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What Are The Best Materials for Making DIY Masks?

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Best material fabric for making DIY masks to capture viruses

With masks sold out during the coronavirus outbreak, many people will have to make do with what some scientists have called “the last resort”: the DIY mask.

Data shows that DIY and homemade masks are effective at capturing viruses. But if forced to make our own mask, what material is best suited to make a mask? As the coronavirus spread around China, netizens reported making masks with tissue paper, kitchen towels, cotton clothing fabrics, and even oranges!

DIY homemade mask against coronavirus made from orange

The Best Material for Making a Homemade DIY Mask

Researchers at Cambridge University tested a wide range of household materials for homemade masks. To measure effectiveness, they shot Bacillus atrophaeus bacteria (0.93-1.25 microns) and Bacteriophage MS virus (0.023 microns in size) at different household materials.

Particle Sizes - Virus Labelled

They measured what percentage the materials could capture and compared them to the more common surgical mask.

Homemade Mask Virus Effectiveness

Not surprisingly, the surgical mask performed best, capturing 97% of the 1-micron bacteria. Yet every single material filtered out at least 50% of particles. The top performers were the vacuum cleaner bag (95%), the dish cloth (“tea towel” in the UK! 83%), the cotton blend shirt fabric (74%), and the 100% cotton shirt (69%).

Homemade Masks vs. Viruses

The test above used bacteria that were 1 micron large, yet the coronavirus is just 0.1 microns – ten times smaller. Can homemade masks capture smaller virus particles? To answer this question, the scientists tested 0.02 micron Bacteriophage MS2 particles (5 times smaller than the coronavirus).

Homemade Mask Materials Particle Capture Effectiveness

On average, the homemade masks captured 7% fewer virus particles than the larger bacteria particles. However, all of the homemade materials managed to capture 50% of virus particles or more (with the exception of the scarf at 49%).

Coronavirus & Mask Livestream

Wondering whether masks work to protect you against the coronavirus? Check out our livestream recap covering all the info here!

Are Two-Layered DIY Masks More Effective?

If the problem is filtration effectiveness, would the masks work better if we doubled up with two layers of fabric? The scientists tested virus-size particles against double-layered versions of the dish towel, pillow case, and 100% cotton shirt fabrics.

Overall, the double layers didn’t help much. The double-layer pillowcase captured 1% more particles, and the double-layer shirt captured just 2% more particles. Yet the extra dish cloth layer boosted performance by 14%. That boost made the tea towel as effective as the surgical mask.

Looking at the data, the dish towel and vacuum cleaner bag were the top-performing materials. However, the researchers didn’t choose these as the best materials for DIY masks:

Pillowcase and cotton t-shirt best for homemade DIY mask

Instead, they concluded the pillowcase and the 100% cotton t-shirt are the best materials for DIY masks. Why?

The Importance of DIY Mask Breathability

The answer lies in breathability. How easy it is to breathe through your mask is an important factor that will affect how comfortable it is. And comfort isn’t merely a luxury. Comfort will influence how long you can wear your mask.

Fortunately, in addition to particle effectiveness, the researchers tested the pressure drop across each type of fabric. This gives us a good indication of how easy it is to breathe through each material. As a benchmark, they compared breathability of each DIY mask material to the surgical mask.

DIY Mask Material Breathability Pressure Drop

Although the tea towel and the vacuum bag captured the most particles, they were also the hardest to breath through. With two layers, the tea towel was over twice as hard to breathe through as the surgical mask. In contrast, the pillow case, t-shirt, scarf, and linen were all easier to breathe through than the surgical mask.

 

Researchers’ Pick for Best-Performing Homemade Mask Material

Based on particle capture and breathability, the researchers concluded that cotton t-shirts and pillow cases are the best choices for DIY masks.

Best material for making homemade DIY masks out of cotton and pillowcase fabric

Are there any other materials we can use? The Cambridge researchers left out one common material: paper towel. We tested how well paper towel masks capture sub-micron particles.

Making DIY Masks with Household Materials

Bottom line: Test data shows that the best choices for DIY masks are cotton t-shirts, pillowcases, or other cotton materials.

These materials filter out approximately 50% of 0.2 micron particles, similar in size to the coronavirus. They are also as easy to breathe through as surgical masks, which makes them more comfortable enough to wear for several hours.

Doubling the layers of material for your DIY mask gives a very small increase in filtration effectiveness, but makes the mask much more difficult to breathe through.

 

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Patients with COVID-19 may shed virus after symptom resolution

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In a small study conducted in China, many patients with mild cases of COVID-19 infection continued to test positive for the virus up to 8 day after their symptoms had resolved, according to a research letter published in the American Journal of Respiratory and Critical Care Medicine.

“The most significant finding from our study is that half of the patients kept shedding the virus even after resolution of their symptoms,” Lokesh Sharma, PhD, instructor of medicine in the section of pulmonary, critical care and sleep medicine at Yale School of Medicine, said in a press release. “More severe infections may have even longer shedding times.”

“If you had mild respiratory symptoms from COVID-19 and were staying at home so as not to infect people, extend your quarantine for another 2 weeks after recovery to ensure that you don’t infect other people,” Lixin Xie, MD, professor at the College of Pulmonary and Critical Care Medicine at the Chinese PLA General Hospital in Beijing, said in the release.

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This Is How Many People Die From the Flu Each Year, According to the CDC

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Are more people dying from the flu this year compared to other seasons? Here's what to know.

By Claire Gillespie 
Updated March 26, 2020
 This Is How Many People Die From the Flu Each Year, According to the CDC
The official toll of the 2019-2020 influenza season won't be known for months—not that anyone is really fretting about that right now. Worries over the novel coronavirus, also known as COVID-19, have eclipsed many people's concerns about coming down with a case of the flu.

Not that you ought to take influenza lightly. Flu season in the US, which runs from October through May, claims tens of thousands of lives every year. This season CDC estimates that, as of mid-March, between 29,000 and 59,000 have died due to influenza illnesses. Add to that the misery of hundreds of thousands of flu-related hospitalizations and millions of medical visits for flu symptoms this season.

So while the flu has long been considered a dangerous seasonal scourge, new data on the COVID-19 epidemic underscore a frightening fact: COVID-19 is even deadlier.

RELATED: Why Do Some People Die From the Flu? 

“The current flu season has been difficult but it has not reached epidemic threshold,” infectious disease expert Amesh A. Adalja, MD, senior scholar at the John's Hopkins Center for Health Security in Baltimore, told Health in February. “In the next couple of weeks, when more data is available, it will become clear just how severe the season was given that we had an initial dominance of influenza B and now dominance of influenza A H1N1.” (When a second strain begins to dominate the flu season, this can cause the season to last longer, he explained.) 

When Health interviewed Dr. Adalja, there were only 13 confirmed cases of the new coronavirus in the US, according to the CDC. In a matter of weeks, COVID-19 has reached pandemic status, sickening staggering numbers of people around the globe and spreading to every state in the US.

As of March 26, more than a half million people around the world have contracted COVID-19, and nearly 24,000 have died, according to Johns Hopkins University's real-time tracker. In the US, nearly 80,000 cases have been confirmed, and more than 1,100 people have died.

So how do the flu and coronavirus compare? Just a few weeks ago, the flu appeared to be the more menacing concern. The death rate from influenza is generally just a fraction of 1%.

How things have changed.

During a March 11 hearing of the House Oversight and Reform Committee on coronavirus preparedness, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Disease, put it plainly: "The seasonal flu that we deal with every year has a mortality of 0.1%,” he told the congressional panel, whereas coronavirus is "10 times more lethal than the seasonal flu," per STAT news.

 

As if the current situation weren't dire enough, Dr. Fauci, a member of the White House Coronavirus Task Force, cautioned on March 25 that coronavirus could become a cyclical event, much like the flu. He said that the U.S. needs to be prepared for the inevitability of a second cycle beginning in the fall of 2020.

RELATED: Influenza B Is Dominating This Year's Flu Season. Here's What You Need to Know

This year's flu season is shaping up to be possibly less severe than the 2017-2018 season, when 61,000 deaths were linked to the virus. However, it could equal or surpass the 2018-2019 season's 34,200 flu-related deaths. 

Overall, the CDC estimates that 12,000 and 61,000 deaths annually since 2010 can be blamed on the flu. Globally, the World Health Organization (WHO) estimates that the flu kills 290,000 to 650,000 people per year. 

The annual death rate depends on the specific strain of the virus that is dominant, how well the vaccine is working to protect against that strain, and how many people got vaccinated, according to Dr. Adalja. The flu can be harder to fight off for specific populations, such as infants and young children, the elderly, and people who are immunocompromised due to chronic illnesses such as HIV or cancer.

RELATED: Surgical Masks Are Selling Out Because of Coronavirus Fears—but Do You Really Need One?

The CDC recommends that everyone 6 months and older get a flu vaccine every year. It's the first and most important step that people can take to guard against the flu and its complications, says CDC.

In recent weeks, however, the spotlight has shifted to the new coronavirus, which is sickening people of all ages, especially older adults and people with underlying health issues. Unlike the seasonal flu, there's no vaccine to prevent COVID-19, at least not yet. And that makes it all the more important for all of us to take precautions to guard against the risk of acquiring and transmitting the new virus.

The CDC recommends putting distance (at least 6 feet) between yourself and others, practicing frequent handwashing, and cleaning and disinfecting frequently touched surfaces—especially when someone is ill. 

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDCWHO, and their local public health department as resources.      To get our top stories delivered to your inbox, sign up for the Healthy  iving newsletter  

 
 
 

Welcome to the Virosphere

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SARS-CoV-2, the cause of the pandemic, belongs to one of 6,828 named species of virus. Hundreds of thousands more species are known, with perhaps trillions waiting to be found.  

Credit...Sean McSorley

 
 

In January, Chinese virologists isolated the virus that causes Covid-19. Earlier this month, a team of virologists gave this new virus a new name: SARS-CoV-2.

To do so, they had to move the virus to the head of a very, very long line.

In recent years, scientists have discovered that the world of virus diversity — what they sometimes call the virosphere — is unimaginably vast. They have uncovered hundreds of thousands of new species that have yet to be named. And they suspect that there are millions, perhaps even trillions, of species waiting to be found.

“Suffice to say that we have only sampled a minuscule fraction of the virosphere,” said Edward Holmes of the University of Sydney in Australia.

With the discovery of viruses in the late 1800s, scientists soon recognized that different species caused different diseases — rabies and influenza, for example. Later, virologists learned how to recognize new kinds of viruses by growing them in labs, where subtler biological features emerged.

 

After decades of this painstaking work, virologists have officially named 6,828 species of viruses; the figure includes 1,000 or so that will be formally accepted in the next few weeks by the International Committee on the Taxonomy of Viruses. That’s a paltry count when you consider that entomologists have named 380,000 species of beetles alone.

But in recent years, virologists have changed the way they hunt. Now they look for bits of genetic material in samples — water, mud, blood — and use sophisticated computer programs to recognize viral genes.

​Matthew Sullivan, a virologist at Ohio State University, has used this method to search for viruses that infect life in the ocean. He and his colleagues analyzed genetic material in seawater collected on a scientific voyage around the world. Some genes belonged to species already known to science. But many were new. In 2016, Dr. Sullivan and his colleagues reported over 15,000 viruses, each representing a new species.

 

That was more than twice as many species as all the previously identified viruses. And with that, Dr. Sullivan thought he and his colleagues had pretty much finished off the diversity of viruses in the sea. But they went on collecting more water, and invented new ways to search it for the genetic material of viruses. In 2019, they reported finding a total of 200,000 species.

“I’ve stopped saying, ‘We’re done,’” Dr. Sullivan said.

Other researchers are discovering thousands of new viruses as well. “Right now, we are in the exponential phase,” said Dr. Jens H. Kuhn, the lead virologist at the Integrated Research Facility at Fort Detrick in Maryland. “If someone gives me a million dollars and I go out and sample sea cucumbers, I will present you with 10,000 new viruses.”  

Formally describing a new virus remains a time-consuming task. When Chinese researchers isolated the Covid-19-causing virus earlier this year, they found that it had a distinctive crown of proteins. This hallmark told them that the virus belonged to the coronavirus family, which contains 39 known species. The World Health Organization used this finding to give the disease its name — Coronavirus Disease 2019, or Covid-19 for short.

To determine just what kind of coronavirus they were dealing with, virologists sequenced its genes. The virus was genetically similar to the one that caused the SARS outbreak in 2002. In March, the International Committee on Taxonomy of Viruses declared that the two viruses belonged to the same species. The virus that caused SARS is known as SARS-CoV. So they called the Covid-19-causing virus SARS-CoV-2.

Sign up to receive our daily Coronavirus Briefing, an informed guide with the latest developments and expert advice.
 
 
The viruses that infect humans are the best understood of all. But only about 250 species of viruses choose us as their host — “an insignificant fraction of the virosphere infect humans,” Dr. Holmes said.

While hundreds of thousands of new species still await their own names, virologists believe that far more await discovery. Dr. Holmes estimates that the viruses infecting animals, plants, fungi and protozoans (a group called eukaryotes) number 100 million species.

Bacteria and other single-celled microbes belong to a group called prokaryotes. In a paper published on March 4 in Microbiology and Molecular Biology Reviews, Dr. Kuhn and his colleagues argued that there are, at minimum, 100 million species of viruses that infect prokaryotes.

But some researchers suspect there are many more species of prokaryotes in the world — which would mean many more species of viruses. The true figure might be as high as 10 trillion.

For each of those species, scientists will have to figure out how it is related to other viruses. That is far harder to determine for viruses than for familiar life-forms like animals and plants.

Tool to Evaluate Penicillin-Allergy Risk and Severity

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TAKE-HOME MESSAGE

  • This diagnostic assessment subjected a penicillin allergy decision rule (PEN-FAST), derived from a prospective cohort of patients tested for penicillin allergy to internal and external validation among 622 patients and 945 patients, respectively. The tool was found to be practical and had a high negative predictive value of 96.3% of ruling-out patients with severe penicillin allergy.
  • The PEN-FAST tool uses a patient’s history of penicillin allergy to identify low-risk penicillin allergies that can be detected without formal allergy testing. Specifically, a PEN-FAST score of <3 can be used to detect patients who have a low risk of penicillin allergies, and rule-out those with a severe allergy. This tool may aid the risk stratification of patients with penicillin allergy and help formulate treatment plans.

Think You Have COVID-19? Here’s What to Do

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If you believe you’ve been exposed to the coronavirus, isolate yourself immediately. Then, take these steps.

BY MARY ELIZABETH DALLAS

Updated on March 27 at 11:00am EST.

As cases of COVID-19 rise across the United States and many other parts of the world, fears of infection are mounting. So much so that every cough, sneeze or sniffle may beg the question: Do I have the new coronavirus?

Complicating matters, this pandemic is occurring during cold, flu and now allergy season in the U.S.—a time when runny noses, fevers, sore throats and coughs are common.

If you, or someone in your home, has symptoms consistent with a respiratory infection, don’t panic. Even if you believe you were exposed to COVID-19, do not go to a local emergency room, urgent care center or your doctor’s office.

Do this instead:

Step 1. Take immediate steps to isolate yourself to avoid spreading your illness to others. This means keeping distance between yourself and the other people in your home.

If possible, confine yourself to a specific room and use a separate bathroom. Limit your contact with any pets in your home and, if you have one available, wear a facemask if you are around other people.

Be sure to also cover your mouth and nose with a tissue when you cough or sneeze and then throw the tissue away. Be vigilant about washing your hands, avoid touching commonly used surfaces and do not share cups, utensils, towels, bedding or other items with anyone else in your home.

These measures are important, even if you’re not feeling very sick or your symptoms are mild. Many otherwise healthy younger adults and children with COVID-19 only develop mild symptoms.

In fact, some people infected with COVID-19 may be able to pass the novel coronavirus on to others before they develop symptoms—so-called silent spreaders. This incubation period (the time that passes between when you’re exposed to the virus and when your symptoms appear) may range from 2 to 14 days, according to the Centers for Disease Control and Prevention (CDC).

A March 2020 study published in the Annals of Internal Medicine estimated that the median incubation period for COVID-19 is slightly more than 5 days, and the vast majority of people will develop symptoms within 12 days. In some cases, however, symptoms may appear even after 14 days.

This is why social distancing plays a critical role in curbing the spread of the infection.

Step 2. Call your healthcare provider (HCP) for instructions. Do not go to your doctor’s office without calling ahead first and letting the office staff know that you suspect you’ve been exposed to COVID-19.

You can also take advantage of telemedicine and check in with your doctor or HCP through a tablet, computer or smartphone if you have symptoms that may be associated with COVID-19. This type of remote care would not only help prevent the spread of the novel coronavirus to others but also help conserve essential medical supplies, such as masks and gowns, which are in short supply.

 

Your doctor can determine if you can be treated at home and also work with your local public health department and the CDC to determine if you should be tested for the coronavirus and where that should be done.

The CDC offers guidance for who should be tested but decisions about testing are up to your doctor as well as your state and local health officials. Depending on where you live, you may need an order from your doctor to get tested for COVID-19.

It’s important to understand however, that not everyone with suspected novel coronavirus infections will be able to be tested right now.

Testing is available in all 50 states as well as Washington D.C., Guam and Puerto Rico. At least 91 public health labs in the United States are offering COVID-19 testing and the number of labs around the country with the ability to test is increasing.

But demand is outpacing the ability of states and local communities to test. There simply aren’t enough tests, masks and other medical supplies to go around. As a result, the White House Coronavirus Task Force advises states to prioritize testing.

“Everyone across the country should understand that those hospitalized or in an ICU are our priority for testing,” said task force member Admiral Brett P. Giroir, MD, in a March 21 White House briefing. “Symptomatic health care workers, for obvious reasons—we want to make sure that their health is preserved and that they are not going to spread to those who may be seriously ill.”

Many people with mild cases are able to recover on their own at home with supportive care. Aside from healthcare workers, testing may be restricted to people with severe symptoms and those who are at higher risk for life-threatening complications, including older adults and those with chronic health issues, such as heart or lung disease, diabetes, cancer and other conditions that weaken the immune system.

If you develop serious warning signs of COVID-19, however, you need to seek immediate medical attention. These reg flags may include:

  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest
  • Feeling confused
  • Bluish lips or face

Call 911 and let the operator know that you have or think you may have COVID-19. If you have a medical mask, put it on before help arrives.

Step 3. If you are advised to be tested, you will receive specific instructions about how to get to the testing site. Be sure to follow these directions carefully to protect those around you, including the healthcare provider that performs your test.

The COVID-19 test is currently a Real-Time Reverse Transcriptase (RT)-PCR Diagnostic Panel. Results may be ready in a matter of hours, but in some cases, it could take several days. For the test, you will be asked to provide a mucus sample. Using a swab, a healthcare provider will take the sample from inside your nose. If you are coughing up mucus, that may be tested as well.

This test measures the presence of viral RNA in your body and can tell you if you currently have COVID-19.

Another type of blood test, known as an antibody test, would be needed to determine if you’ve ever had the novel coronavirus and since recovered. Since many cases are mild and may go undetected, this test would help give scientists a more accurate picture of how far and wide the disease has spread across the world. An antibody test for COVID-19 is not yet clinically available but researchers are already working to change that.

Medically reviewed in March 2020.

Sources:
Centers for Disease Control and Prevention. “Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19).”
SA Lauer, KH Grantz, Q Bi, et al. “The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application.” Annals of Internal Medicine. 2020.
Centers for Disease Control and Prevention. “What To Do if You Are Sick.”
Centers for Disease Control and Prevention. “Testing for COVID-19.”
Centers for Disease Control and Prevention. “Testing in U.S.”
U.S. Food and Drug Administration. “LabCorp COVID-19 RT-PCR test EUA Summary.”
Centers for Disease Control and Prevention. “CDC Tests for COVID-19.”

The Germ That Causes Bad Breath... and Alzheimer's Disease?

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It might seem like a bizarre connection, but a common mouth germ could be responsible for more than just bad breath. It may be one more puzzle piece in understanding why and how Alzheimer’s disease forms.

The bacteria that causes bad breath and gingivitis, the same mouth germ that can cause endocarditis if it travels to the heart, may now be implicated in Alzheimer’s disease. Studies have shown the buildup of beta-amyloid proteins and tau, long believed to be the destructive forces behind Alzheimer’s symptoms, may actually be a response to the bacteria’s presence. There's more, so let's take a look at this discovery and what's happening as a result.


The Bacterial Connection
 

Do you or someone you know suffer from gum disease? There may now be one more reason to get that infection under control. Researchers have discovered cultures of Porphyromonas gingivalis growing in the brains of Alzheimer’s patients. P. gingivalis is the mouth germ most commonly associated with gum disease.

The germ produces a toxin called gingipains, which has shown evidence of being neurotoxic. Studies on mice have shown chronic, low-level infection with P. gingivalis leads to accumulations of gingipains in the hippocampus, one of the areas of the brain responsible for memory. The infected mice also showed neurodegeneration symptoms that were consistent with Alzheimer’s disease.

We’ve long known that infections in the mouth can make their way to other areas in the body. For example, bacterial endocarditis often originates as an infection in the mouth. But it’s only been recently that we’ve begun to develop theories about how such an infection might affect the brain.


Infection, Beta-Amyloid and Tau
 

One of the most significant pieces to the Alzheimer’s disease puzzle has been findings on tangled proteins called beta-amyloid and tau. Researchers have long understood that there’s a connection between a buildup of these proteins in the brain and Alzheimer’s disease, but the common belief has been that they’re the root of the illness. Now, studies are showing that gum disease may be to blame.

It all points back to gingipains, the neurotoxin the gingivitis bacteria give off. Gingipains alters the shape and function of tau, making it more prone to tangling. It also appears to be the reason behind the high amounts of beta-amyloid associated with Alzheimer’s symptoms.

Beta-amyloid can be incredibly destructive wherever it accumulates, but it may also serve as a defensive barrier. When bacteria like P. gingivalis find their way to the brain, you’re likely to find deposits of beta-amyloid trying to contain and destroy it. Alzheimer’s symptoms occur when that response becomes excessive — and that’s where genetics come into play. Some people appear to be genetically predisposed to respond more aggressively to the bacteria’s presence, supporting previous observations that Alzheimer’s disease often runs in families.


Looking at Potential Treatment Options
 

With the understanding that P. gingivalis and its neurotoxin gingipains are the likely sources of beta-amyloid and tau accumulations, researchers are looking for new approaches to treating it. One pharmaceutical company, Cortexyme, Inc., is conducting the second phase of clinical trials on a medication that targets gingipain. The GAIN Alzheimer's trial is currently recruiting people between 55 and 80 years old who have mild to moderate Alzheimer’s disease to test the safety and efficacy of this new medication. So maybe we're not far off from a solution to a problem that has torn families apart for far too long.

Alzheimer’s disease has confounded researchers for decades, but new insights into its cause of could take treatment to a whole new level. Be on the lookout for updates on the GAIN Alzheimer’s trial. The cure could be right around the corner.

Copyright 2019, Wellness.com

Singapore's coronavirus playbook: How it fought back against the COVID-19 pandemic

Link   Panorama of Singapore skyline

Singapore was among the first countries in the world to get hit by the novel coronavirus. It confirmed its first COVID-19 case on Jan. 23.

Italy reported its 3,405th coronavirus death on Thursday, officially overtaking China as the nation with the most coronavirus fatalities. Not long ago, it looked as though that grim distinction could have gone to Singapore.

The city-state was just the third country to report cases of COVID-19, and by mid-February, two months after the disease originated in Wuhan, China, Singapore had reported 80 cases. It was the worst-hit country outside mainland China at the time. Since then, however, it's emerged as a model for how to curb the virus' spread, along with Hong Kong and Taiwan, earning praise from the World Health Organization for its defense strategy.

Fast-forward to the present day. Singapore has reported fewer than 390 cases and had zero deaths until Saturday when it confirmed its first two fatalities since the outbreak began there in late January. While new coronavirus cases have clearly increased there, it's far less compared to countries like Italy that saw a spike in cases to the thousands. New York City, which has a similar population size and density to Singapore, has nearly 4,000 cases, despite confirming its first case on March 1, more than a month after Singapore, which confirmed its first case on Jan. 23.

The contrast is staggering and comes at a time when the world is grappling with the rapid spread of the coronavirus. Across the world, cities have gone into lockdown, closing schools and nonessential businesses like movie theaters and urging residents to stay home. Italy has closed itself off, followed by several other European countries, while the US and Canada in recent days restricted nonessential travel across their borders. 

 

Singapore's relatively low rate of infection came through a potent combination of early and intensive policy intervention, including shutting its borders to Chinese travelers on Feb. 1 -- roughly a week after China announced it would lock down the city of Wuhan. The government also set up a virus-fighting task force, promptly imposed strict hospital and home quarantine measures, and banned large-scale gatherings. It did stop short of shutting down schools and fully closing its borders. 

"We want to stay one or two steps ahead of the virus," Vernon Lee, director of the communicable diseases division at Singapore's Ministry of Health, is reported to have said. "If you chase the virus, you will always be behind the curve."

Proactive, not reactive

Within 24 hours of a new infection, Singapore races to stitch together a holistic picture of an infected person's movements. It does this, in part, through an exhaustive process known as contact tracing, which involves mobilizing a team of more than a hundred dedicated contact tracers who work around the clock.

"Once a case is confirmed, within 2 hours  [contact tracers] create a detailed activity log of the patient's movements and interactions in the 14 days before admission," Singapore's Prime Minister Lee Hsien Loong said in a Facebook post

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