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20.02.2021 – The Conversation

Ebola strikes West Africa again: key questions and lessons from the past
Médecins Sans Frontières staff dressed in protective clothing (Image by CDC Global – Attribution 2.0 Generic (CC BY 2.0))

News of a new outbreak of Ebola in Guinea is indeed distressing. The last in West Africa occurred between 2014 and 2015 and affected Liberia, Sierra Leone and Guinea. It was the world’s deadliest Ebola outbreak, which began in Guinea and in which more than 11,300 people died. Among these were over 500 health workers.

But countries in the West African region are in a very different position seven years on.

Liberia and Sierra Leone have already mobilised and activated their national response and preparedness plans. A clear indication that the political will is there.

Countries in the region also have the experience of the past, as well as new tools to tackle Ebola. They have an experienced workforce, laboratory systems are more developed and regional organisations, such as the Mano River Union – a regional economic and security body – and the Economic Community of West African States (ECOWAS) are more proactive.

For example, one of the outcomes of a 2018 planning meeting in Freetown, Sierre Leone, was to prepare for cross-border transmission. A whatsapp platform was developed that provided for real time tracking of outbreaks. It is now operational and is being used to transmit updates from Guinea to the surveillance and response teams from member countries.

However, as Pierre Formenty, the head of the World Health Organisation’s viral and haemorrhagic fever team, once pointed out to me: the worst mistake anyone can make about Ebola is to underestimate Ebola, or to think they know all about Ebola.

I’m an infectious disease expert and have led national response teams in previous Ebola outbreaks. A fundamental lesson I’ve learned is that the success of a control strategy is not based on the obvious information you have, but the subtle unanswered questions. I learnt this the hard way.

One particular incident has stayed with me. In early August, 2014, I met with Liberia’s WHO Representative who asked me how West Point was doing. West Point is Liberia’s largest slum and is located in Monrovia, Liberia’s capital. I said, with great confidence, that it was very quiet and had no ongoing Ebola transmissions. However, at that very time, there were active Ebola transmissions in the area and secret burials were happening in the early morning hours. The cases in West Point exploded.

It’s crucial to keep digging, and keep questioning. I’ve compiled a series of questions which are key to preparedness strategies, and which all countries in the region should address.

Key questions

There are some key biological questions that those leading surveillance and contact tracing need to answer.

1) The first is: how long was the first case sick before they died?

Answering this question is crucial so that neighbouring countries can trace possible times a sick person – or contact from the current cluster – may have come into their country. Many of the cases spread through the region in this way during the 2014 to 2015 outbreak. Many people crossed over to escape an outbreak or seek help.

Ebola does not kill within a day. The virus has an incubation period of between two and 21 days. People get progressively sicker as the virus multiplies in their bodies. Some studies from the previous outbreak in Guinea indicted an average of eight days from the onset of symptoms to death.

Having a timeline is crucial to understand who they might have passed the virus on to.

2) The second important question is: What was the source of infection? How did they get infected?

This helps surveillance teams identify whether the person was the index – or first case – and can identify their contacts. If this isn’t known it means the source of the infection is out there, and there could be multiple cases around.

Once the first case is infected, we know it spreads from human to human through direct contacts, fluids, dead bodies and contaminated materials from an infected person.

3) The final and most serious question is: what strain of Ebola is being dealt with?

Vaccines are available for the Ebola Zaire strain, but not for others. Reports I’ve received indicate that the current outbreak in Guinea is due to the Zaire strain.

There are also critical epidemiological questions that needs to be answered quickly too:

1) How many contacts – meaning people they came into contact with – has the first recognised case generated so far?

It is crucial to find 100% of the contacts. Missing just one can lead to an outbreak. This will require tracking movements, interviewing families, friends and places they might have sought treatment. This is where the complex detective work of contact tracing kicks in.

In the case of this recent outbreak in Guinea, infected persons had attended the burial of a nurse. Knowing this is vital because it allows the team to begin to map the potential spread of the disease.

In this case, the fact that it’s a funeral and that she was a nurse, indicates that this is a super-spreader event.

Funerals are often attended by relatives who might have travelled long distances to get there, and possibly even from other countries. Action can be taken on this basis – neighbouring countries are put on alert. In 2016 border checks worked. We were able to catch cases that had escaped from Guinea to seek refuge with relatives in Liberia.

The fact that she was a nurse points to a bigger, undetected outbreak.

2) What is the alert case’s demography? This includes age, ethnicity, occupation and economic activities.

All these are pertinent in understanding who the person might have come in contact with.

For instance, in 2014, an infected case from Guinea, crossed over to Sierra Leone to seek care from a traditional healer among her ethnic group. This set the stage for the biggest outbreak in Sierra Leone which then spilled over into Liberia.

3) What were the person’s movements and how many places did the person visit when they became ill?

This includes hospitals, clinics and traditional healers. A transmission map must be built which examines all the possible movements and transmissions. If the index case moved using public transport, vehicle logs and movements for other passengers are needed.

In Liberia, we worked with transport unions, visited hospitals and pored over patient records. We worked with commercial motorbike riders to piece these complex transmission maps to determine the the total number of contacts, locations and status. The reason this is critical is that in the control of Ebola it is an “all or nothing principle”. You must reach 100% contacts and follow them up and ensure that none escape or get sick and die in the community. Otherwise, there’s a new transmission chain.

Until each of these very complex questions are answered, neighbouring countries should operate under the assumption that cases are in their countries. There is a already an alert of a suspected case in Liberia that came from Guinea.

Next steps

The governments of these countries must sustain the high levels of alertness and preparedness they have initiated. Everything must be done to ensure Ebola doesn’t enter densely populated areas.

Surveillance must be carried out – especially in border towns. Symptoms surveillance teams must look out for include fever, headache, joint pain and redness of eyes. Surveillance activities should also screen for ethnic groups to which sick people belong. It’s better to pick up all potential cases, rather than risk missing one.

There should also be visits to all hospitals and clinics in bordering towns. Patient records must be checked.

Any medication and vaccines that can treat the disease must be on the ready to be deployed rapidly.

And finally, Ebola starts and ends in the community. It’s crucial to activate, educate and empower communities to say something and report something when they see something.

 The original article can be found on our partner’s website here

20.02.2021 – Pressenza India

World Localization Day: Local Futures, Economics of Happiness

In 2020, people from 172 countries tuned into World Localization Day – an event that included contributions from Noam Chomsky, Russell Brand, Vandana Shiva and over 100 other voices. This is testimony to the fact that, wherever you look, positive things really are happening!

World Localization Day returns on June 20th, 2021, to galvanize the growing support for localization into a force to be reckoned with.

Announcing World Localization Day 2021

This year, Local Futures will be working with our networks on five continents to celebrate World Localization Day in their own regions. Events of various sizes across the world will lead up to an international online event on June 20th – a celebration of the worldwide localization movement and a discussion of strategies to take it to the next level.

Save the date, and spread the word to friends and family! And if you would like to be involved by hosting a WLD celebration (however big or small), please get in touch! We’d love to hear your ideas.

World Localization Day 2020 – full conversations available now

Every month in the lead-up to World Localization Day 2021, we will be sharing three in-depth conversations conducted for last year’s event. These conversations cover topics from the human brain to the rise of authoritarianism, from indigenous wisdom to local food as a lever for systemic transformation.

This month, we’re sharing the conversations between Helena Norberg-Hodge and Vandana Shiva, Johann Hari and Noam Chomsky. Watch the video recordings or listen to the audio versions, and learn why thought-leaders in diverse fields are coming together to support localization as the best path forward.

Vandana Shiva–– ‘the flourishing of life begins with localization’

Environmental activist and author Vandana Shiva contemplates what the globalized world will look like after the Covid-19 pandemic. She explains that the pandemic itself is a result of economic globalization, and that small-scale, diversified farming is hugely important if we are to heal ecosystems and the climate. Localization, she says, is where the flourishing of life begins. – ‘the flourishing of life begins with localization’.

Johann Hari — ‘mental health, community & connection’

Journalist and author Johann Hari analyzes the rise of depression and anxiety in a fragmented, corporatized world, with a focus on both underlying causes and long-term solutions. During this heartwarming and inspiring conversation, Johann shares anecdotes about the healing of individuals – as well as an entire neighborhood – through the rebuilding of connections.

Noam Chomsky  — ‘signs of hope in a confluence of crises’

Social critic and political activist Noam Chomsky speaks with guarded optimism about our chance to solve the multiple crises we face. He is encouraged by the rise of mutual support community initiatives – from the rust-belt in the USA to impoverished favelas in Brazil. – ‘signs of hope in a confluence of crises’

New Blogposts

Progress and the Modernization of Ladakh‘, by Kunzang Deachen, is an authentic interrogation of the path of “progress” that is being foisted on Ladakh. She asks “can we find a genuine progress that is about wellbeing, health, contentment and true prosperity, instead of competition and endless consumption?”

Debbie Weingarten’s  How to fix a food system that’s not designed to feed people is a treasure trove of facts and experiences that, in no unclear terms, points towards the need for food system transformation.

In  ‘Cities and Green Orthodoxy‘ Christopher Ketcham thoroughly debunks an idea that still plagues the environmental movement: that pulling people out of rural areas into exploding urban centers is a path to sustainability.

For more information and updates, visit  https://worldlocalizationday.org/ Those who are not subscribed to Local Futures’ mailing list may RSVP here to receive event updates.

20.02.2021 – Los Angeles, USA – Robert Hunziker

Ecocide!
Source: Wikimedia Commons. Photo by Sam Saunders from Bristol

Ecocide is the destruction of large areas of the natural environment as a consequence of human activity.

That destruction of “large areas” has grown so conspicuously large, so threatening to all species, including human existence, that a group of international legal experts is working to submit a draft of a new law “Ecocide” to the International Criminal Court (“ICC”) at The Hague.

Stop Ecocide is the group supporting this initiative. The Stop Ecocide website mission statement says: “Protecting the future of life on Earth means stopping the mass damage and destruction of ecosystems taking place globally. We call this serious harm to nature ‘ecocide’. And right now, in most of the world, it is legally permitted. It’s time to change the rules. We’re working to make it an international crime at the International Criminal Court.”

It’s no small undertaking. The European Parliament supports the effort, the Canadian government is closely following it, President Macron of France champions it, and Belgium has already raised the issue at the ICC in its official 2020 statement. Meanwhile, a drafting panel of powerful legal minds plans to complete its work for submission to the ICC in June 2021.

There’s something horribly disturbing about this effort to label Ecocide alongside (1) Genocide (2) Crimes Against Humanity (3) War Crimes and (4) Crimes of Aggression, all four within the auspices of the International Criminal Court. More on that later, but first the genesis of ICC goes back to the recognition of the necessity of such a court via UN Resolution #260 in December 1948, in response to the fascists of the prior decade. Thereafter, the UN adopted the Rome Statute, providing for the ICC on July 17, 1998. That statute at The Hague, Netherlands is enforced as of December 2015.

The ICC, after way too many years of consideration and procedural moves, is now officially recognized by approximately 123 states; however, that recognition is a moving target, as today’s brand of fascism doesn’t necessarily buy into it. Some signatories have withdrawn, like the Philippines (2019) and some countries have signed but not ratified the Rome Statute and four signatory states have informed the UN Secretary-General that they no longer want to play ball. These are Israel, Sudan, the U.S. and Russia. Prompting the query: What’s the common interest in degrading the effectiveness of the ICC? Answer: The distinct likelihood of being nailed as a defendant.

The Philippines under President Rodrigo Duterte withdrew as soon as the ICC opened preliminary investigations into its drug war. The Trump administration (fascism-lite), assuming it can be called an administration, which is likely a misnomer, went so far as to threaten prosecutions and financial sanctions on ICC judges and staff as well as imposing visa bans in response to any American charged, especially regarding crimes against humanity in Afghanistan. Of course, the U.S. did not ratify the Rome Statute in the first instance, and under Trump it went even further down the rabbit hole, openly challenging “the honesty, the integrity, the truthfulness” of the ICC in addition to various harsh (juvenile) threats to the international organization. The world community was not blind-sided by that rogue behavior, not in the least. They expected it. (Footnote: As of Jan. 26th the Biden administration is “thoroughly reviewing” U.S. sanctions imposed on ICC officials.)

Still, in all, the most disturbing aspect of the Ecocide movement is a simple fact that it is necessary. The initiative speaks volumes about the broken-down status of various ecosystems, which are starting to crumble, as some are starting to disintegrate right before humanity’s eyes, especially in the far north. In fact, the brutal truth is the Ecocide movement may be too late. After all, the planet’s already wobbly.

The earmarks of a lost planet in its final throes of life support are abundant, for example, complex life forms such as wild mammals, birds, reptiles, and amphibians nowadays only constitute 5% of the planet’s total biomass with the remaining 95% livestock and humans. As such, cows, chickens, pigs, and humans huddle together in a vast free-for-all, chasing nature’s leftovers.

Two-thirds (67%) of all wild vertebrate species are gone in only 50 years. Poof!  That’s only points off the Permian-Triassic extinction event of 252MYA when 70% of terrestrial vertebrate species (and 95% of marine species) went extinct in the planet’s worst-ever extinction, aka: The Great Dying. Clearly, today’s Anthropocene Era is already “in the thick of it.” What of the next 50 years?

And, global wetlands have been hammered, badly destroyed, plowed under to only 13% of 300 years ago, as some insect populations have been decimated by up to 80%, just ask Krefeld Entomological Society (est. 1905) Germany about insect abundance plummeting in 63 nature preserves, where the environment is protected.

Along the way, human population grows like a weed whilst spraying or implanting toxic insecticides onto everything in sight. In fact, not much remains that hasn’t been directly or indirectly lathered in toxins, including humans and domestic animals based upon, mostly untested, chemicals; in fact, 80,000 in the U.S. alone. Meantime, one-half of the U.S. population suffers from a chronic disease (Rand study, 2017): (1) arthritis (2) asthma (3) cancer (4) ALS (5) cystic fibrosis (6) Alzheimer’s (7) other dementias (8) osteoporosis (9) heart disease and (10) diabetes, any one of which could have been environmentally induced.

Toxins tyrannize the planet, found everywhere, from the top of Mount Everest, 29,032 feet, where climbers discovered arsenic and cadmium in the snow exceeding EPA guidelines, to the bottom of the Mariana Trench -36,069 feet below, where undersea explorers discovered crustaceans with toxin levels 50 times greater than crustaceans that live within China’s most heavily polluted rivers, and that takes some doing!

All of which brings to mind a proper description for a planet that’s deadening, on its last leg, with natural resources of kelp forests  (-40%) coral reefs (-50%) and all plant life (-40%) widely decimated, including 103,000 wildfires in the Brazilian rainforest alone in only one year (2020) almost entirely (90%) of human origin?

This is deadly serious stuff that gets posted in articles like this, read by a designated number of people (thx), but regrettably, not much gets done about it, as the horrors continue to worsen by the year. We’re gonna run out of years!

For significantly deeper concern, look to wetlands, disappearing three times faster than forests, which are at the heart of the biosphere, the wetlands are colloquially known as the “kidneys of the world”: (a) cleanse water, (b) mitigate flooding (Midwest and Houston), (c) recharge aquifers (Middle East dilemma) and (d) support habitat for biodiversity, only 13% remains after a 300-year span. Ergo: “We are in a crisis!” (Martha Rojas Urrego, head of Ramsar Convention on Wetlands)

How does the planet continue supporting life with only 13% of original wetlands whilst world human population grows by 200,000 newborns per day? Nobody has an answer for that all-important aspect of survival. Do the math! Then, must it be reduced to Darwin’s survival of the fittest? Maybe, but the big truth/lie is: Nobody knows what to do other than pretend that growth to infinity, the hallmark of capitalism, is just fine and dandy. Is it? Really, is it?

Doughnut Economics may be a good, solid sustainable alternative? (For planet-friendly relief, Google: “Doughnut Economics Boots Capitalism Out!”)

All of which helps explain why some really smart people are drafting a new law for the ICC to stop ecocide. Honestly though, it’s already so obvious that it prompts an important question, which is: How could concerned parties not be incited to draft a law to prevent what’s already happened? Hmm! Nevertheless, will it be soon enough to make a difference? For certain, it’ll require a helluva lot more than drafting a new law!

Postscript: There is a real danger of losing our tenure on the planet altogether… Earth is in dire trouble. (James Lovelock, The Vanishing Face of Gaia: A Final Warning, Publ. Allen Lane/Basic Books, 2009)

Additionally:  You cannot plant an ecosystem. An ecosystem includes: Bacteria or haematids, insects, invertebrates and all kinds of stuff, all the way up to big trees. You cannot plant ecosystems… it has to come naturally. (Lovelock, at 101-years, walks 3-5 miles daily and has planted over 2,000 trees, motto: “Keep walking – that’s the secret to longevity. And keep interested.”)

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Dietrich Bonhoeffer

We must act and dare the appropiateness and not whatever comes to our mind not floating in the likelihood but grasp the reality as brave as we can be freedom lies in action not in the absence of mind obedience knows the essence of good and satisfies it, freedom dares to act and returns God the ultimate judgment of what is right and what is wrong, Obedience performs blindly but Freedom is wide awake Freedom wants to know why, Obedience has its hands tied, Freedom is inventive obedient man respects God’s commands and by virtu of his Freedom, he creats new commands. Both Obedience and Freedom come true in responsability (Dietrich Bonhoeffer)

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