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Letters to the Editor Issue 267

by Letters(more info)

listed in letters to the editor, originally published in issue 267 - January 2021

Study to Examine whether Vitamin D can Offer Protection from Covid-19

 

Republished from leedsbeckettuni-newsroom.prgloo.com

https://leedsbeckettuni-newsroom.prgloo.com/news/study-to-examine-whether-vitamin-d-can-offer-protection-from-covid-19  

 

Researchers at Leeds Beckett University (LBU) in collaboration with the Defence Medical Services are looking to examine whether vitamin D can offer protection from Covid-19 as part of a study amid mounting evidence the supplement could be beneficial.

The project is investigating the time period during which antibodies develop for SARS-CoV-2, the causative virus of Covid-19, in young people compared against military recruits taking the nutritional supplement.

A research team at LBU is looking for 450 males and females aged 18 to 33 from Leeds and the surrounding areas who are not already taking vitamin D.

The research aims to understand whether military recruits who are taking prevention measures, including vitamin D, show different rates of infection from the SARS-CoV-2 virus compared with an age matched population.

It could help demonstrate whether coronavirus infection can be suppressed below the expected level in young adults with simple and cost-effective strategies.

The 16-week study, being carried out by LBU and the Defence Medical Services, will involve blood tests to look at calcium and vitamin D levels, as well as finger-prick blood tests every four-five weeks to look at the development of antibodies to SARS-CoV-2, the cause of Covid-19 infection.

Participants will also need to fill out questionnaires regularly to record any symptoms they experience related to Covid-19.

John O’Hara, Professor in the Carnegie School of Sport at LBU, Colonel David Woods of the Defence Medical Services and Professor Julie Greeves of Army Health and Performance Research, are leading the study.

They said: “This should be a simple, yet highly informative study and if the results show a benefit from higher vitamin D levels due to supplementation it could make a big difference to people.”

The research is happening during the first and second terms of the academic year and will require two visits to the Carnegie School of Sport at the Headingley Campus, each visit lasting less than 30 minutes.

Volunteers will receive a £25 Amazon voucher on completion of the study which is investigating ways of reducing the impact of coronavirus.

Further Information and to Sign Up

To sign up or find out more, visit www.leedsbeckett.ac.uk/impactcovid or contact the team at impact-covid19@leedsbeckett.ac.uk.

Acknowledgment Citation

Republished from leedsbeckettuni-newsroom.prgloo.com

https://leedsbeckettuni-newsroom.prgloo.com/news/study-to-examine-whether-vitamin-d-can-offer-protection-from-covid-19  

 

 

Actionagainst5G – Be A Light to the World – Next Global Protest Day March 20, 2021 –  Equinox; Candlelight Vigil December 20, 2020 – Solstice (almost)

Actionagainst5G are taking legal action to challenge the government’s failure to take notice of the health risks and public concern about 5G. It is about a law coming into place in December, without public notification, making it impossible for people to object to masts near their homes, schools etc. so it needs to be transposed correctly. The point is to make public health an imperative and have a competent authority to reconcile the health and environmental impacts of radiofrequency radiation.

Join in as we collectively call for a stop to 5G, and a move toward safer, more respectful and life-affirming technology. Stop5G’s next global protest event is simple to participate in, appropriate for the coming season and rather lovely – Be A Light To The World.

Throughout millennia, the sky has been our clock and calendar, and the rhythms reflected in nature have served as the foundation for all human endeavour.  From the 24-hour darkness-light cycle, to lunar months and the flow of seasons, ancient cultures spanning the globe were synchronized by Natural Law. Technological innovations offer many benefits, but when used without balance and wisdom our human-generated techno- “eco system” interferes with and seeks to supplant Nature’s true eco-system. Accumulated knowledge and time-honoured wisdom of great civilizations − once codified into patterns for planting and harvesting as well as for sustaining health − have been obliterated by our drive for yet “faster” and “more” connectivity.

In its current form, the 5G/data-harvesting/AI wireless paradigm is intensifying an attitude of destructive entitlement that now extends beyond the confines of the planet itself into the skies. Similar to industries such as tobacco and asbestos that ignored early warnings and denied evidence of harm, tech companies are controlling “the commons,” the science, the economics, the narrative, and our future.

In the name of “progress”, Precision Agriculture may destroy our food supply due to blindness to the synchronizing role of the sun’s rays and the intelligence of the plant world. “Telehealth” risks compromising true health as the benefits of connectivity are conflated with a massive increase in artificial radio frequency exposure. E-waste decimates ecosystems in impoverished nations as affluent nations design ever more technological “fixes” in the name of sustainability. Inequities are perpetrated as harsh working conditions from e-waste processing, conflict minerals, and manufacturing continue unabated.

And Nature Must Shoulder it All

The solstices and equinoxes are times of balance and transition between darkness and light. The winter solstice − this year December 21 − marks the shortest day of the year in the Northern Hemisphere, and the longest in the Southern Hemisphere. The Equinox − March 20, 2021 −  is where days and nights are of equal duration everywhere on earth.  Both Protest Events have been planned around the natural rhythms of the heavens and earth. Perhaps the inherent wisdom of nature’s “desire” to heal, grow and transform will inform our way forward. 

Please consider holding a Candlelight Vigil on December 20, 2020, and a jubilant and festive Protest Day Event on March 20, 2021 as we collectively call for a stop to 5G, and a move toward safer, more respectful and life-affirming technology. Even if only participating by lighting a few candles, send a photo to Stop5GInternational (see below) or their Facebook page:

https://stop5ginternational.org/candle-lantern-vigils-for-safer-technology-december-20-2020/

Spread the Love

Stop 5G International does not endorse any forms of vandalism or destruction in its advocacy for safer technology and environmental stewardship.

Source and Media Contact

Amanda Kenton <amanda@amandakenton.com>

 

 

Mass Testing for Covid-19 in the UK

bmj.com

https://www.bmj.com/content/371/bmj.m4436?s=09

by Mike Gill, former regional director public health, England1,  mgilm1@gmail.com and Muir Gray, visiting professor2 Nuffield Department  Primary Care Health Sciences, University of Oxford, Oxford, UK.

An Unevaluated, Under Designed, and Costly Mess

Quick turnaround testing for covid-19 is to be made available to everybody, initially to those without symptoms, across England at a cost of £100bn (€110bn; $130bn).1 This follows a still uncompleted “pilot” in Liverpool, which started on 6 November at the invitation of Liverpool City Council in October, after incidence had peaked. The objective is “to demonstrate that massive asymptomatic testing can help identify far more cases and break the chain of transmission of coronavirus.”2

Participation in this pilot is voluntary. There is no call or recall. All participants receive two tests, the standard PCR test and the rapid turnaround (within 1 hour) lateral flow Innova test. Those with a positive result in either test are asked to self-isolate and are registered with the national track and trace programme, which initiates contact tracing. Key workers, health and social care staff, school staff, and children aged 11 and over are being targeted, but anyone can get tested, preferably at least twice within two weeks.

This is a screening programme, not opportunistic case finding: people are invited to have a test they would not otherwise have had, or asked for. If judged against the criteria drawn up by the UK’s National Screening Committee for appraisal of a programme’s viability, effectiveness, and appropriateness,3 it does not do well and has been already roundly criticised.4

Many asymptomatic people testing positive for covid-19 are probably relatively uninfectious.5 Evidence suggests at least a half may develop symptoms6 requiring self-isolation without the need for a test. Since few currently adhere to self-isolation,7 this is an obvious area for improvement before we embark on an expensive screening programme. Without a systematic approach to call and recall, those most at risk of being infected and transmitting may be least likely to present for screening.8

Potential Harms

Despite claims by the city council that the Innova test is “very accurate with high sensitivity and specificity,”2 it has not been evaluated in these conditions. The test’s instructions for use state that it should not be used on asymptomatic people. A preliminary evaluation from Porton Down and Oxford University9 throws little light on its performance in asymptomatic people or in the field. It suggests the test misses between one in two and one in four cases. The false positive rate of 0.6% means that at the current prevalence in Liverpool, for every person found truly positive, at least one other may be wrongly required to self-isolate. As prevalence drops, this will become much worse.

The self-isolation and tracing of contacts triggered by a positive result can of course be seen as benefiting the individual and others, such as household members. But we know self-isolation has a regressive effect: income level influences adherence to self-isolation10 and the likelihood of household transmission.11 This underlines the importance of reducing the rate of false positive results and providing appropriate support – financial, psychological, and material – to people who must isolate.

Evidence that this pilot will reduce transmission is not yet established. This makes it even more critical that it is carefully planned; the different components, including testing centres, contact tracing, laboratories, and primary care contributions, are quality assured; its total resource requirements identified and costed; and the pilot evaluated for cost effectiveness.

Shaky Ground

With incidence across Liverpool already falling, attributing and quantifying any additional effect from the programme may prove complex. Instead, similar programmes are being rolled out across the country to universities and local authorities even before this pilot is complete.

The queues of people seeking tests in Liverpool suggest the initial acceptability of this pilot is high, at least to some. Its ethical basis, however, looks shaky. The council claims, wrongly, that the test detects infectiousness and is accurate. In fact, if used alone it will lead to many incorrect results with potentially substantial consequences. The context for gaining consent has been tarnished by the enthusiasm of some local officials and politicians. In the case of schools, the programme has been culpably rushed: parents have had to respond unreasonably promptly to a request to opt out if they do not want their child screened.12

There is no protocol for this pilot in the public domain, let alone systems specification or ethical approval. The public has had no chance to contribute, as required by the UK standards for public involvement in research.13

Spending the equivalent of 77% of the NHS annual revenue budget on an unevaluated under designed national programme leading to a regressive, insufficiently supported intervention – in many cases for the wrong people – cannot be defended. The experience of the National Screening Committee and National Institute for Health Research (NIHR) tells us that allowing testing programmes to drift into use without the right system in place leads to a mess, and the more resources invested the bigger the mess. This system should be designed with up to 10 clear objectives to deliver the aim of reducing the impact of covid – for example, to identify cases more quickly or to mitigate the effects of deprivation on risk of infection and poor outcomes. Progress in each objective (or lack of it) should be measured against explicit criteria. Screening programmes based on experience and on the literature relating to complex adaptive systems14 offer a model for rapid progress.

At a minimum, there should be an immediate pause, until the fundamental building blocks of this mass testing programme have been externally and independently scrutinised by the National Screening Committee and NIHR. In the meantime, nobody’s freedom or behaviour should be made contingent on having had a novel rapid test. It is premature to offer testing as the route to individuals’ release from restrictions. Instead we must heed the advice of the World Health Organization and the government’s Scientific Advisory Group for Emergencies (SAGE), radically improve the woeful performance of the “find, test, trace, and isolate” system, and renew the focus on identifying symptomatic people, especially among those sections of society most at risk. The current approach will open Pandora’s box.

Footnotes

  • Competing interests: We have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.
  • Provenance and peer review: Commissioned; not externally peer reviewed.

References

  1. Iacobucci G, Coombes R . Covid-19: government plans to spend £100bn on expanding testing to 10 million a day. BMJ2020;370:m3520. doi:10.1136/bmj.m3520 pmid:32907851
  2. Liverpool City Council. Mass testing FAQs (accessed 11 Nov 2020). https://liverpool.gov.uk/communities-and-safety/emergency-planning/coronavirus/how-to-get-tested/mass-testing-faqs/ accessed 11/11/20.
  3. Public Health England. Criteria for appraising the viability, effectiveness and appropriateness of a screening programme. 2015. https://www.gov.uk/government/publications/evidence-review-criteria-national-screening-programmes/criteria-for-appraising-the-viability-effectiveness-and-appropriateness-of-a-screening-programme.
  4. Raffle A. Screening the healthy population for covid-19 is of unknown value, but is being introduced nationwide. BMJ Opinion, 9 Nov 2020. https://blogs.bmj.com/bmj/2020/11/09/screening-the-healthy-population-for-covid-19-is-of-unknown-value-but-is-being-introduced-nationwide/
  5. WHO. Transmission of COVID-19 by asymptomatic cases. http://www.emro.who.int/health-topics/corona-virus/transmission-of-covid-19-by-asymptomatic-cases.html#:~:text=Available%20evidence%20from%20contact%20tracing,transmission%20of%20the%20virus
  6. He J, Guo Y, Mao R, Zhang J. . Proportion of asymptomatic coronavirus disease 2019: a systematic review and meta-analysis. J Med Virol2020. doi:10.1002/jmv.26326 pmid:32691881
  7. Smith L, Potts HWW, Amlot R, et al. Adherence to the test, trace and isolate system: results from a time series of 21 nationally representative surveys in the UK (the COVID-19 Rapid Survey of Adherence to Interventions and Responses [CORSAIR] study).medRxiv2020. [Preprint.] https://www.medrxiv.org/content/10.1101/2020.09.15.20191957v1.full.pdf
  8. Hart JT . The inverse care law. Lancet1971;1:405-12. doi:10.1016/S0140-6736(71)92410-X pmid:4100731
  9. Preliminary report from the Joint PHE Porton Down & University of Oxford SARS-CoV-2 test development and validation cell: rapid evaluation of lateral flow viral antigen detection devices (LFDs) for mass community testing. 8 Nov 2020. https://www.ox.ac.uk/sites/files/oxford/media_wysiwyg/UK%20evaluation_PHE%20Porton%20Down%20%20University%20of%20Oxford_final.pdf
  10. Waugh P. NHS test and trace chief admits workers fear “financial” hit if they self-isolate. Huffington Post 2020 Nov 7. https://www.huffingtonpost.co.uk/entry/dido-harding-self-isolation-financial-worry_uk_5f036a9cc5b612083c5ffc8d?ncid=other_huffpostre_pqylmel2bk8&utm_campaign=related_articles&guce_referrer=aHR0cHM6Ly9ibG9ncy5sc2UuYWMudWsv&guce_referrer_sig=AQAAAGjUJEj7iTmbyTL7F55sleFEZJUGcD4Zs9osMFstHe_Hu7M-&_guc_consent_skip=1605190198.
  11. Haroon S, Chandan JS, Middleton J, Cheng KK. Covid-19: breaking the chain of household transmission. BMJ2020;370:m3181. doi:10.1136/bmj.m3181 pmid:32816710
  12. Jones RAK. Is the Liverpool Sars-Cov-2 screening project a true pilot study or the start of mass screening? [Electronic response to Iacobucci G. BMJ 2020;371:m4268.] BMJ 2020. https://www.bmj.com/content/371/bmj.m4268/rapid-responses
  13. UK Standards for Public Involvement. Setting the scene. https://sites.google.com/nihr.ac.uk/pi-standards/standards/setting-the-scene#h.p_1bDA7s6A2WhH
  14. Gray . Population healthcare: designing population-based systems. J R Soc Med2017;110:183-7doi:10.1177/0141076817703028.

Publication Reference:

Gill M. and Gray M. Mass testing for covid-19 in the UK. BMJ;371:m4436. 16 Nov 2020. doi: https://doi.org/10.1136/bmj.m4436

 

 

Pioneering Research Potentially Reveals Early Detection of Prostate Cancer

Pioneering research conducted by the University of Virginia in collaboration with Manchester UK based APIS Assay Technologies has discovered Hormone-Upregulated lncRNA within the lymphocyte-specific protein tyrosine kinase (HULLK) is detectable in non-invasive prostate cancer patient samples. The breakthrough data provides a potential new approach to address the unmet medical need of early diagnostics for prostate cancer, in combination with avoiding the invasive cancer tissue sample collection from a biopsy.

Study potentially reveals early detection of prostate cancer and alternative to invasive biopsies

Pioneering research conducted by University of Virginia in collaboration with Manchester UK based APIS Assay Technologies Ltd has discovered Hormone-Upregulated lncRNA within the lymphocyte-specific protein tyrosine kinase (HULLK) is detectable in non-invasive prostate cancer patient samples.

The breakthrough data provides a potential new approach to address the unmet medical need of early diagnostics for prostate cancer, in combination with avoiding the invasive cancer tissue sample collection from biopsy.

Dr Daniel Gioeli, Associate Professor, Microbiology, Immunology, and Cancer Biology at the University of Virginia, has shown that HULLK could be isolated from urine of prostate cancer patients and therefore provides a major advantage compared to current invasive sample collection.

The data on the detection of HULLK in urine samples from patients with high grade prostate cancer (PCa) will be presented by Dr  Gioeli during the 2020 Annual Meeting of the Society for Basic Urologic Research, Inc. (SBUR), Saturday November 14th.

APIS Assay Technologies and the University of Virginia entered into a Research Agreement in December 2019, after optioning the HULLK technology, which is described in a previous publication from Dr Gioeli´s Group (Ta et al, Molecular Cancer, 18:113, 2019) demonstrating the potential role of this biomarker in FFPE samples from PCa patients.

HULLK an unannotated lncRNA is within exon six and the 3’UTR of the LCK gene, is dramatically upregulated by androgen in a dose-dependent manner, and this hormone-induced increase is completely blocked by the anti-androgen enzalutamide. Remarkably, there was a significant positive correlation between HULLK expression and high-grade PCa in three independent cohorts: the University of Virginia, the University of Texas Southwestern, and The Cancer Genome Atlas.

Dr Gioeli said: "Virtually all patients with metastatic prostate cancer (PCa) will relapse and develop lethal castration-resistant prostate cancer (CRPC)". The new data being presented, continues to support the hypothesis on the potential use of HULLK as a biomarker for PCa.

"The latest data, which demonstrates the presence of this biomarker in non-invasive biofluids such as urine, is an exciting step forward" stated Ian Kavanagh, COO, of APIS Assay Technologies. "Our intention at APIS Assay Technologies is to implement HULLK into a clinically relevant signature for early detection of patients with metastatic prostate cancer and provide a guidance for further treatment."

The overall goal of the collaboration between UVA and APIS is to address the unmet medical need associated with PCa and evaluate the level of HULLK in PCa patients in order to establish the parameters necessary for a clinical trial demonstrating the effectiveness of HULLK as a relevant Biomarker.

Dr  Schorr, CEO added: "Overall lncRNAs are emerging as critical regulatory elements of many cellular biological processes, that’s why APIS is also working with other lncRNA biomarkers in additional cancer related indications."

Despite most cancer studies have been focused on protein-coding genes, the evidence that about 97% of human genome consists of non-protein-coding sequences led scientists to investigate the untranslated transcripts, called non-coding RNAs (ncRNAs). The un-translated transcripts, called non-coding RNAs (ncRNAs) can be classified in short (19-31 nucleo- tides), mid (20-200 nucleotides) and long (> 200 nucleotides) based on their length. long-ncRNAs (lncRNAs), which represent the largest class of non- coding transcripts with about 55,000 genes along the human genome.

lncRNAs may regulate gene expression through their interaction domains for DNA, mRNAs, miRNAs and proteins. The ncRNAs have cell type, tissue and cancer specificity, thus RNA profiling has become a mean to identify useful biomarkers of tumor development, progression and metastasis. Although miRNAs represent the most widely investigated ncRNAs, lncRNAs are emerging as cancer key regulators (Grillone et al. Journal of Experimental & Clinical Cancer Research (2020) 39:11).

LncRNA expression profiles can also identify clinically relevant cancer subtypes that predict tumor behaviour and disease prognosis, which defines them to very promising diagnostic and therapeutic biomarkers.

With nearly one in every five men diagnosed during their lifetime, prostate cancer (PCa) is a worldwide common disease. The implementation of screening and aggressive treatment has led to an improved survival rates, while "overtreatment" and treatment-related side effects can influence the quality of life for survivors and has come under considerable controversy over the last decade. (Mo.Med 2018 Mar-Apr; 115(2): 131.)

Further Information

For more information, please contact: Julia Price on julia@juliaprice.co.uk  or call +44 (0)7737 864878.

Source and Media Contact

Leigh Dilley ldilley@lifesciencenewswire.com

Media and Client Services Manager, Life Science Newswire  Tel: +44 01223 627137

 

 

‘Ground Breaking’ Effective new Approach for Treating People Affected by Diabetic Eye Disease

A new study, published in Diabetologia,[1] presents the results of the largest clinical trial for diabetic retinopathy. The study highlights a new approach that could transform diabetic eye screening around the world that also has a significant cost saving for the NHS.

The number of people living with diabetes in the world is over 460 million and is likely to rise to over 700 million in the next 35 years. Diabetes affects the eye by damaging the blood vessels in the retina, and is known as diabetic retinopathy. The high blood sugar causes the fine blood vessels in the retina to leak fluid causing waterlogging or to close resulting in the retina becoming starved of oxygen.

Diabetic retinopathy (DR) is one of the commonest causes of visual loss in the world and can be prevented if it is detected early. A person with DR isn’t aware of the problem until vision loss is so reduced that the patient notices, a stage when the damage is often irreversible. Prompt laser treatment, injections of drugs into the eye or complex eye surgery are required to limit the damage.

The UK is at the forefront of screening for DR. People have retinal photographs taken which show the early stages of retinopathy and if present they are referred for close monitoring and/or treatment before vision is affected. Liverpool has been leading research into screening since 1991 and many of the techniques used for screening worldwide have been developed here.

Largest Trial of its Kind

In an effort to improve screening for DR, researchers, led by Professor Simon Harding, Chair Professor of Clinical Ophthalmology and Head of the University of Liverpool’s Department of Eye and Vision Science, and Dr Deborah Broadbent, Honorary Senior Lecturer in Eye and Vision Science, conducted a study to ascertain whether a personalized / individualized approach to screening was more beneficial than the established yearly screening approach.

The study, entitled ‘Individualised Screening for Diabetic Retinopathy’ (ISDR) recruited more than 4,500 patients over seven years making it the largest trial of its kind. Patients recruited to the study were either entered into a control group or a personalised, or individualized, approach group. The control group of patients continued to have their eyes screened every year to detect early changes of diabetic retinopathy, which is the current approach in most countries.  The individualized group underwent a novel, innovative screening method in which the time between each screening episode varied depending on the amount of retinopathy and the level of control of blood sugar, blood pressure and cholesterol. By combining all these important factors, the Liverpool system calculates the risk for each person using their own health information, the “individualised” approach. Patients were then given six-month appointments if they were classed as at high risk of developing sight threatening disease , a 12-month appointment for medium risk or a 24-month appointment for a low risk.

Results

The results of the seven-year study showed that 81.9% of patients in the individualized group were deemed to be low risk patients and therefore did not need to be screened every year.  This meant they only needed to attend an NHS appointment every two years, saving them time off work, travel costs and inconvenience. 

The trial showed that 43.2% fewer appointments were required, releasing £27.2 million per year or £19.73 per patient per year. The study also found that there was societal cost saving of £26.19 per patient per year.

The trial also found that sight-threatening diabetic retinopathy was detected earlier in the high-risk people in the individualised group verses the control group and most importantly the safety of the patient was not compromised by longer screen intervals in the low risk group.

The ISDR trial was been funded by the National Institute for Health Research (NIHR) the NHS Research and Development body. It was hosted by St Paul’s Eye Unit, Liverpool University Hospital NHS Foundation Trust and the University of Liverpool.

Digital technologies

Professor Harding, Chief Investigator of the ISDR Programme, said: “Attending lots of clinics each year is a huge problem for people with diabetes, especially as many are working.  So, reducing these will be a big help to them, and will free up the pressure on NHS eye clinics.  There are currently just under eight million ophthalmology appointments required each year, the largest of any speciality. 

“This study shows how introducing new digital technologies can improve routine healthcare. We can more effectively monitor the eyes of people with diabetes, save them money travelling to and from clinics and free up much needed funds for the NHS.”

Ground breaking research

Dr Broadbent, Principle Investigator of the ISDR trial, said: “The people of Liverpool have a great track record of contributing to ground breaking research and this is a fantastic example.  To recruit over 4,500 patients for any study is a tremendous achievement and I would like to thank our patients for so enthusiastically agreeing to be a part of this ground-breaking study.

“I would also like to thank our highly motivated patient group who helped us to design the study, the ISDR research team for their painstaking work and the NIHR for funding this study.”

Reference

1. Broadbent, DM. Wang A, Cheyne, CP et al. Safety and cost-effectiveness of individualised screening for diabetic retinopathy: the ISDR open-label, equivalence RCT. Diabetologia. https://doi.org/10.1007/s00125-020-05313-2  2020.

Further Information and Media Contact:

For a copy of the paper, further information or an interview with Professor Harding or Dr Broadbent please contact Tom Southern on 07718926022

 

 

Report by EU Advisor: Pandemic Signals Breaching Planetary ‘Tipping Point’ by Global Economy

A new study by a top advisor to an EU-backed scientific research programme concludes that the COVID-19 pandemic is a symptom of global industrial civilisation’s breach of key planetary boundaries, which are critical to maintaining a safe operating space for human survival on the planet.

The COVID-19 crisis is an urgent early warning signal for how industrial civilization is rapidly eroding the very conditions of its own existence.

The global economy, the study warns, has now entered a volatile new phase of chronic instability which can only be resolved through a transition to a ‘lifeboat economy’. This must involve debt-free financing for the renewable energy transition, nationalisation and winding down of fossil fuel industries, as well as ecological restoration for clean manufacturing and agriculture.

But most of all, we have to roll back the dangerous trajectory of deforestation through a radically different approach to commodities like palm oil to transition to sustainable production. That requires a new global pact on deforestation premised on ensuring that major commodities from beef to soy are produced within planetary boundaries based on consistent global standards.

The new report ‘Deforestation and the Risk of Collapse: Reframing COVID-19 as a Planetary Boundary Effect’, is published in the journal System Change by the Schumacher Institute for Sustainable Systems, an independent think tank in the UK which has led the European Commission’s Converge research programme.

Report author Dr Nafeez Ahmed, Research Fellow at the Schumacher Institute, said: “The COVID-19 pandemic is not just a pandemic. When looked at in the context of a wide-range of scientific data about the escalating human footprint on the planet, the pandemic represents the passing of a major civilizational tipping-point into a dangerous new era of converging ecological emergencies. The COVID-19 crisis is an urgent early warning signal for how industrial civilization is rapidly eroding the very conditions of its own existence.”

Dr Nafeez Ahmed sits on the Board of Stakeholders of the European Commission’s Horizon 2020-funded MEDEAS research programme, ‘Guiding European Policy toward a low-carbon economy.’ A world-renowned systems theorist and environment journalist, Dr Ahmed is Executive Director of the System Shift Lab, a transdisciplinary network of natural and social scientists working on strategies for system change, and is a Commissioner for Cambridge University Press’ Sustainability Commission on Scaling Sustainable Behaviour Change.

The COVID-19 pandemic has exposed structural fragilities and interdependencies across global systems, the new report says. But at the heart of these fragilities is the increasing dependence of industrial consumption on processes that are accelerating deforestation. That requires both enforcing sustainable practices by producers in the South while curtailing demand in the North.

The probability of a global pandemic was dramatically increased by relentless and unregulated industrial expansion, which has destabilized ecosystems critical for planetary life-support. The same processes are driving other ecological crises which threaten to permanently undermine the health of the global economy.

The report concludes that without a transition to a ‘lifeboat economy’ where markets are “recalibrated” to protect public health and natural systems, humanity faces a heightening risk of cascading breakdowns across interconnected social, economic and political systems.

According to Dr Ahmed:

“Policymakers need to pay attention to the fact that the public health crisis is a symptom of a deeper crisis: a civilization degrading the very conditions of its own existence. There is now a clear body of scientific data suggesting that industrial civilization has crossed a major tipping point by simultaneously driving interlinked crises across climate change; our fossil fuel dependent energy system; industrial agriculture; the rate of species extinction; and deforestation. The COVID-19 pandemic is an early symptom of these increasing dangers we face. The synchronicity between all these crises threatens to overwhelm our institutional capacity to respond. Unless we draw back our economies to operate within planetary boundaries, we will face a future of deepening economic crisis and social upheaval.”

Further Information

The new report was launched on 12th November 4-6pm UK GMT at an exclusive online event hosted by The Schumacher Institute where Dr Ahmed will explain his findings. Journalists can register for the event here. The report’s Executive Summary & Policy Recommendations can be downloaded here, and the full report is available here.

For any further information or to arrange an interview with Dr Nafeez Ahmed please email iprdoffice@gmail.com  or call +44(0)7824 441044.

Source and Media Contact

The Schumacher Institute <wire@pressat.net>

 

 

Call for a National Covid-19 Resilience Programme to Keep Older People Healthy and Resilient

Public health agencies across the UK should launch a National Covid-19 Resilience Programme to support older people through the pandemic and to keep them healthy and resilient over the winter – that’s the recommendation from a leading group of scientists and clinicians working in the fields of physiology, nutrition and physiotherapy.

The recommendation will be made in a new report by The Physiological Society and Centre for Ageing Better to be launched this Monday at a meeting of Parliamentary and Scientific Committee.[1] The Expert Panel for the project brought together 20 leading scientists and clinicians.[2]

New polling carried out by YouGov for the project found that almost 1 in 3 older people did less physical activity during the first lockdown in March. Of those, 43% said that this was because they no longer had a reason, or had less reason, to get out of the house and be active; 32% were worried about catching Covid-19; and 29% reported lacking motivation to exercise. [3]

Physical activity is an important factor in staying healthy and resilient. Home confinement in older people will be associated with muscle loss, body fat gain and the development of insulin resistance, which are driving factors in the development of weakness and Type 2 diabetes. These changes happen within days if inactivity is marked. This could have dramatic functional consequences for older people, perhaps tilting the balance from being just able to do something, such as rise from a chair, to not.

Increased risks of Covid-19 hospitalization, disease severity and death are associated with a high body mass index and frailty in older people. Therefore, it is essential to support older people in staying fit and healthy during lockdown to improve their resilience to Covid-19.

A National Covid-19 Resilience Programme would bring together a package of measures to support older people through the lockdown and beyond, keeping them healthy and resilient over the winter. The Government should repeat the approach taken at the start of the first national lockdown in March to identify and proactively contact those at highest risk to offer support and advice.[4]

A National Covid-19 Resilience Programme Should Include:

A tailored exercise programme, focused on older people with key Covid-19 risk factors (obesity, type 2 Diabetes, cardiovascular disease, and sarcopenia). This can draw on existing programmes such as “Make Movement Your Mission”; (www.facebook.com/groups/MakeMovementYourMission );

Clear guidance about the importance of a healthy balanced diet containing sufficient levels of protein and appropriate energy content;

Enhance mental health through the creation of virtual communities to counter social isolation;

Enlist help of relatives and volunteers to support behaviour change among older people.

This programme should be supported by a digital platform and by national broadcasters such as through regular televised activity classes on the BBC.

Professor Paul Greenhaff, University of Nottingham, UK and Expert Panel Co-Chair said:

“With England now in its second lockdown it is likely that people across the country will be less physically active. Physical activity is an important factor in staying healthy and resilient and will help protect against risks from Covid-19.

“Lockdowns, while important to reduce transmission of Covid-19, can have a detrimental effect on both the physical and mental health of older people. These changes happen rapidly: within 3 days of not using muscles, people can experience significant decreases in muscle mass and quality which might be the difference of an older people being able to get out of a chair by themselves or not.

“We are calling on public health agencies to urgently address this by launching a National Covid-19 Resilience Programme to support older people through the pandemic. Older people need clear, tailored guidance, about how to keep healthy and resilient, that covers physical activity, nutrition and mental wellbeing.

“Older people are facing this lockdown as the days are getting shorter and colder and therefore we must all re-double efforts to keep older people healthy.”

Dr Alison Giles, Centre for Ageing Better, and Expert Panel Co-Chair said:

“As this report highlights, coronavirus lockdowns can be particularly challenging for older people as they can exacerbate a variety of health issues, such as cardiorespiratory deconditioning and weight gain, as well as increased loneliness and social isolation.

 “As the country enters a second national lockdown it’s important to acknowledge that blanket advice based on age can lead people to feel that they don’t have control over managing their own health and risk around COVID-19.

“A National Covid-19 Resilience Programme would give older people more control and offer guidance on how to take care of themselves as the pandemic continues. We must provide people with tools that will allow them to make their own informed decisions on their health, wellbeing and resilience.”

Notes

1. The Physiological Society brings together over 4,500 scientists from over 60 countries. The Society promotes physiology with the public and parliament alike. It supports physiologists by organising world-class conferences and offering grants for research and also publishes the latest developments in the field in its three leading scientific journals, The Journal of Physiology, Experimental Physiology and Physiological Reports.

Centre for Ageing Better: The UK’s population is undergoing a massive age shift. In less than 20 years, one in four people will be over 65. The fact that many of us are living longer is a great achievement. But unless radical action is taken by government, business and others in society, millions of us risk missing out on enjoying those extra years. At the Centre for Ageing Better we want everyone to enjoy later life. We create change in policy and practice informed by evidence and work with partners across England to improve employment, housing, health and communities. We are a charitable foundation, funded by The National Lottery Community Fund, and part of the Government’s What Works Network.

2. The report will be available on The Physiological Society’s website on Monday afternoon ahead of the launch: www.physoc.org/policy/covid19resilience . Please email amackenzie@physoc.org  for an embargoed copy. Please see the website for more information about the report and the Expert Panel. The report is going to be launched at Parliamentary and Scientific Committee taking place at 17:30 GMT on Monday 9 November.

3. All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 2226 adults. Fieldwork was undertaken between 13th - 16th October 2020.  The survey was carried out online. The figures have been weighted and are representative of all UK adults (aged 50+).

4. A National Covid-19 Resilience Programme should comprise the following elements:

Encourage appropriate exercise:  A tailored exercise programme should be made available nationally, focusing on older people with key Covid-19 risk factors (obesity, type 2 Diabetes, cardiovascular disease and sarcopenia). This should offer indoor physical activity recommendations designed for people with different levels of fitness. It will need to be designed in conjunction with exercise scientists and older people themselves and need to generate benefits within a short space of time. This could draw on the “Make Movement Your Mission” model (www.facebook.com/groups/MakeMovementYourMission ) or similar schemes, with public health authorities across the UK (Public Health England, Public Health Scotland, Public Health Wales and the Public Health Agency in Northern Ireland) rolling a programme like this out nationally.

A broader intervention to support increased activity levels with guidelines detailed enough to cover “when”, “how” and “how frequently” to exercise, which should be provided using multiple channels. As well as a digital platform, the national broadcasters should promote the benefits of physical activity by running regular televised activity classes. These should be developed in conjunction with exercise scientists in order to ensure that the approach is suitable for older people with different underlying levels of fitness and frailty.

Support Optimised Nutrition:

Clear guidance about the importance of a healthy balanced diet containing sufficient levels of protein, with an appropriate energy content. This advice should be linked explicitly to maintaining health and the body’s resilience against Covid-19, so that older people understand the direct link between lifestyle choices and health and resilience.

Enhance Mental Health and Wellbeing:

Using communities (both virtual and physical) to counter loneliness and isolation in order to improve mental health. Virtual communities, such as the community that has formed around Make Movement Your Mission, can also be of benefit to mental health – existing organizations and charities could be supported to explore widening the participation of older people in virtual communities using social media and video conferencing. Explore viability of allowing older people to form “super bubbles” to enable them to interact in slightly larger groups (e.g. four people across two households), provided social interactions are restricted beyond the super bubble.

Embed Behaviour Change:

None of this will work unless we can successfully re-build older adults’ confidence and support them to stay active and keep well. Therefore, we will need to be able to enlist the help of relatives, care workers and other professionals to reinforce messages around resilience in their day-to-day interactions with older people in their families or for whom they care. There may also be a role for NHS Volunteer Responders to play in supporting this behaviour change, perhaps through telephone befriending or other schemes, provided appropriate safety checks have been carried out.

Repeat the approaches taken at the start of the first national lockdown in March to identify and proactively contact those at highest risk to offer support and advice, using social prescribing link workers and the NHS responders.

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