Health24.com | More evidence masks slow Covid spread

  • After Massachusetts healthcare workers were required to wear masks, Covid-19 infections among them sharply decreased
  • At the same time, infections in the community continued to rise 
  • This serves as a clear indication that wearing masks helps to prevent infection

Here’s more proof that masking up reduces transmission of Covid-19: A new Massachusetts study found that wearing face coverings resulted in a decrease in coronavirus cases among healthcare workers as infections were increasing in the surrounding community.

“We found clear benefits to universal masking for preventing infectious spread within the work environment,” researcher Dr Stefanos Kales said. He’s division chief of occupational and environmental medicine at the Cambridge Health Alliance (a Harvard-affiliated community health system) and a professor at Harvard Medical School.

Universal masking implemented and maintained

For the study, the researchers compared the rate of Covid-19 cases between the Cambridge Health Alliance (CHA) and Massachusetts residents from 17 March to 6 May. The CHA started requiring masks on 26 March.

The universal masking was done during a time of rising infections in both the healthcare system and the community. After the policy was instituted, infections among healthcare workers sharply decreased, while community infections continued to rise until their peak on April 20. Before the mask mandate, infection rates increased almost identically in the healthcare system and the state’s population, the study found.

The report was published on 21 October in Occupational Medicine.

“Our findings suggest that universal masking policy should be implemented and maintained in healthcare settings as well as within indoor businesses when physical distancing and ventilation may be inadequate,” Kales added in a CHA news release.

Image credit: Getty Images

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Australian scientists discover 500-meter-tall coral reef in the Great Barrier Reef

Scientists have discovered a massive detached coral reef in the Great Barrier Reef — the first to be discovered in over 120 years, Schmidt Ocean Institute announced. Measuring more than 500 meters high — taller than the Empire State Building, the Sydney Tower and the Petronas Twin Towers — the reef was discovered by Australian scientists aboard Schmidt Ocean Institute’s research vessel Falkor, currently on a 12-month exploration of the ocean surrounding Australia.

The reef was first found on Oct. 20, as a team of scientists led by Dr. Robin Beaman from James Cook University was conducting underwater mapping of the northern Great Barrier Reef seafloor. The team then conducted a dive on Oct. 25 using Schmidt Ocean Institute’s underwater robot SuBastian to explore the new reef. The dive was live-streamed, with the high-resolution footage viewed for the first time and broadcast on Schmidt Ocean Institute’s website and YouTube channel. [Editor’s note: see link below.]

The base of the blade-like reef is 1.5km-wide, then rises 500m to its shallowest depth of only 40m below the sea surface. This newly discovered detached reef adds to the seven other tall detached reefs in the area, mapped since the late 1800s, including the reef at Raine Island — the world’s most important green sea turtle nesting area.

“This unexpected discovery affirms that we continue to find unknown structures and new species in our Ocean,” said Wendy Schmidt, co-founder of Schmidt Ocean Institute. “The state of our knowledge about what’s in the Ocean has long been so limited. Thanks to new technologies that work as our eyes, ears and hands in the deep ocean, we have the capacity to explore like never before. New oceanscapes are opening to us, revealing the ecosystems and diverse life forms that share the planet with us.”

“We are surprised and elated by what we have found,” said Dr. Beaman. “To not only 3D map the reef in detail, but also visually see this discovery with SuBastian is incredible. This has only been made possible by the commitment of Schmidt Ocean Institute to grant ship time to Australia’s scientists.”

The discovery of this new coral reef adds to a year of underwater discoveries by Schmidt Ocean Institute. In April, scientists discovered the longest recorded sea creature — a 45m siphonophore in Ningaloo Canyon, plus up to 30 new species. In August, scientists discovered five undescribed species of black coral and sponges and recorded Australia’s first observation of rare scorpionfish in the Coral Sea and Great Barrier Reef Marine Parks. And the year started with the discovery in February of deep sea coral gardens and graveyards in Bremer Canyon Marine Park.

“To find a new half-a-kilometer tall reef in the offshore Cape York area of the well-recognized Great Barrier Reef shows how mysterious the world is just beyond our coastline,” said Dr. Jyotika Virmani, executive director of Schmidt Ocean Institute. “This powerful combination of mapping data and underwater imagery will be used to understand this new reef and its role within the incredible Great Barrier Reef World Heritage Area.”

The Northern depths of the Great Barrier Reef voyage will continue until Nov. 17 as part of Schmidt Ocean Institute’s broader year-long Australia campaign. The maps created will be available through AusSeabed, a national Australian seabed mapping program, and will also contribute to the Nippon Foundation GEBCO Seabed 2030 Project.

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Materials provided by Schmidt Ocean Institute. Note: Content may be edited for style and length.

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The sweet spot of flagellar assembly

To build the machinery that enables bacteria to swim, over 50 proteins have to be assembled according to a logic and well-defined order to form the flagellum, the cellular equivalent of an offshore engine of a boat. To be functional, the flagellum is assembled piece by piece, ending with the helix called flagellar filament, composed of six different subunits called flagellins. Microbiologists from the University of Geneva (UNIGE) have demonstrated that adding sugar to the flagellins is crucial for the flagellum’s assembly and functionality. This glycosylation is carried out by a newly discovered enzyme FlmG, whose role was hitherto unknown. Based on this observation — which you can read all about in the journal eLife — the researchers followed up with a second discovery published in Developmental Cell. Among the six flagellins of Caulobacter crescentus, the model bacterium in the two studies, one is the special one serving a signalling role to trigger the final assembly of the flagellum.

The flagellum is the locomotive engine of bacteria. Thanks to the flagellum, bacteria can swim towards food whether in the lake Geneva (Léman) or inside the host during an infection. The flagellum — which, due to its complexity, is similar to an offshore engine — is made up of a basic structure, a rotary motor and a helical propeller. It is synthesized inside the bacteria in their cytosol. “The 50 proteins must be produced sequentially and assembled in the right order,” begins Patrick Viollier, a researcher in UNIGE’s Department of Microbiology and Molecular Medicine. At the same time the flagellum must be embedded within the bacterial envelope that contains up to three cell layers before ending up on the outside. While the flagellar subunits are known many of the subtleties in flagellar assembly control and targeting mechanisms are still poorly understood.

Sweet suprise

The UNIGE microbiologists studied the bacterium Caulobacter crescentus. “These bacteria are very interesting for studying flagella since they produce two different daughter cells: one has a flagellum and the other doesn’t. They’re ideal for understanding what is needed for building a flagellum ,” explains Nicolas Kint, co-author of the study. Another peculiarity is that the flagellar filament of this bacterium is an assembly consisting of six flagellin sub-units, meaning it isn’t the result of the polymerisation of a single protein, as is the case for many other bacteria. “When analysing these six flagellins, we discovered they were decorated with sugars, indicating that a glycosylation step — an enzymatic reaction adding sugars to proteins — was taking place and was needed for assembly. It was a surprising discovery, since this reaction is not very common and not well understood in bacteria,” continues Professor Viollier.

Viollier’s research team succeeded in demonstrating that the glycosylation of the six flagellins that make up the filament is essential for the formation and functionality of the flagellum. “To demonstrate this, we first identified the gene that produces the glycosylation enzyme, FlmG. When it’s absent, it results in bacteria without flagellum. Secondly, we genetically modified another type of bacterium, Escherichia coli, to express one of the six flagellins, the glycosylation enzyme and sugar producing enzymes from Caulobacter crescentus. All these elements are required to obtain a modified flagellin,” adds Nicolas Kint.

A versatile black sheep

“The different elements of the flagellum are produced one after the other: the molecules of the base first, then those of the rotor and finally the propeller. The scientific literature indicates that this sequential process is important. However, we don’t know how the order of manufacturing the sub-units is controlled .” The researcher and his team focused on the synthesis of the six flagellins, discovering a black sheep among them: a sub-unit that has only 50% sequence homology with the other five. “This sub-unit serves as become a checkpoint protein, a repressive molecular traffic cop restraining the synthesis of the other flagellin proteins,” says Professor Viollier. It is present before the synthesis of the other five sub-units, and it acts as a negative regulator. As long as it is present in the cytosol, the synthesis of the other sub-units is prevented. Once the elements of the flagellum are assembled, apart from the filament, the cop is exported to the membrane and thus removed. Then the synthesis of the last five sub-units can then begin. “It is a sensor for the protein synthesis and a component of the flagellar filament at the same time: a dual function that is unique of its kind,” says the microbiologist with great enthusiasm.

This discovery is fundamental for understanding the motility of bacteria and the assembly of proteins. “It also provides clues for understanding the synthesis and assembly of tubulin, an essential part of the cytoskeleton,” concludes Professor Viollier.

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Materials provided by Université de Genève. Note: Content may be edited for style and length.

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Post-wildfire hazards: Toward an understanding of when and how slope failure may occur

Across the western U.S., severe wildfires fueled by tinder-dry vegetation have already burned more than 3.2 million hectares (8 million acres — an area the size of Maryland —  as of th end of October, 2020, and nearly six times that area burned this year in Australia. And even though neither country’s worst-ever fire year is not yet over, concerns are already mounting regarding the next hazard these regions will face: dangerous and destructive debris flows.

Debris flows are fast-moving slurries of soil, rock, water, and vegetation that are especially perilous because they usually occur without any warning. Some debris flows are powerful enough to cart off everything in their paths, including trees, boulders , vehicles — and even homes.

Two years ago in Montecito, California, 23 people were killed and more than 400 homes damaged by a series of debris flows spawned by intense rain falling on hills scorched by what at the time had been the largest fire in California history.

To better understand the origin of these hazards, researchers at the U.S. Geological Survey (USGS) studied slope failure at two sites in Southern California’s San Gabriel Mountains. The first site burned in 2016 during the San Gabriel Complex fire, whereas a second, nearby site was charred during the 2014 Colby fire. The findings, presented Wednesday during the annual meeting of The Geological Society of America, indicate there were major differences in slope failure between the first and the third years following incineration. The results will help inform land managers and residents about when and where debris flows and other types of slope failure are more likely to occur.

“In the first year after each fire, we observed debris flows generated by rainfall runoff,” says Francis Rengers, a USGS research geologist who led the study. “But as we continued monitoring, we were surprised to see that a storm with a higher rainfall intensity than the first year’s storms, resulted in more than 280 shallow landslides, rather than debris flows, in the third year.”

In contrast to debris flows, which have fluid-like behavior, landslides glide as cohesive masses along a rupture plane. The researchers, including scientists from the University of Arizona, the Desert Research Institute, the USGS, and the German Research Centre (GFZ) believe this difference is due to changes in how much water can infiltrate into the ground during storms that follow wildfires. Because severe wildfires make soils more water-repellent, Rengers says, rainfall tends to run off burned ground. “If water is not soaking in,” he explains, “it’s flowing over the surface.” By removing ground cover, wildfires also reduce a hillslope’s roughness, which helps the slurry pick up speed. Incineration can also allow rainfall on bare soil to create what he calls a “surface seal” that further increases runoff.

Because landslides have much shorter runouts than debris flows, they pose different hazards. “The landslides we observed would primarily impact local infrastructure in the forest, such as roads, transmission lines, and culverts,” Rengers explains. By contrast, he says, debris flows move sediment much further downstream and therefore pose a hazard beyond the steep, mountainous hillslopes. “Runoff-generated debris flows threaten lives and property, including homes,” he says.

The results offer a ray of hope that the threat of slope failure has a limited duration: the researchers found that within five years, the density of landslides on burnt slopes in the San Gabriels was nearly equal to the density in unburned regions. This indicates the vegetation in this region recovers within half a decade.

Based on these observations, the researchers have developed a new conceptual model of post-wildfire slope failure that has three distinct stages. During the ‘no-recovery’ phase, increased runoff makes debris flows more prevalent. Within a couple of years, increasing water percolation, combined with the decay of roots from vegetation destroyed in the fire, make the slopes more susceptible to landsliding during the ‘initial recovery’ stage. After about five years, new roots become established enough to stabilize the hillside in the final ‘fully recovered’ phase.

In the future, the researchers plan to investigate whether this same model applies to other regions, such as the Rockies and the Pacific Northwest, which also experienced severe wildfires this year. For now, the results have immediate and practical applications for land managers who are dealing with the 2020 aftermath. “Our model suggests that debris flows will be the primary concern during the next one to two years, at least in the burn scars in Southern California, and after that the concern will shift toward shallow landslide hazards” says Rengers. “I hope our work offers land managers useful expectations regarding how these processes are likely to evolve and helps them prioritize post-wildfire mitigation and planning.”

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Coronavirus: Europe’s daily deaths rise by nearly 40% compared with last week – WHO

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Covid: Antibodies ‘fall rapidly after infection’

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Covid has thrived on racial discrimination, says Baroness Doreen Lawrence

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Don’t hold home firework displays, urge doctors

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Healthcare as a climate solution

Although the link may not be obvious, healthcare and climate change — two issues that pose major challenges around the world — are in fact more connected than society may realize. So say researchers, who are increasingly proving this to be true.

Case in point: A new study by UC Santa Barbara’s Andy MacDonald found that improving healthcare in rural Indonesia reduced incentives for illegal logging in a nearby national park, averting millions of dollars’ worth of atmospheric carbon emissions.

The analysis, published in the Proceedings of the National Academy of Sciences, finds that deforestation in the national park declined 70% in the 10 years after an affordable health clinic opened in the area. This equates to more than $65 million worth of avoided carbon emissions when translated to the European carbon market, the study reports.

“The results illustrate a strong link between human health and conservation in tropical forests in the developing world,” said MacDonald, an assistant researcher at the Earth Research Institute who coauthored the study with UC Santa Barbara’s David Lopez-Carr and colleagues at Stanford University, North Carolina State University Raleigh, Oregon Health and Science University, Natural Capital Advisors, and two NGOs involved in the intervention.

The Indonesian clinic accepts barter as payment and gives discounts to villages based on community-wide reductions in logging. Given its success, it could provide a blueprint for preserving the world’s biodiverse carbon sinks while reducing poverty and illness.

“This innovative model has clear global health implications,” said coauthor Michele Barry, senior associate dean of global health at Stanford and director of the Center for Innovation in Global Health. “Health and climate can and should be addressed in unison, and done in coordination with and respect for local communities.”

Every second, more than 100 trees disappear from tropical forests around the world. These forests, some of the world’s most important carbon reservoirs, are crucial to slowing climate change and mass extinction.

The current paradigm for conserving tropical forests — establishing protected areas — often excludes and disenfranchises local communities. This failure to address people’s needs can lead communities with few economic alternatives to illegally log and convert the land. Lack of access to high-quality, affordable healthcare can compound the problem by perpetuating cycles of poor health and expanding out-of-pocket costs.

With this in mind, the nonprofit organizations Alam Sehat Lestari and Health In Harmony in 2007 established a healthcare clinic adjacent to Gunung Palung National Park in West Kalimantan, Indonesia, with the support of the local government. The clinic was able to serve thousands of patients by accepting a range of alternative payments, such as tree seedlings, handicrafts and labor — an approach that was created in collaboration with the communities themselves.

Through agreements with most of the region’s district leaders, the clinic also provided discounts to villages that could show evidence of reductions in illegal logging. Between 1985 and 2001, this region had lost 60% of its forest to this activity. In addition to affordable health care, the intervention provided training in sustainable, organic agriculture and a chainsaw buyback program.

Researchers worked with the two non-profits to analyze more than 10 years of the clinic’s patient health records, coupled with satellite observations of forest cover over that time. “Private foundations funded the interventions, but it’s innovative new programs at Stanford and the University of California that are funding the research,” MacDonald said.

The medical care led to a significant decline in a range of diseases such as malaria, tuberculosis and diabetes. At the same time, satellite images of the national park showed a 70% reduction in deforestation, compared to forest loss at control sites, an amount equivalent to more than 6,770 acres of rainforest.

“We didn’t know what to expect when we started evaluating the program’s health and conservation impacts, but we were continually amazed that the data suggested such a strong link between improvements in healthcare access and tropical forest conservation,” said lead author Isabel Jones, who recently earned her doctorate in biology at Stanford. Looking more closely at community-level logging rates, the researchers found that the greatest drop-offs in logging occurred adjacent to villages with the highest rates of clinic usage.

A global blueprint

“This is a case study of how to design, implement and evaluate a planetary health intervention that addresses human health and the health of rainforests on which our health depends,” said coauthor Susanne Sokolow, a senior research scientist at Stanford.

Globally, about 35% of protected areas are traditionally owned, managed, used or occupied by Indigenous and local communities. Yet the perspective and guidance of Indigenous peoples and local communities are rarely considered in the design of conservation and climate mitigation programs. By contrast, the Indonesian clinic’s success grew out of the early and continued input of local communities who identified the mechanisms driving health and environmental problems as well as possible solutions.

Such holistic approaches can have greater long-term effects by preserving and restoring the ecosystem services that protect human health. These include natural filtering processes that reduce the risk of waterborne diseases and shade-providing forest canopies that reduce ground temperature and heat-related illnesses.

“The data support two important conclusions: human health is integral to the conservation of nature and vice versa, and we need to listen to the guidance of rainforest communities who know best how to live in balance with their forests,” said Monica Nirmala, the executive director of the clinic from 2014 to 2018 and current board member of Health In Harmony.

The clinic in West Kalimantan is still active, and the researchers are currently working on a follow-up project to see whether it and similar interventions in Indonesia have alleviated some of the shock from COVID-19 both on human health and deforestation.

“We would expect illegal logging activity to respond to changes in timber market prices or loss of income associated with COVID-19,” MacDonald said. “We want to know whether the interventions buffered communities against these effects, as well as whether they increased the communities’ resilience in terms of health and wellbeing.

“Health in Harmony is also expanding to Madagascar and Brazil,” he added, “and we want to be able to robustly evaluate the impacts of their interventions there.”

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