26 Mar – 1 Apr

A snapshot of media coverage on COVID-19

David Heymann speaks to…

(29/03) CBS about the state of the COVID-19 pandemic in America. David said: “This is a vicious, violent virus, and everywhere it has appeared, it’s caused great numbers of people to die. And it’s also spread very easily in communities. So what’s happening in the US has happened around the world. What has been different is the strategies to contain the virus.”

(29/03) Bloomberg about why different countries have had such different outcomes in the fight against the coronavirus. David said: “A little bit of investment before these outbreaks would have prevented the major investments that are having to be made now.”

(29/03) The Times about the UK’s COVID-19 strategy. David said: “I think they have been doing what is necessary in the UK, as are many other countries. They may have used a different mixture in the UK, but no one can say at this point what is right or wrong. In two to three weeks when they do their risk assessments, they will be looking to see if they’ve accomplished the goal of what they set out to do.”

(27/03) Reuters about the worldwide implications of COVID-19. David said: “What’s happening is that the world is experiencing something it never has before, and I think the world will be forever changed by it. There is a great mobilisation now to share and collaborate, and I hope that continues after this crisis abates. If so, I think the world will be a better place.”

Sally Bloomfield speaks to…

(31/03) Yahoo! News about how supermarkets could be a potential hotspot for COVID-19 transmission. Sally said: “The supermarket provides an ideal setting for this to occur – many people touching and replacing items, checkout belts, cash cards, paper receipts – not to mention being in the proximity of several other people.”

(27/03) BBC News about how to clean food packaging properly. Sally said: “For contained or packaged goods, either store them for 72 hours before using them or spray and wipe plastic or glass containers with bleach that is carefully diluted as directed on the bottle.”

Heidi Larson speaks to…

(30/03) Nature about how suppressing information about COVID-19 could fuel misinformation and endanger public health. Heidi said: “This is a complicated landscape that is not just a matter of debunking a piece of misinformation. Advice to “Keep calm and carry on” can have exactly the opposite effect in the context of a fatal, and evolving, new virus.”

(27/03) The BMJ Opinion about the need for greater trust in vaccines as well as the institutions and individuals that deliver them. Heidi said: “Trust building is urgently needed at multiple levels and will be paramount for public health.”

Ed Parker speaks to…

(30/03) The Guardian about the potential cumulative effects of a low viral load. Ed said: “Studies in mice have also shown that repeated exposure to low doses may be just as infectious as a single high dose. So all in all, it is crucial for us to limit all possible exposures to COVID-19, whether these are to highly symptomatic individuals coughing up large quantities of virus or to asymptomatic individuals shedding small quantities.”

(27/03) New Scientist about viral load. Ed said: “The viral load is a measure of how bright the fire is burning in an individual, whereas the infectious dose is the spark that gets that fire going.”

Kalpana Sabapathy speaks to…

(31/03) BBC News about the likelihood of the NHS becoming overwhelmed during the coronavirus outbreak. Kalpana said: “The simple answer is that we don’t really know. It’s always going to be a close call. But obviously, the sooner they can bring out additional beds, additional staff, additional equipment, the better.”

(26/03) BBC News about guidance for people in high-risk groups when it comes to shopping for food. Kalpana said: “I would suggest contacting your local GP practice who can put you in touch with volunteer groups offering their services. But if that’s not possible, then trying to go to the supermarket at times when it’s quiet would be advisable, and certainly not forgetting the two metre rule.”

Jimmy Whitworth speaks to…

(01/04) New Scientist about the seasonality of COVID-19. Jimmy said: “If we look at the epidemic in Australia  – where it is still their summer, moving towards their autumn – there are a lot of cases and they’re having an acceleration of an epidemic there. So I take from that that warm weather is not going to be highly protective for us.”

(01/04) The Herald about the potential effectiveness of earlier lockdown measures in Scotland. Jimmy said: “It is pretty clear when you look at the data for different countries that the earlier you introduce these measures the more effective they are, so in that respect if they were introduced in Scotland – or Scotland was part of them – at an earlier stage then it will have had more effect.”

(31/03) Full Fact about the likelihood of COVID-19 reinfection. Jimmy said: “There have been a few isolated examples where reinfection has been reported. That people were positive, then they were negative, then they were positive again. It looks like, in the great majority of cases, this doesn’t happen. That people get infected once. My suspicion is that those discrepant test results that we get are to do with, actually, the sampling.”

(28/03) The Telegraph (£) about why European governments may have been slower to lockdown communities due to a ‘wait and see’ approach. Jimmy said: “Now it is here and it’s very much a reality, I think the public is taking these public health control measures very seriously. I think the Government here and the general public are determined to get on top of this. We are, after all, trying to minimise deaths.”

Adam Kucharski speaks to…

(31/03) BBC Radio 4 (from 9:50) about what determines the spread of a disease such as COVID-19. Adam said: “I call it the D.O.T.S… The first is D, the duration of infectiousness. How long are you spreading virus for? But then it’s also what happens when you’re infectious, the O. The opportunities you have. How many conversations you have, how many places you go. The T is the transmission probability. During an opportunity there’s a certain probability you might cough. The S is the susceptibility of the person you’re interacting with.”

(28/03) The Hindu about how transportation networks and interlocking economies can amplify the effects of epidemics like COVID-19. Adam said: “When you have that connectivity, what happens in a local area of China can quickly influence what happens in other countries. Potentially, what would have been a very small outbreak a few decades ago that wouldn’t have affected other places, now affects what happens elsewhere, such as the UK, the U.S., or India.”

(27/03) The Financial Times about the importance of a disease’s reproduction number. Adam said: “Breaking the reproduction number down . . . can help us work out the best way to control an epidemic.”

(26/03) The Guardian about why caution needs to be taken when interpreting the results of a preliminary University of Oxford study, suggesting that half of the UK population have already been infected with COVID-19. Adam said: “We still don’t know the exact risk, and we won’t until we have the results from a large-scale analysis of blood samples.”

Stephen Evans speaks to…

(30/03) The Daily Mail about the dangers of self-medicating with non-approved substances to treat symptoms of the coronavirus. Stephen said: “Using non-approved substances, even if the active ingredient in a medicine is in another non-medical product, it is dangerous to use it as if it were a medicine.”

(27/03) The Guardian about human trials for a COVID-19 vaccine. Stephen said: “There are risks that some aspects of pre-human testing have been reduced or omitted, but the benefits of getting the vaccine as quickly as possible could outweigh such potential theoretical risks.”

Martin McKee speaks to…

(01/04) LBC about the global shortage in COVID-19 testing kits. Martin said: “The difficulty is that we came to a very late stage of the challenge and as a consequence, everybody is looking for the equipment to do this, the chemicals required. There are shortages of all these things required worldwide.”

(27/03) The BMJ Opinion about why politicians need to be careful before deflecting blame during a pandemic. Martin said: “Words have consequences, especially when amplified by media outlets that seem determined to inflame hatred of others. Politicians, wherever they are, should think very carefully before speaking in the present circumstances.”

Other LSHTM experts…

(01/04) John Edmunds is quoted in Reuters about the importance of adhering to the UK government’s COVID-19 measures, following preliminary estimates from LSHTM suggesting that lockdown restrictions could be driving the reproduction number below one. John said: “Our estimates are not to be read as ‘job done’. Rather, they should be used as motivation for us all to keep following UK government instructions. It’s imperative we don’t take our foot off the pedal. We must continue to stop transmission of the virus to reduce the burden on the NHS now, and over the coming months.” John’s comments also feature in the Straits Times and The Times of Israel.

(31/03) In the CFR’s Think Global Health forum, Mishal Khan discusses the challenges that people in resource-constrained settings face during COVID-19, including accessing quality healthcare. Mishal said: “One size will not fit all when it comes to lower-income country responses, and a rapid analysis of the risk factors for COVID-19 spread relevant to each country, led by the government’s COVID-19 task force, should form the foundation of coordinated actions.”

(31/03) David Leon discusses the value of COVID-19 figures from the Office of National Statistics in The Guardian. David said: “What ONS has done is important as it starts to provide a more complete picture of the impact of COVID-19 on mortality.”

(31/03) Andy Haines, Anna Goodman and Sam Clifford are quoted in The Telegraph (£) about the benefits of cycling, amidst early signs of its discontinuation during the coronavirus outbreak. They said: “Cycling, particularly in green space, is good for mental as well as physical health. Cycling can be compatible with social distancing if people are responsible.”

(31/03) Ellen Fragaszy comments on the potential seasonality of the current COVID-19 outbreak in the Daily Mail. Ellen said: “In temperate regions, many respiratory viruses follow a seasonal pattern, with winter peaks during the cold and flu season.”

(31/03) Graham Medley explains why the UK government is struggling to scale up COVID-19 testing in iNews. Graham said: “Now that every country in the world wishes to increase testing capacity the international supply chains are stretched, and it is proving difficult to set up the infrastructure quickly. It will happen, but not immediately.”

(31/03) In South China Morning Post, Leesa Lin cautions that discrimination against East Asians could prevent best health practices during the coronavirus outbreak. Leesa said: “Targeting Asians creates a false sense of security that others, based on their appearance alone, may be exempt from social distancing or physical distance in practice.”

(30/03) Liam Smeeth discusses why Germany’s case-fatality rate is low, despite being one of the worst-affected countries in TIME. Liam said: “Between countries there are several reasons why the death rate might vary, but they’re very small compared to the impact of how many people get tested. Germany very rapidly rolled out testing to a very large number of people, relative to the population.”

(30/03) Shunmay Yeung emphasises that mask-wearing is not essential for the majority of people in South China Morning Post. Shunmay said: “One of the problems if lots of people who don’t need face masks are using face masks or stockpiling them, it means that there aren’t enough face masks available where they’re really needed.”

(30/03) In The Guardian, John Edmunds explains that a lag between social distancing policies and hospitalisations mean that any slight slowdown in the rate of COVID-19 cases is unlikely to reflect the impact of the lockdown yet. John said: “It takes that long to feed into the system.”

(29/03) Citing polio, Grace Macklin discusses how vaccines may create problems when immunisation campaigns do not reach everyone on BBC World Service (from 22:03). Grace said: “If you conduct poor quality response and perhaps only provide immunity for 60 or 70 per cent of the population, the virus will persist.”

(29/03) Tim Crocker-Buqué questions reports that coronavirus patients in critical care have a 50 per cent survival rate in inews. Tim said: “To say the mortality rate of ICU patients is 50% is misleading and may induce panic. More accurately, it shows of the 21% of those patients who have left critical care, 48% of them had died. However, it excludes the 79% patients who do not have an outcome yet.”

(29/03) In the Evening Standard, Brendan Wren warns that the UK’s coronavirus death toll will continue to rise as the outbreak moves towards an expected peak in around three weeks. Brendan said: “Coupled with the observation that the infection can affect all walks of life even without underlying health conditions, this may be a sobering thought for any of the population flouting hygiene measures and/or social distancing.”

(28/03) Roz Eggo discusses the effectiveness of the UK’s physical distancing measures on Channel 4 News (from 3:07). Roz said: “We know that decreasing the number of contacts between people should slow transmission. Because of time delays – about five days from getting infected to showing symptoms, and about a week from showing symptoms to needing hospital care – we’ll be able to see a decrease in transmission first in the hospital care cases and then later in death. So there will be some indication sooner than three weeks that things are working and we need to keep an eye on those.”

(28/03) James Logan is quoted in The Telegraph about the possibility of dogs becoming diagnostic tools for COVID-19, amidst new research involving LSHTM. James said: “We know that other respiratory diseases change our body odour so there is a very high chance that dogs will be able to detect this virus. If this could become a diagnostic tool, it has the potential to revolutionise our response to COVID-19.” James’ comments also feature in The Times of India and New York Post.

(28/03) In Forbes, Sunil Bhopal calls for lower speed limits to ease the pressure on coronavirus-impacted hospitals. Sunil said: “In England alone, there are around 35,000 non-fatal admissions to hospital every year related to road traffic accidents.”

(27/03) Mark Jitt talks to New York Times about the possibility of a second outbreak spurring future clampdowns. Mark said: “People should be prepared for the fact that we are not going back to completely normal life for a while. But we also need to allow people to see the light at end of the tunnel.”

(27/03) Alex Akin speaks to BBC Newsbeat about whether rooms need to be deep cleaned after self-isolating in them. Alex said: “Viruses are actually fairly delicate bits of material, so they don’t survive very long.”

(27/03) Barbara De Barros explains how weakend immune systems make those affected by leprosy in India vulnerable to COVID-19 in The Independent. Barbara said: “The corticosteroids used to treat leprosy reactions significantly alter the immune system. These people are at high risk of developing severe COVID-19 because of this.”

(26/03) In The Guardian, Kiesha Prem cautions against relaxing COVID-19 restrictions in Wuhan too soon. Kiesha said: “The city now needs to be really careful to avoid prematurely lifting physical distancing measures, because that could lead to an earlier secondary peak in cases. But if they relax the restrictions gradually, this is likely to both delay and flatten the peak.”

(26/03) Martin Hibberd is quoted in WIRED about why Germany’s case-fatality rate sits comparatively low to other countries. Martin said: “Germany’s a little bit earlier on in the process than Italy. It takes two or three weeks of intensive care before people often succumb to the disease.”

(26/03) Stefan Flasche discusses the possibility of multiple COVID-19 peaks in NBC. Stefan said: “One scenario is we can indeed reverse the spread as done in China and South Korea, then reach a point to lift the distancing measures. But we may have to repeat this cycle for a few times because of an inevitable resurgence of cases in the absence of population immunity. In that scenario, we would see multiple peaks in the upcoming 12 months.”

(26/03) Yang Liu speaks is quoted in Reuters about the effectiveness of social distancing measures to curb the spread of COVID-19 worldwide. Yang said: “We think one thing probably applies everywhere: physical distancing measures are very useful, and we need to carefully adjust their lifting to avoid subsequent waves of infection when workers and school children return to their normal routine. If those waves come too quickly, that could overwhelm health systems.”

Further LSHTM coverage

LSHTM’s Centre on Climate Change & Planetary Health’s call for climate-damaging products to come with smoking-style warning labels features in The Guardian. They said: “Warning labels connect the abstract threat of the climate emergency with the use of fossil fuels in the here and now, drawing attention to the true cost of fossil fuels pictorially or quantitatively.”

Andy Haines and Pauline Scheelbeek write in The BMJ about the integral role healthcare professionals play in protecting public health and tackling climate change. Andy and Pauline said: “Health professionals have a responsibility to act locally, nationally, and internationally—both as individuals and through their professional bodies—taking a leading role in supporting the implementation of policies that will protect health and tackle the pressing challenges of the Anthropocene.”

On social media

This week’s social media highlight comes from Twitter, where we celebrated reaching 100,000+ sign ups to our online COVID-19 course.

Opening of London School of Hygiene & Tropical Medicine

On this day in 1924, the School became the London School of Hygiene & Tropical Medicine and received its Royal Charter. 

The School originally opened as the London School of Tropical Medicine on 2nd October 1899 as part of the Seamen’s Hospital Society’s Branch Hospital at the Royal Albert Dock Hospital in the East End of London. The object of the School was not only to acquaint the students with tropical diseases and teach them how to treat them, but also to train them to investigate, observe, record and study the diseases.

London School of Tropical Medicine

Following the First World War, the School decided to move from the East End to Central London. The School’s new building and Hospital for Tropical Diseases in Endsleigh Garden was officially opened on 11th November 1920 by HRH The Duke of York. This was a former hotel which had been used as a hospital for officers during the First World War. The building is still standing in Gordon Street and is now the student union for University College London.

The School became the London School of Hygiene & Tropical Medicine as a result of the Athlone Committee report published in May 1921 which recommended ‘An institute of state medicine should be established by the University of London in which instruction should be given in Public Health, Forensic Medicine, Industrial Medicine and in medical ethics and economics’, and discussions with the Rockefeller Foundation who recommended that there should be an institution in London which could be the European counterpart of the John Hopkins School of Hygiene and Public Health in Baltimore. The London School of Hygiene & Tropical Medicine was given Royal approval by H M King George V when the Charter was signed.  

The position of the new School as the country’s Central School of Public Health and Hygiene was sealed by the Royal Charter’s point 1 that  

‘all persons…in accordance with this Our Charter…members of the Board of Management…shall be one body corporate and politic under the name of the London School of Hygiene and Tropical Medicine for the purpose of promoting study of and education in public health, hygiene, State medicine, and tropical medicine in Great Britain, the British Dominions, Colonies and Possessions, and in other countries, having a perpetual succession and a Common Seal…. ‘

Sir Andrew Balfour

The new School’s Director, Sir Andrew Balfour was appointed in June 1923. His choice of career was influenced by the founder of the London School, Sir Patrick Manson; tropical medicine became Balfour’s life’s work when he was appointed director of the Wellcome Tropical Research Laboratories at Khartoum and local Medical Officer of Health. In 1913 he returned to England to head the Wellcome Bureau of Scientific Research. He played an important role in the Royal Army Medical Corps during the First World War before joining the School. As well as overseeing the transition of the new School, he also managed the construction of the Keppel Street building which opened in 1929. 

An alternative guide to the Barnard classification scheme

In 1936, Cyril Cuthbert Barnard (1894-1959) published the first edition of his Classification for Medical and Veterinary Libraries. Barnard was the School’s first Librarian, in post between 1921-1959. In selecting resources it soon became apparent to Barnard that the classification schemes available at the time were not suitable for the specialist focus of the London School of Hygiene & Tropical Medicine. Barnard devised his own classification scheme focusing on tropical medicine and public health, revising it in 1955 to accommodate new and emerging subjects. The Library, together with other academic libraries and health organisations, has used the scheme ever since.

In 2019 the Library began a (somewhat overdue) project to revise and update the Barnard classification scheme. The scheme is used by the Collection Services Team in the Library to arrange books and resources into certain categories known as classes. The scheme is alphabetical, apart from an auxiliary schedule. Each term or subject within a class is given a unique term and notation. For example, Bacteriology is Class J, Virology is Class K, Parasitology is Class L, etc. In Class J, Tuberculosis is JC, in Class K HIV is KM, and in Class L Malaria is LF.

The Library is aiming to have the third edition of Barnard’s scheme ready for publication in 2021. Given the intervening years since the second edition, many revisions and additions have been necessary. It is also vital for the scheme to be flexible enough for future developments within subject and research areas, and to be adaptable for the needs of a C21st library.

However, there is also time for a more light-hearted look at the scheme. Over the next twelve or so weeks, the Library will post an alternative guide to the scheme. We hope it may provide a fun introduction or refresher to some of the classes and subjects of the scheme.

COVID-19 PANDEMIC: FROM ISOLATION TO SOLIDARITY

By Richard Coker (London School of Hygiene & Tropical Medicine)

An epidemiological tsunami is sweeping the world. The most vulnerable will succumb directly from infection and, often forgotten, indirectly from being unable to access health care services. As this pandemic unfolds, it may be difficult to see any positive consequences. But there may be.

All pandemic infectious disease threats are zoonotic, that is, they emerge from animals that then exploit a new ecological niche, humans. They test our social, political, cultural, economic and moral norms. Global crises may test these norms to destruction. The Black Death in the 14th century decimated the global population with profound social and economic consequences. For the survivors of the Black Death, wages rose, land became more abundant, and the feudal system was destabilised. World War 1 (along with the Spanish influenza pandemic) transformed the economies and polities of Europe. Working lives, especially for women, were transformed, universal suffrage became widespread,and political systems changed, most notably with the emergence of communism. WW1 also led to the League of Nations, the precursor to the United Nations. Chernobyl, according to Mikhail Gorbachev, helped trigger the collapse of the Soviet Union. When each of these seismic events started, the consequences would have been difficult to predict. Seismic events result in unexpected consequences.

The COVID-19 Pandemic

This pandemic will test how we look after our neighbours. Protecting our societies’ most vulnerable will test our social contract, perhaps to breaking point. And nowhere is this test likely to be more profound than the United States of America (USA). This exceptional country has the notion of rugged individualism proudly embedded in its DNA. It has, however, also resulted in a health care system especially unsuited to enhancing social solidarity, to risk sharing, or to enabling population-based behavioural measures to prosper. Worldwide, the configuration of health systems reflects political and social values. When private insurance schemes dominate, as in the USA, health systems are ‘individualised’, that is, when you’ve paid your premiums, you demand and expect a service. In times of pandemics such individual-focused systems are likely to falter because your health becomes more dependent on your neighbours’ health. Everyone is in this together. But the US system is engineered to avoid what are perceived to be ‘free-riders’. In a pandemic there’s no such person as a ‘free-rider’. If social solidarity is a necessary pre-requisite for an effective response to this new threat, what does this mean in terms of shifts to our communal values?

The values undergirding health systems eventually, in times of health resource shortages, test moral and ethical norms. Who should get access to ventilators? Ventilators now, therapeutic pharmaceuticals perhaps in 6 months, and vaccines in 12-18 months. Should it be the insured, the rich, the politically connected, the old, the young, the economically active, soldiers, health care workers who gains access preferentially?

Scarce resources test social, institutional, and political systems. Today’s coronavirus is highlighting a fear that some countries will be left in the cold when it comes to drugs and vaccines. Global pharmaceutical supply chains are highly interconnected and there is talk of blocking the export of basic pharmaceutical ingredients from China and India in anticipation of future domestic demand, or some countries getting preferential access to future vaccines. Political self-interest is a powerful motivator. Few politicians will be brave enough to put others, outside their jurisdiction, to the front of the queue.

Belonging to a regional bloc (EU, ASEAN etc) or sizeable manufacturing country (China, India) matters if you don’t want to be left out in the cold. The temperature for those residing outside powerful blocs with pharmaceutical and vaccine manufacturing capacity could get decidedly chilly. Pandemics are not only a public health matter, they are also a matter of power and security.

This power matters at national, community, and individual level. Witness, for example, in Southeast Asia how limited surveillance capacity, including intentionally limited testing, has resulted in woeful under-representations of COVID-19 cases. This has resulted in policy decisions that have, in all likelihood, threatened the health of some of the poorest and most vulnerable in society. Enormous migrations of people from cities undergoing ill-thought out ‘lockdowns’ to their villages and neighbouring countries would challenge even the best resourced and best performing public health systems. Those in SE Asia and much of the world were already challenged ahead of this pandemic. The poorest or the poor, whether migrant workers, refugees, prisoners, or the indigent are at greatest risk, and these risks are magnified in low- and middle-income countries around the world.

Scarce resources always raise moral and political questions. In the US the collision between the political, cultural and the values underpinning the health care system are most stark. The US is the place to watch as this pandemic unfolds. Its traditional ‘exceptionalism’, increasing political isolationism, cultural individualism, and largely for-profit health care system mean it is exceptionally unprepared for what is to come. The demands for change to the social contract in terms of social security and health care are being heard more loudly in the US. This pandemic will raise the volume of the American people’s call for greater social and health care support from a shout to a scream. And when the US screams, the world listens.

The scream for reform needs to be heard by our multilateral global institutions, the successors to the League of Nations. These institutions are meant to serve global welfare. The World Health Organization (WHO) has become a shadow of what it was when it led the global eradication of Smallpox in the 1970s. This has been, in part, by design. The organisation is the tool of governments largely unwilling to give it greater authority. This informs the choice of WHO’s leaders, its bureaucratic and administratively chaotic regional offices, the vulnerability of commitments made, an ever-expanding mandate that is not financed adequately, and increasingly, budgets tied to specific activities of interested parties rather than funding ‘core’ functions. There has long been an insistence by governments to ensure that WHO’s authority doesn’t stray into realms of national sovereignty. The International Health Regulations (2005) that resulted directly from the SARS epidemic highlight this perspective. The regulations lack real teeth. They encourage countries to enhance their risk assessment capacity. But they stop short of mandating countries to improve their risk management capability. Risk management remains a sovereign state issue. But, as the cliché goes, emerging infectious diseases know no borders. The weakest link in global preparedness, once an epidemic has emerged, is the inability of any single country to prevent or contain the emergence of infectious diseases. The world needs a robust WHO, focused on infectious disease control, and armed with the technical, administrative, financial, and legal authority to do its job in a timely fashion.

Conclusion

Perhaps this crisis will cause us all to reassess our values, our sense of social solidarity, national, regional and global. Perhaps too we can see how interconnected and interdependent we are on each other and our relationships with the animal kingdom. All pandemics, after all, emerge from animals. The conversations we have during this emerging time of crisis should constructively inform what sort of society we want to live in and the institutions that enable and support that vision.


Image credit: Wikipedia Commons/OpenMyanmar Photo Project

Alumni Innovators: Dr Bobbi Pritt

Dr Bobbi Pritt studied MSc Medical Parasitology and DTMH at LSHTM. She now works as a Medical Director of the Clincial Parasitology Laboratory at Mayo Clinic in Rochester, USA. In this post she describes her experience at LSHTM, what innovation means to her and how she uses innovation in her work.

Why did you decide to study at LSHTM?

I was extremely fortunate to have full Mayo Clinic sponsorship for obtaining specialty training at the school of my choice. Therefore, I did a careful evaluation of the available schools and LSHTM clearly came out on top. I was very impressed with LSHTM’s history, the esteemed professors, and the opportunities available to students. The opportunity to live in London was also very appealing!

How has your degree at LSHTM complemented your career?

My degree and experiences at LSHTM were life-changing. Not only did I gain knowledge and skills that I needed for my future career at Mayo Clinic, but I also formed invaluable connections with experts in the field, and gained cherished friends from across the globe.

What does innovation mean to you?

To me, innovation is to approach problems with a fresh outlook, and not be afraid to ask ‘why’ when told that something must be done in a certain way.  Two of the most valuable skills I learned as a leader were when to challenge the norm and how to do so in a way that maintains relationships and facilitates team-building.

How do you use innovation in your work?

A large component of my job focuses on innovation – creating new laboratory tests for improving patient care, formulating more efficient ways to run the laboratory, and advancing the science in the field of human medical parasitology through research. I love my job – I get to care for patients, carry out research using cutting edge technology, and teach the next generations of parasitologists!

Sugar levy did not decrease the domestic sales of UK soft drinks manufacturers

Sugar-sweetened beverage (SSB) taxes are widely supported by the public and health professionals to reduce the consumption of sugar and thus improve public health. Such policies have generally met with strong opposition from soft drinks industry with claims that it will result in economic losses to the industry, and therefore have negative impacts overall on economies. 

The Soft Drink Industry Levy (SDIL) announced by the UK government in March 2016 was of no exception. Unlike the SSB taxes in many countries, this levy was designed to incentivise reformulation of SSBs by providing a 2-year delay between the announcement and the enforcement of the levy, and adopting a two-tiered rate based on the sugar content of the drinks. After the announcement, an industry-sponsored modelling study quickly followed suggesting the SDIL could reduce the direct contribution of the soft drinks industry to the UK economy. 

These concerns about economic harm to the industry, however, do not appear to have materialised, according to a recent research, published in Economics & Human Biology, led by PHI|Lab members Dr Cherry Law, Dr Laura Cornelsen and Professor Richard Smith, in collaboration with researchers from Cambridge and Bath Universities. 

Using Office for National Statistics monthly data from April 2010 to March 2019, we assessed the changes in the domestic sales of the UK soft drinks manufacturers* after the SDIL announcement in March 2016 as well as the implementation in April 2018. An interrupted time series analysis was conducted to identify the actual changes in domestic sales while controlling for underlying trends, overall economic environment and changes in soft drinks prices. 

Our results show some evidence of a short-term negative impact of the SDIL announcement on the domestic turnover of the UK soft drinks manufacturers. This effect, however, did not continue post-implementation. This suggests that manufacturers were, to a large extent, able to mitigate the effects of levy before it came into effect. 

This research showcases that SSB taxes, such as the SDIL, do not necessarily cause significant losses to soft drinks industry if the tax structure is carefully designed to motivate reformulation and thus achieve the goal of sugar reduction. More broadly, it also illustrates that by giving sufficient time for industry to react to policy changes, governments can potentially achieve the goal of improving public health while minimising negative impacts on industry.

*This includes the manufacturers of soft drinks, bottled waters and non-alcoholic flavoured and/or sweetened waters, but excludes the manufacture of fruit and vegetable juice, milk-based drinks, coffee, tea, maté products, alcohol-based drinks, non-alcoholic wine, non-alcoholic beer and ice. 

Reference:
Law C, Cornelsen L, Adams A, Pell D, Rutter H, White M, Smith R (2020) “The impact of UK Soft Drinks Industry Levy on manufacturers’ domestic turnover” Economics & Human Biology
https://doi.org/10.1016/j.ehb.2020.100866

Posted in Research | Comments Off on Sugar levy did not decrease the domestic sales of UK soft drinks manufacturers

A message from Professor Peter Piot

Dear Alumni,

I would like to update you on the situation at LSHTM regarding COVID-19 and to convey to you that we are continuously thinking about our alumni community during these times of uncertainty and anxiety.

Since January, we have been monitoring closely and responding to the COVID-19 situation as it unfolds around the world. The skills and expertise of our staff mean that we are uniquely placed both to mount outbreak response efforts and to advise on their planning and mitigation. Working around the clock, our experts are providing accurate information and advice to governments, industry and the public around the world. Here is a link to the COVID response work of the School.

It was inspiring to see the leadership of LSHTM alumni early in the crisis, be it in international organisations such as WHO, or nationally. We are also grateful to you for reaching out to the Alumni team and the school to promote your initiatives. For example, the LSHTM community came together at the start of the outbreak to translate data from Mandarin, making data and information accessible.

This is the time to show what we stand for: health equity in a world globally connected.

We know that our alumni are here for LSHTM. I want you to know that LSHTM is here for you.

Best wishes, 
Peter

Click here to support our researchers continue their real time response to this outbreak.

19 – 25 March

A snapshot of media coverage on COVID-19.

Since 1 January, LSHTM has featured in more than 13,000 pieces of coverage on the coronavirus outbreak across print, broadcast and online.

Many thanks to colleagues who are sparing the time to conduct media engagement in a period when it is vital for the public to receive informed, clear and accurate information on COVID-19.

Annelies Wilder-Smith speaks to…

(25/03) The Guardian about the likelihood of a COVID-19 vaccine being ready before the end of the year. Annelies said: “Like most vaccinologists, I don’t think this vaccine will be ready before 18 months”

(24/03) Al Jazeera about whether the UK’s strategy to curb COVID-19 transmission has gone “far enough”. Annelies said: “With these social distancing measures, there will be a flattening of the curve. But people must be aware it will take a week or two before we see the curve flattening. Until then, we just have to obey the government.”

(24/03) The New York Times (£) about the prevention of profiteering during the COVID-19 outbreak, amidst a surge in private clinics selling ‘scarce’ testing kits at inflated prices. Annelies said: “While I am all for liberal and extensive testing, and am not against the private sector offering testing, the government needs to clamp down on any exploitation during a time of crisis.”

Martin Hibberd speaks to…

(25/03) NewScientist about whether individuals can develop immunity to reinfection after recovering from COVID-19. Martin said: “The evidence is increasingly convincing that infection with SARS-CoV-2 leads to an antibody response that is protective. Most likely this protection is for life. Although we need more evidence to be sure of this.”

(23/03) BBC Panorama (from 12:31) about the need for widespread testing in the UK to combat the outbreak. Martin said: “We can see now that they have ramped up mass testing and we’re now building up relatively slowly compared to some other countries… I would say too little too late.”

(23/03) The Telegraph about the prospects of a new antibody test which can tell whether people have been infected with coronavirus in the past. Martin said: “When this diagnostic does become available, I think it will become a big help in tackling the disease. Most likely this will be reserved for frontline healthcare workers and other key workers first and perhaps vulnerable groups later, before becoming more widely available.”

(20/30) The Telegraph about the difficulty if comparing COVID-19 case numbers across countries, due to discrepancies in testing. Martin said: “It’s too early to make a comparison across Europe. We do not have detailed serosurveillance of the population and we do not know how many asymptomatic people are spreading it.”

(19/03) Reuters about herd immunity. Martin said: “When about 70% of the population have been infected and recovered, the chances of outbreaks of the disease become much less because most people are resistant to infection.”

Sally Bloomfield speaks to…

(25/03) The Sun about the risk of COVID-19 exposure from food packaging. Sally said: “Although hands and hand contact surfaces are thought to be a major contributor to spread, the main risk comes from hand contact surfaces recently and frequently touched by many other people.”

(23/03) BBC Radio London (from 1:08) about social distancing guidance for individuals who are living with those at increased risk of severe illness from COVID-19. Sally said: “You have to behave in the home as if you might be infected. That means keeping your distance from the people who are self-isolating.”

(23/03) Daily Mail about whether businesses such as hair salons should remain open during the pandemic. Sally said: “On the basis that we should limit any non-essential social interaction, hair salons should be closed to fall in line with the other measures that have been introduced.”

Adam Kucharski speaks to…

(25/03) The Guardian about why COVID-19 prevalence data should be treated with caution. Adam said: “We have to make the best use of the data we’ve got when analysing the epidemic, but given that only a proportion of cases are being reported, we should be very cautious about assuming the case counts reflect the actual level of infection out there.”

(24/03) The Times (£) about the need to address coronavirus misinformation online. Adam said: “To tackle the unprecedented situation we are facing with COVID-19, we don’t just need to control the virus. We also need to find ways to deal with the viral information that spreads alongside it.”

(23/03) BBC Breakfast about the importance of social distancing during the COVID-19 outbreak. Adam said: “It’s not just a case of meeting one or two fewer people per day. We really need a massive reduction in our interactions to bring this under control.”

(23/03) The Guardian about the need to consider time lag between infection and death when calculating case-fatality rate from the coronavirus. Adam said: “Strictly speaking we should say something like: transmission in the UK four weeks ago was where Italy was about six weeks ago.”

(21/03) The Daily Express about the importance of collecting data on young people to inform COVID-19 transmission. Adam said: “One of the challenges with survey data is you get much more participation in older age groups. To have these young groups, young professionals, is just fantastic, we don’t have this in such a scale anywhere else.”

(20/03) Vox about the longevity of the coronavirus outbreak. Adam said: “I think this idea that if you close schools and shut restaurants for a couple of weeks, you solve the problem and get back to normal life — that’s not what’s going to happen. The main message that isn’t getting across to a lot of people is just how long we might be in this for.”

(19/03) BBC News about whether lockdown measures alone can curb the spread of COVID-19 in the UK. Adam said: “This idea that we can seal off London isn’t necessarily going to prevent us having a very serious crisis in the rest of the country too.”

Martin McKee speaks to…

(25/03) The Telegraph (£) about the need for international consensus around the classification of COVID-19 cases. Martin said: A pandemic is, by definition, a global problem. The response is only as strong as its weakest link. If one country is failing to collect data accurately, then our picture is by definition incomplete.

(23/03) The Washington Post (£) about the pressure placed on health systems around the world, amidst the current pandemic. Martin said: “The problem is that health systems, we talk about them as adaptive, but they have the capacity to fall over. They can expand so much, but at some point, the whole thing collapses.”

(23/03) LBC about why it’s not possible to truly compare like-with-like when it comes to assessing the outbreak in different areas of the UK. Martin said: “We need to look at the country as a series of regions rather than looking at the country as a whole, because the picture is clearly different in London from what it is in other parts of the country. And with that, there needs to be severe restrictions in London.”

Kalpana Sabapathy speaks to…

(24/03) Daily Express about whether drinking warm water can kill the coronavirus. Kalpana said: “One gaping hole in it is the likelihood that you managed to flush the viral particles down into your stomach. You would probably have already got them in your nostrils by then, for example – it’s not fool proof.”

(21/03) BBC News about why masks are not an effective preventative measure against COVID-19. Kalpana said: “They end up being counterproductive because what happens is, it’s irritating, it makes you sweaty, it itches. People then end up touching their face and touching the areas that are inadvisable to.”

John Edmunds speaks to…

(24/03) BBC Radio 4 (from 21:18) about the lag between the implementation of travel restrictions and their impact on the COVID-19 curve. John said: “It looks like the NHS is going to reach capacity in the next couple of weeks and because of these lags, we have to take rapid action right now to stop the epidemic growth.”

(19/03) Science Focus about reducing the reproduction number of COVID-19. John said: “All the measures that we have put in place will reduce R0. Exactly by how much is hard to say at this time, as we have never tried these measures before. But overall, we would expect them to reduce R0 to a low level – even to below 1. The aim is to try and reduce transmission and minimise the size of the epidemic.”

Jimmy Whitworth speaks to…

(22/03) The Guardian about the COVID-19 situation worldwide. Jimmy said: “This disease is going to stick with us for a long time. It is going to be an experience that none of us have had before in our lifetimes.”

(21/03) LBC about the importance of protecting frontline hospital workers amidst strains on the NHS. Jimmy said: “We need to make sure the people who work in intensive care are not getting completely exhausted or not able to protect themselves as well as they should because they’re so tired. We need to make sure we’re able to actually manage the flow of patients through hospitals.”

David Heymann speaks to…

(23/03) David Heymann speaks to BBC World Service about how the 2003 SARS outbreak has aided Hong Kong’s response to COVID-19. David said: “Now they are having quite good success in dealing with this outbreak. In particular, they have been able to get the population to understand clearly how they can protect themselves and others if they themselves are sick by wearing a mask.”

(20/03) The Sun about the aftermath of China’s mass lockdown measures. David said: “The measures had succeeded in stopping spread to other regions. The concern is what will happen after they end these measures.”

Other LSHTM experts…

(25/03) An exclusive live COVID-19 Q&A co-hosted by Jimmy Whitworth and Heidi Larson was featured in PR Week. Katie Steels, Head of Communications and Engagement said: “Giving a global audience the opportunity to interact with such senior scientists in real time offers value to communities around the world – especially during an outbreak which is evolving so rapidly day by day.”

(25/03) On Channel 4 News, Stephen Evans cautions that people suffering from COVID-19 like symptoms should avoid self-medicating with chloroquine. Stephan said: “The precautions required and the dangers of it interfering with or being affected by other medicines are very extensive. It is vital to listen to medical advice from people who know rather than relying on statements from those without detailed medical knowledge.”

(25/03) In The Independent, Rob Hughes highlights the critical need to reduce the strain on the NHS. Rob said: “We all must do everything we can to flatten the curve of the COVID-19 epidemic while also rapidly scaling up hospital capacity. At the same time, we need to not miss opportunities to reduce the demands on NHS emergency services through implementing policies which we know work to keep people safe and out of overstretched hospitals.”

(25/03) In Newsweek, Brendan Wren comments on a report by Imperial College London that found China have appeared to been able to ease social distancing measures without COVID-19 returning. Brendan said: “The latest data from Wuhan is encouraging and points the way to implementing strict social distancing measures in getting the epidemic under control. However, we still have no idea of the proportion of the population who are still susceptible to the potential re-emergence of the virus.”

(25/03) Stefan Flasche is quoted in CNN about how the virus’s peak is influenced by the efficiency of lockdown measures. Stefan said: “One scenario is we can indeed reverse the spread as done in China and South Korea, then reach a point to lift the distancing measures. But we may have to repeat this cycle for a few times because of an inevitable resurgence of cases in the absence of population immunity. In that scenario, we would see multiple peaks in the upcoming 12 months.”

(25/03) Edward Parker talks to Sky News about the importance of individuals reducing their viral load. Edward said: “It is crucial for us to limit all possible exposures to COVID-19, whether these are to highly symptomatic individuals coughing up large quantities of virus or to asymptomatic individuals shedding small quantities.”

(25/03) Richard Coker comments on the case of three UK immigration detention centres detaining people with coronavirus symptoms in Forbes. Richard said: “It is plausible and credible that 60 per cent of detainees could become infected with COVID-19 in a matter of weeks.”

(25/03) Edmong Ng and Leesa Lin discuss the negative impacts of racism on curbing the spread of COVID-19 in China Daily. Edmond said: “Stigmatization may alter the health-seeking behavior of those being discriminated against and may contribute to an increase in the disease spreading.” Leesa added: It creates an untrue impression that some members of society have somehow done something wrong or are less human than the rest of us, which feeds stigma and undermines empathy.”

(23/03) In International Business Times, Mark Jit explores the “best and worst-case scenario” after the COVID-19 outbreak ends. Mark said: “It’s not like a Hollywood movie with a clear ending where everyone is saved, or everyone dies, quickly. The best-case scenario is that we have vaccine in 12 or 18 months and then our lives go back to normal. In the worst-case scenario it takes a long time for a vaccine to be developed, and the world is really changed and our lives aren’t the same again.”

(22/03) Roz Eggo explains to Al Jazeera how different testing policies in countries around the world affect the reliability of COVID-19 prevalence data. Roz said: “A confirmed case in one country doesn’t represent the same confirmed case elsewhere. Some countries only test hospitalised cases. Others test suspected cases in the community. This makes it challenging to interpret and understand the true number of infections out there.”

(20/03) Charlotte Warren-Gash discusses the mixed evidence on whether individuals with COVID-19 should take ibuprofen in The Independent. Charlotte said: “Research is needed into the effects of specific NSAIDs among people with different underlying health conditions, which takes into account the severity of infection.”

(20/03) Beate Kampmann explains the vaccine development process step-by-step in inews. Beate said: “Issues such how easy it is to make the vaccine for millions of people and its availability and costs are considerations when choosing between more than one.”

(19/03) Peter Piot features in CNN’s exclusive flagship Amanpour programme, and explains what we know so far about the coronavirus and how to fight it. Peter said: “It will not be possible to eliminate, to wipe out this virus unless we have an effective vaccine. But what we can do is limit the damage and make sure that people are not dying. And therefore the strategy is to flatten the curve so that not everybody gets infected at the same time, so that the health systems are not overwhelmed.”

Further LSHTM coverage

Alan Dangour speaks to NHK World-Japan about the impact of our changing diet on population health. Alan said: “The evidence is overwhelming. The food system will be enormously challenged by environmental change. We need to act.”

In Devex, Rachel Lowe explains how climate change is having an effect on vector-borne diseases such as malaria. Rachel said: “Variation in climatic conditions, such as temperature, rainfall patterns, and humidity, impact the abundance and longevity of the mosquito, the development of malaria parasites in the mosquito, and, subsequently, malaria transmission.”

On social media

This week’s social media highlight comes from Twitter, where we hosted our second live COVID-19 Q&A with Heidi Larson and Jimmy Whitworth. The live stream was viewed by over 8,000 users on Twitter and YouTube.

COVID-19 Stories

We are so proud of all of our alumni working tirelessly around the world during the COVID-19 outbreak. This is a very challenging time for everyone and we understand that you may be extremely busy and we want you to know we are here for you. We want to share your stories, to show that we are all in this together.

Are you involved in responding to the COVID-19 pandemic? Have you personally had symptoms and would like to share your story? How has your work been affected?

We would love to hear from you all either now if you have time or when the outbreak has slowed. You can contribute in a variety of ways:

  • Write a blog post for our alumni blog: We can provide a blog template to guide you or you can write freely.
  • Send a video: You can do this on any device you wish, either describing your whole COVID-19 experience, capturing a particular moment or sharing what you day consists of.
  • Send a picture: Capture a picture or series of pictures that describes your pandemic experience, write captions to explain what these mean to you.
  • Be interviewed for our LSHTM Viral podcast: Share your story on our global health podcast focusing on the science behind outbreaks and how we respond to them.

To get started please contact alumni@lshtm.ac.uk.
We will be sharing your stories on our Twitter, Facebook and LinkedIn pages.

To note – If identifiable individuals appear in your photo or video, please ensure that you have their permission before submission. 

Self-isolating in a shared space: a quick guide

Let’s face it – the closet introvert in all of us probably quite likes the sound of a bit of self-isolating. You get to hide away in your room, get food delivered to you and not have to make any social plans.

But with so many of our students living in house shares or halls of residence with shared facilities, you may be wondering how best to self-isolate, whether that’s just as a precaution or because one of your household is showing symptoms.

We’ve rounded up some of the top tips for keeping you and your household safe and well during this difficult time:

Keep yourself to yourself

The government’s advice is to stay in a well-ventilated room with an open window and the door closed, keeping separate from others. So while that means being alone, you don’t have to be lonely: make sure you keep in social contact with others via telephone and online, and regularly let friends and family know how you are coping. Try to use communal areas only when no one else is there, and wear a facemask if one has been issued to you.

Using the kitchen

Avoid using a shared kitchen while others are using it, and take meals back to your room to eat (finally, an excuse to eat in bed while gorging on trash TV!). If you have a dishwasher, use it to clean and dry your crockery and cutlery, but if not wash them by hand using detergent and warm water and dry them thoroughly, using a separate tea towel.

Using the bathroom

Experts suggest using a separate bathroom to the rest of the household. As for many of us that simply isn’t possible, you’ll just have to make sure you give it a thorough clean more often – on the upside, with the change in seasons now is the perfect time for ‘spring cleaning’! Try to draw up a rota to share the responsibility, but if a member of the household is self-isolating because of symptoms they should be the last to use the bathroom and ensure they clean it afterwards. They should also use separate towels from anyone else in the house for drying themselves after showering, bathing or washing their hands.

Communicate with each other

Potential is high in this situation for things to get a bit tense around the house, so make sure you keep communicating with those you live with. Acknowledge your feelings to one another and decide together how best to handle the situation. Create boundaries that you can all stick to or adapt as needed, and you will be able to emerge with friendships intact.

* * * * *
So remember, while the above is not an ideal way of living, by taking these simple steps we can help safeguard our own health and the health of those we live with. And in the meantime we can look out the window, enjoy the upturn in weather and look ahead to better times to return, hopefully, soon.

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