Given that phages are able to destroy bacteria, they are of particular interest to science. Basic researchers from the Leibniz-Forschungsinstitut für Molekulare Pharmakologie (FMP) in Berlin are especially interested in the tube used by phages to implant their DNA into bacteria. In collaboration with colleagues from Forschungszentrum Jülich and Jena University Hospital, they have now revealed the 3D structure of this crucial phage component in atomic resolution. The key to success was combining two methods — solid-state NMR and cryo-electron microscopy. The study has just been published in the journal Nature Communications.

The Barbegal watermills in southern France are a unique complex dating back to the 2nd century AD. The construction with 16 waterwheels is, as far as is known, the first attempt in Europe to build a machine complex on an industrial scale. The complex was created when the Roman Empire was at the height of its power. However, little is known about technological advances, particularly in the field of hydraulics, and the spread of knowledge at the time. A team of scientists led by Professor Cees Passchier from Johannes Gutenberg University Mainz (JGU) has now gained new knowledge about the construction and principle of the water supply to the mills in Barbegal. The research results were published in Scientific Reports.

Evidence presented to government confirmed rising infections as schools reopened.

ONS data also says the number of people infected with coronavirus is slowing down.

• The first results for a Covid vaccine are out, with Pfizer and BioNTech reporting 90% efficacy based on early data
• Despite its promise, cold chain requirements mean this jab wouldn’t be the first choice for countries like South Africa
• The vaccine needs to be kept at minus 70 degrees Celsius, well below other vaccines used in South Africa, which poses a huge challenge to its delivery and storage

The world’s first hope for a Covid-19 vaccine – the jab developed by drug companies Pfizer and BioNTech, showing 90% efficacy in preventing Covid-19 in early results – is highly unlikely to become widely available in South Africa.

This is because the vaccine needs to be stored below freezing temperatures – at minus 70 degrees Celsius – that the country doesn’t have the capacity to do on a large scale. If the shots are kept at temperatures too high or too low, they can spoil and become less effective. 

In the United States, large city hospitals are already “rushing to buy the expensive ultra-cold freezers” that cost between R150 000 and R235 000 each, to store the shots, for which Pfizer and BioNTech will apply for an emergency license from the US regulator, the Food and Drug Administration (FDA), later this month, Statnews reports.

And just three days after the announcement of the BNT162b2 vaccine’s first interim results, the European Union signed an agreement with the manufacturers to supply it with 200 million doses and an option to request an additional 100 million doses, “with deliveries anticipated to start by the end of 2020, subject to regulatory approval”.

But South Africa doesn’t have the required ultra-cold freezers to store the vaccine – except for a few at large research institutions such as the National Institute for Communicable Diseases, says director of Vaccines for Africa at the University of Cape Town, Gregory Hussey.

And, along with less well-off rural hospitals in developed countries, the country is unlikely to be able to afford to buy enough of the freezers to be able to make the vaccine available at community health centres or clinics, or pay for the cold chain systems that are necessary to maintain the vaccines.

Most vaccines that are part of South Africa’s immunisation programme have to be kept at temperatures between two and eight degrees Celsius. The country’s system – including vaccine transportation, storage, and monitoring – is therefore not suitable for vaccines that need to be kept below freezing temperatures.

And the Pfizer/BioNTech vaccine is not the only Covid-19 frontrunner that is likely to pose a problem to South Africa. The pharmaceutical company, Moderna’s mRNA-1273 jab, of which the first results are likely to be released before the end of the year, needs to be stored at minus 20 degrees Celsius.

Pfizer/BioNTech and Moderna’s vaccine both use mRNA technology. Such vaccines use pieces of man-made genetic material known as messenger ribonucleic acid, or mRNA, that instructs our bodies to produce proteins, in the form of antibodies and killer cells, to fight off SARS-CoV-2, the virus that causes Covid-19.

But the snag is that these two mRNA vaccines need to be kept at extremely low temperatures, or they risk becoming damaged. 

And to complicate things even further, mRNA vaccine technology is new – not a single vaccine using mRNA messengers has been licensed for human use up to date.

“I don’t know if we could really even contemplate an mRNA vaccine with our present setup,”  explains Barry Schoub, chair of South Africa’s ministerial advisory committee on coronavirus vaccines. “Things may change, but with our present setup, the places where we could actually utilise it would be so limited that it would be a major challenge.”

South Africa’s challenge of keeping vaccines cool    

Maintaining a cold chain — where a product must be consistently stored at a low temperature – is important to ensure that vaccines don’t degrade or lose their efficacy. A 2018 paper in the journal Vaccine, showed that although this deterioration did not pose a safety risk to people receiving the vaccine, the jabs offered less protection after being stored at the wrong temperature.

This is a major risk for rural hospitals and clinics or those facilities that lack adequate infrastructure to properly store doses when a Covid vaccine becomes available, according to Hussey, who also serves on the Covid vaccines ministerial advisory committee.

Schoub, who is also a virologist and former director of the National Institute for Communicable Diseases, agrees: “You can’t really store vaccines reliably and sustainably at minus 20 degrees Celsius anywhere outside the bigger cities. Especially if you’re looking at places with a hotter climate, like the Northern Cape or KwaZulu-Natal, even maintaining a freezer at minus 20 is going to be a question mark.”

According to Schoub, Pfizer/BioNTech are considering freeze-dried vaccines – in the form of frozen powders to which liquid is later added – which could potentially ease cold chain requirements for the jab, because they can be stored between two and eight degrees Celsius. But the timeline for this, he says, is still unclear.  

But even without taking into account the additional obstacles that will arise with maintaining a vaccine at well below 0 degrees Celsius, just regulating the temperature for our existing vaccines is already a challenge.

An assessment of vaccine management in 18 countries done by the World Health Organisation Regional Office for Africa in 2001 found that “only 47% of the indicators were satisfactorily met for buildings, cold chain equipment, and transport at the national level”.

In the Western Cape, a 2015 study published in Vaccine found that government-managed vaccine supply chains were often unable to manage the temperatures at which vaccines need to be stored, adequately. 

The average temperature of health centre fridges in the study ranged from 0.9 to 9.2 degrees Celsius, meaning that the jabs could have potentially been stored at temperatures both too low or too high and been damaged.

Why does 90% efficacy matter? 

Despite the delivery challenges of the Pfizer/BioNTech vaccine, its 90% potential efficacy has physicians and scientists, who mostly expected a much lower efficiency, excited.

Although it is only initial data that could still change as the trial progresses, this kind of efficacy puts the jab in the same category as the world’s most effective vaccines, such as the measles shot.  

Schoub explains: “If it does turn out to be true then that is a major, giant step forward, but at this stage it’s very difficult to assess how accurate that figure is because it’s still early in the trial.”

A higher efficacy rate means that the jab is able to offer more protection to a population. This is important when it comes to the role of a vaccine in offering immunity to a community.

If only half the people receiving a vaccine are going to be protected, you need to vaccinate a much larger portion of the population in order for it to make a difference and properly contain an outbreak.

With herd immunity as the end goal – where enough of the population is protected or resistant to the virus that it stops spreading – the measles vaccine, which is 97% effective at preventing measles, is often held up as the ideal.

But until now, scientists have been skeptical that we would be able to reach the same level when it came to Covid-19.

As Schoub explains, it was speculated that a Covid vaccine would be unlikely to offer the same level of protection as the measles shot because of the differences between the two diseases. While both are spread in a similar manner, through coughs or sneezes, they fundamentally differ in how they affect a person’s body.

Measles is a systemic disease, meaning it affects the whole body, while Covid is initally a pulmonary disease that mainly targets the lungs. In that respect, Covid is more similar to influenza, which is what has been used as the sort of benchmark when it comes to vaccine efficacy, says Schoub.

The distinction in how the disease works matters, because it influences the type of immune response – with measles requiring the production of antibodies in the blood to fight off the measles virus and influenza needing a more complicated immune response through antibodies in respiratory secretions.

The type of immune response needed to fight off influenza is hard to get through vaccinations, with most flu jabs only offering around a 60% chance of protection from the infection.

Most Covid vaccine trials are therefore designed to pick up around 60% efficacy in a vaccine candidate, the director of the American government’s National Institute of Allergy and Infectious Diseases, Anthony Fauci, explained in a Medical Brief webinar in October.  

But regardless of whether the Pfizer/BioNTech candidate is suitable for South Africa, the issue of delivering a vaccine is something we need to begin working on now, says Hussey.

He concludes: “There is a huge cost involved in delivering a vaccine, the World Health Organisation has estimated that cost of delivery of vaccines could be up to two or three-fold greater than the cost of the vaccines alone.

“There is also the additional operational costs of conducting immunization campaigns during the Covid-19 pandemic. We have to ensure that the facilities, the staff administering vaccines and the recipients of vaccines are kept ‘Covid safe’. That’s something we need to factor into our planning.”

And even though South Africa is only expecting to get enough Covid vaccines for around 5% of its population by next year, and a large rollout to the general public will likely only come in the next two years, Hussey cautions: “I think getting the vaccine is a simple thing. Getting the vaccine out to the people who need it is the challenge and we don’t have a great track record in even getting routine vaccines to the communities that need them most.”

*This story was produced by the Bhekisisa Centre for Health Journalism. Sign up for the newsletter.

^{Image credit: Getty Images}

Aisha Abdool Karim

The last time it was Friday 13th, it was an ominous one. It was Friday, 13 March. The Friday before that Sunday, 15 March, when our president declared a state of disaster. To be followed a week later with the announcement of Lockdown Level 5, starting on 26 March.

That 15 March speech still reverberates as our very own “Beware the Ides of March”. The Ides of March, 15 March, was made famous in Shakespeare’s Julius Ceasar, with the soothsayer warning the emperor to “Beware the Ides of March”.

Which did not help, as he was assassinated on 15 March. One of the assassins was one his allies, Brutus, which in turn led to the “et tu, Brute” phrase when a close ally is part of your undoing.

But let’s move from our own last gloomy Friday 13th and our Ides of March to a happier Friday 13th, namely Friday November 13: World Kindness Day.

And don’t we just need a bit of kindness. Or rather, for the sake of humanity, make that a super-duper dose of kindness, what with a pandemic that has deepened existing societal cracks into Rift Valleys, with accompanying human and economic tragedies.

Add to this already existing mental strain and unbearable insecurities, the mountains of corruption, state capture, as well as left and right extremism, and racism. No wonder it is just too much for already suffering human beings to bear.

And if that is not enough, throw in what is playing out on the world stage: An instable global political and social order, led by a destabilised, divided America due to a (now thankfully outvoted) president that demonised everything not partial to him. Which in turn led to a bizarre, brutal Trumpian dystopia in which everything and everyone could be offended with no sign of human kindness whatsoever, forget about presidential statesmanship.

And then, still add to that, two overarching global factors: the pandemic that has become politicised, plus the radicalisation of society in almost every respect.

It’s Stress on Steroids. Yes, in capital letters.

Schtum, and utterly fatigued, we stumble from one incredulous world event to the next. While silently sending out an SOS: please, please, we need some kindness. Some gentleness, some compassion, some sympathy, some kind-heartedness.

Please, can the kindness index move up a little? Please, can we all calm down and give our so frayed nerve endings some relief?

World Kindness Day could not come one day too soon. And seeing that 13 November is on a Friday, let’s supercharge it with positivity and forget about those doomsday superstitions around Friday 13th.

Let’s make sure this Friday 13th is our best Friday 13th in a long, long time.

So, switch on your kindness sensors and see how just one small gesture of kindness to a fellow human being will start an avalanche of kindness. Or show some kindness to a four-legged creature – Covid has also exposed our animal friends to the deepest depths of unkindness.

The World Kindness Movement was launched in 1998, after a number of “kindness NGOs” gathered in 1997 in Japan. Not affiliated to any religious or political movement, its mission is to “create a kinder world by inspiring individuals and nations towards greater kindness”.

Kindness therapy

This year’s theme is simply “Acts of Kindness”. And the smallest of gesture will help. The benefit? It will make you feel much better, because it is known that despite waves of grief and despair breaking in their ruthless violence over you, when you pick yourself up and do something good for someone else, it is actually you that benefits most. So apply some kindness therapy to yourself while you make the world a little bit better for someone else.

Because kindness is all about the positive power of that common thread that binds us, compassion. Make kindness your life philosophy – it bridges all those just too human polarisations that are caused by race, religion, politics, gender, class, education, and nationality.

In fact, the World Kindness Movement wants the United Nations to have World Kindness Day officially recognised. And doesn’t our world need such a “Declaration for World Kindness”.

It is argued that simple acts of kindness – small things, all do-able by you and me – can have a huge impact on the general feeling of despair engulfing our poor planet.

Of course, the kindness movement starts with you. And fortunately, there are so many things you can do. Imagine how kindness will vibrate around our globe this Friday if you do just one act of kindness towards someone else.

Fortunately, the ideas are as many as there are souls upon this earth – all 7,8 billion of us.

Here are just some: You can get some friends together to pick up litter (remember: 1,5 m apart). Or leave a note of kindness in a restroom – it might just be what the next person needs. Google “kindness quotes”, and you’ll find too many to choose from.

Make little cards from the ones you like: Maya Angelou’s “Try to be a rainbow in someone else’s cloud”, or the Dalai Lama’s “Be kind whenever possible. It is always possible.” Or: “We rise by lifting others”, or “Kindness begins with understanding we all struggle”.

Other ways of simply trying to be kind? An easy one is “paying forward” a cup of coffee at your coffee take-away so that the next customer gets a nice surprise.

Or, well, refrain from posting something hurtful. Too many of us do it just too many times. In that sense social media is the most unsocial media there ever have been, bringing out homo sapiens’s unkindest asocial behaviour.

Another kindness act: Bake a batch of cupcakes (yes, you can use that tried and tested Lockdown-banana bread recipe), and deliver them to your neighbours, or, if you’re lucky enough that you can go back to the office, to colleagues, or hand out to municipal workers if it is bin day, or take them to your friendly vet. And tell all of them: Today is World Kindness Day.

Most of all: Let’s make every day Kindness Day. Just as we should not only be aware of no violence against women and children during the campaign of 16 Days of Activism for No Violence Against Women and Children (starting on 25 November), but every single day, we should also, please, not reserve kindness to one World Kindness Day.

So, let’s generate kindness and see how it starts to generate itself, especially in a divided, divisive society. We need empathy, we need goodness, we need compassion. We are human beings: Our hearts beat to the rhythm of kindness. Start your own Kindness Movement today.

^{Lizette Rabe is professor at Stellenbosch University and founder of the non-profit Ithemba Foundation. Ithemba means hope and has two public benefit goals: to raise awareness of the importance of mental health, and to support research. Ithemba’s registration number is 2012/171250/08 and its SARS PBO Number 930/048/019.}

^{Image credit: Dee Copper and Wild, Unsplash}

• The average temperature for healthy persons used to be around 37°C
• Over the last two centuries, it seems there has been a drop in temperature
• Researchers are puzzled as to why this may be the case

In 1868, German physician Carl Wunderlich reported that a healthy body temperature reading was 37°C. Now, almost two centuries later, researchers have noticed that the average body temperature in healthy individuals is declining. 

According to a paper compiled by researchers from Stanford University, temperatures of adults in the United States has decreased 0.03°C per decade, which led the authors to believe that people in higher-income countries now have an average body temperature that is 1.6°C lower than in 1868. Researchers attributed this drop in body temperature to reductions in infectious diseases.

Lower temperatures in high-income countries

A more recent study conducted by a group of physicians, anthropologists and local researchers found similar results when studying the Tsimane Amerindians of the Bolivian Amazon.

The existing hypothesis – that people have lower temperatures in high-income countries – led to researchers further hypothesizing that people in lower-income areas would have higher temperatures. The researchers, led by Michael Gurven (professor of anthropology at University of California Santa Barbara), wanted to test the hypothesis in this population.

Why choose the Tsimane?

The Tsimane are indigenous people of lowland Bolivia who have a minimalistic lifestyle, without access to running water and sanitation.

Researchers found that the Tsimane were exposed to many disease-causing agents, “indicated by elevated immune activation biomarkers throughout life”.

The majority of deaths among the Tsimane was due to infection, and they also exhibit endemic polyparasitism (natural infestation by two or more parasites).

They also have a high resting metabolism, which means when they are not moving their bodies they still burn a high number of calories, leading to an increase in temperature. These reasons further led researchers to believe that they would have higher body temperatures.

Predictions contradicted

Body temperatures collected by the Tsimane Health and Life History Project (THLHP) since 2002 were used in the study. Researchers found that contrary to their predictions, there has also been a rapid decrease in average body temperature in the Tsimane population.

According to researchers, during the earliest study period from 2002 to 2006, unadjusted mean BTs for adult women and men were 37.02°C. However, between 2012 to 2018, body temperature dropped by 0.45°C for women and 0.49°C for men. 

This drop in temperature happened over two decades, whereas the drop in body temperature in the US population was observed over almost two centuries. Surprisingly, researchers could not find the reasons behind this drop in temperature. 

^{Image credit: Unsplash}

Compiled by Virginia Van Wyk

• People with type 2 diabetes are often told to avoid potatoes because they have a high glycemic index (GI)
• This is especially true at night when sugar levels are higher
• A recent study found that type 2 diabetes sufferers do, however, not need to avoid potatoes 

People with type 2 diabetes are often warned against the consumption of high GI foods, such as white potatoes, especially at night as they tend to make it more difficult to control blood sugar levels.

Glycaemic Index (GI) is a measurement used to determine how certain foods raise our blood sugar. This is called our glycaemic response.

Traditional guidelines for type 2 diabetes sufferers involve avoiding potatoes in order to avoid a sharp rise in blood sugar levels after eating. However, a recent study has shown that sufferers of type 2 diabetes need not avoid potatoes, as eating potatoes might in fact result in a desired glycaemic response.

Researchers investigated the impact of potato consumption as part of a mixed evening meal on nocturnal glycaemic response.

Favourable results

Researchers undertook a study involving 24 males and females with type 2 diabetes in four experimental trials after consuming breakfast, lunch and dinner.

Each meal consisted of 50% carbohydrates, 30% fat and 20% protein. Dinner included potatoes that were either boiled, roasted, boiled and cooled, or basmati rice. Blood samples were consistently taken before and after eating to monitor the participants’ glycaemic response and control. They also wore monitors overnight to observe their blood sugar levels while sleeping.

Potatoes do no harm

The study concluded that there was no significant difference in glycemic response after eating high GI boiled or roasted potato-based meals compared to low GI basmati rice. On the contrary, it was found that eating potato-based meals at night had more favourable results than the low GI basmati rice.

Corresponding author Dr Brooke Devlin stated, “Our study shows high GI foods, like potatoes, can be consumed as part of a healthy evening meal without negatively affecting [glycemic response] … while delivering key nutrients in relatively few calories, which is essential for people with [type 2 diabetes].”

^{Image credit: Unsplash}

Compiled by Virginia Van Wyk

The government announces a review following the findings of Public Health England’s report.

LATEST SCIENCE AND RESEARCH

READ | ‘Hidden’ gene discovered in Covid-19 virus could give more insight into its ability to spread

Researchers from the American Museum of Natural History have identified a new “hidden” gene in SARS-CoV-2, the virus that causes Covid-19, and say this may explain why it is so highly infectious.

The discovery of the “overlapping gene”, named ORF3d, could have a significant impact on how we combat the virus, the research team wrote. Overlapping genes (OLGs) are a type of ‘gene within a gene’, effectively concealed in a string of nucleotides, ScienceAlert explains.

“Overlapping genes may be one of an arsenal of ways in which coronaviruses have evolved to replicate efficiently, thwart host immunity, or get themselves transmitted,” said lead author Chase Nelson, a postdoctoral researcher at Academia Sinica in Taiwan and a visiting scientist at the American Museum of Natural History.

“Knowing that overlapping genes exist and how they function may reveal new avenues for coronavirus control, for example through antiviral drugs.”

Their findings were published in the journal eLife.

According to the team’s findings, the newly discovered gene is present in a previously discovered pangolin coronavirus. This, they say, possibly reveals repeated loss or gain of this gene during the evolution of the new coronavirus, as well as related viruses.

READ | OPINION: Unpacking the legal and ethical aspects of South Africa’s Covid-19 track and trace app

The most effective way to stop the spread of a virus is to prevent contact with everyone who is infected. Those who are infected can be isolated and treated if necessary. To determine who they are, it’s necessary to actively look for and manage cases.

During the Covid-19 pandemic, emerging technologies are being repurposed to help trace whoever has been in contact with an infected person.

Some of these technologies, such as the Global Positioning System (GPS), wi-fi and Bluetooth, are not new. GPS has been used to find accident victims at precise geographic locations. Some of the uses of wi-fi are oxygen monitoring devices, smart beds, access to electronic medical records and real-time access to X-rays and magnetic resonance imaging scans.

Now these tools can also help do one of the most important jobs in the pandemic: track and trace. They allow people some movement and economic activity, with the ability to manage their own risk of being exposed to possible infection or spreading any infection.

The South African government recently introduced a mobile application, COVID Alert SA, to help people notify their close contacts if they are infected.

The app is based on smartphone technology enabled by readily available functions developed by Apple or the Google Exposure Notification System. It uses a phone’s signal to generate a random code. The code is then exchanged with other users of the same app within a two metre radius. These codes are stored on the respective devices for two weeks.

CORONAVIRUS CASES LATEST

SA cases update: 

The latest number of confirmed cases is 744 732.

According to the latest update, 20 076 deaths have been recorded in the country.

There have been 690 903 recoveries.

So far, 5 063 457 tests have been conducted, with 25 675 new tests reported.

Global cases update:

For the latest global data, follow this interactive map from Johns Hopkins University & Medicine.

Early on Friday morning, positive cases worldwide were 53 001 867, while deaths were 1 289 474.

The United States had the most cases in the world – 10 488 531, as well as the most deaths – 242 248.

WHAT’S HAPPENING IN SA

Latest news:

READ | Covid-19: ‘Incomprehensible’ to extend state of disaster, says DA leader

Newly elected DA leader John Steenhuisen has come out guns blazing following President Cyril Ramaphosa’s extension of the national state of disaster by another month, to 15 December, in order to keep Covid-19 prevention measures in place.

Ramaphosa made a number of announcements on Wednesday evening.

South Africa will be allowing tourists from all countries across its borders under an upcoming amendment to the Level 1 Covid-19 lockdown regulations, ending the controversial red-list travel system.

Trading hours will also be normalised, “for instance for the sale of alcohol for retail outlets”.

But Steenhuisen said it was “incomprehensible” that the state of disaster has been extended by yet another month.

“Government cannot keep managing South Africa around a single risk when our nation is so imperilled by far greater risks, such as poverty, hunger and unemployment,” the DA leader said in a statement following Ramaphosa’s address.

WHAT’S HAPPENING IN THE REST OF THE WORLD 

Latest news:

READ | There’s a global black market for negative Covid test results, with fakes starting around R3,000

As the coronavirus pandemic continues around the world, some people are turning to an emerging black market for fake negative test results.

In France, at Paris’ Charles de Gaulle Airport in September, a group of seven people were arrested for selling falsified digital certificates intended to prove negative coronavirus results, the AP reported last week.

The group was discovered following an investigation sparked by a traveler leaving France for Ethiopia. The traveler reportedly had a fake digital certificate that claimed they tested negative for the virus.

The group in Paris was reportedly selling the fake test results for $180 (R2,800) to $360 (R5,600) apiece.

In another case, in late October, a group of travelers in Brazil was found with falsified negative test results in an attempt to enter the Fernando de Noronha island group, the AP reported.

Rather than buying fake test results, the group is accused of altering their own results.

READ | A Biden Covid-19 advisor called for a national lockdown in the US lasting up to 6 weeks

Dr. Michael Osterholm, an influential Covid-19 advisor to President-elect Joe Biden, on Wednesday called for a four- to six-week nationwide lockdown to help drive down infection numbers.

Osterholm, part of Biden’s 13-person Covid-19 advisory panel announced Monday, told Yahoo Finance on Wednesday that the US had a “big pool of money” to help pay for people’s lost wages and get the economy back on track during a lockdown while a vaccine was being rolled out.

Osterholm said a national lockdown would drive the number of new cases down, “like they did in New Zealand and Australia.”

“We could pay for a package right now to cover all of the wages, lost wages for individual workers, for losses to small companies, to medium-sized companies or city, state, county governments. We could do all of that,” he said. “If we did that, then we could lock down for four to six weeks.”

He added: “We could really watch ourselves cruising into the vaccine availability in the first and second quarter of next year while bringing back the economy long before that.”

Over the last seven days, the US has recorded an average of more than 112,000 daily cases. Cases reached an all-time peak of more than 132,000 on Friday.

HEALTH TIPS (as recommended by the NICD and WHO)

• Maintain physical distancing – stay at least one metre away from somebody who is coughing or sneezing

• Practise frequent hand-washing, especially after direct contact with ill people or their environment

• Avoid touching your eyes, nose and mouth, as your hands touch many surfaces and could potentially transfer the virus

• Practise respiratory hygiene – cover your mouth with your bent elbow or tissue when you cough or sneeze. Remember to dispose the tissue immediately after use.

^{Image credit: Getty Images}