. In the community we recommend the use of medical masks by people who are sick and those who
    are caring for a sick person at home.

    WHO has been evaluating the use of medical and non-medical masks for COVID-19 more widely. Today WHO is issuing guidance and criteria to support countries in making that decision. For example countries could consider using masks in communities where other measures such as cleaning hands and physical distancing are harder to achieve because of lack of water or cramped living conditions.

    If masks are worn they must be used safely and properly. WHO has guidance on how to put on, take off and dispose of masks. What’s clear is that there is limited research in  this  area. We encourage countries that are considering the use
    of masks for the general population to study their effectiveness so we can all learn. Most importantly masks should only  ever be used as part of a comprehensive package of interventions. There is no black or white answer and no silver bullet.
    Masks alone cannot stop the pandemic. Countries must continue to find, test, isolate and treat every case and trace every contact. Mask or no mask, there are proven things all of us can do to protect ourselves and others.

    00:17:13

    Keep your distance, clean your hands, cough or sneeze into your elbow  and avoid  touching your face. Less than 100 days since WHO was notified about the new coronavirus  research has accelerated at incredible speed. The viral genome
    was mapped  in  early January and shared globally, which enabled tests to be developed and vaccine research to start. More than 70 countries have joined WHO’s Solidarity Trial to accelerate the search for an effective treatment and about
    20 institutions and companies are racing to develop a vaccine.

    WHO is committed to ensuring that as medicines and vaccines are developed they’re shared equitably with all countries  and people.  I want to thank the  Medicines  Patent Pool and Unitaid for the initiative they announced last
    Friday to include medicines and diagnostics for COVID-19 in their licensing pool.

    I also want to thank the President of Costa Rica, President Carlos Alvadaro, and the Health Minister, Daniel Salas, for their proposal to create a pool of rights to tests, medicines and vaccines with free access or licensing on reasonable and affordable
    terms for all countries. Muchas gracias, Mr President. I support this proposal and we’re working with Costa Rica to finalise the details.

    00:19:09

    Poorer countries and fragile  economies  stand to face the biggest  shock from this  pandemic and leaving anyone unprotected will  only  prolong  the health crisis  and harm economies  more.  I call
    on all countries, companies and research institutions to support open data, open science and open collaboration so that all people can enjoy the benefits of science and research.

    Finally we’re nearing the end of the Ebola outbreak in the Democratic Republic of the Congo. This is one piece of good news. If there are no more cases the Government of the Democratic Republic of Congo could declare the outbreak over  as early
    as this  Sunday.  We’re not  there yet and we remain in full response mode. We’re continuing to investigate alerts and to test samples.

    This would not have been possible without the incredible  health workers who have put themselves at risk for more than 18 months to stop this outbreak, just as health workers are putting themselves in danger to save lives from COVID-19. Health
    workers in DRC faced the 
    double threat of fighting a deadly virus in one of the world’s most dangerous and unstable regions, exposing themselves to Ebola and bullets.

    Tomorrow, as you know, is WHO’s birthday, a day we celebrate each year as World Health Day. This year we’re paying tribute to the incredible contribution of all health workers, especially nurses and midwives. Nurses and midwives are the backbone of
    every health system. They’re there from the first moments of life to the last. Tomorrow we’re publishing our first report on the state of the world’s nursing which highlights gaps and makes recommendations for all countries.

    00:22:00

    One of the lessons I hope the world learns from COVID-19 is that we must invest in health workers, not only to protect lives but also to protect livelihoods. I thank you.

    TJ        Thank you very much, Dr Tedros. Also, as always, we have Dr Mike Ryan and Dr Maria Van Kerkhove, who will be answering questions. We will  now open the floor.  I will  go to one question
    that I received by email this morning and I promised to answer; that’s Ankit Kumar from India Today. Ankit is asking; we have recently seen a spike in  cases caused through religious gatherings in India, in fact almost a third of new cases
    were linked to one gathering in India. We have also seen incidents of violence against health workers due to fear and misinformation. Is WHO concerned with these developments, what is WHO’s message to religious and community leaders and their
    followers?

    MR      First and foremost the idea of violence against health workers is driven by fear and it’s driven by misunderstanding but it’s  really  unacceptable. We ask everyone and every community to see our health workers
    as our heroes and to support them in every way we can.

    With regard to gatherings of any type, be they religious or be they for other  purposes,  there are always risks associated with such gatherings in the midst of a major epidemic. WHO has issued guidance on that. Many of these gatherings
    are now postponed or cancelled.  We’ve been working very, very closely with religious  and faith-based organisations  all  over the world including  groups  from the Islamic  tradition,  Christian 
    traditions  and others and continue to work through faith-based organisations to communicate  using  our  Epiwin platform.

    00:24:21

    We’re also continuing to develop guidance specifically  for the holy  month  of Ramadan and are working through our Eastern Mediterranean regional office to be able to advise governments and religious institutions on how best to manage
    the risks associated with such holy events.

    But it’s very important again; having COVID-19 is not anybody’s fault. Every case is a victim and every case needs to be  treated with sensitivity,  as the health workers who treat them so it’s very important that we’re not profiling COVID-19
    along  racial,  along  religious,  along ethnic lines. This is not helpful.

    TJ        Thank you very much. This was a question  from Ankit  Kumar from India  Today. Now we will go to journalists online. We will start with Jamie from Associated Press. Jamie, can you hear us?

    JA        Hi, yes. Can you hear me? TJ            Yes. Please go ahead.

    JA        Great, thank you very much. I wanted to ask you about… Over the weekend Dr Anthony Fauci mentioned that – if I understood it correctly – as much as 50% of transmission could be asymptomatic. Just aligned 
    with that, if  you could  give  us a little  bit  more  about what you’re thinking about the fact that some countries have said that this outbreak is more infectious than influenza. The CDC is saying that it’s up
    to three times more infectious than influenza so what do you have to say about that? Thanks.

    00:26:13

    MK      I’ll start and then perhaps Mike or DG would like to supplement. The modes of transmission and the way in which this virus is transmitted  are of significant  interest to all of us. What we are doing is working
    with member states, we’re working with everyone that’s affected by this, looking through the research and trying to understand  when most transmission is happening, when any transmission is happening.

    What we know from reports, what we know from published literature is that the predominant way in which transmission is occurring is amongst symptomatic individuals  and these are people that can be very early on in symptoms, even when they start
    to feel a little bit unwell. This is supported by some data that attempts to catch a virus from individuals who are symptomatic.

    We also know that it’s possible that people can transmit in the few days before they become symptomatic or in their pre-symptomatic  phase. There have been some studies  that have come out and we learned about this when we were on mission
    in China back in January or early February, that there are individuals that can shed virus one to three days before they develop symptoms.

    However it’s very important to note that even if you are pre-symptomatic or even if you don’t have any recognised symptoms you still have to transmit through  droplets,  you still  have to have these infectious particles that come out
    of your nose and your mouth. So while we know that that is possible we do not believe that it’s a major driver of transmission.

    00:27:42

    We’ve also seen modelling estimates that suggest that there’re large numbers of unrecognised transmission and I used unrecognised on purpose because I’m not saying asymptomatic. I’m saying that we may be missing people who are out there who are infected
    but we’re missing them because of current surveillance strategies. That is certainly possible in many parts of the globe.

    Whether or not those individuals are asymptomatic; we will have to wait until we see the results of serologic studies, which we hope we’ll be seeing in the coming days if not weeks.

    So what we can say is that most people are transmitting this virus while they are symptomatic.

    JA        Hi, Jamie. Just in addition because I think – I would never in any way contradict my good friend, Tony Fauci, such an eminent man. There are many different estimations of what might represent asymptomatic
    transmission or other infections in the community and we do know and everyone accepts that when the seroepidemiology studies do come online we will probably find more people who’ve been infected unknowingly; there’s no question of that.

    The thing we need to address in all of this is  very often the idea of  severity versus infection and there is a huge association  between the dose  of exposure  and the severity  of infection. We see this in many other
    infectious diseases so we also probably need to look  at who is getting sick and very sick and is the dose and the type of exposure they’re getting different to those who may be exposed and seroconverted in the community.

    00:29:26

    So it’s not just a matter of looking at how many people in the community are infected but are there specific elements  of exposure  that cause individuals  to have  a higher dose of exposure or a specific route of exposure 
    that causes more severe infection?  There is  also that concept of infectious dose when we talk about the different types of transmission. If somebody is exposed to a high dose from another individual directly or from a surface that’s
    heavily contaminated you can imagine the large dose.

    In other circumstances individual particles or virus particles potentially floating through  the air; it can be demonstrated that that may happen in certain circumstances, certainly in healthcare settings. But is that significant  in 
    terms of driving  infection,  is  that significant, does that produce an infectious dose that can successfully infect another individual?

    These are all very important things that still need to be studied. Again we’re only a number of weeks into this. I think we need to have the seroepi studies. I think  we need more information on what is the infectious  dose  and particularly 
    the relationship  between the dose  of exposure or infection and the severity of disease subsequently, which has been seen with many, many other diseases in the past including cholera, Ebola and others.

    TJ        Thank you very much, Mike and Maria. We will go now to our next question; that’s Kai Kupferschmidt. Kai, can you hear us?

    00:31:01

    KA      Yes, Tarik. Thanks a lot for taking my question. I wanted to ask about the global  push  to try and find a pre-exposure  prophylaxis  or a post-exposure  prophylaxis. I understand there’re
    several trials going on, most of them with chloroquine  or hydroxychloroquine.  I was just wondering whether you can speak a little bit to what role this could potentially play.

    Of course also there’re a lot of smaller studies going on. Is there any way to make sure that they all lead to results that can be proved in the end?

    MR      Maria can give you more detail but certainly one of the Solidarity trials – I think Solidarity 3 or 4 – we have one of the trials under design which will be a multi-centre study which will look at prophylaxis in healthcare workers to see whether there’s evidence that giving lower doses of drugs like chloroquine or hydroxychloroquine to healthcare workers would reduce their risk of becoming infected in a healthcare environment.

    Those studies are certainly underway and again there are a number of those studies underway in smaller studies around the world but again as WHO we’re trying  to bring  together  a larger set of collaborative studies that will give
    us the answers we need.

    In terms of post-exposure prophylaxis I don’t believe  we have at the moment  studies  planned but Maria can speak to that but there is certainly evidence for the use of – not proven  evidence of effectiveness but there are a number
    of studies underway and trials underway that use hyperimmune globulin  in  the treatment  of disease; in  other words  they use that purified plasma of recovered individuals to give an antibody boost to people who are
    suffering the disease.

    00:32:49

    Similar approaches have been used in post-exposure prophylaxis for other diseases but Maria may be aware of studies underway in that area.

    MK      Only to add that, as you mentioned, there are a number of smaller studies that are happening globally and across a large number of countries.  We have teams through  our science division and through GOARN,
    through the Global Outbreak Alert Network, who are pulling together  available  literature  on a number  of topics,  one  of which is  looking  at different types of therapeutics and drugs.

    The idea is until we can have a study that pulls together enough of a sample size to get these answers to these questions we’re trying  to evaluate  every piece of evidence  that is  published so that we can look at the way in
    which these studies were done, we can look at the strengths, we can look at the limitations so that can help guide us closer  towards an effective treatment for COVID-19.

    TJ        Thank you very much. The next question is from BFM Radio. Is is Kate who is with us?

    KT       Yes, hi. Good evening or good morning.  I’m from BFM Radio  Malaysia. My question is, many countries around the world have imposed lock-downs or some sort of restrictions on movement. I was wondering
    what WHO’s guidance would  be; what’s the sweet spot, the kind of data that governments need to consider before lifting or relaxing  some  of these lock- downs? Thank you very much.

    00:34:29

    MR      Thank you. It is a difficulty for governments right  now  because the lock-downs  in many situations are proving effective in dampening the flames of the epidemic  in  those countries but those
    lock-downs are also causing great economic hardship and everybody especially in the developing world needs to get to a more sustainable way of managing this epidemic and controlling COVID-19 without continuing to damage economic and social life.

    The transition strategy out  of lock-down  requires  a calibrated,  step-wise approach.  It would be probably very inadvisable just to lift a complete lock-down, all of the measures because lock-downs are a general term that
    include closure of schools, closure of  churches, stay-at- home orders, closure of workplaces. It’s a mixture of different things and I think each government needs to break out, what does our lock-down actually constitute, what are the elements
    of our lock-down, where is that happening in the country, do we now understand the epidemiology of the disease in each area in which we have an element of lock-down or shut- down.

    Then to chart the path out, you have to build strong public health capacity to take over from the lock-down. In other words the lock-down is pushing the disease down by putting people back in their homes, by separating communities. Once you raise
    the lock-down you have to have an alternative method to suppress the infection. The  way to do that is active  case finding, testing, isolation of cases, tracking of contacts, quarantining of contacts and strong community education and
    participation and ownership around normal physical distancing, hygiene and giving communities the power to control infection by in effect managing their own physical distance, managing their own capacities to support the response.

    00:36:32

    In that situation, if you’ve strong public health capacity, if you’ve got a community that’s mobilised and empowered and if you’ve strengthened your health system then you’re potentially in a position to start unlocking or unwinding the lock-down.
    The specific parameters you need to be looking at are on two sides.

    One is, it would be very inadvisable to lock down [sic] if the number  of cases coming  through the hospital is already at a level where your  occupancy of  beds is  nearly at 100%.  You need to be in a position where
    you now have free beds in your system so that you’re managing and coping with the caseload and that means you have some absorption capacity left.

    You need to look at things like the doubling  rate; how  many days does it  take for the  number of cases to double? You need to look at positivity rates; what proportion of all samples that we test are positive? You’ll see in
    somewhere like Korea two to 6% of the samples  they test are positive. Last week in New York 37% of tested samples were positive so you need to carefully look at what proportion of people you test are positive.

    00:37:45

    You need to look at the number of contacts that are generated per case and it goes on and on and WHO will be issuing guidance to countries that is a much more specific around the parameters they should be looking at. There are no absolutes here, there
    are no answers, there are no numbers that say if this number is this then you do that. That doesn’t exist but what we can do is offer countries very specific  measurements  that they need to look  at to chart the path out of lock-down.

    That step-wise approach of unlocking somewhat and then waiting to see; I think you need to say, we will stop doing this element of the shut-down  and then we will  wait and we will  look at the data and if that works we go to the next
    stage and the next stage. So a careful, calibrated, step-wise exit from lock-down with putting in place public health capacities, putting in place community capacity, building the capacity of the health system to cope should the disease bounce back up; that’s the safe path out of lock-down.

    We want to achieve it as quickly as possible and we want to avoid many countries going  into that circumstance and we still have many countries around the world who are not in a locked- down situation. In fact their epidemiology would suggest
    they can avoid the worst of this and we need to support them to avoid them going into that situation.

    The most damaging lock-downs are in many developing countries  where people  – as the  DG has said many times – can live from hand to mouth, not from pay cheque to pay cheque but from day to day and we have to find adaptive solutions
    around lock-down and around disease control in vulnerable periurban populations living in poverty,  in  poor  rural communities.  We have to find alternative, adapted ways to manage lock-downs or slow-downs or shut-downs in
    those situations.

    00:39:41

    TJ        Thank you very much. This was Kate from BFM Radio in Malaysia. Now we will  go to Nigeria to Natural Star and it’s Innocent. Innocent, can you hear us?

    IN        Thank you. Can you hear me?

    TJ        Not very well but we will try. Please go ahead.

    IN        Okay, thank you for taking my questions. I have two questions to ask. One; how will WHO assess African countries on what they’ve done concerning the lock-down and management of COVID-19?

    Then the second one; there’s news going around that vaccines are to be tested on Africans when they’re developed. How true is that and is there a window that’s in the nearer future when a vaccine will be developed for COVID-19? Thank you.

    Hello?

    TJ        Yes, we are just trying to make sure that we understood the question but we will try. MR     I think this is Nigeria. Is it?

    TJ        Yes.

    00:41:08

    MR      Maria may answer the question around vaccine development. With regard to our general assessment on lock-down – and the Director-General may wish to comment on this because he’s been speaking with many leaders in Africa
    and, I believe, spoke with  the whole of the African Union leadership and countries late last week so therefore is in a much better position than me to speak about that.

    We would characterise so far, Africa’s actually doing well in this response thus far. Countries have essential capacities for testing, many countries are taking strong action and want to really focus on finding cases and doing contact tracing and trying to stop this disease becoming much more extensive given the fact that health systems are not as strong in many countries. 

    They need support in that though, they need support in testing, they need support with protective gear and they need to be given the resources to be able to mount those types of responses so I would characterise that Africa has not suffered the worst
    of this pandemic so far. The worst of it can be avoided with very, very swift action to support those countries in Africa who really do want to take a comprehensive approach to this disease.

    With the many vulnerable  people  including  refugees and migrants  who live  in  those countries it is our responsibility to provide that support but, DG, you may wish to speak about your interactions with the African
    Union countries.

    00:42:46

    MK      I’ll answer the question  around vaccines. What we can say is  that there are a number of vaccines that are in development and vaccines will be tested through clinical trials with all ethical considerations
    in place in whichever  populations  are under  study  with informed consent, with open and transparent communication. This is of the utmost importance, that not only do we have strong, robust  scientific  evidence 
    but  we ensure that all  of the studies  that are done are done with appropriate and the highest level of ethical considerations.

    One thing on the first question around Africa is that there are a number of countries in Africa right now which have very few cases and Mike has alluded to this in his earlier response.

    Some only have imported cases and there is an opportunity here, this  window  of opportunity that the DG has spoken about exists  in  many countries  still.  There is  an opportunity to prevent the worst from happening
    in a number of countries across Africa and across countries that are still seeing their first case; in some island countries.

    We need to support those governments, those countries, all of the people in those areas to prevent the worst from happening, to prevent these individual cases from becoming clusters, these clusters from becoming community transmission. I think that’s
    where we need to put  a lot of emphasis and support so that we can prevent countries  from reaching a point  where they need to put in these very restrictive movement restrictions.

    TAG    Thank you. Thank you for that question, my brother from Nigeria. On the situation, as Mike said, of course when you see the number of cases the African continent has the lowest number of cases so far but that doesn’t mean that
    the situation will not deteriorate. It may.

    00:45:06

    So Africa should do everything to prevent this situation from getting worse and that’s why African leaders are doing their best. I had a chance to participate in a meeting, a Leaders’ Coalition which was arranged or invited by the current Chairperson
    of the African Union, the President of South Africa, President Ramaphoza and many leaders from all corners of the continent have actually participated.

    The main agenda is to have a continental strategy and also make sure that that continental strategy helps the national strategy but in addition to a coalition of political leaders or the heads of state and government they have also agreed to have a coalition of business leaders. Business leaders in Africa are also getting together because Africa will need resources and one of the major problems that was identified during the discussion
    was especially shortage of equipment starting from medical equipment, PPE and test kits and so on.

    The leaders have agreed to look for concrete solutions to address the problem and they also believe that considering the number of cases we have in the continent testing cases, tracing contacts and isolating them, meaning using the comprehensive approach,
    will actually  help. They believe that lock-downs alone may not help or the physical distancing alone cannot help and they have agreed to do everything to follow the comprehensive approach.

    From WHO’s side we have been supporting and we increased, improved  the testing capacity in Africa significantly in the past two months and many countries in Africa have now testing capability although we may have a shortage of test kits but 
    we’re working  on that too and we’re finding different ways of addressing the gap.

    00:48:06

    But we will support the African Union, we will support the Africa CDC and also we will continue working through our WHO regional office in Congo Brazzaville and continue to support and fight the pandemic together.

    Then on the vaccines issue there was, I think, a comment last week from a couple of

    scientists who said the testing ground for the new vaccines will be Africa. To be honest,  I was so appalled and it was a time when I said, when we needed solidarity these kind of racist remarks actually would not help, it goes against the solidarity.

    Africa cannot and will not be a testing ground for any vaccine. We will follow all the rules to test any vaccine or therapeutics all over the world using exactly the same rules. Whether it’s

    in Europe, Africa or wherever we will use the same protocol and if there is a need to be tested elsewhere to treat human beings the same way, equally.

    The hangover from a colonial mentality has to stop — and WHO will  not  allow  this  to happen. It was a disgrace actually  and appalling  to hear during the 21st century from scientists that kind of remark and we condemn
    this in  the strongest  terms possible  but  we assure you  that this will not happen in Africa and will not happen elsewhere, in any country. Proper protocols will be followed and human beings will be treated as human
    beings because we’re all human beings.

    00:50:37

    Then after saying this the vaccine development; we’re addressing two issues and we will be announcing as soon as possible, hopefully during this week, a big initiative to accelerate the research and development and production of vaccines and also
    design mechanisms for equitable distribution of the vaccines.

    While we’re looking for vaccines, unless we break the barriers to equitable distribution of the products, whether it’s vaccines or therapeutics, we will have a problem, so we need to address the problem ahead of time, we need to address the problem
    of access or challenges to access ahead of time.

    That’s why we will put together a mechanism and we will appoint senior people from the North and South that will work out the details on how they can accelerate production but at the same time how they can ensure equitable distribution. Solidarity
    is very important here. When a vaccine or a medicine is ready we have to be able to deliver it all over the world.

    There should not be a divide between the haves and the have-nots.

    If we say solidarity, solidarity should be in its full form and I hope each and every individual, each and every human being will go for that kind of solidarity. I thank you.

    TJ        Thank you, Dr Tedros. We’ll take a couple more questions. We go to Yang from Xinhua news agency. Yang, can you hear us?

    00:52:58

    YA      Can I hear you?

    TJ        Yes, we can hear you. Please go ahead.

    YA      As World Health Day is approaching  what do you  have to say to the  front-line medical workers in China and around the world in  the global  anti-virus  efforts? This  question is
    for Dr Tedros. Thank you.

    TJ        If we understood well, the question is what is the message to health workers in China and around the world. Maybe you can repeat the question one more time, please.

    YA      Okay. As World Health Day is approaching what would you say and what message do you want to deliver to the front-line medical workers in China  and around the world  in  the global anti-virus effort?

    TAG    I think I have said it earlier;  as you  know,  this  is  the year of  the nurse and the midwife, 2020. We were ready to celebrate it in a big way and it was supposed to be the main event in our
    Assembly in mid-May. Unfortunately we’re in this situation but  we will  be launching a report tomorrow which is the first of its kind.  It’s a report on the  state of nursing. We will launch it tomorrow during the World Health
    Day.

    00:55:01

    But while launching that report, although it’s about nursing, we will celebrate all health workers, midwives, pharmacists, doctors, you name it. I think the world is now seeing the importance and the central role that health workers play. People,
    when they’re asked, of course, to choose they would say health first because it’s only when you’re healthy that you can aspire to anything, whether it’s wealth or fame or anything. It doesn’t matter if you’re not healthy.

    If you’re not healthy the first thing you ask for is to get back your health and our health workers are making sure that happens and they’re central and very important for any individual. So not only during COVID but during other times too health
    professionals are very important because they are safeguarding that very important aspect of life — that’s health.

    So we have to celebrate them every day. Of course during COVID we can see to what extent they’re sacrificing. We have lost many of them. They’re dying while  saving lives  so my message first is to the public at large; that each and every individual 
    should  recognise, whether it’s during normal times or pandemics like now, the role of health  professionals  and help them, protect them, really appreciate and respect what they are doing.

    To the health workers, although especially during this COVID pandemic you’re working in a difficult situation you should know that your work is the most blessed one, your work is something  special to the extent of losing  your  life 
    while  helping  others to live.  We respect you and appreciate you for that and we also believe in you and that you will do everything to control this pandemic.

    00:58:11

    But you should know that you have – and the world understands – the most important job. We can see the humility which is coming from some leaders because of this pandemic. I know they’re seeing, starting from their own lives, the whole world through 
    a different  prism  and they will also see your role.

    But the most important is not the recognition from the public or from leaders but the internal commitment and passion you have and believing that you’re doing the most blessed thing  and you have all our respect and appreciation and we believe in 
    you,  that together  we will  finish this pandemic. All the respect and appreciation we have to you, the greatest respect and appreciation ever. Thank you.

    TJ        Thank you very much, Dr Tedros. I think this important message will be heard from everyone and we will  conclude  this  press briefing with these important  words from Dr Tedros. We will
    have an audio file available in the minutes to come and we invite you for our next briefing on Wednesday. Thank you.

    TAG    [Inaudible] and see you on Wednesday – tomorrow actually for the launch. Yes, see you tomorrow.

    01:00:18

    Virtual Press Conference on COVID-19- 06 April 2020
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  • MCO: No official complaint on worker lay-offs, says Deputy Minister

    MCO: No official complaint on worker lay-offs, says Deputy Minister 2

    PENDANG: No official complaint on the retrenchment of staff has been made all through the imposition of the Movement Control Order (MCO) since its launch on March 18, and the state of affairs continues to be beneath management, mentioned Human Resources Deputy Minister Awang Hashim right this moment.

    He mentioned the federal government would proceed to make sure the pursuits of employers and staff had been safeguarded, whereas establishing a win-win state of affairs for each events as they had been vital elements of the nation’s financial system.

    “So far, there have been no official reports on workers being terminated and the situation is still under control. The government is striving every day to ensure the aid we are providing will be holistic, and this includes looking at how we can help employers and employees,” he mentioned, after presenting meals packs from the Social Welfare Department to the group right here.

    In the occasion that experiences on worker retrenchment are filed, the federal government would endeavour to resolve the matter as quickly as doable, and by viewing it from all views, he added.

    Awang mentioned his ministry welcomed viewpoints and strategies from all events, which might assist the federal government in its efforts to scale back the burden which Covid-19 had wrought on probably the most susceptible segments of the inhabitants, significantly amongst employers and staff.

    So far, the ministry had had discussions with the Malaysian Employers Federation (MEF), Malaysian Trades Union Congress (MTUC), Federation of Malaysian Manufacturers (FMM) and the Congress of Unions of Employees within the Public and Civil Services (Cuepacs).

    These teams, he mentioned, had offered helpful strategies to the federal government which was coping with a harmful pandemic for the primary time, like different nations the world over. — Bernama

    MCO: No official complaint on worker lay-offs, says Deputy Minister
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  • Medical Product Alert N°3/2020

    This Medical Product Alert warns consumers, healthcare professionals, and health authorities against a growing number of falsified medical products that claim to prevent, detect, treat or cure COVID-19. 

    The Coronavirus disease (COVID-19) pandemic (caused by the virus SARS-CoV-2) has increased demand for medicines, vaccines, diagnostics and reagents, all related to COVID-19, creating an opportunity for ill-intended persons to distribute falsified medical products 

    Due diligence is required from all actors in the procurement, use and administration of medical products, in particular those affected by the current crisis of, or related to, COVID-19. 

    1. FALSIFIED IN VITRO DIAGNOSTICS AND LABORATORY REAGENTS 

    WHO has received multiple reports regarding falsified in vitro diagnostics (IVDs) and laboratory reagents for the detection of SARS-CoV-2. Please refer to WHO’s Emergency Use Listing for a list of diagnostics approved for clinical use by WHO. To date, eight countries (Australia, Brazil, Canada, PR China, Russian Federation, Singapore, Republic of Korea, United States of America) have listed IVDs for COVID-19 diagnosis based on expedited regulatory assessments. Please note that, in the European Union, regulatory compliance for SARS-CoV-2 diagnostics are self-declared by the manufacturer.  

    To assist Member States and stakeholders, WHO has published the links to these emergency lists, together with contact details. These links provide information on IVDs authorized for use in the jurisdictions of the International Medical Device Regulators Forum, as well as policies and guidance. WHO will provide updated versions as new information becomes available.

    End-users are encouraged to check the labelling against the information posted by regulatory authorities upon listing to ensure they are in possession of the genuine product. This information might include product name, product code, expiry date, instructions for use and manufacturer details. 

    Unregulated websites supplying medicines and/or vaccines, particularly those concealing their physical address or landline telephone number, are frequently the source of unlicensed, substandard and falsified medical products. WHO has been made aware of various unregistered websites claiming that products on sale can treat or prevent COVID-19. Such products are likely to be falsified medicines. In addition, some websites may appear to provide easy access to legitimate medicines that are otherwise not readily available. End-buyers and consumers should be especially wary of such online scams and exert due diligence when purchasing any medical product, whether online or not.

     2. FALSIFIED MEDICINES AND VACCINES

    At this stage, WHO does not recommend any medicines to treat or cure COVID-19. However, the SOLIDARITY trial, led by WHO, is reviewing potential treatments for COVID-19. 

    WHO requests increased vigilance from national health authorities, healthcare professionals, members of the public and supply chain stakeholders worldwide to prevent the distribution of these falsified medical products. Increased vigilance should focus on hospitals, clinics, health centres, clinical laboratories, wholesalers, distributors, pharmacies and any other suppliers of medical products. All medical products must be obtained from authentic and reliable sources. Their authenticity and condition of the product should be carefully checked. Consumers are advised to seek advice from a healthcare professional in case of doubt. 

    National health authorities are requested to immediately notify WHO if these falsified products are discovered in their country. If you have any information concerning the manufacture, distribution, or supply of these products, please contact rapidalert@who.int

    WHO Global Surveillance and Monitoring System for Substandard and Falsified Medical Products
    For further information, please visit our website: https://www.who.int/medicines/regulation/ssffc/en/ 

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  • COVID-19: Should Education Hit A Pause Or Are We Just Unprepared In Nigeria? By Olabisi Deji-Folutile

    COVID-19: Should Education Hit A Pause Or Are We Just Unprepared In Nigeria? By Olabisi Deji-Folutile

    Olabisi Deji-Folutile
    Olabisi Deji-Folutile

    COVID-19: Should Education Hit A Pause Or Are We Just Unprepared In Nigeria? By Olabisi Deji-Folutile 3Olabisi Deji-Folutile


     

    The world is facing its most trying and unprecedented times as the last few weeks have been most challenging for almost everybody.  What started in Wuhan, China, as an epidemic, has put the entire world in disarray.  Major streets across the globes have become empty. Both the rich and the poor are being ravaged by the plague of COVID-19, which the World Health Organisation has rightly described as a pandemic. Work places have been shut; religious and social gatherings banned and many countries are on total lockdown, in a bid to curb the spread of this viral disease. Expectedly, schools are also affected across board.  Every day people are being told to embrace social distancing and suddenly things like human contacts, hitherto considered as free gifts of life, are becoming very expensive.

    No one knows when this whole chaos will end, so people are making different kinds of adjustments to cope with the situation while it lasts. Many companies have shifted their operations online. Likewise, many schools have opted for e-learning, making use of available technology for teaching and learning.

     Universities around the world are making use of communication technology to ease the effects of the global pandemic on their academic calendars.   In China, universities are going for online teaching instead of in-class teaching; the ones in Australia have moved their classes online just as UK universities have suspended face-to-face teaching.  Turkey started its remote university classes on March 23. In Kenya, universities have activated communication between lecturers and students via social media platforms and emails while classes have gone totally online in the Philippines and Kyrgyzstan.  Teachers in France have been working with their students on Zoom.  

    Just a few days ago, Ghana’s President Addo Dankwa Akufo-Addo, directed the ministry of education to collaborate with the ministry of communications in rolling out open learning programmes in response to the closure of all educational institutions in the country. In the same vein, Mount Kenya University’s Vice-Chancellor Peter Wanderi, has announced the extension of online teaching platforms for regular students to facilitate the learning process.  And to take care of the over six million students that have experienced disruption to their studies, ten North African and 12 Arab countries have begun work on an e-learning initiative to facilitate open and online education.

    These are some of the steps being taken across the globe to bridge the gap created by school closure in the wake of COVID-19.  Unfortunately, while all these activities are going on in other parts of the world, Nigerian government has not said anything about steps being taken to take care of its students’ community.  Rather, the only message from the Federal Government was a total closure of all tertiary institutions and FG-owned unity schools till further notice. A statement issued by the National Universities Commission simply said universities would remain   shut   for one month while the Education Minister, Adamu Adamu, said tertiary institutions would remain shut indefinitely.

     Assuming government has been overwhelmed by the burden of controlling the spread of COVID- 19, hence its silence on options for learning for its teeming student population, one would have expected the higher institutions themselves to at least say something, but as it is, they too are not helping matters. The silence in our universities has been deafening. To worsen the situation, the Academic Staff Union of Universities, decided to choose this time, of all times, to embark on an indefinite strike. One wonders how the academic body   manages to feel comfortable being on a strike at a time when researchers across the globe   are busy looking for solution to a pandemic that is ravaging the entire world.  This kind of action makes one query the essence of having Research and Development as a core component of tertiary education in Nigeria when researchers can be nowhere to be found at a critical time of societal needs.

    By now, our researchers should be adding their voices to the various efforts being made towards developing a vaccine or cure for COVID-19. After all, universities are expected to proffer solutions to societal problems.  This is a wrong time for ASUU to embark on an indefinite strike. This should be a time of strategising and proffering solutions. This is really the time for everyone to get involved. Besides, I think Nigerian universities should also be more forthcoming on their responses to the challenges posed to their students by COVID-19.

    As it is, religious organisations are doing far better in terms of their responses to the effects of this pandemic on their primary constituencies.  Many of them have devised other means of getting the attention of   their members following several government directives prohibiting either gatherings or limiting the number of people allowed to congregate at a time.   Almost all the churches have switched to online platforms for their services.  How come religious organisations are working hard to keep their flocks and both government and higher institutions in Nigeria are just moving on as if all is well?  No word on how to keep the students busy or keep them engaged using available online technology! Should teaching and learning be restricted to the classrooms alone in this 21st century?

     Nigeria has always been described as a religious society. Corona Virus has further exposed the smartness of our religious bodies and the dullness of those in charge of our public educational institutions.  This is not an attempt to blame any religious organisation for having the foresight to deploy technology in reaching their audiences. Instead, it is a wakeup call to managers of our educational institutions to adopt and use available technology to help their students at a time like this.

    Apart from the National Open University of Nigeria, which basically runs online, I doubt if there is any other public university in the country that has capacity for online teaching.  This is in spite of the launch of the Nigerian Communication Satellite known as NIGCOMSAT by the Nigerian Government first in 2007 and then NIGCOMSAT-IR in December 2011, to provide critical ICT backbone infrastructure to support e-learning, among others in the country. 

    What is the essence of investing so much money in a communication satellite if it cannot be deployed at a time of need?   Those in charge of NIGCOMSAT, the commercial arm of Nigeria’s space centre, have consistently claimed that the technology has the capacity to cover the entire Africa.  If that is the case, why is the country still struggling to deploy internet connectivity facilities to its schools to aide e-learning?  If we are truly a serious country, by now, all the schools in urban and rural areas should have been connected to the e-learning services.

    No doubt, COVID-19 has exposed Nigeria’s unpreparedness for e-learning. But, we can’t afford to remain where we are. That is why it is important for every institution to start thinking of how to deploy available technology in the world for the good of their students at this critical period.   Universities should as a matter of urgency migrate online. This shouldn’t be another season of waiting and probably wasting for the Nigerian student.  There is no reason why any higher institution worth its name should suspend all academic activities until the end of Corona Virus with all the available resources and technology in the world today. The minimum expected of them is to upload teaching resources online for students to have access to them.  At least this will give the students the opportunity to learn on their own.

    This is also an opportunity for telecommunications companies like Glo, MTN and the rest of them to make a difference in Nigeria’s educational institutions. They can as part of their corporate social responsibility decide to boost internet facilities in universities and other educational institutions; or provide data at cheaper rates to help poor students have access to the internet for online learning.

    I know there are obvious stumbling blocks to digital learning in Nigeria. Many students don’t even have access to devices while the cost of buying data is still high. These challenges and others have provided    telecommunications companies a huge opportunity of making a difference in Nigerian higher institutions by providing e-learning solutions and broadband connectivity to universities and other higher institutions.

    They can as part of their corporate social responsibility decide to boost internet facilities in universities and other higher institutions; or help poor students who have limited or poor internet access to enhance online learning.

    Olabisi Deji-Folutile is the Editor-in-Chief of Franktalknow.com and member of the Nigerian Guild of Editors. Email: bisideji@yahoo.co.uk

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  • The Political Economy Of Coronavirus By Kunle Wizeman Ajayi

    The Political Economy Of Coronavirus By Kunle Wizeman Ajayi

    The Political Economy Of Coronavirus By Kunle Wizeman Ajayi 4

    The Political Economy Of Coronavirus By Kunle Wizeman Ajayi 5


     

    The most powerful person in Aso Rock, Abba Kyari; who is the chief of staff to the president, has tested positive to Covid19. No government official can reach President Buhari without him. There is a ripe suspicion that the kitchen cabinet might have been infected. Likewise in Europe, the most powerful person, Angela Merkel the chancellor of Germany, has been quarantined. While Trump and Boris Johnson took the same path in trying to ignore the pandemic, their governments are in deep crises of the damages and exposures their neglect has caused the citizens.

    As I type, the fear of corona virus is the beginning of real wisdom as governments are now banning even churches and mosques from gathering. The Nigerian federal ministry of health has announced 42 cases so far. And even the mass of working people who have hitherto doubted our thieving class so far, are now more wary and precautionary over their immediate safety without relying on the failed health institutions. People seldom shake hands now. Corona waves na the way to greet now! That corona virus has turned a corruption racket is what will be duly discussed another day. 

    Industries are closing down as Wall Street falls like pack of cards. US President Donald Trump is shouting “cuts” for the working class and bail-outs for industries and big business. Whereas, Socialist presidential aspirant Bernie Sanders is calling for “healthcare for all” as well as pay for all US citizens staying at home during the pandemic days. The globalised trend of the corona virus needs a global understanding and lessons of how the world is being ruled everywhere. The way US rulers have failed to care for the poor and invest in proper and compulsory healthcare for all but private pharmaceutical companies who make healthcare a commercial quantity that only the rich can afford, is the same way Nigerian rulers failed to build hospitals and kept allocating between 4 to 6% budgetary spending on education while them and their children spend billions on medical tourism. Also, Boris Johnson’s UK government is renting “beds at hospitals.” This is unlike Spain that has nationalized its healthcare!

    The price of crude oil has fallen globally. The global stock exchange has crashed as workers can no longer go to work and make great wealth for their casino. Coronavirus has superceded SARS with its speedy spread and effects globally. So the world economic crises have been, for the first time, propelled by a health crisis. What can the Left and the revolutionaries in Nigeria make out of this global crises that could leave no island untouched? 

    Naomi Klein, the author of the classic ‘The Shock Doctrine: The Rise of Disaster Capitalism’ has come up to warn that “if you’re a hard-core free-market economist, you understand that when market fails it lends itself to progressive change much more organically, than it does (when) the kind of deregulatory policies emerge. Political and economic elites understand that moment of crises is their chance to push through their wish list of unpopular policies that further polarize wealth…”

    I argue that while the government in Nigeria has reduced the cruelly expensive cost of petrol by just #20, and there is lipservice to building new hospitals, there is a larger probability of massive corruption as the federal government has already declared #2trillion intervention fund. Why we the working people have to very much care is because the same elements who created the crises (whichever ways) would end up profiting largely from the crises. This just as many military officers and politicians are billionaires courtesy the Boko Haram war.

    The interplay of methods of these corruptive accumulations on one hand, and the trajectory of working class resistances is critically assessed weighing up why and how the working people were at the loosing ends at the 2008/9 global economic crises that made the Central Bank under the Soludo/Sanusi bail-outs policies made the criminal banks even richer than before. Though a few bank MDs and top officers were detained on “hospital beds” and such other “ajebutter” prisons; no bank owner was even questioned. 

    The fact that both the US and Nigeria are rich governments that have bad healthcare policies, discussing social infrastructures as class struggle under this system of “primitive accumulation” needs to be knocked up as perspectives to guide millions who want an end to crises and build another world that would be for all and not a tiny thieving few.    

    A CLASSLESS PANDEMIC

    The corona virus has shown that the gap between the rich and the poor is just an artificial creation. The nature of humans is more communal than competitive. Plenty of the rich mouth the fact that we are all equal, but some are more equal than others. This virus is a threat to all and shows that the world can organize together and defeat any virus that attacks it. Crises like this shows that there is no policy that is pro-rich that can save society. Most of the capitalists who rule our world have been saying that government cannot help all and cater for the needs of majority. They tend to tell us that getting “healthcare for all” is rocket science. Corona virus has proved that all that is wrong!

    Meanwhile, many Nigerians are debating as to the cause of corona virus, and why it has drawn more attentions than malaria that kills about 800 everyday and child mortality that murders about 300 women daily. These debates became rife when Ibrahim Magu; head of the Economic Financial Crimes Commission (EFCC) asserted that “corona virus is caused by corruption.” His position, while quite misleading, is correct to the point that the virus is actually caused by the greed of man in unsettling the animal and forest lives. Most of the viruses live in the wildest of forests but humans go in and destroy their habitats. These make the virus homeless and have to migrate to live with humans. 

    The corona virus has also made the Nigerian politicians to have no escapist lives again. Most of them used to go abroad for medical tourism. But there is nowhere to run to now! This is why revolutionaries must use this chance to support striking doctors and demand for free, functionally standard and compulsory healthcare for all. We do not want a situation where the ruling class would use state wealth to build defence and cure for corona virus, only for the rich, instead for all. We must avoid repeating case of the last economic meltdown where what we could see is socialism for the rich and leave the poor uncatered for. This is why we must all reject the paltry #20 that was reduced from oil price as well as condemn the full devaluation of the naira. These policies will make the rich eat their cake and have it. Petrol price should be reduced to at least #45 while naira should be strengthened. The time to consider the #RevolutionNow demands of an “economy for the majority” is now! 

    2008/9: A FLASHBACK 

    When the 2008 global economic meltdown stormed Nigeria, the rulers ordered “technocrats” to adopt the Obama measures in bailing out the banks and their thieving managers. After prosecuting five CEOs of Afribank, Oceanic, Finbank, Intercontinental, and Union bank, The CBN went ahead to put #460bn as bail-outs for the banks after recovering just #70bn. The CEOs lost their posts for giving out #700bn loans without collateral. The loans portfolio of the bank, according to CBN, is #2.8tn. The richest guys in the country were involved in this public racket and were never touched. A good instance is Aliko Dangote who had a loan worth $15m with Oceanic Bank but got elected to replace Ndi OKereke as Nigerian Stock Exchange president. The same person has the monopoly of trading in rice, salt, sugar, textiles, and vegetable oil. The same persons who created the crises in the same place got rewarded after the crises. This is what Naomi Klein is warning about. For the rich, socialism is never good for the majority. The rich, in the time of corona virus and other disasters, want bail-outs but never for the working people. Just as Omoyele Sowore noted; “when crises arises, capitalism retires and socialism becomes the messiah!  

    We must start asking for Cost of Living Allowance (COLA) from the federal government. Every Nigerian must each be paid at least #100,000 monthly as the corona virus effect billing. We should also demand a standard hospital per 5 streets with the doctors and nurses paid appropriately! 

    THE TRUMP/BUHARI DISORDER

    President Buhari’s address to Nigerians has failed to address the pandemic. Trump’s tweets are of the same mental disorders like those of the ministers and officials of Buhari’s government.  Trump boasted that the “virus is under total control…The market will take care of itself,” he had to recant after the Dow Jones Industrial closed with its worst one-day decline since 1987; “The market will be very strong as soon as we get rid of the virus.”

    “But even as he was doing so, Trump maintained that he hadn’t said the virus was “under control,” which is something he has most definitely said on many occasions — along with other attempts to play down fears” CNN noted.

    Garba Shehu and other spokespersons of President Buhari have also been speaking from all sides of their mouths. They first downplayed the effect of the virus by revealing that malaria has been killing hundreds…Until they made some allocations of about $1.2trillion to the virus effects. The question remains the goals of the government. Many Nigerians do not trust the same government that has never given as much as 8% budgetary allocation to healthcare since the Buhari regime came into place, just like the PDP governments before it. While the president is one of the most sick, he prefers to betray electoral promises and visit private hospitals in the UK for months instead of building standard public health care. 

    Working people in US,UK, and Nigeria should look beyond their reactionary rulers and make real political demands that will make sure the same rogues who cause the crises don’t come back to claim to be the super heroes of the same crises. The case of Ebola and Lassa in Nigeria are classics in this regard. While Nigeria was lucky to get over the Ebola case with the sacrifice of health officials; Lassa fever has killed thousands so far loosely tackled because rodents most likely cannot enter luxury houses.

    Nigerians should be aware that both Buhari and Trump are exponents of crazy capitalism and prefers to give false answers to real threats and would only be falsely apologetic later. We must understand that the rulers are neither interested in our well being nor our future. Their fear is that the virus should never become for all. They prefer crises for just the masses. But oga corona no mind. This is why despite Trump trying to call it Chinese virus or Buhari trying to boycott addressing the country, nothing matters to the working people than having a healthy society. Arms in arms, we will have to care for one another and defeat the most dangerous virus ever in the history of the world! 

    OPIUMS ON THE CROSS

    Pastors in Nigeria, aside the ban on public and mass gatherings, are seriously on trial! Many a youths are asking what their “God” would do in this time of corona virus to save the followers from untimely deaths. The first pastor to become so fearless had predicted that he would go to China to cure the virus. But by the time the Italian became the first case in view; the pastor got admitted in a hospital for unknown reasons.

    Also, the mosques are closing shop. Even many are contemplating drinking alcohol to help in preventing corona virus. Despite the fact that many a churches and mosques become well attended public places, the belief in better life and a prosperous world without danger have been the egg tacts around the building of these beliefs. Saudi Arabia has stopped religious visitations. Government everywhere is banning all worshipping junctures. If these bans have been summoned by political demands of the left, it couldn’t have sailed through but the struggle is being marshaled by a pandemic. Bernie Sanders was seen as too extreme but most of those pro-establishment strollers must be shitting in their yanshes now!

    Karl Marx was very clear that “religion is the opium of the masses, the soul of the soulless.” The realizations of the fact that the immediacy of the problems of society can only be derailed if the people think that there is an umbrella or belief that can make some magic. With corona now, even the state that employs religion is not apologetic in banning its public activities. Sadly, many priests still in shock as to a possible demarketing have kept on lying to their congregations. A viral video shows a pastor saying “coronavirus cannot enter Nigeria where there is corrosive anointing;” so cocky in ignorance.  Such public ranting must be condemned.

    CONFUSION BREAK BONE; NAIJA HEALTH IN CRISES

    When the deposed emir of Kano, former CBN governor Sanusi Lamido Sanusi, was banned to Awe in Nassarawa State; the town has two (2) doctors to two hundred thousand (200,000) people. Such is the metaphor of health care in Nigeria.  Most doctors, nurses, and other medical personnel have migrated to other climes in an unprecedented brain drain. As Yusuf posited “7 out of 10 Nigerians live on less than $1.25 (~500 Naira) a day and they also live in a country where 70% of health expenditures are out-of-pocket payments. Nineteen years after the Abuja Declaration where African Union states pledged to allocate at least 15% of their annual budget to health, Nigeria continues to default. With over 23,584 public primary health care facilities, 8,290 private primary health care facilities and 200,000 patent and proprietary medicine vendors (PPMVs) in Nigeria, yet the country’s health indices and other health indicators continue to remain abysmal without any significant improvement compared to other countries in Sub-Saharan Africa.

    Citizens are condemned to self-care using several unregulated drugs and African raw herbs. The yearly allocations to health care in the budget never rise beyond 6 and 8%. This is despite the fact that Aisha, wife of President Buhari once publicly complained that Aso rock clinic has no syringe! At the Teaching hospitals, one has to pay heavily to get health care as the state has been practicing health care commercialization. The medical equipments are really not there while there are so poor remunerations of medical personnel. Yet, when Ebola came knocking in 2014, the health workers paid the sacrifices. 

    Corona virus is global and has now halted the medical tourism of the rich class of whom President Buhari is the chief. If not for Covid-19, he would have gone visiting his London doctors for the umpteenth time!  

    The health workers’ unions have been fighting for a better system for years. This has been led by the Joint Health Staffs Union (JOHESU) and the Nigeria Medical Associations (NMA.) JOHESU has led enormous strikes and pickets but the neo-liberal policies of the ruling class keep ignoring these strikes. As I write, doctors in Abuja are on strike. The rulers are now in a quagmire. This is the time for the unions to collaborate with the civil society and revolutionary movements to take up the state and fight for “free health care for all.”

    THE EXAMPLE OF CUBA

    Fidel Castro’s people are the certified global doctors today! 

    A small island at the backyard of the United States of North America; Cuba is a state-capitalist economy led by revolutionary socialists. While the state have yet boomed since 1959 as a result of the prevailing capitalist globe, it has been vociferous on social welfarism especially education, food, health, and housing. This has been the minimum with which the Communist Party has been working on since the revolution. With its third president in charge now; Cuba is the country that is now rescuing the world from the genocide of corona virus. The vessel that is wholly affected by the virus has been shipped to the Cuban shore and Cuba has been treating the patients on board. Italy is receiving about 200 Cuban doctors and nurses as the catholic country leads the population of casualties. The Cuban health statistics shows that 98% is living healthily just as education is 98.5%. 

    Cuba stood by the world on hurricane Katrina; by South Africa against apartheid; by Angola against imperialist Portugal, and now that “God-forsaken communist country” stands by the world with the best of its great medical care against corona virus. This is a lesson that we need to abide by and make the world a socialist island. The current system of “greed and power” is a pandemic. It is ruled by political viruses that live mainly on primitive accumulations of the sweat and blood of the majority. The working class of all lands should unite and fight capitalism to the ruins and replace it with a world led by the people who make the wealth, not those who do nothing but steal the wealth.  

    IN ALL; THIS PANDEMIC WILL FALL

    The struggle for a safer world is in danger of that “common ruins of the contending classes.” Italy, Nigeria, Spain, China, US, and some others have recorded deaths through corona virus. It is currently rumoured that some senators and members of the House of Representatives have contracted the deadly virus. We have 582 deaths in US and 46,145 cases with only 295 recoveries. One death has been recorded in Nigeria with 46 cases recorded. 6,777 are dead out of 63,927 cases in Italy. China has 16,578 dead in 382,570 incidents. Germany has 29,056 with 123 people dead. German chancellor, Angela Merkel has been quarantined. India with over 1 billion population has about 500 cases with no deaths. 

    The Indian case is very peculiar in lessons for Nigeria. Public health care in all tiers is free and subsidized for those below the poverty line. The Indian health sector encompasses 18% of total outpatient care and 44% of total impatient care. Middle and upper class use public health care less than those with a lower standard of living

    The Covid19 pandemic has exposed big countries like Britain, US, China, Nigeria, and others. The pandemic have also exposed capitalism as an idea that is deficient to the mass of working people. The idea does not care for the majority but the thieving minority. The rich continue to be richer while the poor becomes poorer. We need labour and civil society to work together and reconstitute revolutionary relationships to make sure that working people does not be at the receiving end of this pandemic. We must remember that those who destroy the country must not be allowed to continue with their madness after the covid19. We must demand for #FreeHealthCareForAll!

    We must also demand that world-class hospitals are built massively all over the country and we leave the madness of neo-liberalism in the dustbin of ruins. To do these works, we need a movement of the working people dedicated to the revolution that will build a country for all like the Take It Back movement and the Coalition for Revolution (CORE). Socialist organizations like the Socialist Workers and Youth League (SWL) serve as the political tribunes that remind us all on the ideal and alternatives to the rot that is causing pandemics and wars to the world today.

    Capitalist presidents that combine neo-liberalism and fascism are in deep shit today as the covid19 has exposed their inefficiencies and monumental social infrastructural dangers. The health of the world is the safety net to our wealth. Why would we allow those who care about the wealth alone to continue to rule us? Why should we continue to allow those who think of only the individual and never the collective to continue to rule us? When Greta Thunberg was leading the climate change campaigns, Donald Trump was scolding her. Bernie Sanders, Jeremyn Corbyn, Omoyele Sowore, Elvo Morales, Bobbi Wine and other revolutionary change-seeking eggheads have all campaigned for another world; the point is for we the working people and all oppressed, in unity and action, lead #RevolutionNow to get a life warranty of #FreeHealthCareForAll!

    Nigerians should demand for Cost of living allowance (COLA) of at least #100,000 in order to survive as the country is being locked down. We all must observe hand washing regularly; social distancing; avoid touching of faces, and other sophisticated parts of the body. Government should provide water, gloves and hands sanitizers to all. There is no electricity just as there is very poor housing for the majority of the people. We need the majority of empty house in cities and towns to be massively redistributed. Electricity must be renationalized.

    With all unity and actions, we will defeat the yet another genocidal virus. This also tells us that we must choose to build the world for all and not for the few as the threat of grand barbarism stares us all in the face once again. Rosa Luxembourg would be rolling and smiling in her grave as we are condemned to learn from her battle cry: “socialism or barbarism!” 

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    Kunle Wizeman Ajayi

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    The Political Economy Of Coronavirus By Kunle Wizeman Ajayi
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  • Nigerian Youth Have Gone To Sleep? By Tao Bakare

    Nigerian Youth Have Gone To Sleep? By Tao Bakare

    Nigerian Youth Have Gone To Sleep? By Tao Bakare 6

    Nigerian Youth Have Gone To Sleep? By Tao Bakare 7


    Woke up this morning to the unfortunate reality of the Nigerian state, the failure of her youth to take up responsibilities as the thread and wool that holds her fabric together.
      
    Flashback to the time when our past heroes, who were at the time youths, took up giant strides and went through the battles, upheavals, fights that ensured the liberation of the Nigerian state.
     
    In the nineties, Nigeria was lucky to have the likes of Chinua Achebe, Wole Soyinka, Fela Anikulapo Kuti, Gani Fawehinmi, Femi Falana amongst others responsible for the many historical and  ground-breaking achievement through measures of journalism, arts, literature and activism amongst others.
      
    Unfortunately, today, the reverse is the case, as we now have illiterates, educated hypocrites and mediocres that make up over sixty five percent of the Nigerian population.
      
    However, the blame cannot solely lie on the youths themselves, as it is loud enough that our leaders whom we entrusted our future unto have failed woefully to deliver in this respect. But also, it is noteworthy that the youths themselves have not helped to correct the anomalies, but have glaringly resolved to fold arms and watch their own future rubbed in the mud.
     
     In the Nigeria of today, youths have been relegated to the position of back benchers, applauding mammoth and mere on Lookers in the running of state affairs, which they ought to be at the fore front, as in the times of the West African Students Union, when students, youths, led liberation movements across Africa, and also saw to the independence of West African states.
     
    Obviously, it is crystal clear that youths, who occupy the largest percentage of Nigeria’s population now see themselves and thus submit to our doomed leaders, as election thugs, political hallelujah boys, political assassins and trash can. Instead of them to look ahead, beyond ethic bigotry and difference, it is unfortunate they now lead ethnic hate discussions and debates both online and offline, in turn, parading themselves as useless ‘ leaders of tomorrow’. I wonder how this country will pay it’s debts in the next twenty years, with this kind of bad debtors in town, the so called youths.
     
    In a sane society, the youths should be the ultimate institution of political accountability and policy partner to the government, thereby, holding erring leaders accountable. Also, youths should serve as the rebranding tool for a collapsing or collapsed entity, like ours.
      
    Recently, the chief of police, ordered for the disbandment of zonal SARS in Ogun State following the death of a  promising young man, Tiamiyu Kazeem popularly known as Kaka, who until his death was the Vice Captain of Remo Stars Football Club.
       
    The order of the IGP, came, not only regarding the fact that the young man who was the victim of yet another SARS menace, was a known football star, but also because the youths in Sagamu community flaunted their power as youths!
      
    Moral of this recent case and it’s achievement, is that, so much can be achieved if youths wake up from their long mouth drooling slumber and take full responsibility for their own future.
      
    Nevertheless, if they fall to do this, I fear they may sleep and never wake up.

    The time To Take It Back is now!
     

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  • Air Canada to lay off more than 5,000 flight attendants: union

    Air Canada to lay off more than 5,000 flight attendants: union

    Air Canada plans to temporarily lay off more than 5,000 flight attendants, due to the new coronavirus pandemic, their union said Friday.

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