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Secret Intelligence Service
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(C-I) Unit Principal Officer
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Recent appears last
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Secret Intelligence Service
(C-I) Unit. 28 02 2020
Seminars. Harrogate > Virtual Secure Room <
Hello, this will be an involved series of discussions on the topic :
SARS-CoV-2. Covid-19 and Emerging Variants
> The Threat of Infectious Disease to the United Kingdom <
> The Global Pandemic : The Consequent Threat and its Enormity <
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(Note : During the past weeks and for the forseeable future we are using the secure virtual room)
Note (i) The following has certain sections omitted. (ii) Visual materials and documents are not included.
(ii) Certain is excluded in its entirety
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Recent Appears Last
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Here are my own outline notes. They are far from all inclusive but do, I hope, suggest a useful direction for us to take.
It is the case that certain of the biggest/worst infectious disease threats in humankind’s history have been dealt with, such as; polio, diptheria and smallpox. However . . . the detection and control of infectious diseases is an on-going and evolving story. Recent threats have included viral agents such as Ebola, Zika and Influenza, and now we are witnessing rapid increases in the rate of drug resistance in numerous infectious pathogens. In our globalised/interconnected world where physical interactions between people are faster than ever before, diseases can spread far and wide in a short space of time.
Running parallel to these challenges is the development of altogether new technologies that will deliver enhancements to detection and control capabilities. These include the following; rapid communications and genome sequencing – which provide the tools to rapidly share information and advice, bringing greater accuracy to investigations.
There are ongoing opportunities to harness and embed new technologies, to link and integrate data, and improve surveillance. Combined with the thorough exploitation of new technologies and expertise, including whole genome sequencing, it is predicted that further opportunities to deliver faster and more precise responses to control infectious diseases will occur.
Preventing
Protecting
Detecting
Controlling
Preparing
Responding
Building
Applying
Advising
Collaborating
Generating
Sharing
Protecting susceptible people in our population from acquiring infections
Using networks, data and capabilities to recognise and manage cases, clusters, outbreaks and incidents of infectious disease
Proactively planning and responding to emerging infectious disease threats locally, nationally and globally
Through research, evaluation, translation and innovation to develop, drive and evaluate new approaches to detecting and responding to infectious diseases
Working with partners to strengthen the ability of the health protection system to respond to infectious diseases
Utilising core functions and strategic priorities to generate information on interventions that prevent and control infections and improve public health
Optimising vaccine provision and reduce vaccine preventable diseases in the United Kingdom
Capitalising on emerging technologies to enhance our data and infectious disease surveillance capability
Strengthening the response to major incidents and emergencies, including pandemic influenza
Building evidence to address infectious diseases linked with health inequalities
Integrating and strengthening the U.K’s Health Protection System
Defining the value generated by delivering the Infectious Diseases Strategy
Being a world leader in tackling Antimicrobial Resistance (AMR)
Eliminating Hepatitis B and C, Tuberculosis and HIV and halting the rise in sexually transmitted infections in our population
Embedding Whole Genome Sequencing (WGS) in PHE labs and optimising the use of WGS-based information
Strengthening our Global Health activities to protect health in the United Kingdom and globally………
Secret Intelligence Service
(C-I) Unit. 28 02 2020
Seminar. 29. 02. 2020 Harrogate
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PANDEMIC : A pandemic is a worldwide spread of a new disease. An influenza pandemic occurs when a new influenza virus emerges and spreads throughout the world, and most people do not have immunity.
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Infected individuals produce a large quantity of virus in the upper respiratory tract during a prodrome period, are mobile, and carry on usual activities, contributing to the spread of infection. By contrast, transmission of SARS-CoV did not readily occur during the prodromal period when those infected were mildly ill, and most transmission is thought to have occurred when infected individuals presented with severe illness, thus possibly making it easier to contain the outbreaks SARS-CoV caused, unlike the current outbreaks with COVID-19.
>severe pneumonia with acute respiratory distress syndrome (ARDS) that begins with mild symptoms for 7–8 days and then progresses to rapid deterioration and ARDS requiring advanced life support
Secret Intelligence Service
(C-I) Unit. London. 09 03 2020
From the Seminar (07 03 2020) recent : Harrogate
Including guest who spoke about the 1919 ‘Spanish Flu’ / Influenza pandemic. The topic focus; COVID-19. Seminar II – Notes :
> The responsibilities regarding pandemic preparedness and response
> Relevant advice and guidance
> What is understood – regarding COVID-19 and the diseases it causes
> How the U.K. is preparing for infectious disease outbreaks
> The response to the current COVID-19 outbreak
The current COVID-19 outbreak, which began in December 2019, does present with a very significant challenge for the entire world.
The U.K. government and the delegated administrations, including the health and social care systems, have planned extensively over the years for an event such as this, and the UK is therefore well prepared to respond in a way that offers substantial protection to the public.
This is a novel virus, and new technology and the increasing connectivity of our world means that plans must be kept up to date, so to reflect that illnesses – and news and information regarding illnesses – people travel much more quickly today than ever before.
What the U.K. has done – and plans to do further – to tackle the current COVID-19 outbreak, based on our wealth of experience dealing with other infectious diseases and influenza pandemic preparedness work.
The exact response will be tailored to the nature, scale and location of the threat in the U.K. as our understanding of this is developing.
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Secret Intelligence Service
(C-I) Unit. London. 09 03 2020
From the Seminar (07 03 2020) recent : Harrogate
Including guest who spoke about the 1919 ‘Spanish Flu’ / Influenza pandemic. The topic focus; COVID-19. Seminar II – Notes
Secret Intelligence Service
(C-I) Unit. Seminar topic. 15 03 2020.
Harrogate
The seminar topic is to examine ‘compliance’; given this particular scenario (the condition regarding > quarantining < and the COVID-19 pandemic) what does the maintaining of obedience / compliance suggest? If we are considering a situation whose arrival requires a novel extent of compliance, what objective might information management require? The point being that there is the issue of ‘maintaining lustre’ (becoming quickly familiar with something, thereby in varying extents actively opposing) and therefore maintaining compliance has to involve what is external to the individual / group – in other words removing what was previously voluntary. There are international examples at hand now displaying certain characteristics dictated by the extent of the democratic principles (or otherwise) in operation. We should examine the latter because without wanting to state the obvious; the U.K. owns a particularly unique collective perception of the world and in this certain precious values and expectations. Considering the latter how crucial is it that information management handles this effectively and what is the best way forward?
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Simplistic definitions – objective for achieving maximum effect :
Isolation relates to those who are sick and could transmit their infection to others,”
With isolation, those with symptoms of infection or confirmed diagnoses are separated from the rest of the population, most often in a hospital but also at home. Isolation may involve special hospital rooms with separate ventilation systems to prevent airborne transmission.
Social distancing relates to measures intended to cut down on interactions between people the goal being to slow the spread of a contagious disease. Social distancing may include avoiding or shutting down public transit, working from home, cutting down on hand shaking kisses, and / or banning sporting events.
While the terms are often used interchangeably, quarantine really falls in between these two categories.
Quarantine (quaranta giorni – 40 days) relates to the precautionary isolation of people who there is reason to believe have been exposed to a communicable disease but have not shown signs of infection themselves.
The government has the power to quarantine and / or isolate groups of people suspected to be carriers infectious diseases
In any quarantine situation, there are logistical considerations: How will food be obtained? How will other needs be met? Will the person/s be alone or with a partner, children or roommates? Where do the homeless go? Will there be compensation for lost work hours? How will the condition of those quarantined be monitored?
> How will quarantine be enforced?<
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Secret Intelligence Service
(C-I) Unit. London. 15 03 2020
Secret Intelligence Service
(C-I) Unit.
Seminar. Harrogate. 04 04 2020
We have a guest who will talk on the topic; ‘addressing the challenge posed by COVID-19.’
Here is a precis of the talk :
(C-I)
The focus is on emergency response planning, including containment, treatment procedures, and vaccine development – few would doubt our overriding concern – the urgent need for these measures.
We live in increasingly global, interdependent, and environmentally constrained societies and the COVID-19 pandemic exemplifies these aspects of our world. We are wise therefore to be mindful of an ‘integrated perspective on this disease’, the impacts of which have already shifted into the areas of; economics, international trade, politics, and inequality. Resilience planning should therefore (ideally) deal with these cascading impacts, and prevention efforts (should) require a similarly wide lens so to encompass ecosystems, wild animal disease surveillance, agricultural practices, eating habits, cultural traditions and contexts.
Questions :
Should we be considering a ‘planetary health perspective’ i.e., that encompasses domains of; knowledge, governance, and economic sectors so to better address the challenge posed by COVID-19?
Can we achieve this?
How best to facilitate it?
What are, might be the security implications?
Secret Intelligence Service
(C-I) Unit.
Seminar. Harrogate. 04 04 2020
We have a guest who will talk on; ‘addressing the challenge posed by COVID-19.’
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Note : During the past weeks and for the forseable future we are using a secure virtual room.
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SECRET INTELLIGENCE SERVICE
(C-I) UNIT.
Seminar. 04 03 2020. Harrogate
Hi. The seminar topic is to focus our minds (and others too) on what will continue being the case once ‘things’ are back on fast track. We must remain positive in our thinking!
So, here are my notes (re; on the subject of globalisation) for the discussion, which by the way will take up the afternoon and evening : >>
The requirement is to reflect a continually changing development model, by optimising structure and transforming the drivers of growth.
Indeed, not confined to the U.K. the developing of a modernised economy is an urgent requirement of all nations, so to expand foreign trade, cultivate new types and modes of international trade, and to promote the construction of a strong trading nation.
In the U.K. the task of building a modernised economy has been to expand the real economy sector that focuses on, though not confined to service and advanced manufacturing. > In this way has created a solid foundation to become a U.K. global economic force. <
We will continue implementing innovation-driven development strategies. In mannufacturing, the competition in international trade comes down to quality, brand, and innovation.
U.K. enterprises will continue cultivating advantages in product quality centred on technology, brands, and services; use innovation (novel technologies) to enhance competitiveness; and gradually grasp the international pricing power so as to create a global value chain.
Foreign trade management will continue to be deepened and high-level trade and investment liberalisation and facilitation policy will be continually implemented.
The new types and modes of foreign trade mainly, though not exclusively, include trans-national e-commerce, market procurement trade and a comprehensive foreign trade service platform.
Trans-national e-commerce is a new growth source for foreign trade. Market procurement trade enhances the function of the traditional commodity market. The comprehensive foreign trade service platforms help small and medium-sized enterprises to achieve professional and standardised operations in what is a fiercely competitive international business environment.
In order to actively encourage the development of new trade modes, on the one hand, is the intention to promote the further construction of trans-national e-commerce public service platforms; upgrade financial services; improve logistics, supply chain services and to facilitate enterprises so to carry out trans-national e-commerce business.
In addition we will expand market procurement trade to even more fields which integrate functions of market procurement, e-commerce, convention and exhibition, and modern logistics.
It is necessary to further cultivate and support U.K. enterprises with strong capabilities and to build an all-round service platform for foreign trade.
The U.K. government will continue in a friendly environment for expanding new types and modes of foreign trade.
The U.K. government will continue conducting in-depth studies on new / novel business modes and new / novel economic phenomena such as; global value chain management, cross-border e-commerce….
In addition the timely adjusting of regulatory concepts, supervisory procedures and management, the developing of an altogether modernised / futuristic economy typical of this new era. All the while encouraging, supporting, and guiding the development of the private sector.
The further establishment of the close government-business relationship will further enhance entrepreneurship and guarantee even better and faster development of enterprises, creating a fair and orderly market competition environment, and improvement of the market economy system.
Such close government-business relationships favour healthy atmosphere in which entrepreneurs are respected and become willing to apply new / emerging technologies, to innovate business models, and to continuously accumulate and upgrade core competitiveness…..
SECRET INTELLIGENCE SERVICE
(C-I) UNIT.
Seminar. 04 03 2020. Harrogate
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Secret Intelligence Service
(C-I) Unit. London. 21 03 2020
‘In an extreme situation, one looks into the eyes of death itself, to foresee its approach, not trying to deceive oneself, but to remain true to oneself until the last moment. Not to weaken is a matter of a strong nature, is not taught at school, it must be experienced.’
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Secret Intelligence Service
(C-I) Unit
Principal Officer. London
Covid-19 information / conduit : The content of the Unit discussion / seminar (20-03-2020) will follow anticipated shifts rapidly taking place both at home and internationally. The focus thereby is reflective of the strictest dictate : to present information in the most appropriate manner – and thereby; it be constructive, helpful and serves to build confidence in a positive outcome.
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Secret Intelligence Service
(C-I) Unit.
Seminar. Harrogate. 04 04 2020
We have a guest who will talk on the topic; ‘addressing the challenge posed by COVID-19.’
Here is a precis of the talk :
(C-I)
The focus is on emergency response planning, including containment, treatment procedures, and vaccine development – few would doubt our overriding concern – the urgent need for these measures.
We live in increasingly global, interdependent, and environmentally constrained societies and the COVID-19 pandemic exemplifies these aspects of our world. We are wise therefore to be mindful of an ‘integrated perspective on this disease’, the impacts of which have already shifted into the areas of; economics, international trade, politics, and inequality. Resilience planning should therefore (ideally) deal with these cascading impacts, and prevention efforts (should) require a similarly wide lens so to encompass ecosystems, wild animal disease surveillance, agricultural practices, eating habits, cultural traditions and contexts.
Questions :
Should we be considering a ‘planetary health perspective’ i.e., that encompasses domains of; knowledge, governance, and economic sectors so to better address the challenge posed by COVID-19?
Can we achieve this?
How best to facilitate it?
What are, might be the security implications?
Secret Intelligence Service
(C-I) Unit.
Seminar. Harrogate. 04 04 2020
We have a guest who will talk on; ‘addressing the challenge posed by COVID-19.’
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Secret Intelligence Service
(C-I) Unit. 07 04 2020
Hello to everyone, do please stay safe.
For the seminar today (07 04 2030) Harrogate. I want to discuss the following – here are my notes :
The actions prompted throughout China include the following:
a complete lockdown of cities
active case surveillance
rapid investments in increased testing capacity
isolation of cases
treatment of severe cases
quarantine of cases and high-risk groups
behavioural risk-reduction strategies such as the compulsory use of masks in the general population.
The course of the epidemic curves in China alone has suggested that these measures, indeed some of them at the far extreme, might well have led to significant reductions in transmission as of the later end of March 2020.
China made decisions regarding complex trade-offs between;
(I) the economic and social consequences
(2) the severe health effects on the basis of little historical data.
These actions more than merely ‘suggest’ a way for the U.K. (and other countries) to design responses to the COVID-19 virus pandemic on the basis of their experiences. The encouraging results do provide assurance, in that rapid control might well be possible, >> although with consummate high economic and social costs. <<
We are making similar policy decisions, effectively halting the economy in the hopes of circumventing a massive death toll, but the question persists regarding lockdowns persisting indefinitely.
A new and sustainable normal?
During the ensuing months, we will, inevitably, adopt an assortment of approaches. Through open documentation of these varying policy choices and timelines, and real-time assessments of their effects, we can and must generate evidence to minimise the acute and long-term consequences of this pandemic.
Discussion. Seminar
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Secret Intelligence Service
(C-I) UNIT. London. 08 04 2020
For the extended SEMINAR (09 04 2020. Harrogate), you need to consider the following for the expert presentation on using projection (stochastic) modelling :
The transmission and control of COVID-19 : mathematical modelling. Understanding the early transmission dynamics of the infection and evaluating the effectiveness of control measures is crucial for assessing the potential for sustained transmission to occur in new areas.
Specifically and for example; in combining a stochastic transmission model with data on cases of COVID-19 in Wuhan, PRC – China, and international cases beginning in Wuhan to estimate how transmission has varied over time. Based on these estimates, it is possible to calculate the probability that newly introduced cases might generate outbreaks in other areas. To estimate the early dynamics of transmission in Wuhan, a projection / ‘stochastic transmission dynamic model’ is applicable – so to multiple publicly available datasets on cases in Wuhan and internationally exported cases from Wuhan.
The four datasets fitted to :
daily number of new internationally exported cases, by date of onset, as of Jan 26, 2020
daily number of new cases in Wuhan with no market exposure, by date of onset, between Dec 1, 2019, and Jan 1, 2020
daily number of new cases in China, by date of onset, between Dec 29, 2019, and Jan 23, 2020
proportion of infected passengers on evacuation flights between Jan 29, 2020, and Feb 4, 2020
An additional two datasets for comparison with model outputs, notably :
daily number of new exported cases from Wuhan, in countries with high connectivity to Wuhan by date of confirmation, as of Feb 10, 2020
data on new confirmed cases reported in Wuhan between Jan 16, 2020, and Feb 11, 2020.
Please do stay safe.
(C-I)
Secret Intelligence Service
(C-I) Unit. London. 08 04 2020
For the extended SEMINAR (09 04 2020. Harrogate), you need to consider the following for the expert presentation
SECRET INTELLIGENCE SERVICE
(C-I) Unit. London. 11 04 2020
Seminar 12 04 2020. Secure Room
We shall be discussing a complicated question : ‘How do we perceive the future / new normal?’
You will need to consider all of the relevant factors, per the present situation and moving forwards.
Expect the session to last until evening. More details to follow.
Secret Intelligence Service
(C-I) Unit. London. 11 04 2020
Seminar 12 04 2020
SECRET INTELLIGENCE SERVICE
(C-I) Unit. London. 14 04 2020
Seminar / discussion. We have a Geneticist joining us and will address the topic : The Genomes of COVID-19.
SEMINAR DISCUSSION. 14 04 2020. Secure Room
Here are my very brief notes and a somewhat surface sample of the topic, but it indicates the direction we will be taking and why it is important :
As a virus travels it can mutate while it reacts to the genetics of localised populations, thus creating different strains which may behave in different ways to treatments, vaccines and the body’s immune response.
Generation of sequence data is thereby essential so to track this process.
Data and from international sources is vital in mapping the trends in these mutations.
Analyses of the viral genome are already providing clues to the origins of the outbreak and even possible ways to treat the infection, a need that is becoming more urgent by the day.
Reading the genome (made of RNA) allows researchers to monitor how 2019-nCoV is changing and provides a map for developing a diagnostic test and a vaccine.
The genetics can tell the true timing of the first cases and whether they occurred earlier than it first realised. It can also inform how the outbreak began, from a single event of a virus jumping from an infected animal to a person or from a lot of animals being infected. And the genetics can tell what is sustaining the outbreak, new introductions from animals or human-to-human transmission.
Scientists in China sequenced the virus’s genome and made it available on Jan. 10. 2020, a month after the Dec. 8 2019 report of the first case of pneumonia from an unknown virus in Wuhan. (In contrast, after the SARS outbreak began in late 2002, it took much longer to sequence that coronavirus. It peaked in February 2003 and the complete genome of 29,727 nucleotides wasn’t sequenced until April).
Since the sequencing of the first 2019-nCoV sample, from an early patient, science has completed nearly two dozen more (sequences).
The genome of the Wuhan virus is 29,903 bases long, one of many clues that have led to the belief that it is very similar to SARS.
By comparing the two dozen genomes, science can address the question of when it began. Various samples, including including from Wuhan, have shown a very limited genetic variation, thus concluding this is symptomatic of a relatively recent common ancestor for all these viruses……..
(C-I)
SECRET INTELLIGENCE SERVICE
(C-I) Unit. London. 14 04 2020
Seminar / discussion. We have a Geneticist joining us and will address the topic : The Genomes of COVID-19.
Secret Intelligence Service
(C-I) Unit. Seminar 08 05 2020
Secure Virtual Room
I want the discussion to focus on modelling covid-19, significantly where we might be moving toward.
Here are my notes :
Modelling of the Covid-19 pandemic has been proving to be very challenging. However, there is data which can be used to project resource demands. Estimates of the reproductive number of SARS-CoV-2 does indicate that at the outset of the pandemic, each infected person spread the virus to at least two others, on average. A cautiously moderate estimate was that 5% of the population could well be infected within three months. Preliminary data from China and Italy regarding the distribution of case severity and fatality varied widely. A large-scale analysis from China did suggest that 80% of those infected either were asymptomatic or had mild symptoms, thus implying that demand for advanced medical services might apply to only 20% of the total infected. Of patients infected with Covid-19, approximately 15% had severe illness and 5% had critical illness. Overall mortality ranging from 0.25% to as high as 3.0%. Case fatality rates being higher for vulnerable populations, such as those aged over the age of 80 (less than14%) and those with co-existing conditions (10% for those with cardiovascular disease and 7% with diabetes). Overall, Covid-19 is substantially deadlier than seasonal influenza, which has mortality of roughly 0.1%.
I want the discussion to focus on modelling covid-19, significantly where we might be moving toward.
(C-I)
Secret Intelligence Service
(C-I) Unit. Seminar 08 05 2020
Secure Virtual Room
Secret Intelligence Service
(C-I) Unit. London
Seminar – Secure Virtual Room. 17 05 2020
We were to discuss the issue of; ‘The Covid-19 pandemic and its global destablisation effect.’ However I have changed the orientation to an appropriate beginning point. Here are my notes :
Currently, the major low and a few middle income nations such as; Bangladesh, Brazil, Democratic Republic of Congo, India, Indonesia, Mexico, Nigeria, Pakistan, Philippines, and South Africa, as well as Central American and other nations are beginning to report an increase in COVID-19 cases, but the numbers are still relatively small. For example, these highly populated nations now only account for about 1% of the confirmed cases, even though they represent approximately one-third of the global population.
Almost certainly, this situation will shift in the coming weeks and months. It is likely the current numbers represent under-estimates due to inadequate testing. Lack of access to diagnostic kits comprises one of the many components of weak health systems in resource-poor nations.
Beyond testing, it may turn out that the seasonal nature of some respiratory virus pathogens might well extend to the SARS CoV2. >>Assumption – the cases would decline with warming temperatures, independent of control efforts. (nb. Via lab testing, some are disputing this)<<
However, this would also indicate that though COVID-19 might be peaking in the northern hemisphere this winter and spring, there is a real probability that it will advance into tropical countries and the Southern Hemisphere later this year, 2020. In such case,certain of the nations just mentioned might well be vulnerable to the next wave of SARS CoV2 dissemination.
>> If SARS CoV2 becomes a major respiratory virus pathogen in resource-poor countries of the tropics and subtropics, one might well envision unprecedented levels of global morbidity and mortality. << It is already seen how even strong health systems such as in New York and northern Italy very quickly became completely overwhelmed, and one can only imagine the awful consequences of this virus in the poorest parts of Africa, Asia, and Latin America.
In addition, based on the levels of illness we have seen to date in the Northern Hemisphere, one is especially concerned for the fate of thousands of dedicated doctors, nurses, and other health care providers.
(C-I)
Secret Intelligence Service
(C-I) Unit. London
Seminar – Secure Room 17 05 2020
We were to discuss the issue of; ‘The Covid-19 pandemic and its global destablisation effect.’ However I have changed the orientation to an appropriate beginning point.
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SECRET INTELLIGENCE SERVICE
(C-I) Unit. London.
HARROGATE – REQUIREMENT to ATTEND at Seminar – Including Secure Virtual Room. 21 05 2020
Topic : ‘Our Observations Regarding the Experience of Quarantine on the Public’. Here are MY notes, bring yours :
During an epidemic, though out of the experience of most people, it is usual to become stressed and worried. Common responses of people affected, directly and indirectly, appear to include the following :
A fear of becoming ill and dying. An avoiding of the attendance at health facilities due to fear of becoming infected while there. A fear of losing one’s livelihood, not being able to work during isolation, of being terminated from work. A fear of being socially excluded/placed in quarantine because of being associated with the virus. A feeling of powerless in protecting loved ones and a fear of losing loved ones because of the virus. A fear of being separated from loved ones and caregivers due to quarantine regime. A refusal to care for unaccompanied or separated minors, people with disabilities or the elderly due to fear of infection, because parents or caregivers have been taken into quarantine. A feeling of boredom, loneliness and depression as a result of being isolated. A fear of reliving the experience of a previous epidemic (if such applies).
Emergencies are stressful experiences, but specific stressors particular to the Covid-19 outbreak do affect the population. Stressors appear to include the following :
A risk of being infected and infecting others, especially if the transmission mode of the virus is not 100% clear. Common symptoms of other health problems (e.g. a fever) can be mistaken for Covid-19 and lead to fear of being infected. Caregivers may feel increasingly concerned for their children being at home alone (due to school closures) without appropriate care and support. Risk deterioration of physical and mental health of vulnerable individuals, e.g., older adults and people with disabilities, if caregivers are placed in quarantine if other care and support is not in place.
In addition, frontline workers (nurses, doctors, ambulance drivers, case identifiers, and others) likely will experience additional stressors during the Covid-19 outbreak:
The stigmatisation towards those working with Covid-19 patients appears to remain. Strict bio-security measures :
Physical strain of protective equipment. Physical isolation making it difficult to provide comfort to someone who is sick or in distress. Constant awareness and vigilance. Strict procedures to follow preventing spontaneity and autonomy. Higher demands in the work setting, including longer working hours, increased patient numbers and keeping up-to-date with best practices as information about Covid-19 develops. Reduced capacity to use social support due to intense work schedules and stigma within the community towards frontline workers. Insufficient personal or energy capacity to implement basic self-care. Insufficient information about the long-term exposure to individuals infected by Covid-19. Fear that frontline workers will pass Covid-19 onto their friends and family as a result of their jobs.
The constant fear, worry and stressors in the population during the Covid-19 outbreak can well lead to long-term consequences within communities and families :
A deterioration of social networks, local dynamics and economies. A stigma towards surviving patients resulting in rejection by their communities. Possible anger and aggression against government and frontline workers. Possible mistrust of information provided by government and other authorities. People with developing and/or existing mental health and substance use disorders experiencing relapses and other negative outcomes because they are avoiding health facilities and/or unable to access their care providers
Indeed certain of these fears and reactions spring from realistic dangers, but many reactions and behaviours are also a consequence of a lack of knowledge, rumours and misinformation. Common rumours regarding Covid-19 appear to include the following :
That the Covid-19 only attacks old people and spares young people and children. That the virus can be transmitted through pets and people should abandon their pets. That the use of mouthwash, antibiotics, cigarettes, and alcohol can kill Covid-19. That the disease is pre-meditated and Covid-19 is a bioweapon designed to target specific members of the population. That food is poisoned. That only members of specific cultural or ethnic groups can spread the virus
Social stigma and discrimination can be associated with Covid-19, including towards persons who have been infected, their family members and health care and other frontline workers. >>Steps therefore are being taken to address stigma and discrimination at all phases of the Covid-19 emergency response.<< Care is being taken to promote the integration of people who have been affected by Covid-19 without over-targeting.
Believe it or not, certain people appear to be having positive experiences, such as pride about finding ways of coping and resilience. Faced with disaster, community members often show great altruism and cooperation, and people may experience great satisfaction from helping others. Examples of community activities during the Covid-19 outbreak appear to include the following :
The maintaining of social contact with people who might be isolated using phone calls or text messages. The sharing key factual messages within the community, especially with individuals who do not use social media. The provision of care and support to those who have been separated from their families and caregivers. Continued……….
(C-I) Senior Officer
Secret Intelligence Service
(C-I) Unit. London.
HARROGATE – Requirement to Attend at Seminar – Including Secure Virtual Room. 21 05 2020
Topic : ‘Our Observations Regarding the Experience of Quarantine on the Public’
SECRET INTELLIGENCE SERVICE
(C-I) Unit. London
United Kingdom
Brief precis of notes from Seminar (21 05 2020). Harrogate. Unit. Harrogate
Fostering individual wellbeing and promoting adaptive behaviour change.
Stress (the feeling of not being able to cope with specific demands and events) is normal and can be more pronounced in those whose loved ones are in parts of the world hardest hit by the outbreak. We all have a role to play in helping people cope effectively and manage stress in the current climate of concerns regarding Covid-19 spread.
Thus we are :
>helping to recognise signs of stress
>showing how to relieve anxiety reactions
>presenting accurate and calming information regarding Covid-19 risk
>providing means so to seek further help if / when required
There are key ‘tenets’ for U.K. health – regarding the psychological welfare of our collective public to follow while providing assistance during situations such as the Covid-19 outbreak.
Obviously significant local variation exists in methods of expression which we recognise and basically which are :
The promoting a feeling of safety
Covid-19 is dounbtlessly extremely challenging to one’s psychological sense of safety, bringing worry regarding infection and potentially, death. All interventions do / are restoring a sense of relative safety thus minimising such psychological consequences. In the case of Covid-19, fear is being minimised via education regarding the means of virus transmission, what people can do to protect themselves and accurate information regarding the likelihood of severe illness and risk of death related to the illness.
The promoting of a sense of self
Indeed Covid-19 has engendered feelings of helplessness in respect of preventing infection, of managing the course of illness, and protecting one’s family. Again, such feelings of helplessness and anger have arisen because people hold concerns (erroneous and media generated hype) regarding the government’s perceived transparency and capacity to manage public health (i.e., control the spread of disease). The govt. from the outset has recognised the vital importance of steps outlined in detail that individuals, families, and organisations should and are taking.
The encouraging of active coping that aligns with public health guidance and messaging :
For encouraging people to read Covid-19-related information only from trusted sources. Doing so serves to increase confidence in the ability of people to engage proper courses of action. Information regarding using technology so to support and share information / resources also helps promote ‘community’ (sense of belonging) and a sense of control in responding to this situation.
The encouraging of a sense of being associated
Social support – crucial in dealing with all stressors. During this particular outbreak where people are urged to stay away from those sick, to avoid large gatherings, and may even facing quarantine themselves, such is demanding to maintain. Help in facilitating connectedness therefore, through the use of technology, texting and email mutual support forums, web-based chat rooms and video conference / call – is/has been most important for people separated because of quarantine. In addition, has helped people to confront and work through the anger and guilt they may feel regarding staying away from loved ones during quarantine i.e., the restriction adherence in place.
The upholding of a sense of calm
Personal contacts and messages delivered to the public; health care providers and community managers can and indeed are helping make a stressful time feel less stormy. Providers are also promoting for example, relaxation strategies via requisite apps, advice, and training programmes too. They can also are helping to correct inaccurate negative perceptions / beliefs regarding Covid-19. For their part, public officials are working to reassure and stop the spread of rumours / false perceptions.
The furthering of a sense of optimism
Public communication efforts are focussing on what is being achieved in addressing the outbreak, resources that are available to help those affected by Covid-19, indeed these are optimistic messages relating to very positive aspects of our large-scale response and the time-limited nature of the outbreak, and inspirational accounts of transcending these no less than extremely challenging circumstances.
The encouraging of a perception of best performance !
With the aforementioned ‘tenets’ if you like, all designated are taking requisite steps to boost public trust in the government’s response, thus we are; fostering social connections, fostering the support community and fostering individual wellbeing, and while promoting adaptive behaviour change.
continued
SECRET INTELLIGENCE SERVICE
(C-I) Unit. London
United Kingdom
Brief precis of notes from Seminar 21 05 2020. Harrogate. Unit. Harrogate
Fostering individual wellbeing and promoting adaptive behaviour change.
Secret Intelligence Service
(C-I) Unit. London
Seminar : 01 06 2020 Harrogate / Secure Virtual Room
Discussion : Economic pandemic <> Covid-19 pandemic – which will kill more people – given that and if you agree, throughout history pandemics have shaped political transformation.
Here are my notes. Bring yours.
Do you agree which the supposition that the study of epidemics and pandemics can actually provide a way to understand how societies function, i.e., by assembling values and relationships between individuals their economic systems, if so how precisely and to what extent?
As I said, epidemic diseases in particular and the substantial transformation of the evolution of societies and their (epidemics) impact upon economic/industrial growth can be seen as inextricably linked.
What are the major factors (what activities) with regard to the present? What might be the cause of the appearance of novel viruses during the present time?
Continued on website
Secret Intelligence Service
(C-I) Unit. London
Seminar : 01 06 2020 Harrogate / Secure Virtual Room
Discussion : Economic pandemic <> Covid-19 pandemic – which will kill more people – given that and if you agree, throughout history pandemics have shaped political transformation.
Secret Intelligence Service
(C-I) Unit. London. U.K.
Seminar. Harrogate and Secure Virtual Room . (06 06 2020)
Topic : ‘Ensemble methods and their potential to deliver better / more reliable predictions of the transmission of infectious diseases (such as Covid-19)’.
Note that we have a guest speaker who is an expert in the field of disease transmission prediction. These are my notes and do note also they are very partial because I am not the expert so do not ask me any questions.
The accurate and reliable predicting of infectious disease is invaluable to all who are planning interventions so to decrease or prevent infectious disease transmission. A great variety of models have been developed using different model structures, covariates and targets for prediction. It has been shown that the performance of these models does vary because some tend to perform more usefully or otherwise during different seasons or at differing points within a season. >> Ensemble methods (topic of the discussion) combine multiple models so to obtain a single prediction that draws the strengths of each model.<< Simple, yes! So, in light of this, one can consider as we are going to, that a range of ensemble methods each form a ‘predictive density’ for a target of interest as a ‘weighted sum of the predictive densities from component models’. In the simplest case, equal weight being assigned to each component model and in the most complex case, the weights vary with the region, prediction target, week of the season when the predictions are made, a measure of component model uncertainty, and recent observations of disease incidence. These methods are in fact been applied so to predict measures of influenza season timing and severity (using three component models). Ensemble methods thus can / do offer the potential to deliver more reliable predictions of infectious disease transmission to decision makers.
Secret Intelligence Service
(C-I) Unit. London.
Seminar. Harrogate and Secure Virtual Room . (06 06 2020)
Topic : Ensemble methods and their potential to deliver better / more reliable predictions of the transmission of infectious diseases (such as Covid-19).
Note that we have a guest speaker who is an expert in the field of disease transmission prediction
Secret Intelligence Service
(C-I) Unit. London.
Seminar 18 06 2020 Topic : The Properties (Epidemiology, Virology, and Clinical Characteristics of COVID-19
– guest expert
Here are my own notes but take cogniscance of the fact that this will be an advanced interpretation of what is an extremely complex virus and concomitant situation.
Epidemiology in brief : December 31, 2019 : the Wuhan Municipal Health Committee reported a cluster of 27 pneumonia-like cases of unknown aetiology, including 7 severe cases, with a common reported link to the Huanan Seafood Wholesale Market at Wuhan. Subsequently a new strain of coronavirus was isolated from these patients, differing from prior SARS-CoV and MERS-CoV, though with some sequence similarity. This virus was temporarily named 2019-nCoV by the WHO, and then officially named SARS-CoV-2 by the International Committee on Taxonomy of Viruses.
Although important epidemiological risks include a history of travel from Wuhan or close contact with a patient with COVID-19 during the 14 days before symptom onset, recent studies point to the fact that the Huanan Seafood Wholesale Market in Wuhan may not be the only source of SARS-CoV-2 infection, although 33 out of 585 samples taken from the market did show evidence of SARS-CoV-2. In fact, certain early cases (8.6%–51%) had no epidemiological link with this market. As you know, the main transmission route of SARS-CoV-2 from person to person is respiratory droplets or contact. Other possible routes include aerosol or oral-faecal transmission. Certain groups of any population, especially elderly males and those with underlying diseases are more susceptible to SARS-CoV-2 infection. Children, infants, and pregnant women are also shown to have SARS-CoV-2 infection. New evidence shows that young adults 20 and 55 years of age are also vulnerable to SARS-CoV-2. Based on the first 425 confirmed cases the mean incubation period of the virus is 5.2 days, with a 95th percentile distribution of 12.5 days, and its basic reproductive number is 2.2 – which is lower than the 3.0 for SARS-CoV . More recently, 2 studies showed that the mean incubation period of the virus is 3 days (range, 0–24 days) or 4.75 days (range, 3–7.2 days), respectively. This survey discovered that only 1.18% of patients experienced a direct contact with wildlife, whereas 31.30% had been to Wuhan and 71.80% had contact with people from Wuhan, revealing the complex epidemiology of this outbreak. Notably, 4.5% patients with COVID-19 have no symptoms of pneumonia, highlighting the immense pressure for the early detection of SARS-CoV-2 infection, via lab testing. The basic reproductive number (R0)—the average number of secondary cases generated by a primary case—of SARS-CoV-2 is 1.4–6.47. However, the R0 of SARS-CoV and MERS-CoV is 0.3–1.3 and 2.2–3.7, respectively, indicating that SRAS-CoV-2 may have a higher transmission capacity than SRAS-CoV and MERS-CoV.
Secret Intelligence Service
(C-I) Unit. London.
Seminar 18 06 2020 Topic : The Properties (Epidemiology, Virology, and Clinical Characteristics of COVID-19
– guest expert
Here are my own notes but take cogniscance of the fact that this will be an advanced interpretation of what is an extremely complex virus and concomitant situation.
Secret Intelligence Service
(C-I) Unit. London. 20 06 2020
RE: SEMINAR 21 06 2020. Secure Virtual Room
Topic :
‘’The world is in a new and dangerous place. Many people are understandably fed up with being at home. Countries are understandably eager to open up their societies and economies, but . . . the virus is still spreading very fast, it is still deadly and most people are still susceptible.’’ CDC as of 19 06 2020
Notes. Where might this take us?
>> From extensive reporting of data regarding COVID-19 from different regions of the world, 75% of COVID-19 infection cases and 92% of deaths related to COVID-19 infections have been registered in seven countries. The severely infectious characteristric of COVID-19 : this being, that within a span of seven days the mortality rates have varied considerably. 2–9% Germany, 3.6% France, 4.4% United Kingdom, and so on.
The obtained estimates of lethal duration of exposure provide us with an indication of the casualty rates across the spectrum of COVID-19 disease and eventually will help to implement appropriate strategies to tackle the pandemic by taking necessary and appropriate steps such as precautions, self-sanitisation and isolation, and by social distancing.
It is apparent that the most common pathological symptom observed among those infected with COVID-19 is that the virus damages the alveolar (hollow cup-shaped cavity found in the lung parenchyma where gas exchange takes place. Lung alveoli are found in the acini at the beginning of the respiratory zone. They are located sparsely in the respiratory bronchioles, they line the walls of the alveolar ducts, and are more numerous in the blind-ended alveolar sacs). Briefly, this leads to a respiratory failure and as akin to flu, fever, cold, cough and shortness of breath, along with other severe symptoms, which as observed are; sputum production, haemoptysis, lymphophenia and pneumonia, in some cases increasing dyspnea and hypoxemia in the upper lobe of the lung.
COVID-19 and its associated symptoms will appear during incubation period of 2–14 days. Ads we know, COVID-19 can infect individuals of all ages and genders and can spread easily from one person to another, but the likelihood of getting infected is higher among older population, on various medical conditions, such as, diabetes, cardiovascular diseases, hypertension, cancer and chronic respiratory diseases. Severe illness due to the COVID-19 leads to death – mortality rate of 3% approximately.
In genomic sequence analysis COVID-19 has been found to be similar (82% of SARS-Cov and 50% of MERS-Cov) to earlier coronaviruses, indicating that mammals are more likely to be the link between COVID-19 and humans.
As of now, no vaccine or anti-viral drugs is available against COVID-19 infection for potential therapy. Therefore, precautions, self-sanitisation and isolation, and practicing social distancing are only alternatives measures recommended to control the current outbreak. In order to minimise the transmission and spreading of COVID-19, ‘community-wide containment’ has also been required to be implemented.
Secret Intelligence Service
(C-I) Unit. London. 20 06 2020
RE: SEMINAR 21 06 2020. Secure Virtual Room
Topic :
The world is in a new and dangerous phase. Many people are understandably fed up with being at home. Countries are understandably eager to open up their societies and economies, but . . . the virus is still spreading very fast, it is still deadly and most people are still susceptible. CDC as of 19 06 2020
Secret Intelligence Service
(C-I) Unit. London. 23 06 2020
Seminar. Virtual Secure Room. 24 06 2020
This is a discussion somewhat general in nature – still continuing on Covid-19 series.
Here are my notes. Read them and bring your own.
According to the Lancet Journal of Global Health read on 22 06 2020 (data being derived from 188 countries), 22 per cent of the world’s population (which computes to around 1.7 billion people) are at increased risk of severe COVID-19 if they are infected with the virus as a result of having at least one underlying health condition. We need to consider this.
So, in order to formulate the most appropriate strategy so to protect who are at increased risk one first needs to know how many there are. Simple! Not really.
Estimates focus on chronic clinical conditions and exclude several risk factors but can provide a beginning point for considering the minimum number of people that might require more rigorous/strict social distancing measures. Note that these are being relaxed for the general population.
Severe disease is defined by WHO, thus : a patient with severe acute respiratory illness, that being fever and at least one sign/symptom of respiratory disease – shortness of breath, cough and requiring hospitalisation.
To aid interpretation of the degree of risk among individuals at increased risk, one must estimate the number of individuals at high risk – defined thus as being those that would require hospital admission if infected, calculated using previously estimated age-specific infection, hospitalisation ratios for COVID-19. >> Globally it is estimated that 22% are at increased risk and in this figure; 4% are at high risk. It is also really important to consider how these risks vary by age. <<
Estimates are inexact as you know but should provide useful starting points for designing possible shielding or vaccination (if/when) policies.
Analysis is ideally an attempt to lay down a basis – estimates of numbers at risk by age/sex/country, so that policies can then be designed. >>Units with behavioural science and policy expertise are best suited to design the appropriate measures and make sure they are tailored to the United Kingdom.<<
Secret Intelligence Service
(C-I) Unit. London. 23 06 2020
Seminar. Virtual Secure Room. 24 06 2020
This is a discussion somewhat general in nature – still continuing on Covid-19 series.
SECRET INTELLIGENCE SERVICE
(C-I) Unit. London.
SEMINAR. Virtual Secure Room. 07 07 2020
Topic for discussion : Political control amid the long term considerations of the Covid-19 pandemic upon our society.
Here are my notes :
We know how authoritarian regimes often focus on coercive institutions with the intention of strengthening state capacity. So, given our continuing experience of Covid-19, what is an unprecedented and dramatic imposition upon our society i.e., the quickly burgeoning ‘new normal’ as we perceive it, I want us to focus on every day, informal methods of ‘coercion’.
Informal institutions of control that are created by civil society groups encourage obedience by calling upon the obligations, allegiances and bonds that non-state groups create. Drawing on evidence from qualitative case studies (which we will discuss), it is shown how three mechanisms operate through which informal control occurs :
The cultivating of civil society groups
The co-opting of local somebodies
The infiltrating of society
Consider that informal control fosters compliance with the state but can also backfire in the long run by creating grievances and linking activists to each other. So how might we strategically deploy each of these strategies?
(C-I)
SECRET INTELLIGENCE SERVICE
(C-I) Unit. London.
SEMINAR. Virtual Secure Room. 07 07 2020
Topic for discussion : Political control amid the long term considerations of the Covid-19 pandemic upon our society.
SECRET INTELLIGENCE SERVICE
(C-I) Unit. London 4 07 2020. UK.
Unit Seminar : Virtual Secure Room. 15 07 2020
TOPIC : Estimating the proportion of people >>who have been infected with the coronavirus but have no symptoms<< must be a priority. Why?
Here are my notes (C-I) :
As coronavirus outbreaks surge research teams are trying to understand a crucial epidemiological dilemma, which is : >>> what proportion of infected people have mild or no symptoms and might be passing the virus on to others. Some of the first detailed estimates of these covert cases suggest that they could represent some 60% of all infections. <<
Many have suspected that there is an undetected pool of covert cases showing limited to no symptoms at all, because an increasing number of infected people cannot be linked to known Covid-19 cases or travel to epidemic hotspots. Most people with mild infections would not be sufficiently ill to seek medical help, and would probably slip past screening methods such as temperature checks, so the extent of the phenomenon and its role in virus transmission has remained elusive.
Understanding the proportion of asymptomatic or mildly ill cases is going to be important in any understand what is driving this particular epidemic.
To gauge the extent of covert infections, a team of researchers in China and the USA have developed a model using clinical data from 26,000 lab confirmed cases reported to the health commission of Wuhan, the epicentre of the outbreak, in the Chinese province of Hubei.
As was posted online on 6 March 2020, the group suggested that by 18 February 2020, there were 37,400 people with the virus in Wuhan whom authorities did not know about. Most of those unreported cases were in people who had mild or no symptoms but could still be contagious.
A conservative estimate of at least 59% of the infected individuals were out and about, without being tested and potentially infecting others – public-health expert at Huazhong University of Science and Technology in Wuhan (who apparently led the study). This may explain why the virus spread so quickly in Hubei and is now circulating around the world.
The team’s results are within the range of the estimates of several other studies based on much smaller data sets, such as one at the London School of Hygiene and Tropical Medicine, concluding; that this is the most recent analysis of the best data set and the methodology is sound.
Question : The model assumes that everyone in the community has the same opportunity to be in contact with anyone else. In reality, one has more chances of interacting with a small fraction of people : family, friends and colleagues, By assuming there is homogeneous mixing, the model likelyoverestimates the transmission rate and exaggerates the number of infections with mild or no symptoms. But the result is in the right direction?
Yet another study looked at 565 Japanese citizens who were evacuated from Wuhan during early February 2020 and were repeatedly tested and monitored for the virus and symptoms. In a paper published on 13 March 2020 in the International Journal of Infectious Diseases, a team in Japan reported that 13 evacuees were infected, of whom 4, or 31%, never developed symptoms.
But probably the best-documented evidence for asymptomatic cases has come from the Diamond Princess cruise ship, if you remember, which had a Covid-19 outbreak in early February while in Japanese waters.
The ship was quarantined and the 3,711 passengers and crew members were repeatedly tested and closely monitored.
About 18% of some 700 infected individuals on Diamond Princess never showed symptoms.
One has to keep in mind that this was a special population with lots of elderly people. Older people tend to fare badly when infected with the new coronavirus, so the rate of asymptomatic infections in a general population might be closer to the 31% that the Japanese team reported.
Taking the results from several studies into account, asymptomatic or mild cases combined represent about 40–50% of all infections.
What is viral shedding?
Can people with mild or no symptoms infect others? In a study posted online on 8 March 2020, a German-based team showed that some people with Covid-19 had high levels of the virus in throat swabs early in their illness, when their symptoms were mild. That means the pathogen could easily be released through coughs or sneezes – viral shedding and spread to others.
Another team, in China, detected high viral loads in 17 people with Covid-19 soon after they became ill. Moreover, another infected individual never developed symptoms but shed a similar amount of virus to those who did – The New England Journal of Medicine.
>>>> These are the first detailed analyses of the extent of viral shedding at different stages of the disease. The data confirms what many have suspected : that some infected people can be highly contagious when they have mild or no symptoms. <<<<<
The scale of the problem is still unclear.
SECRET INTELLIGENCE SERVICE
(C-I) Unit. London 4 07 2020
Unit Seminar : Virtual Secure Room. 15 07 2020
TOPIC : Estimating the proportion of people who have been infected with the coronavirus but have no symptoms must be a priority.
UNITED KINGDOM
SECRET INTELLIGENCE SERVICE
(C-I) Unit. London
Seminar. Virtual Secure Room. 17 07 2020
Topic : The 21st century will see a transformation in the story of our human civilisation. Why is this the case?
Here are my notes
Read the article and formulate appropriate questions :
Article. The Lancet. ‘Fertility, mortality, migration, and population scenarios for 195 countries and territories from 2017 to 2100: a forecasting analysis for the Global Burden of Disease Study. July 14. 2020.’
New research * The Lancet, emphasises the importance of population forecasts as a planning and risk management tool so to chart the long-term future with a better understanding of potentially unfolding scenarios amid geopolitical impacts.
Shifts in economic power will be triggered by a decrease of the global population after the middle of this century,
Data provided in the forecasting analysis for the Global Burden of Disease Study suggests that there will be around 9.7 billion people on the planet by 2064, but that the number will decrease to 8.8 billion by the year 2100.
23 countries, including Japan, Spain and Italy, are forecast to witness a decline of their population by more than half.
China, along with another 34 countries, will see a population drop of more than 25 percent.
The trend will not apply to sub-Saharan Africa, which is predicted as seeing close to three-fold population growth due to falling death rates and a growing number of women reaching child-bearing age.
In population growth, south and southeast Asia will concede their current positions as the most populated regions, with the nations of Africa predicted to take the lead.
Niger’s population is set to grow by 765 percent by 2100, Chad’s will grow by 710 percent, South Sudan’s by 594 percent and Mali’s by 321 percent.
North America is set to overtake the region comprising Central Europe, Eastern Europe and Central Asia, as the population of the latter region will be the lowest.
The most marked population drop is to be expected in Latvia (78 percent), and El Salvador (77 percent).
Despite a fall in population of around 300 million people, India, which currently has the world’s second-largest population, will reach the number one within a decade and remain there during 2100.
China will rank third in 2100, with its population to dwindle by over 25 percent.
Nigeria, which currently has the seventh-highest population, will shoot up to second place by 2100.
As for age distribution across the globe, in stark contrast to today, when there are more young people than older people, the population will become more middle-aged by 2100.
Over-80s are predicted to outnumber under-fives by a factor of two-to-one by 2100. This data marks a dramatic change in the working age population, set to impact countries such as here in the UK, China, Spain, and Germany.
The shrinking size of the workforce may stunt economic growth, bringing about geopolitical power shifts, as African and Arab countries surge ahead economically.
Qu : >> Will Africa and the Arab World will shape the future, Europe and Asia receding in their influence? <<
By the end of the century, the world will be multi-polar. This will truly be a new world, one we should be preparing for.
With a dramatically lower birth rate by 2100 in Western countries, such as the US, Australia and Canada, sustaining a working age population will possibly require liberalising their stance on immigration.
The research does chart a future that we need to be planning for. It offers a vision for radical shifts in geopolitical power, challenges myths about immigration. The 21st century will see a transformation in the story of our human civilisation.
SECRET INTELLIGENCE SERVICE
(C-I) Unit. London
Seminar. Virtual Secure Room. 17 07 2020
Topic : The 21st century will see a transformation in the story of our human civilisation. Why is this the case?
SECRET INTELLIGENCE SERVICE
(C-I) Unit. London. 01 08 2020
There is a Unit Seminar 01 08 2020 (Secure Virtual Room) that the Unit MUST attend, with the absence of one, who is still in recovery from facial surgery.
Here are my notes. >> You MUST be prepared for a considerably EXTENDED and INVOLVED day. <<
The Covid-19 pandemic has antagonised both the United Kingdom and the entire world and its challenge remains both urgent and unsolved.
The pandemic marks the third deadly outbreak due to a coronavirus following severe acute respiratory syndrome in 2003, and Middle East respiratory syndrome in 2012.
In the absence of effective testing and contact tracing systems in many countries, Covid-19 as of today (01 08 2020), has caused the deaths of almost 700 000 people that we know of and disrupted quite literally the entire world, sparing no region, anywhere.
In April this year (2020), more than half of the world’s population resided in countries enforcing a lockdown, resulting in massively disruptive impacts on individuals, businesses, and entire sectors of society, such as global travel.
Even countries that have suppressed the pandemic are consequently experiencing incredibly harsh economic effects from the rest of the world. The International Monetary Fund downgraded the decline in global gross domestic product from –3% in April, 2020, to –4·9% in June, 2020.
Although everyone has been affected by the Covid-19 pandemic, poor and vulnerable populations, including low-skilled workers and refugees, are suffering far more than the wealthy in terms of lost lives, vulnerability to infection, declining incomes (including entire loss of income, and unemployment.
>> Effective Covid-19 treatments and vaccines do remain a considerable number of months away at the minimum. <<
So what are WE facing?
Well, to be brief here, the over-riding challenge I think, is to suppress the pandemic as rapidly and decisively as possible. The dire and pressing needs of vulnerable groups such as the poor, minorities and the elderly have to be continually met. The public health emergency has to be prevented from turning into a catastrophic financial crisis for government, business and households. Our society has to be rebuilt in an even better way (we have a govt in the UK very capable of achieving this); with an NHS (free health service) even more irrepressible than it is already, our institutions be these global and an economy transformed accordingly on the basis of sustainable and inclusive development and so on……
(C-I) Intelligence Officer
SECRET INTELLIGENCE SERVICE (C-I) Unit. London. 01 08 2020
There is a Unit Seminar 01 08 2020 (Secure Virtual Room) that the Unit MUST attend, with the absence of one, who is in recovery from facial surgery.
Here are my notes. >> You must be prepared for a considerably extended and involved day. <<
SECRET INTELLIGENCE SERVICE
(C-I) Unit. London. 04 08 2020
Seminar. Virtual Secure Room. 05 08 2020
I want to focus our attention on bio-warfare agents (obviously very highly dangerous infectious diseases including recombitant / gene modified agents). > Specifically relating to the containment thereof within medico-biological and ‘other’ facilities. <
SECRET INTELLIGENCE SERVICE
(C-I) Unit. London. 04 08 2020
Seminar. Virtual Secure Room. 05 08 2020
SECRET INTELLIGENCE SERVICE
(C-I) UNIT. LONDON. 08 09 2020
UNITED KINGDOM
Seminar : Covid-19. Virtual Secure Room. 09 08 2020
Beginning Sunday. 09 08 2020. Note : ALL the Unit will attend.
The expert contributors, over the coming weeks, in view of our shared commitment to excellence and to diversity across gender and sectors of society – will discuss strategies to halt the Covid-19 pandemic and the soundest ways envisaged to date so to promote a reasonable and workable recovery.
What might be the specific dimensions to be addressed? Well, in brief I wanted these to include / cover the following which is more a focus on very specific dimensions i.e., topics regarding :
Broadly, what is the nature, origin, and prevention of infectious diseases caused by pathogens ( infectious agents such as bacteria, a virus, parasites that can / have hopped from a non-human (usually a vertebrate but not always) to a human).
What is the soundest public health system that can be envisaged for surveillance, testing, tracing and isolation of Covid-19 cases?
What is the current development and distribution of a Covid-19 vaccine and medicine?
How best can we protect at our risk groups?
What might be the issues in welfare and mental health with regard to the context of >pandemic control< such as Covid-19?
How to finance pandemic control
The restoring / remodelling of societal norms in the post-Covid-19 economy, so to achieve sustainable development (We have discussed this before but it is necessary to have further, up to date data).
(C-I)
SECRET INTELLIGENCE SERVICE
(C-I) UNIT. LONDON. 08 09 2020
Seminar : Covid-19. Virtual Secure Room. 09 08 2020
Beginning Sunday. 09 08 2020. Note : ALL the Unit will attend.
So, SARS-CoV-2 :
It is prudent to focus on the genomic, transmission and clinical characteristics of SARS-CoV-2, and comprehensively summarise the principles and related details of assays for SARS-CoV-2. In addition to explore the quality assurance measures for these assays.
SARS-CoV-2 has certain unique gene sequences and specific transmission and clinical features that can inform the conduct of molecular and serological assays in many aspects, including the design of primers, the selection of specimens and testing strategies at different disease stages. Appropriate quality assurance measures for molecular and serological assays are required to maintain testing proficiency. Because serological assays have the potential to identify later stages of the infection and to confirm highly suspected cases with negative molecular assay results, a combination of these two assays is needed to achieve a reliable capacity to detect SARS-CoV-2.
.
.
SARS-CoV-2 is a positive-sense single-stranded RNA virus whose genome is of a low stability thus is more prone for mutation accumulation, with approximately 9.8 × 10−4 substitutions/site yearly. The architecture of SARS-CoV-2 is made of two groups of proteins: structural proteins (SP) and non-structural proteins (NSP). SPs are encoded by 4 genes, including E (envelop), M (membrane), S (spike) and N (nucleocapsid) genes. NSPs are mostly enzymes or functional proteins that play a role in viral replication and methylation and may induce host responses to infection. These genes are encoded in several groups, namely ORF1a (NSP1-11), ORF1b (NSP12-16), ORF3a, ORF6, ORF7a, ORF7b, ORF8 and ORF10.
A variant can be as simply as a virus bearing a deviant mutation or complicated combinations of deviations leading to significant phenotypical alteration from original genome. Although by the beginning of May 2021, there has been reported more than 1.4 million sequences and among them 3913 major representative variants genomes that have been identified and included in the global SARS-CoV-2 sequence database operated by Global Initiative on Sharing Avian Influenza Data (GISAID) not all genetic mutations lead to variation in major proteins and/or alter virus infectivity. The spike gene mutations account for most of the clinically influential VOCs while the ORF1a frame of the genome serves as a key region for NSP mutations.
We will focus our discussion here on the VOCs that have major global health impacts since the 4th quarter of the year 2020, including Alpha variant (B.1.1.7), Beta (B.1.351), Gamma (P.1) and Kappa and Delta (B.1.617.1 and B.1.617.2).
Spike protein mediates the virus attachment to human cell surface angiotensin converting enzyme 2 (ACE2) receptor, thus facilitating viral entry during infection. It is split into two subunits, S1 and S2. The S1 unit possess the receptor-binding domain (RBD) which can directly bind to ACE2 receptor and is also the dominant target of neutralizing antibodies (Ab) against SARS-CoV-2. S1 is thus considered a hotspot for mutations that may have high clinical relevance in terms of virulence, transmissibility, and host immune evasion.
The Alpha variant has an N501Y mutation: at the 501 residue, N asparagine has been replaced with Y tyrosine, as well as K417N—lysine K replaced with asparagine N. An emerging variant derived from B.1.1.7 also carries E484K mutation—glutamic acid E replaced with lysine K. Both Beta and Gamma variants have more substitutions other than N501Y. The Beta variant has E484K, while the Gamma variant has the E484K and the K417T mutations. The latest major variants, Delta and Kappa, sharing two mutations E484Q (glutamic acid E substituted by glutamine Q) and L452R (leucine L altered by arginine R) were identified in India’s second COVID-19 wave. Other than the two mutations above, Delta also harbours a unique mutation, T478K (threonine T replaced by lysine K).
The S1 mutations significantly increases the binding affinity to ACE2 while showing lower affinity to neutralizing antibodies suggesting a possible explanation for their occurring higher transmissibility and virulence.
Another mutation at non-RBD sites, named D614G, is the most spreading mutation carried by over 99% of prevalent variants since early 2020. Such mutation does not change the binding affinity to ACE2 or neutralizing Abs for the virion, yet it may increase spike density by preserving the integrity of spike and avoiding S1 shedding.. With more functional spikes available, D614G variants are armed with increased infectivity and hence increased replication in vitro while earlier transmission in vivo. Recently, increasing deletions are observed in the neutralizing Ab-recognizing domain, namely recurrent deletion regions (RDRs), in the N-terminus of S1 subunit. Deletions in RDRs wipe out the epitopes, and eventually aiding the virus evading host’s immune supervision and potentially defecting certain neutralizing Abs or vaccines. A majority of Alpha derived variants (ΔRDR1, S: ΔHV 69–70, & ΔRDR2, S: ΔY144), Beta derived variants (ΔRDR4, S: ΔLAL 242–244) and B.1.36 (ΔRDR3, S: ΔI210) carry this kind of mutation.
Two mutation hot-spots, NSP1 of ORF1a/ORF1ab, and ORF8, have been found related to the virulence and transmissibility. NSP1 is a key protein to antagonize type I interferon induction in the host and benefit the replication of the virus itself.ORF8 is known as an immune-evasive protein that downregulates major histocompatibility complex class I (MHC-I) in host cells.Recently, the Alpha variant, identified from a single immunocompromised individual, was shown to contains a premature stop codon at position 27 of ORF8.
Variants with partial deletion of NSP1 and ORF8 have been identified (e.g., the NSP1: Δ500-532 variant in Sichuan, China, and the ORF8: Δ382 variant in Singapore).Despite that truncated NSP1 and ORF8 both contribute to milder infections and account for less than 5% of infections worldwide, they have become the major variants in Africa since late 2020.
It was shown that S-protein mutation D614G may impact SARS-CoV-2 transmissibility rate due to higher affinity for olfactory epithelium and it was shown to have higher transmissibility in animal models. It was also shown that it has a higher virion stability and was shown to be more resistant to proteolytic cleave as well as higher viral titer in upper airways suggesting that it may potentially affect virus transmissibility and virulence. Yet, it showed increased susceptibility for neutralizing antibodies and no difference in clinical severity nor hospitalization outcomes and mortality was observed.
Evidence suggest that the VOCs Alpha and Beta increased transmissibility rate at ~ 50% especially in younger group ages and children. Alpha variant was shown to increase hospitalizations and mortality that may be attributed to their escape from neutralizing Abs due to their RBD mutations.
The Epsilon variant (B.1.427/B.1.429, California variants) increased transmissibility up to 24% with higher viral shedding, which is attributed to the of L452R spike mutation that was shown to stabilize spike-ACE2 receptor interaction.
Although it is also suggested that other variants such as Gamma, Epsilon variants and recent Iota variants (B.1526, New York variant) may also have increased virulence due to spike mutations that increase affinity to ACE2, there is still no data available regarding viral virulence.
The new VOCs can reduce the detection sensitivity of RT-PCR based diagnostic tools especially when mutations occur in locations where probes and primers may bind. Reports suggest that 79% of the primer binding sites used in the RT-PCR assay are already mutated in at least one genome with the highest significance of the GGG → AAC substitution.Recent analysis which mapped primers or probes binding sites showed a cumulative variants frequency of ≥ 1% in the global SARS-CoV-2 genomes.The Alpha lineage was shown to have higher false-negative results when using specific commercial kits directed to the spike (S) gene but not when using standard protocols such as Berlin-Cherite protocol since it does not involve the S protein-encoding gene as target.Another concern is a variant detected in France of a S deletion (ΔH69-V70) which has shown to be associated with S-gene target gene detection failure in three-target RT-PCR. Several reports have targeted mutations in different open reading frames (ORFs) especially ORF8 position which was found in some isolates from Mexico, Belize and Guatemala as potentially leading to epitope loss and reduced sensitivity for serological testing.
On the other hand, other studies showed that although mismatches in the primer/probes binding regions of SARS-CoV-2 diagnostic assays can be detected in different SARS-CoV-2 variants, they were tolerated and did not result in reduced assay performance and false-negative results. Moreover, according to bioinformatic analysis performed, the known variability occurring in the SARS-CoV-2 population have minimal or no effect on the sensitivity existing diagnostic tools for viral detection.
Still, the continuous emergence of SARS-CoV-2 variants and possible mismatches highlight the importance of global molecular surveillance and designing diagnostic strategies such as combining diagnostic methods during future outbreaks or perform assays that target two or more positions in highly conserved regions of the viral genome to promote higher specificity and sensitivity results as well as developing highly specific diagnostic tools using CRISPR.
Currently, all vaccines are based on introducing spike protein, which is the major superficial virulence of SARS-CoV-2, using the reference genome isolates early in the pandemic. As there is no sufficient evidence to support the effect of vaccines against Delta and Kappa variants, we’ll focus on the Alpha, Beta and Kappa variants.
Two major mRNA-based anti-SARS-CoV-2 vaccines have been approved: BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna). Studies suggest that BNT162b2 vaccines were able to stimulate the recipients to generate capable antibodies to neutralize Alpha and Gamma variants yet being significantly less protective against Beta variant mRNA-1273 was shown to enhance sufficient neutralizing ability against Alpha variant yet lower reciprocal titer against Beta variant.
There are 4 adenovirus-based vaccines that have been authorized for general or emergency use. Among of which, Ad26.COV2.S is a recombinant, replication-incompetent adenovirus serotype 26 (Ad26) vector encoding a full-length and stabilized SARS-CoV-2 spike protein (Janssen) was shown to have reduced efficacies to Beta variant (64%) and Gamma dominant Latin America variant (61%), compared to the U.S. (72%) where Alpha is the dominant strain. ChAdOx1 nCoV-19 (Oxford) is a chimpanzee adenovirus-vectored vaccine expressing the SARS-CoV-2 spike protein. Recent studies revealed that the efficacy of ChAdOx1 nCoV-19 was 74.6% against Alpha but as low as 10.4% against Beta.Gam-COVID-Vac (Ad26 and Ad5) is also claimed protective to the global VOCs, yet the clinical trial result has not yet been publicized. An ongoing clinical trial on the combination of ChAdOx1 nCoV-19 and Gam-COVID-Vac (Russia), which is a heterologous COVID-19 vaccine consisting of two components, a recombinant adenovirus type 26 (rAd26) vector and a recombinant adenovirus type 5 (rAd5) vector, both carrying the gene for SARS-CoV-2 spike glycoprotein. There is no data regarding its efficacy on VOCs.
NVX-CoV2373 (Novavax) contains a full-length, prefusion spike protein, and shows an 86.3% efficacy against Alpha, yet 48.6% against Beta. However, none of the recombinant protein-based vaccines have yet to be approved for general use.
Three inactivated virus- based vaccines have been approved so far and have been widely used in China, India and Brazil. A recent in vitro study suggests that antisera elicited by BBIBP-CorV vaccine (Sinopharm) are able to neutralize the Beta variant in a differentially weaker level compared to the wildtype strain and the D614G variant . A recent serological study has shown that BBV152 (Bharat Biotech International Limited) vaccinated human serum is able to neutralize the Alpha variant.Preliminary data from a study conducted in Sao Paulo, Brazil indicate that the most widely vaccinated vaccine, CoronaVac (Sinovac Biotech), is effective against Gamma variant.The same research facility claimed the vaccine also ‘works well’ against the Alpha and Gamma variants.
To conclude, it appears that Beta is most likely variant to affect the approved vaccines efficiency while Alpha and Gamma variants do not. These results suggest that a new vaccine might be required specifically to target Beta variant. Many strategies are currently under development to cope with Beta variant challenge such as booster vaccines.
Whether specifically targeting spike proteins using small peptide-based therapies or using single-domains neutralizing antibodies against any of those targets, these therapeutic strategies efficiency may be compromised by the emergence of SARS-CoV-2 variants especially those possessing spike proteins and RBD mutations that increase affinity to ACE2 such as Alpha, and Iota variant, by potentially escaping neutralizing antibodies and competing with those agents for the same binding targets. In order to avoid antibody escape, strategies to combine different neutralizing antibody cocktail have been suggested as a therapeutic approach against the emerging variants.Other treatments such as anti-RBD nanobodies isolated from llamas were shown to neutralize RBD variants suggesting they might be a promising tool against new SARS-CoV-2 VOCs as well.
Different engineered variants of human recombinant soluble ACE2 (hrACE2), were reported to significantly inhibit SARS-CoV-2 infection in vitro and causing sustained viral entry blockade upon engagement of hrACE2 with the RBD in SARS-CoV-2 S protein with high affinity.This is a potentially powerful treatment against SARS-CoV-2 VOCs as it can exploit the increase S-protein host receptor-binding affinity caused by S-mutations, toward increasing S-protein affinity to hrACE2. Moreover, no mutations that limit receptor-binding affinity were discovered as this will decrease affinity to native ACE2 receptor and may likely to attenuate virulence, suggesting that viral escape from hrACE is very unlikely.
Targeting endosomal formation of SARS-CoV-2 to block entry to host cells such as antimalarial drugs and macrolides, and us of drugs targeting host cell transmembrane protease serine 2 (TMPRSS2) such as Camostat or A disintegrin and metalloprotease 17 (ADAM17) inhibitors.
Promising antiviral drugs such as the FDA-approved Remdesivir and its metabolites, Ribaverin and Galidesivir have been shown to inhibit viral replication in vitro and in vivo studies due to their effect on inhibiting RNA dependent RNA polymerase (RdRp). The discovery of RdRp hotspot mutations in SARS-CoV-2, found mostly in European strains may lead to drug-resistance of to RdRp inhibitors in a similar mechanism found in Influenza and Hepatitis C However, it has been shown currently that those variants have minimal impact for pre-existing resistance to Remdesivir.
Another potential approach is Prophylactic Antiviral CRISPR in Human Cells (PAC-MAN), which is a Cas13d-based strategy that target reserved regions such as nucleocapsid protein and RdRp in SARS-CoV-2 viral genome and may serve as pan-coronavirus strategy for any future coronaviruses and variant that may emerge.
Emerging VOCs have the potential to effect clinical and global health outcomes, emphasizing the necessity for genomically tailored therapeutic approach in the future therefore we suggest that a combination strategy targeting different components in viral cycle and immune host response may be critical but overlooked in the combat against SARS-CoV-2 VOCs.
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