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Monday 17th of August 2020
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There was no one named Floyd in her life. Still, that was the start. Even before she saw the little girl in the red pinafore, there were those disconnected words.@NewYorker Misc. |
Bill drove around the curve. A pair of black crows, plump and shiny, lifted off from something pasted to the macadam in a splat of blood. They had eaten so well that Carol wasn’t sure they were going to get out of the way until they did. There were no crosses, not on the left, not on the right. Just roadkill in the middle, a woodchuck or something, now passing beneath a luxury car that had never been north of the Mason-Dixon Line.
But there was another sign. It was Mary the Mother of God, the ghost of all her childhood days, holding out her hands the way she did on the medallion Carol’s grandmother had given her for her tenth birthday. Her grandmother had pressed it into her hand and looped the chain around her fingers, saying, “Wear her always as you grow, because all the hard days are coming.” She had worn it, all right. At Our Lady of Angels grammar and middle school she had worn it, then at St. Vincent de Paul high. She wore the medal until breasts grew around it like ordinary miracles, and then someplace, probably on the class trip to Hampton Beach, she had lost it. Coming home on the bus she had tongue-kissed for the first time. Butch Soucy had been the boy, and she had been able to taste the cotton candy he’d eaten.
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Madagascar president's herbal tonic fails to halt Covid-19 spike @BBC Africa |
Hospitals in Madagascar have been struggling to cope with a surge of Covid-19 cases, while the president has been promoting an unproven product he says can cure the disease despite the World Health Organization (WHO) warning against using untested remedies.
Cases have quadrupled in the past month in the Indian Ocean island, with more than 13,000 infections and 162 deaths from coronavirus, which has spread to all but one of its 22 regions.
Despite the spike, President Andry Rajoelina stands by the herbal concoction called Covid-Organics, which was launched to great fanfare in April.
"Just because we have condoms, does that mean we shouldn't be careful about Aids or that Aids is over? It's the same thing," says the president's communications director Rinah Rakotomanga.
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Africa reported its millionth official COVID-19 case last week, it seems to have weathered the pandemic relatively well so far, with fewer than one confirmed case for every thousand people @ScienceMagazine Africa |
After testing more than 3000 blood donors, Uyoga and colleagues estimated in a preprint last month that one in 20 Kenyans aged 15 to 64—or 1.6 million people—has antibodies to SARS-CoV-2, an indication of past infection.
That would put Kenya on a par with Spain in mid-May when that country was descending from its coronavirus peak and had 27,000 official COVID-19 deaths.
Kenya’s official toll stood at 100 when the study ended. And Kenya’s hospitals are not reporting huge numbers of people with COVID-19 symptoms.
Other antibody studies in Africa have yielded similarly surprising findings.
From a survey of 500 asymptomatic health care workers in Blantyre, Malawi, immunologist Kondwani Jambo of the Malawi–Liverpool Wellcome Trust Clinical Research Programme and colleagues concluded that up to 12.3% of them had been exposed to the coronavirus.
Based on those findings and mortality ratios for COVID-19 elsewhere, they estimated that the reported number of deaths in Blantyre at the time, 17, was eight times lower than expected.
Scientists who surveyed about 10,000 people in the northeastern cities of Nampula and Pemba in Mozambique found antibodies to SARS-CoV-2 in 3% to 10% of participants, depending on their occupation; market vendors had the highest rates, followed by health workers.
Yet in Nampula, a city of approximately 750,000, a mere 300 infections had been confirmed at the time. Mozambique only has 16 confirmed COVID-19 deaths.
Yap Boum, a microbiologist and epidemiologist with Epicentre Africa, the research and training arm of Doctors Without Borders, says he found a high prevalence of SARS-CoV-2 antibodies in people from Cameroon as well, a result that remains unpublished.
So what explains the huge gap between antibody data on the one hand and the official case and death counts on the other?
Part of the reason may be that Africa misses many more cases than other parts of the world because it has far less testing capacity. Kenya tests about one in every 10,000 inhabitants daily for active SARS-CoV-2 infections, one-tenth of the rate in Spain or Canada.
Nigeria, the continent’s most populous nation, tests one out of every 50,000 people per day. Even many people who die from COVID-19 may not get a proper diagnosis.
But in that case, you would still expect an overall rise in mortality, which Kenya has not seen, says pathologist Anne Barasa of the University of Nairobi who did not participate in the country’s coronavirus antibody study.
(In South Africa, by contrast, the number of excess natural deaths reported between 6 May and 28 July exceeded its official COVID-19 death toll by a factor of four to one.)
Uyoga cautions that the pandemic has hamstrung Kenya’s mortality surveillance system, however, as fieldworkers have been unable to move around.
Marina Pollán of the Carlos III Health Institute in Madrid, who led Spain’s antibody survey, says Africa’s youthfulness may protect it. Spain’s median age is 45; in Kenya and Malawi, it’s 20 and 18, respectively.
Young people around the world are far less likely to get severely ill or die from the virus. And the population in Kenya’s cities, where the pandemic first took hold, skews even younger than the country as a whole, says Thumbi Mwangi, an epidemiologist at the University of Nairobi.
The number of severe and fatal cases “may go higher when the disease has moved to the rural areas where we have populations with advanced age,” he says.
Jambo is exploring the hypothesis that Africans have had more exposure to other coronaviruses that cause little more than colds in humans, which may provide some defense against COVID-19.
Another possibility is that regular exposure to malaria or other infectious diseases could prime the immune system to fight new pathogens, including SARS-CoV-2, Boum adds.
Barasa, on the other hand, suspects genetic factors protect the Kenyan population from severe disease.
It’s not at all clear whether antibodies actually confer immunity, and if so, how long it lasts, Gray notes—in which case, she asks, “What do these numbers really tell us?” |
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COVID-19 in Africa: Dampening the storm? @ScienceMagazine Africa |
Coronavirus disease 2019 (COVID-19) has spread rapidly and extensively to most countries in the world, resulting in considerable mortality in Europe and the United States, as well as in numerous upper-middle-income countries in South America and Asia. Experts predicted millions of COVID-19 deaths in Africa because many countries in the continent rank poorly on the United Nations Development Programme's Human Development Index. However, more than 4 months after the first cases in Africa were detected, prevalence and mortality are still low. It remains unclear if Africa is really spared from substantial cases and deaths. However, differences between Africa and the most affected countries in reliable reporting and death registration, lockdown stringency, demography, sociocultural aspects, environmental exposures, genetics, and the immune system could help to explain the experience of COVID-19 in Africa.
Population densities are very high in most African capital cities such as Dakar (12,617 persons/km2), Abidjan (11,155 persons/km2), or Lagos (13,909 persons/km2), whereas New York City has 7101 persons/km2
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“All the world’s a stage” Africa |
All the world’s a stage,
And all the men and women merely players;
They have their exits and their entrances;
And one man in his time plays many parts,
His acts being seven ages. At first the infant,
Mewling and puking in the nurse’s arms;
And then the whining school-boy, with his satchel
And shining morning face, creeping like snail
Unwillingly to school. And then the lover,
Sighing like furnace, with a woeful ballad
Made to his mistress’ eyebrow. Then a soldier,
Full of strange oaths, and bearded like the pard,
Jealous in honour, sudden and quick in quarrel,
Seeking the bubble reputation
Even in the cannon’s mouth. And then the justice,
In fair round belly with good capon lin’d,
With eyes severe and beard of formal cut,
Full of wise saws and modern instances;
And so he plays his part. The sixth age shifts
Into the lean and slipper’d pantaloon,
With spectacles on nose and pouch on side;
His youthful hose, well sav’d, a world too wide
For his shrunk shank; and his big manly voice,
Turning again toward childish treble, pipes
And whistles in his sound. Last scene of all,
That ends this strange eventful history,
Is second childishness and mere oblivion;
Sans teeth, sans eyes, sans taste, sans everything. |
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