Stig Östlund

lördag, februari 29, 2020

Ingen av de elva personer i Sverige som konstaterats smittade av det nya coronaviruset är i behov av avancerad vård, säger Folkhälsomyndighetens statsepidemiolog Anders Tegnell till TT. – Många av dem är så friska redan från början att de knappt behöver ligga på sjukhus, säger han. Personerna hålls ändå isolerade, på grund av virusets oklara smittsamhet. Alla de elva personerna smittades antingen i samband med utlandsresor till de värst drabbade länderna som Iran och Italien eller genom kontakt med en person som har smittats på det viset.

”Kan ta emot hundra fall utan att vi har spridning”

 Folkhälsomyndighetens statsepidemiolog Anders Tegnell säger till DN att antalet insjuknade i Sverige, som nu ligger på 11 personer, inte är avgörande för hur myndigheten agerar.

– Vi kan ta emot flera hundra importfall utan att det innebär att vi har en spridning i Sverige. Vi tar varje år emot ett femtiotal fall av mässling i Sverige och stoppar smittan mot dem, säger han.

Enligt honom är det avgörande om man börjar hitta smittade personer som inte kan spåras tillbaka till personer som varit ute och rest. Tegnell menar att sådant skulle signalera att det sker en spridning i befolkningen och inte mellan enstaka personer.


Basic protective measures against the new coronavirus (WHO)


Basic protective measures against the new coronavirus

Stay aware of the latest information on the COVID-19 outbreak, available on the WHO website 
and through your national and local public health authority. COVID-19 is still affecting mostly
 people in China with some outbreaks in other countries. Most people who become infected 
experience mild illness and recover, but it can be more severe for others. Take care of your 
health and protect others by doing the following:


Wash your hands frequently

Regularly and thoroughly clean your hands with an alcohol-based hand rub or wash them 
with soap and water.
Why? Washing your hands with soap and water or using alcohol-based hand rub kills 
viruses that may be on your hands.

Maintain social distancing

Maintain at least 1 metre (3 feet) distance between yourself and anyone who is coughing
 or sneezing.
Why? When someone coughs or sneezes they spray small liquid droplets from their nose 
or mouth which may contain virus. If you are too close, you can breathe in the droplets,
 including the COVID-19 virus if the person coughing has the disease.
Avoid touching eyes, nose and mouth
Why? Hands touch many surfaces and can pick up viruses. Once contaminated, hands can transfer the virus to your eyes, nose or mouth. From there, the virus can enter your body and can make you sick.

Practice respiratory hygiene
Make sure you, and the people around you, follow good respiratory hygiene. This means covering your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately.

Why? Droplets spread virus. By following good respiratory hygiene you protect the people around you from viruses such as cold, flu and COVID-19.

If you have fever, cough and difficulty breathing, seek medical care early
Stay home if you feel unwell. If you have a fever, cough and difficulty breathing, seek medical attention and call in advance. Follow the directions of your local health authority.

Why? National and local authorities will have the most up to date information on the situation in your area. Calling in advance will allow your health care provider to quickly direct you to the right health facility. This will also protect you and help prevent spread of viruses and other infections.


Avoid touching eyes, nose and mouth

Why? Hands touch many surfaces and can pick up viruses. Once contaminated, hands can 
transfer the virus to your eyes, nose or mouth. From there, the virus can enter your body and
 can make you sick.

Practice respiratory hygiene

Make sure you, and the people around you, follow good respiratory hygiene. This means 
covering your mouth and nose with your bent elbow or tissue when you cough or sneeze. 
Then dispose of the used tissue immediately.
Why? Droplets spread virus. By following good respiratory hygiene you protect the people 
around you from viruses such as cold, flu and COVID-19.

If you have fever, cough and difficulty breathing, seek medical care early

Stay home if you feel unwell. If you have a fever, cough and difficulty breathing, seek medical 
attention and call in advance. Follow the directions of your local health authority.
Why? National and local authorities will have the most up to date information on the situation
 in your area. Calling in advance will allow your health care provider to quickly direct you to
 the right health facility. This will also protect you and help prevent spread of viruses and 
other infections.


Stay informed and follow advice given by your healthcare provider

Stay informed on the latest developments about COVID-19. Follow advice given by your
 healthcare provider, your national and local public health authority or your employer on how 
to protect yourself and others from COVID-19.
Why? National and local authorities will have the most up to date information on whether 
COVID-19 is spreading in your area. They are best placed to advise on what people in your 
area should be doing to protect themselves.

Protection measures for persons who are in or have
recently visited (past 14 days) areas where COVID-19
is spreading

  • Follow the guidance outlined above.
  • Stay at home if you begin to feel unwell, even with mild symptoms such as headache and 
  • slight runny nose, until you recover. Why? Avoiding contact with others and visits to 
  • medical facilities will allow these facilities to operate more effectively and help protect you 
  • and others from possible COVID-19 and other viruses.
  • If you develop fever, cough and difficulty breathing, seek medical advice promptly as this 
  • may be due to a respiratory infection or other serious condition. Call in advance and tell 
  • your provider of any recent travel or contact with travelers. Why? Calling in advance will
  •  allow your health care provider to quickly direct you to the right health facility. This will 
  • also help to prevent possible spread of COVID-19 and other viruses.


Responding to Covid-19 — A Once-in-a-Century Pandemic?

William Henry ”Bill” Gates III, född 28 oktober 1955 i Seattle i Washington, är en amerikansk datorpionjär och filantrop. Han är medgrundare till Microsoft, där han är styrelseordförande. Han har nu lämnat det dagliga arbetet inom Microsoft för att arbeta heltid inom Bill & Melinda Gates Foundation







By: Bill Gates 

In any crisis, leaders have two equally important responsibilities: solve the immediate problem and keep it from happening again. The Covid-19 pandemic is a case in point. We need to save lives now while also improving the way we respond to outbreaks in general. The first point is more pressing, but the second has crucial long-term consequences.
The long-term challenge — improving our ability to respond to outbreaks — isn’t new. Global health experts have been saying for years that another pandemic whose speed and severity rivaled those of the 1918 influenza epidemic was a matter not of if but of when. The Bill and Melinda Gates Foundation has committed substantial resources in recent years to helping the world prepare for such a scenario.
Now we also face an immediate crisis. In the past week, Covid-19 has started behaving a lot like the once-in-a-century pathogen we’ve been worried about. I hope it’s not that bad, but we should assume it will be until we know otherwise.
There are two reasons that Covid-19 is such a threat. First, it can kill healthy adults in addition to elderly people with existing health problems. The data so far suggest that the virus has a case fatality risk around 1%; this rate would make it many times more severe than typical seasonal influenza, putting it somewhere between the 1957 influenza pandemic (0.6%) and the 1918 influenza pandemic (2%).
Second, Covid-19 is transmitted quite efficiently. The average infected person spreads the disease to two or three others — an exponential rate of increase. There is also strong evidence that it can be transmitted by people who are just mildly ill or even presymptomatic.  That means Covid-19 will be much harder to contain than the Middle East respiratory syndrome or severe acute respiratory syndrome (SARS), which were spread much less efficiently and only by symptomatic people. In fact, Covid-19 has already caused 10 times as many cases as SARS in a quarter of the time.
National, state, and local governments and public health agencies can take steps over the next few weeks to slow the virus’s spread. For example, in addition to helping their own citizens respond, donor governments can help low- and middle-income countries (LMICs) prepare for this pandemic. Many LMIC health systems are already stretched thin, and a pathogen like the coronavirus can quickly overwhelm them. And poorer countries have little political or economic leverage, given wealthier countries’ natural desire to put their own people first.
By helping African and South Asian countries get ready now, we can save lives and slow the global circulation of the virus. (A substantial portion of the commitment Melinda and I recently made to help kickstart the global response to Covid-19 — which could total up to $100 million — is focused on LMICs.)
The world also needs to accelerate work on treatments and vaccines for Covid-19.  Scientists sequenced the genome of the virus and developed several promising vaccine candidates in a matter of days, and the Coalition for Epidemic Preparedness Innovations is already preparing up to eight promising vaccine candidates for clinical trials. If some of these vaccines prove safe and effective in animal models, they could be ready for larger-scale trials as early as June. Drug discovery can also be accelerated by drawing on libraries of compounds that have already been tested for safety and by applying new screening techniques, including machine learning, to identify antivirals that could be ready for large-scale clinical trials within weeks.
All these steps would help address the current crisis. But we also need to make larger systemic changes so we can respond more efficiently and effectively when the next epidemic arrives.
It’s essential to help LMICs strengthen their primary health care systems. When you build a health clinic, you’re also creating part of the infrastructure for fighting epidemics. Trained health care workers not only deliver vaccines; they can also monitor disease patterns, serving as part of the early warning systems that alert the world to potential outbreaks.
We also need to invest in disease surveillance, including a case database that is instantly accessible to relevant organizations, and rules requiring countries to share information. Governments should have access to lists of trained personnel, from local leaders to global experts, who are prepared to deal with an epidemic immediately, as well as lists of supplies to be stockpiled or redirected in an emergency.
In addition, we need to build a system that can develop safe, effective vaccines and antivirals, get them approved, and deliver billions of doses within a few months after the discovery of a fast-moving pathogen. That’s a tough challenge that presents technical, diplomatic, and budgetary obstacles, as well as demanding partnership between the public and private sectors. But all these obstacles can be overcome.
One of the main technical challenges for vaccines is to improve on the old ways of manufacturing proteins, which are too slow for responding to an epidemic. We need to develop platforms that are predictably safe, so regulatory reviews can happen quickly, and that make it easy for manufacturers to produce doses at low cost on a massive scale. For antivirals, we need an organized system to screen existing treatments and candidate molecules in a swift and standardized manner.
Another technical challenge involves constructs based on nucleic acids. These constructs can be produced within hours after a virus’s genome has been sequenced; now we need to find ways to produce them at scale.
Beyond these technical solutions, we’ll need diplomatic efforts to drive international collaboration and data sharing. Developing antivirals and vaccines involves massive clinical trials and licensing agreements that would cross national borders. We should make the most of global forums that can help achieve consensus on research priorities and trial protocols so that promising vaccine and antiviral candidates can move quickly through this process. These platforms include the World Health Organization R&D Blueprint, the International Severe Acute Respiratory and Emerging Infection Consortium trial network, and the Global Research Collaboration for Infectious Disease Preparedness. The goal of this work should be to get conclusive clinical trial results and regulatory approval in 3 months or less, without compromising patients’ safety.
Then there’s the question of funding. Budgets for these efforts need to be expanded several times over. Billions more dollars are needed to complete phase 3 trials and secure regulatory approval for coronavirus vaccines, and still more funding will be needed to improve disease surveillance and response.
Government funding is needed because pandemic products are extraordinarily high-risk investments; public funding will minimize risk for pharmaceutical companies and get them to jump in with both feet. In addition, governments and other donors will need to fund — as a global public good — manufacturing facilities that can generate a vaccine supply in a matter of weeks. These facilities can make vaccines for routine immunization programs in normal times and be quickly refitted for production during a pandemic. Finally, governments will need to finance the procurement and distribution of vaccines to the populations that need them.
Billions of dollars for antipandemic efforts is a lot of money. But that’s the scale of investment required to solve the problem. And given the economic pain that an epidemic can impose — we’re already seeing how Covid-19 can disrupt supply chains and stock markets, not to mention people’s lives — it will be a bargain.
Finally, governments and industry will need to come to an agreement: during a pandemic, vaccines and antivirals can’t simply be sold to the highest bidder. They should be available and affordable for people who are at the heart of the outbreak and in greatest need. Not only is such distribution the right thing to do, it’s also the right strategy for short-circuiting transmission and preventing future pandemics.
These are the actions that leaders should be taking now. There is no time to waste.
Discklosure forms  provided by the author are available at NEJM.org.

First came the flood, then came the disease. Over the past three months, the tourism industry of Venice, has had its share of plague

Rows of empty tables in St. Mark’s Square in Venice, one of the world’s
 most popular tourist destinations 

fredag, februari 28, 2020

Coronavirus - News

Covid-19

Data as reported by 10AM CET 27 February 2020* Coronavirus disease 2019 (COVID-19) S

SITUATION IN NUMBERS
Total and new cases in last 24 hours
Globally 82 294 confirmed (1185 new)
China 78 630 confirmed (439 new) 2747 deaths (29 new)
Outside of China 3664 confirmed (746 new)
46 countries (9 new) 57 deaths (13 new)
WHO RISK ASSESSMENT China Very High Regional Level High Global Level High

torsdag, februari 27, 2020

Fem nya bekräftade Coronafall i Sverige

Fem nya fall av coronavirus i Sverige har bekräftats, skriver GP. Det rör sig om tre personer i Västra Götaland, en person i Region Uppsala och en person i Region Stockholm.Fallet i Uppsala rör en kvinna som vistats i Tyskland och som uppsökte vård i Sverige efter att hon fått symptom på en luftvägsinfektion.– Patienten får nu vård i enlighet med de rutiner som gäller. Någon närmare information om hälsotillståndet kan vi i dagsläget inte lämna, säger smittskyddsläkare Johan Nöjd vid Region Uppsala .


Vad man behöver veta:

De allra flesta får lindriga symptom som vanlig förkylning, feber och luftvägssymptom, och tillfrisknar rätt snabbt.

– Men en del blir mycket sjuka och får allvarliga besvär i luftvägarna så att de får svårt att andas, säger Anders Tegnell, statsepidemiolog på Folkhälsomyndigheten.
Hur smittar det?
Coronaviruset, sars-cov-2, smittar genom nära kontakt med människor.

– Det brukar kallas droppsmitta och bygger på att någon som är sjuk har virus i sina luftvägar och slemhinnor som hamnar på någon annan. Det kan smitta till exempel genom att du nyser och någon står nära dig, eller genom att någon får det på händerna och sedan tar sig i ansiktet.
För att smittas krävs det att man är nära någon en längre tid, till exempel på en arbetsplats eller i hemmet. Det är väldigt osannolikt att bli smittad bara genom att passera någon utomhus eller stå bredvid någon en kort stund i kollektivtrafiken, enligt Anders Tegnell.
Viruset smittar inte heller via ytor eller föremål, och det är vanligare att bli smittad inomhus än utomhus.
– Dels är man närmre varandra inomhus och delar mer luft, dels trivs inte viruset i solljus.
Hur lång är inkubationstiden?
Enligt Världshälsoorganisationen WHO är tiden mellan smittotillfälle och insjuknande mellan en och fjorton dagar.
– Medeltiden är fem dagar, de allra flesta insjuknar någon gång mellan dag tre och sju. Det har förekommit uppgifter om att inkubationstiden skulle vara längre, men det har inte gått att verifiera så vi håller oss till det WHO säger, säger Anders Tegnell.
Hur smittsamt är det?
Smittsamhetsindexet för coronaviruset ligger på mellan två och tre. Det är ungefär samma smittsamhetsgrad som vanligt influensa, berättar Anders Tegnell. Jämförelsevis har mässling ett smittsamhetsindex på fjorton, medan sars låg på mellan ett och två.
Hur skyddar man sig mot smitta?
Det allra bästa är att tvätta händerna med tvål och vatten. Har man inte tillgång till det kan man använda handsprit.
Är det större risk att smittas i ett slutet ventilationssystem, som ett flygplan?
Eftersom viruset inte är luftburet, utan smittar vid nära kontakt vet man inte hur ett slutet ventilationssystem påverkar, enligt Anders Tegnell.
– Vi har inte sett någon större smittspridning på något flygplan än så länge, säger han.
Hur dödligt är viruset?
– I Kina finns en sammanställning på 70 000 personer som kommit till sjukvården, av dem dog ungefär två procent. Men väldigt många blir inte så sjuka att de kommer till sjukvården, så på en befolkningsnivå ligger förmodligen dödligheten betydligt lägre, säger Anders Tegnell.
Vilken behandling ges till den som smittas?
Det finns inget botemedel mot viruset, utan den vård som ges behandlar symptomen.
– Men de allra flesta tillfrisknar själva, möjligtvis kan de få lite febernedsättande.
Att tillverka ett vaccin mot viruset skulle ta flera år.
– I första hand testar man de varianter som redan finns mot olika virus, det verkar ha en viss effekt, säger Tegnell.
Hur länge kan epidemin pågå?
– Det är jättesvårt att veta. Men jag tror att vi kan räkna med det ett bra tag till, ett antal månader. Definitivt fram till sommaren och förmodligen även under nästa höst.
Källa: GP

Fler bör äta fullkornsbröd

För att ett bröd skall få kallas "rikt på fullkorn" eller "fullkornsbröd" ska de ha samma fullkornsmängd som gäller för nyckelhålet säger Maria Sitell, talsperson för Brödinstitutet (dotterbolag till branschorganisationen Sveriges bagare & konditorer). Men det finns inga krav på hur mycket salt eller socker som får ingå.

Fullkornsbröd innehåller mjöl av till exempel vete, råg, korn och havre där alla delar av spannmålskornet har använts.










Fullkornsbröd

Råg Gott (Hatting). Andel fullkorn     100%; Kolhydrater per 100 gram -- g varav sockerarter 3,9 g.
Rågbröd (Kung Markatta)                  100% resp  1,5 g 
Rågkusar (Fazer)                               91% resp  2,2 g ("min" sort sedan länge.".
Råggrova (Pågen)                              85% resp  2,5 g
Bondens surdegsbröd (Fazer)           79%  resp   1   g 
Rågform  (Fazer)                               70%  resp   3,4 g   
Fyra sädesslag (Kung Markatta)       66% resp    4 g
Rågbitar Solros & Pumpafrön           51 % resp   2,2 g (mest fett av de här nämnda)
Ekologiskt Fullkornsbröd med Linfrön (Hatting) 49% resp 2,2 g
Rågbröd pumpa (Ica)                        45% resp  4,5 g
Fiberrost skivad (Skogaholm)           36% resp 2,6 g
Linfröbröd (Kvarnvingen)                  31% resp 3,9 g
Rasker (Pågen)                                  31% resp 4,8 g
Trehörning grov (Bonjour)                30% resp 0,3 g (mest protein av de här nämnda)
Grovt bröd vital (Garant)                  30% resp 0,5 g
Sund & God Råg (polarbröd)           30% resp 4,8 g 
Lingongrova Special (Pågen)           30% resp 5,0 g (mest socker av de här nämnda)

Beträffande salt har Pågens Råggrova och Garants Ekonomiska Fullkornsbröd med Linfrön 0,7g/100= lägst av alla här ovan nämnda brödsorter. De övriga = 1g/100 eller mycket nära 1g/100 g
högst har "mina" rågkusar med 1,2g/100g. 

Kraven på nyckelhålsbröd

Mjukt bröd (ej rågbröd):

Sockerarter högst 5g/100g
Fibrer minst 5g/100g
Fullkorn minst 30%
Salt högst 1g/100g
Fett högst 7 g/100g

Rågbröd (minst 30%råg):

Sockerarter högst 5g/100g
Fibrer minst 6g/100g
Fullkorn minst 35%
Salt högst 1,2 g/100g (av de här nämnda ligger alla på 1g eller nära 1g per 100 g 
Fett högst 7g/100g

Glutenfritt bröd:

Sockerarter högst 5g/100 g
Fibrer minst 5g/100g
Fullkorn minst 10%
Salt högst 1 g/100g
Fett högst 7g/100g


Lingongrova kanske goda men inte ett "hälsobröd" (?)
Om rågkusar: prishöjes relativt ofta ("smyghöjningar".

Kung Markattas rågbröd tror jag mycket på, men något
"svårhanterliga" för mina osmidiga händer. Dock
Hälsosamasom rågkusar och godare



Källa: det mesta från nya numret av Råd & Rön

Rätta mig (meddela) om något fel upptäckes ovan






radron.se/brod hittas nyckelhålsmärkta brödsorter och innehållsförteckningar till bröden till här nämnda bröd. Desutom kan
man läsa om 72 sorters knäckebröd på radron.se/knackebrod.

Coronavirus in Europe


The New York Times is beginning a coronavirus newsletter

The Times is beginning a coronavirus newsletter,  an informed guide to the outbreak with the latest developments and expert advice about prevention and treatment.
Every day at 6 p.m. Eastern (7 a.m. in Hong Kong), we’ll tell you exactly what you need to know about this far-reaching and fast-moving story.

Coronaviruset. ”Avgörande punkt”.

Det nya coronavirusets utbrott befinner sig just nu vid en ”avgörande punkt”. Det sa världshälsoorganisationen WHO:s generalsekreterare Tedros Adhanom Ghebreyesus vid en pressträff under torsdagen. Än så länge väljer WHO att inte kalla utbrottet för en pandemi. Under pressträffen uppmanade generalsekreteraren de länder som drabbats av smittan att agera skyndsamt. 

– Om ni agerar nu kan ni stoppa viruset, ni kan undvika att människor blir sjuka och ni kan rädda liv.

Champions League igår



Real Madrid – Manchester City 1–2
60 min 1–0 Isco
78 min 1–1 Gabriel Jesus
83 min 1–2 Kevin De Bruyne
Lyon – Juventus 1–0
31 min 1–0 Lucas Tousart







OL:
Olympique Lyonnais skapades 1950 från Lyon Olympique, som bildades 1899. Fotbollssektionen bröt sig ur och skaffade ett nytt namn: Olympique Lyonnais. Därför anser klubbens supportrar att klubben skapades 1899.
Klubben dominerade fransk fotboll i början av 2000-talet. Efter en andraplats 2001, vann klubben sju franska mästerskap i rad (2002–2008).
I januari 2016 ersatte den nybyggda Parc Olympique Olympique Lyonnais den äldre Stade de Gerland som hemmaarena för Lyon./Wikipedia


Første dansker smittet med coronavirus

Coronavirus


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