Nature Briefing

View this email in your browser Tuesday 30 June 2020

Hello Nature readers, Today we read about a swine-flu strain with human pandemic potential found in pigs, ponder whether cosmic rays explain the handedness of life, and learn that quantum computers work better when no one’s around.

Habitat destruction is one of the main drivers of species loss. (Robin Moore/National Geographic)

Speaking in the name of nature Earlier this month, Elizabeth Maruma Mrema was appointed executive secretary of the United Nations Convention on Biological Diversity. She is the first woman from Africa to lead the intergovernmental body, and will oversee the creation of a global biodiversity agreement for the next decade. Mrema spoke to Nature about how the coronavirus pandemic has influenced negotiations, and the challenges ahead. “One could say that I have been appointed at a bad time for biodiversity, considering that the whole world is just emerging from, or still in, lockdown,” she says. “But at the same time, I see it as a major opportunity, as biodiversity is being discussed more than ever before.” Nature | 6 min read

Pigs in China carry risky swine-flu strain Scientists carrying out routine monitoring of influenza strains in China have found that pigs are widely infected with a virus with the potential to trigger a pandemic. The strain, called G4, is a genetic blend of three lineages. These include the H1N1 virus that caused the 2009 pandemic, suggesting that it might be able to adapt for human-to-human transmission. Antibody tests showed that more than 4% of humans surveyed had been exposed to G4. In its current form, the virus is not considered dangerous, but scientists warn that, given the unpredictability of influenza viruses, a vaccine should be developed. “We need to be vigilant about other infectious disease threats even as COVID is going on because viruses have no interest in whether we’re already having another pandemic,” says evolutionary biologist Martha Nelson. Science | 6 min read Reference: PNAS paper

A cosmic origin for the handedness of life Nineteenth-century biologist Louis Pasteur speculated that life’s preference for using certain organic molecules but not their mirror-image counterparts is “one of the links between life on Earth and the cosmos”. Now, two astrophysicists have a new interpretation of that connection. They say that the never-ending bombardment of Earth by cosmic rays could have led to DNA that is unerringly right-handed and amino acids that are nearly always left-handed. Cosmic rays that hit the upper atmosphere produce new particles, some of which are endowed with a preferred handedness caused by the weak nuclear force, the only fundamental force known to distinguish left from right. Over eons, that asymmetry could have trickled down to organic matter. Quanta | 6 min read Reference: Astrophysical Journal Letters paper

COVID-19 coronavirus update (Cergios/Shutterstock) The state of the vaccination race The race to develop a vaccine has been going on for almost six months. Who’s in the lead? Chemistry World offers a plain-language update on the vaccine pipeline. Its pick for leader is US biotech company Moderna’s messenger RNA-based vaccine. But it would be the first RNA vaccine for any disease to ever make it to market. Chemistry World | 8 min read How to decide who gets the vaccine Organizations including the World Health Organization and the US Centers for Disease Control and Prevention are debating the thorny problem of who should be the focus of the first waves of vaccinations for COVID-19. Young and healthy people — who are least at risk themselves, but might tolerate a vaccine better than older people, creating a ring of protection? Or maybe pregnant women, in whom the risk to mother and baby must be carefully weighed? Or perhaps priority should be given to people from specific ethnic groups, who are dying at a disproportionate rate? “These are tough decisions, because everybody can make a case for why somebody should be ahead of somebody else in line,” says vaccine specialist Bruce Gellin. “Nobody’s going to debate health care workers and first responders — people who are putting themselves at risk for others and keeping things moving. After that is when it gets complicated.” Science | 6 min read Doctors flag fevers and rashes among children Two studies have revealed the progress of multisystem inflammation syndrome, a dangerous side effect of COVID-19 that occurs in children and looks similar to a condition called Kawasaki’s disease. Of the nearly 300 children in the studies, 6 died. On the whole, children seem to be less susceptible to COVID-19 than are adults, and to experience milder symptoms if they do fall ill. But the researchers recommend that carers look out for fevers and rashes in children who have recently had COVID-19, or who live in areas with a lot of infections. STAT | 5 min read Reference: The New England Journal of Medicine paper 1 & paper 2

Notable quotable “Oh my goodness, this is one of us.” Physician Luis Lobon recognized his colleague, hospital worker Marie Deus, when he treated her for COVID-19. She was the first employee to die of the disease at the hospital in Boston, Massachusetts, where she worked. The moving story of her life and death weaves together how racial inequality and job insecurity contribute to the risk for many front-line workers. (STAT | 18 min read)

Features & opinion

How to put the fun into virtual conferences Organizing a virtual conference changed how sustainability researchers Christina Bidmon, Cristyn Meath and René Bohnsack think about academic exchange. “When COVID-19 hit, we optimistically thought, ‘We will take our conference virtual’,” they write. “In the process, we’ve found that, instead of thinking of online conferences as replacements-by-necessity for physical conferences that should resemble the ‘real thing’, we should try to accept them as an entirely different model of academic exchange.” They share their tips for using a conference platform, helping participants mingle and maintaining the fun factor. Nature | 4 min read

To improve quantum computers, keep away Christopher Monroe and his team spent three years setting up their quantum computer to be operated remotely. When the COVID–19 pandemic struck, those efforts paid off in an unexpected way: quantum computers work best without humans walking around the lab and producing vibrations or temperature fluctuations. Their machine “has kept running — all day, every day”, Monroe writes. “And the data have been excellent because the campus has been a ghost town.” The bigger lesson is that a remote mode of operation could hasten the development of these potentially revolutionary machines, Monroe says. Nature | 4 min read

Infographic of the week

From electric vehicles to smart grids, the path to a greener future is paved with lithium-ion batteries — lots of them. That means we need better ways to keep them cool. But the task has been hindered by a lack of a standard way to judge their thermal performance. Five engineers propose the cell cooling coefficient, a measure for the rate of heat removal from battery packs that gives manufacturers a simple way to compare products. (Nature | 8 min read)

Sure, I’ve baked some lockdown bread. I’ve even made jam. But conservation biologist William Sutherland cooked an entire Babylonian meal from a recipe chiselled on a tablet in 1750 BC — the oldest known cookbook in the world. Share your favourite old family recipe — or any feedback on this newsletter — with me at briefing@nature.com. Flora Graham, senior editor, Nature Briefing With contributions by David Cyranoski and Davide Castelvecchi

Freak pains and half-broken lungs persist months later

‘It’s frightening’: Doctors say half of ‘cured’ COVID patients still suffer

Bnei Brak woman tells The Times of Israel that a month after testing negative she has severe fatigue and anxiety – and her husband is worse than he was when hospitalized

By Nathan Jeffay 28 June 2020, 11:09 pm 9

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A medical team at the coronavirus unit, in the Ichilov hospital, Tel Aviv, Israel, May 4, 2020. (Yossi Aloni/Flash90)

Recovered COVID patients are baffling doctors with complaints of freak pains, lungs that just won’t get back to normal, and a range of incapacitating psychological issues.
“What we are seeing is very frightening,” Prof. Gabriel Izbicki of Jerusalem’s Shaare Zedek Medical Center told The Times of Israel. “More than half the patients, weeks after testing negative, are still symptomatic.”

Izbicki is working on a study that involves follow-up with patients who were in hospitals or coronavirus hotels, looking at the aftereffects of the virus and trying to understand why patients continue to suffer long after being confirmed negative. “There is very little research about the mid-term affect of coronavirus,” he said, adding that it is much needed to guide doctors.

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In Bnei Brak, at Israel’s first community clinic, doctors have been seeing a spike in recent days in the patients with pains that appear to come from nowhere.
“It can appear in the arms, legs, or other places where the virus doesn’t have a direct impact, and if you ask about the pain level on a 1 to 10 scale, can be 10, with people saying they can’t get to sleep,” said Eran Schenker, director of the month-old clinic in Bnei Brak run by Maccabi Healthcare Services. “It’s something which we’re starting to see much more in the last week.”

Man coughing (iStock)

‘Broken’ by the virus

A patient from the clinic spoke to The Times of Israel on condition that her name is not published. She was diagnosed in March and tested negative a month ago. But the woman, a Bnei Brak resident in her 40s, still has severe fatigue and anxiety, and can only walk for a few minutes at a time.

Her husband, who also caught coronavirus in March and tested negative last month, now “feels like he’s broken,” she said. “He’s actually worse than he was when he was hospitalized.”

Her husband, 55, had some health problems before contracting coronavirus in March, but was active “from morning until night,” with plenty of energy. He is now extremely lethargic, can hardly walk, and has heart problems, she said.

This came as a particular shock to the family, as during his initial hospitalization in March and early April he did not require oxygen and X-rays showed no damage to his lungs. He was hospitalized again during April with pneumonia-like symptoms, and declared negative in May. But the man then developed pains and significant breathing problems, and has seen cardiologists, neurology experts, rehabilitation teams, and other professionals at the clinic.

This man was “one of the hard cases, but he’s not the worst and we have patients who suffer more,” according to Schenker.

He said that with all illnesses patients can be left reeling from long hospitalizations, and ventilators use can slow full recuperation — but COVID-19 is causing patterns that are not usually seen.

“We’re amazed that people aren’t just suffering from the things we expected, but things we just weren’t aware would have relevance,” he told The Times of Israel. “It’s not textbook.”

He stressed that his patients are not all newly recovered. “Some of them had coronavirus in March, so they may have been recovered for months,” he said.

Gabriel Izbicki, head of the Pulmonary Institute at Jerusalem’s Shaare Zedek Medical Center (Shaare Zedek Medical Center)

Izbicki, director of Shaare Zedek’s Pulmonary Institute, also emphasized that many of his patients have long been declared coronavirus-free. One of the biggest surprises, he said, is that there is no predicting which patients will find the disease hard to shake, and which will not.
“There is no correlation between seriousness of disease during hospitalization and extent of symptoms afterwards,” he said, discussing preliminary results from his study on recovered patients who were treated in hospitals and coronavirus hotels.
“Within the symptoms that we checked for, we revealed general weakness among the majority of patients alongside shortness of breath, sustained cough, and other complex breathing and pulmonary issues,” he said, adding that he is also familiar with the freak pains that Schenker discussed.

These pains — seen in young patients and old alike — have doctors scratching their heads. Schenker said: “Painkillers block the pain but don’t relieve the source, but we don’t know how to address the source and you can’t be on painkillers the rest of your life.”

While the pains are excruciating for some, others describe the pains more as a major discomfort: burning sensations, tingling, or just a hard-to-place sense that a limb does not feel normal.

The patients with these pains do not normally raise red flags during the main medical examinations. Schenker said: “We check their lung and hearts and they have no disease, and they have no neurological issues. We do scans and can’t see anything, but they have this pain — we’re told about it again and again.”

Dan Oyero, deputy director of medicine in central Israel for Maccabi Healthcare Services (courtesy of Maccabi Healthcare Services)

Dan Oyero, Maccabi’s deputy director of medicine in central Israel, said that the overarching issue doctors are dealing with is the far-reaching change in people’s lives, for which doctors cannot predict an end point.
“The most distressing thing is that people compare how they feel now compared to how they were a few weeks ago before they were infected,” he said. “And they say they just can’t do the things they used to do.”
The sense of taste and smell, lost during the illness, sometimes does not return. When patients ask if it will come back, given that doctors have such limited experience of the disease, they cannot give a clear answer. “We just don’t know,” said Oyero.
When doctors can invoke a precedent from other illnesses, it can be bad news.

Elderly patients who were badly stricken by the coronavirus, even if they had no previous respiratory issues, can find their lungs working at half capacity, long after testing negative, said Schenker.

Eran Schenker, director of the clinic for recovered COVID patients in Bnei Brak run by Maccabi Healthcare Services (courtesy of Maccabi Healthcare Services)

“They have two lungs, but they are the equivalent of one, because each lung is working at 50% — and it could be like this for the rest of their lives,” he said. He draws this conclusion from the pattern of lung damage that is seen from some other diseases — but normally only affecting patients who had previous lung complications.
“The damage was not done by the virus, but by an inflammation process which, we know from other diseases, will not leave lungs with the capacity to exchange oxygen as before,” Schenker commented.
Izbicki said that in his experience, COVID-related lung damage can affect patients of all ages, and said he shares the concern that people will not regain full lung performance. “We don’t know if the lung function tests will become normal,” he said.
Some patients require physical therapy. Schenker said: “We’ve seen cases of weight loss that have been so extreme that people find it hard to walk.” Meanwhile, some who are physically able to move around just don’t have the energy or motivation to do so.

A recovered coronavirus patient sees a cardiologist at the special clinic in Bnei Brak run by Maccabi Healthcare Services (courtesy of Maccabi Healthcare Services)

Some of these patients are young and normally energetic, Schenker said.
“It’s amazing how many people went back to work — they can be educators, lawyers and in other professions — but when they sit for an hour they feel anxiety, feel insecure, and sometimes the people suffer from depression beyond what we expected.”

Oyero said:“The main complaints are actually fatigue, compacts [intense periods] of low energy — nothing we can give a name to. Many people say that they don’t have the energy they had before. They are more tired. Some say they don’t have the drive to do things. We can’t give the complaints a name or tell them they have a particular syndrome, but we’re trying to help them.”

Nature Briefing

Hello Nature readers, Today we hear that dexamethasone is the first drug to be shown to reduce deaths among people seriously ill with COVID-19. Plus, we ponder the super-eruption that once rocked Yellowstone.

Castle Geyser erupting in Yellowstone National Park. (Getty)

Yellowstone had even more explosive past Almost nine million years ago, the Yellowstone volcanic hotspot, which stretches over areas of the western United States, experienced one of the largest eruptions ever known. An array of analyses has revealed that rocks once thought to have formed in several distinct eruptions came from a single ‘super-eruption’. The event scattered 2,800 cubic kilometres of rock and ash over an area of tens of thousands of square kilometres. “When you get your maps out and measure the scale, you think, ‘That can’t be right,’” says geochemist Thomas Knott. “‘They can’t possibly be that far apart and be from the same volcanic eruption.’” Scientific American | 4 min read Source: Geology paper

Twitter’s saddest weeks ever Researchers aiming to quantify global happiness on social media have called the period starting on 26 May “the saddest two weeks” on Twitter. Since 2008, a pair of applied mathematicians have been gauging the positivity and negativity of randomly sampled tweets. Their happiness index had been gradually recovering from the bleak beginnings of the coronavirus pandemic, but dropped sharply following the killing of George Floyd in Minnesota late last month. The lowest point, in May, was far below the previous record, hit after a mass shooting in Las Vegas, Nevada, in 2017. But sadness can galvanize people into action. “It’s one thing to tell the world ‘this is the saddest week’,” says social scientist Desmond Patton. “But also in the saddest week, you have thousands and thousands of people who are now activated and moving towards equality and social justice.” Nature | 3 min read

Sharpiegate panel condemns NOAA head The head of the US National Oceanic and Atmospheric Administration (NOAA) violated the agency’s ethics code last year when he backed up US President Donald Trump’s claims that a hurricane could hit Alabama, finds a NOAA panel. The panel concluded that acting administrator Neil Jacobs “engaged in the misconduct intentionally, knowingly, or in reckless disregard” of the agency’s scientific-integrity policy by censoring its office in Birmingham, Alabama, which had tweeted that the state would not see a major impact from Hurricane Dorian. The controversy was dubbed ‘sharpiegate’ after Trump showed a NOAA map that had been altered with a black marker during a press conference last September. New York Times | 3 min read

COVID-19 coronavirus update The steroid dexamethasone was given to thousands of people critically ill with the coronavirus in a randomized, controlled trial. ((Dr P. Marazzi/SPL)) Dexamethasone shown to save lives A cheap and widely available steroid called dexamethasone is the first drug to be shown to reduce deaths among people seriously ill with COVID-19. Researchers working with the Randomized Evaluation of COVID-19 Therapy (RECOVERY) trial, which is assessing the capacity of six medications to treat the disease, announced the findings in a press release. The results have not yet been peer reviewed. The study enrolled 2,100 participants who received dexamethasone and tracked how they fared in comparison with about 4,300 people who received standard care. For people on ventilators, it reduced deaths by about one-third. For patients needing oxygen, it cut the risk of death by one-fifth. The drug seems to reduce the damage from a hyperactive immune reaction called cytokine storm. Nature | 5 min read Scientists close in on fatality rate One of the most crucial questions about an emerging infectious disease such as the new coronavirus is how deadly it is — the infection fatality rate (IFR). This is the proportion of infected people who will die as a result, including those who don’t get tested or show symptoms. Now, numerous studies — using a range of methods — estimate that 0.5-1% of people infected with SARS-CoV-2 will die. There are many caveats: the IFR is particularly hard to pin down for COVID-19 because there are many infected people who don’t show symptoms, and many countries are struggling to count all their virus-related deaths. Nature | 7 min read We were warned A ranking of the world’s health-care systems, drawn up before the pandemic by iconoclastic health researcher Ezekiel Emanuel, “presciently marks the United States among the worst in class”, writes reviewer Eric Topol. Emanuel dug deep into 22 dimensions on topics including health-insurance coverage, financing, payment, delivery, pharmacy prices and workforce. Nowhere is crowned outright winner, but four strong contenders — Germany, the Netherlands, Norway and Taiwan — have so far been among the most successful in managing COVID-19. Nature | 6 min read Coronapod: The Surgisphere scandal A questionable data set from a mysterious company has forced high-profile retractions and thrown doubt on drug trials and public-health policies. The Nature news team explores the fallout for research and for public trust. Nature Coronapod podcast | 33 min listen Subscribe to the Nature Podcast on iTunes, Google Podcasts or Spotify.

Notable quotable “I eat, breathe, sleep science.” In 2018, biologist Lynika Strozier told the Chicago Reader about her passion for science. On Wednesday, the Field Museum in Chicago, Illinois, where she worked, announced that Strozier had died owing to complications from COVID-19, aged 35. Strozier, who had a disadvantaged childhood and a learning disability, established an enviable scientific career. Her family and colleagues plan to establish a scholarship fund for aspiring scientists in her honour.

Features & opinion

Study animals are often STRANGE Are your turtles tired, your spiders jaded or your fish oddly bold? Ten years to the day after the call to widen the pool of human participants in psychology studies beyond those from WEIRD societies (that’s Western, Educated, Industrialized, Rich and Democratic), animal-behaviour researchers Michael Webster and Christian Rutz write that “mounting evidence suggests that there could be similar sampling problems in research on animals”. They propose a framework with a fitting acronym — STRANGE — that researchers can use to design studies, and to declare and discuss potential biases. Nature | 10 min read

Quote of the day “It’s a startling result. It will clearly have a massive global impact.” Intensive-care physician Kenneth Baillie, who serves on the steering committee of the RECOVERY coronavirus-drug trial, responds to results suggesting that dexamethasone reduces deaths among seriously ill people with COVID-19. (Nature | x min read)

Astronomy Picture of the Day — that’s APOD to fans — celebrates 25 years of stunning space photography today. This delightful oral history of the site from 2015 tells the story of its birth and explains why it still looks basically like it did in 1995. Flora Graham, senior editor, Nature Briefing With contributions by David Cyranoski and Davide Castelvecchi

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COVID-19 Updates Is It Safe to Go to the Pool? USDOT Providing Travelers 100 Million Face Masks As Summer Begins, CDC Updates Social Guidelines

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