As airports and airlines around the world continue to operate in the midst of a global pandemic, not every flight and region has the same Covid-19 protocols. Three WSJ reporters flew to different regions around the world to look at how air travel has changed.
There are over 35,000,000 reported cases of COVID-19 disease and 1 000 000 deaths across more than 200 countries worldwide.1 With cases continuing to rise and a robust vaccine not yet available for safe and widespread delivery, lifestyle adaptations will be needed for the foreseeable future. As we try to contain the spread of the virus, adults are spending more time at home. Recent evidence2 suggests that physical activity levels have decreased by ~30% and sitting time has increased by ~30%. This is a major concern as physical inactivity and sedentary behaviour are risk factors3 for cardiovascular disease, obesity, cancer, diabetes, hypertension, bone and joint disease, depression and premature death.
To date, more than 130 authors from across the world have provided COVID-19-related commentary on these concerns. Many experts4 have emphasised the importance of increasing healthy living behaviours and others5 have indicated that we are now simultaneously fighting not one but two pandemics (ie, COVID-19, physical inactivity). Physical inactivity alone results in over 3 million deaths per year5 and a global burden of US$50 billion.6 Immediate action is required to facilitate physical activity during the COVID-19 pandemic because it is an effective form of medicine3 to promote good health, prevent disease and bolster immune function. Accordingly, widespread messaging to keep adults physically active is of paramount importance.
Several organisations including the WHO, American Heart Association and American College of Sports Medicine have offered initial suggestions and resources for engaging in physical activity during the COVID-19 pandemic. Expanding on these resources, our infographic aims to present a comprehensive illustration for promoting daily physical activity to the lay audience during the COVID-19 pandemic (figure 1). As illustrated, adults are spending more time at home, moving less and sitting more. Physical activity provides numerous health benefits, some of which may even help directly combat the effects of COVID-19. For substantial health benefits, adults should engage in 150–300 min of moderate-to-vigorous intensity physical activity each week and limit the time spent sitting. The recommended levels of physical activity are safely attainable even at home. Using a combination of both formal and informal activities, 150 min can be reached during the week with frequent sessions of physical activity spread throughout the day. Sedentary behaviour can be further reduced by breaking up prolonged sitting with short active breaks. In summary, this infographic offers as an evidence-based tool for public health officials, clinicians, educators and policymakers to communicate the importance of engaging in physical activity during the COVID-19 pandemic.
Gao has developed a new way to power wireless wearable sensors: He harvests kinetic energy that is produced by a person as they move around.
“Our triboelectric generator, also called a nanogenerator, has a stator, which is fixed to the torso, and a slider, which is attached to the inside of the arm. The slider slides against the stator during human motion, and, an electrical current is generated at the same time,” Gao says. “The mechanism is quite simple. Friction results in electrical generation. This is not something new, concept-wise.”
This energy harvesting is done with a thin sandwich of materials (Teflon, copper, and polyimide) that are attached to the person’s skin. As the person moves, these sheets of material rub against a sliding layer made of copper and polyimide, and generate small amounts of electricity. The effect, known as triboelectricity, is perhaps best illustrated by the static electric shock a person might receive after walking across a carpeted floor and then touching a metal doorknob.
What Is Herd Immunity?
Herd immunity occurs when a significant portion of a population becomes immune to an infectious disease, limiting further disease spread.
Disease spread occurs when some proportion of a population is susceptible to the disease. Herd immunity occurs when a significant portion of a population becomes immune to an infectious disease and the risk of spread from person to person decreases; those who are not immune are indirectly protected because ongoing disease spread is very small.
The proportion of a population who must be immune to achieve herd immunity varies by disease. For example, a disease that is very contagious, such as measles, requires more than 95% of the population to be immune to stop sustained disease transmission and achieve herd immunity.
How Is Herd Immunity Achieved?
Herd immunity may be achieved either through infection and recovery or by vaccination. Vaccination creates immunity without having to contract a disease. Herd immunity also protects those who are unable to be vaccinated, such as newborns and immunocompromised people, because the disease spread within the population is very limited. Communities with lower vaccine coverage may have outbreaks of vaccine-preventable diseases because the proportion of people who are vaccinated is below the necessary herd immunity threshold. In addition, the protection offered by vaccines may wane over time, requiring repeat vaccination.
Achieving herd immunity through infection relies on enough people being infected with the disease and recovering from it, during which they develop antibodies against future infection. In some situations, even if a large proportion of adults have developed immunity after prior infection, the disease may still circulate among children. In addition, antibodies from a prior infection may only provide protection for a limited duration.
People who do not have immunity to a disease may still contract an infectious disease and have severe consequences of that disease even when herd immunity is very high. Herd immunity reduces the risk of getting a disease but does not prevent it for nonimmune people.
Herd Immunity and COVID-19
There is no effective vaccine against coronavirus disease 2019 (COVID-19) yet, although several are currently in development. It is not yet known if having this disease confers immunity to future infection, and if so, for how long. A large proportion of people would likely need to be infected and recover to achieve herd immunity; however, this situation could overwhelm the health care system and lead to many deaths and complications. To prevent disease transmission, keep distance between yourself and others, wash your hands often with soap and water or sanitizer that contains at least 60% alcohol, and wear a face covering in public spaces where it is difficult to avoid close contact with others.
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There may be few issues that unite Americans ahead of the 2020 election as do their concerns about the cost of prescription drugs.
A clear majority — 75% — of respondents to a July survey said the cost of prescription medicines would be among the factors likely to influence their votes this year, according to a report from Gallup and the nonprofit West Health. Gallup reported on results from 1,007 interviews conducted with adults between July 1 and July 24.
1. What are the 2020 presidential candidates saying they will do to lower drug prices?
Both President Donald Trump, a Republican, and former Vice President Joe Biden, a Democrat, have highlighted insulin costs in their discussions of the need to lower drug prices.
In a January interview with the New York Times editorial board, Biden noted the widespread discontent among Americans about sticker shock often experienced at pharmacies. He spoke of a need for the federal government to act to make medicines more affordable.
“This is a place where I find, whether you’re Republican or Democrat, you think you’re getting screwed on drug prices. And you are, in terms of everything from insulin to inhalers and a whole range of other things,” Biden said. “So, again, can I guarantee that it gets done? No, but I can tell you what, if anybody can get it done, I can, and I think there’s a consensus for it.”
2. Why doesn’t Medicare, the biggest U.S. purchaser of drugs, directly negotiate on drug prices?
Congress has taken different approaches in designing the terms under which the two largest federal health programs, Medicaid and Medicare, buy drugs.
Medicaid is a program run by states with federal contributions and oversight. It covers people with low incomes and disabilities. Almost 67 million people were enrolled in Medicaid as of May 2020, including about 29 million children. In 1990 Congress decided that drugmakers who want to have their products covered by Medicaid must give rebates to the government. The initial rebate is equal to 23.1% of the average manufacturer price (AMP) for most drugs, or the AMP minus the best price provided to most other private-sector payers, whichever is greater. An additional rebate kicks in when prices rise faster than general inflation.
3. What’s the deal with rebates and discounts?
There’s widespread frustration among lawmakers and policy analysts about the lack of clarity about the role of middlemen in the supply chain for medicines. Known as pharmacy benefit managers (PBMs), these businesses describe the aim of their business as making drugs more affordable for consumers. Insurers like Cigna and UnitedHealth operate some of the nation’s largest PBMs, as does pharmacy giant CVS Health, which also owns insurer Aetna.
“They will tell you their mission is to lower drug costs,” said Rep. Earl L. “Buddy” Carter, a Georgia Republican, a pharmacist and a critic of PBMs, in a speech on the House floor last year. “My question to you would be: How is that working out?”
4. What is the “distinctly American” phenomenon of specialty drugs?
Kesselheim also has written on what he terms “Specialty Drugs — A Distinctly American Phenomenon.” That’s the title of a 2020 paper in the New England Journal of Medicine Kesselheim authored with Huseyin Naci, an associate professor of health policy at the London School of Economics.
In this Perspective article, Kesselheim and Naci look at how the “specialty” designation morphed from its origin in the 1970s. It then referred to a need for extra steps for preparation and delivery of new injectable and infusion products.
5. How much does it cost to bring a new drug to market anyway?
The median cost for a medicine developed in recent years was $985 million, according to a study published in JAMA in March 2020, “Estimated Research and Development Investment Needed to Bring a New Medicine to Market, 2009-2018.”
“Rising drug prices have attracted public debate in the United States and abroad on fairness of drug pricing and revenues,” write the study’s authors: Olivier J. Wouters of the London School of Economics; Martin McKee of the London School of Hygiene and Tropical Medicine; and Jeroen Luyten of Leuven Institute for Healthcare Policy, KU Leuven, Belgium. “Central to this debate is the scale of research and development investment by companies that is required to bring new medicines to market.”
NPR News Now reports: Vice President Debate tonight, Stimulus Bill update, health care needs in rural America, and other top news.
When the coronavirus hit, why were countless Americans left unprotected amid a desperate shortage of PPE and other critical medical equipment?
FRONTLINE, The Associated Press and the Global Reporting Centre investigate.
In the wake of President Donald Trump’s COVID-positive diagnosis, and as cases spike in parts of the country, “America’s Medical Supply Crisis” examines why the United States was left vulnerable to key equipment shortages — and why problems persist, months into the coronavirus crisis.