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<h1 data-aos="fade-down" id="covid-19-sentry">Covid-19 Sentry</h1>
<h1 data-aos="fade-right" data-aos-anchor-placement="top-bottom" id="contents">Contents</h1>
<ul>
<li><a href="#from-preprints">From Preprints</a></li>
<li><a href="#from-clinical-trials">From Clinical Trials</a></li>
<li><a href="#from-pubmed">From PubMed</a></li>
<li><a href="#from-patent-search">From Patent Search</a></li>
</ul>
<h1 data-aos="fade-right" id="from-preprints">From Preprints</h1>
<ul>
<li><strong>Scars from a Previous Epidemic among White and Black Women: Social Proximity to Zika and Fertility Intentions During the Covid-19 Pandemic</strong> -
<div>
The Covid-19 pandemic has led to a rise in morbidity and mortality, but its demographic consequences may not end there. Since the pandemic began, the public has experienced tremendous uncertainty and worry about SARS-CoV-2 infection, especially because scientific understanding of a novel disease takes time to develop and disseminate. During periods of extreme uncertainty and worry, people may revise their fertility intentions, drawing on their prior experiences, particularly prior epidemics. To investigate this possibility, we examine whether women’s experiences during the Zika epidemic predict their fertility intentions during the Covid-19 pandemic. We apply Structural Equation Models on unique microdata from 3,998 Brazilian women in Brazil, the country most affected by the Zika epidemic, to understand whether a novel infectious disease outbreak left lasting imprints that shape fertility intentions during a subsequent novel infectious disease outbreak, the Covid-19 pandemic, and whether these scarring effects operate differently by race. Our results demonstrate a scarring effect of one novel infectious disease outbreak to another such that a woman’s social proximity to Zika directly predicts fertility intentions three years later, during the Covid-19 pandemic, regardless of whether a woman herself had or suspected that she had Zika. Findings also show that social proximity to Zika is associated with increased perceived risk of Covid-19 infection and worry about pregnancy and fetal complications from Covid-19. Finding also show that white and non-white women have scarred differently from the Zika epidemic. Broadly, our findings speak to the transformative consequences of novel infectious disease outbreaks that go beyond mortality and health.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/preprints/socarxiv/3nqvy/" target="_blank">Scars from a Previous Epidemic among White and Black Women: Social Proximity to Zika and Fertility Intentions During the Covid-19 Pandemic</a>
</div></li>
<li><strong>SARS-CoV-2 virus transfers to skin through contact with contaminated solids</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Transfer of SARS-CoV-2 from solids to fingers is one step in infection via contaminated solids, and the possibility of infection from this route has driven calls for increased frequency of handwashing during the COVID-19 pandemic. To analyze this route of infection, we measured the percentage of SARS-CoV-2 that was transferred from a solid to an artificial finger. A droplet of SARS-CoV-2 suspension (1 μL) was placed on a solid, and then artificial skin was briefly pressed against the solid with a light force (3 N). Transfer from a variety of solids was detected, and transfer from the non-porous solids, glass, stainless steel, and Teflon, was substantial (13-16 %) when the droplet was still wet. Transfer still occurred after the droplet evaporated, but it was smaller. We found a lower level of transfer from porous solids but did not find a significant effect of solid wettability for non-porous solids.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.04.24.21256044v1" target="_blank">SARS-CoV-2 virus transfers to skin through contact with contaminated solids</a>
</div></li>
<li><strong>Thermostable designed ankyrin repeat proteins (DARPins) as building blocks for innovative drugs</strong> -
<div>
Designed Ankyrin Repeat Proteins (DARPins) are a class of antibody mimetics with a high and mostly unexplored potential in drug development. They are clinically validated and thus represent a true alternative to classical immunoglobulin formats. In contrast to immunoglobulins, they are built from solenoid protein domains comprising an N-terminal capping repeat, one or more internal repeats and a C-terminal capping repeat. By using in silico analysis and a rationally guided Ala-Scan, we identified position 17 of the N-terminal capping repeat to play a key role for the overall protein thermostability. The melting temperature of a DARPin domain with a single full-consensus internal repeat was increased by about 8{degrees}C to 10{degrees}C when the original Asp17 was replaced by Leu, Val, Ile, Met, Ala or Thr, as shown by high-temperature unfolding experiments at equilibrium. We then transferred the Asp17Leu mutation to various backgrounds, including different N- and C-terminal capping repeats and clinically validated DARPin domains, such as the VEGF-binding ankyrin repeat domain of abicipar pegol. In all cases, the proteins remained monomeric and showed improvements in the thermostability of about 8{degrees}C to 16{degrees}C. Thus, the replacement of Asp17 seems to be generically applicable to this drug class. Molecular dynamics simulations show that the Asp17Leu mutation reduces electrostatic repulsion and improves van-der-Waals packing, rendering the DARPin domain less flexible and more stable. Interestingly, such a beneficial Asp17Leu mutation is present in the N-terminal caps of three of the five DARPin domains of ensovibep, a SARS-CoV-2 entry inhibitor currently in clinical development. This mutation is likely responsible, at least in part, for the very high melting temperature (&gt;90{degrees}C) of this promising anti-Covid-19 drug. Overall, such N-terminal capping repeats with increased thermostability seem to be beneficial for the development of innovative drugs based on DARPins.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2021.04.27.441521v1" target="_blank">Thermostable designed ankyrin repeat proteins (DARPins) as building blocks for innovative drugs</a>
</div></li>
<li><strong>It’s complicated: characterizing the time-varying relationship between cell phone mobility and COVID-19 spread in the US</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Restricting in-person interactions is an important technique for limiting the spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Although early research found strong associations between cell phone mobility and infection spread during the initial outbreaks in the United States, it is unclear whether this relationship persists across locations and time. We propose an interpretable statistical model to identify spatiotemporal variation in the association between mobility and infection rates. Using one year of US county-level data, we found that sharp drops in mobility often coincided with declining infection rates in the most populous counties in spring 2020. However, the association varied considerably in other locations and across time. Our findings are sensitive to model flexibility, as more restrictive models average over local effects and mask much of the spatiotemporal variation. We conclude that mobility does not appear to be a reliable leading indicator of infection rates, which may have important policy implications.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.04.24.21255827v1" target="_blank">It’s complicated: characterizing the time-varying relationship between cell phone mobility and COVID-19 spread in the US</a>
</div></li>
<li><strong>The dark side of SARS-CoV-2 rapid antigen testing: screening asymptomatic patients.</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Most of the reports describing SARS-CoV-2 rapid antigen tests (RATs) performances derive from COVID-19 symptomatic subjects in outpatient settings during periods of highest incidence of infections and high rates of hospital admissions. Here we investigated the role of RATs in an Emergency Department, as a screening tool before admission for COVID-19 asymptomatic patients. Each patient was screened with two simultaneous nasopharyngeal swabs: one immediately analyzed at the bedside using RAT and the other sent to the laboratory for RT-PCR analysis. A total of 116 patients were screened at hospital admission in a 250-bed community hospital in Morges (EHC), Switzerland. With a disease prevalence of 6% based on RT-PCR results, RAT detected only two out of seven RT-PCR positive patients (sensitivity 28.6%) and delivered two false positive results (specificity 98.2%), thus resulting not fiable enough to be used as a screening method in this clinical scenario.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.04.24.21256040v1" target="_blank">The dark side of SARS-CoV-2 rapid antigen testing: screening asymptomatic patients.</a>
</div></li>
<li><strong>Performance Decay of Molecular Assays Near the Limit of Detection: Probabilistic Modeling using Real-World COVID-19 Data</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The gold standard for diagnosis of COVID-19 is detection of SARS-CoV-2 RNA by RT-PCR. However, the effect of systematic changes in specimen viral burden on the overall assay performance is not quantitatively described. We observed decreased viral burdens in our testing population as the pandemic progressed, with median sample Ct values increasing from 22.7 to 32.8 from weeks 14 and 20, respectively. We developed a method using computer simulations to quantify the implications of variable SARS-CoV-2 viral burden on observed assay performance. We found that overall decreasing viral burden can have profound effects on assay detection rates. When real-world Ct values were used as source data in a bootstrap resampling simulation, the sensitivity of the same hypothetical assay decreased from 97.59 (95% CI 97.3-97.9) in week 12, to 74.42 (95% CI 73.9-75) in week 20. Furthermore, simulated assays with a 3-fold or 10-fold reduced sensitivity would both appear to be &gt;95% sensitive early in the pandemic, but sensitivity would fall to 85.55 (95% CI 84.9-86.2) and 74.38 (95% CI 73.6-75.1) later in the pandemic, respectively. Our modeling approach can be used to better quantitate the impact that specimen viral burden may have on the clinical application of tests and specimens.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.04.26.21254638v1" target="_blank">Performance Decay of Molecular Assays Near the Limit of Detection: Probabilistic Modeling using Real-World COVID-19 Data</a>
</div></li>
<li><strong>Clinical validation of RCSMS: a rapid and sensitive CRISPR-Cas12a test for the molecular detection of SARS-CoV-2 from saliva</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Early detection of SARS-CoV-2 using molecular techniques is paramount to the fight against COVID-19. Due to its high sensitivity and specificity, RT-qPCR is the 9gold standard9 method for this purpose. However, its technical requirements, processing time and elevated costs hamper its use towards massive and timely molecular testing for COVID-19 in rural and socioeconomically deprived areas of Latin America. The advent and rapid evolution of CRISPR-Cas technology has boosted the development of new pathogen detection methodologies. Recently, DETECTR -a combination of isothermal RT-LAMP amplification and Cas12a-mediated enzymatic detection- has been successfully validated in the Netherlands and the USA as a rapid and low-cost alternative to RT-qPCR for the detection of SARS-CoV-2 from nasopharyngeal swabs. Here, we evaluated the performance of RCSMS, a locally adapted variant of DETECTR, to ascertain the presence of SARS-CoV-2 in saliva samples from 276 patients in two hospitals in Lima, Peru (current status over a total of 350 samples). We show that a low-cost thermochemical treatment with TCEP/EDTA is sufficient to inactivate viral particles and cellular nucleases in saliva, eliminating the need to extract viral RNA with commercial kits, as well as the cumbersome nasopharyngeal swab procedure and the requirement of biosafety level 2 laboratories for molecular analyses. Our clinical validation shows that RCSMS detects up to 5 viral copies per reaction in 40 min, with sensitivity and specificity of 97.4% and 97.5% in the field, respectively, relative to RT-qPCR. Since CRISPR-Cas biosensors can be easily reprogrammed by using different guide RNA molecules, RCSMS has the potential to be quickly adapted for the detection of new SARS-CoV-2 variants. Furthermore, our field study validates use of lateral flow strips to easily visualize the presence of SARS-CoV-2, which opens up the possibility of deploying RCSMS as a 9point of care9 test in environments with limited access to state-of-the-art diagnostic laboratories. In sum, RCSMS is a fast, efficient and inexpensive alternative to RT-qPCR for expanding COVID-19 testing capacity in low- and middle-income countries.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.04.26.21256081v1" target="_blank">Clinical validation of RCSMS: a rapid and sensitive CRISPR-Cas12a test for the molecular detection of SARS-CoV-2 from saliva</a>
</div></li>
<li><strong>Virtual mindfulness interventions to promote well-being in young adults: A mixed-methods systematic review</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Background With the onset of the COVID-19 pandemic, students have experienced drastic changes in their academic and social lives with ensuing consequences towards their physical and mental well-being. The purpose of this systematic review is to identify virtual mindfulness-based interventions for the well-being of young adults aged 15 to 40 years in developed countries and examine the efficacy of these techniques/exercises. Methods This mixed-methods systematic review follows the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines with a registered PROSPERO protocol. With a convergent integrated synthesis approach, IEEE Xplore, PsychInfo, Web of Science and OVID were searched with a predetermined criteria and search strategy employing booleans and filters for peer-reviewed and grey literature. Data screening and extraction were independently performed by two authors, with a third author settling disagreements after reconciliation. Study quality of selected articles was assessed with two independent authors using the Mixed Methods Appraisal Tool (MMAT). Studies were analyzed qualitatively (precluding meta and statistical analysis) due to the heterogeneous study results from diverse study designs in present literature. Results Common mindfulness-based interventions used in the appraised studies included practicing basic mindfulness, Mindfulness-Based Stress Reduction (MBSR) programs, Mindfulness-Based Cognitive Therapy programs (MBCT) and the Learning 2 BREATHE (L2B) program. Conclusion Studies implementing mindfulness interventions demonstrated an overall improvement in well-being. Modified versions of these interventions can be implemented in a virtual context, so young adults can improve their well-being through an accessible format.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.04.24.21256035v1" target="_blank">Virtual mindfulness interventions to promote well-being in young adults: A mixed-methods systematic review</a>
</div></li>
<li><strong>Aerosol Exposure of Cynomolgus Macaques to SARS-CoV-2 Results in More Severe Pathology than Existing Models</strong> -
<div>
The emergence of SARS-CoV-2 pandemic has highlighted the need for animal models that faithfully recapitulate the salient features of COVID-19 disease in humans; these models are necessary for the rapid down-selection, testing, and evaluation of medical countermeasures. Here we performed a direct comparison of two distinct routes of SARS-CoV-2 exposure, combined intratracheal/intranasal and small particle aerosol, in two nonhuman primate species: rhesus and cynomolgus macaques. While all four experimental groups displayed very few outward clinical signs, evidence of mild to moderate respiratory disease was present on radiographs and at the time of necropsy. Cynomolgus macaques exposed via the aerosol route also developed the most consistent fever responses and had the most severe respiratory disease and pathology. This study demonstrates that while all four models were suitable representations of mild COVID-like illness, aerosol exposure of cynomolgus macaques to SARS-CoV-2 produced the most severe disease, which may provide additional clinical endpoints for evaluating therapeutics and vaccines.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2021.04.27.441510v1" target="_blank">Aerosol Exposure of Cynomolgus Macaques to SARS-CoV-2 Results in More Severe Pathology than Existing Models</a>
</div></li>
<li><strong>SARS-CoV-2 subgenomic RNA kinetics in longitudinal clinical samples</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Abstract Background In light of numerous reports during the COVID-19 pandemic demonstrating an inexplicable persistence of viral RNA in clinically recovered patients, subgenomic RNAs (sgRNA) have recently been reported as potential molecular viability markers for SARS-CoV-2. However, few data are available on the longitudinal kinetics of sgRNA, compared with genomic RNA (gRNA), in clinical samples. Methods We analyzed 536 samples from 205 patients with COVID-19 from placebo-controlled, outpatient trials of Peginterferon Lambda-1a (Lambda; n=177) and favipiravir (n=359). Nasal swabs were collected at three time points in the Lambda (Day 1, 4 and 6) and favipiravir (Day 1, 5, and 10) trials. N-gene gRNA and sgRNA were quantified by RT-qPCR. To investigate the decay kinetics in vitro, we measured gRNA and sgRNA in A549ACE2+ cells infected with SARS-CoV-2, following treatment with remdesivir or DMSO control. Results At six days in the Lambda trial and ten days in Favipiravir trial, sgRNA remained detectable in 51.6% (32/62) and 49.5% (51/106) of the samples, respectively. Cycle threshold values for gRNA and sgRNA were highly linearly correlated (Pearsons r= 0.87) and the daily rate of increase did not differ significantly in Lambda (1.36 cycles/day vs 1.36 cycles/day; p = 0.97) or favipiravir (1.03 cycles/day vs 0.94 cycles/day; p=0.26) trials. From samples collected 15-21 days after symptom onset, sgRNA was detectable in 48.1% (40/83) of participants. In SARS-CoV-2 infected A549ACE2+ cells treated with remdesivir, the rate of Ct increase did not differ between gRNA and sgRNA. Conclusions In clinical samples and in vitro, sgRNA was highly correlated with gRNA and did not demonstrate different decay patterns to support its application as a molecular viability marker.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.04.26.21256131v1" target="_blank">SARS-CoV-2 subgenomic RNA kinetics in longitudinal clinical samples</a>
</div></li>
<li><strong>Implementation of Rapid and Frequent SARS-CoV2 Antigen Testing and Response in Congregate Homeless Shelters</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Background People experiencing homelessness who live in congregate shelters are at high risk of SARS-CoV2 transmission and severe COVID-19. Current screening and response protocols using rRT-PCR in homeless shelters are expensive, require specialized staff and have delays in returning results and implementing responses. Methods We piloted a program to offer frequent, rapid antigen-based tests (BinaxNOW) to residents and staff of congregate-living shelters in San Francisco, California, from January 15th to February 19th, 2021. We used the Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) framework to evaluate the implementation. Results Reach: We offered testing at ten of twelve eligible shelters. Shelter residents and staff had variable participation across shelters; approximately half of eligible individuals tested at least once; few tested consistently during the study. Effectiveness: 2.2% of participants tested positive. We identified three outbreaks, but none exceeded 5 cases. All BinaxNOW-positive participants were isolated or left the shelters. Adoption: We offered testing to all eligible participants within weeks of the project9s initiation. Implementation: Adaptations made to increase reach and improve consistency were promptly implemented. Maintenance: San Francisco Department of Public Health expanded and maintained testing with minimal support after the end of the pilot. Conclusion Rapid and frequent antigen testing for SARS-CoV2 in homeless shelters is a viable alternative to rRT-PCR testing that can lead to immediate isolation of infectious individuals. Using the RE-AIM framework, we evaluated and adapted interventions to enable the expansion and maintenance of protocols.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.04.20.21255787v1" target="_blank">Implementation of Rapid and Frequent SARS-CoV2 Antigen Testing and Response in Congregate Homeless Shelters</a>
</div></li>
<li><strong>How the COVID-19 pandemic is shaping research in Africa: inequalities in scholarly output and collaborations and new opportunities for scientific leadership</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Background: Scientometrics enables scholars to assess and visualize emerging research trends and hot-spots in the scientific literature from a quantitative standpoint. In the last decades, Africa has nearly doubled its absolute count of scholarly output, even though its share in global knowledge production has dramatically decreased. This limited contribution of African scholars to the global research output is in part impacted by the availability of adequate infrastructures and research collaborative networks. The still ongoing COVID-19 pandemic has profoundly impacted the way scholarly research is conducted, published and disseminated. However, the COVID-19 related research focus, the scientific productivity and the research collaborative network of African researchers during the ongoing COVID-19 pandemic remain to be elucidated yet. Methods: This study aimed to clarify the COVID-19 research patterns among African researchers and estimate the strength of collaborations and partnerships between African researchers and scholars from the rest of the world during the COVID-19 pandemic, collecting data from electronic scholarly databases such as Web of Sciences (WoS), PubMed/MEDLINE and African Journals OnLine (AJOL), the largest and prominent platform of African-published scholarly journals. Results: In the present bibliometric study, we found that COVID-19 related collaboration patterns varied among African regions, being shaped and driven by historical, social, cultural, linguistic, and even religious determinants. For instance, most of the scholarly partnerships occurred with formerly colonial countries (like European or North-American countries). In other cases, scholarly ties of North African countries were above all with the Kingdom of Saudi Arabia. In terms of amount of publications, South Africa and Egypt were among the most productive countries. Discussion: Bibliometrics and, in particular, scientometrics can help scholars identify research areas of particular interest, as well as emerging topics, such as the COVID-19 pandemic. With a specific focus on the still ongoing viral outbreak, they can assist decision- and policy-makers in allocating funding and economic-financial, logistic, organizational, and human resources, based on the specific gaps and needs of a given country or research area. Conclusions: In conclusion, the ongoing COVID-19 pandemic has exerting a subtle, complex impact on research and publishing patterns in African countries. On the one hand, it has distorted and even amplified existing inequalities and disparities in terms of amount of scholarly output, share of global knowledge, and patterns of collaborations. On the other hand, COVID-19 provided new opportunities for research collaborations.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.04.24.21256053v1" target="_blank">How the COVID-19 pandemic is shaping research in Africa: inequalities in scholarly output and collaborations and new opportunities for scientific leadership</a>
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<li><strong>Miami-Dade: A Case Study of Domestic Violence Arrests During the COVID-19 Pandemic</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The global health crisis that started early in 2020 has triggered a surge of interest in the effect (if any) of COVID-19 on patterns of domestic violence.1 The first systematic review and meta-analysis examining domestic violence during the pandemic revealed quite a lot of diversity in the approaches used to measure potential effects. Drawing on the time series forecasting literature, this brief report contributes to the growing body of evidence around the issue of domestic violence during the pandemic. Arrest data from Miami-Dade County (US) are leveraged along with a robust approach towards model identification, which is used to generate a suitably accurate forecast against which the observed pandemic period domestic violence data can be compared. The pattern uncovered for Miami-Dade County was similar what was found in other U.S. cities that during the pandemic experienced spikes (+95 CI) in the level of domestic violence arrests that were greater than expected. Interestingly these spikes appeared shortly after dips (-95 CI) in observed arrests fell below the expected level.
</p>
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.04.20.21255830v1" target="_blank">Miami-Dade: A Case Study of Domestic Violence Arrests During the COVID-19 Pandemic</a>
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<li><strong>Interleukin-6 receptor genetic variation and tocilizumab treatment response to COVID-19</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Interleukin-6 receptor (IL6R) stimulates the inflammatory pathways as part of the acute-phase response to infection. Tocilizumab is a monoclonal antibody that inhibits both membrane-bound and soluble IL6R and is used to treat inflammatory conditions, including COVID-19. Despite the disproportionate incidence of COVID-19 among underserved, racial, and ethnic minority populations, the efficacy of tocilizumab in hospitalized COVID-19 patients from these populations is unclear. In this work, three genetic markers for the IL6R gene were analyzed across diverse ethnic backgrounds to identify population differences in response to tocilizumab treatment. Genetic structure analyses showed that African populations were significantly different from other described populations. In addition, mapped frequencies of these alleles showed that Sub-Saharan African populations were 3.4x more likely to show an impaired response to tocilizumab than East Asian populations, and 1.8x more likely than European ancestry populations. Existing IL6R genotype results may identify populations at increased therapeutic failure risk. As results from current clinical trials on the efficacy of tocilizumab treatment for extreme COVID-19 infections are conflicting, more studies are needed across diverse patient backgrounds to better understand the genetic factors necessary to predict treatment efficacy. This work demonstrates how pharmacogenomics studies can elucidate genetic variation on treatment efficacy on COVID-19.
</p>
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.04.24.21256047v1" target="_blank">Interleukin-6 receptor genetic variation and tocilizumab treatment response to COVID-19</a>
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<li><strong>Stimulation of vascular organoids with SARS-CoV-2 antigens increases endothelial permeability and regulates vasculopathy</strong> -
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Thrombotic complications and vasculopathy have been extensively associated with severe COVID-19 infection, however the mechanisms by which endotheliitis is induced remain poorly understood. Here we investigate vascular permeability in the context of SARS-CoV-2-mediated endotheliitis in patient samples and a vascular organoid model. We report the presence of the Spike glycoprotein in pericytes associated with pericyte activation and increased endothelial permeability in post-mortem COVID-19 lung autopsies. A pronounced decrease in the expression of the adhesion molecule VE-cadherin is observed in patients with thrombotic complications. Interestingly, fibrin-rich thrombi did not contain platelets, did not colocalize with tissue factor and have heterogenous levels of Von Willebrand factor, suggesting a biomarker-guided therapy might be required to target thrombosis in severe patients. Using a 3D vascular organoid model, we observe that ACE2 is primarily expressed in pericytes adjacent to vascular networks, consistent with patient data, indicating a preferential uptake of the S glycoprotein by these cells. Exposure of vascular organoids to SARS-CoV-2 or its antigens, recombinant trimeric Spike glycoprotein and Nucleocapsid protein, reduced endothelial cell and pericyte viability as well as CD144 expression with no additive effect upon endothelial activation via IL-1β. Our data suggest that pericyte uptake of SARS-CoV-2 or Spike glycoprotein contributes to vasculopathy by altering endothelial permeability increasing the risk of thrombotic complications.
</p>
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.04.25.21255890v1" target="_blank">Stimulation of vascular organoids with SARS-CoV-2 antigens increases endothelial permeability and regulates vasculopathy</a>
</div></li>
</ul>
<h1 data-aos="fade-right" id="from-clinical-trials">From Clinical Trials</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Oestrogen Treatment for COVID-19 Symptoms</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Drug: Transdermal estradiol gel<br/><b>Sponsors</b>:   Hamad Medical Corporation;   Laboratoires Besins International<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Virgin Coconut Oil as Adjunctive Therapy for Hospitalized COVID-19 Patients</strong> - <b>Condition</b>:   Covid19<br/><b>Intervention</b>:   Drug: Virgin Coconut Oil<br/><b>Sponsors</b>:   University of the Philippines;   Philippine Coconut Authority;   Philippine Council for Health Research &amp; Development<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Impact of GSE and Xylitol (Xlear) on COVID-19 Symptoms and Time to PCR Negativisation in COVID-19 Patients</strong> - <b>Condition</b>:   Covid19<br/><b>Intervention</b>:   Drug: GSE and Xylitol<br/><b>Sponsor</b>:   Larkin Community Hospital<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Hydroxychloroquine (HCQ) as Post Exposure Prophylaxis (PEP) for Prevention of COVID-19</strong> - <b>Conditions</b>:   Covid19;   COVID-19 Prevention<br/><b>Interventions</b>:   Drug: Hydroxychloroquine (HCQ);   Other: Standard care;   Other: Placebo<br/><b>Sponsor</b>:   Postgraduate Institute of Medical Education and Research<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Study to Evaluate a Single Dose of LTX-109 in Subjects With COVID-19 (Coronavirus Disease 2019) Infection.</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: LTX-109 gel, 3%;   Drug: Placebo gel<br/><b>Sponsors</b>:   Pharma Holdings AS;   Clinical Trial Consultants AB<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Safety and Efficacy of Niclosamide in Patients With COVID-19 With Gastrointestinal Infection</strong> - <b>Condition</b>:   Covid19<br/><b>Interventions</b>:   Drug: Niclosamide;   Drug: Placebo<br/><b>Sponsor</b>:   AzurRx BioPharma, Inc.<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Immunobridging and Immunization Schedules Study of COVID-19 Vaccine (Vero Cell), Inactivated</strong> - <b>Condition</b>:   Covid19<br/><b>Interventions</b>:   Biological: 3-doses schedule 1 of COVID-19 Vaccine (Vero Cell), Inactivated;   Biological: 3-doses schedule 2 of COVID-19 Vaccine (Vero Cell), Inactivated;   Biological: 3-doses schedule 3 of COVID-19 Vaccine (Vero Cell), Inactivated;   Biological: 2 doses of vaccine<br/><b>Sponsors</b>:   China National Biotec Group Company Limited;   Beijing Institute of Biological Products Co Ltd.<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Clinical Study Evaluating Inhaled Aviptadil on COVID-19</strong> - <b>Condition</b>:   Covid19<br/><b>Interventions</b>:   Drug: Inhaled Aviptadil;   Drug: Placebo<br/><b>Sponsors</b>:   Centurion Pharma;   Klinar CRO<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>ACTIV-3b: Therapeutics for Severely Ill Inpatients With COVID-19</strong> - <b>Condition</b>:   Covid19<br/><b>Interventions</b>:   Biological: Remdesivir;   Drug: Remdesivir Placebo;   Biological: Aviptadil;   Drug: Aviptadil Placebo;   Drug: Corticosteroid<br/><b>Sponsors</b>:   National Institute of Allergy and Infectious Diseases (NIAID);   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT);   University of Copenhagen;   Medical Research Council;   Kirby Institute;   Washington D.C. Veterans Affairs Medical Center;   AIDS Clinical Trials Group;   National Heart, Lung, and Blood Institute (NHLBI);   US Department of Veterans Affairs;   Prevention and Early Treatment of Acute Lung Injury (PETAL);   Cardiothoracic Surgical Trials Network (CTSN);   NeuroRx, Inc.;   Gilead Sciences<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>COVID-19 Close Contact Self-Testing Study</strong> - <b>Condition</b>:   Covid19<br/><b>Interventions</b>:   Behavioral: COVID-19 self-test;   Behavioral: COVID-19 test referral<br/><b>Sponsors</b>:   University of Pennsylvania;   Public Health Management Corporation<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Detection of Covid-19 in Nasopharyngeal Swabs by Using Multi-Spectral Spectrophotometry</strong> - <b>Condition</b>:   Covid19<br/><b>Intervention</b>:   Diagnostic Test: AP-23<br/><b>Sponsor</b>:   Fable Biyoteknoloji San ve Tic A.S<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Safety and Immunogenicity of Demi-dose of Two Covid-19 mRNA Vaccines in Healthy Population</strong> - <b>Condition</b>:   Covid19<br/><b>Intervention</b>:   Diagnostic Test: immunogenicity after first and second dose<br/><b>Sponsors</b>:   Sciensano;   Mensura EDPB;   Institute of Tropical Medicine, Belgium;   Erasme University Hospital<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Remdesivir Efficacy In Management Of COVID-19 Patients</strong> - <b>Condition</b>:   Covid19<br/><b>Interventions</b>:   Drug: Remdesivir;   Drug: Standard of care_1;   Drug: Standard of care_2<br/><b>Sponsor</b>:   Ain Shams University<br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>SLV213 Treatment in COVID-19 Patients</strong> - <b>Condition</b>:   Covid19<br/><b>Interventions</b>:   Drug: SLV213;   Drug: Placebo<br/><b>Sponsors</b>:   Kenneth Krantz, MD, PhD;   FHI Clinical, Inc.<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Assessment of Efficacy of KAN-JANG® in Mild COVID-19</strong> - <b>Condition</b>:   Covid19<br/><b>Interventions</b>:   Drug: Kan Jang capsules;   Other: Placebo capsules<br/><b>Sponsors</b>:   Swedish Herbal Institute AB;   Tbilisi State Medical University;   Phytomed AB<br/><b>Not yet recruiting</b></p></li>
</ul>
<h1 data-aos="fade-right" id="from-pubmed">From PubMed</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Immunobiology and nanotherapeutics of severe acute respiratory syndrome 2 (SARS-CoV-2): a current update</strong> - The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) constitutes the most significant global public health challenge in a century. It has reignited research interest in coronavirus. While little information is available, research is currently in progress to comprehensively understand the general biology and immune response mechanism against SARS-CoV-2. The spike proteins (S protein) of SARS-CoV-2 perform a crucial function in viral infection establishment. ACE2 and…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Monoclonal antibody therapy in COVID-19 induced by SARS-CoV-2</strong> - Acute severe respiratory syndrome coronavirus-2 (SARS-CoV-2) infection causes coronavirus disease-2019 (COVID-19) which is associated with inflammation, thrombosis edema, hemorrhage, intra-alveolar fibrin deposition, and vascular and pulmonary damage. In COVID-19, the coronavirus activates macrophages by inducing the generation of pro-inflammatory cytokines [interleukin (IL)-1, IL-6, IL-18 and TNF] that can damage endothelial cells, activate platelets and neutrophils to produce thromboxane A2…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Targeting SARS-CoV-2 Spike Protein/ACE2 Protein-Protein Interactions: a Computational Study</strong> - The spike glycoprotein (S) of the SARS-CoV-2 virus surface plays a key role in receptor binding and virus entry. The S protein uses the angiotensin converting enzyme (ACE2) for entry into the host cell and binding to ACE2 occurs at the receptor binding domain (RBD) of the S protein. Therefore, the protein-protein interactions (PPIs) between the SARS-CoV-2 RBD and human ACE2, could be attractive therapeutic targets for drug discovery approaches designed to inhibit the entry of SARS-CoV-2 into the…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>NeutrobodyPlex-monitoring SARS-CoV-2 neutralizing immune responses using nanobodies</strong> - In light of the COVID-19 pandemic, there is an ongoing need for diagnostic tools to monitor the immune status of large patient cohorts and the effectiveness of vaccination campaigns. Here, we present 11 unique nanobodies (Nbs) specific for the SARS-CoV-2 spike receptor-binding domain (RBD), of which 8 Nbs potently inhibit the interaction of RBD with angiotensin-converting enzyme 2 (ACE2) as the major viral docking site. Following detailed epitope mapping and structural analysis, we select two…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>New alpha-Hydrazinophosphonic acid: Synthesis, characterization, DFT study and in silico prediction of its potential inhibition of SARS-CoV-2 main protease</strong> - A new α-Hydrazinophosphonic acid (HDZPA) has been synthesized and its molecular structure was determined using spectroscopic methods. The Density Functional Theory (DFT) at the B3LYP/6-31G (d,p) level was utilized to determine the electronic properties, vibrational modes and active sites of the examined molecule. In this context, some quantum chemical parameters have been calculated in order to discuss the reactivity of the studied molecule. Also, the inhibition activity of the investigated…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Overcoming culture restriction for SARS-CoV-2 in human cells facilitates the screening of compounds inhibiting viral replication</strong> - Efforts to mitigate the COVID-19 pandemic include screening of existing antiviral molecules that could be re-purposed to treat SARS-CoV-2 infections. Although SARS-CoV-2 replicates and propagates efficiently in African green monkey kidney (Vero) cells, antivirals such as nucleos(t)ide analogs (nucs) often show decreased activity in these cells due to inefficient metabolization. SARS-CoV-2 exhibits low viability in human cells in culture. Here, serial passages of a SARS-CoV-2 isolate…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Plitidepsin, an inhibitor of the cell elongation factor eEF1a, and molnupiravir an analogue of the ribonucleoside cytidine, two new chemical compounds with intense activity against SARS-CoV-2</strong> - The knowledge of the replicative cycle of SARS-CoV-2 and its interactions with cellular proteins has opened a new therapeutic possibility based on blocking those essential for the virus. The cellular protein elongation factor eEF1A could be a good target. Among its natural inhibitors are didemnins and their related chemical compounds such as plitidepsin. In human cell culture, this compound is capable of inhibiting the virus with a potency 27,5 times that of remdesivir. It must be administered…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Synthesis, antioxidant, antimicrobial and antiviral docking studies of ethyl 2-(2-(arylidene)hydrazinyl)thiazole-4-carboxylates</strong> - A series of ethyl 2-(2-(arylidene)hydrazinyl)thiazole-4-carboxylates (2a-r) was synthesized in two steps from thiosemicarbazones (1a-r), which were cyclized with ethyl bromopyruvate to ethyl 2-(2-(arylidene)hydrazinyl)thiazole-4-carboxylates (2a-r). The structures of compounds (2a-r) were established by FT-IR, ¹H- and ^(13)C-NMR. The structure of compound 2a was confirmed by HRMS. The compounds (2a-r) were then evaluated for their antimicrobial and antioxidant assays. The antioxidant studies…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>N-Glycosylated Ganoderma lucidum immunomodulatory protein improved anti-inflammatory activity via inhibition of the p38 MAPK pathway</strong> - The global health emergency generated by coronavirus disease-2019 has prompted the search for immunomodulatory agents. There are many potential natural products for drug discovery and development to tackle this disease. One of these candidates is the Ganoderma lucidum fungal immunomodulatory protein (FIP-glu). In the present study, we clarify the influences of N-linked glycans on the improvement of anti-inflammatory activity and the potential mechanisms of action. Four proteins, including…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Inhibition mechanism and hot-spot prediction of nine potential drugs for SARS-CoV-2 M(pro) by large-scale molecular dynamic simulations combined with accurate binding free energy calculations</strong> - Coronavirus disease 2019 (COVID-19), which is caused by a new coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is spreading around the world. However, a universally effective treatment regimen has not been developed to date. The main protease (Mpro), a key enzyme of SARS-CoV-2, plays a crucial role in the replication and transcription of this virus in cells and has become the ideal target for rational antiviral drug design. In this study, we performed molecular…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Rapid, Multiplex Dual Reporter IgG and IgM SARS-CoV-2 Neutralization Assay for a Multiplexed Bead-Based Flow Analysis System</strong> - The COVID-19 pandemic has underscored the need for rapid high-throughput methods for sensitive and specific serological detection of infection with novel pathogens, such as SARS-CoV-2. Multiplex serological testing can be particularly useful because it can simultaneously analyze antibodies to multiple antigens that optimizes pathogen coverage, and controls for variability in the organism and the individual host response. Here we describe a SARS-CoV-2 IgG 3-plex fluorescent microsphere-based…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Mucosal immunity to severe acute respiratory syndrome coronavirus 2 infection</strong> - PURPOSE OF REVIEW: Despite its crucial role in protection against viral infections, mucosal immunity has been largely understudied in the context of coronavirus disease 2019 (COVID-19). This review outlines the current evidence about the role of mucosal immune responses in the clearance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, as well as potential mucosal mechanisms of protection against (re-)infection.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>COVID-19: captures iron and generates reactive oxygen species to damage the human immune system</strong> - Currently, the novel coronavirus pneumonia has been widespread globally, and there is no specific medicine. In response to the emergency, we employed bioinformatics methods to investigate the virus’s pathogenic mechanism, finding possible control methods. We speculated in previous studies that E protein was associated with viral infectivity. The present study adopted the domain search techniques to analyse the E protein. According to the results, the E protein could bind iron or haem. The iron…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Manipulation of genes could inhibit SARS-CoV-2 infection that causes COVID-19 pandemics</strong> - The year 2020 witnessed an unpredictable pandemic situation due to novel coronavirus (COVID-19) outbreaks. This condition can be more severe if the patient has comorbidities. Failure of viable treatment for such viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is due to lack of identification. Thus, modern and productive biotechnology-based tools are being used to manipulate target genes by introducing the clustered regularly interspaced short palindromic…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Structure-Based Virtual Screening to Identify Novel Potential Compound as an Alternative to Remdesivir to Overcome the RdRp Protein Mutations in SARS-CoV-2</strong> - The number of confirmed COVID-19 cases is rapidly increasing with no direct treatment for the disease. Few repurposed drugs, such as Remdesivir, Chloroquine, Hydroxychloroquine, Lopinavir, and Ritonavir, are being tested against SARS-CoV-2. Remdesivir is the drug of choice for Ebola virus disease and has been authorized for emergency use. This drug acts against SARS-CoV-2 by inhibiting the RNA-dependent-RNA-polymerase (RdRp) of SARS-CoV-2. RdRp of viruses is prone to mutations that confer drug…</p></li>
</ul>
<h1 data-aos="fade-right" id="from-patent-search">From Patent Search</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Compositions and methods for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection</strong> - - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=AU321590214">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>5-(4-TERT-BUTOXY PHENYL)-3-(4N-OCTYLOXYPHENYL)-4,5-DIHYDROISOXAZOLE MOLECULE (C-I): A PROMISING DRUG FOR SARS-COV-2 (TARGET I) AND BLOOD CANCER (TARGET II)</strong> - The present invention relates to a method ofmolecular docking of crystalline compound (C-I) with SARS-COV 2 proteins and its repurposing with proteins of blood cancer, comprising the steps of ; employing an algorithmto carry molecular docking calculations of the crystalized compound (C-I); studying the compound computationally to understand the effect of binding groups with the atoms of the amino acids on at least four target proteins of SARS-COV 2; downloading the structure of the proteins; removing water molecules, co enzymes and inhibitors attached to the enzymes; drawing the structure using Chem Sketch software; converting the mol file into a PDB file; using crystalized compound (C-I) for comparative and drug repurposing with two other mutated proteins; docking compound into the groove of the proteins; saving format of docked molecules retrieved; and filtering and docking the best docked results. - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=IN320884617">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>AQUEOUS ZINC OXIDE NANOSPRAY COMPOSITIONS</strong> - Disclosed herein is aqueous zinc oxide nano spray compositions comprising zinc oxide nanoparticles and a synthetic surfactant for controlling the spread of Covid-19 virus. - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=IN321836709">link</a></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Bettverlängerungssystem</strong> -
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
</p><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">Bettverlängerungssystem (1) für in Bauchlage beatmungspflichtige Patienten in Gestalt mit zumindest einer Platte (16), dadurch gekennzeichnet, dass die Platte (16) im Kopflagerungsbereich einen Luftwegezugangsdurchbruch (8) mit einem den Luftwegezugangsdurchbruch (8) umgebenden Auflagerbereich für ein durchbrochenes Kopfauflagepolster (14) aufweist, durch den von der Bettunterseite her und durch das Kopfauflagepolster (14) hindurch die Ver- und Entsorgungsschläuche für eine orotracheale Intubation oder eine nasotracheale Intubation ventral an das Gesicht des Patienten herangeführt werden können, und dass die Platte (16) im Bereich ihrer dem Kopfende eines Bettrosts (15) zugeordneten Stirnseite (6) ein Fixierelement (2) zur Befestigung der Platte (16) am Bettrost (15) nach Art eines einseitig frei über das Kopfende des Bettrosts hinausragenden Kragträgers aufweist.</p></li>
</ul>
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<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=DE322212040">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>一种肝素类药物组合物、喷鼻剂及其制备方法及应用</strong> - 本发明公开了一种肝素类药物组合物、喷鼻剂及其制备方法及应用。该肝素类药物组合物包括肝素钠和阿比朵尔。本发明中的肝素类药物组合物首次采用肝素钠和阿比朵尔联合使用，普通肝素钠联合1μM/L以上的阿比朵尔病毒抑制效率显著高于单独普通肝素钠或单独阿比多尔组（p&lt;0.05）。 - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=CN321712860">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>USING CLINICAL ONTOLOGIES TO BUILD KNOWLEDGE BASED CLINICAL DECISION SUPPORT SYSTEM FOR NOVEL CORONAVIRUS (COVID-19) WITH THE ADOPTION OF TELECONFERENCING FOR THE PRIMARY HEALTH CENTRES/SATELLITE CLINICS OF ROYAL OMAN POLICE IN SULTANATE OF OMAN</strong> - - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=AU320796026">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>抗SARS-COV-2中和抗体</strong> - 本公开提供了针对SARS‑COV‑2的新颖中和抗体和其抗原结合片段。还提供了包括其的药物组合物和试剂盒以及其用途。 - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=CN321712812">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Peptides and their use in diagnosis of SARS-CoV-2 infection</strong> - - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=AU319943278">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Method and compositions for treating coronavirus infection</strong> - A method of treating viral infection, such as viral infection caused by a virus of the Coronaviridae family, is provided. A composition having at least oleandrin is used to treat viral infection. - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=AU319943054">link</a></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Luftdesinfektionssäule</strong> -
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
</p><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">Luftreinigungssäule (1) mit einer Luftaufnahme (2) und einer Luftausgabe (3), wobei zwischen der Luftaufnahme (2) und der Luftausgabe (3) ein luftleitender Bereich (4) mit einem Gebläse (7) und einer UV-Lichtdesinfektionseinrichtung (5) angeordnet ist, dadurch gekennzeichnet, dass der luftleitende Bereich (4) photokathalysatorisch beschichtete Oberflächen (9) aufweist und/oder ein photokathalysatorisch beschichtetes Gitter (11) angeordnet ist, wobei photokathalysatorisch beschichtetes Gitter (11) und die photokathalysatorisch beschichtete Oberflächen (9) mit Titandioxid (TiO<sub>2</sub>) beschichtet sind, wobei die UV-Lichtdesinfektionseinrichtung (5) UV-A-LEDs (12), die UV-A-Strahlung im Wellenlängenbereich 380-315 nm ausstrahlt und UV-C-LEDs (8) die UV-Strahlung im Wellenlängenbereich UV-C 280-200 nm (8) ausstrahlen aufweist und wobei ein Akku (13) zur netzunabhängigen Stromversorgung angeordnet ist.</p></li>
</ul>
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<ul>
<li><a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=DE322212010">link</a></li>
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<h1 data-aos="fade-down" id="daily-dose">Daily-Dose</h1>
<h1 data-aos="fade-right" data-aos-anchor-placement="top-bottom" id="contents">Contents</h1>
<ul>
<li><a href="#from-new-yorker">From New Yorker</a></li>
<li><a href="#from-vox">From Vox</a></li>
<li><a href="#from-the-hindu-sports">From The Hindu: Sports</a></li>
<li><a href="#from-the-hindu-national-news">From The Hindu: National News</a></li>
<li><a href="#from-bbc-europe">From BBC: Europe</a></li>
<li><a href="#from-ars-technica">From Ars Technica</a></li>
<li><a href="#from-jokes-subreddit">From Jokes Subreddit</a></li>
</ul>
<h1 data-aos="fade-right" id="from-new-yorker">From New Yorker</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Significance of the Derek Chauvin Verdict</strong> - The New Yorker’s Jelani Cobb discusses the trial’s outcome. - <a href="https://www.newyorker.com/news/our-columnists/the-significance-of-the-derek-chauvin-verdict">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Forgotten History of the Purging of Chinese from America</strong> - The surge in violence against Asian-Americans is a reminder that America’s present reality reflects its exclusionary past. - <a href="https://www.newyorker.com/news/daily-comment/the-forgotten-history-of-the-purging-of-chinese-from-america">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>How 1.5 Degrees Became the Key to Climate Progress</strong> - The number has dramatically reorganized global thinking around the climate. - <a href="https://www.newyorker.com/news/annals-of-a-warming-planet/how-15-degrees-became-the-key-to-climate-progress">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Cuba After the Castros</strong> - Sixty years after the Bay of Pigs, the Castro brothers are gone from the main stage, and Cuba is a threadbare place facing an uncertain future. - <a href="https://www.newyorker.com/news/daily-comment/cuba-after-the-castros">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Bridging the Divide Between the Police and the Policed</strong> - In New York, the Mayor and police leadership have repeatedly voiced commitments to “create a bond” between cops and communities of color. The problem, according to high-level officials, is that the city chose the wrong people for the right job. - <a href="https://www.newyorker.com/news/our-local-correspondents/bridging-the-divide-between-the-police-and-the-policed">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li><strong>The politics of going big</strong> -
<figure>
<img alt="" src="https://cdn.vox-cdn.com/thumbor/ZGiZoAATadU1tLMEJXZ4YRrQm6Y=/626x0:5631x3754/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/69197992/GettyImages_1229315228.0.jpg"/>
<figcaption>
Supporters watch as Democratic presidential nominee Joe Biden arrives at a drive-in campaign rally on October 27, 2020, in Atlanta. | Drew Angerer/Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Women and people of color were crucial to Biden’s presidential win, and they’re crucial to his jobs plan.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="b76Y7e">
The Biden administration’s theory of policy so far is to go big. The same goes for its politics.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="J8ykRb">
Taken together, President Joe Biden’s $2.25 trillion American Jobs Plan and newly introduced $1.8 trillion American Families Plan come out to slightly over $4 trillion in proposed new spending. It’s an enormous investment in American job creation; the last bipartisan infrastructure bill <a href="https://apnews.com/article/f1b2c8dee7ea45b2a91b2d306b180429">Congress passed in 2015</a> clocked in at about $305 billion — about one-thirteenth the size of Biden’s proposed plan. And Obama’s $800 billion stimulus plan of 2009 was about one-fifth of Biden’s plan, not even taking into account the $1.9 trillion in Covid-19 relief that has already been signed into law.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bOBktS">
That sheer amount of proposed federal funding is meant to do a lot of things, but the main goal is to get as many jobs to as many people in as many voter constituencies as possible. Under Biden’s plan, infrastructure no longer calls to mind images of white men in hard hats; it includes working mothers, home health aides who care for the nation’s elderly, and workers of color across the nation. Women and people of color were crucial to Biden’s presidential win, and they are also crucial elements in his jobs plan.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rAnUYo">
“We talk about the working middle class as white men in pickup trucks in Ohio, but they’re really Black and brown workers that are keeping our economy afloat,” said longtime Democratic strategist Chuck Rocha, who is advising the pro-Biden outside group Building Back Together on outreach to Latino voters.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wqnrUQ">
Republicans are making a bet that the sheer size of Biden’s collective “Build Back Better” agenda could be a problem for him, and that voters will be turned off by trillions of dollars in new spending.<strong> </strong>Congressional Republicans<strong> </strong>have pitched a package that’s about <a href="https://www.vox.com/2021/4/22/22397517/republican-infrastructure-plan-biden">a quarter of the size</a> of Biden’s American Jobs Plan. Meanwhile, prominent progressives including Rep. Alexandria Ocasio-Cortez (D-NY) want Biden to go as big as <a href="https://www.axios.com/aoc-biden-infrastructure-f2cbe0df-099e-47f6-a358-3c0938d4f642.html">$10 trillion in infrastructure spending over the next decade</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="x6iO1u">
But the White House and Democrats are already building a public case that infrastructure accounts for a lot more than roads and bridges. They seem to have had success so far; numerous pollsters Vox interviewed said “infrastructure” is a nebulous concept to many voters.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="D0erbl">
“What people don’t realize is that the majority of voters don’t know what infrastructure is to begin with,” said veteran Democratic pollster Celinda Lake, who advised and polled for Biden’s presidential campaign. “The caregiving situation is as critical as the road you drive on to get to work. The Covid experience has really brought that home.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="w8gNox">
“Jobs,” on the other hand, is a term that voters understand well. And Biden’s massive plan — funded by raising taxes on the wealthy and corporations — is jobs creation on steroids.
</p>
<h3 id="1EKOZJ">
Democrats are arguing infrastructure is more than transportation
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JBIVAV">
Historically, the word infrastructure has called to mind very male-dominated jobs: Construction, manufacturing, and maintenance, getting shovels in the ground. Indeed, just <a href="https://www.statista.com/statistics/434758/employment-within-us-construction-by-gender/">10 percent of construction jobs</a> are held by women.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3OLcP7">
Multiple experts told Vox that if roads and bridges are the physical infrastructure Americans need to get to work, the Covid-19 pandemic has laid bare a long-existing reality about the lack of “human infrastructure” in the US. Often, affordable child care or elder care makes all the difference as to whether women with care obligations are able to work at all.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="san0Ua">
“Without a robust care infrastructure, we’re essentially choosing to bench half our labor market,” Rakeen Mabud, managing director of policy and research and chief economist at Groundwork Collaborative, told Vox. “The fact we’re even having a debate of whether or not care is infrastructure … is so deeply rooted in racialized and gendered deservingness.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VnTYtm">
Biden’s American Jobs Plan contains $400 billion specifically to lower the costs of long-term care for elderly and disabled patients, keeping them in their homes. But it also aims to raise the low wages of home heath aides and caregivers themselves, who <a href="https://www.vox.com/the-goods/22360152/child-care-free-public-funding">are predominantly Black and brown women</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="16d8f7">
“Receiving the respect, recognition and compensation they are due is not only essential and necessary, but it is just the beginning of what we must do to address the long history of racial exclusion that this workforce has faced,” Ai-jen Poo, the co-founder and executive director of the National Domestic Workers Alliance, told Vox.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wPfZdn">
The Biden administration also employs a number of progressive economists who have spent their careers focusing on how to make the US economy more equal for women and workers of color. Mabud’s argument is echoed within the administration by people like Janelle Jones, who formerly led policy and research at Groundwork Collaborative and is now the chief economist for the US Department of Labor.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="V2HMDX">
“I think the pandemic and this recession have shown that … an economy built on the structural flaws of racism and inequality is less stable for everyone,” Jones said during a <a href="https://www.npr.org/2021/04/09/985860394/women-are-leading-bidens-economic-recovery-plan-for-the-country-and-other-women">recent interview with NPR</a>. “It really has shown that when we have an economy that is just the rich getting richer and everyone else doing worse off — we’re all worse off.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0DKfjN">
The Covid-19 pandemic has made this situation acute. Data shows <a href="https://www.cbsnews.com/news/covid-crisis-3-million-women-labor-force/">that women</a> and <a href="https://www.cbpp.org/research/economy/labor-market-weaker-than-headline-numbers-suggest">workers of color</a> were forced out of the labor market, owing to lower-wage jobs being more likely to be cut during the pandemic, and women being unable to work while also providing at-home school and care for their children.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="anmlod">
This makes good policy sense for Biden, but it’s also good political sense. Biden’s base is diverse; his presidential win and Democrats’ surprise wins in Georgia were powered by women and voters of color alike. Appealing to a large base that government policy has left behind for decades is a shrewd political move ahead of the 2022 midterms.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Tp4ZBK">
It’s also responding to the current moment. A recent <a href="https://www.washingtonpost.com/business/2021/04/27/poll-women-pandemic-worse-off/">Washington Post-ABC News poll</a> found that 25 percent of women and 27 percent of workers of color said their family’s financial situation is worse off today than it was before March 2020, when pandemic shutdowns went into effect. The survey also found that middle-aged and younger women were impacted more, with 29 percent of women younger than 65 saying they are financially worse off today, compared to 10 percent of women who are 65 and older.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="b7YLGw">
As the <a href="https://www.nytimes.com/2021/04/27/briefing/vaccines-gavin-newsom-ransomware-attack.html?referringSource=articleShare">New York Times’s David Leonhardt writes</a>, recent US census data showed the US birth rate grew by just 7.4 percent, the smallest increase since the Depression-era 1930s. One of the big reasons could be the high cost of raising children, coupled with relatively <a href="https://www.pewresearch.org/social-trends/2020/01/09/trends-in-income-and-wealth-inequality/">modest income increases</a> in the US that often aren’t enough to compete with rising costs.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="UVb3Kl">
“The decline in the birthrate, in other words, is partly a reflection of American society’s failure to support families,” Leonhardt wrote. Biden’s American Families Plan is a bid to fix that.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QjAoCY">
Finally, while the current unemployment rate is hovering around 6 percent, it’s a different scenario for workers of color in the United States. Unemployment for Black workers is 9.6 percent, while unemployment for Latino workers is around 7.9 percent, according to the <a href="https://www.bls.gov/news.release/pdf/empsit.pdf">Bureau of Labor Statistics</a>. And top economic officials including Federal Reserve Chair Jerome Powell say <a href="https://www.washingtonpost.com/business/2021/02/10/powell-unemployment-january/">this is likely an undercount</a>; workers who dropped out of the workforce altogether to school their children at home wouldn’t necessarily be captured by these statistics because they are not actively looking for work.<strong> </strong>The impact of the Covid-19 pandemic was unequal, and the US recovery continues to be.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7bt33l">
“We’re not just coming out of a crisis, we’re rebuilding from decades of disinvestment,” said Mabud. “We know women have been hit hardest in this crisis, and Black and Latinx women in particular. We can’t stop until we see a full recovery and then some for women.”
</p>
<h3 id="FtAdaH">
The public is receptive to Biden’s large proposals
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9lV5IF">
A range of polling shows that Biden’s expansive view of what counts as infrastructure has fairly broad support among the American public.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9ZSduh">
A recent <a href="https://www.cnbc.com/2021/04/25/biden-job-approval-hits-53percent-majority-support-infrastructure-plan-nbc-news-poll.html">NBC News poll</a> found that 59 percent of respondents supported Biden’s American Jobs Plan. A recent <a href="https://www.vox.com/2021/4/15/22383587/biden-american-jobs-plan-long-term-care">Vox and Data for Progress poll</a> found that 68 percent of likely voters support the plan. And a <a href="https://www.monmouth.edu/polling-institute/documents/monmouthpoll_us_042621.pdf/">Monmouth University poll</a> released Monday found 68 percent of respondents supported Biden’s infrastructure bill, with another 64 percent supportive of the ideas in Biden’s American Families Plan, which aims to make child care, higher education, and health care more affordable.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EnGVFb">
As Republicans and Democrats argue over the semantics of what constitutes “infrastructure,” Monmouth polling director Patrick Murray told Vox that Biden’s broad brush does not appear to be turning off voters so far.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="iX4kyW">
For instance, <a href="https://www.vox.com/2021/4/15/22383587/biden-american-jobs-plan-long-term-care">Vox and Data for Progress polling</a> found that a majority of likely voters of all parties supported Biden’s proposal of putting $400 billion into bringing down the costs of long-term care: 88 percent of Democrats, 72 percent of independents, and 55 percent of Republicans support the idea. And recent polling from <a href="https://assets.morningconsult.com/wp-uploads/2021/03/31082502/2103166_crosstabs_POLITICO_RVs_v1_AUTO.pdf">Politico and Morning Consult</a> shows that a large majority of Black voters support Biden’s pledge to increase housing options for low-income Americans; 80 percent of Black voters support that measure, and 58 percent “strongly” support it.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ULgcPI">
In other words, voters seem to care more about things that directly impact their lives than they do about whether these things meet a strict definition of “infrastructure.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CJnwOZ">
“[Biden] understood that just a straightforward infrastructure plan on roads and bridges was not going to sell as well as a broader plan where people could see a potential benefit coming directly to them,” Murray told Vox. “He knows he’s not going to get support from Republicans on this; certainly not on the Hill. But he might try to build Republican support in the public once these things start rolling out.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fp7lKn">
Murray noted that though support for Biden’s plan is split along party lines, about one-third of Republicans support his plans, which is not extremely low. The pollster also cautioned that the problem that former President Barack Obama and Vice President Biden encountered with the 2009 stimulus bill was too small. Their initial plan polled well, but that changed after it was watered down to appease congressional Republicans.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ly1rh2">
“By the end of 2009, it tanked in public opinion,” Murray said. “What the public was asking at that point was, ‘What’s in it for me?’” The Biden administration appears to have absorbed this important lesson of the Obama era.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fwapfD">
Both Murray and Cameron Easley, senior editor at Morning Consult, noted that Biden’s plan goes up in popularity when poll respondents are told it will be paid for with higher taxes on corporations and America’s wealthy. Easley told Vox that “pay-for” seems more popular among voters than deficit spending, where the government continues to borrow rather than pay for its plans outright. The popularity of raising corporate taxes also complicates congressional Republican opposition to the plan.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8bWGNV">
Easley said the public would “much rather fund it by hiking taxes on corporations or the rich than they would by deficit spending.”
</p>
<h3 id="MxOUUq">
Trying to define infrastructure as roads and bridges could be a problem for Republicans
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DkamWB">
Republicans struggled to effectively attack Biden’s $1.9 trillion Covid-19 relief bill in large part because the bill — which included $1,400 stimulus checks — was <a href="https://www.usatoday.com/story/news/politics/2021/03/10/covid-19-stimulus-package-polls-find-strong-support-relief/6936053002/">popular</a> with their constituents.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kctgmD">
Now, “it seems Republicans have had trouble finding an effective message on infrastructure like they have had finding an effective message on Covid relief,” Easley told Vox.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8x8840">
So far, the main Republican attack on Biden’s American Jobs Plan is that it takes too expansive a view of infrastructure, which Republicans more narrowly define as conventional transportation infrastructure, along with broadband access. Last week, Senate Republicans unveiled a $568 billion counteroffer, which they see as the starting point of their negotiations with the White House.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="r2x7nN">
“What do people think of in our states when they think of infrastructure? Roads and bridges; public transit systems; rail — which could be cargo, passenger rail; water and wastewater …ports and inland waterways; airports; broadband,” Sen. Shelley Moore Capito (R-WV) said at a press conference.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1LX3O5">
The <a href="https://www.monmouth.edu/polling-institute/documents/monmouthpoll_us_042621.pdf/">Monmouth University poll</a> found that a majority of voters equally favor Biden’s plan to spend heavily on infrastructure and his plan to spend on child care, health care, and education; 54 percent said both plans were equally important, compared to 19 percent who said infrastructure was more important and 21 percent who said a plan to extend health care and child care was more important.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QMvRgm">
Rocha, the political strategist focusing on outreach to Latinos, says he’s advising Democrats to scrap the word “infrastructure” and focus with laser-like intensity on jobs.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="U9IPcL">
“When talking to voters, you should always use the word ‘jobs,’” Rocha said. “Infrastructure is just something that sits out there that people don’t understand. What I am advising all Democrats is to talk about American jobs.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="A41cFj">
Ultimately, some Democrats anticipate the most effective Republican attack may be about the overall price tag of Biden’s cumulative plans. The nearly $4 trillion in proposed spending, plus the $1.8 trillion already out the door, will likely be featured in GOP attack ads.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="PcJ2wF">
“Where we have to win in the debate is the pay-for,” said Democratic strategist Molly Murphy. “Republicans are basically just going to say it’s a lie, there’s no way to pay for this without raising middle-class taxes, you’ll just pay for it. They will talk about how expensive this is the whole way through.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Iv7JFX">
But Murphy noted Republicans will also have to navigate the fact that paying for these plans by raising taxes on corporations and the wealthy — the thing they dislike the most — is also popular with voters.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="B1jpCr">
“Right now, Americans believe this can be paid for by raising taxes on the wealthy, which they support,” Murphy said. “We need to keep it that way.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jAq9sG">
</p></li>
<li><strong>Biden takes aim at American inequality by investing $1.8 trillion in families</strong> -
<figure>
<img alt="President Biden Delivers Remarks On Administration’s COVID-19 Response" src="https://cdn.vox-cdn.com/thumbor/pBbI0a7okaWy4I4EUqzU2PWsojI=/157x0:5625x4101/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/69197866/1232562722.0.jpg"/>
<figcaption>
President Joe Biden speaks about updated CDC mask guidance on the North Lawn of the White House on April 27, 2021, in Washington, DC. | Drew Angerer/Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Biden’s new plan would be life-changing for many American families. Can it pass?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ASmtVr">
President Joe Biden on Wednesday proposed a $1.8 trillion package that, if passed, would be the largest American investment in child care, paid leave, and early education in recent history — if not ever.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="WIOcbU">
The American Families Plan would work with states to incentivize universal preschool for all 3- and 4-year-olds in the nation, provide two years of free community college to those who want it, make child care more affordable for low- and middle-income families, create a new national program for family and medical leave, and expand the maximum Pell Grant for college by about 20 percent. The plan also provides $800 billion worth of tax relief for families with children: It extends the expanded child tax credit from Biden’s Covid relief package until 2025, and permanently expands Affordable Care Act tax credits to lower health insurance costs for millions of Americans, among other things.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uz9DAj">
Biden’s plan would make a huge dent in inequality — in a country that currently provides very little government support for American families. The United States stands alone among developed countries in failing to <a href="https://www.pewresearch.org/fact-tank/2019/12/16/u-s-lacks-mandated-paid-parental-leave/">mandate paid leave for new parents</a>, or <a href="https://www.statesman.com/story/news/politics/politifact/2021/01/29/united-states-industrialized-nation-no-paid-family-medical-leave-plan/4313107001/">paid family medical leave</a>. And many other high-income countries subsidize child care and preschool.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4szyfS">
Analysis shows the expanded child tax credit alone will cut US child poverty in half, and the expanded child care in Biden’s plan will be welcome for parents — particularly mothers — who have spent the past year attempting to juggle work and caring for children. A recent <a href="https://www.washingtonpost.com/business/2021/04/27/poll-women-pandemic-worse-off/">Washington Post/ABC News poll</a> found that 25 percent of women and 27 percent of workers of color said their family’s financial situation is worse off today than it was before March 2020, when pandemic shutdowns went into effect.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nF7P0d">
Biden will formally introduce his plan on Wednesday night, during his first speech before a joint session of Congress. There, he’ll also unveil pay-fors for the plan, new tax increases on America’s wealthy, and funding for tax enforcement the administration says will fully pay for these investments in 15 years.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QtuJNv">
Specifically, the Biden administration is asking Congress to raise<strong> </strong>taxes on the nation’s wealthiest 1 percent of individuals by returning the top individual income tax rate to 39.6 percent — a reversal of the GOP’s 2017 tax cuts. Administration officials repeatedly underscored that anyone making less than $400,000 per year would be excluded from higher taxes. The tax plan also includes new measures to <a href="https://www.vox.com/22405898/joe-biden-irs-funding">beef up IRS enforcement</a> to ensure wealthy people who skirt paying their taxes have to pay up.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Awjxjt">
Child care and paid leave advocates say these investments are important because<strong> </strong>American parents and other caregivers — the majority of them women — can’t work without them.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ByKhUZ">
“This isn’t just a ‘nice to have,’” Vicki Shabo, senior fellow for paid leave policy and strategy at New America, told Vox. “This is a core economic issue for the country.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Zj2NM5">
Now, however, it will be up to the Biden administration to take that message to Congress — where multibillion-dollar spending on child care and early education <a href="https://www.washingtonpost.com/us-policy/2021/04/24/biden-families-plan-tax/">may be a harder sell</a> than roads and bridges. Conservatives have opposed federal funding for child care for decades, arguing that it would <a href="https://www.vox.com/the-highlight/21432940/child-care-bailout-covid-economy-work-parents-great-rebuild">threaten American families</a>, and the provisions in the American Families Plan are unlikely to attract Republican support.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="j6nAxv">
There are a lot of details still to be worked out, but many care advocates believe their time is now.<strong> </strong>The pandemic has shown that “everybody is vulnerable in some way when a serious personal health or caregiving issue strikes,” Shabo said. “All of these issues have become much more relatable as people across region, across family situation, across income, have struggled in one way or another with this really unprecedented moment.”
</p>
<h3 id="lfFG4t">
What’s in the American Families Plan
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="56SCs0">
Biden’s latest plan is the second of his two-plank vision for economic recovery. While the <a href="https://www.vox.com/2021/3/31/22357179/biden-two-trillion-infrastructure-jobs-plan-explained">American Jobs Plan</a> focused on building roads and schools, investing in green energy, and <a href="https://www.vox.com/2021/4/15/22383587/biden-american-jobs-plan-long-term-care">supplementing long-term care</a> for older adults and those with disabilities, this twin plan invests in the “human infrastructure” that makes the economy function.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1YVTK8">
Broadly, the American Families Plan is focused on bringing down the high costs of raising children, attending school and pursuing higher education, and getting health insurance. The plan also contains a number of provisions on nutrition and healthy school means.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="NLttd5">
The White House outlined several main points:
</p>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DI3HOw">
$200 billion for universal preschool for all 3- and 4-year-olds, which the administration estimates would benefit 5 million children and save the average family $13,000. There would be no income cap for this program, according to administration officials.
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="zdPQLv">
$109 billion to offer two free years of community college to all Americans who want it, and an increase of the maximum Pell Grant award by approximately $1,400 per year.
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="zirbgy">
Biden is calling on Congress to double scholarships for students studying to become teachers from $4,000 to $8,000, and is asking Congress to invest $1.6 billion to help educators get certified in high-cost areas like special education.
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ffqf0q">
$2.25 billion to make child care more affordable, fully covering child care costs for the lowest-income working families, and ensuring families earning 1.5 times their state median income pay no more than 7 percent of their income for children under the age of 5.
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="krrLyQ">
$225 billion to creating a national comprehensive paid leave family and medical leave program, providing up to $4,000, which covers up to 80 percent of wages for the lowest-paid workers. The administration pointed to research that over 30 million workers, including 67 percent of low-wage workers, don’t have access to a single paid sick day.
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="f6TzLE">
$45 billion to expand summer EBT to all eligible children nationwide, expand healthy school meals, support schools that are offering healthy foods, and allow formerly incarcerated individuals to re-enroll in SNAP.
</li>
<li id="0LfGNo">
Biden commits to strengthening and “modernizing” unemployment insurance, including working with Congress on <a href="https://www.vox.com/policy-and-politics/22277339/covid-19-relief-bill-automatic-stabilizers">automatic stabilizers</a> — which would automatically adjust the length and amount of UI benefits workers receive if the economy goes into recession, rather than Congress having to reauthorize benefits.
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jAGAuZ">
$800 billion worth of tax credits and cuts for American families and workers, including extending expanded ACA premiums tax credits, making health insurance cheaper for millions; extending the child tax credit increases in Biden’s Covid relief plan through 2025 and making the child tax credit permanently fully refundable; permanently increasing the temporary child and dependent care tax credit; and making the earned income tax credit expansion for childless workers permanent.
</li>
</ul>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XRZiKM">
To pay for all of this, Biden is proposing:
</p>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4MZs71">
Increasing the top tax rate on the wealthiest 1 percent of Americans to 39.6 percent, a reversal of the 2017 GOP tax cut. Biden is also proposing ending capital income tax breaks and other loopholes for households making over $1 million, making them pay the same 39.6 percent rate on all their income.
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QiCOrT">
Closing a number of other tax loopholes, including accumulated gains loopholes and the carried interest loophole, the latter of which primarily impacts hedge fund partners.
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Nn1nSg">
Increasing IRS funding so that the agency can actually enforce penalties on wealthy Americans who do not pay their taxes. The Biden administration estimates that enforcement alone would raise $700 billion over 10 years.
</li>
</ul>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7RL0PZ">
Some details of this plan<strong> </strong>may not make it into a final bill when Congress begins drafting. But it shows that the administration is planting its flag on big investments in America’s middle and lower classes — and thinks the upper class should pay for it.
</p>
<h3 id="7a4tZf">
Biden is prioritizing the care economy
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="whUCCP">
The American Families Plan builds on a commitment Biden made on the campaign trail: to take an inclusive view of the country’s economic success that encompassed not just the kinds of manufacturing jobs emphasized by past administrations but also jobs in fields like child care and elder care. These jobs are often done by women, especially women of color, and, since women shoulder the majority of caregiving responsibilities within families, supporting caregiving jobs allows more women to enter the labor force as well.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="R0AXUm">
“When we usually talk about jobs packages, there is a big push on shovel-ready jobs,” Biden <a href="https://www.vox.com/2020/7/24/21334114/biden-child-care-plan-explained"><strong>said in a speech</strong></a> last July. “But that’s what care jobs are. … The workers are ready now. These jobs can be filled now. Allowing millions of people, primarily women, to get back to work now.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8HMnks">
The first part of the president’s infrastructure package, released in March, included some money for care jobs — namely, <a href="https://www.vox.com/2021/4/15/22383587/biden-american-jobs-plan-long-term-care">$400 billion</a> for home- and community-based health and elder care. But the bulk of the president’s care-economy agenda is contained in the American Families Plan.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yKBmL6">
The proposed investments have the potential to transform the lives of workers in caregiving jobs and of families who need care. On paid leave, for example, the plan would close a gaping hole in the American social safety net. Before the pandemic, just 20 percent of American private sector workers — and just 8 percent of workers in the bottom quartile of low-wage workers — had access to paid leave to care for a new child or family member, <a href="https://www.americanprogress.org/issues/women/news/2021/02/05/495504/quick-facts-paid-family-medical-leave/">according to the Center for American Progress</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ojjO5S">
“The lack of access to paid leave in this country keeps women out of the workforce, depresses women’s wages, and means that family members who need care from a family member often can’t get it.” Shabo explained. Meanwhile, “people who have a serious health issue often have to go to work or take unpaid leave,” the latter of which can push them into poverty.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Qdb6wQ">
Though many college-educated workers already have paid leave benefits as part of their employment package, the vast majority of workers do not. One estimate put the total of employees who had access to paid family leave at just <a href="https://www.washingtonpost.com/news/wonk/wp/2015/08/19/the-shocking-number-of-new-moms-who-return-to-work-two-weeks-after-childbirth/">13 percent</a>.<strong> </strong>The American Families Plan would change that, allowing American workers to take paid time to care for a child or recover from an illness, and still return to their jobs.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="w5nAAG">
The plan also has the potential to remake America’s patchwork child care system. Child care in many states currently costs more than tuition at a public university, yet workers in the industry make poverty-level wages, around $11 an hour. The <a href="https://www.vox.com/policy-and-politics/2021/3/10/22320350/stimulus-bill-covid-19-passes-house">American Rescue Plan</a>, the Covid-19 stimulus bill signed in March, contained $39 billion to help the child care industry weather the immediate challenge of the pandemic, but it wasn’t enough to fundamentally change the system for the future. Funding at the level of the American Families Plan, however, “sends a signal to states and to the field that this is an intended long-term investment,” Rhian Allvin, CEO of the National Association for the Education of Young Children, told Vox.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yX9P87">
Indeed, the plan would ensure that families making under 1.5 times a state’s median income pay no more than 7 percent of their income on child care, while the lowest-income families would pay nothing. Meanwhile, it would raise wages for child care workers to $15 an hour, or to parity with kindergarten teachers if workers have similar qualifications.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cT1jJz">
Such reforms would be an enormous boon to child care workers, the majority of whom are women and 40 percent of whom are women of color. They would also help more mothers — who still do the majority of child care in families — work outside the home. That’s especially consequential during a pandemic that has led <a href="https://www.vox.com/21536100/economy-pandemic-lose-generation-working-mothers">millions of women to leave the labor force</a>, many of them due to a lack of child care.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mW0Crc">
That’s one of the many reasons experts say it makes sense to think about caregiving as part of any economic or infrastructure plan. “Without a robust care infrastructure, we’re essentially choosing to bench half our labor market,” Rakeen Mabud, managing director of policy and research and chief economist at Groundwork Collaborative, told Vox.
</p>
<h3 id="FWXdDC">
The American Families Plan could have a tough road ahead in Congress
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jrPCrY">
Some advocates are concerned that the American Families Plan could be less politically palatable to conservatives and moderates in Congress than the infrastructure-focused American Jobs Plan.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7u8Lui">
It’s yet to be seen whether Democrats will attempt to pass these packages piecemeal or roll them up into one giant piece of budget reconciliation legislation that could be passed with Republican support. Democrats passed Biden’s $1.9 trillion Covid relief plan with budget reconciliation and are considering the same with infrastructure.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="FkujcG">
Either way, the child care and paid leave portions of the president’s agenda could fall by the wayside in congressional negotiations, whether it’s because moderates will object to lumping everything together or because they don’t want to vote for a third package that adds another nearly $2 trillion in spending.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="iEWQON">
“Getting the infrastructure provisions done is going to be hard enough, because Republicans may not want to play ball,” Jim Manley, who was an aide to then-Senate Majority Leader Harry M. Reid (D-NV), <a href="https://www.washingtonpost.com/us-policy/2021/04/24/biden-families-plan-tax/">told the Washington Post</a>. “But getting the other domestic spending plans over the finish line is going to be a heck of a lot tougher.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JHWB0P">
Some fear that by splitting up the plans, the White House might have increased the likelihood that child care and other centerpieces of the second plan get left behind, especially since long-term care made it into the American Jobs Plan. Rep. Katie Porter (D-CA) <a href="https://www.vox.com/22362607/child-care-biden-infrastructure-plan-bill">expressed concern at a summit in March</a> that a point could come when “golly gee, there’s no money left to help make it possible for women to recover economically.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JBImXs">
After a recent ruling from Senate Parliamentarian Elizabeth MacDonough, Democrats can pass two more budget reconciliation packages this fiscal year. However, this strategy is unprecedented and relatively untested, and is likely to prompt a negative reaction from Senate institutionalists.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="PgThx4">
Progressives like Sen. Elizabeth Warren (D-MA) say they want to keep infrastructure and child care in one large package.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KpJVFp">
“For people to go to work, we need roads and bridges and child care,” Warren told reporters recently. “And we need a jobs package that produces jobs for men, which is often in the roads and bridges construction, and for women, which is often in child care. We need it all, and I think it should be in one package.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0lJbs8">
</p></li>
<li><strong>How Senegal stretched its health care system to stop Covid-19</strong> -
<figure>
<img alt="" src="https://cdn.vox-cdn.com/thumbor/V9Qfnp2JUdRgfCeYyxdm4uDjC0M=/180x0:2847x2000/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/69197818/APRIL_2021_SENEGAL_COVID_RICCI_SHRYOCK_39.0.jpg"/>
<figcaption>
Aissatou Diao (center) is one of many community health outreach officers who has worked to contain the spread of Covid-19 in Senegal. | <a class="ql-link" href="http://www.riccimedia.com/" target="_blank">Ricci Shryock</a> for Vox
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Senegal’s quarantine policy sought to slow transmission, and local health care workers battled the pandemic from the ground up.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MdOS5E">
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ujzKhS">
<em>This story is one in our six-part series The Pandemic Playbook.</em><em><strong> </strong></em><a href="https://www.vox.com/22381700/pandemic-playbook"><em><strong>Explore all the stories here.</strong></em></a>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9viwXA">
DAKAR, Senegal — Aissatou Diao talked about Covid-19 a lot. How to socially distance, what to do if you have a cough or a fever. But when the first coronavirus case arrived in Yeumbeul, a village outside Dakar where she does health outreach as a community relay, she couldn’t believe it.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jlF3nx">
“I almost died when I heard I was on the list of people who were in contact with the Covid patient,” Diao recalls.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QHdIFI">
That single contact brought Diao to Novotel, an upscale hotel in Dakar with Atlantic Ocean views. As part of its pandemic response, Senegal sought to provide a bed to everyone with Covid-19 — including mild or asymptomatic cases — and their direct contacts. In the spring of 2020, for about six months, <a href="https://www.ifrc.org/en/what-we-do/where-we-work/africa/senegalese-red-cross-society/">Red Cross</a> volunteers replaced hotel staff at Novotel, and rooms filled with people like Diao, exposed to Covid-19 and sent away to isolate.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gxrP22">
Her fellow community relays, who did Covid-19 outreach with her, kept calling and calling to check her status. They wanted to know if they’d be next. “We all got ready with our luggage, waiting for the results,” one of them said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lsAkCN">
Diao tested negative, twice, and she left quarantine after just four days. A year later, she calls it a funny story: a short stay in quarantine as she tries to make others aware of the seriousness of Covid-19.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="YqVJ6F">
Diao’s experience captures both sides of Senegal’s Covid-19 response. The West African country used aggressive interventions like this isolation policy to slow transmission. At the same time, community and local health actors bolstered the public health response from the bottom up, relying on longstanding relationships and trust to convince people to wear masks, seek out testing, and get treatment.
</p>
<div class="c-wide-block">
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/COlSSM-tTYwBZ0nhc3D-VKjcXhI=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22468548/APRIL_2021_SENEGAL_COVID_RICCI_SHRYOCK_48.jpg"/>
<figcaption>
Aissatou Diao (far left) and Amy Gningue (far right) work on community health outreach in their town of Yeumbeul on April 8.
</figcaption>
</figure>
<div class="c-image-grid">
<div class="c-image-grid__item">
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/3xxpAMZaFX16Aa1b7aaJqTYe6QQ=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22468564/APRIL_2021_SENEGAL_COVID_RICCI_SHRYOCK_51.jpg"/>
<figcaption>
Senegal depended on local leaders and health agents to curb the spread of Covid-19.
</figcaption>
</figure>
</div>
<div class="c-image-grid__item">
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/IuA-itvNBKbfV6jThIeTqAIhnbA=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22468565/APRIL_2021_SENEGAL_COVID_RICCI_SHRYOCK_52.jpg"/>
<figcaption>
Aissatou Diao is one of many local health workers who explained Covid-19 prevention policies in their neighborhoods.
</figcaption>
</figure>
</div>
</div>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4tIasQ">
“We have what we call a ‘chain of solidarity’: The nation joined hands together,” Moussa Seydi, chief of infectious disease service at Dakar’s University of Fann Hospital Center, said. “Religious leaders came to join the political decision-makers, and also, the community involved themselves in giving this response to Covid-19.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="i957BK">
Vox reported in Senegal at the end of March, just a little more than a year after <a href="https://www.afro.who.int/news/senegal-reports-first-covid-19-case">the country detected its first Covid-19 infection</a>. In Dakar and in the surrounding districts, we spoke to government and local officials, public health experts, doctors, nurses, community leaders, and volunteers to understand how Senegal’s early action from the government and the community buttressed a fragile health care system. This article is part of <a href="https://www.vox.com/22381700/pandemic-playbook">The Pandemic Playbook</a>, Vox’s exploration of how six nations developed strategies to fight Covid-19.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="zmKbeQ">
Senegal’s early policy of isolating people in treatment centers or hotels — combined with other top-down public health measures, such as <a href="https://www.google.com/search?q=senegal+curfew+2020&amp;rlz=1C5CHFA_enUS769US769&amp;ei=HG50YP3DBKa8gge_lpCIBA&amp;oq=senegal+curfew+2020&amp;gs_lcp=Cgdnd3Mtd2l6EAM6BQghEKABOgUIIRCrAlDlH1jVImDaI2gBcAB4AIABoAGIAZYFkgEDMi40mAEAoAEBqgEHZ3dzLXdpesABAQ&amp;sclient=gws-wiz&amp;ved=0ahUKEwj9wY-pifnvAhUmnuAKHT8LBEEQ4dUDCA0&amp;uact=5">curfews</a>, <a href="https://news.yahoo.com/several-african-nations-roll-measures-184709688.html">mass gathering bans</a>, and <a href="https://www.unicef.org/media/82526/file/Senegal-COVID19-SitRep-8-May-2020.pdf">temporary school closures</a> — sought to slow transmission in a place that has limited hospital beds, doctors, and resources. A 2017 World Bank study estimates that Senegal only has <a href="https://data.worldbank.org/indicator/SH.MED.PHYS.ZS?locations=SN">seven doctors per 100,000 patients</a>. The United States, by comparison, has <a href="https://data.worldbank.org/indicator/SH.MED.PHYS.ZS?locations=US">about 260 physicians per 100,000 people</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bjweau">
The country relied on its experience battling other outbreaks, from the Ebola epidemic in 2014 to HIV/AIDS, to prepare and act early. Senegal depended on local leaders and health agents, all front-line workers, often with multiple job descriptions: communicators, contact tracers, caregivers. They tried, and sometimes struggled, to make the Covid-19 policies work in their communities. They handed out masks. They went on local radio to talk about the coronavirus. These tiny acts, replicated from neighborhood to neighborhood, helped persuade a public to comply with public health measures.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RFWDPz">
“When we talk to the population and tell [them] to face this Covid, it’s the community who can do it,” Abdoulaye Bousso, the director of Senegal’s Health Emergency Operation Center, who helped lead the country’s Covid-19 response, said. “It’s not the health system, it’s the community.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fhAeYx">
Those interventions helped Senegal withstand a first wave, with <a href="https://www.worldometers.info/coronavirus/country/senegal/">fewer than 15,000 cases and just over 310 deaths by the end of September</a>. By then, the country had relaxed many of its most stringent policies, a combination of its early success and a growing recognition that cost and <a href="https://www.aljazeera.com/news/2020/6/4/coronavirus-protests-rock-senegal-capital-and-holy-city-touba">sometimes fierce</a> public backlash had started to make those measures unsustainable.
</p>
<div class="c-wide-block">
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/ov8uR-98IT9Nc8rT_nGVeEUkgQA=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22468884/GettyImages_1213154639.jpg"/> <cite>John Wessels/AFP/Getty Images</cite>
<figcaption>
Worshippers at the Mosque of the Mourides, which reopened after being closed for two months due to Covid-19 restrictions, in Dakar on May 15, 2020.
</figcaption>
</figure>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JGLvs3">
Those trade-offs, along with a false sense of security and the toll of restrictions, may have helped fuel a more potent second surge in Senegal, one that tested the country’s health system. Senegal has now recorded <a href="https://sante.sec.gouv.sn/Actualites/coronavirus-communiqu%C3%A9-de-presse-n%C2%B0421-du-lundi-26-avril-2021-du-minist%C3%A8re-de-la-sant%C3%A9-et">more than 40,000 cases</a> in the pandemic, out of more than 4 million recorded in Africa, and just over 1,000 deaths have been confirmed. But the country — and its communities — responded to the surge, and cases have declined steadily since their daily peak of about 460 in mid-February.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gr0Q8A">
Other factors likely played some role in the country’s relatively low death toll so far. About 60 to 70 percent of Senegal’s population is under 35, likely leading to more asymptomatic or mild spread and less severe disease than in nations with older populations. Senegal’s testing is rapid, but the country still faces limits on its <a href="https://ourworldindata.org/explorers/coronavirus-data-explorer?zoomToSelection=true&amp;time=2020-03-01..latest&amp;pickerSort=asc&amp;pickerMetric=location&amp;Metric=Tests&amp;Interval=7-day+rolling+average&amp;Relative+to+Population=true&amp;Align+outbreaks=false&amp;country=EuropeanUnion~SEN~ZAF~USA">testing capacity</a>, so many cases are likely unrecorded. Some early serological studies point to much greater community spread than the official numbers show. And there are plenty of unexplained disparities <a href="https://go.redirectingat.com?id=66960X1516588&amp;xs=1&amp;url=https%3A%2F%2Fwww.newyorker.com%2Fmagazine%2F2021%2F03%2F01%2Fwhy-does-the-pandemic-seem-to-be-hitting-some-countries-harder-than-others&amp;referrer=vox.com&amp;sref=https%3A%2F%2Fwww.vox.com%2F22397842%2Fsenegal-covid-19-pandemic-playbook" rel="sponsored nofollow noopener" target="_blank">between poor and wealthy countries</a>, and between different regions, that we still don’t fully understand.
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/YUFTgHrKwf9rX3ItPEl6eUi2nkw=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22473833/senegal_covid_cases.jpg"/> <cite>Christina Animashaun/Vox</cite>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TNC4RR">
But Senegal was also ready. “People were saying: ‘You all will die with this Covid. Africa will disappear with this Covid,’” Seydi said. “Africans got so scared that they didn’t have any other choice but to prepare themselves. More than usual! And this preparation contributed to the fight against this disease.”
</p>
<h3 id="v9Bcxz">
Senegal prepared for Covid-19 by looking to a much more lethal disease
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xtSeUT">
The 2014 Ebola epidemic left a grim wake in West Africa. It sickened <a href="https://www.who.int/mediacentre/news/ebola/17-october-2014/en/">28,000 people in Liberia, Sierra Leone, and Guinea. Nearly half those infections were fatal</a>. Senegal recorded its first case that August, <a href="https://wwwnc.cdc.gov/eid/article/23/6/16-1092_article">a traveler who arrived to Dakar from Guinea</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cbDg0w">
The Ebola patient was identified, but only days after his symptoms started. Once that happened, he was isolated, his contacts quarantined. Doctors and officials, with help from some international agencies, coordinated care and the response. After one case, <a href="https://www.who.int/mediacentre/news/ebola/17-october-2014/en/">and the requisite waiting period</a>, Senegal was declared Ebola-free.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OwTmr3">
Senegal had contained the outbreak. Abdoulaye Bousso saw all the ways it might not have worked. The lesson from Ebola, he said, was that Senegal needed to invest in a permanent emergency response system, something the country wouldn’t have to put together and take down after each crisis. Senegal, like many countries in Africa, dealt with outbreaks and public health challenges <a href="https://www.who.int/csr/don/29-december-2020-yellow-fever-senegal/en/">all the time</a>. They often had to do so with scarce resources. This was all going to happen again.
</p>
<div class="c-float-right c-float-hang">
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/tOisU8MpLFLFIg3tFkAdPDMGyUA=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22473840/senegal_locator_map.jpg"/> <cite>Christina Animashaun/Vox</cite>
</figure>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6FSeMm">
After Ebola in 2014, Bousso helped establish Senegal’s Health Emergency Operations Center, which he now leads. It gave Senegal five years to strengthen its system <a href="https://www.vox.com/2020/1/21/21075017/coronavirus-sars-wuhan-china-pneumonia">when a new coronavirus</a> was detected in Wuhan, China.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MqcVbs">
This was “peacetime” preparation, Amadou Sall, the head of Senegal’s Pasteur Institute, said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Ng5VZA">
“When you’re having an epidemic that is at that scale, all you have to do is reinforce — you don’t have to build from scratch,” he said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qtXOjW">
Senegal ramped up those reinforcements in January. “We use the same strategy in Ebola,” Bousso said. “The most important thing is to detect — to test rapidly, to isolate, and to treat patients.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CkY0yU">
At the start of the pandemic, the Pasteur Institute in Dakar was the only lab in Senegal that could test for Covid-19, and just one of two labs in Africa that the World Health Organization designated for Covid-19 testing. Fann Hospital, in Dakar, which Seydi oversees and which treated the lone Ebola patient, was the only facility equipped to care for Covid-19 patients at the start of the pandemic. It had <a href="https://www.theafricareport.com/24821/coronavirus-it-would-be-suicidal-for-africa-not-to-learn-the-lessons-from-europe/">12 spaces with beds to isolate patients</a> when Covid-19 hit.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xHEfwn">
Testing in 48 hours or less became Senegal’s gold standard. “You want to increase the number of people to test, but you also want to make sure you can deliver in a very short period of time,” said Souleymane Mboup, <a href="https://www.encyclopedia.com/education/news-wires-white-papers-and-books/mboup-souleymane-1951">one of Senegal’s premier researchers</a> and the head of the Institute for Health Research, Epidemiological Surveillance, and Training, whose lab eventually oversaw testing in Senegal’s Thies region and for travelers.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="AJlHDT">
The process also had to exist across Senegal. “We managed to have [field labs in] each of the regions of Senegal, a few labs that were in a position to deliver a test in 24 hours,” Sall said. Senegal never performed as many tests per capita as the United States, but the <a href="https://ourworldindata.org/explorers/coronavirus-data-explorer?zoomToSelection=true&amp;time=2020-03-01..latest&amp;pickerSort=asc&amp;pickerMetric=location&amp;Metric=Share+of+positive+tests&amp;Interval=7-day+rolling+average&amp;Relative+to+Population=false&amp;Align+outbreaks=false&amp;country=USA~EuropeanUnion~ZAF~SEN">share of tests coming back positive</a> — one indicator of whether enough testing is being done — dropped quickly in the early weeks of the pandemic, and has, at times, been lower than positive rates in the US.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HFpylW">
Quick test results made the isolation policy possible. “We decided that that person should be isolated and put in quarantine,” Mamadou Ndiaye, the director of prevention at the Senegalese Ministry of Health and Social Action, said. “This was the best way we could limit the transmission of the virus among the community.”
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/D_amWExntvnMaThBQYPALMzPEE0=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22468899/GettyImages_1210833718.jpg"/> <cite>John Wessels/AFP/Getty Images</cite>
<figcaption>
A health worker tends to a patient inside a Covid-19 ward that houses suspected cases in Pikine Hospital in Dakar on April 23, 2020.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="w9HXRP">
Rather than ask people to quarantine or isolate at home, the government put coronavirus patients, regardless of severity of symptoms, and their contacts in separate facilities to limit the possibility of transmission.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qeQX7e">
Senegal needed beds to do this, and people to take care of patients. Seydi and his team trained personnel across Senegal. The country added beds where it could to hospitals and health care facilities. It set up field hospitals. The country expanded its maximum capacity to 1,500 beds. That figure does not include hotels, emptied of guests, which mainly became quarantine centers for people who had been in contact with a Covid-19 case. More than 3,200 Red Cross volunteers helped take care of those in quarantine.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="m0Ra3X">
This national blueprint also had to work in each part of Senegal, from Dakar to the country’s rural corners. Senegal has 14 medical regions, subdivided into 79 health districts. The districts have health centers with doctors and nurses. Below those centers are “postes de santé,” or health posts — often staffed with a head nurse and midwife — and health huts, the closest link to the community. Those institutions are all building close relationships with the community, working with volunteers and leaders for outreach and campaigns.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4j7DVq">
“Anything that happened in one place can be somehow detected and then taken care of by the people at the level where those people are,” Sall said.
</p>
<h3 id="mxnWRP">
Meeting people where they are
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ealxio">
When Amy Gningue enters a home, she greets people with “Salaam alaikum” and asks to speak to her cousins. There will always be cousins: Everyone in her community in Yeumbeul counts as a cousin. She was born here, grew up here, got married here. This makes the conversation go a little easier when, after the greetings, and maybe breakfast, she begins speaking to the head of the family, asking questions like, “Are you aware of the existence of Covid-19?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ty1qDa">
If the answer is yes, Gningue might ask more questions: “What do you think we can do to prevent the disease?” She wants to start a dialogue: He may say that he’s asking family members not to shake hands, to use hand sanitizer, to wear a mask. But if he doesn’t know all this, Gningue might offer advice: Masks work, and it might help to get some antiseptic gel.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="iLdolz">
“I do not impose on people,” Gningue said. “When I see someone who is not wearing a mask, I come respectfully to him and ask the reason why he is not wearing masks, knowing they are in danger by not wearing a mask. You see, I have this advantage.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZDCXcI">
Her advantage is that she’s the community’s badienou gokh<em>, </em>a neighborhood godmother or auntie.<em> </em>“For some, I am ‘badiene,’ meaning sister to their fathers. For others, I am aunt; for some, I am sister. For other people, I’m just a woman, a wife,” Gningue said. Badienou gokhs also have a formal role in health, often in maternal or reproductive care. Her stature and roots in the community mean her word counts as much as, or more than, what doctors or health officials say.
</p>
<div class="c-wide-block">
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<img alt=" " src="https://cdn.vox-cdn.com/thumbor/GophRQxY5U4GQvZLbuH6zhxYOg0=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22468918/APRIL_2021_SENEGAL_COVID_RICCI_SHRYOCK_43.jpg"/>
<figcaption>
Amy Gningue (center) is Yeumbeul’s badienou gokh,<em> </em>or community auntie, with formal health training and the trust of the people in her town.
</figcaption>
</figure>
</div>
<div class="c-image-grid__item">
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/7lKlAbqZh-_KzwVPikqbaezmuIY=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22468920/APRIL_2021_SENEGAL_COVID_RICCI_SHRYOCK_33.jpg"/>
<figcaption>
Yeumbeul is a rural municipality less than an hour outside of Dakar, the country’s capital city.
</figcaption>
</figure>
</div>
</div>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="zKzdKp">
Covid-19 consumed Gningue’s year. She visited with patients. She tried to find assistance for families who’d lost income or jobs. But much of what she does is general outreach, working alongside about 10 community relays, including Aissatou Diao. They target eight districts in Yeumbeul Nord and Yeumbeul Sud, a rural municipality that is still less than an hour outside of Dakar.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cMF3xc">
“As grown-up children of the community, we are trusted,” Ramatoulaye Ka, who works with Gningue and is the president of the community relays, said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="osOrVA">
When Gningue and her colleagues talk about their work, sitting on black couches pushed against each wall of Gningue’s living room, they do so with a mix of pride and exhaustion. They believe they’ve made a difference; when we speak at the end of March, Yeumbeul has not recorded any new cases in almost a week, a point of success for them. It’s been a long year of going door to door, hosting focus groups, telling people to wash their hands and wear a mask.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LczGrh">
Those like Gningue have long been a link between the community and the health care system. There may not be a doctor in every village, or a hospital in the region, so this infrastructure exists to connect people to care, whether it’s childhood vaccines or postnatal checkups. Community outreach happens around other diseases, like HIV/AIDS prevention or malaria.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JKeTLJ">
“The pandemic,” Mouhamet Thioune, another community relay and ambulance driver in Yeumbeul, told me, “is just a disease. Like any other disease.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Vd2ZHj">
So they got to work prioritizing Covid-19. They did this in two ways: by raising awareness of Covid-19 and in helping to make the Covid-19 policies — test, trace, and isolate — work across communities.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wIuohE">
Consistent messaging from government and public health officials helped these efforts. Ndiaye, the minister of prevention, delivered daily press conferences during the pandemic, and <a href="https://sante.sec.gouv.sn/sites/default/files/communique%20421.pdf">the Ministry of Health and Social Action</a> gives updates each day on cases, hospitalizations, deaths. “The weak points and strong points,” Ndiaye said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nBoa8I">
Religious leaders, especially imams in a country that’s 95 percent Muslim, helped reinforce the seriousness of Covid-19, many of them getting on board with mosque closures at the start of the pandemic, or urging social distancing when restrictions were lifted. Some even <a href="https://www.voanews.com/covid-19-pandemic/senegal-muslims-divided-mosques-opening-during-pandemic">continued</a> to keep their mosques closed. Graffiti artists created murals; <a href="https://www.youtube.com/watch?v=06YbY1MLp4A">artists rapped in full protective gear</a>.
</p>
<div class="c-wide-block">
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/qqxu7QpQmj3islSBQMZnTOrmN9I=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22468953/_MGL3791.jpg"/> <cite>Ina Makosi for Vox</cite>
<figcaption>
Murals raise awareness of the coronavirus in Malika City, 40 miles outside Dakar.
</figcaption>
</figure>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HKEoWx">
Community efforts did the same from the bottom up. Badienou gokhs and community relays often helped with tracing contacts, urging people to get tested or trying to convince them to go into quarantine. They were “firemen,” said Ibrahima Niang, president of a network of community leaders in Dakar, intervening when people hesitated about interacting with the health system. Trusted figures like Niang and his fellow leaders tried to persuade them, so that every citizen would understand that they depend on each other in the crisis. We “inform them this is not the end of the world,” Niang said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rjjyA6">
“We’re are doing it because there is a process we need to follow to save our communities,” he added.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Wq7Rzz">
Daouda Thioub, an infectious and tropical disease specialist and deputy coordinator of the Fann Hospital Epidemic Treatment Center, said that while not everyone would listen to the experts, they would often listen to leaders in the community. When he would talk about Covid-19, he’d appear on local radio, speaking in Fulani, his dialect, rather than French.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0pZ30p">
“We cannot work against you. We work for you, because we belong to you,” Thioub said. “This was a very effective message.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="e9c7Zn">
Youth groups, women’s groups,<em> </em>savings and loan clubs, and educational groups all got involved. In Notto Diobass, a village near the city of Thies, a youth organization handed out masks and sanitizer, installing hand-washing equipment people could use before entering their homes. The Love Your Husband club, a women’s social group, raised money through its mobile bank to buy equipment, soap, and masks.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="umoKTG">
“We all felt that we have one enemy to fight. It was Covid,” Ka, in Yeumbeul, said. “We say the whole community join[ed] hands, from community leaders, to politicians, or young people or any kind of association that we have in the district. People come together and join forces to face the enemy.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8CTiNq">
It was still not easy work. Especially in the early days of the Covid-19 response, community workers felt they weren’t adequately included in the government’s measures. They fought against misinformation: that Covid-19 was a fake disease, an old person’s disease, a city disease. Thioub said he has had patients who refuse to believe they are sick with the coronavirus. As the pandemic wore on, people became fatigued and frustrated.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="PCZ19q">
And the community relays were fighting not just fatigue and misinformation but stigma — a stigma that, they say, the government’s isolation policy worsened.
</p>
<div class="c-float-right c-float-hang">
<div id="VhD8qI">
<div>
</div>
</div>
</div>
<h3 id="lEp8oy">
Senegal’s Ebola playbook worked — until it didn’t
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Yl6nw3">
Youssoupha Thiaw had never done room service like this before: Put the food down on the floor, knock, and run away. “That’s all you could do,” he said in his tiny office at the Hotel Le Ravin, in Guédiawaye, a district outside of Dakar.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Nnvqu6">
Last year, from March until June, his hotel hosted a few hundred people who had been in contact with confirmed Covid-19 cases. There was a short period before the Red Cross volunteers arrived, and his staff helped, dropping off food and doing minor cleaning, like changing the bedding between patients. “We did it badly,” Thiaw said. They rushed the job to get the heck out of that room.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="PCld9Y">
Thiaw was scared, but he understood what Senegal was trying to do: For each Covid-19 case they could take out of circulation, they could break one more chain of transmission. This would tightly control community spread, and it would put Covid-19 patients under the care of doctors and nurses, who could offer treatment that might stave off more severe disease. The more closely managed Covid-19 cases, the less likely Senegal’s health care system could be surprised by an onslaught.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8h1RLU">
“Isolation was almost perfect,” Sall, of the Pasteur Institute, said. “That has been extremely efficient in monitoring and controlling the disease at the very beginning, I would say for the first three to four months.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7NCc6q">
But by June, it was becoming clear that almost-perfect isolation only worked if everyone complied, got tested, knew their contacts. “At a certain moment, we realized that the virus was almost certainly in the community,” Seydi, of Fann, said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jYdl4U">
The policy had started to become unsustainable in other ways. Paying for hotels — Thiaw says he received XOF 50,000 per room, or about $90 — is costly. So is caring for people at treatment centers who are mostly fine. It strained testing capacity, as resources went to screening people already in quarantine. Khadidiatou Tine, the head nurse at the Poste Santé de Notto said they often experienced shortages of tests, but they used many on people in quarantine, where few would actually come back positive. “It was,” she said, “a waste of time.” About 60 percent of the Covid-positive patients isolated under the policy had mild symptoms, or no symptoms at all.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vGG1vP">
The government also struggled to support people who had to quarantine. Senegal’s economy is largely informal; people work day to day. Quarantine means they cannot earn any money. The government tried to provide food staples, like oil and rice, but that help had its limits, often leaving community groups and organizations, including NGOs, to fill the void. And even if people understood the rationale behind the policy, it became a source of frustration and<a href="https://www.aljazeera.com/economy/2020/6/4/senegal-to-ease-some-coronavirus-curbs-after-protests-escalate"> fury in the form of protests</a>. And sometimes fear.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LGOwlc">
Fear, in particular, as the isolation policy intensified the stigma around getting Covid-19. Diao, the community relay in Yeumbeul, said that after her quarantine, people still believed she had Covid-19, even though she did not. “You are stigmatized. People are like, ‘This is a Covid family. These are Covid children,” Diao said. Her kids, she said, got teased in school.
</p>
<div class="c-wide-block">
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<img alt=" " src="https://cdn.vox-cdn.com/thumbor/baMDWYAgAeVZD_XN5c3GsPHBxlw=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22469075/APRIL_2021_SENEGAL_COVID_RICCI_SHRYOCK_79.jpg"/>
<figcaption>
People who had been in contact with Covid-19 patients were isolated at Hotel Le Ravin.
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<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/LF3AN0rj-W6_XRAvDA9oPjl6BOU=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22469077/APRIL_2021_SENEGAL_COVID_RICCI_SHRYOCK_2.jpg"/>
<figcaption>
Khadidiatou Tine, head nurse at the Poste Santé de Notto, treats a patient in her office.
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</div>
<div class="c-image-grid__item">
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/kkRk2SxVIlawNTNI2ahxD8lGjJI=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22469078/APRIL_2021_SENEGAL_COVID_RICCI_SHRYOCK_19.jpg"/>
<figcaption>
Chiefs from surrounding villages gather at Notto Diobass Health Center to receive Covid-19 vaccines.
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<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/y7CHXw0Og4-gMID3FP-mGK5Foe8=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22469079/APRIL_2021_SENEGAL_COVID_RICCI_SHRYOCK_76.jpg"/>
<figcaption>
Hotels like Le Ravin played a key role in the early pandemic response.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="N8twME">
That sense of fear was sometimes even more intense for those who tested positive. An ambulance would come to their homes, with a full medical team equipped in head-to-toe PPE. These were Ebola procedures, applied to the coronavirus. Those people, in goggles and white gloves, when you see them, Gningue said, “You say, ‘This is danger.’”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2X67rn">
Ndeye Coumba Sene, a health official with the District Centre de Santé Wakhinane in Guediawaye, said people would turn off their phones, or hide from community relays or contact tracers, as if trying to outrun quarantine. When people did test positive, she added, they sometimes were in denial because they feared the stigmatization that might come when they returned to the neighborhood. “The community considered Covid-19 a shameful disease; this was a problem,” Sene said. “And that’s the reason why most of them were very reluctant to be tested, but also — even though they present some symptoms of Covid — they refuse to go to hospitals.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vW89vB">
Front-line community actors and nurses understood that this resistance made Senegal’s Covid-19 response less effective. Gningue said she and others pushed back, urging the doctors and officials to change their approach or risk Covid-19 spreading. They also saw more of a role for themselves in the larger Covid-19 response; they felt if they, not the ambulances, showed up at people’s homes, their neighbors would be more likely to follow the measures.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Xy5zxL">
“The state kept on saying this is a medical battle, so the approach should be health-based. And the community kept on saying this is a community battle, the approach should be community-based,” Niang, in Dakar, said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EUYQfi">
Officials like Bousso eventually recognized the fear, and the stigma it generated. “We saw that it’s not necessary to put all those patients in hospital,” he said. “Now we decide to use the home isolation, and the home isolation permits our health system to brace and to not be very stressed.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0AJBEP">
All of that shifted the country to a policy of home isolation, meant to quarantine and protect those most at risk of becoming seriously ill. 
</p>
<div class="c-float-right c-float-hang">
<aside id="16VsTU">
<q>“Africans got so scared that they didn’t have any other choice but to prepare themselves. More than usual! And this preparation contributed to the fight against this disease.”</q>
</aside>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ODscRi">
Those who test positive for Covid-19 but aren’t really sick wait it out at home, unless they are considered higher-risk and might need a treatment center. At home, their cases are monitored, and a doctor will call to see what their temperature is, how their breathing is. Sometimes a mobile unit — usually a doctor, maybe with one other person — will drop by to take vitals. If “the situation of the patients are worsening, [these teams] inform the local medical authorities,” Sene, from the District Centre de Santé Wakhinane, said. Those local authorities are supposed to notify regional medical authorities if a patient now needs a bed, the distribution of which is carefully monitored.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="o3jpp0">
Contact tracing still happens, but it now mostly comes with the advice to stay home unless their status changes. Only those who might be at risk — older adults and those with underlying conditions — are urged to get a test.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="y7hy3z">
It makes a Covid-19 diagnosis, and the aftermath, a lot less dramatic. A doctor might knock on a door, along with a community relay, to tell you to get a test, or that you have Covid-19. “It’s just kind of a visitor coming to inform that you are supposed to have [a] Covid test,” Ka said. “Nobody knows; people are conducting it secretly.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vZgL6e">
The confidentiality blunted some of the stigma, even if it did not fall away completely.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="NhgWRE">
“The day the government has decided and the scientists have decided that if your symptoms are not severe, you will be kept at home, and treat[ed] there; that was a tipping point,” Daouda Diouf, the director of Enda Santé, said. “Communities felt that the government is recognizing also their role in addressing the pandemic, in responding to the pandemic.”
</p>
<h3 id="aPWaK5">
The move away from the isolation meant trade-offs. Some were felt during Senegal’s second wave.
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4wMZ8u">
In her office, Louise Fortes shakes a cardboard box, white prescription boxes rattling inside. They are donations from Covid-19 patients who’ve left the hospital, recovered. They ask what they can do, and Fortes tells them how to buy the medications.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lAje6O">
Those are the good news stories. Because most of Fortes’s patients are now over 60, or have diabetes or some other condition. By the time she sees them on her ward in Dalal Diam hospital, in Guediawaye, they are often already very sick. “Sometimes,” she said, “it’s too late.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="PsPmXI">
Fortes is the head physician in charge of Covid-19 patients in Dalal Diam, Senegal’s largest treatment center, with 200 beds. She started this role on March 27, 2020, an exhausting anniversary that arrives as Senegal is emerging from its far more brutal second wave. On a Tuesday in late March when we meet, 70 patients are still here, a small slice of the 2,600 patients who have received treatment at Dalal Diam since March 2020. Right now, the Covid-19 ward feels cavernous and empty, like a high school after the last bell rings.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="31WOOF">
The second wave tested Dalal Diam, though never fully overwhelmed it. Still, between December and February, Senegal saw an increase in emergency cases and, especially, deaths across the country.
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/-Z50iboiZSz9cUjIHNPxOKcfe6Q=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22468973/APRIL_2021_SENEGAL_COVID_RICCI_SHRYOCK_81.jpg"/>
<figcaption>
Louise Fortes is in charge of treating Covid-19 patients at Dalal Diam, Senegal’s largest treatment center.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pF2hju">
Senegal’s Covid-19 response looked very different once the second wave arrived. Most restrictions had lifted; people isolated at home. But as cases and deaths began to climb again, the country had to reckon with the trade-offs it had made as it adjusted its strategies.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="NQFxqb">
Quarantining at home meant the “almost perfect” isolation no longer existed. People did not always comply with the advice to stay home, and some likely just felt they couldn’t, especially for Senegalese who needed to earn money each day. There was an acceptance, if not exactly explicit, that infections would slip through.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9TUK6p">
The change in isolation strategy accompanied a redirection of testing to symptomatic and mostly at-risk people. This helped guarantee that testing covered those most likely to spread the virus, and those most vulnerable. But it also meant it was much harder to get a sense of the scale of the outbreak, and that the case numbers recorded likely couldn’t account for the true spread of the virus.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fm8R4B">
“Those who are ill and unknown are not tested — that’s why if we have recorded 200 cases, this might not be a right figure compared to those who are staying home and who have not been tested,” Thioub, the infectious and tropical disease specialist at Fann Hospital, said. Those likely lower-than-reality figures gave people a false sense of security, so they weren’t as vigilant about mask-wearing or social distancing.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6ttceY">
After the first wave, in about September and October, Senegal also began to demobilize treatment centers. At that time, cases were low, just low double digits daily. But when cases started to inch up again, Senegal was left playing catch-up.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lvQ8vY">
“The intensity with which we were working during the first wave that enabled us to achieve results has led us to close a certain number of centers that were open, and the staff that were hired had been reduced,” Ndiaye, the minister of prevention, said. “So some centers closed, reducing the staff — and we were surprised with the surge that came later.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Epas6P">
“It took time to reorganize to face the second wave,” Ndiaye said. “We tried to update, to reopen and restart, but it took time.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yct353">
The government tried to reimpose some restrictions early this year, declaring a new state of emergency and introducing another <a href="https://www.rfi.fr/en/africa/20210106-senegal-declares-state-of-emergency-curfew-to-combat-spike-in-covid-19-africa-health">overnight curfew</a> in Dakar and Thies, two cities that saw big spikes in cases. But the intensity of the measures, especially for Senegal’s workers, didn’t seem proportionate to the crisis, and people resisted. Some began pushing back against mask mandates, religious ceremonies restarted again, and demonstrators filled the streets.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0emwtz">
“The unity we saw when the first wave occurred slowly cracked through the second wave,” Seydi said. The blame, he said, is spread around. “Why the Ministry of Health? Because the Ministry of Health reacted late to the second wave. Why the community? Because the community has been rebelling against the decisions that would be implemented by the authorities.”
</p>
<h3 id="iJRZ25">
Senegal’s Covid-19 response came with difficult choices. But it had to adapt for a drawn-out fight.
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QpZ5L0">
The case numbers, but most of all the deaths, woke up many more people to the reality of Covid-19, Tine, the head nurse at the Poste Santé de Notto, said in March. She and her community outreach workers wanted people to take the disease seriously before people died.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="afJ3Rq">
Sometimes, she said, she felt like she and her volunteers were fighting alone against the pandemic. The government didn’t involve the community in their early plans. The health post needed donations to obtain basic supplies. Once, early in the pandemic, she and her team of community health outreach workers got chased away because they were wearing T-shirts that said Covid-19.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="v6MBgZ">
This has been the reality of Senegal’s Covid-19 fight: trying to leverage its resources and experiences to contain a pandemic that has bested far richer and more powerful countries. Senegal is also digging in for a long fight, one that has implications for the entire globe as new variants emerge. Vaccine distribution has started in Senegal, with <a href="https://sante.sec.gouv.sn/mediatheque">about 400,000 people vaccinated</a>. But the country had only acquired about 600,000 doses by the end of March, <a href="https://www.reuters.com/article/uk-health-coronavirus-senegal/senegal-takes-delivery-of-chinas-sinopharm-vaccine-idUSKBN2AI0OU">buying doses from China</a> and receiving<a href="https://www.reuters.com/article/us-health-coronavirus-senegal-vaccinatio/senegal-receives-its-first-astrazeneca-vaccines-under-covax-idUSKCN2AV181"> a donation from Covax</a>. John Nkengasong, the director of the Africa CDC, has said, in the best-case scenario, just 60 percent of the continent’s population could be vaccinated by the end of 2022.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7leubE">
Senegal did not have the technical or financial tools of richer countries, but it also had no other option. It had to prepare, but it also had to be flexible, and adapt, as the pandemic wore on. “You have to learn how to survive with the means you have,” Mboup, of the Institute for Health Research, Epidemiological Surveillance, and Training, said.
</p>
<div class="c-wide-block">
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/waxY2uWjYBtKS9RDGE3Mx2Mcid8=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22468980/APRIL_2021_SENEGAL_COVID_RICCI_SHRYOCK_26b.jpg"/>
<figcaption>
Residents of Notto Diobass, a village near the city of Thies, receive Covid-19 vaccines on March 25.
</figcaption>
</figure>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5IjTHj">
Senegal’s response also crashed up against the economic pressures. The country saw anti-lockdown protests last spring. Thousands flooded Dakar’s streets in March <a href="https://foreignpolicy.com/2021/03/12/senegal-protest-ousmane-sonko-macky-sall/">for political protests</a>, and many saw the social unrest as tied to the furor and despair over coronavirus restrictions. One economist has estimated that <a href="https://www.barrons.com/news/after-protests-senegal-s-virus-battered-economy-in-spotlight-01616062805">more than 2 million people in Senegal — out of 16 million — have fallen into poverty</a> since the pandemic began. In sheer numbers, the full force of the pandemic will be felt there, and many more people spoke about being out of work, or struggling to find income, than of being sick with, or even scared of, the coronavirus.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZxyZrt">
“In this country, all we know is hard work and supporting our families,” Amary Lo, a resident of Notto, said. Some of the lockdown measures made that even harder, with negative ripples throughout the community. “We suffered a lot during the lockdown because compensation was not enough,” he added.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="BOnnrT">
The pandemic is not over in Senegal. The at-home isolation policy is still intact. Contact tracers are still tracking people down, cajoling symptomatic or at-risk people to get tested. The second wave looks to be behind Senegal, but doctors worry about another, and maybe another, around the corner. They also worry people will get complacent again, and cases will come roaring back. With a meager vaccination campaign, Senegal will have to grapple with these uncertainties for many, many months more.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="GH3zbD">
In Dakar, during lockdown, Niang and his team of community leaders would take a tam-tam and bang it through the neighborhood, chanting messages about Covid-19 prevention, an on-foot caravan. There was no dancing, no singing, no ceremonies, so you could hear the tam-tam everywhere. People had nothing better to do than come and watch.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="eVYCZp">
The streets are filled again in Dakar. Restrictions were lifted in mid-March. The vaccination campaign is small, and stuttering, but happening. Their groups are still doing their caravans, trying to tell people how to protect themselves from Covid-19. As one of them said, they will continue doing it “until we hear that we’ve recorded zero cases in Senegal.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lWbVvZ">
<a href="http://www.riccimedia.com/"><em>Ricci Shryock</em></a> <em>is an independent journalist and photographer based in Dakar. Since 2008, most of her work has been in West and Central Africa, focusing on the Ebola crisis and migration trends.</em>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="baqs3p">
<em>Ousmane Balde</em><strong> </strong><em>is a freelance reporter, fixer, and translator based in Dakar. </em>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="crFLER">
</p></li>
</ul>
<h1 data-aos="fade-right" id="from-the-hindu-sports">From The Hindu: Sports</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>COVID-19 surge | Women’s T20 challenge unlikely to happen: BCCI sources</strong> - None of the Australian, English, South African or West Indies cricketers will be able to travel to India due to air travel restrictions</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>COVID-19 surge | Asian Boxing Championship moved from Delhi to Dubai</strong> - The tournament was to be held at the Indira Gandhi Indoor Stadium from May 21 to 31 in the national capital</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>IPL 2021: Business nosedives for Chepauk’s famous sports stores without spectators</strong> - Amid a raging pandemic and voices of dissent, the IPL continues. However, there is a slightly stranger case to be made for the people and businesses that depend on cricket…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Former Sri Lankan cricketer Nuwan Zoysa banned for 6 years for trying to fix matches</strong> - The ban on the left-arm seamer, is backdated to October 31, 2018, when he was provisionally suspended.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>KKR’s floundering batting faces strong DC test</strong> - First-up, Morgan will have to fix the Gill conundrum.</p></li>
</ul>
<h1 data-aos="fade-right" id="from-the-hindu-national-news">From The Hindu: National News</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Heatwave conditions likely in parts of Rajasthan: State Met department</strong> - There is a possibility of heatwave in Bikaner, Jaipur and Bharatpur divisions of northern Rajasthan in the next 48 hours.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>COVID-19 surge | Prince Charles charity joins UK aid efforts to India</strong> - The British Asian Trust launched an emergency appeal called “Oxygen for India” to buy oxygen concentrators</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Covid-19 | Govt. to procure 1 lakh portable oxygen concentrators with PM Cares Fund</strong> - Along with this, 500 PSA plants will be added for use in district headquarters and tier-2 cities.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Amit Shah assures to provide cryogenic oxygen tankers to Madhya Pradesh</strong> - In a tweet, the Chief Minister’s Office also said that the State will get oxygen concentrators in collaboration with the Central government.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Paytm to make available 21,000 oxygen concentrators from May 1st week</strong> - Following overwhelming support and contribution from people across the country, Paytm is now aiming to raise over ₹14 crore to source over 3,000 OCs over the next few days</p></li>
</ul>
<h1 data-aos="fade-right" id="from-bbc-europe">From BBC: Europe</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Brexit: European Parliament backs UK trade deal</strong> - Euro MPs back the EU-UK trade deal by 660 votes to 5 despite rows over fishing and Northern Ireland.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Covid: Spain hopes for tourists as EU votes on digital passports</strong> - Spain says it hopes to open up to overseas travellers in June with a pilot test next month.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Latvia fire: Riga hostel blaze kills eight</strong> - Most of the dead and injured are believed to be foreign tourists, Riga’s mayor says.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Grenade-shaped sex toy sparks police alert in Germany</strong> - Police say a female jogger spotted the suspect device in a forest on Monday evening.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>France arrests ex-members of Italy extremist group Red Brigades</strong> - Italy has long been demanding the extradition of far-left extremists offered protection in France.</p></li>
</ul>
<h1 data-aos="fade-right" id="from-ars-technica">From Ars Technica</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Ransomware crooks threaten to ID informants if cops don’t pay up</strong> - The FBI is investigating claim hackers obtained 250GB of police department data. - <a href="https://arstechnica.com/?p=1760792">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Nestlé threatened with cease-and-desist over alleged illegal water use</strong> - Company’s claims hinge on how much water early-1900s rail cars carried. - <a href="https://arstechnica.com/?p=1760783">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>High-bandwidth wireless BCI demonstrated in humans for first time</strong> - BrainGate device complements Neuralink’s successful test of wireless BCI in monkey. - <a href="https://arstechnica.com/?p=1760509">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Lyft is getting out of the self-driving business</strong> - Lyft will save about $100 million without its self-driving project. - <a href="https://arstechnica.com/?p=1760718">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>FCC lets SpaceX cut satellite altitude to improve Starlink speed and latency</strong> - Rival satellite companies opposed change that cuts altitude in half, to 540 km. - <a href="https://arstechnica.com/?p=1760553">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-jokes-subreddit">From Jokes Subreddit</h1>
<ul>
<li><strong>I encountered a milf at a bar last night</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
although she is 57 years old, she is still very charming and sexy
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
we were drinking, chatting, laughing, and having a good time
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
then, she asked me flirtatiously
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“have you ever tried a mother-daughter threesome before?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
I said, “Nope, not yet”.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
She drank a little more, and said, “well, darling, tonight is your lucky night.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
So she took me to her place.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
She took out her keys
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
opens her door
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
turn on the light
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
and she yells towards upstairs
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Mom, are you still awake？”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/soysssauce"> /u/soysssauce </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/n08iul/i_encountered_a_milf_at_a_bar_last_night/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/n08iul/i_encountered_a_milf_at_a_bar_last_night/">[comments]</a></span></p></li>
<li><strong>What’s the difference between dark humour, morbid humour and brutal humour?</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Dark humour is ten children in one trash can, morbid humour is one child in ten trash cans and brutal humour is ten trash cans in one child.
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Not-A-Marsh"> /u/Not-A-Marsh </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/n0adr0/whats_the_difference_between_dark_humour_morbid/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/n0adr0/whats_the_difference_between_dark_humour_morbid/">[comments]</a></span></p></li>
<li><strong>My wife complains about constantly being sexually harassed at work</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
I told her she can stop working from home and go back to the office if she doesn’t like it
</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/AC85"> /u/AC85 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/mzstsm/my_wife_complains_about_constantly_being_sexually/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/mzstsm/my_wife_complains_about_constantly_being_sexually/">[comments]</a></span></p></li>
<li><strong>I got fired from my job as a masseur.</strong> - <!-- SC_OFF -->
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There wasn’t any specific incident, apparently I just rub people the wrong way.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Invisible-Pancreas"> /u/Invisible-Pancreas </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/mzoc3g/i_got_fired_from_my_job_as_a_masseur/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/mzoc3g/i_got_fired_from_my_job_as_a_masseur/">[comments]</a></span></p></li>
<li><strong>Someone called me lazy today</strong> - <!-- SC_OFF -->
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I almost replied…
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Jinno69"> /u/Jinno69 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/n08ehj/someone_called_me_lazy_today/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/n08ehj/someone_called_me_lazy_today/">[comments]</a></span></p></li>
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