COVID19

Cyber, Cities and COVID-19- why urban leaders need a digital strategy

Photo by Isabella Mori, who provides this context: In traditional Taiwanese night markets, since people and sellers are in close contact, most people / vendors wear masks now, in order to protect themselves and others.

The 1918 Influenza pandemic likely killed between fifty and one hundred million people globally. While the case fatality rate varies with circumstances, the current outbreak of COVID-19 may be as deadly unless vaccines are developed in time. Since the start of this year global cities like New York have faced immense strains. As always during a pandemic, one of the concerns that leaders face is how to prevent panic and discrimination, which can be spread by social media and other digital platforms. At the same time, the internet provides a host of tools that can help during a pandemic, with everything from telemedicine to mass collaboration. While cyber tools -such as digital tracking apps for individuals under quarantine- are powerful, they also come with human rights questions. In adapting these cyber tools for telemedicine, digital health communication, outbreak modeling and other uses (Liu and the HIMSS Greater China Health Team, 2020), city leaders and health authorities must address issues of transparency, privacy and public trust, which will require them to have a strategy for digital issues.

The 1918 pandemic and COVID-19

Food market in Taiwan. Note the plastic partitions separating customers. Photo taken by Isabella Mori in May 2020.

Like many people, I’ve been struck by the parallels between the current COVID-19 pandemic and the 1918 pandemic.  In 1918 many media outlets in Europe and the United States did not initially give the outbreak adequate coverage, because they were censored during the war, or did not want to reveal their nation’s weaknesses. In the United States and Brazil now, populist leaders are dismissive of the news and data on COVID-19, because it reveals their failures. For this reason, their followers tend to view all COVID-19 information through the lens of partisan politics. Indeed, President Bolsonaro of Brazil has called his followers to storm hospitals to take photos and videos to show whether COVID-19 patients are truly filling hospital beds, as the hospitals and state leaders claim. Such denial has caused painful climbs in COVID-19 deaths in both Brazil and the United States. …

COVID-19 in Latin America

Flyer for our upcoming presentation

Next Tuesday my department will be having a presentation on Zoom  about COVID-19  in Latin America. During this discussion I’ll be talking about Bolsonaro’s leadership in Brazil, and the current pandemic trends in that country. Dr. Rodriguez will be talking about Argentina’s response, while Dr. Young will be discussing the experience of both Cuba and Mexico. Since I know little about the COVID-19 situation outside of Brazil in Latin America, I am particularly interested to hear what my co-presenters will say. The talk will be 2pm West Coast (US) time. Please RSVP if you are interested in participating.

Shawn Smallman

The power of smartphones in online teaching

Before entering restaurants in Taiwan people sanitize their hands and have their temperature taken. Image courtesy of Isabella Mori.

One of the great lessons in life is the power of radical simplification. Everyone who has traveled has had the experience of realizing that even the most basic statements and vocabulary can allow you to exchange key information. Right now, many people are radically simplifying their lives in self-quarantine, whether it be having a family member cut their hair, or using an old sewing machine to make face masks. The number of people rediscovering the value of even a small garden reminds me of England during World War Two. Our grandparents and great-grandparents already did this.

So it’s interesting to learn that the same trend is happening in online education, where people are interested in how to use phones as a learning tool. The idea alone might make some of my senior colleagues’ heads’ spin around much like Linda Blair’s in the 1973 American horror film “the Exorcist.” They believe that phones are responsible for the decline of civilization and culture, much as Plato and Socrates once argued that the invention of writing had destroyed memory skills and damaged learning. Nonetheless, in some developing nations smart phones are playing a key role in permitting online learning during the COVID-19. I recommend this article by Anya Kamenentz in NPR on “How Cellphones Can Keep People Learning Around The World.” It turns out that phones may also be an appropriate technology in many educational contexts. …

Fear, Fact and Fiction: COVID-19’s Origins and Spread

 

Photo by Isabella Mori, who provides this context: In traditional Taiwanese night markets, since people / food stands are in close contacts, most people / vendors wear masks now, in order to protect themselves and others.

I gave a talk yesterday for WorldOregon on COVID-19, and what we know about it’s origins and spread, as compared to conspiracy theories. What you might not know when you watch this is that I wrote a talk before asking how long it should be. So I wound up having a fifty minute talk for a twenty minute delivery. Throughout the whole talk I was trying to summarize. My bad. But I had a good time and enjoyed hearing the questions. Thanks WorldOregon! …

Upcoming talk on COVID-19

I’m giving a talk for World Oregon members next Tuesday at noon (Portland time) via Zoom. You can learn more and register at this link: Virtual Program: Fear, Fiction and Fact: COVID-19’s Origins & Spread. 

Shawn Smallman, 2020

Health care and Cyber-attacks

An Opte Project visualization of routing paths through a portion of the Internet. (http://creativecommons.org/licenses/by/2.5) via Wikimedia Commons.

Sadly, one of the most common cyberattacks is upon health care centers, particularly ransom-ware attacks upon hospitals. While digital records and telemedicine are proving essential during the COVID-19 pandemic, hospitals’ reliance upon digital resources also make our health care systems vulnerable to attack. As this article by Jocelinn Kang and Tom Uren says, cyber-defense efforts now need to prioritize our health care systems.

If you are interested in hearing more about global topics, please listen to my podcast, Dispatch 7. You can find it on Spotify here, or by searching whichever podcast platform you prefer.

Shawn Smallman, 2020

Cyber tools for predicting COVID-19’s spread

 

The Spanish Influenza. Chart showing mortality from the 1918 influenza pandemic in the US and Europe. Wikipedia commons.

The New York Times had a remarkable story yesterday morning by Donald G. McNeil Jr. , which talked about a company (Kinsa) that markets smart thermometers. The company can use the data on fevers from these devices to foretell where the outbreak will grow, before that data shows up in other sources.  You can see the company’s map here. As the NYT article says, there is so much interesting data here.

As someone who has spent a lot of time in Florida (my mother was a mystery writer, who set her novels in the bars of West Florida) I am deeply worried by the data on southeast Florida, as well as around Tampa. And even some of northern Florida, such as Duval county, has high levels of atypical fevers. But what is happening in Michigan? The map around Detroit has not lit up as red as Miami, but there is a swath in the south of the state where the levels of atypical fevers have raised. The swatch stretches as far west in the state as Kent county. I wouldn’t have expected what appears to be happening in Utah county, and Salt Lake county, Utah. But these counties still do not light up as much as Broward, Palm Beach, and Miami-Dade do in Florida. …

Strengthening the U.S. health care system

Image of globe on light, McGill University. Photo by Smallman

In our textbook, the health chapter begins by this comparison of nations: “Chile, Costa Rica, Cyprus, Guadalupe, Hong Kong, Israel, Macau, Malta, Martinique, Singapore, and the United Arab Emirates are a diverse set of nations and territories. Yet they all have one fact in common: their citizens live longer than those of the United States, as do the citizens of many developed countries (United Nations 2006). This truth is unexpected, given the wide gap between the wealth, power, and technology of these countries and that of the United States. But health inevitably becomes linked to broader issues of politics and policy.” This is certainly the case in the United States’ ability to respond to a pandemic.

What have some of the lessons of this pandemic been for the United States? Our health care system has a number of weaknesses during an epidemic:

  1. A health care system that invests heavily in technology, but less so in people, such as the public health professionals who do contact tracing.
  2. A lack of recent experience with pandemics, such as South Korea and Canada had with SARS and MERS.
  3. An inadequate stockpile of personal protective equipment. A failed effort to develop a stockpile of ventilators wasted over a decade, and left the United States undersupplied.
  4. A popular belief that epidemics are something that happens elsewhere, so that the first and best response is only to put in place border restrictions.
  5. A sense of hubris, so that outbreaks in China or South Korea are assumed to be something that could not happen here, because our hospitals -with their advanced technologies- would be able to manage the situation.
  6. A health care system in which peoples’ insurance is tied to their employment. This has meant that when people lose their employment during a pandemic, they also lose health care.
  7. Deep health inequalities, which mean that case fatality rates may vary widely depending upon class and geography.
  8. A lack of sick leave for U.S. workers, so that people feel compelled to come to work when they are sick, or to face an immediate financial crisis if they are forced to stay at home.
  9. A sense of hubris regarding the U.S. medical system, which led U.S. health authorities to reject a German developed test for COVID-19 that the World Health Organization (WHO) endorsed. Instead, the U.S. frittered away precious time developing its own test. When that did not work, the CDC and FDA wasted even more time resolving the situation.
  10. A CDC and FDA that had become too swamped by bureaucracy and hence struggled to adapt, despite having outstanding and dedicated people. The system’s senior leadership has ossified.
  11. A U.S. health care system that is too decentralized to respond to a national level emergency, although this decentralization also has some benefits when there are failures at the top.
  12. An over-reliance on overseas manufacturing for key health goods, for everything from masks to medications.
  13. A society that undervalues the very people who turn out to be particularly critical during a pandemic:  janitors, grocery store clerks, truck drivers, nurses, farmers, and others. As many people have said, it is only during a pandemic you learn whose job really counts. And there is not a good correlation between peoples’ pay and how important their job truly is. The same holds true for respect.
  14. A high rate of chronic diseases that leave people vulnerable to a disease such as COVID-19. The “diseases of development” such as diabetes, sleep apnea, high blood pressure and morbid obesity have led to higher case fatality rates. Most of these issues connect to the Standard American Diet (SAD) and the U.S. food system. No technology can replace a good diet.
  15. A chronic underfunding of public health. A good public health system is like a seat belt. You forget that it should be there until you really need it. And it seems kind of basic, but when the moment comes, there is nothing else that can replace it.
  16. Basic public health relies on people, and salaries are expensive. But not having an adequately funded public health system is what is truly expensive. Contact tracing, outreach, education, follow-up, monitoring, epidemiology, and health communication take time and people. Perhaps because they do not rely as much on technology they are also undervalued in the United States, which always likes to use technology to solve all problems. But there is no substitute for public health professionals.
  17. The basic systems that are always there in public health -nurses in schools, communication campaigns, testing systems, contract tracing- are the same systems that are needed in a pandemic. So having good public health in ordinary times gives you the tools and the people that are needed during extraordinary times.

Turkey’s strikes in Syria

“Chest X-rays, 3D Image of lungs, Sagital Plane Image” by Praisaeng at freedigitalphotos.net

With the COVID-19 pandemic rampant, it’s easy to forget that other world events are still taking place, and with good reason. No other events now matter as much. Even so, after 33 of its soldiers were killed by the Syrian military (or perhaps by a Russian airstrike) last month, the Turkish government launched a devastating counterstrike against the Syrian military on February 27, 2020. The use of drones and other technology simply overwhelmed the Syrian armed forces, and let to the destruction of even the most sophisticated Russian equipment, such as the Pantsir anti-air systems. As usual, the Oryx blog has the best information. The list of destroyed military equipment on this website is striking. For example, the Syrians likely lost 32 tanks, which they could ill afford, and eight aircraft (mostly helicopters). …

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