Coronavirus is a breeding ground for conspiracy theories

by Daniel Jolley and Pia Lamberty, The Conversation

Credit: Angelina Bambina / Shutterstock

The novel coronavirus continues to spread around the world, with new cases being reported all the time. Spreading just as fast, it seems, are conspiracy theories that claim powerful actors are plotting something sinister to do with the virus. Our research into medical conspiracy theories shows that this has the potential to be just as dangerous for societies as the outbreak itself.

29 feb 2020--One conspiracy theory proposes that the coronavirus is actually a bio-weapon engineered by the CIA as a way to wage war on China. Others are convinced that the UK and US governments introduced the coronavirus as a way to make money from a potential vaccine. Some people even suggest that Bill Gates is sponsoring the coronavirus.

Although many of these conspiracy theories seem far-fetched, the belief that evil powers are pursuing a secret plan is widespread in every society. Often these relate to health. A large 2019 YouGov poll found 16% of respondents in Spain believe that HIV was created and spread around the world on purpose by a secret group or organisation. And 27% of French and 12% of British respondents were convinced that "the truth about the harmful effects of vaccines is being deliberately hidden from the public."

The spread of fake news and conspiracy theories around the coronavirus is such a significant problem that the World Health Organisation (WHO) has created a "myth busters" webpage to try and tackle them.

Spread of conspiracy theories

Research shows that conspiracy theories have a tendency to arise in relation to moments of crisis in society – like terrorist attacks, rapid political changes or economic crisis. Conspiracy theories bloom in periods of uncertainty and threat, where we seek to make sense of a chaotic world. These are the same conditions produced by virus outbreaks, which explains the spread of conspiracy theories in relation to coronavirus.

Similar conditions occurred with the 2015-16 outbreak of Zika virus. Zika conspiracy theories proposed that the virus was a biological weapon rather than a natural occurrence. Research examining comments on Reddit during the Zika virus outbreak found conspiracy talk emerged as a way for people to cope with the extreme uncertainty they felt over Zika.

Trust in the recommendations from health professionals and organisations is an important resource for dealing with a health crisis. But people who believe in conspiracy theories generally do not trust groups they perceive as powerful, including managers, politicians and drug companies. If people do not trust, they are less likely to follow medical advice.

Researchers have shown that medical conspiracy theories have the power to increase distrust in medical authorities, which can impact people's willingness to protect themselves. People who endorse medical conspiracy theories are less likely to get vaccinated or use antibiotics and are more likely to take herbal supplements or vitamins. Plus, they are more likely to say they would trust medical advice from nonprofessionals such as friends and family.

Severe consequences

In light of these results, people who endorse conspiracy theories about the coronavirus may be less likely to follow health advice like frequent hand-cleaning with alcohol-based hand rub or soap, or self-isolating after visiting at-risk areas.

Instead, these people may be more likely to have negative attitudes towards prevention behaviour or use dangerous alternatives as treatments. This would increase the likelihood of the virus spreading and put more people in danger.

Already, we can see "alternative healing approaches" to coronavirus cropping up—some of them very dangerous. Promoters of the popular QAnon conspiracy theory, for example, have said the coronavirus was planned by the so-called "deep state" and claimed the virus can be warded off by drinking bleach.

The spread of medical conspiracy theories can also have severe consequences for other sections of society. For example, during the Black Death in Europe, Jews were scapegoated as responsible for the pandemic. These conspiracy theories led to violent attacks and massacres of Jewish communities all over Europe. The outbreak of the coronavirus has led to a worldwide increase in racist attacks targeted towards people perceived as East Asian.

It is possible to intervene and halt the spread of conspiracy theories, however. Research shows that campaigns promoting counterarguments to medical conspiracy theories are likely to have some success in rectifying conspiracy beliefs. Games such as Bad News, in which people can take the role of a fake news producer, have been shown to improve people's ability to spot and resist misinformation.

Conspiracy theories can be very harmful for society. Not only can they influence people's health choices, they can interfere with how different groups relate to each other and increase hostility and violence towards those who are perceived to be "conspiring." So as well as acting to combat the spread of the coronavirus, governments should also act to stop misinformation and conspiracy theories relating to the virus from getting out of hand.

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Provided by The Conversation 

First-ever pathology of the early phase of lung infection with the 2019 novel coronavirus (COVID-19)

by International Association for the Study of Lung Cancer

Credit: CC0 Public Domain

An international team of clinicians and researchers for the first time have described the pathology of the SARS-CoV-2, or coronavirus, and published their findings in the Journal of Thoracic Oncology, the journal of the International Association for the Study of Lung Cancer.

28 feb 2020--The article's senior author, Shu-Yuan Xiao, M.D., from the University of Chicago Medicine in Chicago, teamed up with a small group of clinicians from the Zhongnan Hospital of Wuhan University, in Wuhan, China.

"This is the first study to describe the pathology of disease caused by SARS-CoV-2, or COVID-19 pneumonina, since no autopsy or biopsies had been performed thus far," Dr. Xiao said. "This would be the only descriptions of early phase pathology of the disease due to this rare coincidence. There would be no other circumstance that this will happen. Autopsies will only show late or end stage changes of the disease."

The article describes two patients who recently underwent lung lobectomies for adenocarcinoma and were retrospectively found to have had COVID-19 at the time of surgery. Pathologic examinations revealed that, apart from the tumors, the lungs of both patients exhibited edema, proteinaceous exudate, focal reactive hyperplasia of pneumocytes with patchy inflammatory cellular infiltration, and multinucleated giant cells. Fibroblastic plugs were noted in airspaces.

"Since both patients did not exhibit symptoms of pneumonia at the time of surgery, these changes likely represent an early phase of the lung pathology of COVID-19 pneumonia," Dr. Xiao said.

CASE 1 was a female patient of 84 years of age who was admitted for treatment evaluation of a tumor measuring 1.5 centimeters in the right middle lobe of the lung. The tumor was discovered on chest CT scan at an outside hospital. She had a past medical history of hypertension for 30 years, as well as type 2 diabetes. Despite comprehensive treatment, assisted oxygenation, and other supportive care, the patient's condition deteriorated, and she died. Subsequent clinical information confirmed that she was exposed to another patient in the same room who was subsequently found to be infected with the 2019 novel coronavirus.

CASE 2 was a male patient of 73 years of age, who presented for elective surgery for lung cancer, in the form of a small in the right lower lobe of the lung. He had a past medical history of hypertension for 20 years, which had been adequately managed. Nine days after lung surgery, he developed a fever with dry cough, chest tightness, and muscle pain. A nucleic acid test for SARS-CoV-2 came back as positive. He gradually recovered and was discharged after twenty days of treatment in the infectious disease unit.

According to the study, these two incidences also typify a common scenario during the earlier phase of the SARS-CoV-2 outbreak, during which a significant number of healthcare providers became infected in hospitals in Wuhan, and patients in the same hospital room were cross-infected, as they were exposed to unknown infectious sources. The presence of early lung lesions days before the patients developed symptoms, corresponds to the long incubation period (usually 3-14 days) of COVID-19. Making it difficult to prevent transmission during the early days of this outbreak, as many healthcare workers in Wuhan became infected, when they were seeing patients without sufficient protection, according to Dr. Xiao. As of today, more than 15 doctors in Wuhan died of COVID-19, from infections while they were taking care of patients. Some of them were previously healthy and as young as 29 years old.

"We believe it is imperative to report the findings of routine histopathology for better understanding of the mechanism by which the SARS-CoV-2 causes lung injury in the unfortunate tens and thousands of patients in Wuhan and worldwide," Dr. Xiao said. Further studies by Dr. Xiao's team and collaborators on COVID-19 pathology through postmortem biopsies are ongoing, which should provide data on the late changes of this disease.

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More information: Sufang Tian et al, Pulmonary pathology of early phase 2019 novel coronavirus (COVID-19) pneumonia in two patients with lung cancer, Journal of Thoracic Oncology (2020). DOI: 10.1016/j.jtho.2020.02.010

Journal information: Journal of Thoracic Oncology 

Provided by International Association for the Study of Lung Cancer

Brazil confirms Latin America's first coronavirus case

Credit: CC0 Public Domain

Brazil's health ministry said on Wednesday a Sao Paulo resident has been diagnosed with the novel coronavirus, the first such case recorded in Latin America.

26 feb 2020--The 61-year-old patient had returned on February 21 from the Lombardy region of Italy, the epicenter of an outbreak in the European country, Brazil's Health Minister Luiz Henrique Mandetta said.

Mandetta said authorities were trying to identify people that had been in contact with the patient as well as his family members.

The man had visited a doctor complaining of flu symptoms. He has been placed in home isolation but is said to be "fine."

Sao Paulo is Brazil's largest city with 12 million inhabitants.

Another 20 cases are under investigation, said health ministry official Wanderson Kleber de Oliveira.

Twelve of those had traveled to Italy while one was in China, the origin of the outbreak.

Before confirming the case, Mandetta had spoken to CBN radio station downplaying the virus as a simple "flu."

"We need to stay calm, it's a flu and we'll overcome it," he said.

However, he added that it was a virus that appeared in a northern hemisphere winter and there was no way to predict how it would react to a southern hemisphere summer.

"It could be better, or worse," he said.

Coronavirus has killed over 2,700 people and infected more than 80,000, the vast majority in China.

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© 2020 AFP

Number of people with dementia is set to double by 2050, according to new report

by Alzheimer Europe

The number of people with dementia in EU28 + Non-EU, from 2018 to 2050. Credit: Alzheimer Europe

Today, at a European Parliament lunch debate hosted by Christophe Hansen MEP (Luxembourg), Alzheimer Europe launched a new report presenting the findings of its collaborative analysis of recent prevalence studies and setting out updated prevalence rates for dementia in Europe.

23 feb 2020--Over the past three decades, a number of significant pieces of work have been undertaken to estimate the prevalence of dementia at a European level, including:

• EURODEM study in the early 80s (updated in 2000)
• Alzheimer Europe's project European Collaboration on Dementia—EuroCoDe (2006-2008)
• ALCOVE, the 1st EU Joint Action on Dementia (2011-2013).

As the most recent of these studies is six years old, Alzheimer Europe recognised the importance of establishing more recent dementia prevalence estimates, using the most up-to-date academic literature on the subject.

The findings presented below are based on a collaborative analysis of prevalence studies published since the conclusion of the EuroCoDe project. A total of 16 studies meeting predefined quality criteria were included in the collaborative analysis.

The key findings of this new Alzheimer Europe report include:

• For men, there has been a reduction in the prevalence of dementia across all age groups over the past ten years when compared to Alzheimer Europe's 2008 EuroCoDe estimates.
• For women, apart from the age group of women between 75 and 79 years, there has been a reduction in the prevalence of dementia over the past ten years when compared to EuroCoDe.
• The number of people living with dementia in the European Union (EU27) is estimated to be 7,853,705 and in European countries represented by AE members, 9,780,678. Compared to its earlier estimates, this constitutes a significant reduction from 8,785,645 for the EU27 and from 10,935,444 for the broader European region.Women continue to be disproportionately affected by dementia with 6,650,228 women and 3,130,449 men living with dementia in Europe.
• The number of people with dementia in Europe will almost double by 2050, increasing to 14,298,671 in the European Union and 18,846,286 in the wider European region.

Alzheimer Europe's Yearbook also highlighted significant limitations in the available research into dementia prevalence and a lack of research into:

• the prevalence of younger people with dementia (i.e. those aged under 65)
• the prevalence of different types of dementia
• the number of people affected by different stages of dementia including mild cognitive impairment
• the prevalence of dementia of people from ethnic minority groups.

Commenting on the findings, Alzheimer Europe Executive Director, Jean Georges, said:

"It is promising to see that healthier lifestyles, better education and improved control of cardiovascular risk factors seem to have contributed to a reduction of the prevalence of dementia. However, our report also demonstrates that the number of people living with the condition is set to increase substantially in the years ahead, which will only place greater pressure on care and support services unless better ways of treating and preventing dementia are identified. If people with dementia, their families and carers are to receive the high-quality and person-centred care they need, governments must ensure their health and care systems are ready to meet this demand and greater investments in research into the treatment and prevention of dementia are needed."

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More information: www.alzheimer-europe.org/Publi … eimer-Europe-Reports

Provided by Alzheimer Europe 

Telemonitoring plus phone counseling lowers blood pressure among black and Hispanic stroke survivors

by American Heart Association

Credit: CC0 Public Domain

Adding phone-based lifestyle counseling to home blood pressure telemonitoring is an effective strategy to improve long-term blood pressure control among minority stroke survivors with uncontrolled high blood pressure, according to late breaking science presented today at the American Stroke Association's International Stroke Conference 2020.

22 feb 2020--Uncontrolled high blood pressure, or hypertension, is a major predictor of racial disparities in stroke outcomes in the United States. Improving blood pressure control among minority stroke survivors is key to secondary stroke prevention. Although home blood pressure telemonitoring and lifestyle counseling by nurses have proven effective in controlling blood pressure, this study is the first time this strategy has been tested specifically among minority stroke survivors.

Researchers randomly assigned 450 black and Hispanic stroke survivors with uncontrolled blood pressure (average age 62; 51% black; 44% women) to home blood pressure telemonitoring alone with monthly feedback to primary care providers, or home blood pressure telemonitoring plus telephone-based counseling by nurses. The nurses counseled patients via telephone on lifestyle behaviors and strategies to improve their blood pressure and reported the blood pressure readings to the patient's doctor.

After 12 months, patients who received the home blood pressure telemonitoring plus lifestyle counseling by nurses, experienced a 14-point reduction in their systolic blood pressure, while those who received only home blood pressure telemonitoring had only a 5-point drop in their systolic blood pressure.

"The magnitude of reduction in systolic blood pressure for those who received lifestyle counseling and support was much larger than we expected," said Gbenga Ogedegbe, M.D., M.P.H., lead study author, director, Division of Health and Behavior and the Center for Healthful Behavior Change in the Department of Population Health at NYU Grossman School of Medicine in New York City. "The reduction in systolic blood pressure of 14 mmHg among these patients would be expected to translate to at least a 20% decrease in stroke deaths and 34% fewer secondary strokes. These are pretty robust findings."

Ogedegbe said, "The results suggest that hypertension management in patients at high risk for recurrent stroke should involve telephone-based lifestyle counseling by a non-physician health worker coupled with home blood pressure telemonitoring. The role of the nurse case manager could be played by the patient's pharmacist or other trained non-physician health workers."

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Provided by American Heart Association 

Most coronavirus infections are mild, says Chinese study

A medical worker takes a swab for testing from a Chinese paramilitary police officer in Shenzhen, Guangdong province

Most people infected by the new coronavirus in China have mild symptoms, with older patients and those with underlying conditions most at risk from the disease, according to a study by Chinese researchers.

20 feb 2020--The disease has now killed nearly 1,900 people and infected more than 72,000 in China since it first emerged in the central city of Wuhan late last year.

A paper published in the Chinese Journal of Epidemiology looked at 72,314 confirmed, suspected, clinically diagnosed, and asymptomatic cases of COVID-19 illness across China as of February 11.

It is the biggest study on novel coronavirus patients since the outbreak began in late December.

Here are the main findings from the paper by the Chinese Centre for Disease Control and Prevention (CCDC):

Elderly, sick at risk:

Some 80.9 percent of infections are classified as mild, 13.8 percent as severe and only 4.7 percent as critical.

The highest fatality rate is for people aged 80 and older, at 14.8 percent.

The study finds that patients with cardiovascular disease are most likely to die of complications from the novel coronavirus, followed by patients with diabetes, chronic respiratory disease and hypertension.

There were no deaths among children aged up to 9, despite at least two cases of newborn babies infected through their mothers.

Up to age 39, the death rate remains low at 0.2 percent.

The fatality rate increases gradually with age. For people in their 40s it is 0.4 percent, in their 50s it is 1.3 percent, in their 60s it is 3.6 percent and their 70s it is 8.0 percent.

Men are more likely to die (2.8 percent) than women (1.7 percent).

The overall death rate from the virus stood at 2.3 percent.

While the Severe Acute Respiratory Syndrome (SARS) outbreak of 2002-2003 affected fewer people, the fatality rate was nearly 10 percent.

The US Centres for Disease Control says between 26 million to 36 million Americans contracted seasonal flu between October 2019 and February 8 this year, and there were between 14,000 to 36,000 deaths—a fatality rate of around 0.1 percent.

'Wuhan exposure'

Nearly 86 percent of those who have contracted the illness had either lived in or travelled to Wuhan, where a seafood market that illegally sold wild animals is believed to be the original source of the virus.

The city in central China's Hubei province has been under lockdown since January 23.

Risk to medical workers

A total of 3,019 health workers have been diagnosed, 1,716 of whom were confirmed cases, and five had died as of February 11, the report said.

An analysis of 1,688 severe cases among medical staff showed that 64 percent of them were working in Wuhan.

"The percentage of severe cases among Wuhan medical staff has gradually decreased from 38.9 percent at the peak (on January 28) to 12.7 percent in early February," the report said.

A hospital director in Wuhan died from the illness on Tuesday.

Earlier this month Wuhan ophthalmologist Li Wenliang, who had been punished by authorities for sounding the alarm about the virus, also died.

'Downward trend'

The epidemic reached its "first peak" between January 24 and 26, the report said.

It suggests there is has been a "downward trend" in the overall epidemic curve since February 11—meaning the spread of the disease, especially outside Hubei province, was slowing.

On February 13, China broadened its definition of confirmed cases to include those who were clinically diagnosed through lung imaging, in addition to those with a positive lab test result.

The report hints that China's decision to lock down Wuhan—a city of 11 million people—and impose strict transport curbs in other affected areas may have paid off.

'Possible rebound'

The virus spread as millions of people criss-crossed the country for the Lunar New Year holiday in late January.

The authors warn that with many people returning from the holiday, the country needs to brace itself for a "possible rebound of the epidemic".

Coronaviruses may continue to "adapt over time and become more virulent", the report warns and urges doctors to "remain vigilant".

As we age, women are frailer but more resilient than men

by Medical Journal of Australia (MJA)

Credit: CC0 Public Domain

Women tend to have poorer health status and are more frail, but are more resilient and have longer life expectancy than men, according to the authors of a narrative review on frailty, published online today by the Medical Journal of Australia.

15 feb 2020--Frailty can be defined as a state of increased vulnerability that is associated with adverse health outcomes.

"It has been estimated that just over 10% of community dwelling adults aged 65 years and over are frail," wrote the authors, Dr. Emily Gordon, a consultant geriatrician, and Professor Ruth Hubbard, from the Centre for Health Services Research at the University of Queensland.

"A frail older person takes longer to recover after any sort of insult (such as infection, infarction or adverse drug reactions) and during the period of recovery is more vulnerable to further stressors. Increasing frailty is associated with syndromic disease presentations; falls, delirium, functional decline and new urinary incontinence may reflect acute illness in a frail older person and should never be dismissed as 'normal for age.'"

Gordon and Hubbard described the differences in frailty between men and women as the "sex-frailty paradox."

"In community dwelling populations aged over 65 years, women are more likely to be frail and to have a greater burden of frailty than men of the same age. Yet women appear to be more resilient—at any given age or level of frailty, their mortality rates are lower," they wrote.

"In Australia, the life expectancy of females continues to be about four years longer than that of males. Yet throughout their lives, women are burdened by chronic disease and disability to a greater extent than men and, unsurprisingly, women have poorer self-rated health."

In their review Gordon and Hubbard examined the evidence about frailty interventions. Exercise and nutrition-based interventions were found to have the highest levels of evidence.

"Many of these interventions target phenotypic features of frailty, including weakness, slowness and wasting," they wrote.

"Yet frailty is more than just physical signs and symptoms. Cognitive training strategies and comprehensive geriatric assessment with interdisciplinary interventions address important non-physical health domains.

"More recently, researchers have reported benefits from multifactorial interventions incorporating exercise, a nutritional intervention, and cognitive training with social support or medication review.

"It is also important to note that very few studies have examined interventions to prevent the development of frailty in non-frail older adults. Further, the evidence-base for interventions to prevent or reduce frailty in institutionalized or hospitalized older adults is limited."

Some evidence implies that some interventions work better for one sex than the other, wrote Gordon and Hubbard.

"Sex differences in the effectiveness of interventions have not been specifically addressed by the research literature to date," they wrote.

"Exercise programs appear to be effective in both sexes. However, sarcopenia, low physical activity and functional impairment are more prevalent in older women than men, and it is possible that women may benefit from a different type or intensity of exercise intervention than men.

"With respect to nutrition, men may benefit from interventions to a greater extent than women. Several studies have indicated that men tend to have a poorer understanding of nutrition and make unhealthy dietary decisions.

"Sex differences in frailty highlight that older men and women may respond to interventions in different ways and may benefit from more sex-specific strategies."

The authors concluded that there was a scope and growing need for further research into frailty, and particularly the sex-frailty paradox.

"To provide optimal, patient-centered care, sex differences should inform our practice," they wrote.

"While the evidence base for sex-specific frailty interventions is lacking at the present time, the knowledge gleaned and hypotheses generated from observational data should inspire programs of research, instigate public health initiatives, and prompt reflection by health professionals."

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More information: Emily H Gordon et al. Differences in frailty in older men and women, Medical Journal of Australia (2019). DOI: 10.5694/mja2.50466

Journal information: Medical Journal of Australia 

Provided by Medical Journal of Australia (MJA

Coronavirus 2019-nCoV: The largest meta-analysis of the sequenced genomes of the virus

by University of Bologna

Phylogenetic tree of all the 2019-nCov sequences available at 02-Feb-2020 (branches shown in blue), plus six Bat coronavirus sequences (default black, as they are split in multiple taxa), six Human SARS (green) and 2 MERS (orange). The percentage of bootstraps supporting each branch is reported. Branches corresponding to partitions reproduced in less than 50% bootstrap replicates are collapsed. Credit: University of Bologna

The largest analysis of coronavirus 2019-nCoV genomes that have been sequenced so far confirms that the virus originates in bats and shows a low virus heterogeneity. At the same time, researchers identified a hyper-variable genomic hotspot in the proteins of the virus responsible for the existence of two virus subtypes. The leading author of this study, published in the Journal of Medical Virology, is Federico M. Giorgi, bioinformatics researcher at the Department of Pharmacy and Biotechnology of the University of Bologna.

08 feb 2020--The data released by the World Health Organization reveal that to date, the coronavirus 2019-nCoV has infected 28,276 people, of whom 565 died. This new study analyzed the genomes of the 56 coronavirus strains sequenced in different parts of the world, including those extracted from the two Chinese patients held at the Infectious Disease Ward of Lazzaro Spallanzani Hospital in Rome, Italy. This is the most comprehensive study of coronavirus genomes so far conducted.

Researchers confirmed the notion that the virus probably originates from a zoonotic pathogen: its closest relative, which was isolated in the past few weeks, matches the coronavirus sequence EPI_ISL_402131 found in the Rhinolophus affinis, a medium-size Asian bat of the Yunnan Province (China). The human coronavirus genome shares at least 96.2% of its identity with its bat relative, while its similarity rate with the human strain of the SARS virus (severe acute respiratory syndrome) is much lower, only 80.3%.

The researchers have also discovered that all the existing DNA sequences of coronavirus are very similar, even if they come from different regions of China and from various parts of the world—the genomes obtained from patients since the beginning of the outbreak share a sequence identity over 99%. "The virus shows low heterogeneity and variability—this is good news," explains Federico M. Giorgi. "With a homogeneous viral population, potential drug therapies are deemed to be more effective on everyone."

However, the study identified for the first time a hyper-variable hotspot in the virus proteins, eventually pinpointing two virus subtypes. The latter differ only by a single amino acid, which is able to change the sequence and the structure of ORF8-encoded protein, a virus component yet to be characterized.

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More information: Carmine Ceraolo et al. Genomic variance of the 2019‐nCoV coronavirus, Journal of Medical Virology (2020). DOI: 10.1002/jmv.25700

Provided by University of Bologna 

Fighting coronavirus fear with empathy: Lessons learned from how Africans got blamed for Ebola

by Kevin J.a. Thomas, The Conversation

Ebola virus particles (red) on a larger cell. Credit: NIAID

With coronavirus cases exploding in China, the U.S. is once again responding to a global epidemic. Five years ago, when the Ebola virus infected more than 28,000 people in 10 countries, many people were surprised to learn that four of these cases were diagnosed on U.S. soil.

08 feb 2020--Based on research I conducted for a book about the Ebola crisis and prejudice against certain groups of people associated with it, I fear that Americans might make immigrants the villain instead of the virus during the coronavirus epidemic.

There's reason for concern. Since the first case of the coronavirus was discovered in December 2019, it has affected more than 20,000 people, including 11 in the U.S.

If the U.S.' experience with epidemics tell us anything, it is that these events will be followed by increased public attention aimed at immigrants from China. This is because during epidemics, attention is typically focused on groups from countries where they started. And, this attention is rarely accompanied by an understanding of immigrants' complicated experiences.

More often, it is about blame. Chinese immigrants in Canada already are reporting examples of xenophobia. Several students at the University of California, Berkeley complained about what they considered to be a xenophobic Instagram post from the university after news of the coronavirus; the university deleted the post.

As I argue, based on research presented in my book "Global Epidemics, Local Implications: African Immigrants and the Ebola Crisis in Dallas," the experience of African immigrants during the Ebola epidemic in 2014 can provide us with important lessons about how the U.S. and its people should respond.

This does not imply that the Ebola virus and the new coronavirus are similar. Yet, there are important facets of African immigrants' experiences during the Ebola crisis that can inform how Americans think about the current experiences of Chinese immigrants.

Fear and concern for loved ones far away

For starters, the public tends to ignore the fears and traumas experienced by immigrants who see epidemics unfolding in their origin countries.

Some immigrants experience the devastation firsthand, because they had traveled to their countries of origin when the outbreak occurred. During the 2014 Ebola epidemic, for example, African immigrants visiting West Africa when the outbreak began lived through the ensuing social disorder, witnessed the rising death toll and feared infection from the deadly virus.

More often, however, immigrants experience outbreaks from afar. During the Ebola epidemic, my research shows that immigrants who remained in the U.S. were not spared from these emotional experiences. While advances in global travel and communications technology have helped immigrants maintain connections with these countries, they also provide channels through which the consequences of disease outbreaks abroad are experienced.

News of the mounting deaths of family members created a paralyzing feeling for immigrants in the U.S. who knew that they couldn't risk traveling to the endemic countries abroad. At the same time, they felt being guilty about their inability to participate in customary burial rites.

But worst of all, blame

In addition to fear and guilt, however, immigrants often experience a great deal of blame. During the Ebola crisis, negative responses from Americans who used caricatures of immigrants' ethnicity to stigmatize them as carriers of disease only worsened immigrants' stress and fear. For example, many heard racist tropes about Africans' presumed penchant for kissing corpses and their habit of consuming exotic beasts.

In this current coronavirus epidemic, we have already begun to see the rise of xenophobia and the use of ethnic stereotypes about Chinese consumption of exotic meats to link the presumed cultural practices of Chinese immigrants with the spread of the virus.

Such negative reactions are not new. They are similar to past public reactions that blamed Russian Jews for the 1892 typhoid epidemic and Italians for the spread of polio in 1916.

Stigmatizing immigrants does nothing to contribute to the fight against epidemics. Instead, such actions are usually counterproductive because they fail to incorporate immigrants into broader efforts to combat the spread of disease.

How immigrant communities help

Immigrant communities provide a critical line of defense for detecting, monitoring and preventing the spread of the disease, as I discuss in my book. With Ebola, these included the development of strategies to prevent the spread of the virus and improve public health by African immigrants after the first case of Ebola was discovered in the U.S.

Accordingly, African immigrant communities promoted initiatives to discourage travel to affected countries. They also helped develop systems for ensuring that Africans returning from these countries abide by quarantine period required by the Centers for Disease Control and Prevention.

Beyond these actions, West African immigrants took other practical steps to reduce person-to-person transmissions of Ebola, while also supporting efforts to address the consequences of the disease abroad. In addition, these immigrants promoted the practice of frequent hand-washing with chlorine-based solutions and discouraged social norms of hand-shaking withing their communities. These actions were complemented by efforts to assist in contact tracing, the identification of people who may have come in contact with infected persons.

Building on these initiatives, they also collaborated with local businesses and other mainstream institutions to care for families affected by Ebola and assisted humanitarian organizations working to combat the spread of disease in West Africa.

When a nation responds to epidemics by stigmatizing immigrants, it misses opportunities to build strategic coalitions for preventing the spread of viruses. Now that the first person-to-person transmission of the coronavirus has been confirmed in the U.S., the need for such coalitions has become more urgent.

In my view, our nation's response to Chinese immigrant communities should be based on actions informed by facts and not fear. Without such actions, we risk failure in our attempts to build the resilient communities needed to prevent the occurrence of a greater public health emergency within our borders.

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Provided by The Conversation 

Radiologists describe coronavirus imaging features

by Radiological Society of North America

29-year old male with unknown exposure history, presenting with fever and cough, ultimately requiring intensive care unit admission. (a) Axial thin-section non-contrast CT scan shows diffuse bilateral confluent and patchy ground-glass (solid arrows) and consolidative (dashed arrows) pulmonary opacities. (b) The disease in the right middle and lower lobes has a striking peripheral distribution (arrow). Credit: Radiological Society of North America

In a special report published today in the journal Radiology, researchers describe CT imaging features that aid in the early detection and diagnosis of Wuhan coronavirus.

08 feb 2020--"Early disease recognition is important not only for prompt implementation of treatment, but also for patient isolation and effective public health surveillance, containment and response," said the study's lead author, Michael Chung, M.D., assistant professor in the Department of Diagnostic, Interventional and Molecular Radiology in the Mount Sinai Health System in New York, N.Y.

On December 31, 2019, the World Health Organization (WHO) learned of several cases of a respiratory illness clinically resembling viral pneumonia and manifesting as fever, cough, and shortness of breath. The newly discovered virus emerging from Wuhan City, Hubei Province of China, has been temporarily named "novel coronavirus" (2019-nCoV). This new coronavirus belongs to a family of viruses that include Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).

The outbreak is escalating quickly, with thousands of confirmed 2019-nCoV cases reported globally. On January 30, the U.S. reported the first confirmed instance of person-to-person spread of the virus.

In this retrospective case series, Dr. Chung and colleagues set out to characterize the key chest CT imaging findings in a group of patients infected with 2019-nCoV in China with the goal of familiarizing radiologists and clinical teams with the imaging manifestations of this new outbreak.

36-year old male with history of recent travel to Wuhan, presenting with fever, fatigue and myalgias. Coronal thin-section non-contrast CT image shows ground-glass opacities with a rounded morphology in both upper lobes (arrows). Credit: Radiological Society of North America

From January 18, 2020, until January 27, 2020, 21 patients admitted to three hospitals in three provinces in China with confirmed 2019-nCoV infection underwent chest CT. The 21 patients consisted of 13 men and 8 women ranging in age from 29 to 77 years old, with a mean age of 51.2 years. All patients were confirmed positive for infection via laboratory testing of respiratory secretions.

For each of the 21 patients, the initial CT scan was evaluated for the following characteristics: (1) presence of ground-glass opacities, (2) presence of consolidation, (3) number of lobes affected by ground-glass or consolidative opacities, (4) degree of lobe involvement in addition to overall lung "total severity score," (5) presence of nodules, (6) presence of a pleural effusion, (7) presence of thoracic lymphadenopathy (lymph nodes of abnormal size or morphology), and (8) presence of underlying lung disease such as emphysema or fibrosis. Any other thoracic abnormalities were also noted.

The analysis showed that 2019-nCoV typically manifests on CT with bilateral ground-glass and consolidative pulmonary opacities. Nodular opacities, crazy-paving pattern, and a peripheral distribution of disease may be additional features helpful in early diagnosis. The researchers also noted that lung cavitation, discrete pulmonary nodules, pleural effusions and lymphadenopathy are characteristically absent in cases of 2019-nCoV.

Follow-up imaging in seven of eight patients showed mild or moderate progression of disease as manifested by increasing extent and density of airspace opacities.

Dr. Chung cautioned that absence of abnormal CT findings upon initial examination does not rule out the presence of 2019-nCoV.

69-year old male with history of recent travel to Wuhan, presenting with fever. Axial thin-section non-contrast CT scan shows ground-glass opacities in the lower lobes with a pronounced peripheral distribution (arrows). Credit: Radiological Society of North America

"Our patient population is unique from other published series on the Wuhan coronavirus in that three of our patients had normal initial chest CTs," he said. "One of these patients progressed three days later and developed a solitary nodular ground-glass lesion in the right lower lobe, indicating this pattern may represent the very first radiologically visible manifestation of disease in some patients infected with Wuhan coronavirus."

He added that a second patient had a normal follow-up chest CT four days after her initial normal imaging exam.

"This suggests that chest CT lacks complete sensitivity and does not have a perfect negative predictive value," Dr. Chung said. "We can't rely on CT alone to fully exclude presence of the virus."

This finding may be related to the fact that infection with 2019-nCoV is characterized by an incubation period of several days, and there may be a phase where viral infection manifests with symptoms prior to visible abnormalities on CT.

The researchers note that further study is required to understand how patients fare after treatment but suggest that experience and imaging findings from MERS and SARS epidemics might be helpful in managing the current outbreak.

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More information: Michael Chung et al, CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV), Radiology (2020). DOI: 10.1148/radiol.2020200230

Journal information: Radiology 

Provided by Radiological Society of North America