A Doctor’s Mask Worn Awry Leads Me to Promising New COVID-19 Research

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Image courtesy of pixabay.com

I had an appointment with a substitute doctor this week. Attesting to his renown, his office walls were crowded with yearly awards demonstrating his leadership in his field.

He is a hematologist/oncologist. I was there to receive one of the twice-yearly injections I receive for osteoporosis. The same medication is given in greater strength and frequency to cancer patients to prevent bone fractures.

As he leaned forward to give me the injection, his mask was comfortably positioned beneath his nose.

I was distressed by his apparent carelessness: the man deals with cancer patients all day long, for goodness sake.

I was also amused, as it reminded me of a cartoon I’d seen, which I hope does not offend. I think it makes an important point in a memorable way.

Two roughly drawn panels—black outline, white interior. Inside the left panel is a sketch of a man with a long thin face and long thin nose. His mask is comfortably positioned beneath his nose. The legend reads: “Wearing your mask like this…” 

The right panel features a full-length sketch of the same man. That legend reads: “…is like wearing your underwear like this.”

But this was serious business, so I asked the doctor about his mask.

“I had COVID in March,” he told me. “I lost weight and slept a lot, and on the 14th day, I got up and could have run a marathon.”

He added that his wife, daughters, and one daughter’s boyfriend had also had mild cases and fully recovered. “And,” he said with certainty, “I’ll never get it again.”

I questioned him about the antibodies, which my reading had suggested was far from a settled matter. In fact, there are more than 100 vaccines in the works that are based on antibodies. But some people who recover never have antibodies, and others have them only briefly. 

“It’s not the antibodies,” he responded. “It’s the T cells. They carry memory of the virus and prevent it from reinfecting.”

He said he was so sure he’s safe that he often greets his elderly neighbor with a hug, unworried that he might infect her.

Huh! Or more specifically, Huh?

I had heard the T-cell theory, so I did a little research. In fact, there’s some exciting emerging research based on T cells and the coronavirus. Little had been known til recently about the role of the T cells in SARS-CoV-2, the virus that causes COVID-19.

For much of the following, I’m relying on Derek Lowe, who writes about drug discovery and pharma for In the Pipeline, an “editorially independent blog from the publishers of Science Translational Medicine. 

In May, Lowe wrote:

“One of the big (and so far unanswered) questions about the coronavirus epidemic is what kind of immunity people have after becoming infected. This is important for the idea of ‘re-infection’ (is it even possible?) and of course for vaccine development.”

I’ll spare you Lowe’s careful explanation of the various and complex aspects of our immune systems; if you’re interested, you can read it via the above link.

Instead, we’ll focus on two primary types of T cells. One is CD8+ T cells (among other names), which kill the virus-infected cells “before they can break open and spread more viral particles,” writes Lowe. 

“And then there’s another crowd, the CD4+ T cells, also known as T-helper cells and by other names…The helper T cells have a list of immune functions as long as your leg, interacting with many other cell types.” 

Those immune functions include spurring the CD8+ cells and “activating B cells to start producing specific antibodies,” among other tasks.

Lowe describes what I think of as the “Goldilocks response” to COVID-19:

“What you want: a robust response that clears the virus, remembers what happened for later, and doesn’t go on to attack the body’s own tissues in the process.”

This was what a team from La Jolla Institute for Immunology in California and Mt. Sinai in New York was studying. Comparing infected patients who’d recovered with those who hadn’t been exposed to the virus, they found all the exposed patients had CD4+ cells that responded to three specific proteins: Spike, M, and N. 

Lowe suggested that this discovery made the prospect of a vaccine more likely, and that though most efforts have been focused on Spike, adding the other proteins to the mix might further strengthen a vaccine’s efficacy.

Another study suggested that the memory T cells may protect some people with COVID-19 because they “remember” previous encounters with other human coronaviruses.

Of the large family of coronaviruses, six of them have been found in humans. Four are responsible for the common cold. The other two are more dangerous; they caused SARS (SARS-CoV-1) and MERS (MERS-CoV). ( I assume that means SARS-CoV-2 is number seven.)

Here’s the cool part: in that second study, reported in Nature,  Antonio Bertoletti of the Duke NUS Medical School in Singapore and his team looked at blood samples from people who’d recently recovered from mild to severe COVID-19. They all produced T cells that recognized many parts of the SARS-CoV-2 virus.

Then they looked at blood samples from people who’d also survived SARS 17 years ago—and their memory T cells from that illness also recognized parts of SARS-CoV-1.

Apparently, their immune systems were still attuned to protecting against the disease 17 years later.

After that, they checked for these T cells in blood samples from healthy people who’d had neither SARS nor COVID-19—and more than half had T cells that recognize one or more of the proteins under study.

So it’s possible that there are people who have some immunity to COVID-19 based on their previous bouts with the common cold.

Writes Lowe:

“This makes one think, as many have been wondering, that T-cell driven immunity is perhaps the way to reconcile the apparent paradox between (1) antibody responses that seem to be dropping week by week in convalescent patients but (2) few (if any) reliable reports of actual re-infection. That would be good news indeed.”

Francis Collins, MD, who heads the National Institutes of Health, writes cautiously in the NIH Director’s Blog:

“It’s still not clear if this acquired immunity stems from previous infection with coronaviruses that cause the common cold or perhaps from exposure to other as-yet unknown coronaviruses.

“What’s clear from this study is our past experiences with coronavirus infections may have something important to tell us about COVID-19. Bertoletti’s team and others are pursuing this intriguing lead to see where it will lead—not only in explaining our varied responses to the virus, but also in designing new treatments and optimized vaccines.”

These studies may have huge implications in helping us combat COVID-19.

Bottom line for me: When I see that doctor again for my injection in 6 months, though I hope he’s wearing his mask properly, I won’t be quite as worried as I was this time. The degree of his certitude may not yet be warranted, but at least his decision is based on some solid emerging research.

Annie

Continue reading “A Doctor’s Mask Worn Awry Leads Me to Promising New COVID-19 Research”

After Dogs Detecting COVID-19, What’s Next?

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Image courtesy of en.wikimedia.org

You may recall my recent post describing studies that demonstrate how accurately dogs can sniff out COVID-19. The answer to “What’s Next?” may be found on your wrist right now.

“Wearables” outfitted with artificial intelligence (AI) to report back health data may send a message to asymptomatic or presymptomatic people with the virus before they spread the disease. That means Fitbits, smartwatches, and heart rate monitors that cardiac patients strap to their wrists may help us fight against those dreaded spikes we’re seeing nationwide. The key is that these wristlets monitor heart rate.

In a fascinating discussion, Abraham Verghese, MD, Professor and Vice Chair in Theory and Practice of Medicine at Stanford in California, spoke with Eric J. Topol, MD, Professor of Genomics at The Scripps Research Institute in La Jolla, California. Topol is also the editor-in-chief of Medscape, which carried the video and transcript of their interview.

First, a couple of items that may seem surprising. You know how diligently everyone’s taking your temperature as a precaution? I’ve visited two doctors, my dentist, and my hairdresser over the past several weeks; each time, my temperature was dutifully taken before I’d stepped well into the reception area.

“But that’s so silly,” said Topol, “because…multiple prospective studies about fever and COVID-19 have found that large numbers of people don’t have a fever.”

Topol mentioned a large study published in Nature Medicine that found only 30% of COVID-19 patients had a fever. Another recent study, published by Color genomics, put that figure even lower: 12%.

So temperature taking may catch some potential COVID-19 infections, but not that many. However, it’s such a noninvasive and seemingly inexpensive method that it seemed to me worthwhile. Unless, of course, it’s causing a distraction, and that appears to be Topol’s objection.

Wth those study findings in mind,  consider that between 30% and 40% of COVID-19 patients are asymptomatic but are still shedding virus—and that presymptomatic people are also shedding virus and are as infectious, possibly even more infectious, than those with symptoms.

For these reasons, Topol calls temperature taking “a placebo.”

Verghese agrees.

“We learned too late that we didn’t emphasize masks enough and we overemphasized temperature measurements.”

Lest anyone be thinking, “Oh, these scientists; they don’t know what they’re doing,” I want to underscore here—because science and scientists are under such unjustifiable and dangerous fire now—that both men agreed the progress that’s been made with the coronavirus has been remarkable.

Said Topol:

“The science is moving at a pace that I’ve never seen—everything, from the structural biology of the virus and the antibodies to the virus from patient, to the design of drugs and vaccines and neutralizing antibodies. The sequence of tracing it temporally and spatially geographically through the world has been extraordinary.”

The point is that this is a very complex virus causing a worldwide pandemic. Equally important, scientific progress isn’t linear: there are bound to be erroneous assumptions, initial errors, blind alleys, and failed medication/vaccine clinical trials.

It’s always been that way. Many of us just haven’t followed the process so closely because we’ve never been in a pandemic before—in which there’s such pressure to move quickly and get things right (and in the US, I must add, ignorant political interference that has had lethal effect).

Topol did discuss testing problems, including the false negatives, the logistics of testing done appropriately to scale, and the expense and time limitation of all these one-time tests. He looks forward to home testing but believes that’s at least several months from now. (See also The New York Times for this article about better testing.)

The big question remains:

“How can we find people in a cluster or an emerging outbreak before it spreads more? Because we know, by the famous Pareto rule or principle, that 80% of transmission comes from 20% of the cases.”

Since we can’t test everyone constantly, the urgency is to locate and concentrate on those “early spreaders.” And that’s where the wearables show promise.

Apparently, such wearables had been generating great interest even before the pandemic, but are now attracting the attention of large research consortiums because of their potential to forewarn about infection with this tricky and highly contagious virus.

Acknowledging that the US is far behind most countries in controlling the spread, Topol said:

“Here is the opportunity to use sensors that get continuous data and would give us an edge.”

In a project named DETECT, begun in March, he and colleagues now have roughly 38,000 participants using a smartwatch or fitness band. Other studies are using rings.

In the first 30,000 people, they found changes in three indicators: increased resting heart rate, more sleep, and fewer steps. And all three indicators then correlated with symptoms and positive tests.

Topol’s group had previously used sensor technology in studying a flu-like illness. When their findings were published in January, a group in Germany developed a smartwatch app that’s being worn by more than 500,000 people; in China, 1.3 million are using such an app.

Verghese, impressed by the number of people involved in Topol’s study, asked two questions: have the results been rigorously tested?; and “do we get the signal early enough to make a difference in some way?”

Topol said they still have to validate the results, but in their Fitbit flu-like illness study, they saw the signal well before the CDC had even observed the presence of the illness. COVID-19 is even more suited to the technology, he believes, because of the large numbers of asymptomatic people.

Studies of asymptomatic people who were on the Diamond Princess cruise ship and in Korea found more than half of them showed the same lung abnormalities as people who’d had symptoms. The presumption is that their heart rates would have shown what they did not feel.

Amazingly, more than 100 million people in the US are currently wearing some kind of wrist sensor to monitor their heart rates. Twenty percent of Americans wear a fitness tracker, according to a Pew Research poll done in January.

I sense that if this approach is validated, it might escape the politicization we’re currently seeing over wearing masks!  Think that’s possible? Of course, it wouldn’t replace masks, but it might be acceptable to some of the diehard anti-maskers among us.

Topol points out that the measure isn’t as helpful on the individual level as it is in a neighborhood.

“If your heart rate goes up, you still don’t know why. But if COVID-19 is in your neighborhood, if there is a cluster, then that makes it more of a real signal.”

Then what? Suppose your Fitbit is yelling at you (digitally)—what do you do next? That’s when testing, tracing, isolation come in, says Topol—while we await more accurate home tests that could provide quick results.

As to the wearable alerts, he says:

“The issue is to get people to be citizen scientists….a lot of people like to get their data and like to get a notification that something in their neighborhood is showing a potential signal, without inducing anxiety. But I’d like to at least raise awareness. You don’t need everyone in the country to be a citizen scientist; you just need enough. We have every state covered but not densely enough yet, so that will be important.”

Verghese raised an important question about equity and access. Not everyone has a Fitbit, smartwatch, or heart rate monitor.

“How do we ensure that we truly are studying a representative cross-section of this country and that everyone has equal access to what is basically a public health issue?”

Acknowledging the gravity of the question, especially in terms of the statistics showing the far greater burden of the pandemic on minorities, Topol stressed that not everyone needs a device: if enough people in the area are alerted to a problem, “The people who don’t have this technology will still derive the benefit of knowing that there’s an outbreak potential in their area.”

I would hope that with this knowledge, there would be a concerted effort to ensure that sufficient numbers of wearables were available in areas most likely to see disease clusters.

But that’s not enough. Topol pointed out:

“The problem is that people in these underrepresented minorities and of lower socioeconomic status don’t have access to testing. They aren’t looked after. Many of them are afraid to come in because they could be deported, or who knows what could happen to them. We have a lot of collateral damage from the pandemic here because of our tenuous and, in many cases pathetic, framework of healthcare.”

It is deeply troubling that we continually confront the vast numbers of people, particularly poor and minorities, who are being deprived of decent health care in our still wealthy nation. But I was pleased to see that the question was at least asked and discussed in this conversation. I’ll be looking at additional ways healthcare has been inequitably skewed in the near future.

My questions for you: Do you currently wear a Fitbit, smartwatch, or heart rate monitor? If you do, would you like to have it inform you if you have possible COVID-19 symptoms? If you don’t wear one, would you be willing to for this purpose? And any other comments you’d care to add are, as always, most welcome!

Annie

Continue reading “After Dogs Detecting COVID-19, What’s Next?”

Paging Dr. Dog! Another Weapon in the Battle Against COVID-19

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Image courtesy of flickr.com

We often see them in airports, sniffing around for drugs and other questionable substances. Now, it seems, dogs are being trained to use their powerful sniffers (aka snouts) to detect the coronavirus.

How do they do it? First, let’s look at the dog’s olfactory advantage for this work. Humans have a mere six million smell receptors; dogs have as many as 300 million.

Dogs trained in scent detection can discern low levels of what are called volatile organic compounds (VOCs) that are found in human blood, breath, urine, and saliva and have been associated with a number of diseases. I hope to write more about these fabulous pups and their detection of other diseases in the near future.

As to our urgent international need, here’s a sampling of some ongoing studies:

In the UK

They’re actually engaged right now in what might be considered the first step toward an airport version of a clinical trial.

There are six dogs, aptly called “The Super Six,” a combo of labrador retrievers and cocker spaniels. The premise is that the dogs will be able to detect the scent of the disease on asymptomatic travelers.

So our future may include appearing at the airport, suitcases ready, passports in hand, and then a cold little nose says, in effect, “No trip for you, buddy! You’re outta here!”

But as a dog worshipper, I can’t think of a happier way to help bring a worldwide pandemic under control.

This effort is backed by the UK government, which has donated funds to a research team from the London School of Hygiene and Tropical Medicine, in collaboration with Durham University and a charity named Medical Detection Dogs.

And the head of the research team, Professor James Logan, who also heads the department of disease control at the London School of Hygiene and Tropical Medicine, expresses optimism.

He observed in an interview with cnn.com that this work evolved from earlier research findings that people infected with malaria have a specific body odor—and “dogs can be trained to detect that with very high accuracy.”

The training involves dogs’ sniffing face masks and/or nylon socks worn by both individuals who have tested positive for COVID-19 and those who haven’t.

Why nylon socks? Professor Steve Lindsay, a public health entomologist at the university, acknowledges that it’s a “bit strange,” but their experiences have shown them it’s “a really good way of collecting odors from people and it’s such an easy way to do it.”

In the US (Two Studies) [NOTE: SEE CLARIFICATION BELOW]

Similar research is being done at the University of Pennsylvania’s School of Veterinary Medicine (Penn Vet). Same premise: uncover asymptomatic patients, who are most likely to spread the disease. Also: focus on screening in specifically challenging environments for testing, such as hospitals or businesses.

In the Penn Vet study, which began with eight dogs, the dogs were first given saliva and urine samples from COVID-19 positive patients in a lab-oratory (spelled out and hyphenated to avoid confusion with this post’s stars!). Then they were given negative samples.

The researchers plan to begin testing the trained dogs with live humans in July. They’ll test both sensitivity—the ability to correctly identify those who have the disease (true positive rate)—and specificity—the ability to correctly identify those who don’t have the disease (true negative rate).

Cynthia Otto, DVM, PhD, professor of Working Dog Sciences and Sports Medicine and director of the Penn Vet Working Dog Center, is leading a multidisciplinary group across the University.

According to Otto:

“The potential impact of these dogs and their capacity to detect COVID-19 could be substantial. This study will harness the dog’s extraordinary ability to support the nation’s COVID-19 surveillance systems, with the goal of reducing community spread.”

Another study, at Cold Spring Harbor Laboratory in New York State, bears the names of numerous authors. Involving 198 samples of axillary (armpit) sweat collected from various hospitals, the study was conducted with 18 dogs on three sites. It took the dogs between one and four hours to learn to recognize the odor and then four to ten hours to detect positive samples.

In a subset to demonstrate proof-of-concept, the researchers focused on eight dogs that had previously been trained to detect explosives or colon cancer and had now expanded their doggie resumes with this new specialty.

Their task was to pick out the positive sample from among negative or mock (made up) samples. After 368 trials, here are their percentages: four dogs scored 100%; one achieved 83%; another 84%; another 90%, and the eighth dog 94%.

All those percentages were deemed significantly different from what would occur by chance.

Thus,

“We conclude that there is a very high evidence that the armpits sweat odor of COVID-19+ persons is different, and that dogs can detect a person infected by the SARS-CoV-2 virus.”

Perhaps, theorizes Annie the English major, that also means that armpit sweat can be added to the bodily substances cited earlier that contain volatile organic compounds.

And in Finland

This article’s title appeals to my weakness for bad puns: “The Finnish COVID dogs’ nose knows!”

At the University of Helsinki, researchers from the veterinary and human medicine faculties are working together. The first dogs have successfully differentiated between the urine samples of patients that have COVID-19 and those that don’t.

The researcher and DogRisk group leader, Anna Hielm-Bjorkman, observed:

“We have solid experience in training disease related scent detection dogs. It was fantastic to see how fast the dogs took to the new smell.”

The preliminary tests have demonstrated that the dogs learned fast and worked fast, outperforming the COVID-19 tests based on molecular approaches.

But now comes the big step, prior to moving the scent detection into practice. They’ll begin a randomized double-blinded setting, “introducing them to a larger number of patient samples that are either positive or negative.

And they’ll throw in a curve ball: some of the negative samples will have other respiratory diseases.

They foresee the many beneficial possibilities, which include identifying infected individuals in nursing or retirement homes, and screening health care workers to discern those who are actually ill, rather than just having been exposed, thereby avoiding unnecessary quarantines.

And, to bring us back to where we began, they’re also looking toward screening at airport checkpoints and other border points.

These are, as far as I can tell, all preliminary studies, with the Finnish study moving closest to peer review status, and the Penn Vet study ready to take a big leap forward in just a few weeks.

But with the dogged determination of researchers, trainers, and humans’ best friends, it certainly looks as though we may soon see a warm and fuzzy side of the successful efforts to contain this terrible pandemic.

Though most of these tests will be processed in lab-oratories, if you were in an airport and given the choice, which would you prefer: a large swab inserted into your nostril, or a tail-wagging canine circling around you once or twice (no petting allowed!)?

Warmest thanks and profound love to my daughter the professional dog trainer, par excellence, who suggested the idea and provided me with the articles that formed the basis of this post.

Annie

CLARIFICATION: The study I attributed above to the Cold Spring Harbor Laboratory in the US was based on an abstract bearing its logo. I subsequently learned that the study is, in fact, being conducted in Paris, at the Alfort School of Veterinary Medicine; Ajaccio, France, at the South Corsica Fire and Emergency Dept, and Beirout (sic), Lebanon, at the French-Lebanese University Saint Joseph.

Continue reading “Paging Dr. Dog! Another Weapon in the Battle Against COVID-19”

The President’s Daily Coronavirus Briefings–What Do You Think the Press Should Do? My Reassessment

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Image courtesy of flickr.com

I am hoping that recent events will make the reason for this post irrelevant. But I have my doubts. Despite efforts by his staff to persuade him to limit his appearances at daily press briefings, this President does not seem capable of surrendering the limelight.

In my April 8 post on this topic, I expressed some ambivalence about the idea that the press should no longer cover these briefings live at all.

It was never my belief that they needed to show the two-plus hour nightly events in their soul-sapping entirety, but I also wondered whether disbanding live coverage completely might be a bad precedent.

The approach that some were following seemed to be a good compromise: airing a portion and then cutting away, rather than dropping long-held norms just because he was slashing and burning them.

On Friday, I heard Eli Stokols, a White House reporter for the Los Angeles Times, say that covering this President raises profound problems for the press and is in fact, the central issue for them at this point.

I can imagine that most, if not all, members of the Fourth Estate are struggling to determine how to do their jobs when faced with the double whammy of a pandemic that requires them to deliver timely information to the public—and a President who lies, contradicts himself, insults them, and seems to care not one whit about anyone or anything but himself.

And then, as you know, this President offhandedly suggested that the scientists should look into the question of whether drinking or injecting disinfectants could be a possible treatment for the coronavirus.

For me, that was a moment of clarity.

He faced others on the podium as he raised what he apparently thought was a clever idea, and his scientific adviser, Dr. Deborah Birx, to her discredit, remained silent, eventually mumbling “not a treatment.” She wilted.

Stokols and his colleagues at the LA Times reacted with some thoughtful reporting and observations:

“A slew of federal and state agencies — and the makers of laundry bleach — issued an implicit rebuke to President Trump on Friday, warning the public that his off-the-cuff medical advice and off-the-wall musings in nightly White House briefings could endanger even more lives as the country’s coronavirus death toll passed 50,000…

“Trump’s inclination to view his rhetoric as fungible — his comments are often intentionally open-ended and then open to ex post facto dismissals — reflects a lifelong effort by a highly public figure to blur context and avoid consequences for his comments and actions.”

“Trump’s shifting and often self-contradictory comments are not a bug but a feature of his nightly briefings, where, even amid a profound national crisis and widespread anxiety, questions and specifics typically drown in a sea of self-lavished superlatives.

“Last week, he managed to flip-flop three times on how quickly to lift stay-at-home orders, first insisting that he had “total” authority to order states to reopen, then telling governors that they, not he, had that authority, and then urging citizens to protest decisions by the governors and “liberate” their states.

“When pressed Thursday as to why he continued to float untested and potentially dangerous remedies from the presidential podium, Trump lashed out at the reporter who questioned him.
“I’m the president and you’re fake news,” he said. “I’m just here to present talent. I’m here to present ideas, because we want ideas to get rid of this thing. And if heat is good and if sunlight is good, that’s a great thing as far as I’m concerned.”

The next day, the President falsely claimed that he was sarcastically responding to a hostile press query.

In the meantime, while all responsible parties have been trying to contain the pandemic, protect the public, and find scientifically sound ways to consider when it’s safe to lift the quarantine,  Trump’s suggestion that internal disinfectants were worth considering caused consternation and warnings from many quarters.

So many people spent so much valuable time that should have been devoted to more worthy efforts as this gargantuan threat persists.

Those who raced to address this obvious danger ranged from the Consumer Product Safety Commission to the US Surgeon General to the American Chemistry Council to the makers of Chlorox and Lysol, among others.

And former Vice President Joe Biden, the presumptive Democratic presidential nominee, exerting leadership from his basement, tweeted:

“I can’t believe I have to say this, but please don’t drink bleach.”

Lest you think that Americans wouldn’t be foolish enough to consider such a ridiculous idea, the Maryland Emergency Management Agency reported that its emergency hotline received more than 100 inquiries about whether the injection or ingestion of disinfectants could be a cure for COVID-19.

Reading that, the noted Constitutional scholar Lawrence Tribe tweeted:

“What worries me is how many DIDN’T call but just tried Trump’s insane experiment on themselves or their kids.”

On April 24, Congressman Adam Schiff tweeted:

“A week ago I asked whether it was responsible to carry Trump’s nightly stream of consciousness on live TV.

Today, he suggested drinking or injecting disinfectants or ‘sunlight’ to kill the virus.

So I will ask again: What value is there to this spectacle?”

There’s no longer any doubt in my mind. I fully agree with Adam Schiff. We have a President who is hazardous to our health. He needs to be quarantined—his every word fact-checked and accurately reported.

And it’s just as important that the press and cable TV programs stop allowing him to control the narrative. The public needs information.

That’s why they listen so intently when New York Governor Andrew Cuomo speaks—or Maryland Governor Larry Hogan—or the mayors who have been thrown in disarray when the governors of their states have precipitously decided to disregard scientific caution and remove the quarantines.

We’re not getting information from these press conferences. We’re getting bad theater, farce-turned-deadly.

As many have pointed out, his wacky schemes often serve as a distraction: reporters must follow the story and not ask their questions about the climbing and undoubtedly underreported incidence of infection and death and—his protestations notwithstanding—the lack of adequate testing, largely because he refuses to exert power when he really must.

Here’s a possible example of what might have been reported immediately after Trump made his bizarre recommendation.

“President Trump suggested today that ingesting or injecting disinfectants might be a treatment for coronavirus. This is a dangerous suggestion that could prove lethal, as the makers of Chlorox and Lysol rushed to emphasize. We regret to report that you will endanger your health and possibly lose your life if you listen to the President.

“And now, here’s a report on the impact of the lifting of regulations to prevent water pollution in neighboring communities…” or “Here’s the latest on President Trump’s pressuring the United Kingdom to bail out his failing golf course in Scotland….” or “What will the implications be from the President’s recent temporary Executive Order halting the issuance of many new green cards?”

With his poll numbers plummeting, his staff is reportedly engaged in an effort to persuade him to shorten these dreadful marathons. That is, at least, a start. But we’ll see if they’re successful, and if so, for how long.

He’s not suitable for prime time.

Annie

Continue reading “The President’s Daily Coronavirus Briefings–What Do You Think the Press Should Do? My Reassessment”

Why Are Women World Leaders Combating the Coronavirus Pandemic So Well–and What Does This Tell Us About Leadership?

With the world caught in the vortex of the pandemic, it’s clear that some of the best results to date have occurred in countries that have elected women as their leaders. Indeed, an article in The Guardian bore this headline:

“The Secret Weapon in the Fight Against Coronavirus: Women.”

I find this phenomenon intriguing and have been wondering what lessons might emerge to help us going forward. There seem to be several commonalities among these women.

First, Let’s Look at Some of the Notable Success Stories.

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Tsai Ind-Wen, President, Taiwan

There’s Tsai Ing-Wen, who was elected President of Taiwan in 2016. Although Taiwan is close to mainland China, where the virus first surfaced and rampaged, her rapid actions resulted in fewer than 400 confirmed cases and six deaths out of a population of about 24 million people. 

Working with her vice president, an epidemiologist, she ordered all planes from Wuhan inspected when she first heard about the virus in December. She then restricted flights from Mainland China, Hong Kong, and Macau, created an epidemic command center, and increased production of personal protective equipment (PPE).

These efforts were so successful that Taiwan has actually been donating masks to the US and 11 European countries.

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Katrin Jakobsdottir, PM, Iceland

Katrin Jakobsdottir, Prime Minister of Iceland, has overseen testing of nearly 12% of her country’s population, a much greater percentage than any other country. She’s done so by collaborating with a biotech company that offers free tests to anyone who wants one—regardless of whether they have symptoms or believe they’ve been exposed to the virus. Iceland also does in-depth contact tracing to locate and isolate people who may have been exposed.

Although there hasn’t been a countrywide lockdown, they’ve banned gatherings of more than 20 people. I’m assuming that with a population of just over 364,000, that degree of testing and tracing inspires some confidence that greater restrictions aren’t needed.

In fact they’ve screened five times the number of people as South Korea. As of April 17, Iceland had 1,739 known cases, with eight deaths.

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Sanna Marin, PM, Finland

Sanna Marin, Prime Minister of Finland, is the youngest female leader in the world, at age 34, and has a largely female cabinet. Finland recently increased its testing capacity by 50% and began nationwide antibody testing.

With a population of about 5.5 million, Finland has seen 3,489 cases and 75 deaths. According to The Christian Science Monitor, a Finnish Broadcast reporter said:

“Her performance at press conferences and in parliament has been just what works best for Finns–clear, concise, unemotional; but with an undertone of warmth.”  

A recent poll showed that 85% of Finns approve of Marin’s handling of the pandemic.

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Erna Solberg, PM, Norway

Erna Solberg, Prime Minister of Norway, announced recently that the contagion curve has been sufficiently leveled so that her country “has managed to gain control of the virus.” She began lifting the strict controls by reopening some businesses and kindergartens. The known incidence in Norway, with a population of nearly 5.4 million, is 6,905 cases and 157 deaths.

Solberg has followed the scientists’ advice in her actions and comforted her people: she said in a news conference that “It’s okay to be scared,” and that she missed hugging her friends, words she felt were especially important for young people to hear.

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Jacinda Ardern, PM, New Zealand

Jacinda Ardern, Prime Minister of New Zealand, closed the borders immediately, prepared people for self-quarantine, and implemented widespread testing; to date, there have been 1300 cases and just one death in a population of 4.8 million people. The fact that New Zealand is an island has been a factor in her success, but Ardern has also received high marks for the clarity of her leadership and her compassion.

She’s appeared in streaming videos at home, reassured kids that she counts the Tooth Fairy and Easter Bunny as “essential workers,” and announced that she and her cabinet would take 20 percent pay cuts for six months. She’s been said to demonstrate that a head of state can actually lead with both resolve and kindness.” 

Unknown-7
Angela Merkel, Chancellor, Germany

And then there’s Angela Merkel, Chancellor of Germany. There have been more than 148,000 infections among its 83 million people, but very low deaths per million (fewer than 5000 as of April 17)—considerably lower than other European countries. Germany has the most large-scale testing program in Europe and the most intensive care beds.

Merkel’s popularity has skyrocketed because she’s handled the crisis so well. She told the public:

“I’m absolutely sure we will overcome this crisis. But how many casualties will there be? How many loved ones will we lose?…We are a community in which every life and every person counts.” 

A Guardian account reported:

“As one wag on Twitter joked: if you’re asking why death rates are so low in Germany and so high in America, it’s ‘because their president used to be a quantum chemist and your president used to be a reality television host.”

Merkel, whose title is chancellor, has a doctorate in quantum chemistry.

Why Have These Women Been So Successful?

According to The Guardian reporter,

“Correlation is obviously not causation. Being a woman doesn’t automatically make you better at handling a global pandemic. Nor does it automatically make you a better leader; suggesting it does reinforces sexist and unhelpful ideas that women are innately more compassionate and cooperative.

“What is true, however, is that women generally have to be better in order to become leaders…held to far higher standards than men…you have to be twice as good as a man in order to be taken half as seriously. You have to work twice as hard.”

It seems fairly obvious that what makes a successful leader is a combination of strength, effective decision-making, and compassion. That doesn’t necessarily describe a woman.

New York Governor Andrew Cuomo’s reputation has soared, despite the delay in aggressively confronting the threat, because his tough guy persona has been substantially softened by what appears to be genuine compassion. 

But the effective women leaders are the result of a specific environment, says Kathleen Gersen, a sociology professor at New York University.

“Female leaders are also likely to be nourished and supported within societies that themselves have a certain culture.”

For Gersen,

“If you have a political culture in which there’s a relative support and trust in the government, and it’s a culture that doesn’t make stark distinctions between women and men, you’ve already got a head start.” 

She also thinks that women who reach such lofty positions feel less tied to traditional methods of leading.

“There are so many ways that men are expected to behave when they’re leaders that I think it sometimes makes it difficult for them to step over those boundaries and act in a different way from the norm.” 

Though Gersen offers Governor Cuomo as an example of this breakthrough, we’ve seen one terrible—and several poor—examples of male leadership, or lack thereof, that involved differing from the norm. 

These bad examples show us in the negative why the ways the women have acted have been successful. 

In fact, the pandemic forces leaders to face the vastness of unknowns, so they must rely on their inner strengths and creativity more than on existing norms. They have acted promptly and forcefully.

They have also sought expert advice and relied upon the science. And, importantly, they have brought along the people they serve by communicating with them with honesty, clarity, and compassion.

Looking Forward…

If, Gersen says, women leaders can demonstrate that strength and compassion are not conflicting traits—that they actually complement one another and are both essential for good leadership,

“I think not only will society benefit. but so will men. Maybe then we can begin to open up the scripts for roles that leaders play”—regardless of gender. 

What do you think? Women presently make up only 25% of the world’s leaders, but they’ve been the shining lights in this darkest of times.

Do you agree with Kathleen Gersen’s belief that women succeed where there’s relative support and trust in government and not the stark distinctions between men and women?

If so, what does that assessment say about our future in the US—or wherever else you, my thoughtful readers, reside?

Annie

Continue reading “Why Are Women World Leaders Combating the Coronavirus Pandemic So Well–and What Does This Tell Us About Leadership?”