International
Gut reaction: How the gut microbiome may influence the severity of COVID-19
Gut reaction: How the gut microbiome may influence the severity of COVID-19
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The risk of severe COVID-19 infection is more common in those with high blood pressure, diabetes and obesity, conditions that are all associated with changes to the composition of the gut microbiome — the community of bacteria, viruses and fungi that live in the intestines. This raises the question of whether the gut microbiome has a role in dictating COVID-19 severity.
Let’s recap what we know about COVID-19. COVID-19 is a new disease caused by a very contagious virus called SARS-CoV-2.
In most infected individuals, the virus does not cause serious illness. However, it causes a very serious respiratory disease — and even death — in a minority of patients. Through many studies of people with COVID-19 over the past few months, we have learned what characteristics are more likely to be linked to mild versus severe forms of the disease.
Who is predisposed to serious COVID-19?
Children and young adults are less likely to develop symptomatic COVID-19, although infection readily occurs in young people with equally high viral loads in the airway, suggesting that they can certainly infect others. In contrast, people of older age and those with pre-existing chronic conditions are highly at risk and very likely develop symptomatic, severe disease.
If we consider the gradient of severity of the disease, children are at one end, and the elderly and patients with chronic conditions are at the other end.
What conditions are linked to severe COVID-19?
The information collected by researchers from many countries all points to similar characteristics and health conditions that are more commonly seen in patients with severe disease. These include older age, high blood pressure, diabetes and obesity.
The strength of these associations is even more prominent among younger individuals, as younger patients with obesity and diabetes are more likely to have serious disease.
In New York City, 5,279 patients tested positive for COVID-19 between March 1 and April 8, 2020. Of these, 22.6 per cent had diabetes and 35.3 per cent were obese.
Obesity was associated with an increased rate of hospital admission and critical illness. Similar findings were provided by investigators in the United Kingdom about the outbreak in Britain, where obese patients were twice as likely to develop severe disease.
Do these findings raise the possibility that the mechanisms underlying high blood pressure, diabetes and obesity may help explain why these conditions lead to severe COVID-19 disease? Before exploring this question, let’s zoom in on cellular and molecular mechanisms known to be involved in COVID-19 disease.
How does the body fight COVID-19 infection?
When the virus enters the body, it mostly goes to the airways and the gastrointestinal tract. The virus then binds to specific receptors present on the surface of epithelial cells to enter these cells. Viral replication within the cells leads to cell damage and cell death. This results in the release of specific signalling molecules that alert the local immune system.
Armies of immune cells are then dispatched to initiate an antiviral response. Some of these cells are specialized to locate and identify the virus, while others mount a specific immune attack. The immune response results in the release of cytokines, chemokines and antibodies, which in many cases can defeat the virus, and the patient recovers.
Sometimes the immune system is dangerously at high alert and overreacts. In this case, the immune cells mount an especially strong inflammatory response — one that goes beyond what is required to kill the virus. This extra-strong attack releases cytokines and chemokines on a massive scale throughout the body, resulting in a cytokine storm, which causes widespread inflammation and tissue damage in patients with severe COVID-19.
One of the reasons for an abnormal, overreactive immune response lies in the gastrointestinal tract. Millions of interactions are constantly occurring between the immune system and trillions of non-dangerous microbes that live within the body. These interactions educate the immune system in how to function and, importantly, in how not to overreact to infectious microbes. Could this help explain why some people are more likely to develop uncontrolled inflammation upon COVID-19 infection?
Trillions of micro-organisms that call your gastrointestinal tract home
The gut microbiome is the community of micro-organisms living inside the gastrointestinal tract, mostly in the large bowel. The microbiome contains bacteria, fungi (yeast), viruses and protozoa, all of which contribute to maintaining a balanced ecosystem and human health. These microbes collectively perform many beneficial functions, including educating the immune system.
When studying the microbiome, scientists examine the composition (what is there) and function (what are they doing) of this ecosystem. We have learned that both composition and function of the gut microbiome are important features linked to human health. In certain conditions, the balance of the gut microbiome composition and function is disrupted in a way that leads to disease, a phenomenon called microbiome dysbiosis.
There is accumulating evidence from animal and human studies that gut microbiome dysbiosis has a causal role in metabolism dysregulation manifested as diabetes and obesity — the risk factors of severe COVID-19 disease.
Is gut microbiome predisposing patients to severe COVID-19?
The gut microbiome regulates host defences against viral infections including respiratory viruses, such as influenza virus. This occurs through the activation of immune antiviral mechanisms and the prevention of excessive inflammation.
Different species of the gut microbiome have pro- or anti-inflammatory properties and play different roles in regulating the immune system. In the context of COVID-19, a recent preprint study (not yet peer reviewed) showed that specific members of the gut microbiome were associated with severe disease and with immune markers known to be elevated in severe disease. The association of these gut bacteria with the immune markers was even higher than that of the known risk factors of COVID-19 severity: age and obesity.
Further work is needed to confirm that pro-inflammatory microbial species can contribute to the immune responses that make severe COVID-19 more likely, but based on what we know about the microbiome, this is certainly a possibility. This also could mean that beneficial gut microbiome species, the type that promote low inflammation, have the potential to prevent or remediate the immune alterations that lead to severe COVID-19.
Potential for treatments and prevention
The research community is working very hard to develop and test safe and effective vaccines and treatments against COVID-19. Tapping into the potential of the gut microbiome is another avenue that we can pursue to identify potential safe and affordable probiotics for prevention and treatment. This is not unprecedented in the context of viral respiratory diseases: probiotics and prebiotics can affect the immune response to the flu vaccine, and may improve outcomes in flu-like illnesses.
Until effective treatments are available, “mind your microbes” and maintain a healthy lifestyle.
Shirin Moossavi receives funding from Canadian Institute of Health Research.
Marie-Claire Arrieta receives funding from the Cumming School of Medicine, the Alberta Children Hospital Research Institute, the Snyder Institute of Chronic Diseases, the Canadian Institutes for Health Research, the Sick Kids Foundation, the W. Garfield Weston Foundation, and the Canadian Lung Association. She is affiliated with the University of Calgary.
International
What Follows US Hegemony
What Follows US Hegemony
Authored by Vijay Prashad via thetricontiental.org,
On 24 February 2023, the Chinese Foreign Ministry released a…
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Authored by Vijay Prashad via thetricontiental.org,
On 24 February 2023, the Chinese Foreign Ministry released a twelve-point plan entitled ‘China’s Position on the Political Settlement of the Ukraine Crisis’.
This ‘peace plan’, as it has been called, is anchored in the concept of sovereignty, building upon the well-established principles of the United Nations Charter (1945) and the Ten Principles from the Bandung Conference of African and Asian states held in 1955. The plan was released two days after China’s senior diplomat Wang Yi visited Moscow, where he met with Russia’s President Vladimir Putin.
Russia’s interest in the plan was confirmed by Kremlin spokesperson Dmitry Peskov shortly after the visit: ‘Any attempt to produce a plan that would put the [Ukraine] conflict on a peace track deserves attention. We are considering the plan of our Chinese friends with great attention’.
Ukraine’s President Volodymyr Zelensky welcomed the plan hours after it was made public, saying that he would like to meet China’s President Xi Jinping as soon as possible to discuss a potential peace process. France’s President Emmanuel Macron echoed this sentiment, saying that he would visit Beijing in early April. There are many interesting aspects of this plan, notably a call to end all hostilities near nuclear power plants and a pledge by China to help fund the reconstruction of Ukraine. But perhaps the most interesting feature is that a peace plan did not come from any country in the West, but from Beijing.
When I read ‘China’s Position on the Political Settlement of the Ukraine Crisis’, I was reminded of ‘On the Pulse of Morning’, a poem published by Maya Angelou in 1993, the rubble of the Soviet Union before us, the terrible bombardment of Iraq by the United States still producing aftershocks, the tremors felt in Afghanistan and Bosnia. The title of this newsletter, ‘Birth Again the Dream of Global Peace and Mutual Respect’, sits at the heart of the poem. Angelou wrote alongside the rocks and the trees, those who outlive humans and watch us destroy the world. Two sections of the poem bear repeating:
Each of you, a bordered country,
Delicate and strangely made proud,
Yet thrusting perpetually under siege.
Your armed struggles for profit
Have left collars of waste upon
My shore, currents of debris upon my breast.
Yet today I call you to my riverside,
If you will study war no more. Come,
Clad in peace, and I will sing the songs
The Creator gave to me when I and the
Tree and the rock were one.
Before cynicism was a bloody sear across your
Brow and when you yet knew you still
Knew nothing.
The River sang and sings on.…
History, despite its wrenching pain
Cannot be unlived, but if faced
With courage, need not be lived again.
History cannot be forgotten, but it need not be repeated. That is the message of Angelou’s poem and the message of the study we released last week, Eight Contradictions of the Imperialist ‘Rules-Based Order’.
In October 2022, Cuba’s Centre for International Policy Research (CIPI) held its 7th Conference on Strategic Studies, which studied the shifts taking place in international relations, with an emphasis on the declining power of the Western states and the emergence of a new confidence in the developing world. There is no doubt that the United States and its allies continue to exercise immense power over the world through military force and control over financial systems. But with the economic rise of several developing countries, with China at their head, a qualitative change can be felt on the world stage. An example of this trend is the ongoing dispute amongst the G20 countries, many of which have refused to line up against Moscow despite pressure by the United States and its European allies to firmly condemn Russia for the war in Ukraine. This change in the geopolitical atmosphere requires precise analysis based on the facts.
To that end, our latest dossier, Sovereignty, Dignity, and Regionalism in the New International Order (March 2023), produced in collaboration with CIPI, brings together some of the thinking about the emergence of a new global dispensation that will follow the period of US hegemony.
The text opens with a foreword by CIPI’s director, José R. Cabañas Rodríguez, who makes the point that the world is already at war, namely a war imposed on much of the world (including Cuba) by the United States and its allies through blockades and economic policies such as sanctions that strangle the possibilities for development. As Greece’s former Finance Minister Yanis Varoufakis said, coups these days ‘do not need tanks. They achieve the same result with banks’.
The US is attempting to maintain its position of ‘single master’ through an aggressive military and diplomatic push both in Ukraine and Taiwan, unconcerned about the great destabilisation this has inflicted upon the world. This approach was reflected in US Defence Secretary Lloyd Austin’s admission that ‘We want to see Russia weakened’ and in US House Foreign Affairs Committee Chairman Michael McCaul’s statement that ‘Ukraine today – it’s going to be Taiwan tomorrow’. It is a concern about this destabilisation and the declining fortunes of the West that has led most of the countries in the world to refuse to join efforts to isolate Russia.
As some of the larger developing countries, such as China, Brazil, India, Mexico, Indonesia, and South Africa, pivot away from reliance upon the United States and its Western allies, they have begun to discuss a new architecture for a new world order. What is quite clear is that most of these countries – despite great differences in the political traditions of their respective governments – now recognise that the United States ‘rules-based international order’ is no longer able to exercise the authority it once had. The actual movement of history shows that the world order is moving from one anchored by US hegemony to one that is far more regional in character. US policymakers, as part of their fearmongering, suggest that China wants to take over the world, along the grain of the ‘Thucydides Trap’ argument that when a new aspirant to hegemony appears on the scene, it tends to result in war between the emerging power and existing great power. However, this argument is not based on facts.
Rather than seek to generate additional poles of power – in the mould of the United States – and build a ‘multipolar’ world, developing countries are calling for a world order rooted in the UN Charter as well as strong regional trade and development systems. ‘This new internationalism can only be created – and a period of global Balkanisation avoided’, we write in our latest dossier, ‘by building upon a foundation of mutual respect and strength of regional trade systems, security organisations, and political formations’. Indicators of this new attitude are present in the discussions taking place in the Global South about the war in Ukraine and are reflected in the Chinese plan for peace.
Our dossier analyses at some length this moment of fragility for US power and its ‘rules-based international order’. We trace the revival of multilateralism and regionalism, which are key concepts of the emerging world order. The growth of regionalism is reflected in the creation of a host of vital regional bodies, from the Community of Latin American and Caribbean States (CELAC) to the Shanghai Cooperation Organisation (SCO), alongside increasing regional trade (with the BRICS bloc being a kind of ‘regionalism plus’ for our period). Meanwhile, the emphasis on returning to international institutions for global decision-making, as evidenced by the formation of the Group of Friends in Defence of the UN Charter, for example, illustrates the reinvigorated desire for multilateralism.
The United States remains a powerful country, but it has not come to terms with the immense changes taking place in the world order. It must temper its belief in its ‘manifest destiny’ and recognise that it is nothing more than another country amongst the 193 members states of the United Nations. The great powers – including the United States – will either find ways to accommodate and cooperate for the common good, or they will all collapse together.
At the start of the pandemic, the head of the World Health Organisation, Dr Tedros Adhanom Ghebreyesus, urged the countries of the world to be more collaborative and less confrontational, saying that ‘this is the time for solidarity, not stigma’ and repeating, in the years since, that nations must ‘work together across ideological divides to find common solutions to common problems’.
These wise words must be heeded.
Government
Royal Caribbean Officially Makes Controversial Change
The cruise line has made a controversial change that some passengers will love while others will be angry.
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The cruise line has made a controversial change that some passengers will love while others will be angry.
During the early days of the cruise industry's comeback from the covid pandemic, Royal Caribbean outlawed smoking in the casino. At the time, the Centers for Disease Control (CDC) required passengers to wear masks in public areas of the ship except when eating or drinking while stationary.
Smoking was, at first, a sort of loophole. People would smoke in the casino and remove their masks (or at least move them to the side) while playing slot machines. That basically meant that unlike drinking, where your mask could be moved and then replaced for a sip, smokers were essentially not wearing a mask.
DON'T MISS: Carnival Cruise Line Comments on a Possible (Very) Adult Change
Royal Caribbean (RCL) - Get Free Report closed that loop by fully outlawing smoking in its casinos while masks were still required. That was something that smokers weren't happy about, but probably understood given how large a role the CDC was playing in setting cruise ship rules.
Once the CDC stopped requiring masks (and regulating cruise ships at all), Royal Caribbean reverted to its pre-pandemic smoking policies. That meant that every casino on its ships had a smoking section. Technically, smoking is only allowed when actually playing a slot machine, but that's hard to enforce and the casinos quickly filled back up with smoke.
Now, the cruise line has officially made a long-rumored move that should make non-smokers really happy while angering a whole different group of the cruise line's passengers.
Image source: Matt Cardy/Getty Images
Oasis-Class Ships Getting Non-Smoking Area
Wonder of the Seas, the newest member of Royal Caribbean's Oasis class was originally built to sail out of China. It was moved to Florida due to the covid pandemic which created a sort of happy accident for non-smokers.
The ship was built with a secondary casino that was originally intended as a high rollers room. Once the ship was repurposed to sail from the United States, that smaller casino was shifted from an area designed to cater to big-money players into a non-smoking casino.
For months, it has been rumored that the cruise line would turn the "Jazz on 4" space -- the same location as the non-smoking "Golden Roon" on Wonder of the Seas -- into similar non-smoking casinos. Royal Caribbean never commented on those rumors, but it did warn passengers on some sailings that service in the Diamond Lounge, an area next to Jazz on 4 reserved for Diamond and higher members of the company's loyalty program, would be disrupted due to construction.
The results of that construction have been revealed on another Oasis-class ship, Harmony of the Seas. Johnny Travalor shared pictures of the new casino in a Facebook group for fans of Royal Caribbean's casinos.
"The brand new non-smoking casino on Harmony officially opened today and I have been here since the opening playing, donating!" he shared.
That's not official confirmation that all Oasis-class ships will have Jazz on 4 turned into a non-smoking casino, but all signs point in that direction.
Royal Caribbean Makes Some Passengers Mad
No change on a cruise ship will make all passengers happy. Some Royal Caribbean gamblers have suggested that the non-smoking area, which is much smaller than the original casino, should be the smoking area.
"Maybe once they see the non-smokers are bursting at the seam in that space and the smoking casino isn’t as crowded they will reverse it," Barb Boyer Green shared.
"That should be the smoking room...seems like the non-smokers are being put in a closet," Maureen Ethier added.
Not all passengers, however, are upset because of the size of the non-smoking area. Some are lamenting the loss of Jazz on 4, which hosted live jazz music.
"I think this is an overall loss, with now an entertainment area being taken over on this ship. I always enjoyed the jazz club and this will do nothing for the smell of the ship, net loss for all passengers" Justin Rogers wrote.
"It was our fav such a sad day. It was our escape, great talent, romantic, not another venue like it. Such a shame," added Julia Doumad.
cdc disease control pandemic chinaInternational
The limits of expert judgment: Lessons from social science forecasting during the pandemic
A sobering picture emerges from a study testing social scientists’ ability to predict societal change during the COVID-19 pandemic.
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Imagine being a policymaker at the beginning of the COVID-19 pandemic. You have to decide which actions to recommend, how much risk to tolerate and what sacrifices to ask your citizens to bear.
Who would you turn to for an accurate prediction about how people would react? Many would recommend going to the experts — social scientists. But we are here to tell you this would be bad advice.
As psychological scientists with decades of combined experience studying decision-making, wisdom, expert judgment and societal change, we hoped social scientists’ predictions would be accurate and useful. But we also had our doubts.
Our discipline has been undergoing a crisis due to failed study replications and questionable research practices. If basic findings can’t be reproduced in controlled experiments, how confident can we be that our theories can explain complex real-world outcomes?
Predicting social change
To find out how well social scientists could predict societal change, we ran the largest forecasting initiative in our field’s history using predictions about change in the first year of the COVID-19 pandemic as a test case.
To do this, we tested how well social scientists could predict societal change in two ways. First, we asked social scientists for quick guesses about how things would change over the next two years of the pandemic.
Second, we ran a competition where over 100 teams of social scientists with access to historical data made month-by-month forecasts. We formally assessed their predictions for a range of social sciences phenomena, including changes in prejudice, subjective well-being, violence, individualism and political polarization between May 2020 and May 2021.
Our findings, detailed in peer-reviewed papers in Nature Human Behaviour and in American Psychologist, paint a sobering picture. Despite the causal nature of most theories in the social sciences, and the fields’ emphasis on prediction in controlled settings, social scientists’ forecasts were generally not very good.
In both papers, we found that experts’ predictions were generally no more accurate than those made by samples of the general public. Further, their predictions were often worse than predictions generated by simple statistical models.
Improving predictions
Our studies did still give us reasons to be optimistic. First, forecasts were more accurate when teams had specific expertise in the domain they were making predictions in. If someone was an expert in depression, for example, they were better at predicting societal trends in depression.
Second, when teams were made up of scientists from different fields working together, they tended to do better at forecasting. Finally, teams that used simpler models to generate their predictions and made use of past data generally outperformed those that didn’t.
These findings suggest that, despite the poor performance of the social scientists in our studies, there are steps scientists can take to improve their accuracy at this type of forecasting.
Our research also found that, compared to lay people, social scientists were more aware of the herculean nature of the task at hand. In our studies, they expressed uncertainty and less confidence than lay people when making forecasts.
Similarly, social scientists expressed uncertainty in their open-ended predictions for the World after COVID project, a video series we conducted with eminent scholars in the first year of the pandemic.
Thus, social scientists still have some wisdom to offer, reminding us of the uncertainty and the need for humility when forecasting the future.
A call to action
Our work highlights the importance of developing reliable sources of data and suggests strategies that can improve the accuracy of such forecasts.
These results are a call to action for the scientific community to continue developing better methods for predicting societal change so the public can rely on scientists in times of crisis.
Our projects show that expert prediction of societal change during the COVID-19 pandemic was far from perfect. But they also suggest ways such predictions can be improved. By drawing on specific expertise, collaborating across disciplines and making data-driven models, social scientists can produce more accurate and useful forecasts for policymakers and the public.
The scientific community should strive to develop better methods for predicting societal change, while acknowledging the uncertainty and complexity involved. Policymakers should appreciate the value of expert insight, but also be aware of its limitations and potential biases. If we want to predict the future, or shape it for that matter, than a bit of humility would likely help.
Igor Grossmann receives funding from the Social Sciences and Humanities Research Council of Canada, Ontario Ministry of Research, Innovation and Science, The John Templeton Foundation, and the Templeton World Charity Foundation.
Cendri Hutcherson receives funding from the Social Sciences and Humanities Research Council of Canada, the Natural Sciences and Engineering Research Council of Canada, the Canada Foundation for Innovation, the Ontario Ministry of Research and Innovation, and the National Institutes for Mental Health (USA).
Michael Varnum has received funding from the National Science Foundation (USA), the US Fulbright Program, and the China Postdoctoral Science Foundation.
depression pandemic covid-19 canada ontario china
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